JP2012050728A - Exercise device for recovering function of semi-paralyzed finger - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an exercise device capable of urging spontaneous extension.SOLUTION: The exercise device 100 for recovering the functions of a semi-paralyzed finger includes a hand rest 102 that reciprocates up and down while using a position near the wrist of a hand placed thereon as a fulcrum 26 of oscillation; a finger bending mechanism 105 for pushing down and bending one finger of the hand placed on the hand rest 102, without obstructing extension action by which the finger bent returns to its original position; and a finger tapping mechanism 108 for tapping the root of the finger pushed down by the finger bending mechanism 105 to urge the extension action. Since the extension of the finger 11 is spontaneous extension action, the patient is urged to extend his finger spontaneously and the effect of recovery exercise can be enhanced.

Description

  The present invention relates to a hemiplegic finger function recovery training device for recovery training of a finger of a patient who has been paralyzed with a finger of one hand.

Hemiplegia often remains after a stroke. In this hemiplegia, finger function can be restored by rehabilitation. This rehabilitation is carried out by skilled doctors and therapists, but since the training takes a long time and a long period of time, the physical burden on the doctors and therapists is great.
For the purpose of eliminating this burden, conventionally, a training apparatus has been proposed (see, for example, Patent Document 1 (FIG. 15)).

Patent document 1 is demonstrated based on the following figure.
FIG. 27 is a diagram for explaining the basic principle of the prior art. In this training apparatus 200, links 203 to 206 extend from a second support body 202 that supports a hand 201 indicated by an imaginary line. A fifth mounting portion 207 is provided at a connection portion with 205, and a fourth mounting portion 208 is provided at the tip of the link 206.

  As described in paragraph [0078] of Patent Document 1, with the above configuration, the finger movement support mechanism for the second finger to the fifth finger can displace the affected upper limb finger in various modes.

  The bending of the finger 209 by applying a force from the outside at the fourth mounting portion 208 or the fifth mounting portion 207 is referred to as other dynamic bending. In addition, extending the finger 209 by applying an external force is referred to as other dynamic extension. On the other hand, extending the finger 209 by the patient's force without applying external force is referred to as self-stretching.

In the conventional training apparatus that alternately repeats other dynamic flexion and other dynamic extension on the finger 209, it is unclear whether or not the patient's own force is reflected. If the patient's own power is not reflected, the effect of the training is small and the training is prolonged.
Therefore, a training apparatus that can promote self-extension is desired.

JP 2008-67852 A

  An object of the present invention is to provide a training device that can promote self-stretching.

The invention according to claim 1 is a hemiplegic finger function recovery training device for recovery training of the finger of a patient whose finger of one hand is paralyzed,
This hemiplegic finger function recovery training device has a hand platform on which a hand is placed and an extension operation in which one of the fingers on the hand platform is pushed down to bend and the bent finger tries to return. Consists of a finger bending mechanism that does not hinder and a finger tapping mechanism that urges the base of the finger pushed down by this finger bending mechanism to promote the extension operation,
The finger bending mechanism includes a first arm that extends substantially along the hand platform from a first shaft provided below the hand platform and pivots up and down around the first axis. A first servo motor that pivots the arm up and down, a first torque measuring mechanism that detects torque applied to the first arm, a first slider that is movably provided on the first arm, and a A second arm that extends from a second axis provided above to intersect the first arm and pivots up and down around the second axis, and a second arm that pivots the second arm up and down. A servo motor; a second torque measuring mechanism for detecting a torque applied to the second arm; a second slider movably provided on the second arm; and a first extending upward from the first slider. An extension and the second A second extension extending from the rider toward the platform, and an intersection at which a tip of the first extension intersects a tip of the second extension, the first extension and the second extension It comprises a finger pressing unit that supports the swinging and depressing the finger, and a control unit that acquires torque information from the first and second torque measurement mechanisms and controls the first servo motor and the second servo motor. It is characterized by that.

  According to a second aspect of the present invention, the finger tapping mechanism includes a rail member provided on the side of the second arm, a moving body that is guided by the rail member, and a swingable support on the moving body. A third arm to be rotated, a finger tapping roller that is rotatably provided at the tip of the third arm and strikes the base of the finger, and a third servo motor that advances and retracts the finger tapping roller toward the base of the finger. It is characterized by becoming.

  The invention according to claim 3 is characterized in that the hand platform reciprocates up and down with the vicinity of the wrist of the hand as a swing fulcrum.

  According to a fourth aspect of the present invention, a fourth servo motor that reciprocates the hand table up and down is connected to a swing shaft that swings the hand table, and a hand that detects torque applied to the table is detected. A platform torque measurement mechanism is provided on the rear surface of the platform, and the control unit acquires torque information from the platform platform torque measurement mechanism and controls the fourth servo motor.

  The invention according to claim 5 is characterized in that the hand platform is provided with a stopper mechanism for defining the range of the reciprocation.

In the invention which concerns on Claim 1, the finger base after a bending | flexion is hit with a finger hitting mechanism. Then, the motor nerves of the patient are stimulated, and the finger tries to return to its original state, and self-stretching is expected.
That is, according to the present invention, a training apparatus capable of promoting self-stretching is provided.

Furthermore, in the invention which concerns on Claim 1, in the training apparatus which makes a patient's finger perform passive bending and self-stretching, the mechanism which moves a patient's finger is the 1st arm and the 2nd arm, and these The first servo motor and the second servo motor that actuate the first arm and the second arm, and finger pressing portions arranged at the intersections between the first slider and the extended portions extending from the second slider are configured.
The first arm is driven by the first servo motor, and the second arm is driven by the second servo motor.
By controlling the output of the first servo motor and the output of the second servo motor, the finger pressing unit can be held at an arbitrary position and can be moved on an arbitrary movement locus.

The above-mentioned movement trajectory can also be obtained by the cam mechanism, but if the movement trajectory needs to be corrected, the cam must be replaced, and correction is difficult. In this regard, according to the present invention, it is possible to cope with this by simply changing the motor output, and the movement locus can be corrected very easily.
Therefore, training of various patients can be carried out by one training apparatus, and the operating rate of the training apparatus can be increased.

  In addition, in the invention according to claim 1, the tip of the second extension portion extended from the second slider is supported by the finger pressing portion. That is, the second extension portion connects the second slider to the finger pressing portion. A material having a small thickness can be used for the second extension portion that is not particularly subjected to a large load. Since the thickness is small, the width dimension of the finger pressing part obtained by adding the thickness of the second extension part to the axial length of the finger pressing part can be reduced.

  The patient inserts one finger into the finger press. The other finger is spread so as to sandwich the finger pressing portion, that is, the second extension portion. At this time, if the width of the second extension is small, it is not necessary to spread the fingers excessively, the burden on the patient is reduced, and training can be performed more easily.

  In the invention according to claim 2, the finger hitting roller is rotatably provided. By making it possible to rotate, the friction generated when the finger hitting roller comes into contact with the finger can be reduced.

  In the invention which concerns on Claim 3, a patient's wrist is rock | fluctuated by a hand stand. The wrist dorsiflexion motion can be added to the self-stretching motion of the finger, and the effect of the recovery training can be enhanced as compared with the finger-only training.

  The invention according to claim 4 includes the fourth servo motor that reciprocates the hand table up and down, and the hand table torque measuring mechanism that detects the torque applied to the table. By controlling the fourth servo motor by the control unit, it is possible to perform a predetermined movement also on the wrist. It is desirable that various movements can be realized with one apparatus.

  In the invention which concerns on Claim 5, the hand stand is equipped with the stopper mechanism which prescribes | regulates the range of reciprocation. Even when the table is going to reciprocate beyond a predetermined range, the stopper mechanism can prevent reciprocation beyond the predetermined range. By providing a separate stopper mechanism, it is possible to reliably prevent unnecessary movement of the platform.

It is a figure explaining the mode of training which recovers the hemiplegia finger function concerning the present invention. 1 is a perspective view of a hemiplegic finger function recovery training device according to Embodiment 1. FIG. It is sectional drawing of a hemiplegia finger function recovery training apparatus. It is a figure explaining the structure of a slider. FIG. 5 is a sectional view taken along line 5-5 of FIG. It is a triangle figure for demonstrating the principle of a finger bending mechanism. It is a figure explaining the principle of operation of a finger bending mechanism. It is an effect | action figure explaining from a finger's other dynamic bending start to the middle of bending. It is an action figure explaining self-extension from the end of other dynamic bending of a finger. It is a figure explaining the change Example of a finger hitting mechanism. It is a figure explaining the operation | movement which the finger | toe hitting mechanism of FIG. It is a figure explaining the operation | movement which the finger tapping mechanism of FIG. 10 prints up a finger. It is a perspective view of a torque measurement mechanism. It is sectional drawing of the hemiplegic finger function recovery training apparatus which concerns on Example 2. FIG. It is a perspective view explaining the finger bending mechanism which concerns on Example 2. FIG. It is principal part sectional drawing of a 2nd slider. It is a figure explaining the principle of operation of the finger bending mechanism concerning Example 2. It is action | operation explanatory drawing of the finger bending mechanism which concerns on Example 2. FIG. It is a perspective view explaining the finger tapping mechanism which concerns on Example 2. FIG. FIG. 20 is a sectional view taken along line 20-20 in FIG. 19. FIG. 10 is an operation explanatory diagram of a finger tapping mechanism according to a second embodiment. FIG. 6 is a perspective view for explaining a hand rest according to a second embodiment. FIG. 10 is an explanatory diagram of the operation of the hand platform according to the second embodiment. It is explanatory drawing of a stopper mechanism. It is a figure explaining the example of a change of FIG. It is a figure explaining the effect | action of FIG. It is a figure explaining the basic composition of the conventional hemiplegia finger function recovery training device.

  Embodiments of the present invention will be described below with reference to the accompanying drawings. The drawings are viewed in the direction of the reference numerals.

First, the content of training aimed by the present invention will be described with reference to FIG.
In FIG. 1 (a), the assistant applies force F1 to the index finger 11 of the patient's hand 10, and starts the bending operation of the finger as indicated by the arrow (1). At the same time, the caregiver bends the bent wrist 12 (arrow (2)).

Then, as shown in (b), the finger 11 is continuously bent by the force F2 (arrow (3)).
Further, as shown in (c), the finger 11 is continuously bent by the force F3 (arrow (4)), and the wrist 12 is bent (arrow (5)).
In (a) to (c), bending the finger 11 with the force F of the assistant is called other dynamic bending.

Next, at (d), the assistant taps the base 13 of the finger 11 as shown by the arrow (6). By tapping it, the patient's motor nerve is stimulated, and the finger 11 expands as shown in (e) (arrow (7)) and returns to (a). At this time, the assistant's fingers 15 and 16 are attached to the upper surface of the patient's finger 11, and the assistant's fingers 15 and 16 are raised following the extension operation of the finger 11.
In (d) to (e) to (a), the finger 11 expands by itself without external force. This is called self-stretching.

A preferred embodiment of a training apparatus capable of performing the other dynamic bending and self-extension described above will be described with reference to the drawings.
As shown in FIG. 2, the hemiplegic finger mechanism recovery training device 20 (hereinafter abbreviated as “training device 20”) includes a rectangular base plate 21 and a vertical wall portion that stands vertically and parallel to the base plate 21. 22, 22, a slope portion 25 that supports the patient's arm 24 passed to the hypotenuses of these vertical wall portions 22, 22, and a patient's hand 27 supported by the swing shaft 26 passed to the vertical wall portions 22, 22. A supporting table 28, a gate-shaped or box-shaped bracket 29 extending upward from the front of the table 28, and a finger bending mechanism 40 that is attached to the bracket 29 and depresses the index finger 11, for example. .

  As shown in FIG. 3, the finger bending mechanism 40 extends substantially from the first shaft 41 provided below the hand platform 28 along the hand platform 28, and pivots up and down around the first shaft 41. A first arm 42, a first servo motor 44 that is supported by an L-shaped sub-bracket 43 extending downward from the hand rest 28 and pivots the first arm 42 up and down, and a portal or box-shaped bracket 29 A second arm 46 extending from the second shaft 45 provided to the first arm 42 so as to intersect the first arm 42 and pivoting up and down about the second shaft 45, and a second arm 46 provided on the bracket 29. The second servomotor 47 that pivots up and down is disposed at the intersection 48 of the first arm 42 and the second arm 46, and is attached to the first arm movably in the axial direction of the first arm 42 and the second arm Free to move in 46 axial directions A slider 49 attached to the second arm 46, a finger pressing part 51 attached to the slider 49 for pressing down a finger (FIG. 2, reference numeral 11), a first encoder 52 for monitoring the rotation angle of the first servo motor 44, and It comprises a control unit 54 that acquires rotation angle information from a second encoder 53 that monitors the rotation angle of the second servo motor 47 and controls the first servo motor 44 and the second servo motor 47.

  A special first torque measurement mechanism 90 that can measure the drive torque (Term1) of the first arm 42 is provided at the base of the first arm 42, and torque information is sent to the control unit 54. Similarly, a special second torque measuring mechanism 95 that can measure the driving torque (Term2) of the second arm 46 is provided at the base of the second arm 46, and torque information is sent to the control unit 54.

  Torque is obtained by measuring strain with a strain gauge and converting this strain. It can be considered that a strain gauge for this purpose is directly attached to the first arm 42. However, when the distortion generated in the first arm 42 is very small, the influence of the error becomes remarkable, and the reliability of measurement is lowered. As a countermeasure, the present embodiment employs special torque measuring mechanisms 90 and 95 that can expand (amplify) the distortion.

First, the first torque measurement mechanism 90 will be described with reference to FIG.
In FIG. 13, a support block 91 is rotatably attached to the first shaft 41, and the first arm 42 is fixed to the support block 91. In this state, the driving torque from the first shaft 41 is not transmitted to the first arm 42.
Therefore, the driving plate 92 is fixed to the first shaft 41, a constricted portion 93 is provided in the middle of the driving plate 92, and a strain gauge 94 is attached (or built in) to the constricted portion 93, and the tip of the driving plate 92 is provided. Is connected to the first arm 42.

According to the first torque measurement mechanism 90 having such a structure, the drive torque from the first shaft 41 is transmitted to the first arm 42 via the drive plate 92. At this time, since the constricted portion 93 bends more than other portions, the distortion is increased.
Since the second torque measurement mechanism 95 attached to the second arm 46 has the same structure, the description thereof is omitted.

  Returning to FIG. 3, the third servo motor 55 provided on the hand platform 28, the third encoder 56 for monitoring the rotation angle of the third servo motor 55, and the punch turned up and down by the third servo motor 55 The training apparatus 20 includes a finger striking mechanism 58 for striking the base of the patient's finger.

  Preferably, it comprises a fourth servo motor 59 provided on the vertical wall portion 22 for swinging (rotating) the swing shaft 26 and a fourth encoder 61 for monitoring the rotation angle of the fourth servo motor 59. The training apparatus 20 includes a wrist bending / stretching mechanism 62 that reciprocates 28 up and down.

  The control unit 54 acquires the rotation angle information from the third and fourth encoders 56 and 61 in addition to the first and second encoders 52 and 53, and in addition to the first and second servomotors 47, • The fourth servomotors 55 and 59 are also controlled comprehensively.

Next, the structure of the slider 49 disposed at the intersection 48 between the first arm 42 and the second arm 46 will be described.
As shown in FIG. 4, the slider 49 includes a slider main body 64 that extends vertically, a first roller 65 that is rotatably attached to the upper portion of the slider main body 64 and that freely rotates along the upper surface of the first arm 42, A second roller 66 rotatably attached to the lower portion of the slider body 64 and freely rotating along the lower surface of the first arm 42, a protrusion 67 extending from the slider body 64 along the first arm 42, and the protrusion A third roller 68 that is rotatably mounted on the portion 67 and freely rotates along the side surface (outer surface) of the first arm 42; and a side surface of the first arm 42 that is rotatably mounted below the protrusion 67 (see FIG. And a fourth roller 69 that freely rotates along the outer surface.

FIG. 5 is a cross-sectional view taken along line 5-5 in FIG. 3, and two sliders 49 and 49 are connected by a single support shaft 71. The support shaft 71 passes through the first arm 42 and the second arm 46, and is provided with a finger pressing portion 51 having a cylindrical shape at the center and a surface fastener 72 affixed on the surface thereof. It moves along the second arm 46 via the rollers 73 and 73.
That is, the support shaft 71 moves along the first arm 42 and the second arm 46.

  A hook-and-loop fastener 74 is wound around the finger 11, and the hook-and-loop fastener 74 is coupled to a hook-and-loop fastener 72 on the support shaft 71 side. Thereafter, the finger 11 moves together without leaving the finger pressing portion 51.

  In FIG. 3, when the center of the first axis 41 is A, the center of the second axis 45 is O, and the intersection 48 is B, the triangle OAB shown in FIG. 6 can be drawn. The side OA has a fixed length, and the other sides AB and OB have variable lengths.

In the triangle OAB shown in FIG. 6, the axis passing through the side OA is the x axis, the axis passing through the point O (origin) and perpendicular to the x axis is the y axis, the length of the side 0A is L (constant value), and the length of the side OB Let L1 (variation value), angle O be θ1, and angle (outer angle) A be θ2.
From angle O + angle B = angle A, angle B = angle A−angle O = θ 2 −θ 1, and angle B becomes (θ 2 −θ 1). The inner angle A is (2π−θ2).

If the coordinates of the point B are (x, y), x = L1 · cos θ1 and y = L1 · sin θ1.
From the sine theorem, L / sin (θ2−θ1) = L1 / sin (2π−θ2).
Here, sin (2π−θ2) = sin θ2. When L / sin (θ2−θ1) = L1 / sinθ2 is arranged with respect to L1, L1 = L · sin θ2 / sin (θ2−θ1) is obtained. This L1 is substituted into x = L1 · cos θ1 and y = L1 · sin θ1.
x = L · cos θ1 · sin θ2 / sin (θ2−θ1)
y = L · sin θ1 · sin θ2 / sin (θ2−θ1)

  The point B, that is, the position of the finger pressing portion is uniquely determined by θ1 and θ2, and the finger pressing portion can be controlled on a two-dimensional plane. The relational expression of the speed (hand speed) and the force (hand external force) relating to the point B can be expressed as follows.

The locus of point B can be described by another simple method.
In FIG. 7A, it is assumed that the first arm 42 is kept in a non-rotating state and the second arm 46 is rotated clockwise by the driving torque Term2. Then, the point B moves along the first arm 42 as indicated by an arrow (11).

  Further, in (b), it is assumed that the second arm 46 is maintained in a non-rotating state and the first arm 42 is rotated clockwise by the drive torque Term1. Then, the point B moves along the second arm 46 as indicated by an arrow (12).

In (c), when the first arm 42 is rotated clockwise by the driving torque Term1, and the second arm 46 is rotated clockwise by the driving torque Term2, the point B is as shown by the arrow (13). Moving. This movement trajectory can be arbitrarily drawn by changing Term2 and Term1.
Therefore, in FIG. 3, the position, moving direction, speed, and force of the finger pressing unit 51 can be arbitrarily set by changing the driving torque, the rotating direction, the rotating speed, and the like of the first servo motor 44 and the second servo motor 47. Can be controlled.

Next, the operation of the training apparatus 10 described above will be described.
As shown in FIG. 8A, the hand 27 is placed on the hand rest 28 and the finger 11 around which the surface fastener 74 is wound is inserted under the finger pressing portion 51. And a training apparatus (FIG. 2, code | symbol 20) is started. Then, the finger pressing part 51 starts to descend as shown by an arrow. The angle between the table 28 and the slope 25 is α.

Subsequently, as shown in (b), the table 28 is rotated counterclockwise in the figure (arrow (11)), and the angle between the table 28 and the slope 25 is increased to β (angle α < Angle β). Thus, the wrist 12 is bent back.
In parallel with this dorsiflexion, the finger 11 continues to descend (arrow (12)).

In FIG. 9A, the other dynamic bending of the finger 11 is completed, and the base 13 of the finger 11 is hit with the punch 57 in this state (arrow (13)). The punch 57 is returned.
At the same time, the finger pressing portion 51 is moved counterclockwise in the figure at a speed at which the finger 11 returns (arrow (14)). The finger pressing unit 51 does not apply an external force to the finger 11 but attaches it, and does not hinder the self-extension of the finger 11. At the same time, the hand platform 28 is turned counterclockwise (arrow (15)). Thus, the wrist 12 is bent.
As shown in FIG. 8B, the finger 11 extends by itself (arrow (16)), and the process returns to FIG.

  As described above, the other dynamic bending / extension and self-extension of the finger 11 are repeated. In addition, the bending and dorsiflexion of the wrist 12 are repeated. Since the training equivalent to the training described in FIG. 1 is performed by the training device 10 of the present invention, the burden on doctors and therapists who have been engaged in training can be greatly reduced.

Next, an example of changing the finger tapping mechanism will be described.
As shown in FIG. 10, the changed finger tapping mechanism 80 includes a crank-shaped (or Z-shaped) bracket 81, a third servo motor 55 attached to the lower portion of the crank-shaped bracket 81, and the third servo motor. The rectangular piece 83 fixed to the motor shaft 82 of 55, the punch 57 having the groove 84 for movably storing the rectangular piece 83, and the rectangular piece 83 fitted in the groove 84 are moved toward the tip of the punch 57. It comprises a compression spring 85 for pushing, a free roller 86 provided at the rear end of the punch 57, and a cam plate 87 fixed to the upper part of the crank-shaped bracket 81 for guiding the free roller 86.

  Preferably, a protrusion 89 made of a soft material is attached to the lower surface of the tip of the punch 57. The protrusion 89 has a softness and a shape imitating the fingertip of the assistant.

  The straight portion of the cam plate 87 forms an angle γ (γ is a positive number not including 0) with the longitudinal axis 88 of the punch 57. The position of the motor shaft 82 and the position of the cam plate 87 are unchanged, but γ changes because the punch 57 moves. This point will be described below.

  In FIG. 11A, the position (position) of the tip of the punch 57 is Pa. From this state, the motor shaft 82 is rotated clockwise in the figure. Then, the punch 57 tries to rotate clockwise in the figure.

  As a result, as shown in (b), the free roller 86 starts to rotate along the cam plate 87 (arrow (21)). Then, the rectangular piece 83 supported by the motor shaft 82 rotates slightly clockwise, and the punch 57 moves (advances) to the lower right in the figure in order to allow the movement of the punch 57. The compression spring 85 contracts. The position of the tip of the punch 57 in the figure is Pb.

Furthermore, as shown in (c), the free roller 86 continues to rotate along the cam plate 87 (arrow (22)). The punch 57 further moves to the lower right in the figure, and the projection 89 strikes the second joint of the finger 11. The compression spring 85 further shrinks. The position of the tip of the punch 57 in the figure is Pc.
That is, by rotating the motor shaft 82 in the forward direction, the tip of the punch 57 moves in the order of Pa → Pb → Pc and strikes the second joint of the finger 11.

When struck, the motor shaft 82 is quickly reversed, that is, rotated counterclockwise in the figure. Then, the tip of the punch 57 returns as Pc → Pb → Pa. This operation will be described in detail.
As shown in FIG. 12A, the finger 11 returns as shown by the arrow (23) by self-extension. The tip of the punch 57 returns to Pb so as to follow this operation. At this time, the punch 57 not only rises, but also retreats as indicated by an arrow (24), and slides the upper surface of the finger 11. Then, the self-extension of the finger 11 is further promoted.
Subsequently, as shown in (b), the finger 11 returns as shown by the arrow (25) by self-extension. The tip of the punch 57 returns to Pa so as to follow the movement of the finger 11.

  That is, in FIG. 11C to FIG. 12B, it can be expected that the punch 57 moving as Pa → Pb → Pc slides up the upper surface of the finger 11 and promotes the self-extension of the finger 11.

  In the first and second aspects, the finger bending mechanism is not limited to the mechanism described in the embodiment including the first arm, the second arm, and the slider, but the finger pressing portion is reciprocated on a desired locus by a cam mechanism. It may be moved. However, in the case of a cam mechanism, it is necessary to replace the cam plate when the shape of the training object changes greatly, such as when the length of a patient's finger changes. In this regard, if the mechanism is composed of the first arm, the second arm, and the slider, the locus of the finger pressing unit can be arbitrarily changed by controlling the torque applied to the first arm and the torque applied to the second arm. Because it can, it is highly versatile.

  In addition, in the first aspect, the hand platform may be reciprocally movable up and down, or may not be reciprocally movable. If it does so, the structure of a training apparatus will become simple and it can manufacture at low cost.

  The inventors further studied the training apparatus 20 shown in FIG. 3 and improved the training apparatus. Specifically, the finger bending mechanism 40, the finger hitting mechanism 58, and the hand platform 28 are changed, and a stopper mechanism is newly added. Details will be described in the following figures.

Next, a second embodiment of the present invention will be described with reference to the drawings.
As shown in FIG. 14, the training apparatus 100 includes a rectangular base plate 21, vertical wall portions 101 and 101 (only one on the back side is displayed) standing upright and parallel to the base plate 21, and these The slope part 25 that is passed to the oblique sides of the vertical wall parts 101 and 101 and supports the patient's arm, the hand platform 102 that is supported by the swing shaft 26 that is passed to the vertical wall parts 101 and 101 and supports the patient's hand, and this hand Side plates 103 and 103 (only one on the back side) mounted on the side of the platform 102 and swingable with the hand platform 102, and the tip of the support plate 104 spanned between these side plates 103 and 103 A finger bending mechanism 105 that supports and pushes down the finger, a finger striking mechanism 108 that is provided in the vicinity of the support plate 104 and moves the third arm 107 forward and backward, and a hand rest that is provided below the hand rest 102. Specifies the range of reciprocating motion And a stopper mechanism 109, including.

The other basic configuration is the same as that of the training apparatus 20 shown in FIG.
Details of the finger bending mechanism 105 will be described in the following figures.

  As shown in FIG. 15, the finger bending mechanism 105 includes a first arm 111 supported by a first shaft 41 via a first torque mechanism 90, and a first slider provided so as to be movable on the first arm 111. 112, a second arm 113 supported by the second shaft 45 via a second torque mechanism 95, a second slider 114 provided movably on the second arm 113, and upward from the first slider 112. A first extension 116 extending toward the first extension 116 and a finger pressing portion 118 provided at an intersection C with the second extension 117 extending from the second slider toward the first extension 116.

  The first arm 111 includes a base 121 provided on the first shaft 41, a lowering part 122 lowered from the base 121, and two arm parts 123, 123 extending from the lowering part 122 in a substantially horizontal direction. And a connection portion 124 that connects the ends of these arm portions 123 and 123.

  The first slider 112 includes a box body 126 partially indicated by an imaginary line, a base section 128 that is lowered from the lid section 127 of the box body 126 and moves between the two arm sections 123, 123, and the base The roller member 129 extends from the portion 128 toward the arm portions 123 and 123 and rolls on the upper surface or the lower surface of the arm portions 123 and 123.

  The base portion 128 is provided between the arm portions 123 and 123, and the roller member 129 is provided so as to sandwich the arm portions 123 and 123 from the base portion 128. When the first slider 112 is about to move in the width direction of the first arm 111, the base portion 128 contacts the arm portions 123 and 123. By contacting, the first slider is prevented from shifting in the width direction of the first arm 111.

  In addition, the upper and lower surfaces of the arm portions 123 and 123 are sandwiched between the roller members 129. Since the roller members 129 are in contact with the upper and lower surfaces, the first slider 112 can be prevented from shifting in the vertical direction.

  The second arm 113 includes a base portion 131 provided on the second shaft 45, a horizontal portion 132 extending substantially horizontally from the base portion 131, and an arm portion of the first arm 111 lowered from the horizontal portion 132 in a substantially vertical direction. 123 is a substantially L-shaped member including a second arm portion 133 passed between the first and second arm portions 123.

  The second slider 114 includes a box 135 partially indicated by an imaginary line, a roller member 136 that is provided inside the box 135 and rolls on the second arm 133, and is provided on the side of the roller member 136. And a lid portion 137 as a lid of the box body 135 to be manufactured.

The finger pressing portion 118 is a shaft-like member that supports the first extension portion 116 and the second extension portion 117 so as to be swingable.
Further details of the second slider 114 will be described with reference to the next figure.

  As shown in FIG. 16, the second slider 114 is provided with shafts 138 so as to be laid on opposing surfaces in the box body 126, and roller members 136 are provided on these shafts 138, respectively.

  When the cross section of the second arm part 133 is rectangular, an arbitrary one surface is a first surface 141, a surface adjacent to the first surface 141 is a second surface 142, and a third surface 143 and a fourth surface 144 are sequentially formed. And

  The roller member 136a in contact with the first surface 141 and the roller member 136c in contact with the third surface 143 are arranged at the same height in the vertical direction of the box body 126 (the front and back of the drawing). Similarly, the roller member 136b in contact with the second surface 142 and the roller member 136d in contact with the fourth surface 144 are disposed at the same height.

  Roller members 136a in contact with the first surface 141 and roller members 136c in contact with the third surface 143, and roller members 136b in contact with the second surface 142 and roller members 136d in contact with the fourth surface 144 are alternately arranged in the height direction. Is done.

By providing the roller members 136 in contact with the facing surfaces (for example, the first surface 141 and the third surface 143) at the same height, more roller members 136 can be arranged.
Further, the roller member 136 is in contact with all the surfaces of the second arm portion 133 having a rectangular cross section, so that the second slider 114 can be prevented from falling off from the second arm portion 133.
The operation of the finger bending mechanism 105 will be described with reference to the next figure.

As shown in FIG. 17A, the finger pressing portion 118a indicates that the finger pressing portion is in a position before operation. From this state, when the second shaft 45 is rotated clockwise as shown in (b), the second arm 113 is also rotated. As the second arm 113 rotates, the first slider 112 mainly moves. That is, the finger pressing unit 118b moves in a substantially horizontal direction.
From the state shown in (b), the finger pressing portion 118b returns to the position shown in (a) by turning the second shaft 45 counterclockwise.

On the other hand, by rotating the first shaft 41 counterclockwise from the state of (a), the first arm 111 also rotates as shown in (c). As the first arm 111 rotates, the second slider 114 mainly moves. That is, the finger pressing part 118c moves in a substantially vertical direction.
From the state shown in (c), the finger pressing part 118c returns to the position shown in (a) by rotating the first shaft 41 clockwise.

  Training is performed by fixing a finger to the finger pressing unit 118. When performing training, the finger of the patient can be moved to an arbitrary trajectory by combining the movements of the first arm 111 and the second arm 113. That is, other dynamic bending is performed.

The training apparatus 100 returns to FIG. 14 and can be said as follows.
In the training apparatus 100 that causes the patient's finger to perform passive bending and self-extension, a mechanism for moving the patient's finger (finger bending mechanism 105) includes a first arm 111, a second arm 113, and the first of them. Intersection of the first servo motor 44 and the second servo motor 47 that operate the first arm 111 and the second arm 113 and the first and second extension portions 116 and 117 extended from the first slider 112 and the second slider 114 The finger pressing unit 118 arranged in C is configured.

The first arm 111 is driven by the first servo motor 44, and the second arm 113 is driven by the second servo motor 47.
By controlling the output of the first servo motor 44 and the output of the second servo motor 47 with the control unit (FIG. 3, reference numeral 54), the finger pressing unit 118 can be held at an arbitrary position. It can be moved on the movement trajectory.

The above-mentioned movement trajectory can also be obtained by the cam mechanism, but if the movement trajectory needs to be corrected, the cam must be replaced, and correction is difficult. In this regard, according to the present invention, it is possible to cope with this by simply changing the motor output, and the movement locus can be corrected very easily.
Therefore, training of various patients can be carried out by one training apparatus, and the operating rate of the training apparatus can be increased.
The effect of the finger bending mechanism 105 used in the training apparatus 100 will be described with reference to FIG.

As shown in FIG. 18B, when training is performed, a hook-and-loop fastener 72 is attached to the finger pressing portion 118, and a hook-and-loop fastener 74 is also attached to the finger to be trained (in this case, the middle finger 145). (FIG. 14, code | symbol 102) puts a hand, and performs training, after connecting the hook_and_loop | surface fasteners 72 and 74. FIG.
Here, 147 and 148 are an index finger and a ring finger, respectively.

  As shown to (a), in Example 1, the 2nd arms 46 and 46 supported the finger | toe press part 51 directly. Since the second arms 46 and 46 are required to have high strength, a predetermined size is required. Since the predetermined size is necessary, the width dimension L0, which is obtained by adding the thicknesses of the second arms 46 and 46 that support the finger pressing portion 51 to the axial length of the finger pressing portion 51, becomes extremely long.

  When training, the index finger 147 and the ring finger 148 are kept in an expanded state so as not to contact the second arms 46 and 46 provided in the vicinity of the finger pressing portion 51. That is, it is necessary to keep at least L0 or more.

  On the other hand, as shown in (b), in the second embodiment, the finger pressing part 118 is supported via the second extension part 117. A material having a small thickness can be used for the second extension portion 117 which is not particularly loaded. Since the thickness is small, the width dimension L1 of the finger pressing portion obtained by adding the thickness of the second extension portion 117 to the axial length of the finger pressing portion 118 can be reduced.

The patient inserts one finger (for example, the middle finger 145) into the finger pressing unit 118. The other fingers (for example, the index finger 147 and the ring finger 148) are spread so as to sandwich the finger pressing part 118, that is, the second extension part 117. At this time, if the width dimension L1 of the second extension 117 is small, it is not necessary to spread the fingers 147 and 148 excessively, the burden on the patient is reduced, and training can be performed more easily.
Details of the finger tapping mechanism (FIG. 14, reference numeral 108) will be described in the following figures.

  As shown in FIG. 19, the finger tapping mechanism 108 is disposed between the rail member 154 including the lower rail 152 and the upper rail 153 indicated by an imaginary line, and the upper and lower rails 152 and 153 and moves on the rail member 154. A body 155, a third arm 107 swingably supported via a shaft member 156 of the moving body 155, and a tip of the third arm 107 rotatably provided via a shaft member 157. And a finger tapping roller 158 for tapping.

The upper and lower rails 152 and 153 are rectangular plate members. Notches 159 and 159 are provided along the moving direction of the moving body 155 so that the third arm 107 can swing.
The rail member 154, the movable body 155, and the third arm 107 can be manufactured using general-purpose products. If it can manufacture with a general purpose product, the manufacturing cost of a training apparatus can be made cheap.

  The moving body 155 includes a shaft member 156, plate bodies 161 and 161 provided at both ends of the shaft member 156, and a plurality of movable bodies 155 that are rotatably supported by the plate bodies 161 and 161 (in this case, a total of eight movable bodies 155). ) Of the roller member 162.

  The third arm 107 has a base portion that connects the two third arm portions 163 and 163 that are swingably supported by the shaft member 156 of the moving body 155 and the tips of the third arm portions 163 and 163. The shaft member 157 is provided and supports the finger tapping roller 158.

The finger hitting roller 158 is preferably made of urethane resin or urethane rubber. These materials are excellent in terms of hardness when used for finger tapping rollers.
The advance and retreat of the third arm 107 will be described in detail in the following figures.

  As shown in FIG. 20, a third servo motor 55 is provided on the upper surface of the upper rail 153. A third shaft 167 is rotatably provided on the third servo motor 55 via pulleys 164 and 165 and a belt 166. A transmission member 168 that transmits the force of the third servo motor 55 and advances and retracts the third arm 107 is provided on the third shaft 167.

  The transmission member 168 is mounted on the third shaft 167 and can be rotated together with the third shaft 167, and the third torque measuring mechanism 171 and the third shaft 167 are provided on the third shaft 167. Consists of a base 172 that circulates in the interior, a box 173 connected to the base 172, and a roller member 174 that is provided in the box 173 and is in contact with the upper and lower surfaces of the third arm 163.

The basic configuration of the third torque mechanism 171 is the same as that of the first torque mechanism 90 and the second torque mechanism 95 shown in FIG.
The details of the operation of the third arm 107 when the third servomotor 55 is operated will be described with reference to FIG.

In FIG. 21A, the position (position) of the shaft member 157 is Pd. From this state, the third shaft 167 is rotated clockwise in the figure. Then, the box 173 tries to rotate clockwise in the figure.
As a result, as shown in (b), the roller member 162 rotates along the upper rail 153, and the third arm 107 starts to advance. The shaft member 157 in the figure is Pe.

Furthermore, as shown in (c), the roller member 162 continues to rotate along the upper rail 153. The third arm 107 further moves to the lower right in the figure, and the finger hitting roller 158 hits the second joint of the finger 11. The position of the tip of the shaft member 157 in the figure is Pf.
That is, when the third shaft 167 is rotated forward, the shaft member 157 moves as Pd → Pe → Pf and strikes the second joint of the finger 11.

  A finger hitting roller 158 is rotatably provided. By enabling rotation, the friction generated when the finger hitting roller 158 contacts the finger 11 can be reduced.

  After hitting, the third shaft 167 is quickly reversed, that is, rotated counterclockwise in the figure. Then, the roller member 162 is brought into sliding contact with the lower rail 152, and the shaft member 157 returns as Pf → Pe → Pd.

By rotating the third shaft 167, the roller member 162 moves backward while sliding on the lower rail 152. That is, when the finger hitting roller 158 is moved backward, the lower rail 152 guides the moving body 155. By being guided, the movement locus of the moving body 155 becomes a constant locus. Due to the constant trajectory, the moving body 155 can be easily controlled even when the finger hitting roller 158 is retracted.
Details of the table (FIG. 14, reference numeral 102) will be described with reference to the next figure.

  As shown in FIG. 22 (a), the hand platform 102 has a substantially U-shaped notch 177 at the site where the finger to be trained is placed so that the finger to be trained can be moved up and down with respect to the base plate 176. Grooves 178 and 178 are provided from the notches 177 in the width direction of the base plate 176, and notches 179 and 179 are formed along the longitudinal direction of the base plate 176 from the ends of the grooves 178 and 178. Is provided.

As shown in (b), the table 102 is easy to bend by providing the notch 179 and the groove 178. A finger other than the finger to be trained is placed in the flexible portion (for example, the index finger 147 and the ring finger 148 in FIG. 18).
The merit which arises by making it bend easily is demonstrated with the following figure.

  As shown in FIG. 23A, the strain gauge 181 is attached to the back surface of the groove portion 178 of the hand platform 102 (or incorporated in the lower portion of the groove portion 178). The strain gauge 181 is connected to a control unit (FIG. 3, reference numeral 54).

  By configuring the table 102 to be easily distorted, the distortion can be increased as shown in FIG. By enlarging the strain, even a minute change can be detected by the strain gauge 181 and the accuracy of measurement is increased.

  From the above, the hand table torque measuring mechanism 183 that measures the torque applied to the table 102 can be constituted only by the strain gauge 181, but the notch 179 and the groove 178 provided on the table 102 are provided. It can also be said that it is desirable to include.

Returning to FIG. 14, the following can be said.
A fourth servo motor 59 that reciprocates the table 102 and a table torque measuring mechanism 183 that detects torque applied to the table 102 are provided. By controlling the fourth servo motor 59 by the control unit (FIG. 3, reference numeral 54), it is possible to perform a predetermined movement also on the wrist. It is desirable that various movements can be realized with one apparatus.
The stopper mechanism of the wrist bending / extension mechanism (FIG. 24, reference numeral 184) will be described with reference to the next figure.

  As shown in FIG. 24A, the wrist bending / extending mechanism 184 that bends and extends the wrist includes a fourth servo motor 59 attached to the vertical wall portion 101, a swing shaft 26 rotated by the fourth servo motor 59, From a swingable stand 102 supported by the swing shaft 26, a side plate 103 attached to a side portion of the lifttable 102, and a stopper mechanism 109 that defines a range of reciprocation of the handrest plate 102. Become.

The stopper mechanism 109 includes a projection 187 attached from the vertical wall 101 to the side plate 103 (from the back to the front of the drawing) and a hole 188 provided in the side plate 103 through which the projection 187 passes. Become.
By operating the fourth servo motor 59, the swing shaft 26 rotates. As the swing shaft 26 rotates, the hand plate 102 and the side plate 103 also rotate.

  By continuing to rotate the fourth servo motor 59, the protrusion 187 contacts the lower end 189 of the hole 188 as shown in FIG. By contact, the swinging of the hand-clad plate 102 is forcibly limited.

  Next, the fourth servo motor 59 is rotated in the reverse direction. By rotating in the reverse direction, the hand-carrying plate 102 swings in the clockwise direction, and the projection 187 contacts the upper end 191 of the hole 188 as shown in FIG. By contact, the swinging of the hand-clad plate 102 is forcibly limited.

  The wrist bending / extension mechanism 184 includes a stopper mechanism 109 that defines a range of reciprocation. Even when the table 102 attempts to reciprocate beyond a predetermined range, the stopper mechanism 109 can prevent reciprocation beyond the predetermined range. By providing a separate stopper mechanism, it is possible to reliably prevent the hand platform 102 from moving more than necessary.

  As shown in FIG. 25, the transmission member 192 includes a third servo motor 55 as a power source, and a third shaft 167 rotatably connected to the third servo motor 55 via pulleys 164 and 165 and a belt 166. The fan-shaped pinion portion 193 that is supported by the third shaft 167 and idles on the third shaft 167, and one end is fixed to the pin 194 provided on the pinion portion 193 and the other end is supported by the third shaft 167. A third torque measuring mechanism 171 that is provided on the third shaft 167 together with the third torque measuring mechanism 171, and a box 173 that is connected to the base 172. The box body 173 includes a rack portion 195 that is formed on an upper portion of the third arm portion 163 that reciprocates within the box body 173 and meshes with the pinion portion 193.

  When the third servo motor 55 is operated, the third shaft 167 rotates via the pulley 164, the belt 166, and the pulley 165. As the third shaft 167 rotates, the third torque measurement mechanism 171 rotates, and the pinion portion 193 connected to the third torque measurement mechanism 171 via the pin 194 rotates. The rack portion 195 that meshes with the pinion portion 193 moves linearly. That is, the third arm portion 163 having the rack portion 195 formed thereon moves linearly on the roller member 174.

The box body 173 rotates in accordance with the moving direction of the third arm portion 163.
The basic configuration of the third torque measuring mechanism 171 is the same as that of the first torque mechanism 90 and the second torque mechanism 95 shown in FIG.
The details of the action of the third arm when the third servo motor 55 is operated will be described with reference to FIG.

  As shown in FIG. 26A, by operating the third servo motor (FIG. 25, reference numeral 55), the pinion portion 193 rotates counterclockwise as indicated by an arrow (30). As the pinion portion 193 rotates counterclockwise, the third arm 196 and the finger hitting roller 158 move forward toward the index finger 11. By moving forward, the finger hitting roller 158 hits the index finger 11 as shown in FIG.

Even when such a transmission member 192 is used, the effect of the present invention can be obtained.
In particular, when the transmission member 192 is configured by the pinion portion 193 and the rack portion 195, the configuration is simple, and the manufacturing cost of the transmission member 192 can be reduced.

  The present invention is suitable for a training apparatus used for function recovery training for hemiplegic fingers.

  10, 27 ... Patient's hand, 11 ... Finger (index finger), 12 ... Wrist, 13 ... Base of finger, 15, 16 ... Helper's finger, 41 ... First axis, 44 ... First servo motor, 45 ... First 2-axis, 47 ... second servo motor, 54 ... control unit, 90 ... first torque measurement mechanism, 95 ... second torque measurement mechanism, 100 ... hemiplegia finger mechanism recovery training device, 102 ... hand rest, 105 ... finger Bending function, 107 ... third arm, 108 ... finger tapping mechanism, 109 ... stopper mechanism, 111 ... first arm, 112 ... first slider, 113 ... second arm, 114 ... second slider, 116 ... first extension 117: Second extension portion, 118: Finger pressing portion, 121: Base portion (of the first arm), 123 ... Arm portion, 124 ... Connection portion, 154 ... Rail member, 155 ... Moving body, 158 ... Finger tapping roller, 183 ... Hand stand torque measuring machine , 184 ... wrist bending and stretching mechanism, C ... intersection.

Claims (5)

A hemiplegic finger function recovery training device for recovery training of the finger of a patient whose one hand is paralyzed,
This hemiplegic finger function recovery training device
A platform for placing hands,
A finger bending mechanism that pushes down and bends one of the fingers of the hand placed on the table and does not hinder the stretching operation in which the bent finger tries to return;
It consists of a finger tapping mechanism that strikes the base of the finger pushed down by this finger bending mechanism and promotes the extension operation,
The finger bending mechanism is
A first arm extending substantially along the table from a first axis provided below the table, and pivoting up and down about the first axis;
A first servo motor that swings the first arm up and down;
A first torque measuring mechanism for detecting torque applied to the first arm;
A first slider movably provided on the first arm;
A second arm that extends from a second shaft provided above the hand platform so as to intersect the first arm and pivots up and down about the second shaft;
A second servo motor that swings the second arm up and down;
A second torque measuring mechanism for detecting torque applied to the second arm;
A second slider movably provided on the second arm;
A first extension extending upward from the first slider;
A second extension that extends from the second slider toward the platform;
A finger pressing part that swingably supports the first extension part and the second extension part at an intersection where the tip of the first extension part intersects the tip of the second extension part;
A hemiplegic finger function recovery training apparatus comprising: a control unit that acquires torque information from the first and second torque measurement mechanisms and controls the first servo motor and the second servo motor.   The finger tapping mechanism includes a rail member provided on a side of the second arm, a moving body that is guided by the rail member, a third arm that is swingably supported by the moving body, 4. A finger hitting roller that is rotatably provided at the tip of a third arm and taps the base of the finger, and a third servo motor that advances and retracts the finger hitting roller toward the base of the finger. The paralysis finger function recovery training device according to 1.   The hemiplegic finger function recovery training device according to claim 1 or 2, wherein the hand platform reciprocates up and down with a vicinity of the wrist of the hand as a swing fulcrum. A fourth servo motor for reciprocating the hand table up and down is connected to a swing shaft for swinging the table.
A hand table torque measuring mechanism for detecting torque applied to the table is provided on the back surface of the table;
The paralysis finger function recovery training device according to claim 3, wherein the control unit acquires torque information from the hand platform torque measurement mechanism and controls the fourth servo motor.   The paralysis finger function recovery training device according to claim 3, wherein the hand-carrying table includes a stopper mechanism that defines a range of the reciprocation.

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