JP2016049427A - Upper/lower extremity rehabilitation training device for motion function recovery - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a device for realizing a function at a low cost with compactness and high picture quality, the function including a rehabilitation training screen displaying a superimposed upper extremity of a patient himself/herself for enabling correction or feed back of a motion when a cooperation motion being a pathologic motion in apoplexy occurs, in order to solve a problem that an image of the upper extremity of the patient himself/herself is not displayed and only a position of a grip part is displayed on the rehabilitation training screen in many upper rehabilitation support systems using a vertical display.SOLUTION: As shown in Fig. 8, rehabilitation training is performed on a rehabilitation training table 23 including a surface in a chromakey background color or background pattern. An image is captured by an overhead image camera. The image obtained using a chromakey technique and image synthetic technique is displayed on a vertical display arranged in front of a patient. The patient performs rehabilitation training while observing the image and operating a grip part of a force sense presentation system.SELECTED DRAWING: Figure 8

Description

  The present invention relates to an upper limb / lower limb rehabilitation training apparatus having a high training effect used in medical and welfare fields such as rehabilitation and motor function recovery training.

  The total number of stroke patients in Japan is estimated to be about 1.4 million in Japan, and there is concern over further increases as the population ages and the survival rate improves. Many patients such as stroke have impaired motor function in their four limbs. Patients whose symptoms improve if they continue rehabilitation are not always able to receive sufficient treatment under the current medical and welfare rehabilitation environment, and daily life activities (ADL) are not becoming independent. .

  There are many reports that the plasticity of the brain depends on the frequency of use of the body part. To recover from paralysis, it is necessary to increase the spontaneous momentum of the paralyzed upper and lower limbs. However, due to the shortage of therapists, the upper and lower limb function training cannot be performed for a long time. Therefore, a self-training program may be implemented after training, but the training content is limited. On the other hand, the upper limb / lower limb rehabilitation support system using virtual reality technology has high game characteristics, allows various program settings, and allows easy long-time training (Patent Document 1, Patent Document 2, Patent) Document 3 and Patent document 4).

  In recent years, aggressive therapeutic intervention based on the premise of brain plasticity has also been performed for patients in the chronic stage. For example, clinical evaluation for stroke hemiplegic patients shows that re-learning of movement can be obtained by repeated reaching movement (reaching movement) or the like. However, there are problems with medical insurance and other systems, and rehabilitation at current medical institutions is not sufficient in terms of quantity (training time, hospitalization period, training period). In order to solve these problems, it is desired to develop a device capable of repeatedly training for a long time while maintaining motivation by incorporating quantitative display of training effects to patients, game elements, and the like.

  Stroke, which is said to be one in six Japanese, will become an increasingly serious social problem as the population ages. Stroke was once the leading cause of death, but is now the fourth leading cause of death due to the development of various treatment techniques. As a result, an increasing number of patients have sequelae of stroke. Many of them are impaired in motor function and generally become hemiplegic, which causes motor paralysis on one side of the body. The concept of stroke rehabilitation is changing globally as follows. Various rehabilitation devices incorporating computer systems have been found to be effective in rehabilitation, with recreational games and interactive equipment leading to improved performance. Only a small amount of inpatients are used for training and learning in one day, and semi-automated training using robotics and mechatronics technology enables easy long-term training. In addition, it is necessary to shift to difficult tasks step by step according to the ability of the trainer, and a comprehensive rehabilitation training support system that incorporates information technology is required.

  In the rehabilitation program at an early stage after the stroke, voluntary muscle contraction force of the lower limbs and control of the lower limb muscle groups are often insufficient. For such patients, it is necessary to spend time for exercise aimed at enhancing the activity of a specific muscle group, or for partial exercise, that is, exercise for constituting a walking exercise. Thus, there is a need for a rehabilitation training support system that can be developed into sitting, standing, standing and balance exercises, and walking exercises as the patient recovers.

  The US MIT upper limb rehabilitation device (Patent Document 1) was first put to practical use as an upper limb rehabilitation training device using robot technology. The main purpose of this device is to recover the motor function of patients with hemiplegia of the upper limb due to stroke, and the patient grasps the grip at the tip of the robot arm and follows his / her instructions on the display screen placed vertically in front of the patient. This device is based on the idea of neurorehabilitation, in which movement is re-learned by the plasticity of the brain while the upper limb is repeatedly moved with will. However, since the arm movement is driven by a direct drive motor, if there is a bug in the motor control software, training software, etc., or if there is a failure in the sensor, control device, etc., the motor may run away and cause a serious accident. There is. In order to prevent accidents due to runaway, various safety measures are taken for the apparatus, and highly reliable and expensive parts are used, resulting in an extremely expensive apparatus. Furthermore, in order to prevent bugs in control software and training software, there is a problem that software is fixed and development of new software is difficult.

  A number of force sense presentation systems using an active actuator such as a servo motor as a force generation unit have been developed. For example, a haptic master manufactured by FCS Control Systems (Non-Patent Document 1) uses three servo motors for three basic axes, and provides a three-dimensional force sense using a rotary joint and a linear joint. System. The haptic presentation system can also be used as an upper limb rehabilitation support system, and many studies have been conducted on the upper limb rehabilitation support system using a haptic master.

  In addition, many rehabilitation support systems using actuators such as motors and hydraulic / pneumatic pressure have been researched and developed, including commercial and research (Patent Document 1, Patent Document 2, Patent Document 3, Non-Patent Document 2, Non-Patent Document 2, (Patent Literature 3, Non-Patent Literature 4, Non-Patent Literature 5, Non-Patent Literature 6, Non-Patent Literature 40, Non-Patent Literature 41). The system of Non-Patent Document 6 can be applied not only to the upper limb rehabilitation support system but also to the lower limb rehabilitation support.

  When an actuator such as a motor is used for the force generation part of the force sense presentation system, there is a possibility that it may be dangerous for a person who operates due to an unexpected accident such as failure or runaway. Although it is possible to enhance safety by taking measures in terms of electrical or software, the apparatus and system become expensive and it is difficult to completely eliminate the danger. Therefore, functional fluid actuators that can ensure safety at the actuator level have been developed (Non-patent Document 7). The functional fluid actuator includes a functional fluid clutch and its drive unit. The limb rehabilitation support system EMUL using a functional fluid actuator has been researched and developed in the 5-year NEDO project (1999-2003) and is being clinically evaluated (Non-patent Document 8, Non-patent Document 9, Non-patent) Pp. 117 of Literature 10, Non-Patent Literature 11, Non-Patent Literature 12, and Non-Patent Literature 30).

  Examples of the functional fluid include an ER fluid whose non-patent document 13 and 13 can control its rheological characteristics with an electric field, an MR fluid whose non-patent document 13 can control its rheological characteristics with a magnetic field, and nanoparticles. MR fluid (Patent Document 5, Non-Patent Document 14) and the like are used. The ER fluid is a colloidal solution in which dielectric fine particles are dispersed in insulating oil, and when an electric field is applied thereto, the fine particles form a chain structure, and the apparent viscoelasticity changes.

  Compared with the force sense presentation system using such an actuator, the force sense presentation system using a passive force generation unit such as a brake (Patent Document 6) presents only a resistance against the force applied by the operator. Inadvertently, the device will not harm the operator.

  Regarding such a force sense presentation using a passive force generation unit, there is a research on a force sense presentation system (Non-patent Document 15) using a powder clutch of Saito et al. This system uses a single powder clutch to present a one-dimensional force sense. Furuso et al. Also researched and developed a two-dimensional passive force presentation system PLEMO-P-Prototype (Non-Patent Document 16) using two particle-based ER fluid brakes.

  As a passive force generator that can be used in the present invention, there is a mechanism using a functional fluid. FIG. 1 shows an example of a cross-sectional view of a passive force generation unit using a functional fluid whose rheological characteristics are changed by an external field (electric field, magnetic field) such as ER fluid, MR fluid, or nanoparticle MR fluid. Yes. Fig. 1 (a) shows a cylindrical type and Fig. 1 (b) shows a disk type. The functional fluid 4 is filled in the gap between the functional fluid brake main body 1 and the functional fluid brake output cylindrical portion 2 or the functional fluid brake output disc portion 3. By changing the external field (magnetic field or electric field) applied to the functional fluid 4, the brake torque is applied to the output connecting portion 5 attached to the functional fluid brake output cylindrical portion 2 or the functional fluid brake output disc portion 3. Occurs. The functional fluid brake output cylindrical part 2 or the functional fluid brake output disk part 3 is a multiple cylinder or a multiple disk, so that the generated force can be increased.

  A functional elastomer “ER gel” having a completely new function has been developed by forming an ER fluid into a gel structure. The function is an “electric adhesive effect” in which the adhesiveness of the surface changes when an electric field is applied (Non-patent Document 17). ER gel can also be used for the passive force generator.

  Examples of the passive force generator that can be used in the present invention include a powder brake and a powder clutch shown in FIG. FIG. 2 (a) shows the basic structure of the powder brake. Reference numeral 6 in the figure indicates a powder made of a magnetic material, and reference numeral 7 indicates a coil for generating a magnetic field. Reference numeral 8 denotes a rotating shaft of the powder brake. Reference numeral 9 denotes a powder brake housing. Brake torque is generated between the rotating shaft 8 and the housing 9 by passing a current through the coil 7. FIG. 2B shows the basic structure of the powder clutch. Reference numeral 10 denotes one rotating shaft of the powder clutch, and reference numeral 11 denotes another rotating shaft of the powder clutch. Torque is transmitted between the rotary shaft 10 and the rotary shaft 11 by passing a current through the coil 7. These can be used as a passive force generator that can be used in the present invention.

  Next, I will summarize the research and development related to the structure of the haptic presentation system using the passive force generator.

  Since the force that can be generated by a passive force generator is limited, if only the minimum number of force generators necessary to realize a force sense of a certain degree of freedom is used, the tactile and force sensations that can be presented are limited. May occur. On the other hand, by using a redundant number of passive force generators that are more redundant than the minimum necessary to present a force sense of a certain degree of freedom, it is presented when the minimum necessary number is used. It is possible to present precise tactile sensations and force sensations that cannot be performed (Patent Document 7, etc.).

  As a tactile sensation presentation system using such a redundant number of passive force generation units, there are Davis and Book et al. PTER using a redundant number of electromagnetic brakes (Non-patent Document 18). In addition, a force sense presentation system using a redundant number of ER fluid brakes (including a clutch) and MR fluid brakes (including a clutch) has been proposed (Patent Document 7).

  The haptic presentation system is required to have excellent haptic presentation performance for the frequency of sensations experienced in the real world. The most basic thing is to present a force sense in the direction opposite to the direction of motion. For example, when realizing a motion in a viscous field, it is necessary to always present a force sense opposite to the direction of motion of the gripping portion. This problem can be solved by introducing a redundant number of brakes as described above.

  Also, a method for solving this problem without introducing redundant brakes in the force sense presentation system has been proposed (Non-Patent Document 19).

  Next, a rehabilitation training table, a quasi-three-dimensional rehabilitation support system, a vertical display, and a horizontal display will be described.

  In many of the upper and lower limb rehabilitation support systems that perform rehabilitation while looking at the display, the rehabilitation training screen is displayed on a display that is substantially perpendicular to the rehabilitation training table. FIG. 3 shows a case of upper limb rehabilitation training. FIG. 3A is a top view of the upper limb rehabilitation support system. The state of the rehabilitation training performed while operating the grip 15 attached to the tip of the force sense arm 14 while looking at the vertical display 13 placed vertically on the front on the rehabilitation training table 12 is shown. . FIG. 3B is an example of a training screen displayed on the vertical display. Reaching training is performed in order from the center at the bottom of the screen toward target points (1) to (5). The purpose of the training is that the circle 16 indicating the position of the gripping part on the rehabilitation training table reaches the target point.

      FIG. 4 shows the case of rehabilitation training for the lower limbs. FIG. 4 is a top view of the lower limb rehabilitation support system. While looking at the vertical display 13 placed vertically in front, the slipper-like mounting portion 17 attached to the tip of the force sense presentation arm is operated to perform rehabilitation training on the horizontal rehabilitation training table 12. This shows the state of rehabilitation training. Rehabilitation training is performed while watching the training screen displayed on the vertical display that is arranged almost vertically on the rehabilitation training table. Reference numeral 18 in the figure indicates a box containing a force sense presentation mechanism.

  For example, in MIT-Manus (Patent Document 1), Kinestage (Non-Patent Document 6), etc., the gripping part of the rehabilitation training arm is gripped on the rehabilitation training table placed horizontally (or the hand is gripped with Velcro etc.) While holding the rehabilitation training screen almost perpendicular to the rehabilitation training table, operate the gripping part and perform rehabilitation training of the upper limbs. In the kine stage (Non-Patent Document 6), a rehabilitation training table can be placed on the floor, and a slipper-like wearing device attached to the tip for force sense presentation can be worn to perform rehabilitation training of the lower limbs.

  In PLEMO-P3 (Non-Patent Document 20 and Non-Patent Document 21), the angle of the rehabilitation table is variable both upward and downward, and the upper limb is rehabilitated with a fixed inclination angle according to the training menu. Can do. As a result, training of the operation of taking an object at a high position with the angle of the rehabilitation table upward, or the operation of taking an object at a low position (e.g. a meal operation) with the angle of the rehabilitation table downward. Can do. Therefore, it leads to improvement of daily living behavior (ADL). Such a rehabilitation support system that can tilt the rehabilitation training table is called a quasi-three-dimensional rehabilitation support system (Non-Patent Document 11, Non-Patent Document 20, Non-Patent Document 21).

    A conceptual diagram of the quasi-three-dimensional upper limb / lower limb rehabilitation support system is shown in FIG. FIG. 5A is a conceptual diagram of a quasi-three-dimensional upper limb rehabilitation support system. The rehabilitation training table 12 to which the force sense presentation mechanism and the vertical display 13 are attached is rotatable around the rehabilitation training table angle adjustment rotating shaft 19. The angle of the rehabilitation training table is adjusted according to the training content.

    FIG. 5B is a conceptual diagram of training in the standing position of the quasi-three-dimensional lower limb rehabilitation support system. The rehabilitation training table 12 is rotatable around the rehabilitation training table angle adjusting rotary shaft 19. Since the rehabilitation training drawing table can be tilted, it becomes the training of the lower limbs on the slope. An armrest 20 is attached to hold the posture in the standing posture training, and the patient performs rehabilitation training while looking at the vertical display 13.

  In PLEMO-P3, the display is mounted almost vertically on the rehabilitation training table, and its angle is adjustable. Such a display is also called a vertical display. A display incorporated in the rehabilitation training table is called a horizontal display.

  The quasi-three-dimensional upper limb rehabilitation support system PLEMO-P3 that uses a brake to present haptics is briefly introduced.

  On the rehabilitation training screen of PLEMO-P3 (Non-Patent Document 20, Non-Patent Document 21, Non-Patent Document 40, Non-Patent Document 41), various rehabilitation training software screens as shown in FIG. 6 are displayed. FIG. 6A shows the basic rehabilitation training software of PLEMO-P3. The left figure of Fig.6 (a) shows the screen of the leaching (nonpatent literature 22, nonpatent literature 39) training software. The reaching training is a training for extending an arm from the front to the front, and is a basic training in a rehabilitation training for stroke. Reach (reaching) is performed in the order of numbers from the front side toward the round targets numbered 1 to 13 shown in the figure. On the rehabilitation screen, the position of the grip 15 on the rehabilitation training table is displayed as the hand position. When the grip 15 on the rehabilitation training table is moved, the hand position mark also moves on the screen.

  The middle diagram in FIG. 6A shows a screen display of the trajectory tracking training. The target moving on the circular orbit is tracked by moving the grip. The right figure of Fig.6 (a) shows virtual sanding. The sphere in the figure indicates the position of the grip portion. Sanding is training to move a weight up and down on an inclined table (Non-Patent Document 34), and a rectangular parallelepiped in the figure indicates a weight of sanding. The grip 15 is presented with a force sense using a brake, and this exercise is a force adjustment exercise.

  FIG. 6B is rehabilitation training software simulating apple picking, and the picked apples are placed on a rectangular table in the foreground. As more apples are placed on the rectangular table in the foreground, patients feel a sense of accomplishment and motivate them to continue rehabilitation.

  FIG. 6C shows rehabilitation training software that simulates making a snowman. As the snow ball rolls, the snow ball grows and becomes large enough to make a snowman. With this rehabilitation software, the patient can feel a sense of accomplishment.

  PLEMO-P3 is used for clinical evaluation by a plurality of stroke patients, and its effectiveness in rehabilitation and as an evaluation machine for motor ability have been confirmed (Non-patent document 20, Non-patent document 21, Non-patent document Patent Document 41).

  Let us consider a case where a human performs an operation (reaching operation) of reaching a target position while obtaining information visually. In order to reach the target represented by the visual coordinates, it is necessary to convert the visual coordinates to the movement coordinates in the brain and control the movement of the arm (Non-Patent Document 23). In stroke, physical schema disorders and visuospatial disorders may appear.

  In the upper limb rehabilitation support system using a conventional display, as shown in FIGS. 3 and 4, a display 13 perpendicular to the surface of the rehabilitation training table 12 which is the movement surface of the gripping part is used. Activities that require high body and spatial awareness. That is, rehabilitation training by a system using a display perpendicular to the surface of the training table is highly difficult for a patient who has developed a body graphic disorder or visuospatial disorder.

  Research and development of an upper limb / lower limb rehabilitation support system that uses two displays, a horizontal display and a vertical display, to display a rehabilitation training screen for patients with body diagrammatic disorders or visuospatial disorders (Patent Document 4, Non-Patent Document 24, Non-Patent Document 25).

  FIG. 7 shows a conceptual diagram of an upper limb rehabilitation support system and a lower limb rehabilitation support system that use two displays, a horizontal display and a vertical display. FIG. 7A shows the case of the upper limb rehabilitation support system, and FIG. 7B shows the case of the lower limb rehabilitation support system. Reference numeral 21 denotes a horizontal display incorporated in the rehabilitation training table. It has been proposed to display various information and distant views on the vertical display 13 (Patent Document 4).

  FIG. 3 shows a case where the leaching training is performed while looking at the vertical display of the upper limb rehabilitation support system, and FIG. 7A is a case where the same leaching training is performed while looking at the horizontal display. As can be seen from the comparison of these figures, training using a horizontal display also has the advantage of matching visual perception with actual movement. Easy to apply.

  According to Patent Literature 4, “Upper limb / lower limb rehabilitation training apparatus using horizontal / vertical display”, “For patients with physical figure disorders or visuospatial disorders, a display perpendicular to the surface of the training table was used. The rehabilitation training by the system is a difficult task, "was the problem to be solved by the invention. The effects of the invention of Patent Document 4 were the following three points.

  The horizontal display built into the rehabilitation training table matches the visual perception with the actual movement. The level of body recognition and spatial recognition required for training is low.

  In the horizontal display (display embedded in the rehabilitation training table) in the upper limb rehabilitation system, a high training effect can be expected because the patient's upper limb enters the field of view and provides visual feedback of movement.

  In addition, in the horizontal display (display embedded in the rehabilitation training table) in the rehabilitation system for the lower limbs, since the patient's lower limbs enter the visual field and the visual feedback of the movement is obtained, a high training effect can be expected.

  Next, we briefly summarize the concept of stroke rehabilitation and feedback of visual information during rehabilitation.

  Miyai is described in Non-Patent Document 26, pp. 69 states as follows. What is important in rehabilitation is that repeated simple movements do not improve function and the brain does not change. In fact, in Dr. Nude's squirrel monkey experiment (Non-patent Document 27), instead of feeding small foods that are difficult to feed, it ’s easy It has been found that the distribution of motor neurons does not change. Research on rehabilitation for patients with stroke is being pointed out that it is important to challenge things that are a little more difficult than what is possible now, and that if it can be done, it will lead to functional improvements. As can be seen from this indication, it is important to make the problem of rehabilitation little by little while looking at the patient's condition, and this can be easily realized in a rehabilitation support apparatus incorporating a computer.

  Hase said that learning to treat movement disorders due to neurological disorders (such as stroke) differs from learning normal motor skills. (Pp. 2 of Non-Patent Document 28). In other words, sports training methods are also effective in rehabilitation of movement disorders due to neurological diseases (such as stroke).

  The motor skill acquired in order to master a certain task is composed of muscle activity-output-movement (trajectory) based on the motor command, and the result of using the motor skill under various environments, We can see as a performance. Feedback is sensory information itself necessary for acquiring athletic skills, and is a base for the learner to build performance (pp. 35-36 of Non-Patent Document 28).

  Feedback is classified into two types: intrinsic feedback in which information about motor skills during task execution is input through the learner's own vision and deep senses, and external feedback taught from the performance and results of the task. Is done. Intrinsic feedback is the sensory information that the learner obtains from the exercise performed by the learner. The learner constructs motor skills while following the procedure of implicitly or explicitly processing the intrinsic feedback via visual or proper sensation and applying it to the next performance (Non-patent Document 28, pp) .36).

  Carr et al., In Chapter 1 of Non-Patent Document 22, “Adaptive System: Plasticity and Recovery” (pp. 2-15), that advanced and repetitive training has a positive effect on recovery of motor function, And evidence that the patient's voluntary involvement is important.

  In addition, in the presentation section (pp. 47 of Non-Patent Document 22), modeling by video or coaching action allows the learner to develop an understanding of the action, mental image or conceptual representation or action template. To help. The presentation is given by a therapist demonstrating movement or by a performance video.

  Mental practice combined with physical practice has been used effectively for decades to promote athletes' motor skills learning. Carr et al., In the Mental Practice section of Non-Patent Document 22 (pp. 53-54), “Recent reviews have revealed that mental practice is effective in motor performance in patients with nerve injury.” It is said.

  Carr et al. Described the following in the section of computer assistance, virtual reality, robot and electronic training in Non-Patent Document 22 (pp. 55-59). New equipment currently being developed and researched increases the time spent on physical and cognitive activities by allowing patients to repeat activities more and practice independently. The device can provide feedback (pp. 35 of Non-Patent Document 28), elicit physical participation, increase the intensity of practice, and increase motivation.

  Also, in recent reviews by Pomeroy et al., Observing with the intention of imitating the performance of others can cause activity of the motor execution system (including paralyzed muscles) and improve functional activity after stroke (Non-patent Document 29).

  A method for improving a motion by imaging a series of motions without actually exercising is generally known as image training. It was first introduced in the field of sports science from the beginning of the 20th century, and its effect has been studied on the basis of scientific data as an academic practice (or mental rehearsal). In particular, recent advances in neurological imaging and magnetic stimulation have revealed a detailed mechanism of brain activity when imagining exercise, and many studies have been conducted on healthy subjects and diseases. (Pp. 66-71 of Non-Patent Document 30). The difference between a motion image and a visual image is that the motion image is to imagine that your body is moving, and the visual image is to visually image the movement as if you were looking from the outside. The motion image is described as “internal image”, and the visual image is described as “external image”.

  Research on the basis of the effect of technological improvement by mental practices is being conducted. (For example, Non-Patent Document 31) The summary is described in pp. 66-67.

  In the field of exercise psychology, not only the image of exercise, but also the use of visual images and psychological approaches are regarded as important. For example, since the technology improves by observing a purposeful movement, it is necessary to report the relationship between vision and movement (Non-patent Document 32), to improve relaxation and motivation, or to increase concentration, Attempts have also been made to use the respiratory rate and brain waves on a monitor. Furthermore, biofeedback training is also being attempted to improve the training effect of the monitor data through visual and auditory senses. (Non-Patent Document 30, pp. 67, etc.)

  There is a rehabilitation technique “Kawahira method” (pp. 58-61 of Non-Patent Document 33, Non-Patent Document 30) mainly for strokes that are highly evaluated by rehabilitation doctors, physical therapists, occupational therapists, etc. . In Kawahira's method, it is important to repeat many movements to be realized in the paralyzed limbs in order to extract the plasticity of the brain. In order to bring out the plasticity of the brain, many repetitions are required. Therefore, it is desired to introduce a rehabilitation support apparatus in which a computer such as robotics and mechatronics technology is introduced as part of the rehabilitation training.

  Kawahira has stated as follows in the visual information processing and voluntary movement of FIG. Among the neurons that memorize the motor program of the premotor cortex, there are cells that are excited only by visual stimuli associated with the program, and are called visual motor neurons. Some cells with a finger movement motor program that manipulates scissors begin to excite just by seeing others manipulate the scissors, and are called mirror neurons. The existence of such visual motor neurons allows us to cause movements that are suitable for the subject without thinking.

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Neurophysiol. , Vol. 113-1141 (2002) Heiwami: Exercise therapy for hemiplegia (the theory and practice of facilitating repeated therapy “Kawahira method”), Medical School (2010, 2nd edition) Ueda: Visual Rehabilitation Medicine, Second Edition, University of Tokyo Press (1994) Koji Ito: Psychosomatic system theory (learning and control of movement by human robotics), Chapter 5 Space and movement (integration with body image), Kyoritsu Shuppan, pp. 52-81 (2005) Porter, et al: Compositing Digital Images, Computer Graphics (SIGGRAPH 1984), Vol. 18, no. 3, pp. 253-259 (1984) Suspension, et al .: Extraction by chroma key using checkered background, Information Processing Society of Japan (2005-AVM-51 (11)), pp. 57-62 (2005) Yamashita, et al .: Striped chroma key using active contour model, Journal of the Video Media Society, Vol. 61, no. 2, pp. 101-109 (2007) Shadmehr et al: Computational neurology of reaching and pointing (Foundation of Motor Learning), MIT Press (2005) Furuso, et al .: Development of next-generation technology for human motor function and movement (for the spread of assistive devices close to users), Chapter 6 Upper limb function support robot, Section 1, Development status, NT Corporation・ S, pp. 124-134 (2014) Furuso, et al .: Development of next-generation technology for human motor functions and movement (toward the spread of assistive devices close to the user) Chapter 6 Upper limb function support robot Section 2 Usage status, NTS Corporation , Pp. 135-141 (2014)

  In an limb / lower limb rehabilitation support system using many vertical displays such as MIT-Manus (patent document 1), kine stage (non-patent document 13), PLEMO-P3 (non-patent document 11, non-patent document 12) There is a problem in that an image of the own upper limb (or lower limb) is not displayed, and only the position of the grasping portion (a slipper-like wearing portion in the case of the lower limb) is displayed on the rehabilitation training screen. For example, in FIG.3 (b), only the round mark 16 which displays the image of a leaching training and the position of the holding part on a rehabilitation training table is displayed on the rehabilitation training screen.

  On the other hand, in the horizontal display 21 incorporated in the rehabilitation training table of FIG. 7, the patient's own upper limb (or lower limb) enters the same field of view as the rehabilitation training screen. The problem that only the position of) is displayed is solved. However, when this method is adopted, there are problems such as cost increase and safety due to the horizontal display incorporated in the rehabilitation training table. Furthermore, the image quality problem of the rehabilitation training screen, the gripping part 15 (slipper-like wearing part 17 in the case of the lower limbs), the arm mechanism for haptic presentation and the upper limbs (or the lower limbs) give visibility to the rehabilitation training screen. There is also the problem of blocking. Further, in walking rehabilitation, there is a problem that it is not desirable to perform rehabilitation training while looking down at the horizontal display.

  Advantages obtained by displaying the patient's own upper limb (or lower limb) superimposed on the rehabilitation training screen are the following three points. In order to obtain these advantages, it is a problem to be solved by the present invention to display a patient's own upper limb (or lower limb) superimposed on a rehabilitation training screen in a low-cost, compact and safe manner.

  The first advantage is that when the patient's own upper limb (or lower limb) is displayed on the rehabilitation training screen, joint exercise (pp. 16 of Non-Patent Document 34, Non-Patent Document 26) is a pathological exercise in stroke. Pp. 43), the generation of the joint movement can be known from the movement of its own upper limb (or lower limb) displayed on the vertical display. Using this information, the patient can correct the movement. One of the central tasks in rehabilitation of stroke is to lead joint movement, which is a pathological movement in stroke, to separation and independence of each joint. (For example, Non-Patent Document 34)

  The second advantage is that when the patient's own upper limb (or lower limb) is displayed together with the rehabilitation training screen, the patient's upper limb (or lower limb) enters the field of view, and a visual feedback effect of exercise is also obtained. Can be expected. That is, when the patient's own upper limb (or lower limb) is displayed, the body's own cognitive function or the like (Non-patent Document 35) is utilized, and a rehabilitation effect that exceeds the conventional rehabilitation support system can be expected.

  The third advantage is obtained by performing rehabilitation training by the following method. First, the correct movement pattern change is displayed over the rehabilitation training screen, and the patient observes and stores the display. Next, by performing rehabilitation training using the apparatus of the present invention, comparing the own exercise pattern with the correct exercise pattern, and correcting the own exercise pattern, the rehabilitation training effect can be obtained. As a method of displaying a correct exercise pattern, there are a method of displaying an image obtained by a computer graphics technique, a method of obtaining an image obtained by photographing a patient's own exercise by correcting it into a correct exercise pattern, and the like.

  As shown in FIG. 8, an image including the patient's upper limb (or lower limb), the rehabilitation training table 23 whose surface is a chroma key background color or background pattern, the force sense presentation arm 14, etc. is taken with the overhead view camera 22. . Next, an image to which the chroma key technique (Non-patent Document 36) and the image composition technique are applied is displayed on the vertical display 13. While viewing the image on the vertical display 13, the patient performs rehabilitation training by operating the grip portion 15 (in the case of the lower limbs, a slipper-like mounting portion attached to the tip of the force sense presentation arm). The surface of the rehabilitation training table (chroma key background) is green or blue so that the chroma key technique can be applied. When the same color as the background is included in the extraction target, a method of using a checkered pattern background consisting of two colors (Non-Patent Document 37), a method of using a striped background (Non-Patent Document 38), etc. are adopted. To do. FIG. 8A shows the system for the upper limbs, and FIG. 8B shows the system for the lower limbs.

  Next, a method for obtaining a rehabilitation training screen to be displayed on the vertical display 13 using the chroma key and the image composition technique in the present invention will be described with reference to FIG. 9 as an example. The same method is used for the lower limbs.

    FIG. 9A shows an image taken by the overhead view camera when a green or blue background color is adopted. Since a single background color of green or blue is adopted, there is nothing drawn on the rehabilitation training table, unlike the two-color checkered background method and the striped background method. Only the image 24 of the gripping part, the image 25 of the forearm, and the image 26 of the force sense presentation arm are taken.

  FIG. 9B shows the case where the upper limbs and the rehabilitation training arm are extracted. The upper limb of the patient to be extracted and the arm for rehabilitation training are combined with the rehabilitation training screen and displayed on the vertical display. The patient performs rehabilitation training while watching this screen. As the rehabilitation training, a case of reaching (or reach operation) (pp. 142 of non-patent document 22, non-patent document 20, non-patent document 21) is shown as an example. Starting from the previous point (S), reaching training is performed one after another toward the target points (1) to (5). The dotted line in the figure is the target trajectory from the starting point (S) to the target point (3). The deviation from the orbit and the arrival time are evaluated. The patient's upper limb is displayed at the same time, and the patient knows the occurrence of joint movement (pp. 16 of Non-Patent Document 34), which is a pathological movement in stroke, while performing his / her feedback while watching his / her upper limb. Thus, the training effect can be enhanced.

  FIG. 9C shows a case where the upper limb is an extraction target. The upper limb to be extracted and the rehabilitation training screen are synthesized and displayed on the vertical display. The patient performs rehabilitation training while watching this screen. As the rehabilitation training, a case of reaching training is shown as an example. Starting from the previous point (S), reaching training is performed one after another toward the target points (1) to (5). The dotted line in the figure is the target trajectory from the starting point (S) to the target point (3). The deviation from the orbit and the arrival time are evaluated. The upper limbs of the patient are displayed at the same time, and the patient can increase the training effect by knowing the occurrence of joint movement while viewing his / her upper limbs and performing various feedbacks.

  Taking the reaching training in FIG. 9C as an example, three methods for showing the rehabilitation training screen, the upper limbs, the gripping portion, and the like on the vertical display 13 will be described below.

  FIG. 10 shows the first method. In the first method, the rehabilitation training screen is the lower layer in the image display, and the upper limbs, the gripping portion, and the like are displayed on the upper layer. That is, at the start of the reaching training screen shown in FIG. 10 (a), the image 24 of the gripping part and the image 25 of the forearm are represented on the starting point ▲ S, and the starting point ▲ S ▼ is hidden. . Next, during the reaching training shown in FIG. 10 (b), the dotted line of the target trajectory connecting the starting point (S) and the target point (3) is below the image 24 of the gripping part and the image 25 of the forearm. It is hidden. This expression is a natural way to represent the upper limb and gripping part on the rehabilitation training table, but the target trajectory and target point may be hidden in the upper limb, gripping part, etc., so it moves accurately along the target trajectory. There is a drawback that it is difficult for patients to understand whether or not they are doing.

    The second method is substantially the same as the first method shown in FIG. 10, but is a method of making the image of the gripping part (or the gripping part and the hand part) translucent. As a result, the target trajectory, the target point, and the like are not completely hidden by the gripping part (or the gripping part and the hand part). Therefore, the patient can know whether or not he / she is accurately moving along the target trajectory. Therefore, it becomes possible to develop rehabilitation training software capable of finely setting the difficulty level of rehabilitation training. Therefore, it is possible to respond to the claims of Miyai (Non-Patent Document 26), Nude (Non-Patent Document 27) and the like that it is important to make it difficult to rehabilitate the patient little by little while watching the patient's condition.

  FIG. 11 shows a third method. The expression method shown in FIG. 11 is employed when targeting a patient with a high degree of recovery or when evaluating exercise ability with high accuracy. In the method shown in FIG. 11, basic images, characters, etc. on the rehabilitation training screen are displayed on the bottom layer. Therefore, the basic image, characters, etc. of the rehabilitation training screen are hidden by the upper layer image. “Leaching training” (indicated by reference numeral 29) in the lower left of FIG. 11 (a) and FIG. 11 (b) is a basic image, character, etc. on the rehabilitation training screen and is displayed in the bottom layer. . The grip portion image 24 and the forearm image 25 are displayed on the intermediate layer thereon. The starting point 27, the target trajectory, the target point, etc. on the rehabilitation training screen are further displayed on the intermediate layer above. A mark 28 indicating the center of the gripping part is displayed on the uppermost layer so as not to be hidden. That is, the display is divided into four layers.

  At the start of the reaching training screen shown in FIG. 11A, the grip portion image 24 and the forearm image 25 are displayed under the starting point ▲ S ▼ 27. Is hidden under the starting point ▲ S ▼ 27. However, since the mark 28 indicating the center of the gripping portion is displayed on the uppermost layer, it is always displayed. Even in the middle of the reaching training screen shown in FIG. 11B, the mark 28 indicating the center of the gripping portion is always shown, and the deviation from the target trajectory can be accurately recognized by the patient and the trainee. In addition, the patient and the trainee can also know whether or not the target point (3) has been reached accurately. Therefore, it becomes possible to develop rehabilitation training software capable of finely setting the difficulty level of rehabilitation training. Therefore, it is possible to respond to the claims of Miyai (Non-Patent Document 26), Nude (Non-Patent Document 27) and the like that it is important to make it difficult to rehabilitate the patient little by little while watching the patient's condition.

  FIG. 12 shows a method different from the present invention for displaying the rehabilitation training screen and the upper limb (or lower limb) of the patient on the same screen. The difference between the method of FIG. 8 which is the method of the present invention and the method of FIG. 12 is that the surface of the rehabilitation training table has a chroma key background color or background pattern in the method of FIG. In contrast to using the rehabilitation training table 23, the method shown in FIG. 12 uses a rehabilitation training table in which a horizontal display is incorporated.

  In the method of FIG. 12, an image including a horizontal display 21 incorporated in the patient's upper limb (or lower limb), a rehabilitation training arm, and a rehabilitation training table is taken with the overhead view camera 22 with the overhead view camera. In addition, the image thus taken is displayed on a vertical display. However, this method has the following problems in terms of cost, size, and safety of the horizontal display 21 incorporated in the rehabilitation training table. Furthermore, there are the following problems in terms of the quality of the image displayed on the vertical display.

  The first problem is that in the horizontal display 21 incorporated in the rehabilitation training table, a display such as a liquid crystal display and a tempered glass for protecting the display are required, resulting in an increase in cost. In addition, the size and weight increase, making it difficult to make the system compact.

  A second problem is that when tempered glass or the like that protects the horizontal display 21 incorporated in the rehabilitation training table is broken, there is a risk of injury due to broken pieces of glass or the like. Particularly in the rehabilitation of the lower limbs, there is a risk of dropping when the tempered glass is broken.

  The third problem is a problem of deterioration in the image quality of the rehabilitation training screen when the horizontal display 21 incorporated in the rehabilitation training table is photographed with the overhead view video camera and then displayed on the vertical display. The cause of the deterioration in image quality is due to the number of pixels of the display used in the rehabilitation training table capable of displaying the rehabilitation training screen and the number of pixels of the overhead view video camera. In addition, there is a lighting reflection on the surface of the rehabilitation training table on which the rehabilitation training screen can be displayed. In addition, there are those caused by distortion and resolution of the lens of the overhead view camera.

  The fourth problem is that the grip 15 (moving part 17 attached to the tip of the force sense arm in the case of the lower limb) or the upper limb (in the case of the lower limb) moves on the horizontal display 21 incorporated in the rehabilitation training table. Alternatively, the lower limbs are in a point of hiding the target locus or target point. For this reason, there arises a problem that the patient does not know whether or not the trajectory is accurately tracked and whether or not the target point has been accurately reached.

  A clean image display of a rehabilitation training screen including an image of a patient's upper limb (or lower limb) can be obtained at low cost, high safety, and compact without causing the above problems in the apparatus shown in FIG. This is the effect of the present invention. The patient can enhance the training effect by watching the upper limbs (or lower limbs) of the patient, knowing the occurrence of joint movement, and performing various feedbacks.

  Furthermore, as an effect when the apparatus of the present invention is used for rehabilitation of the lower limbs, there are the following. The rehabilitation training table may be a plate having a surface coated with a paint necessary for chroma key technology. Therefore, in the lower limb rehabilitation support system, the rehabilitation training surface that is a walking surface is lowered, safety is increased, and cost is also reduced.

  As a first embodiment for rehabilitation of the upper limb, there is an embodiment shown in FIG. As a method for displaying an image on the vertical display, the first method, the second method, the third method and the like described in “Means for Solving the Problems” are used. The method of displaying an image on a vertical display is common to all of the following embodiments.

    There is one embodiment as an upper limb rehabilitation support system shown in FIG. An overhead video camera is mounted on a tiltable rehabilitation training table. Since the rehabilitation training table can be tilted, it is possible to train to take a high one or take a low one for a meal or the like. Therefore, it contributes to the improvement of ADL (daily life operation).

  In the upper limb and lower limb rehabilitation support system shown in FIGS. 8A and 8B, there is a form in which a force sense is not presented to the grasping part (in the case of the lower limb, an attachment to the foot). Even if force sense is not presented to the gripping part, for example, reaching training shown in the left diagram of FIG. 6A or rehabilitation training for tracking the target shown in the center diagram of FIG. Effective in the targeted rehabilitation training. In an apparatus that does not present a force sense to the grip portion, the cost is greatly reduced, the intensity of the apparatus can be lowered, and the size is also reduced.

  In the form that does not present the force sense, the force sense presenting arm is not necessarily required, and the upper limb holds a dedicated paddle, the lower limb wears dedicated shoes, etc., and rehabilitation is performed on the rehabilitation training table. There are also.

  FIG. 13B shows one embodiment for the upper limb rehabilitation support as the above embodiment. The paddle-shaped gripping part (moving while sliding on the rehabilitation training table) 31 is gripped, and rehabilitation training is performed while viewing the screen displayed on the vertical display 13.

  In rehabilitation programs in the early stages after a stroke, voluntary muscle contraction and lower limb muscle group control are often insufficient. For such patients, it is necessary to spend time for exercise aimed at enhancing the activity of a specific muscle group, or for partial exercise, that is, exercise for constituting a walking exercise. Thus, there is a need for a rehabilitation training support system that can be developed into sitting, standing, standing and balance exercises, and walking exercises as the patient recovers. Four examples for lower limb rehabilitation to achieve this goal are shown in FIG.

  FIG. 14 (a) is an example in the sitting position training. The trainer performs rehabilitation training while sitting on the chair 40 for training in the sitting position. The foot is moved on the rehabilitation training table 23 whose surface is a chroma key background color or background pattern, and rehabilitation training is performed while viewing the image on the vertical display 13. The overhead video camera 22 disposed above is indicated by a dotted line.

  14B and 14C show an embodiment in the standing position. In FIG.14 (c), the angle of a rehabilitation training table is variable, and rehabilitation training with respect to a slope etc. is also possible.

  FIG. 14 (d) shows an example of walking training without support. Rehabilitation training is performed with a harness 32 for weight relief or ensuring safety. On the upper part of the device, a wire control device 33 for suspending the harness is attached.

  FIG. 15 shows an embodiment in walking training on the treadmill 34. The treadmill belt is green, blue or a specific pattern so that the surface is the background of chroma key technology. A range taken by the overhead view video camera is indicated by reference numeral 36. FIG. 15B shows a display screen of the vertical display 13. The code | symbol 37 has shown the image | video of the trainee image | photographed with the camera for bird's-eye view images. Further, the landing target position 38 of the left foot and foot and the target trajectory 39 of the left foot and foot are displayed by the image composition technique. The trainee swings the left foot forward toward the target position 38 along the target trajectory 39.

    The present invention is not limited to the above-described embodiment, and various modes can be adopted within the scope of the present invention.

Conceptual diagram of functional fluid brake (If the housing is rotatable, it becomes a functional fluid clutch) Powder brake and powder clutch Upper limb rehabilitation support system using vertical display Lower limb rehabilitation support system using vertical display Quasi-three-dimensional upper limb rehabilitation support system and quasi-three-dimensional lower limb rehabilitation support system using vertical display Example of rehabilitation training software for quasi-three-dimensional upper limb rehabilitation support system PLEMO-P3 Upper and lower limb rehabilitation support system using horizontal and vertical displays (horizontal display is built into the rehabilitation training table) A rehabilitation support system in which the surface of the rehabilitation training table is the background of chroma key, and the images taken by the overhead view camera are processed and displayed on a vertical display. Examples of images taken with an overhead video camera and images displayed on a vertical display using chroma key technology Example of an image displayed on a vertical display using an overhead video camera and chroma key technology (in the case of the first method in the description of FIG. 10) Example of an image displayed on a vertical display using an overhead video camera and chroma key technology (in the case of the third method in the explanation of FIG. 11) Upper limb / lower limb rehabilitation support system using a horizontal display and an overhead video camera (used for comparison with the system of FIG. 8 of the present invention). Two forms for carrying out the invention for rehabilitation of the upper limb Four examples for implementing the invention for rehabilitation of the lower limbs Example for carrying out the invention for rehabilitation of walking on a treadmill

DESCRIPTION OF SYMBOLS 1 Functional fluid brake main body 2 Functional fluid brake output cylindrical part 3 Functional fluid brake output disk part 4 Functional fluid 5 Output connection part 6 Powder made of magnetic substance 7 Coil for generating a magnetic field 8 Rotating shaft of powder brake 9 Powder brake housing 10 One rotary shaft of the powder clutch 11 Another rotary shaft of the powder clutch 12 Rehabilitation training table 13 Vertical display 14 Arm link 15 for force sense presentation Gripping part 16 Position of the gripping part on the rehabilitation training table A circle 17 to be displayed A slipper-like mounting portion 18 attached to the tip of the haptic presentation arm 18 A box incorporating a haptic presentation mechanism 19 Rehabilitation training table angle adjustment rotary shaft 20 Armrest 21 Rehabilitation for posture maintenance in standing training Horizontal display built into the training table 22 Overhead Video Camera 23 Rehabilitation Training Table 24 with Chroma Key Background Color or Background Pattern 24 Gripping Image 25 Forearm Image 26 Force Display Arm Image 27 Starting Point 28 Mark indicating the center of the grasping unit 29 Basic example of rehabilitation training screen, one example displayed on the bottom layer of characters, etc. 30 Trainer 31 Paddle-shaped gripping part (moves while sliding on the rehabilitation training table)
32 Weight-bearing or safety harness 33 Control device for the wire that suspends the harness 34 Treadmill 35 Treadmill belt (green, blue, or specific surface so that the surface is the background of chroma key technology) It is a pattern.)
36 Range Taken by the Overhead Video Camera 37 Trainee Video 38 Taken by the Overhead Video Camera Landing target point of the left foot on the screen displayed on the vertical display (created by image synthesis technology)
39 Target trajectory of the left foot and feet on the screen displayed on the vertical display (created by image composition technology)
40 Chairs for sitting training

Claims (15)

  The surface of the rehabilitation training table is a chroma key background color (green, blue, etc.) or a background pattern, and the rehabilitation training table including the upper limbs is photographed from above with a camera for a bird's-eye view image. Then, a rehabilitation training screen including the upper limb is synthesized, the image is displayed on a substantially vertical display (vertical display) in front of the trainee, and the grip portion 15 (or 31) is moved by the upper limb while looking at this display, and rehabilitation is performed. An upper limb rehabilitation training system characterized by   The surface of the rehabilitation training table is a chroma key background color (green, blue, etc.) or a background pattern, and the rehabilitation training table including the upper limbs is photographed from above with a camera for overhead view video. When synthesizing a rehabilitation training screen that includes upper limbs using synthesis technology, some of them are made translucent so that the target point, target trajectory, and position of the gripping part that tracks it can be accurately identified, The rehabilitation training screen including the upper limb is synthesized, and the image is displayed on a substantially vertical display (vertical display) in front of the trainee, and the grip portion 15 (or 31) is moved by the upper limb while looking at this display to perform rehabilitation. An upper limb rehabilitation training system characterized by that.   The surface of the rehabilitation training table is a chroma key background color (green, blue, etc.) or a background pattern, and the rehabilitation training table including the upper limbs is photographed from above with a camera for overhead view video. When synthesizing a rehabilitation training screen that includes the upper limb using synthesis technology, the target point, target trajectory, and the target point, target trajectory, and The rehabilitation training screen including the upper limbs is synthesized, and the image of the trainee is composed of the upper part of the synthesized image so that the center of the gripping part for tracking the upper part of the image is not hidden by other images. The image is displayed on a substantially vertical display (vertical display) on the front, and the grip 15 (or 31) is moved by the upper limb while looking at this display. , Upper limb rehabilitation training system and carrying out rehabilitation.     The surface of the rehabilitation training table is a chroma key background color (green, blue, etc.) or a background pattern, and the rehabilitation training table including the lower limbs is photographed from above with a camera for a bird's eye view. The rehabilitation training screen including the lower limbs is synthesized, the image is displayed on a substantially vertical display (vertical display) in front of the trainee, and the slipper-shaped wearing part 17 is moved by the lower limbs while looking at this display to perform the rehabilitation. Lower limb rehabilitation training system characterized by performing.   The surface of the rehabilitation training table is a chroma key background color (green, blue, etc.) or background pattern, and the rehabilitation training table including the lower limbs is photographed from above with a camera for a bird's eye view. When synthesizing a rehabilitation training screen that includes the lower limbs using synthesis technology, a part of them is divided so that the target point, target trajectory, and the position of the slipper-like wearing part that tracks it can be accurately identified. The rehabilitation training screen including the lower limbs is synthesized as transparent, and the image is displayed on a substantially vertical display (vertical display) in front of the trainee, and the slipper-like mounting portion 17 is moved by the lower limbs while viewing this display, and rehabilitation is performed. Lower extremity rehabilitation training system characterized by   The surface of the rehabilitation training table is a chroma key background color (green, blue, etc.) or background pattern, and the rehabilitation training table including the lower limbs is photographed from above with a camera for a bird's eye view. When synthesizing a rehabilitation training screen that includes the lower limbs using synthesis technology, the target point, target trajectory, and the position of the slipper-shaped wearing part center that tracks it are accurately identified. The rehabilitation training screen including the lower limbs is synthesized while the locus and the center of the slipper-like mounting part that tracks it are made the upper layer in the synthesized image so that they are not hidden by other images. The image is displayed on a nearly vertical display (vertical display) in front of the trainee, and while watching this display, Leg rehabilitation training system characterized by moving the like ripper shaped mounting portion, performs rehabilitation.   The surface of the treadmill belt 35 is a chroma key background color (green, blue, etc.) or a background pattern. The treadmill belt is photographed from above by a bird's-eye video camera, including trainees. Using the chroma key technology, a rehabilitation training screen including the trainer is synthesized (for example, FIG. 15B), and the image is displayed on a substantially vertical display (vertical display) in front of the trainer. A lower limb rehabilitation training system characterized by moving a slipper-shaped mounting portion 17 with a lower limb while looking at a display and performing rehabilitation on a treadmill.   The surface of the treadmill belt 35 is a chroma key background color (green, blue, etc.) or a background pattern. The treadmill belt is photographed from above by a bird's-eye video camera, including trainees. When synthesizing rehabilitation training screens including patients and trainers using chroma key technology and image synthesis technology, the target point, target trajectory, and the position of the foot to track it can be accurately identified. Some of them are translucent, and the rehabilitation training screen including the trainee is synthesized, and the image is displayed on the almost vertical display (vertical display) in front of the trainee. A lower limb rehabilitation training system characterized by moving the mounting portion 17 and performing rehabilitation on a treadmill.   The surface of the belt 35 of the treadmill is a chroma key background color (green, blue, etc.) or a background pattern. The treadmill belt is photographed from above by a bird's-eye video camera, including patients and trainees. When synthesizing a rehabilitation training screen that includes trainers, etc., using the chroma key technology and image synthesis technology, the target point, target trajectory, and the position of the slipper-like mounting part center that tracks it are accurate. As you can see, the target point, the target locus, and the center of the slipper-like mounting part that tracks the target point are made upper layers in the combined image so that they are not hidden by other images. , Synthesize a rehabilitation training screen including the trainee, and display the image on the almost vertical display (vertical display) in front of the trainer. While watching, walking rehabilitation training system, characterized in that move and slippers shaped mounting portion by the lower limbs, carry out the rehabilitation.   The surface of the rehabilitation training table is a chroma key background color (green, blue, etc.) or background pattern, including patients and trainees, etc., taken from above the rehabilitation training table with a camera for overhead view video, from the image, The rehabilitation training screen including the image of the patient / trainer's upper limb obtained using the chroma key technology and the image composition technology is displayed on the vertical display, and the upper limb is moved while looking at this display to perform rehabilitation. Upper limb rehabilitation training system.   The surface of the belt 35 of the rehabilitation training table or the treadmill is a chroma key background color (green, blue, etc.) or a background pattern. The rehabilitation training screen including the images of the lower limbs of the patient / trainer obtained from the image by using the chroma key technology and the image synthesis technology is displayed on the vertical display. Lower limb rehabilitation training system characterized by moving and performing rehabilitation.   Claim 1, claim 2, claim 3, claim 4, claim 4 using powder brake, powder clutch, ER fluid brake, MR fluid brake, nano particle MR fluid brake, ER gel brake, etc. for controlling force sense Claim 5, Claim 7, Claim 8, Claim 9, Claim 10, Claim 11, Rehabilitation training system.   Claim 1, Claim 2, Claim 3, Claim 4, Claim 5, Claim 6, Claim 8, Claim 8, wherein actuators such as motors and pulse motors are used to control force sense. 9. The rehabilitation training system according to claim 10, 10 and 11.   Claim 1, Claim 2, Claim 3, Claim 4, Claim 5 and Claim 5, wherein a functional fluid actuator comprising a functional fluid clutch (or powder clutch) and its drive unit is used for controlling the force sense. 6. The rehabilitation training system according to claim 7, claim 8, claim 9, claim 10 and claim 11.   Claim 1, claim 2, claim 3, claim 4, claim 5, claim 7, claim 7, wherein no force sensation is presented to the gripping part (in the case of a leg, a slipper-like one) The rehabilitation training system according to claim 8, claim 9, claim 10, and claim 11.