JP2015047193A - Rehabilitation support device and rehabilitation support method - Google Patents

Abstract

PROBLEM TO BE SOLVED: To realize effective rehabilitation for easing pain such as phantom limb pain, etc. and paralysis due to cerebral infarction, etc.SOLUTION: A rehabilitation support device comprises: a movement detection unit that detects a body movement of a patient carrying out rehabilitation; and an arithmetic processing unit that virtually generates a bodily expression in the patient's brain. The arithmetic processing unit plans the body movement required in the rehabilitation, recognizes the body movement detected by the movement detection unit and then virtually generates the bodily expression in the patient's brain. Then, the device generates an image on the basis of the virtual bodily expression in the patient's brain and presents it to the patient.

Description

  The present invention relates to a rehabilitation support device and a rehabilitation support method for supporting rehabilitation of a patient. In particular, the present invention relates to a rehabilitation support apparatus and a rehabilitation support method that are suitable for rehabilitation of patients with pain called phantom limb pain and rehabilitation of patients with paralysis due to sequelae such as cerebral infarction.

Some people who have lost part of their limbs due to accidents or surgery have pain called phantom limb pain. Phantom limb pain means that a limb that should not exist feels pain, and it is known that some people feel very painful. For example, a patient who loses one hand due to an accident or the like feels pain in the hand that does not exist. For this phantom limb pain, pharmacotherapy such as analgesics and treatments such as nerve resection have been attempted, but pharmacotherapy has only a temporary effect, and even if nerve resection is performed. It may recur and is very difficult to treat.
The principle of phantom limb pain has not been fully elucidated, but the human brain recognizes that there is a limb that does not actually exist, so the state of the limb matches the state of the brain. It is speculated that the discrepancy is causing pain.

Conventionally, mirror therapy (mirror treatment) is known as one of the methods for improving phantom limb pain by rehabilitation. In this mirror therapy, for example, a mirror is placed in front of a patient who has lost the left hand so as to hide the left hand that does not exist, and the right hand, which is the patient's healthy hand, is reflected in front of the mirror. By doing so, the patient can see the left hand that does not exist as a mirror image of the right hand.
For this reason, the patient appears to have both hands visually, and the patient's brain recognizes the presence of both hands by visual information. It is known that phantom limb pain is improved by performing such mirror therapy on a patient for a certain period of time.

  Patent Document 1 describes a treatment support apparatus that uses an electronic display to display an image corresponding to a mirror image and performs treatment. That is, create an avatar image (healthy limb in the virtual space) that moves a healthy limb in the virtual space, show the image to the patient, and match the image with the phantom limb that does not exist Rehabilitation to move Such a treatment in which a non-existing limb is shown to a patient on a display is referred to as mimic therapy. In this mimic therapy, an image corresponding to a mirror image is electronically displayed without using a mirror. However, the effects of rehabilitation are known to be equivalent to mirror treatment.

Japanese Patent No. 4025230

  However, in mirror therapy and imitation therapy, the phantom limbs that do not actually exist are made to reflect in the brain that they are present, thereby reducing the divergence between the actual physical state and the state of the brain. The treatment effect can be expected to temporarily remove pain. However, there is a problem that it is unclear what kind of exercise is effective in reducing pain according to the progress of rehabilitation. In addition, there are patients who cannot remove pain with mirror therapy or imitation therapy, and it has been desired to perform more effective treatment and rehabilitation.

  Also, as a case different from phantom limb pain, rehabilitation should be performed more efficiently even for patients whose brain has been damaged due to diseases such as cerebral infarction and paralysis remains in limb movement Is desired. Conventionally, rehabilitation for a patient who remains paralyzed in the movement of the limbs has performed walking training and the like in order to draw out the motor ability by the function that is not paralyzed. On the other hand, in recent years, it has been found that even if the brain function has been damaged once due to cerebral infarction or the like, the motor function is restored to some extent by performing rehabilitation that directly acts on the brain.

  For rehabilitation aimed at improving brain function in patients with phantom limb pain or patients with paralysis of the limbs, induction and repetition of limb movements called repetitive therapy Rehabilitation to perform is known. In addition, a TMS treatment method (Transcranial magnetic stimulation) in which rehabilitation is performed by attaching a coil that generates a magnetic force to the head of a patient and activating the brain is known.

FIG. 8 shows an example of the effect of these treatments on the body representation in the patient's brain. FIG. 8 shows a patient's sensorimotor system and a body model in the brain.
The sensorimotor system and the intracerebral body model shown in FIG. 8 are viewed from the motor function of the patient's limbs. That is, the brain 10 has a brain body expression function 11, a cognitive function 12, an intention function 13, a primary sensory field function 14, and a primary motor field function 15 as functions for limb movement. ing.
The primary sensory area function 14 senses the sense of the limbs with a signal from the sensory organ 21 of the body 20. Then, with a signal from the primary motor area function 15, the exerciser 22 such as a muscle moves the limb. Movement by the exerciser 22 is recognized by the external environment 30 and fed back to the sensory device 21. For example, hand movement is recognized by the patient's own vision and fed back to the brain.
The sense recognized by the primary sensory area function 14 from the sensory organ 21 is recognized by the cognitive function 12 and is further instructed to move from the state recognized by the planning function 13.

In conventional mirror therapy, mimic therapy, repetitive therapy, and TMS therapy, only the vicinity of the primary sensory area 14, primary motor area 15, sensory organ 21, or motor organ 22 shown in FIG. Expression 11 was not considered actively.
Therefore, when considering such a patient's sensorimotor system and body model in the brain, mirror therapy and imitation therapy mainly eliminate inconsistencies between the primary sensory cortex function 14 and the primary motor cortex function 15. The repetitive therapy is mainly a rehabilitation in which the sensation with the sensory organ 21 can be correctly performed. In addition, the TMS treatment method was mainly considered to be a rehabilitation that improves the primary motor area function 15.

  Thus, even in the therapy for improving the motor function of the patient's limbs, the brain functions that can be expected to improve with each therapy are different. Therefore, in order to advance treatment effectively, it is necessary to combine each therapy appropriately. However, at present, the medical institutions that have developed each therapy are in a situation where each therapy is performed individually, and in order to improve the patient's motor function, an appropriate therapy can be selected according to the patient's condition. It could not be said that the selection was made.

  An object of the present invention is to provide a rehabilitation support device and a rehabilitation support method that can effectively perform rehabilitation for relieving pain such as phantom limb pain or paralysis due to cerebral infarction or the like.

A rehabilitation support device according to the present invention includes a motion detection unit that detects a body motion of a patient who performs rehabilitation, an arithmetic processing unit that virtually generates a body representation in the brain, an image generation unit, and a display unit. .
The arithmetic processing unit contemplates the body movement required in the rehabilitation, and recognizes the body movement detected by the movement detecting unit, thereby virtually generating a body representation in the brain. The image generation unit images the body state determined by the body expression generated by the arithmetic processing unit. The display unit displays the image generated by the image generation unit. In addition, the body representation in the brain indicates the body parameters described by the equation of motion as shown in FIG. 4, the back connection state, and the dynamics thereof.

The rehabilitation support method of the present invention includes a motion detection process of a patient who performs rehabilitation, a virtual body expression generation process that virtually generates a body expression in the brain, and an image process that presents an image to the patient.
The virtual body expression generation process contemplates the body movement required in the rehabilitation, and recognizes the body movement detected by the movement detection process, thereby virtually generating a body expression in the brain. In the image processing, the body state determined by the body representation generated by the virtual body representation generation processing is imaged and presented to the patient.

According to the present invention, the body expression in the patient's brain is estimated by arithmetic processing, the estimated body expression is imaged and presented to the patient, and the patient's own motion is determined by judging the degree of pain of the patient himself / herself. Rehabilitation can be performed while taking into account the influence of the intent on the body expression in the brain. For this reason, for example, it is possible to perform advanced rehabilitation in which the exercise state is changed step by step while confirming the influence of the currently performed rehabilitation in the patient's brain.
Specifically, for example, a patient having phantom limb pain can be rehabilitated so that the physical expression in the patient's brain does not match the actual limb state.
In addition, rehabilitation for gradually recovering the function of the paralyzed brain is possible for a patient with paralysis due to cerebral infarction or the like.

It is a figure which shows the example of the system model by one embodiment of this invention. It is a figure which shows the example of the execution condition of the rehabilitation by one embodiment of this invention. It is a block diagram which shows the example of an apparatus by one embodiment of this invention. It is a figure which shows the example of the model of the body representation in a brain by one embodiment of this invention. It is a figure which shows the example of the equation of motion corresponding to the body representation in the brain by one embodiment of this invention. It is a flowchart which shows the example of the execution procedure of the rehabilitation by one embodiment of this invention. It is a flowchart which shows the example of the procedure which judges the progress state of rehabilitation by one embodiment of this invention. It is a figure which shows the example of the influence which various rehabilitation has on a brain.

[1. Example of system model]
FIG. 1 shows a system model of a rehabilitation support apparatus according to an embodiment of the present invention (hereinafter referred to as “this example”). In FIG. 1, the right half shows an actual patient's sensory-motor system and brain body representation model (real system), and the left half shows a virtual avatar sensori-motor system and brain body representation model realized by the system of this example. (Virtual system).
As shown in FIG. 1, in this example, the patient wears a head-mounted display 131 on the head. The patient can see the image presented on the head mounted display 131. Note that the patient cannot see the actual situation around the patient when the head-mounted display 131 is attached. In other words, the patient recognizes that the image presented on the head mounted display 131 is a state around the patient or a physical state of the patient.
Then, the motion measuring instrument 132 measures the movement of the body of the patient wearing the head mounted display 131.

  The patient's actual sensorimotor system and brain body representation model recognize the environment 30 based on the image presented via the head-mounted display 131 with the sensory device 21 included in the body 20. The sensory organ 21 here is visual. Information obtained by the visual sensory organ 21 is transmitted to the sensory area 14 in the brain 10 of the patient. Among the information transmitted to the sensory area 14, the brain body representation 11 is formed from the information indicating the state of the patient's own body. For example, when the state in which the left hand is raised is recognized by the sensory organ 21, the body representation 11 in the brain formed by the brain 10 is a body representation in a state in which the left hand is raised.

The body representation 11 in the brain includes a cognitive function 12 that recognizes information from the sensory area 14, and a body conscious function 16 that determines how the patient's own brain moves the body recognized by the cognitive function 12. And an intention function 13 for instructing to move the limbs of the body by the body consciousness function 16. The body consciousness function 16 has a body holding feeling and an exercise subject feeling.
Then, when the movement of the limb is transmitted from the body consciousness function 16 to the brain body representation 11 via the planning function 13, the body representation 11 in the brain transmits the state of motion to the motor area 15. In the brain, the body representation 11 in the brain and the body consciousness function 16 transmit information so that they are consistent with each other. Information transmission between the body representation 11 in the brain and the body consciousness function 16 is relatively slow information transmission.

  The motor area 15 in the brain 10 transmits movement to the exerciser 22 of the body 20. For example, when moving the hand, a signal is sent to the nerve that moves the muscles of the hand. The sensory area 14 and the motor area 15 in the brain transmit information to ensure consistency. Information transmission between the sensory area 14 and the motor area 15 is relatively high-speed information transmission.

Next, a virtual sensory motor system and a body representation model in the brain constructed by the rehabilitation support device of this example shown on the left side of FIG. 1 will be described.
This virtual sensorimotor system and body representation model in the brain are composed of a brain model 110, a body model 120, and a virtual environment 130. The virtual environment 130 includes a head mounted display 131, an operation measuring instrument 132, and an electrode 133.
The body model 120 includes a sensory device 121 and an exercise device 122. The sensory device 121 corresponds to a processing unit that determines the movement of each part of the body measured by the motion measuring device 132, and the exercise device 122 corresponds to an image generation processing unit supplied to the head mounted display 131. In addition, the electrode 133 detects a signal transmitted through the nerve of the patient, and the detection signal is fed back to the brain model 110 side. The electrode 133 detects a signal of a nerve connected to the phantom limb when, for example, rehabilitation for relieving phantom limb pain is performed. In the case of a patient whose motor function is paralyzed, the electrode 133 detects a signal of a nerve connected to a limb whose motor function is paralyzed.

The movement of the patient's body detected by the sensory device 121 is transmitted to the sensory area 114 of the brain model 110. Information on the movement of the patient's body detected by the sensory area 114 is transmitted to the body representation 111 in the brain. The brain body representation 111 includes a brain body representation 111, a cognitive function 112, an intention function 113, and a body consciousness function 116, as in the actual brain 10.
The body representation 111 in the brain tells the motor area 115 the state of exercise. Information from the motor area 115 is transmitted to the exerciser 122 of the body model 120. Here, the exerciser 122 corresponds to a processing unit that generates an image in a state in which the body has performed an instructed exercise.

  Then, the image generated by the exerciser 122 is transmitted to the head mounted display 131 provided in the virtual environment 130, and an image showing the movement of the body is displayed on the head mounted display 131.

Using the system model shown in FIG. 1, the patient wearing the head-mounted display 131 imitates the body movement presented by the image on the head-mounted display 131, so that the actual brain body representation of the patient can be obtained. 11 coincides with the body representation 111 in the brain of the brain model 110 of the rehabilitation support apparatus.
Here, as described with reference to FIG. 8 in the section [Means for Solving the Problem], in the case of a patient having pain such as phantom limb pain or paralysis due to cerebral infarction, the patient's brain 10 It is assumed that these functions do not match the functions indicated by the brain model 110 of the rehabilitation support apparatus. For this reason, by performing rehabilitation for the patient, each function in the patient's brain 10 is brought close to each function indicated by the brain model 110 to relieve phantom limb pain and improve function paralysis.

In the case of this example, the patient performs rehabilitation by watching the image presented by the head mounted display 131 and following the movement of the limb shown in the image, and the patient moving the limb. Here, when the patient who performs rehabilitation is a patient with phantom limb pain, it is assumed that the phantom limb also exists as an image presented to the patient on the head mounted display 131.
The rehabilitation support device of this example has a motion in the operation mode as the motion of the limbs by the image presented to the patient. And based on progress of rehabilitation, the image of the several operation mode is switched and the rehabilitation content (therapy) is switched. Details of the switching of the images in the plurality of operation modes will be described later.

[2. Example of rehabilitation execution status]
FIG. 2 shows an example of a state in which the patient performs rehabilitation.
The rehabilitation support device includes a computer device 100 and peripheral devices connected to the computer device 100. That is, the computer apparatus 100 performs processing for creating the virtual sensory motor system and the brain model 110 as the body representation model in the brain shown in FIG. The computer apparatus 100 includes an input unit 101 including a keyboard and a display unit 102.
An operator (doctor, therapist, etc.) instructing the execution of rehabilitation operates the input unit 101 to set the operation mode and the like, and the display on the display unit 102 can confirm the execution status of the rehabilitation. it can.

The patient wears the head mounted display 131 on the head. A motion measuring instrument 132 is placed on the front of the patient. The motion measuring instrument 132 images the patient and detects the movement of the patient's body (limbs, trunk, etc.) from the captured image.
An electrode 133 is attached to a part of the patient's body. Although only one electrode 133 is shown in FIG. 2, a plurality of electrodes may be attached to the patient. In the example of FIG. 2, an example of a patient without a right hand is shown, and rehabilitation is performed by moving the left hand HL. In this case, the electrode 133 is attached to a position (such as the right shoulder) where the signal of the nerve connected to the right hand can be detected.

  The head mounted display 131, the motion measuring instrument 132 and the electrode 133 are connected to the computer apparatus 100 via the interface unit 103.

[3. Example of device configuration]
FIG. 3 shows an example of the configuration of the computer apparatus 100 and its peripheral devices.
The computer apparatus 100 includes a central processing unit 104, a work memory 105 connected to the central processing unit 104, a storage unit 106 such as a hard disk, and an image generation unit 107, each of which is an internal bus line. It is connected. Then, the central processing unit 104 executes the program stored in the storage unit 106, whereby rehabilitation support processing is performed. In this case, the above-described virtual sensorimotor system and intracerebral body representation model are formed in the work memory 105 by the arithmetic processing by the central arithmetic processing unit 104. Data such as parameters necessary for generating the virtual sensory motor system and the body representation model in the brain are stored in the storage unit 106. The storage unit 106 stores data that determines the content of rehabilitation to be performed.

The motion measuring instrument 132 includes a camera 132a and an image analysis unit 132b, and the image analysis unit 132b detects the movement of the patient's body from the image captured by the camera 132a. Information on the detected body movement is transmitted to the central processing unit 104. Information about the signal detection status at the electrode 133 is also transmitted to the central processing unit 104.
Then, the central processing unit 104 instructs the image generation unit 107 to generate an image to be presented to the patient, and an image (moving image) created by the image generation unit 107 is supplied to the head mounted display 131.

[4. Example of model for body expression]
FIG. 4 shows an example of a model of body representation in the brain.
When the computer apparatus 100 forms the brain model 110, for example, as shown in FIG. 4, a model conforming to the actual brain configuration is formed. Specifically, the cerebellum, primary motor cortex (4 fields), upper parietal lobe (5 fields), premotor cortex (6 fields), inferior parietal lobes (7 fields), and spinal motor circuit Form.
The cerebellum predicts the body state using an internal order model and generates motion signals using an internal inverse model.
The lower parietal lobe (seven fields) performs coordinate conversion from the retinal coordinate system to the body coordinate system. In this example, conversion from the coordinate system detected by the motion measuring instrument 132 to the image coordinate system is performed. Done.
The upper parietal lobe (5 fields) integrates multisensory and constitutes the body representation in the brain by optimal Bayesian estimation.
The pre-motion area (six fields) expresses the position, speed, and acceleration of each part of the body in the body coordinate system.
The primary motor area (four fields) represents a vector outer product representation of the body coordinate system.
The spinal motor circuit calculates muscle tension based on the sum of vector cross products.

FIG. 5 shows an example of a specific equation of motion. In this equation of motion, X is the arm position as seen in the human eye coordinate system. A is the acceleration of the arm as seen in the human eye coordinate system. I and r are parameters that determine the motion characteristics. τ is the joint torque.
As shown in FIG. 5, the joint torque is calculated from the position of the upper arm, the position of the forearm, the position of the hand, the position of the wrist, the position of the wrist, and the position of the hand as viewed from the connection point of the forearm of the upper arm. The equation of motion indicated by τ ₁ and τ ₂ is determined.
The equation of motion in FIG. 5 is an example, and another equation of motion may be used.
By using such an equation of motion, the intracerebral body representation 111 of the brain model 110 represents the current motion state of the limb as a mathematical model. Then, the image generation unit 107 generates an image reflecting the state and movement of the body expressed by the body representation 111 in the brain, and the head mounted display 131 displays the image.

[5. Example of rehabilitation procedure]
FIG. 6 is a flowchart illustrating an example of a rehabilitation execution procedure using the rehabilitation support device of this example. The example of FIG. 6 is an example of a rehabilitation procedure for a patient with phantom limb pain.
First, the operator determines the content of the rehabilitation operation (step S11). The content of the rehabilitation operation is selected from those prepared in the database stored in the storage unit 106 in the computer device 100. For example, the prepared action content is to move the lost hand (phantom limb) and the remaining other hand in the same way, or to move one hand (phantom limb) and the other hand alternately. And one hand (phantom limb) and the other hand are in front of the body and turn around each other.
Moreover, when determining the operation | movement which performs rehabilitation, a required parameter is acquired. For example, parameters such as a patient's rehabilitation history and progress are acquired.
Note that the content of the rehabilitation operation in step S11 may be determined by the central processing unit 104 of the computer device 100 automatically selecting an appropriate one based on the past rehabilitation history and progress. .

  When the content of the rehabilitation operation is determined in step S11, the operator gives the patient a task that matches the operation content and causes the patient to perform an operation of moving the limb. For example, give a task such as “Please hold a tray with your left and right hands” or “Use the hand-rolling song to wind a spool and turn your left and right hands.” In the case of this example, an image corresponding to such a problem is not prepared in advance, but a corresponding image is generated by the patient performing the movement indicated as the problem as described below. It is what is done.

  Next, the motion measuring instrument 132 detects the current motion of the patient's limb (step S12). When the motion state of the patient's current limb is detected, the brain model 110 formed by the computer device 100 performs a body representation that combines the motion state of the phantom limb (affected limb) with the current motion state of the limb. Then, the image generation unit 107 generates an image indicating the body expression, and the head mounted display 131 displays an image in which the movement of the phantom limb is combined with the actual movement of the limb (step S13). Here, when the patient is moving to execute the given task, an image for executing the given task is displayed. The speed at which the limbs move in the image at this time also follows the actual movement.

  The motion measuring instrument 132 detects the current motion of the patient's limb while displaying the synthesized image as described above, and the central processing unit 104 of the computer device 100 determines the signal of the electrode 133 (step S14). ). Based on these detection states, the central processing unit 104 evaluates the patient state (step S15). The evaluation here is performed, for example, based on the speed of movement of the limbs actually performed by the patient. Further, based on the detection state at the electrode 133, whether or not a signal is sent from the patient's brain to the phantom limb is added to the evaluation.

  Then, the central processing unit 104 of the computer device 100 determines the progress of rehabilitation based on the type of image displayed for rehabilitation and the state of the patient detected by the display of the image (step S16). ). An example of processing for determining the progress of rehabilitation will be described later.

  Then, the central processing unit 104 of the computer device 100 determines whether or not it is necessary to change the content of the rehabilitation from the progress state determined in step S16 (step S17). Specifically, when the rehabilitation progress is smooth, the current rehabilitation content is continued. Further, if the progress of rehabilitation is not smooth and the difference between the movement shown in the image and the movement of the actual patient is large, it is determined that the current rehabilitation content needs to be changed. Further, when it is determined that the progress of rehabilitation is smooth and it is necessary to proceed to rehabilitation with a high degree of difficulty, it is determined that the content of the rehabilitation needs to be changed.

  If it is determined in step S17 that the rehabilitation content needs to be changed, the process returns to step S11, and the rehabilitation operation is selected by the operator, or automatic selection is performed by the central processing unit 104 of the computer apparatus 100. At this time, even when the operator manually selects the rehabilitation operation, the central processing unit 104 may display the motion candidates on the display unit 102.

  When it is determined in step S17 that it is not necessary to change the contents of the rehabilitation, the central processing unit 104 of the computer device 100 determines whether the rehabilitation is continued or completed (step S18). If it is determined that the process is complete, the process ends. If the rehabilitation is continued, the process returns to step S12.

[6. Example of rehabilitation progress determination process]
An example of determining the progress of rehabilitation will be described. At this time, for example, an image for performing a steady operation as a reference is presented to the patient, and the progress of rehabilitation is determined from the state of the patient viewing the image.
FIG. 7 is a flowchart showing the flow of processing in this case.
First, the central processing unit 104 of the computer apparatus 100 instructs the image generation unit 107 to create an image in which the limb moves at a constant speed (step S21). And a patient is image | photographed using the motion measuring device 132, and a motion of a patient's limb is measured (step S22). Moreover, the state of a patient's brain is detected by a brain imaging method. As the detection by the brain imaging method, for example, a process of obtaining a brain image by a magnetic resonance image or a neuroprojection drawing method by a diffusion tensor method is performed, and a state in the brain is determined from a signal detected by the electrode 133. It may be.

When the patient's motion is measured in step S22, the central processing unit 104 of the computer device 100 detects a speed difference between the motion presented by the image and the motion performed by the patient (step S24). Also, the motion control parameter is identified (step S25).
Then, using the speed difference detected in step S24, the state in the brain detected in step S23, and the motion control parameter identified in step S25, the central processing unit 104 of the computer device 100 uses the patient parameters. Update processing is performed (step S26). The storage unit 106 registers (stores) the updated parameter as a corresponding patient parameter (step S27).

[7. Effects according to example of embodiment]
As described above, by using the rehabilitation support apparatus of this example, rehabilitation of a patient with phantom limb pain can be performed efficiently. Specifically, advanced rehabilitation that changes the motor state step by step while confirming the impact of the current rehabilitation in the patient's brain using a virtual body substrate model. It becomes possible.
The image presented to the patient is not an image of the motion prepared in advance, but an image generated after detecting the motion executed after instructing the patient, which is different from conventional mirror therapy and imitation therapy, More effective rehabilitation is possible.
For example, for a patient with phantom limb pain, first instruct the left and right limbs to move slowly in the same way, then move the limbs slowly or turn the left and right limbs together Thus, optimal rehabilitation is possible at each stage.

  Further, for example, in the case of treatment by slowly moving the left and right limbs in the same manner, the rehabilitation eliminates inconsistency between the sensory area 14 and the motor area 15 of the patient's brain 10 and is more advanced. In the case of treatment by movement, it can be said that the rehabilitation is such that recognition in the body representation 11 in the brain is correct. Therefore, according to the rehabilitation support device of this example, more advanced rehabilitation can be performed in addition to temporary pain relief.

In the rehabilitation execution state shown in FIG. 2, an example of moving the hand is shown. However, as rehabilitation, an instruction to move the hand and the foot cooperatively is given, for example, the movement of both the hand and the foot is measured. Then, an image based on both the measured movements may be presented to the patient. In this case, an operation for coordinating both hands and feet is required from the patient, and more advanced rehabilitation can be performed.
Further, not only the movement of the limbs but also the movement of the trunk may be measured and displayed in the same manner. By performing rehabilitation of the trunk, for example, rehabilitation for an abnormal gravity felt by the trunk is also possible.

In the above description, the case of performing rehabilitation of a patient with phantom limb pain is taken as an example. However, the rehabilitation support apparatus of this example may perform rehabilitation affected by other brains.
For example, rehabilitation for a patient who has paralysis due to sequelae such as cerebral infarction can be performed by the rehabilitation support apparatus of this example. In the case of patients who have paralysis due to sequelae such as cerebral infarction, it is confirmed by the virtual physical substrate model what kind of body expression state is in the brain by repeating the instructed movement by the patient. However, rehabilitation can be performed, and very efficient rehabilitation can be performed. In this case, for example, a coil may be attached to the patient's head, and a TMS treatment method for activating the brain may be performed simultaneously with other therapies.

[8. Modified example]
In the example of the embodiment described above, the motion measuring instrument 132 includes a camera, and the movement is measured from an image captured by the camera. On the other hand, for example, a sensor for detecting motion may be attached to the patient's body, and a motion detection unit that performs motion detection processing based on the sensor may be used.
In the example of the embodiment described above, the electrode 133 is attached to the patient, and a signal sent from the brain to the limb is detected by the electrode 133, and the state of the patient's brain is detected from the signal detected by the electrode 133. Judgment was made. You may make it perform rehabilitation, without using this electrode 133. FIG.
In addition, the virtual body expression generation process described in the example of the embodiment described above is one example, and other virtual body expression models may be applied.
Furthermore, in the above-described embodiment, the rehabilitation support device is configured by a computer device and its peripheral devices, and software (program) installed in the computer device executes the process for supporting rehabilitation described in the embodiment. I did it. On the other hand, you may comprise as a dedicated rehabilitation assistance apparatus provided with each process part.

  DESCRIPTION OF SYMBOLS 10 ... Brain, 11 ... Body expression in brain, 12 ... Cognitive function, 13 ... Intention function, 14 ... Sensory area, 15 ... Motor area, 16 ... Body consciousness function, 20 ... Body, 21 ... Sensory organ, 22 ... Motor organ , 30 ... environment, 100 ... computer device, 101 ... input unit, 102 ... display unit, 103 ... interface unit, 104 ... central processing unit, 105 ... work memory, 106 ... storage unit, 107 ... image generation unit, 110 ... Brain model, 111 ... body expression in brain, 112 ... cognitive function, 113 ... planning function, 114 ... sensory area, 115 ... motor area, 116 ... body consciousness function, 120 ... body model, 121 ... sensory organ, 122 ... motor organ , 130 ... Virtual environment, 131 ... Head mounted display, 132 ... Motion measuring instrument, 132a ... Camera, 132b ... Image analysis unit, 133 ... Electrode

Claims (6)

A motion detector for detecting the motion of the patient's body performing rehabilitation;
An arithmetic processing unit that contemplates the body movement required in rehabilitation and recognizes the body movement detected by the movement detection unit, thereby virtually generating a body representation in the brain;
An image generation unit that images the state of the body determined by the body representation generated by the arithmetic processing unit;
A rehabilitation support apparatus comprising: a display unit that displays an image generated by the image generation unit. The arithmetic processing unit virtually generates a body representation including a movement of a body part lost by a patient who performs rehabilitation, and the image generation unit includes a body state including a body part lost by the patient. The rehabilitation support apparatus according to claim 1. The arithmetic processing unit calculates a deviation between the body movement detected by the movement detection unit and the body movement in the image generated by the image generation unit, and the rehabilitation progress state based on the calculated degree of deviation The rehabilitation support apparatus according to claim 1 or 2. The rehabilitation support apparatus according to claim 3, wherein the body movement requested of the patient is determined based on the determination of the progress of the rehabilitation. A sensor that detects a state of a nerve that connects the brain with a real or nonexistent body part that performs rehabilitation of the patient;
The rehabilitation support apparatus according to any one of claims 1 to 4, wherein the arithmetic processing unit corrects a body expression that is virtually generated based on a detection state of the sensor. A motion detection process for detecting the motion of the body of the patient performing the rehabilitation;
A virtual body expression generation process that virtually generates a body expression in the brain by recognizing the body movement detected by the movement detection process, while contemplating the body movement required in rehabilitation,
A rehabilitation support method comprising: image processing for generating an image to be presented to a patient by imaging a body state determined by the body representation generated by the virtual body representation generation processing.

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