JP2018061849A - Rehabilitation supporting system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To fix a position where a stimulating electrode is arranged on a patient over a plurality of opportunities, without depending on an operator.SOLUTION: A stimulation applying part 202 applies electric stimulation to a paralytic limb 100 of a patient. An image acquisition part 203 acquires an image of the paralytic limb 100 of the patient. A display part 204 displays the image. An evaluation part 205 evaluates, based on the image, the magnitude of a reaction of the paralytic limb 100 of the patient to the electric stimulation. A display control part 206 controls the display part 204 to display a map showing the relation between the position to which the electric stimulation is applied and the magnitude of the reaction.SELECTED DRAWING: Figure 9

Description

  The present invention relates to a system for supporting rehabilitation performed for a hemiplegic patient due to, for example, a stroke.

  In this type of rehabilitation, a stimulation electrode is placed on the patient's paralyzed limb. The stimulation electrode is energized based on a command from the brain to move the paralyzed limb, and electrical stimulation to the paralyzed limb is performed. As a result, the patient can feel as if the paralyzed limb has moved as intended (see, for example, Patent Document 1).

JP 2009-112791 A

  In order to appropriately exert the effect of rehabilitation performed over a plurality of occasions and appropriately evaluate the effect, it is necessary to make the position where the stimulation electrode is disposed on the patient constant.

  Therefore, an object of the present invention is to make the position where the stimulation electrode is disposed on the patient constant over a plurality of occasions regardless of the practitioner.

In order to achieve the above object, a first aspect that the present invention can take is a rehabilitation support system,
A stimulation electrode placed on a part of the patient's body;
An arrangement position storage unit storing arrangement position information indicating a position where the stimulation electrode is arranged;
A guidance information providing unit that provides guidance information for guiding the stimulation electrode to the position based on the arrangement position information;
It has.

  The practitioner (an example of a user) places the stimulation electrode at a predetermined position on a part of the patient's body based on the guidance information provided by the guidance information providing unit. According to such a configuration, the position where the stimulation electrode is arranged on the patient can be made constant over a plurality of occasions regardless of the practitioner. Since such a position is determined as a position where the rehabilitation effect is appropriately exhibited, the effectiveness of the rehabilitation performed over a plurality of occasions can be enhanced. In addition, since the arrangement position of the stimulation electrode is always constant, it is possible to improve the reliability of evaluation with respect to the effect of rehabilitation performed over a plurality of occasions.

  The guidance information providing unit may be configured to optically show the guidance information on a part of the patient's body.

  According to such a configuration, the practitioner can accurately arrange the stimulation electrode at a predetermined position while being visually guided by the guidance information optically shown. Therefore, regardless of the practitioner, the position where the stimulation electrode is arranged on the patient can be made constant over a plurality of occasions.

  The rehabilitation support system may include a display device, and the guidance information providing unit may display the guidance information on the display device.

  As an example, when the guidance information includes an image of a part of the patient's body acquired in the past, the practitioner confirms the position of the stimulation electrode disposed in the rehabilitation performed in the past, The stimulation electrode can be accurately placed at a predetermined position. Therefore, regardless of the practitioner, the position where the stimulation electrode is arranged on the patient can be made constant over a plurality of occasions.

  As another example, when the guidance information is a numerical value indicating the distance to the arrangement position, the practitioner can accurately arrange the stimulation electrode at a predetermined position while confirming that the numerical value approaches zero. Therefore, regardless of the practitioner, the position where the stimulation electrode is arranged on the patient can be made constant over a plurality of occasions.

  The guidance information may be configured to be a sound that changes according to a distance to the arrangement position.

  According to such a configuration, the practitioner can accurately arrange the stimulation electrode at a predetermined position while being audibly guided by the output sound. Therefore, regardless of the practitioner, the position where the stimulation electrode is arranged on the patient can be made constant over a plurality of occasions.

The rehabilitation support system is:
An image acquisition unit for acquiring an image of a part of the patient's body;
Through the image, an electrode position information acquisition unit that acquires electrode position information indicating the position of the stimulation electrode disposed on the patient;
It can be set as the structure provided with.
In this case, the arrangement position storage unit stores the stimulation electrode position information as the arrangement position information.

  According to such a structure, the arrangement | positioning of the stimulation electrode determined in the rehabilitation performed at a certain time is memorize | stored, and it can utilize in the rehabilitation after the next time. Therefore, regardless of the practitioner, the position where the stimulation electrode is arranged on the patient can be made constant over a plurality of occasions.

The rehabilitation support system is:
It can be set as the structure provided with the light emission part which is arrange | positioned adjacent to the said stimulation electrode and radiate | emits the light which has a predetermined wavelength.

  According to such a configuration, it becomes easier to detect the position of the stimulation electrode through the image recognition technique by the image acquisition unit. Thereby, the position of the stimulation electrode can be detected more accurately, and the accuracy of the arrangement position information stored in the arrangement position storage unit can be improved. Therefore, regardless of the practitioner, the position where the stimulation electrode is arranged on the patient can be made constant over a plurality of occasions.

The rehabilitation support system is:
It may be configured with a normalized scale that is placed adjacent to a portion of the patient's body.

  According to such a configuration, the image acquisition unit performs image recognition based on the scale, and the position on the part of the patient's body regardless of the distance between the image acquisition unit and the part of the patient's body, or the like. Can be accurately identified. Thereby, the position of the stimulation electrode can be detected more accurately, and the accuracy of the arrangement position information stored in the arrangement position storage unit can be improved. Therefore, regardless of the practitioner, the position where the stimulation electrode is arranged on the patient can be made constant over a plurality of occasions.

  The stimulation electrode position information may include information indicating feature points included in a part of the patient's body.

  According to such a configuration, the position of the stimulation electrode can be specified using the feature points in a part of the patient's body without using a scale or the like. Since the feature point itself does not change over a plurality of rehabilitations, the placement position of the stimulation electrode can be specified based on the feature point in the next and subsequent rehabilitations. Therefore, regardless of the practitioner, the position where the stimulation electrode is arranged on the patient can be made constant over a plurality of occasions.

The rehabilitation support system is:
A stimulation applying unit that applies electrical stimulation to a part of the patient's body through the stimulation electrode;
Based on the change of the stimulation electrode position information due to the electrical stimulation, an evaluation unit that evaluates the effect of rehabilitation;
It can be set as the structure provided with.

  According to such a configuration, the response of a part of the patient's body to the electrical stimulation, that is, the effect of rehabilitation can be quantitatively evaluated without being observed by the observer. Electrical stimulation is performed through stimulation electrodes that are accurately placed at fixed positions as described above. Therefore, it is possible to ensure the accuracy of both the stimulus input and the response to the stimulus over a plurality of occasions regardless of the practitioner.

The rehabilitation support system is:
It can be set as the structure provided with the inertial sensor arrange | positioned adjacent to the said stimulation electrode.
In this case, the evaluation unit evaluates the effect of rehabilitation based on the output of the inertial sensor.

  According to such a configuration, it is possible to acquire not only the displacement of the stimulation electrode but also information relating to the displacement speed and posture change of the stimulation electrode. Therefore, the effect of rehabilitation can be evaluated in more detail.

The rehabilitation support system is:
It may be configured to include at least one of a temperature sensor and a humidity sensor disposed adjacent to the stimulation electrode.
In this case, the evaluation unit evaluates the effect of rehabilitation based on the output of the at least one of the temperature sensor and the humidity sensor.

  It is known that as the function of a paralyzed part is restored, the temperature and humidity of the part increases. According to the above configuration, information on the degree of recovery can be acquired not only through the displacement of the stimulation electrode but also through at least one of temperature and humidity of a part of the patient's body. Therefore, the effect of rehabilitation can be evaluated in more detail.

The rehabilitation support system is:
The stimulation electrode position information may be configured to include a recording unit that records at least a point in time when the electrode position information is acquired and patient identification information.
In this case, the evaluation unit evaluates the effect of rehabilitation by comparing the stimulation electrode position information for a plurality of time points.

  According to such a configuration, it is possible to quantitatively evaluate the change in the response of a part of the patient's body to the electrical stimulation, that is, the progress of rehabilitation without being visually observed by the observer. Electrical stimulation is performed through stimulation electrodes that are accurately placed at fixed positions as described above. Therefore, it is possible to ensure the accuracy of both the stimulus input and the response to the stimulus over a plurality of occasions regardless of the practitioner.

In order to achieve the above object, a second aspect of the present invention is a rehabilitation support system,
A stimulation application unit that applies electrical stimulation to a part of the patient's body;
An image acquisition unit for acquiring an image of a part of the patient's body;
An evaluation unit that evaluates the magnitude of a response of a part of the patient's body by the electrical stimulation based on the image;
A display unit for displaying the image;
A display control unit that causes the display unit to display a map representing a relationship between the position where the electrical stimulation is applied and the magnitude of the reaction;
It has.

  According to such a configuration, the arrangement position of the stimulation electrode can be determined based on the quantitative evaluation regardless of the evaluator. If the stimulation electrode is arranged at the arrangement position determined in this way, the position where the stimulation electrode is arranged on the patient can be made constant over a plurality of occasions regardless of the practitioner.

  The stimulation applying unit may be configured to include a conductive unit provided at the tip of the rod.

  According to such a configuration, it is possible to efficiently apply electrical stimulation to a plurality of arbitrary locations in a part of the body without an operation of attaching / detaching the stimulation electrode to / from the part of the patient's body. it can. Therefore, the quantitative evaluation for determining the arrangement position of the stimulation electrode can be efficiently performed.

  The stimulation applying unit may include a plurality of conductive units arranged on a sheet body attached to a part of the patient's body.

  According to such a configuration, once the sheet body is attached to a part of the patient's body, electrical stimulation can be efficiently applied to a plurality of locations in the part of the body. In particular, since the positional relationship between the plurality of conductive parts is fixed, it is possible to eliminate the occurrence of a difference in the stimulation position by the evaluator. Therefore, quantitative evaluation for determining the arrangement position of the stimulation electrode can be efficiently performed regardless of the evaluator.

  The display control unit may be configured to display an image indicating a position of at least one of a muscle and a nerve included in a part of the patient's body on the display unit.

  According to such a configuration, the stimulus application position by the stimulus application unit can be determined with reference to the image. Therefore, it is possible to efficiently apply electrical stimulation to a plurality of locations in a part of the patient's body.

It is a figure which shows the rehabilitation assistance system which concerns on 1st Embodiment. It is a figure which shows the stimulation electrode with which said system is provided. It is a figure which shows the example of the guidance information provision part with which the said system is provided. It is a figure which shows the example of the guidance information provision part with which the said system is provided. It is a figure which shows the example of the guidance information provision part with which the said system is provided. It is a figure which shows the example of the guidance information provision part with which the said system is provided. It is a figure which shows the example of the structure which acquires the positional information on the said stimulation electrode. It is a figure which shows the example of the structure which evaluates the effect of rehabilitation. It is a figure which shows the rehabilitation assistance system which concerns on 2nd Embodiment. It is a figure which shows the example of the stimulus application part with which the system of FIG. 9 is provided.

  Exemplary embodiments of the present invention will be described in detail below with reference to the accompanying drawings. FIG. 1 is a functional block diagram showing a rehabilitation support system 1 (hereinafter abbreviated as support system 1) according to the first embodiment. The support system 1 according to the present embodiment is configured to support rehabilitation performed for a hemiplegic patient due to a stroke, for example. The support system 1 includes at least one stimulation electrode 2.

  As shown in FIG. 2, the stimulation electrode 2 is configured to be disposed on a patient's paralyzed limb 100 (an example of a part of the body). For example, the stimulation electrode 2 is used to promote recovery of the brain and nerves by repeatedly operating the paralyzed limb 100 through energization stimulation. The stimulation electrode 2 is connected to an electrical stimulation device (not shown) through the cord 3. The electrical stimulation device is configured to detect a command from the brain of a patient who intends to move the paralyzed limb 100 or a command from the support system 1 and to energize the stimulation electrode 2 based on the command. By the electrical stimulation applied to the paralyzed limb 100 through the stimulation electrode 2, the paralyzed limb 100 moves as shown by a two-dot chain line in FIG. As a result, the patient can feel as if the paralyzed limb has moved as intended. Such repeated stimulation is known to promote functional recovery of the paralyzed limb.

  As shown in FIG. 1, the support system 1 includes an arrangement position storage unit 4. The arrangement position storage unit 4 stores arrangement position information indicating the position where the stimulation electrode 2 is arranged. The arrangement position information can be, for example, three-dimensional coordinates in a space including the paralyzed limb 100. In this case, the position where the stimulation electrode 2 is arranged can be specified by specific three-dimensional coordinates.

  As shown in FIG. 1, the support system includes a guidance information providing unit 5. The guidance information providing unit 5 provides the practitioner (an example of a user) with guidance information for guiding the stimulation electrode 2 to the position indicated by the arrangement position information based on the arrangement position information stored in the arrangement position storage unit 4. Is configured to do. The practitioner places the stimulation electrode 2 at a predetermined position on the paralyzed limb 100 based on the guidance information provided by the guidance information providing unit 5.

  According to such a configuration, the position where the stimulation electrode 2 is disposed on the patient can be made constant over a plurality of occasions regardless of the practitioner. Since such a position is determined as a position where the rehabilitation effect is appropriately exhibited, the effectiveness of the rehabilitation performed over a plurality of occasions can be enhanced. Moreover, since the arrangement position of the stimulation electrode 2 is always constant, it is possible to improve the reliability of the evaluation for the effect of rehabilitation performed over a plurality of occasions.

  FIG. 3A shows a pointer 51 as an example of the guidance information providing unit 5. The pointer 51 includes a light source capable of emitting a light beam 51a. The type of the light source is not limited as long as it can emit a light beam having a certain degree of directivity. The pointer 51 emits a light beam 51 a (an example of guidance information) that points to a point on the paralyzed limb 100 corresponding to the three-dimensional coordinates stored in the arrangement position storage unit 4. The point indicated by the light beam 51a is a position where the stimulation electrode 2 specified by the three-dimensional coordinates is arranged. The practitioner places the stimulation electrode 2 at the position indicated by the light beam 51a.

  According to such a configuration, since the arrangement position of the stimulation electrode 2 is optically indicated on the paralyzed limb 100 by the light beam 51a, the practitioner guides the stimulation electrode 2 to a predetermined position while being guided by the light beam 51a. Can be placed accurately. Therefore, regardless of the practitioner, the position where the stimulation electrode 2 is arranged on the patient can be made constant over a plurality of occasions.

  FIG. 3B shows a projector 52 as an example of the guidance information providing unit 5. The projector 52 is configured to be able to project an image 52 a corresponding to the stimulation electrode 2. The projector 52 projects an image 52 a (an example of guidance information) on a point on the paralyzed limb 100 corresponding to the three-dimensional coordinates stored in the arrangement position storage unit 4. The point on which the image 52a is projected is a position where the stimulation electrode 2 specified by the three-dimensional coordinates is arranged.

  According to such a configuration, since the arrangement position of the stimulation electrode 2 is optically shown on the paralyzed limb 100 by the image 52a, the practitioner guides the stimulation electrode 2 to a predetermined position while being guided by the image 52a. Can be placed accurately. Therefore, regardless of the practitioner, the position where the stimulation electrode 2 is arranged on the patient can be made constant over a plurality of occasions.

  As shown by a broken line in FIG. 1, the support system 1 may be configured to include a display device 6. Examples of the display device 6 include a stationary display device (such as a display and a monitor) and a portable display terminal (such as a smartphone, a tablet terminal, and a head-mounted display). The display device 6 is communicably connected to the guidance information providing unit 5. The guidance information providing unit 5 displays the guidance information on the display device 6.

  FIG. 4A shows an example in which an image 61 is displayed on the display device 6 as guidance information. The image 61 includes the paralyzed limb 100 of the patient on which the stimulation electrode 2 is disposed in the rehabilitation performed in the past. Examples of the image 61 include an image captured by an appropriate imaging unit and a computer graphics image modeled based on the captured image.

  According to such a configuration, the practitioner can accurately arrange the stimulation electrode 2 at a predetermined position while confirming the position of the stimulation electrode 2 disposed in the rehabilitation performed in the past. Therefore, regardless of the practitioner, the position where the stimulation electrode 2 is arranged on the patient can be made constant over a plurality of occasions.

  As shown in FIG. 4B, an image 62 obtained by imaging the current patient's paralyzed limb 100 may be displayed on the display device 6. In this case, the guidance information providing unit 5 displays the image 61 on the display device 6 so as to be aligned with or superimposed on the image 62. According to such a configuration, the arrangement accuracy of the stimulation electrode 2 is further improved. Further, the matching rate between the image 61 and the image 62 may be detected, and an indicator corresponding to the matching rate may be displayed on the display device 6. According to such a configuration, not only the placement accuracy of the stimulation electrode 2 is further improved, but also the misplacement of the patient and the electrode placement site can be prevented.

  As shown in FIG. 5A, a numerical value 63 indicating the distance to the position where the stimulation electrode 2 is arranged may be displayed on the display device 6 as the guidance information. In this case, the guidance information providing unit 5 includes the three-dimensional coordinates (position where the stimulation electrode 2 is arranged) indicated by the arrangement position information stored in the arrangement position storage unit 4 and the three-dimensional coordinates indicating the current position of the stimulation electrode 2. And the result is displayed on the display device 6. The current position of the stimulation electrode 2 can be detected through appropriate imaging means and sensors. When the stimulation electrode 2 is arranged at a predetermined position, the difference between the three-dimensional coordinates indicated by the arrangement position information and the three-dimensional coordinates indicating the current position is zero. The practitioner can recognize that the stimulation electrode 2 is disposed at a predetermined position with the fact that the numerical value 63 displayed on the display device 6 is zero.

  According to such a configuration, the practitioner can accurately arrange the stimulation electrode 2 at a predetermined position while confirming that the numerical value 63 approaches zero. Therefore, regardless of the practitioner, the position where the stimulation electrode 2 is arranged on the patient can be made constant over a plurality of occasions.

  As shown in FIG. 5B, the display device 6 that displays a numerical value 63 indicating the distance to the position where the stimulation electrode 2 is arranged may be provided in a part of the stimulation electrode 2. According to such a configuration, the practitioner can determine the arrangement of the stimulation electrode 2 while confirming the numerical value 63 displayed on the display device 6 provided on the stimulation electrode 2. Therefore, regardless of the practitioner, the position where the stimulation electrode 2 is arranged on the patient can be made constant over a plurality of occasions.

  FIG. 6 shows an example in which a sound that changes according to the distance to the position where the stimulation electrode 2 is arranged is used as the guidance information. In this case, the guidance information providing unit 5 includes the three-dimensional coordinates (position where the stimulation electrode 2 is arranged) indicated by the arrangement position information stored in the arrangement position storage unit 4 and the three-dimensional coordinates indicating the current position of the stimulation electrode 2. The sound corresponding to the difference value is output. The current position of the stimulation electrode 2 can be detected through appropriate imaging means and sensors.

  In the example shown in FIG. 6, the first sound is output when the stimulation electrode 2 is located at a position away from the predetermined arrangement position, and the second sound is output when the stimulation electrode 2 is arranged at the predetermined position. It is output. An example of the difference between the first sound and the second sound is the volume of the sound. For example, the sound output increases as the stimulation electrode 2 approaches a predetermined arrangement position. Another example of the difference between the first sound and the second sound is the sound frequency (high or low). For example, the sound (frequency) output increases as the stimulation electrode 2 approaches a predetermined arrangement position. Another example of the difference between the first sound and the second sound is the pitch of the sound that is repeatedly output. For example, the pitch of the sound repeatedly output becomes shorter as the stimulation electrode 2 approaches a predetermined arrangement position. The first sound may be silence and the second sound may be a predetermined sound. In this case, the predetermined sound is output only when the stimulation electrode 2 is disposed at a predetermined position. Note that the magnitude of the sound, the level of the sound (frequency), and the length of the pitch may be opposite to the example shown here.

  According to such a configuration, the practitioner can accurately place the stimulation electrode 2 at a predetermined position while being guided by the output sound. Therefore, regardless of the practitioner, the position where the stimulation electrode 2 is arranged on the patient can be made constant over a plurality of occasions.

  Next, a configuration for acquiring the arrangement position information stored in the arrangement position storage unit 4 will be described in detail. As indicated by a broken line in FIG. 1, the support system 1 may include an image acquisition unit 7 and an electrode position information acquisition unit 8.

  The image acquisition unit 7 is configured to acquire an image of the patient's paralyzed limb 100. The image acquisition unit 7 is preferably configured to acquire depth information so that the shape of the paralyzed limb 100 of the patient can be grasped three-dimensionally. The electrode position information acquisition unit 8 is configured to acquire electrode position information indicating the position of the stimulation electrode 2 disposed on the paralyzed limb 100 through the image acquired by the image acquisition unit 7. The arrangement position storage unit 4 is configured to store the electrode position information acquired by the electrode position information acquisition unit 8 as the arrangement position information.

  According to such a structure, the arrangement | positioning on the paralyzed limb 100 of the stimulation electrode 2 determined in the rehabilitation performed at a certain time is memorize | stored, and it can utilize in the next rehabilitation. Therefore, regardless of the practitioner, the position where the stimulation electrode 2 is arranged on the patient can be made constant over a plurality of occasions. In addition, in order to acquire electrode position information through an image recognition technique, it is preferable that the stimulation electrode 2 is colored with a color (blue, purple, pink, etc.) that can be clearly distinguished from the patient's skin.

  As shown by a broken line in FIG. 1, the support system 1 may be configured to include a light emitting unit 9. The light emitting unit 9 is arranged adjacent to the stimulation electrode 2 and configured to emit light having a predetermined wavelength. “Light of a predetermined wavelength” means not only visible light but also infrared light. The light emitting unit 9 may be provided as a part of the stimulation electrode 2.

  According to such a configuration, the position detection of the stimulation electrode 2 through the image recognition technique by the image acquisition unit 7 becomes easier. The image acquisition unit 7 preferably has high sensitivity to the wavelength of light emitted from the light emitting unit 9. Thereby, the position of the stimulation electrode 2 can be detected more accurately, and the accuracy of the arrangement position information stored in the arrangement position storage unit 4 can be improved. Therefore, regardless of the practitioner, the position where the stimulation electrode 2 is arranged on the patient can be made constant over a plurality of occasions.

  As indicated by a broken line in FIG. 1, the support system 1 may be configured to include a scale 10. The scale 10 is arranged adjacent to the patient's paralyzed limb 100 and has a normalized scale, as shown in FIG. Here, “normalized” means that one unit on the scale (here, one scale) is associated with another unit such as 1 cm or 1 inch. Instead of a calibrated scale, a size-normalized object may be placed adjacent to the patient's paralyzed limb 100.

  According to such a configuration, the image acquisition unit 7 performs image recognition based on the scale of the scale 10, and the position on the paralyzed limb 100 is determined regardless of the distance between the image acquisition unit 7 and the paralyzed limb 100. It can be accurately identified. Thereby, the position of the stimulation electrode 2 can be detected more accurately, and the accuracy of the arrangement position information stored in the arrangement position storage unit 4 can be improved. Therefore, regardless of the practitioner, the position where the stimulation electrode 2 is arranged on the patient can be made constant over a plurality of occasions.

  The image acquisition unit 7 may be configured to extract feature points such as a mole 100a and a scar 100b on the patient's paralyzed limb 100 as shown in FIG. In this case, the electrode position information acquisition unit 8 may include information indicating the feature point in the electrode position information. For example, the position of the stimulation electrode 2 can be specified based on the direction and distance with respect to the mole 100a. The position of the blood vessel in the paralyzed limb 100 may be extracted as a feature point.

  According to such a configuration, the position of the stimulation electrode 2 can be specified using the feature points in a part of the patient's body without using the scale 10 or the like. Since the feature point itself does not change over a plurality of rehabilitations, the arrangement position of the stimulation electrode 2 can be specified based on the feature point in the next and subsequent rehabilitations. Therefore, regardless of the practitioner, the position where the stimulation electrode 2 is arranged on the patient can be made constant over a plurality of occasions.

  Next, a configuration for quantitatively evaluating the effect of rehabilitation will be described. As shown by a broken line in FIG. 1, the support system 1 may include a stimulus application unit 11 and an evaluation unit 12.

  As shown in FIG. 8, the stimulation applying unit 11 is configured to apply electrical stimulation to the patient's paralyzed limb 100 through the stimulation electrode 2. Due to the electrical stimulation, the paralyzed limb 100 performs reflex movement. The image acquisition unit 7 acquires a state in which the paralyzed limb 100 performs a reflex motion as image data. The electrode position information acquisition unit 8 acquires electrode position information of the stimulation electrode 2 before and after electrical stimulation based on the image acquired by the image acquisition unit 7.

  The evaluation unit 12 is configured to evaluate the effect of rehabilitation based on changes in electrode position information due to electrical stimulation. Specifically, since the electrode position information includes position coordinates of the stimulation electrode 2 in the three-dimensional space as information, the stimulation electrode 2 indicates in which direction and how much the paralyzed limb 100 has moved in response to a certain electrical stimulation. Can be quantitatively grasped based on the displacement of.

  According to such a configuration, the response of the paralyzed limb 100 to electrical stimulation, that is, the effect of rehabilitation can be quantitatively evaluated without being visually observed by an observer. Electrical stimulation is performed through the stimulation electrode 2 that is accurately placed at a fixed position as described above. Therefore, it is possible to ensure the accuracy of both the stimulus input and the response to the stimulus over a plurality of occasions regardless of the practitioner.

  As indicated by a broken line in FIG. 1, the support system 1 may be configured to include an inertial sensor 13. The inertial sensor 13 is disposed adjacent to the stimulation electrode 2. The inertial sensor 13 may be provided as a part of the stimulation electrode 2. The inertial sensor 13 is configured to output a signal corresponding to the displacement (speed, acceleration, posture change) of the stimulation electrode 2 due to electrical stimulation. As shown in FIG. 8, the evaluation unit 12 is configured to evaluate the effect of rehabilitation based on the output of the inertial sensor 13 in addition to the change in electrode position information due to electrical stimulation.

  According to such a configuration, it is possible to acquire not only the displacement of the stimulation electrode 2 in the three-dimensional space but also information relating to the displacement speed and the posture change of the stimulation electrode 2 in the three-dimensional space. Therefore, the effect of rehabilitation can be evaluated in more detail.

  As indicated by a broken line in FIG. 1, the support system 1 may be configured to include a temperature / humidity sensor 14. The temperature / humidity sensor 14 is disposed adjacent to the stimulation electrode 2. The temperature / humidity sensor 14 may be provided as a part of the stimulation electrode 2. The temperature / humidity sensor 14 is configured to output a signal corresponding to at least one of temperature and humidity at a location where the temperature / humidity sensor 14 is disposed. As shown in FIG. 8, the evaluation unit 12 performs rehabilitation based on the output from the temperature / humidity sensor 14 in addition to or in place of the output of the inertial sensor 13 in addition to the change in electrode position information due to electrical stimulation. It is configured to evaluate the effect.

  It is known that as the function of a paralyzed part is restored, the temperature and humidity of the part increases. According to the configuration as described above, information related to the degree of recovery can be acquired through at least one of the temperature and humidity of the paralyzed limb 100 as well as the displacement of the stimulation electrode 2 in the three-dimensional space. Therefore, the effect of rehabilitation can be evaluated in more detail.

  As shown by a broken line in FIG. 1, the support system 1 may be configured to include a recording unit 15. The recording unit 15 is configured to record the electrode position information acquired by the electrode position information acquisition unit 8 in association with at least the time when the electrode position information is acquired and the patient specifying information (name, patient number, etc.). Yes. Examples of other information recorded in the recording unit 15 include disease names, treatment conditions, treatment details, and the like.

  Examples of the recording unit 15 include a large-capacity storage device (such as a hard disk) and a portable storage medium (such as a disk-type storage medium, a card-type storage medium, and a USB memory). The recording unit 15 may be installed at any location as long as the recording unit 15 can communicate with the electrode position information acquisition unit 8 in a wired or wireless manner. The electrode position information acquisition unit 8 and a stand-alone system may be configured, or may be connected to the electrode position information acquisition unit 8 via a LAN or a WAN.

  As illustrated in FIG. 8, the evaluation unit 12 is configured to evaluate the effect of rehabilitation by comparing electrode position information for a plurality of time points. In comparison, at least a part of the electrode position information for a plurality of time points is referred to what is recorded in the recording unit 15. For example, when the same electrical stimulation is applied through the stimulation electrode 2 arranged at the same location based on the above description, the progress of the rehabilitation is quantified by comparing the response in the previous rehabilitation with the response in the current rehabilitation. Can be evaluated. Alternatively, the progress of the rehabilitation can be quantitatively determined by recording images at a plurality of time points acquired by the image acquisition unit 7 under the same imaging condition in the recording unit 15 and evaluating the correlation rate of the plurality of images. Can be evaluated. The evaluation of the correlation rate of the image is not limited to the evaluation of a predetermined state of the paralyzed limb 100 (for example, the end point of the operation), and is an aspect of evaluating the operation trajectory and speed based on the acquired image. Also good.

  According to the above configuration, the change in the response of the paralyzed limb 100 to the electrical stimulation, that is, the progress of rehabilitation can be quantitatively evaluated without being observed by the observer. Electrical stimulation is performed through the stimulation electrode 2 that is accurately placed at a fixed position as described above. Therefore, it is possible to ensure the accuracy of both the stimulus input and the response to the stimulus over a plurality of occasions regardless of the practitioner.

  FIG. 9 is a functional block diagram showing a rehabilitation support system 201 (hereinafter abbreviated as support system 201) according to the second embodiment. The support system 201 according to the present embodiment is configured to support an operation of determining an appropriate arrangement position of the stimulation electrode. The support system 201 includes a stimulus application unit 202, an image acquisition unit 203, a display unit 204, an evaluation unit 205, and a display control unit 206.

  The stimulation application unit 202 is configured to apply electrical stimulation to the patient's paralyzed limb 100 (an example of a part of the patient's body). Due to the electrical stimulation, the paralyzed limb 100 performs reflex movement. The image acquisition unit 203 is configured to acquire, as image data, a state in which the paralyzed limb 100 performs a reflex motion. The display unit 204 is configured to display the image acquired by the image acquisition unit 203.

  The evaluation unit 205 is configured to evaluate the magnitude of the response of the paralyzed limb 100 to the electrical stimulation applied by the stimulation applying unit 202 based on the image acquired by the image acquisition unit 203. Specifically, the coincidence rate between the image of the paralyzed limb 100 before applying the stimulus and the image of the paralyzed limb 100 that has reacted to the stimulus is acquired, and the lower the coincidence rate, the higher the response is evaluated. Alternatively, the magnitude of the reaction may be evaluated by attaching an appropriate marker to the paralyzed limb 100 and recognizing an image of the amount of marker displacement caused by electrical stimulation. By applying electrical stimulation to the plurality of locations in the paralyzed limb 100 by the stimulus applying unit 202 and evaluating the magnitude of the reaction of the paralyzed limb 100 for each stimulus application, the position and magnitude of the response to which the electrical stimulus is applied. A plurality of sets of data in pairs are obtained.

  The display control unit 206 causes the display unit 204 to display a map 207 that represents the relationship between the position where the electrical stimulation is applied by the stimulation application unit 202 and the magnitude of the reaction of the paralyzed limb 100 evaluated by the evaluation unit 205. It is configured. In the example illustrated in FIG. 9, the application portion of the electrical stimulus that has obtained a greater response is displayed on the display unit 204 in a superimposed manner on the image acquired by the image acquisition unit 203. The map 207 suggests a position where the stimulation electrode should be arranged in the rehabilitation. The practitioner determines the placement position of the stimulation electrode based on the map 207.

  The display mode of the map 207 is not limited to the example shown in FIG. For example, contour lines corresponding to the magnitude of the reaction may be superimposed on the image acquired by the image acquisition unit 203. In addition, the map displayed on the display unit 204 does not need to be superimposed on the image acquired by the image acquisition unit 203. The map may be provided as a computer graphics image generated by modeling based on the image of the paralyzed limb 100 acquired by the image acquisition unit 203.

  As indicated by a broken line in FIG. 9, the support system 201 may include a recording unit 208. The recording unit 208 is configured to record the evaluation result by the evaluation unit 205 in association with at least the time when the evaluation is performed and patient identification information (name, patient number, etc.). Examples of other information recorded in the recording unit 208 include a disease name, treatment condition, treatment content, and the like.

  Examples of the recording unit 208 include a large-capacity storage device (such as a hard disk) and a portable storage medium (such as a disk-type storage medium, a card-type storage medium, and a USB memory). The recording unit 15 may be installed anywhere as long as it can communicate with the evaluation unit 205 by wire or wireless. A stand-alone system may be configured with the power evaluation unit 205, or may be connected to the evaluation unit 205 via a LAN or WAN. The recording unit 208 may be the arrangement position storage unit 4 described with reference to the first embodiment.

  According to the above configuration, the arrangement position of the stimulation electrode can be determined based on quantitative evaluation regardless of the evaluator. If the stimulation electrode is arranged at the arrangement position determined in this way, the position where the stimulation electrode is arranged on the patient can be made constant over a plurality of occasions regardless of the practitioner.

  FIG. 10A shows an example of the stimulus application unit 202. In the stimulation applying unit 202 according to this example, a conductive portion 202b is provided at the tip of a rod 202a. Electrical stimulation is applied to the paralyzed limb 100 from the conductive portion 202b in accordance with a signal input through the signal line 202c.

  According to such a configuration, it is possible to efficiently apply electrical stimulation to a plurality of arbitrary locations in the paralyzed limb 100 without an operation of attaching / detaching the stimulation electrode to / from the paralyzed limb 100. Therefore, the quantitative evaluation for determining the arrangement position of the stimulation electrode can be efficiently performed.

  FIG. 10B shows another example of the stimulus applying unit 202. The stimulation applying unit 202 according to this example includes a sheet body 202d to be attached to the paralyzed limb 100. A plurality of conductive portions 202e are arranged on the sheet body 202d. In response to a signal input through the signal line 202f, electrical stimulation is sequentially applied from each conductive portion 202e to the paralyzed limb 100.

  According to such a configuration, once the sheet body 202d is attached to the paralyzed limb 100, electrical stimulation can be efficiently applied to a plurality of locations in the paralyzed limb 100. In particular, since the positional relationship between the plurality of conductive portions 202e is fixed, it is possible to eliminate the occurrence of a difference in stimulation position by the evaluator. Therefore, quantitative evaluation for determining the arrangement position of the stimulation electrode can be efficiently performed regardless of the evaluator.

  As shown by a broken line in FIG. 9, the display control unit 206 can be configured to cause the display unit 204 to display an image 209 showing at least one of muscles and nerves included in the paralyzed limb 100. The image 209 is a computer graphics image created in advance based on anatomical knowledge.

  According to such a configuration, the stimulus application position by the stimulus application unit 202 can be determined with reference to the image 209. Therefore, the application of electrical stimulation to a plurality of locations in the paralyzed limb 100 can be performed efficiently.

  The above embodiment is for facilitating understanding of the present invention, and does not limit the present invention. The present invention can be modified and improved without departing from the spirit of the present invention, and it is obvious that the present invention includes equivalents thereof.

  1: rehabilitation support system, 2: stimulation electrode, 4: arrangement position storage unit, 5: guidance information providing unit, 6: display device, 7: image acquisition unit, 8: electrode position information acquisition unit, 9: light emitting unit, 10 : Scale, 11: Stimulation application unit, 12: Evaluation unit, 13: Inertial sensor, 14: Temperature / humidity sensor, 51: Pointer, 52: Projector, 61, 62: Image, 63: Numerical value, 100: Paralysis limb of patient , 201: rehabilitation support system, 202: stimulation application unit, 202a: rod, 202b: conductive unit, 202d: sheet, 202e: conductive unit, 203: image acquisition unit, 204: display unit, 205: evaluation unit, 206 : Display control unit, 207: Map, 209: Image

Claims (4)

A stimulation application unit that applies electrical stimulation to a part of the patient's body;
An image acquisition unit for acquiring an image of a part of the patient's body;
An evaluation unit that evaluates the magnitude of a response of a part of the patient's body by the electrical stimulation based on the image;
A display unit for displaying the image;
A display control unit that causes the display unit to display a map representing a relationship between the position where the electrical stimulation is applied and the magnitude of the reaction;
Rehabilitation support system equipped with   The rehabilitation support system according to claim 1, wherein the stimulation applying unit includes a conductive unit provided at a tip of the rod.   The rehabilitation support system according to claim 1, wherein the stimulation applying unit includes a plurality of conductive units arranged on a sheet body to be attached to a part of the patient's body.   The rehabilitation support according to any one of claims 1 to 3, wherein the display control unit causes the display unit to display an image indicating a position of at least one of a muscle and a nerve included in a part of the patient's body. system.

Images