JP2015062487A - Electrostimulator - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an electrostimulator capable of applying electric stimulation according to a swallowing intention of a living body of a patient with swallowing dysfunction and the like, which is excellent in user-friendliness and cost performance.SOLUTION: An electrostimulator includes: an electric stimulation part for applying electric stimulation to a muscle of a living body to induce a swallowing motion; a detection element disposed along a skin of the living body for detecting a shape change of the skin; an electric pulse generation part connected to the electric stimulation part and the detection element for applying an electric pulse for electric stimulation to the electric stimulation part based on the shape change of the skin detected by the detection element.

Description

  The present invention relates to an electrical stimulation device, and in particular, it is intended to advantageously provide electrical stimulation according to the intention of swallowing a living body such as a patient with swallowing dysfunction.

  It is clear from many prior documents that it is possible to promote recovery of a patient's swallowing function by applying electrical stimulation to the neck of a patient with swallowing dysfunction caused by a stroke or the like. For example, the electrical stimulation apparatus described in Patent Document 1 includes two sets of channels each having a pair of pair electrodes for applying an electrical pulse as a current to a patient. And according to this electrical stimulation apparatus, the electrical stimulation part of one electrode of a pair of pair electrodes is attached to the position which stimulates the movement point of a patient's cheek muscle, and the electrical stimulation part of the other electrode is attached to a patient. It is said that swallowing dysfunction can be treated by applying an electrical pulse while attached to a position that stimulates the cervical paraspinal muscle. Moreover, in patent document 2, a swallowing dysfunction can be treated by stimulating the superior laryngeal nerve existing deeply by interfering medium-frequency electrical stimulation using two pairs of paired electrodes crossed with respect to the neck. It is said that.

  In addition, in order to effectively restore the swallowing function using such an electrical stimulation device, when assisting swallowing muscle movement by electrical stimulation, synchronize the muscle movement with the patient's intention to swallow. Is also known to be important. However, in the conventional electrical stimulation apparatuses as described in Patent Documents 1 and 2, it is difficult to match the patient's intention to swallow and the electrical stimulation timing because the electrical pulse is applied at a preprogrammed timing. there were.

  Therefore, in recent years, a method of estimating the patient's intention of swallowing by detecting myoelectricity of the submandibular muscle and synchronizing the stimulation timing has been studied (in addition to the electrode for electrical stimulation used in the field of sports). As an example of installing a myoelectric detection element, see Patent Document 3). However, when such a method for detecting myoelectricity is adopted, since there is a large individual difference in the decrease in myoelectric output due to disuse of the submandibular muscle, the setting of sensor sensitivity tailored to the individual, Eliminating induced myoelectric noise is also necessary, and it has been difficult to provide an electrical stimulation device that is excellent in usability and cost performance.

Special table 2009-522059 gazette Japanese Patent No. 4526472 JP 2001-170190 A

  The present invention has been developed in view of the above-mentioned present situation, and can provide an electrical stimulation device that can provide electrical stimulation according to the intention of swallowing a living body such as a patient with dysphagia and has excellent usability and cost performance. Objective.

  The electrical stimulation device of the present invention includes an electrical stimulation unit that induces a swallowing motion by applying electrical stimulation to a muscle of a living body, a detection element that is disposed along the skin of the living body, and detects a change in shape of the skin, An electrical pulse generator connected to the electrical stimulation unit and the detection element, and applying an electrical pulse for electrical stimulation to the electrical stimulation unit based on a change in the shape of the skin detected by the detection element; To do.

  Here, in the electrical stimulation device of the present invention, it is preferable that the electrical pulse generation unit starts applying an electrical pulse to the electrical stimulation unit based on a change in the shape of the skin detected by the detection element.

  In the electrical stimulation device of the present invention, it is preferable that the electrical stimulation unit is attached to the skin of the living body and the detection element is fixed.

  In the electrical stimulation device of the present invention, it is preferable that the detection element is in contact with the skin of the living body directly or via an insulating material.

Moreover, it is preferable that the electrical stimulation apparatus of this invention is further equipped with the soft member which is located in the upper side or both upper and lower sides of the said detection element, and is in contact with the said detection element.
Here, “the upper side of the detection element” means the side opposite to the skin of the detection element in a state where the detection element is arranged along the skin of the living body, and the lower side of the detection element means such a state. Means the skin side of the detection element.

  In the electrical stimulation device according to the present invention, the electrical stimulation unit may include two electrical stimulation units attached to the skin of the living body, and the detection element may be stretched between the electrical stimulation units. preferable.

  Further, in the electrical stimulation device of the present invention, the electrical stimulation unit attached to the skin of the living body has an opening or a notch, and between the two regions facing each other with the opening or the notch interposed therebetween, The detection element is preferably stretched.

  Furthermore, in the electrical stimulation device of the present invention, it is preferable that the detection element is disposed along the cheek surface of the living body and detects a shape change of the cheek surface.

  In addition, the following can be considered as a method which can give an electrical stimulus advantageously according to the swallowing intention of living bodies, such as a swallowing functional disorder patient.

In a method of treating swallowing dysfunction by applying electrical stimulation to muscles of a living body,
A detection step of detecting a change in the shape of the skin of the living body;
An electrical stimulation step of inducing a swallowing motion by applying electrical stimulation to the muscle of the living body based on the detected shape change of the skin.

  According to the present invention, based on a change in the shape of the skin of the living body detected by the detection element, an electrical pulse for electrical stimulation is applied from the electrical pulse generation unit to the electrical stimulation unit, and the electrical muscle is electrically supplied from the electrical stimulation unit to the biological muscle. By giving a stimulus, swallowing movement can be induced. Therefore, according to the present invention, it is possible to provide an electrical stimulation device that can provide electrical stimulation according to the intention of swallowing a living body such as a patient with dysphagia and is excellent in usability and cost performance.

It is an external view which shows the electrical stimulation apparatus which concerns on one Embodiment of this invention. FIG. 2 is a half cross-sectional side view of a detection element fixed electrode provided in the electrical stimulation device of FIG. 1. It is a figure which shows the detection element fixed electrode with which the electrical stimulation apparatus which concerns on other embodiment of this invention is provided, (a) is a top view, (b) is a half cross section shown along the AA line of (a). It is a side view. It is a figure which shows the detection element fixed electrode with which the electrical stimulation apparatus which concerns on further another embodiment of this invention is equipped, (a) is a top view, (b) is the half shown along the BB line of (a). It is a cross-sectional side view. It is a side view which shows the point which arrange | positions the detection element fixed electrode of FIG. 4 on the cheek surface of a biological body.

Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.
First, an electrical stimulation device according to an embodiment of the present invention will be described with reference to FIGS.

  As illustrated in FIG. 1, the electrical stimulation device 1 according to the present embodiment includes two pairs of electrodes 20, a detection element 30, an electrical pulse generator 40, and a wiring 50. The wiring 50 connects between the pair electrode 20 and the electric pulse generator 40 and between the detection element 30 and the electric pulse generator 40. In the present embodiment, the pair electrode 20 includes a detection element fixed electrode 21 to which the detection element 30 is fixed and a detection element fixed electrode 21 except that the detection element 30 is not provided. The electrode 22 has the same configuration. Each of the detection element fixed electrode 21 and the electrode 22 has an electrical stimulation unit E (see FIG. 2 described later) that applies electrical stimulation to muscles of a living body to induce swallowing movement.

  In the present embodiment, two pairs of electrode pairs 20 are provided, but only one set may be provided, or three or more sets may be provided. Further, all the pair electrodes 20 included in the electrical stimulation device 1 may be configured by the detection element fixed electrodes 21.

  As will be described later with reference to FIG. 2, the detection element 30 is arranged along the skin S of the living body, and is composed of, for example, a piezoelectric element or a strain gauge so that a change in the shape of the skin S can be detected.

  The electrical pulse generator 40 is connected to the pair electrode 20 and the detection element 30 by the wiring 50 as described above, and the electrical pulse for electrical stimulation is applied to the pair electrode 20 based on the skin shape change detected by the detection element 30. More preferably, the application of the electric pulse is started. Specifically, an oscillation unit (not shown) that oscillates such an electrical pulse is disposed inside the electrical pulse generation unit 40.

  In addition, the electric pulse generator 40 may be provided with a power supply unit (not shown), an input unit 41, a display unit 42, a control unit (not shown), and an amplification unit (not shown). The power supply unit is made of, for example, a secondary battery and supplies power to the oscillation unit of the electric pulse generation unit 40, the display unit 42, and the like. The input unit 41 is provided with a switch for performing various operations and a switch for performing various settings including, for example, a switch for turning on / off a power supply for electrical stimulation. When the user of the electrical stimulation device 1 presses a switch of the input unit 41, a signal corresponding to the switch is output from the input unit 41, and each output signal is input to the control unit.

  And a control part performs the process according to the signal. The display unit 42 displays various setting values input through the input unit 41, for example, so that the user of the electrical stimulation device 1 can check the setting contents. The amplifying unit is located between the oscillating unit and the pair electrode 20, and amplifies the electrical stimulation current oscillated by the oscillating unit. An electric pulse having appropriate power can be given to the living body by the amplification in the amplifying unit.

  As shown in FIGS. 1 and 2, the detection element fixed electrode 21 has a substantially disc shape, and includes a conductive pressure-sensitive adhesive sheet 23 whose back side is adhered to the skin S of a living body, and a conductive pressure-sensitive adhesive sheet 23. An electrically conductive sheet 24 made of, for example, a carbon sheet bonded to the front surface side, for example, and an insulating sheet 25 (insulating material) made of, for example, a nonwoven fabric, bonded to the surface side of the electrically conductive sheet 24, for example, The sheet 25 has a sheet-like detection element 30 made of, for example, a piezoelectric element, which is joined to the front surface side of the sheet 25. In this embodiment, one electrical stimulation part E is comprised by the conductive adhesive sheet 23 and the conductive sheet 24 which were mentioned above.

  A convex terminal 26 is connected to the center of the surface side of the conductive sheet 24 through an opening formed in the center of the insulating sheet 25. A concave terminal 27 is connected to the tip of the convex terminal 26 by fitting, and a substantially disc-shaped stopper piece 28 is joined to the base end of the concave terminal 27. In addition, one end of a conductive wire 50 a for electrical stimulation disposed in the wiring 50 is connected to the base end of the concave terminal 27 through an opening formed in the center of the stopper piece 28.

  A substantially disk-shaped casing 29 is provided on the surface side of the detection element 30 so as to cover the detection element 30 with a gap between the detection element 30 and the detection element 30. One end of a detection lead wire 50 b arranged in the wiring 50 is connected to the surface side of the detection element 30 through an opening formed in the casing 29.

  The conductive adhesive sheet 23 is an adhesive member, for example, a conductive polymer gel, an electrolyte, or a conductive substance so that the detection element fixed electrode 21 can be attached to the skin S of the living body. It is formed with hydrogel or sol containing. Hydrogels and sols include, for example, poly (amidoamine), poly (dimethylsiloxane), poly (hydroxyethyl methacrylate), poly (N-isopropylacrylamide), poly (acrylamide), poly (acrylic acid), and poly (methacrylic). Acid), polyurethane, poly (ethylene glycol), poly (ethylene glycol monomethacrylate), poly (methacrylic acid) -co-poly (ethylene glycol), poly (vinyl alcohol), poly (vinyl-pyrrolidone), poly (acrylamide) , Poly (aminopropyl methacrylate), poly (N, N-dimethyl-2-aminoethyl methacrylate) or copolymers thereof, block copolymers, graft copolymers, and heteropolymers thereof, or combinations thereof Comprising at least one polymer al selected.

  According to this configuration, the detection element 30 can detect a change in the shape of the skin S of the living body by attaching the detection element fixed electrode 21 to the skin S of the living body. Then, based on the change in the shape of the skin S of the living body detected in this way, the electrical pulse generation unit 40 supplies electrical power for electrical stimulation to the detection element fixed electrode 21 of the pair electrode 20 and the electrical stimulation unit E of the electrode 22. Pulses can be applied, and electrical stimulation can be applied to living body muscles to induce swallowing movements.

  More specifically, among the paired electrodes 20, the electrical stimulation part E of the detection element fixed electrode 21 is attached to a site where a shape change occurs along with the chewing movement on the skin of a living body such as the cheek surface. By sticking the electrical stimulation part E of the other electrode 22 to a part where the swallowing movement can be induced in cooperation with the detection element fixed electrode 21 such as a part where the cervical paraspinal muscle can be stimulated. In addition, it is possible to detect a movement of tightly tightening prior to swallowing as a change in the shape of the skin, and to induce a swallowing movement by applying electrical stimulation at a timing according to the swallowing intention of the living body. In particular, when the electrical stimulation part E of the detection element fixed electrode 21 is attached to the cheek surface, it is possible to detect distortion in the extending direction of the cheek surface when the living body bites tightly, so that the timing is more accurate. It becomes possible to give electrical stimulation.

Next, an electrical stimulation apparatus according to another embodiment of the present invention will be described with reference to FIG.
As shown in FIG. 3, the electrical stimulation apparatus (not shown) of this embodiment is different from the electrical stimulation apparatus 1 described with reference to FIGS. Point, the shape of the conductive adhesive sheet 23, the conductive sheet 24 and the insulating sheet 25 are different, the shape and arrangement of the detection element 30 are different, the convex terminal 26, the concave terminal 27 and the stopper piece. The configuration is the same except that two sets 28 are provided and the flexible member 60 is provided.

  In the present embodiment, the conductive adhesive sheet 23 and the conductive sheet 24 each have a substantially rectangular plate shape in which a rectangular opening is formed at the center. In the present embodiment, the conductive adhesive sheet 23 and the conductive sheet 24 constitute one electrical stimulation unit E that induces swallowing motion by applying electrical stimulation to the muscles of the living body.

  The insulating sheet 25 covers the conductive adhesive sheet 23 and the conductive sheet 24 including the opening formed in the center of the sheets 23 and 24, and the insulating sheet 25, the conductive adhesive sheet 23, At the contact portion with the conductive sheet 24, these sheets 23 and 24 are joined. On the back surface of the insulating sheet 25 excluding the joint portion between the conductive adhesive sheet 23 and the conductive sheet 24, an adhesive material (not shown) that exhibits an adhesive force with living body skin can be provided.

  A rectangular sheet-like detection element 30 is disposed on the surface side of the insulating sheet 25 at a portion located in the opening of the conductive adhesive sheet 23 and the conductive sheet 24. That is, the detection element 30 is in contact with the living body skin S through the insulating sheet 25. In addition, the soft member 60 is located on the upper side of the detection element 30, that is, on the surface side, and the soft member 60 is in contact with the detection element 30. As a material of the flexible member 60, for example, polyethylene, polypropylene, polystyrene, an ethylene vinyl acetate copolymer, a material made of polyurethane with appropriate plasticity, a foamed material, or the like can be used. The thing similar to the electroconductive adhesive sheet 23 can also be used.

  According to such a configuration, not only the same effect as in the case of the electrical stimulation device 1 described above with reference to FIGS. 1 to 2 is obtained, but also the detection element 30 is interposed only through the insulating sheet 25 (and the adhesive material). Thus, the skin S of the living body can be brought into contact with each other, so that an effect that the change in the shape of the skin can be detected more accurately can be obtained. In addition, since the soft member 60 is in contact with the upper side of the detection element 30, the detection element 30 can be fixed without a gap by the soft member 60. Therefore, the durability of the detection element fixed electrode 21 is improved, and thus the electrical stimulation device. Can increase the durability.

  Instead of such a configuration, the flexible member 60 may be positioned both above and below the detection element 30 and in contact with the detection element 30. In the case of such a configuration, it is possible to control the sensitivity of the detection element 30 by adjusting the thickness of the flexible member 60 located on the lower side of the detection element 30. Moreover, it can replace with the said structure and can also be set as the structure which removes the part located in the lower side of the detection element 30 of the insulating sheet 25, and makes the detection element 30 contact the skin S of a biological body directly.

Next, an electrical stimulation device according to still another embodiment of the present invention will be described with reference to FIG.
As shown in FIG. 4, the electrical stimulation device (not shown) of the present embodiment is different from the electrical stimulation device 1 of the example described with reference to FIG. 3, with the conductive adhesive sheet 23, the conductive sheet 24, and the insulating property. The configuration is the same except that the shape of the sheet 25 and the shape and arrangement of the detection elements 30 are different.

  In the present embodiment, the conductive adhesive sheet 23 includes two rectangular sheets 23a and 23b that are spaced apart from each other. Similarly, the conductive sheet 24 and the insulating sheet 25 are each composed of two rectangular sheets 24a and 24b and 25a and 25b that are spaced apart from each other. Both ends of the strip-shaped detection element 30 are joined to the surface sides of the two insulating sheets 25a and 25b that are separated from each other, and the detection element 30 maintains a non-contact state with the skin S of the living body.

  As described above, in this embodiment, the two electrical stimulation portions Ea, which are attached to the skin S of the living body by the two conductive adhesive sheets 23a, 23b and the two conductive sheets 24a, 24b as described above. Eb is configured. A detection element 30 is stretched between the two electrical stimulation units Ea and Eb.

  According to such a configuration, the same effect as in the case of the electrical stimulation device 1 described above with reference to FIG. 3 can be obtained. Moreover, while the vibration from the skin S toward the detection element 30 is attenuated by the electrical stimulation units Ea and Eb, a change in the shape of the living body skin S is detected through relative movement between the two electrical stimulation units Ea and Eb. Therefore, the effect that the shape change of the skin S can be detected more accurately can be obtained.

  In particular, as shown in FIG. 5, the detection element fixed electrode 21 is placed on the cheek surface of the living body in the direction in which the cheek surface expands and contracts with the chewing motion (in the direction of the arrow in FIG. 5), and the two electrical stimulation units Ea, When pasting so that the direction in which Eb is aligned coincides, the expansion and contraction movement of the cheek surface can be detected with high accuracy by the detection element 30, so that electrical stimulation can be given at a more accurate timing. It becomes possible.

  The above description shows only one embodiment of the present invention, and various modifications can be made within the scope of the claims. For example, in the example shown in FIG. 4, two electrical stimulation units Ea and Eb are provided, and the detection element 30 is stretched between the two electrical stimulation units Ea and Eb. For example, like the electrical stimulation unit E shown in FIG. 3, one electrical stimulation unit E having an opening can be provided, and the detection element 30 can be stretched between two regions facing each other across the opening. In this case, the same effect as in the example shown in FIG. 4 can be obtained. In this case, the same effect can be obtained even if a notch is provided instead of the opening.

  In the example illustrated in FIG. 3, the detection element 30 is disposed in the opening of the electrical stimulation unit E. However, a cutout may be provided instead of the opening, and the detection element 30 may be disposed in the cutout. . Alternatively, for example, like the electrical stimulation units Ea and Eb illustrated in FIG. 4, two electrical stimulation units Ea and Eb may be provided, and the detection element 30 may be disposed between the two electrical stimulation units Ea and Eb. In this case, the same effect as in the example shown in FIG. 3 can be obtained.

  Further, in each of the above-described examples, the casing 29 is provided with an opening, and the stopper piece 28 is configured to be retained and held in the opening. Instead of such a configuration, the entire casing 29 is configured by an elastic member, The electrical stimulation parts E, Ea, Eb may be projected directly from the back side of the elastic member. In this case, the conducting wires 50a and 50b and the detection element 30 can be embedded in the elastic member.

DESCRIPTION OF SYMBOLS 1 Electrical stimulator 20 Pair electrode 21 Detection element fixed electrode 22 Electrode 23, 23a, 23b Conductive adhesive sheet 24, 24a, 24b Conductive sheet 25, 25a, 25b Insulating sheet (insulating material)
26 convex terminal 27 concave terminal 28 stopper piece 29 casing 30 detection element 40 electric pulse generator 41 input unit 42 display unit 50 wiring 50a conductive wire 50b conductive wire 60 flexible member S skin E, Ea, Eb electrical stimulation unit

Claims (5)

An electrical stimulation unit that induces swallowing movement by applying electrical stimulation to muscles of the living body,
A detection element that is disposed along the skin of the living body and detects a change in the shape of the skin;
An electrical pulse generator connected to the electrical stimulation unit and the detection element, and applying an electrical pulse for electrical stimulation to the electrical stimulation unit based on a change in the shape of the skin detected by the detection element. An electrical stimulator.   The electrical stimulation device according to claim 1, wherein the electrical pulse generation unit starts applying an electrical pulse to the electrical stimulation unit based on a change in the shape of the skin detected by the detection element.   The electrical stimulation device according to claim 1, wherein the electrical stimulation unit is attached to the skin of the living body, and the detection element is fixed.   The electrical stimulation device according to claim 3, further comprising a soft member that is positioned above or both above and below the detection element and in contact with the detection element.   The electrical stimulation device according to any one of claims 1 to 4, wherein the detection element is disposed along a cheek surface of the living body and detects a shape change of the cheek surface.

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