JP2007136102A - Device for evaluation of kneecap movability - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a device for evaluation of kneecap movability, which evaluates kneecap movability based on a quantitative value with high reproducibility and which easily obtains a value useful as judging material for deciding a proper treatment. <P>SOLUTION: The device 1 for evaluation of kneecap movability fixes a reference surface 2b to the front of the kneecap of a patient with a pair of arms 3 and 4, thereafter adjust the position of a caliper part 9 to a kneecap measurement section, and confirms a display by a display panel 9b to obtain the position of the kneecap measurement section in a measurement direction as a numerical value. That is, a moving distance of the kneecap 104 in the measurement direction A is obtained as the numerical value, when pressing in the measurement direction A until the kneecap 104 stopped. The moving distance of the kneecap in the measurement direction A is equivalent to the movability of the kneecap. Thus, by obtaining the moving distance of the kneecap 104 in the measurement direction A as the numerical value by confirming the display panel 9, the movability of the kneecap 104 in the measurement direction A can be evaluated based on the quantitative value. <P>COPYRIGHT: (C)2007,JPO&INPIT

Description

  The present invention relates to a device for evaluating patella mobility, and in particular, can evaluate patella mobility based on highly reproducible quantitative values, and easily obtain useful values as judgment materials for determining appropriate therapy. The present invention relates to an apparatus for evaluating patella mobility.

  Patellofemoral joint pain is a very frequent disease as an orthopedic disease. As one of the causes of patellofemoral joint pain, abnormal patella mobility is known.

  The knee joint will be described with reference to FIG. FIG. 7 is a diagram schematically showing the knee joint. As shown in FIG. 7, the knee joint includes a femoral neck joint composed of a femur 100 and a tibia 102 and a patellofemoral joint composed of a femur 100 and a patella 104. Further, the femur 100 and the tibia 102 are connected by an inner collateral ligament 108, an outer collateral ligament 110, an anterior cruciate ligament 112, and a posterior cruciate ligament 114. Normally, the patella 104 is movable relative to the femur 100, and its mobility is kept moderate. However, if the patella mobility balance is lost due to some factor, it causes patellofemoral joint pain. . Therefore, in the orthopedic field, in order to investigate the cause of patellofemoral joint pain, the patella mobility of a patient is evaluated.

  In the field of orthopedics, patella mobility is mainly evaluated by a patelag riding test. The pate-gliding test is to grasp the femoral condyles 100a and 100b of the subject (the portions that bulge to the left and right of the lower end of the femur 100, the medial femoral condyle and the lateral femoral condyle), In this test, the examiner presses the patella 104 manually until it stops inside or outside, and determines the relative movement distance of the patella 104 with respect to the femur 100. If the relative movement distance is large, it is determined that the mobility of the patella 104 is high, and if the relative movement distance is small, the mobility of the patella 104 is low.

  This pate-gliding test is also applied in the physical therapy field. For example, appropriate treatment such as stretching, muscle strengthening training, taping, and brace therapy is performed on patients with patellofemoral joint disorders based on the evaluation results of patella mobility by a putter gliding test.

  In addition, there may be a decrease in knee joint flexibility and patella mobility after an artificial knee joint operation (a technique for replacing a knee joint with an artificial joint) or after a knee joint fracture. In such a case, in the field of physical therapy, training for restoring knee joint flexibility and training for restoring patella mobility are performed in parallel. Here, it is known from clinical experience that there is a certain correlation between knee joint flexibility and patella mobility, so we evaluated the patella mobility using a patelag riding test. Based on the results, the training content suitable for the recovery state of the subject is determined.

Thus, in the orthopedic field and the physical therapy field, it is very important to evaluate the patella mobility in selecting an appropriate treatment method and training method. In addition, as another method for evaluating the state of the knee joint, it is known to perform image diagnosis of the knee joint by, for example, MRI, CT, X-ray, or the like (see, for example, Patent Document 1). According to these, although the static alignment of the knee joint can be evaluated, but the patella mobility cannot be evaluated, the evaluation of the patella mobility has no other choice but to rely on the patelag riding test.
JP-T-2004-537357

  However, in the patelag riding test, the examiner subjectively evaluates the mobility of the patella by palpation. That is, the examiner who has performed the putter gliding test must determine an appropriate treatment method or training method (hereinafter referred to as a treatment method or the like) based on the patella mobility evaluated subjectively. Therefore, the correlation between the patella mobility evaluated as a result of the patelag riding test and the appropriate treatment method, etc. must be acquired empirically by the examiner himself, and inexperienced practitioners Then, there was a problem that there was a possibility of selecting the wrong treatment method.

  In addition, as described above, although it is known from experience that there is a certain correlation between patellofemoral joint pain and knee joint flexibility and patella mobility, the clear correlation has not yet been established. Not. Therefore, there has been a problem that even if the patella mobility is evaluated by a putter gliding test, it is not always possible to select an appropriate treatment method.

  In addition, the practitioner may change during rehabilitation or treatment over a long period of time, in which case the later practitioner cannot clearly know the changes in patella mobility during the course of treatment and training. There is a problem that the wrong treatment method may be selected.

  In order to solve such problems, devices that can quantitatively evaluate patella mobility have been studied. This is because if the patella mobility of the subject is obtained as a quantitative value, it can be a useful judgment material for selecting an appropriate treatment method. However, since there are problems that the method of use is not simple and there is a problem that values obtained as measurement results are not reproducible, clinical application has not been achieved. There is no reproducibility between examiners (even if the subject is the same, the measurement result changes if the examiner is different), and there is no reproducibility within the examiner (the same examiner and the subject) Even if the measurement results are different for each measurement, even if the values are quantitatively obtained, they cannot be applied clinically. Possible causes of the inability to obtain reproducibility include rotation of the subject's femur during measurement due to the pressing of the patella and tension of the subject's quadriceps.

  In addition, while other devices that have been studied in the past provide quantitative values for assessing patella mobility, the values may vary depending on the individual anatomical differences of each subject, especially the femoral alignment. Because there was no consideration of the variation in data, there was a problem that truly useful data could not be obtained as clinical data for determining an appropriate treatment method.

  FIG. 8 is a diagram for explaining a Q angle used as an index for evaluating the alignment of the femur in the orthopedic field. As shown in FIG. 8, an imaginary straight line 118 (hereinafter referred to as the femoral long axis 118) connecting the superior anterior iliac spine 116 and the center 104a of the patella 104, and a longitudinal line along the tibia 102 passing through the patella center 104a. An angle between the straight line 120 and the straight line 120 is referred to as a Q angle 122. Although the alignment of the femur evaluated by the Q angle 122 varies depending on each subject, it affects the lower limb function and also affects the patella mobility.

  Therefore, by taking into account the variation in femoral alignment of each subject, if it is possible to obtain a value that excludes anatomical individual differences between each subject, the value is accumulated as clinical data. It is expected that the correlation between patellofemoral joint pain and knee joint flexibility and patella mobility will be clarified. Such an effect could not be expected with the equipment.

  The present invention has been made to solve the above-described problems, and can evaluate patella mobility based on highly reproducible quantitative values, and is useful as a judgment material for determining an appropriate therapy. An object of the present invention is to provide a patella mobility evaluation device that can easily obtain a value.

  In order to achieve this object, a patella mobility evaluation device according to claim 1 is provided with a base portion having a reference plane disposed in front of the subject's patella, and provided at the base portion, and the femoral condyle of the subject. And a display means for displaying a numerical value relating to the position in the measurement direction parallel to the reference plane of the base.

  The patella mobility evaluation device according to claim 2 is the patella mobility evaluation device according to claim 1, wherein the measurement body is provided so as to be relatively movable in the measurement direction with respect to the reference plane, and the measurement body in the measurement direction. Alignment means provided on the measurement body for aligning the position of the measurement body with the measurement site of the patella, and the display means displays a numerical value related to the position of the measurement body in the measurement direction It is.

  The patella mobility display device according to claim 3 is the patella mobility evaluation device according to claim 2, wherein the display means supports the measurement body so as to be capable of reciprocating in a linear direction parallel to the reference plane. The support portion is provided on the base portion so as to be swingable about an axis perpendicular to the reference plane so that the reciprocating direction of the measuring body coincides with the measurement direction desired by the examiner. .

  The patella mobility evaluation device according to claim 4 is the patella mobility evaluation device according to claim 2 or 3, wherein the positioning means includes a state in which the arm sandwiches a femoral condyle and the reference plane is fixed. The light irradiating means is provided so as to be able to irradiate light toward the front surface of the patella of the subject, and is provided so as not to move relative to the measuring body in at least the measurement direction.

  The patella mobility evaluation device according to claim 5 is the patella mobility evaluation device according to any one of claims 1 to 4, wherein a connecting member that connects at least one of the pair of arms and the base is provided. The connecting member permits relative movement of the one arm with respect to the base in a direction to reduce a distance from the other arm and restricts to a direction to increase a distance from the other arm. And a release means for releasing the movement restriction in the direction of increasing the distance from the other arm according to the operation of the user.

  According to the patella mobility evaluation device according to claim 1, since the numerical value related to the position in the measurement direction is displayed on the display means, the numerical value displayed on the display means is checked, and the patella is pressed in the measurement direction until the patella stops. When this is done, the movement distance of the patella in the measurement direction can be obtained numerically. Here, the movement distance of the patella in the measurement direction corresponds to the mobility of the patella. Therefore, it is possible to evaluate the patella mobility in the measurement direction based on the quantitative value by confirming the display of the position by the display means and acquiring the movement distance of the patella in the measurement direction as a numerical value. is there.

  In addition, even if the subject's femur rotates due to the pressure on the patella or the subject's behavior, the reference plane is fixed to the femur by the arm. In conjunction with this rotation, it is possible to suppress the occurrence of errors in the measurement result due to the rotation of the femur and to obtain a result with high reproducibility.

  According to the patella mobility evaluation device according to claim 2, in addition to the effect exhibited by the patella mobility evaluation device according to claim 1, a measuring body provided to be relatively movable in the measurement direction with respect to the reference plane, Since the measuring body is provided with alignment means for aligning with the measurement site of the patella, the examiner uses the alignment means to increase the movement distance of the patella in the measurement direction, that is, the patella mobility. There is an effect that it can be obtained quantitatively. That is, first, by using the alignment means, the measurement body is accurately aligned with the measurement site of the patella, and then pressed in the measurement direction until the patella stops. Since the measurement part of the patella also moves in the measurement direction by this pressing, the measuring body is moved to the measurement part of the patella by using the alignment means again. Since the moving distance of the measurement body at this time corresponds to the patella mobility, it is possible to quantitatively obtain the patella movement distance in the measurement direction, that is, the patella mobility in the measurement direction by confirming the display on the display means. It can be done.

  According to the patella mobility evaluation device according to claim 3, in addition to the effect of the patella mobility evaluation device according to claim 2, the examiner desires the reciprocation direction of the measuring body by swinging the support portion. Since the measurement direction can be matched, the mobility of the patella in the direction desired by the examiner can be evaluated regardless of the individual anatomical difference of the subject. Therefore, there is an effect that it is possible to obtain a useful value as a judgment material for determining an appropriate therapy for each patient or the like regardless of anatomical individual differences among the subjects.

  According to the patella mobility evaluation device according to claim 4, in addition to the effect exhibited by the patella mobility evaluation device according to claim 2, the positioning means includes the arm sandwiching the femoral condyle and the reference In a state where the surface is fixed, it is configured to be able to irradiate light toward the front surface of the subject's patella, and is provided with light irradiation means provided at least in a measurement direction so as not to move relative to the measurement body. By accurately moving the measurement body so that light is irradiated to the measurement site on the front surface of the patella of the person, the measurement site of the patella that moves three-dimensionally (that is, the left-right direction, the up-down direction, and the front-back direction) is accurately indicated. And the position of the measurement body can be easily and accurately aligned with the measurement site of the patella. Therefore, for example, even an inexperienced examiner can easily obtain a useful value with little error and high reproducibility.

  According to the patella mobility evaluation device according to claim 5, in addition to the effect exerted by the patella mobility evaluation device according to any one of claims 1 to 4, the relative movement of one arm with respect to the base portion is changed to the other arm. There is a connecting member that allows the distance between the arm and the other arm to be reduced, and restricts the distance between the arm and the other arm. After interposing and gradually reducing the distance between the pair of arms and sandwiching the femoral condyle, the distance between the pair of arms does not increase, and the femoral condyle can be reliably sandwiched between the pair of arms. Therefore, there is an effect that the deviation of the reference plane with respect to the femur is suppressed and a highly reproducible value is obtained. In addition, since the connecting member is provided with a release means for releasing the movement restriction in the direction of increasing the distance between the other arm when the user operates, the movement restriction is released after the measurement. Thus, there is an effect that the patella mobility evaluation apparatus can be easily detached from the subject's knee by widening the distance between the pair of arms. In addition, there is an effect that it is possible to sandwich knees of various thicknesses with a pair of arms.

  Hereinafter, preferred embodiments of the present invention will be described with reference to the accompanying drawings. 1, 2 and 3 are external perspective views of a patella mobility evaluation apparatus 1 which is an embodiment of the patella mobility evaluation apparatus of the present invention. The patella mobility evaluation apparatus 1 is an apparatus that is attached to the lower limb 124 (see FIG. 3) of the subject and quantitatively evaluates the patella mobility of the subject.

  As shown in FIGS. 1 to 3, the patella mobility evaluation device 1 mainly includes a base 2, a fixed arm 3 provided on the base 2, a sliding arm 4, and arms 3 and 4. A digital caliper gauge 5 provided on the opposite side, an alignment portion 6 attached to the caliper portion 9 of the digital caliper gauge 5, and an adjuster 15 are provided.

  The base 2 is a square bar-shaped member. In addition, the surface to which a pair of arms 3 and 4 are attached among the base parts 2 is called the lower surface 2a, and the surface on the opposite side to the lower surface 2a is called the reference surface 2b.

  The fixed arm 3 and the sliding arm 4 sandwich the subject's femoral condyles 100a and 100b from the inside and outside of the lower limb 124 (see FIG. 3) and fix the reference plane 2b to the femur 100. belongs to. The fixed arm 3 is directly connected to the lower surface 2 a of the base 2 and fixed to the base 2, whereas the sliding arm 4 is connected to the lower surface 2 a of the base 2 via a connecting member 7, On the other hand, relative movement in the longitudinal direction of the base 2 is possible. Accordingly, the reference plane 2b is arranged in front of the subject's patella, and the sliding arm 4 is slid in a direction to reduce the distance from the fixed arm 3, whereby the subject's femoral condyles 100a and 100b. Can be sandwiched between the arms 3 and 4 (see FIG. 3).

  The fixed arm 3 and the sliding arm 4 are respectively arc-shaped arm portions 3a, 4a whose one ends are connected to the base 2 side, and circular gripping portions integrally provided at the other ends of the arm portions 3a, 4a. 3b, 4b and pad portions 3c, 4c provided on the inner surfaces of the grip portions 3b, 4b (surfaces facing each other). The pad portions 3c and 4c come into contact with the femoral condyles 100a and 100b (see FIG. 7) when the femoral condyles 100a and 100b of the subject are sandwiched between the arms 3 and 4, and the contact surfaces. Is concave. As shown in FIG. 7, since the femoral condyles 100a and 100b protrude in a hemispherical shape, the concave surfaces of the pad portions 3c and 4c are brought into close contact with the femoral condyles 100a and 100b of the subject. The femur 100 can be reliably gripped by the pair of arms 3 and 4. The pad portions 3c and 4c are made of elastic members. Therefore, physical pain is not given to the subject.

  In addition, in the gripping portions 3b and 4b, on the outside of the gripping portions 3b and 4b (on the end side in the longitudinal direction of the base portion 2), elliptical members 3d and 4d that can rotate around the axis with respect to the gripping portions 3b and 4b are provided. It has been. The elliptical members 3d and 4d are for holding the annular couplers 3e and 4e. Insert the end portion of one belt 8 into the couplings 3e and 4e, bend the end portion of the belt 8, and fasten the end portion of the belt 8 with Velcro (registered trademark) provided in advance on the surface of the belt 8. Thus, the gripping portions 3b and 4b can be connected by the belt 8. Therefore, after pinching the subject's femoral condyles 100a and 100b (see FIG. 7) with the gripping portions 3b and 4b, the belt 8 is wound around the back of the subject's knee and the end of the belt 8 is gripped. By connecting the parts 3b and 4b, the patella mobility evaluation device 1 can be more reliably fixed around the subject's knee.

  The connecting member 7 is for moving the sliding arm 4 relative to the base 2. The connecting member 7 is guided by the rail-shaped guide portion 7a, a pair of fixing portions 7b for fixing both ends of the guide portion 7a to the lower surface 2a of the base portion 2, and one end of the sliding arm 4 And a sliding portion 7c to be connected. The sliding part 7c allows relative movement of the sliding arm 4 with respect to the base part 2 in a direction in which the distance from the fixed arm 3 is reduced, and restricts in a direction in which the distance from the fixed arm 3 is increased. . Therefore, in a state where the subject's knee is interposed between the fixed arm 3 and the sliding arm 4, the sliding arm 4 is slid in a direction to reduce the distance between the fixed arm 3 and the grip portion 3b. , 4b, the femoral condyles 100a, 100b of the subject are sandwiched between the fixed arm 3 and the sliding arm 4, and the femoral condyles 100a, 100b of the subject are surely secured. The reference plane 2b can be reliably fixed to the femur of the subject (see FIG. 4). In addition, since the sliding part 7 can be comprised using the well-known mechanism which accept | permits only one-way movement, such as a ratchet, detailed description is abbreviate | omitted here.

  The sliding portion 7c is provided with a release button 7d. The release button 7d is for releasing the movement restriction of the sliding arm 4 in the direction of increasing the distance between the fixed arm 3 and the release button 7d. While the release button 7d is being pressed, the sliding arm 4 can be slid in the direction in which the distance from the fixed arm 3 is increased. Therefore, the patella mobility evaluation apparatus 1 is attached to the subject's lower limb 124 by the method described later, and the patella mobility is evaluated. After the evaluation is completed, the release button 7d is pressed, and the fixed arm 3 is slid. By widening the distance from the moving arm 4, the fixed arm 3 and the sliding arm 4 can be easily detached from the subject's knee. Further, by appropriately expanding the space between the fixed arm 3 and the sliding arm 4 while pressing the release button 7d, it is possible to deal with knees having various thicknesses.

  The digital caliper gauge 5 is for quantitatively displaying the patella mobility (movement distance of the patella measurement site) of the subject in the measurement direction, and includes a caliper unit 9 and a scale unit 10. . The scale portion 10 is a thin bar-like member in which a scale 10a indicating the position in the longitudinal direction is engraved on the upper surface parallel to the reference surface 2b. The caliper unit 9 can reciprocate in the longitudinal direction of the scale unit 10 (corresponding to the linear direction of the claims), and the reciprocating direction of the caliper unit 9 corresponds to the measurement direction. In addition, the arrow A in the figure indicates the reciprocating movement direction (measurement direction) of the caliper unit 9.

  The caliper unit 9 is for displaying the position of the subject's patella measurement site in the measurement direction. A side surface of the caliper portion 9 has a T-shaped slide groove 9a on the bottom surface, and a display panel 9b on the top surface. The caliper portion 9 is supported by the scale portion 10 so as to be reciprocally movable by the slide groove 9a. The caliper unit 9 can be reciprocated with respect to the scale unit 10 by gripping and sliding the caliper unit 9 with a finger or the like. On the display panel 9b, the position of the caliper unit 9 in the measurement direction A is displayed numerically. Therefore, by aligning the caliper unit 9 with the measurement site of the subject's patella, the position of the measurement site of the subject's patella in the measurement direction A can be displayed numerically on the display panel 9b.

  The caliper unit 9 further includes a power on / off button 9c (see FIG. 5) and a reset button 9d (see FIG. 5). The power on / off button 9c is a button for switching on and off the display on the display panel 9b. The reset button 9d is a button for resetting the measurement direction position displayed on the display panel 9b to zero. In FIG. 1 to FIG. 3, the power on / off button 9c and the reset button 9d are not shown for easy viewing of the drawings.

  The alignment unit 6 is for aligning the caliper unit 9 to the patella measurement site of the subject and adjusting the angle of the digital caliper gauge 5 with respect to the base 2, and includes a light emitting unit 11, a connecting member 12. The light emitting unit 11 is for irradiating light toward the subject's upper anterior iliac spine 116 (see FIG. 8) or the patella 104, and is a cylindrical member having a light source, for example, a red light emitting diode therein. Composed. A small-diameter hole is formed in the bottom surface 11a of the cylindrical member. Therefore, dot-like light can be irradiated toward the subject's upper anterior iliac spine 116 or the patella 104. The light source in the light emitting unit 11 emits light from a battery attached to a battery box 13 connected to one end of the base 2 by using power supplied through the cord 14.

  The connecting member 12 is a member for connecting the light emitting unit 11 to the caliper unit 9. As shown in FIG. 3, the connecting member 12 has a first connecting part 12 a fixed to the caliper part 9, one end connected to the first connecting part 12 a, and parallel to the measurement direction A with respect to the first connecting part 12 a. A second connecting portion 12b that is rotatably connected around one rotation axis C, and the other end of the second connecting portion 12b and the light emitting portion 11 are connected to the second connecting portion 12b. On the other hand, a third connecting portion 12b that is rotatably connected around a rotation axis D that is parallel to the measuring direction A is provided. Therefore, the light emitting unit 11 cannot move relative to the caliper unit 9 in a direction parallel to the measurement direction A, and can rotate on a plane perpendicular to the measurement direction A.

  The adjuster 15 is for providing the digital caliper gauge 5 on the base 2 so as to be swingable around a single axis (not shown) perpendicular to the reference surface 2b. 17 and a lock member 18 are provided. The base portion 16 is formed in a thin bar shape narrower than the scale portion 10, is fixed to the lower surface of the scale portion 10, and can swing around a uniaxial center perpendicular to the reference surface 2 b. Is provided. Therefore, by swinging the base portion 16 with respect to the base portion 2, the digital caliper gauge 5 can be swung around an axis perpendicular to the reference surface 2b.

  The adjusting portion 17 is an arc-shaped member provided at one end of the base portion 16 and includes a groove portion 17a penetrating in the plate thickness direction. The groove shape of the groove portion 17a is along a virtual circular arc centered on the swing axis of the base portion 16.

  The lock member 18 is for locking the swing of the base portion 16, and includes a screwing shaft 18 a projecting upward from the base portion 2, a fitting portion 18 b, and an outer periphery of the fitting portion 18 b. And a handle portion 18c provided on the surface. The screw shaft 18a is formed in a substantially cylindrical shape, one end of which is fixed to the reference surface 2b, and a male screw is threaded on the outer periphery. The diameter of the screw shaft 18a is smaller than the groove width of the groove portion 17a, and the screw shaft 18a penetrates the groove portion 17a. A substantially cylindrical fitting portion 18b is screwed to the other end side of the screwing shaft 18a.

  Therefore, the fitting portion 18b is rotated in the screwing direction using the handle portion 18c, the distance between the fitting portion 18b and the reference surface 2b is reduced, and the adjustment portion 17 is moved between the lower surface of the fitting portion 18b and the reference surface 2b. By tightening from above and below, the swinging of the adjusting portion 17 and the base portion 16 can be locked, and the digital caliper gauge 5 can be fixed.

  Next, an example of usage of the patella mobility evaluation device 1 will be described with reference to FIGS. FIG. 4 is a diagram illustrating a state in which the patella mobility evaluation device 1 is fixed to the lower limb 124 of the subject. First, the base 2 is placed in front of the patient's patella in the supine position on the bed, the pad portion 3c of the fixed arm 3 is applied to the femoral condyle 100a, and the sliding arm 4 is fixed to the fixed arm. The pad 4c of the sliding arm 4 is applied to the subject's femoral condyle 100b by sliding in the direction close to 3 and the pair of arms 3 and 4 causes the reference surface 2b of the base 2 to be placed on the subject's thigh. Fix against bone. The belt 8 is wound around the examiner's knee, and both ends of the belt 8 are connected to the connectors 3d and 4d, so that the fixing is further ensured.

  Next, the angle of the digital caliper gauge 5 with respect to the base 2 is adjusted so that the measurement direction A by the digital caliper gauge 5 coincides with the direction desired by the examiner. In order to obtain data that eliminates variations in the Q angle 122 of the subject as much as possible, here, a case where the measurement direction A is made to coincide with the direction perpendicular to the thigh long axis 118 will be described.

  First, the lock by the lock member 18 is released, and the digital caliper gauge 5 can be swung with respect to the reference surface 2b. Then, while swinging the digital caliper gauge 5, an angle where the measurement direction A (reciprocating direction of the caliper unit 9) is perpendicular to the thigh long axis 118 is searched. When the measurement direction A can be made to coincide with the direction perpendicular to the thigh long axis 118, the digital caliper gauge 5 is locked at that position.

  Specifically, first, the position of the caliper portion 9 of the digital caliper gauge 5 in the measurement direction A is aligned with the subject's patella center 104a (see FIG. 8). This is performed by adjusting the connecting member 12 or moving the caliper unit 9 so that the point-like light emitted from the light emitting unit 11 can be emitted toward the patella center 104a of the subject. Thereby, the position of the caliper part 9 on the scale part 10 is determined.

  Next, while the measurement direction position of the caliper unit 9 on the scale unit 10 is fixed, the digital caliper gauge 5 is swung, and the light emitting unit 11 is rotated by adjusting the connecting member 12 to thereby rotate the light emitting unit 11. 11 is searched for an angle at which light from 11 can be irradiated toward the subject's upper anterior iliac spine 116 (see FIG. 7). FIG. 4 is a view showing a state in which light from the light emitting unit 11 is irradiated toward the subject's upper anterior iliac spine 116 (see FIG. 8), and * in FIG. Indicates. When the angle at which the patella center 104a and the superior anterior iliac spine 116 can be irradiated with the light emitted from the light emitting unit 11 is determined in this way, the digital caliper gauge 5 is locked at that position. That is, the digital caliper gauge 5 is fixed at an angle at which the light emitting unit 11 can rotate on a plane parallel to the femoral long axis 118 (a straight line connecting the patella center 104a and the superior anterior iliac spine 116).

  As described above, the light emitting unit 11 can rotate only on a plane perpendicular to the reciprocating direction of the caliper unit 9 (that is, the measurement direction A). Therefore, by fixing the digital caliper gauge 5 at an angle at which the rotatable surface of the light emitting unit 11 is parallel to the long thigh axis 118, the measurement direction A coincides with the direction perpendicular to the long thigh axis 118. Can be made.

  Next, the examiner pinches the patella of the subject with a finger and determines the patella outer edge 104b (corresponding to the measurement site in the claims). Next, the caliper unit 9 is moved to a position where light can be emitted by the light emitting unit 11 toward the patella outer edge 104b determined by palpation by the examiner, so that the position of the caliper part 9 in the measurement direction A is the patella outer edge 104b. To be aligned. In FIG. 5, * indicates the irradiation position of light from the light emitting unit 11. As shown in FIG. 5, when the alignment of the caliper unit 9 is completed at a position where light is irradiated toward the outer edge 104b of the patella, the reset button 9d is pressed, and the value displayed on the display panel 9b is set to 0. .

  FIG. 5 is a diagram illustrating a state where the reset button 9d is pressed. Thereby, the measurement direction position of the caliper unit 9 aligned with the patella outer edge 104b in a state where the patella is not pressed is set as the reference position (0).

  Next, the examiner manually pushes the subject's patella from the inside to the outside until the patella stops. In addition, the pressing direction at this time is shown by the arrow a in FIG. That is, the examiner presses it manually to move the patella outward (in the direction of arrow a) by an amount that can be moved. Accordingly, the outer edge 104b of the patella moves to the outer side of the patella. Therefore, the caliper part 9 is moved in the measurement direction (arrow a direction), and the caliper part 9 is aligned with the outer edge 104b of the patella pressed outward. . Similarly, the caliper unit 9 is aligned in the measurement direction by moving the caliper unit 9 to a position where the light emitting unit 11 can irradiate light toward the patella outer edge 104b.

  FIG. 6 is a view showing a state in which the patella of the subject is pressed outward by the hand, and the caliper portion 9 is aligned with the patella outer edge 104b. What is displayed on the display panel 9b of the caliper unit 9 is the position of the caliper unit 9 at the position in the measurement direction A and the movement distance of the caliper unit 9 from the reference position (0). Since the movement distance of the caliper unit 9 is equal to the movement distance in the outward direction of the patella outer edge 104b, a quantitative value corresponding to the outer mobility of the patella is obtained.

  Similarly, the reference position of the caliper unit 9 is determined using the inner edge of the patella as the measurement site, and then the patella is pressed from the outside to the inside until the patella stops, and the caliper part 9 is aligned with the inner edge of the patella. It is also possible to obtain a quantitative value corresponding to mobility.

  Since the caliper unit 9 is moved so that the light from the light emitting unit 11 is irradiated toward the measurement site on the front surface of the subject's patella, the caliper unit 9 is aligned. The measurement site of the patella that moves in the right direction (that is, the left-right direction, the up-down direction, and the front-back direction) can be accurately pointed. Accurate alignment is possible.

  Further, according to the patella mobility evaluation apparatus 1, the base 2 is securely fixed to the femur by the pair of arms 3 and 4 and the belt 8 (see FIG. 3). In the state of being attached to the examiner's lower limb 124, both hands of the examiner are free. Therefore, the examiner can press the subject's patella manually. Furthermore, when the subject's patella is pressed manually, the quadriceps muscles will be palpated directly, so while confirming the contraction and relaxation of the quadriceps muscles with resistance when moving the patella left and right Can be measured, and patella mobility can be appropriately evaluated. If the patella is mechanically pressed by the device rather than by hand, it is difficult for the device to accurately determine the position of the patella, and the evaluation results are likely to have errors due to the inappropriate pressing location. is there.

  Next, the reproducibility of values quantitatively obtained by the patella mobility evaluation apparatus 1 will be described. Experiments were performed under the following conditions, and the reproducibility of the values obtained by the patella mobility evaluation apparatus 1 was confirmed. In addition, this experiment is an experiment for examining the reproducibility within the examiner and the reproducibility between the examiners.

<Subject condition>
Subjects: 30 healthy adults and 30 knees (15 men and 15 women)
Average age of subjects: 29 ± 6 years old
Average height of subjects: 167 ± 8cm
Average weight of subjects: 59 ± 11kg
<Procedure>
Measurements were taken on two different days by two examiners. Each measurement result is blinded. The subject is in the supine position on the bed, and is measured at the knee joint at 0 degrees (fully extended position, that is, when the knee is extended) and the knee joint is 30 degrees (when the knee is bent at 30 degrees with respect to the fully extended position). It was done. The lower limb was turned to the hip joint 0 degree as an intermediate position. The patella mobility evaluation device 1 was placed parallel to the bed in a 0-degree rotation of the hip joint, and fixed to the femoral condyle of the subject by a pair of arms 3 and 4. As described above, the digital caliper gauge 5 was adjusted by the adjuster 15 so that the measurement direction A was perpendicular to the thigh long axis 118. First, in the measurement of the outer patella mobility, the outer edge of the patella is palpated, light is emitted from the light emitting unit 11 to the outer edge 104b of the patella, and the value of the caliper unit 9 is reset to 0 (see FIG. 5). Next, the patella is manually pressed from the inside to the outside until the patella stops, the caliper unit 9 is slid, and the light from the light emitting unit 11 is irradiated again to the outer edge 104b of the patella, and displayed on the display panel 9b of the caliper unit 9. The read value is read (see FIG. 6). The movement distance of the caliper unit 9 (value displayed on the display panel 9b) was defined as the patella lateral movable amount. Similarly, the patella medial mobility was measured by pressing the patella from the outside to the inside. Lateral and medial patella mobilities were measured at both 0 and 30 degrees knee positions. A value obtained by correcting the amount of patella movement by the patella width was defined as the patella mobility index. The width of the patella was measured by palpating the inner and outer edges of the patella and setting the distance between both ends using the light emitting part 11 and the caliper part 9 in the same setting as in the mobility measurement. The representative values of the mobility and the patella width were the average values of three measurements. The average is rounded off to the second decimal place.

<Result>
Based on the patella mobility index obtained as described above, the intraclass correlation coefficient and the standard error were calculated for each of the inspectors and between the inspectors. The results are shown in Table 1 below. As shown in Table 1, intra-examiner reproducibility was within-class correlation coefficient 0.87 to 0.97, and inter-examiner reproducibility was 0.72 to 0.91.

<Discussion>
In clinical evaluation, if the intraclass correlation coefficient is 0.7 or 0.75 or higher, it is considered to be good reproducibility, and this study suggests that patella mobility evaluation by this method can be applied clinically.

  According to the patella mobility evaluation apparatus 1 of the present embodiment, the reference surface 2b of the base 2 is fixed in front of the subject's patella by the pair of arms 3 and 4, and then the caliper 9 is aligned with the patella measurement site. By confirming the display on the display panel 9b, the position of the patella measurement site in the measurement direction parallel to the reference plane 2b can be obtained numerically. Therefore, by confirming the numerical value displayed on the display panel 9, the movement distance of the patella 104 in the measurement direction A when the patella 104 is pressed in the measurement direction A until it stops can be obtained as a numerical value. Here, the movement distance of the patella in A in the measurement direction corresponds to the mobility of the patella. Therefore, by confirming the display of the position on the display panel 9 and acquiring the movement distance of the patella 104 in the measurement direction A as a numerical value, the mobility of the patella 104 in the measurement direction A is evaluated based on a quantitative value. Can do.

  Further, according to the patella mobility evaluation device 1, even if the femur rotates during measurement due to the press of the patella by the examiner or the behavior of the subject, the reference plane is formed by the pair of arms 3 and 4. Since 2b is fixed to the femur 100, the rotation of the femur 100 and the rotation of the reference surface 2b are interlocked, and an error in the measurement result due to the rotation of the femur 100 is suppressed, resulting in highly reproducible results. Is obtained. As proved by the above-described experiment, the high reproducibility of the value quantitatively obtained by the patella mobility evaluation apparatus 1 is sufficiently clinically applicable. In consideration of the shape of the femoral condyles 100a and 100b, it is preferable to fix the reference plane to the tibia 102 (see FIG. 7) instead of fixing the reference plane to the femur. It's easy. However, when the reference surface 2b is fixed to the tibia 102, an error is likely to occur because only the reference surface 2b or the femur 100 may rotate due to the behavior of the subject.

  Further, according to the patella mobility evaluation device 1, the reciprocating direction of the caliper unit 9 can be matched with the measurement direction A desired by the examiner by swinging the scale unit 10 with respect to the base 2. Regardless of the individual anatomical difference of the subject such as Q-angle variation, the mobility of the patella in the direction desired by the examiner can be evaluated. Therefore, a useful value can be obtained as a judgment material for determining an appropriate therapy for each patient or the like.

  In the past, the Patella Gliding Test, which is a subjective evaluation, has been used as a patella mobility assessment, so the relationship between patellofemoral joint pain, knee flexion and patella mobility decline, increase, and medial-lateral balance is strictly Is not known. However, patella femoral joint pain and knee joint flexion are accumulated for many subjects using the patella mobility evaluation device 1 by accumulating patella mobility data that is less affected by individual anatomical individual differences. If a correlation between sex and patella mobility is demonstrated, it can be an important therapeutic guide for these disorders.

  The present invention has been described above based on the embodiments. However, the present invention is not limited to the above embodiments, and various modifications can be easily made without departing from the spirit of the present invention. Can be inferred.

  For example, in the present embodiment, a case has been described in which the movement distance of the patella measurement site (quantitative value indicating patella mobility) is displayed on the display panel 9b provided on the upper surface of the caliper unit 9. The caliper unit 9 does not necessarily have to be provided. For example, data may be output from the caliper unit 9 and an external printer may be configured to print the moving distance of the patella measurement site on a paper medium. In this case, the paper medium on which the moving distance of the patella measurement site is printed corresponds to the display means in the claims. Further, since the scale part 10 is engraved with a scale 10a indicating the position in the measurement direction A, the examiner reads the movement distance of the caliper part 9 from the scale 10a (a quantitative value indicating the patella mobility). May be. In this case, the scale 10a corresponds to the display means in the claims.

  In the present embodiment, the light emitting unit 11 is described as being irradiated with point light, but the light emitted from the light emitting unit 11 may be, for example, a line.

It is the perspective view which looked at the patella mobility evaluation apparatus of a present Example from the front. It is the perspective view which looked at the patella mobility evaluation apparatus of FIG. 1 from back. It is the perspective view which looked at the patella mobility evaluation apparatus of FIG. 1 from the side. It is a figure which shows the state which fixed the patella mobility evaluation apparatus to the subject's leg. It is a figure which shows the state by which the reset button was pressed down. It is a figure which shows the state by which the caliper part was aligned with the patella outer edge at that time, when the patella of a subject was pushed outside by the hand. It is a figure which shows a knee joint typically. It is a figure for demonstrating Q angle used as a parameter | index which evaluates alignment of a femur in the orthopedic field.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Patella mobility evaluation apparatus 2 Base 2a Reference plane 3 Fixed arm (part of a pair of arms)
4 Sliding arms (part of a pair of arms)
6 Positioning part (positioning means)
7 Connecting member 7d Release button (release means)
9 Caliper part (measurement body)
9a Display panel (display means)
10 Scale (supporting part)
11 Light irradiation part (a part of alignment means, light irradiation means)
100 femur 104 patella 104b outer edge of patella (measurement site)
A Measuring direction

Claims (5)

A base having a reference surface disposed in front of the subject's patella;
At least a pair of arms that are provided at the base, sandwich the femoral condyle of the subject from the inside and outside, and fix the reference plane to the femur;
A patella mobility evaluation apparatus comprising: display means for displaying a numerical value related to a position in a measurement direction parallel to a reference plane of the base. A measuring body provided to be movable relative to the reference plane in the measurement direction;
Alignment means provided on the measurement body for aligning the position of the measurement body in the measurement direction with the measurement site of the patella,
The patella mobility evaluation apparatus according to claim 1, wherein the display unit displays a numerical value related to a position of the measurement object in the measurement direction. The display means includes a support portion that supports the measurement body so as to be capable of reciprocating in a linear direction parallel to the reference plane.
The support portion is provided on the base portion so as to be swingable about an axis perpendicular to a reference plane so that a reciprocating direction of the measurement body coincides with a measurement direction desired by an examiner. The patella mobility evaluation apparatus according to claim 2.   The positioning means is configured to be able to irradiate light toward the front surface of the subject's patella in a state where the arm sandwiches the femoral condyle and the reference plane is fixed, and at least in the measurement direction, the measurement is performed. The patella mobility evaluation device according to claim 2 or 3, further comprising light irradiation means provided so as not to move relative to the body. A connecting member that connects at least one of the pair of arms and the base;
The connecting member allows relative movement of the one arm relative to the base in a direction to reduce the distance to the other arm and restricts to a direction to increase the distance to the other arm. Because
The patella mobility evaluation according to any one of claims 1 to 4, further comprising release means for releasing movement restriction in a direction in which the distance between the other arm is increased in accordance with a user operation. apparatus.