JP2020178851A - Electronic peg system for evaluating and training cognitive function and finger motion function - Google Patents

Abstract

To provide a peg board capable of performing training while keeping the motivation of a subject.SOLUTION: A peg has magnetic properties and a peg board has plural detection holes for sensing magnetism, thereby detecting whether an inserted peg is correct or not. Further provided is an indication unit which optically indicates a region of a detection hole into which a subject has to insert the peg. A patient's motivation for training is kept by detecting whether the inserted peg is correct or not and reporting a result with light and sound.SELECTED DRAWING: Figure 1

Description

The present invention relates to a peg system used for training finger movement function. In particular, it relates to an electronic peg system used in rehabilitation.

In patients with upper limb paralysis who have residual paralysis in their arms and hands due to cerebrovascular accidents, fractures of upper limbs / fingers, intractable neurological diseases, etc., rehabilitation of upper limbs and fingers is performed early and continuously to recover their functions. It is very important to maintain a good quality of life for the patient. In rehabilitation, functional recovery training and evaluation of work ability are performed as standard by an occupational therapist.

The evaluation of the skillful movement of fingers includes gripping and releasing of articles of various shapes, tool operation, operability accuracy, operation speed, and the like. Various types of building blocks and beanbags are used to obtain the basic movements of gripping, knobs, and beanbags. Among them, several types of pegs are available on the market and are used according to the level of each patient. To. Occupational therapists may hand-craft pegs for training if there is no suitable peg for each patient's level of dysfunction. In this way, the peg and the peg board (hereinafter, the peg and the peg board are collectively referred to as the peg system) are one of the indispensable tools for rehabilitating the upper limb function. In addition to the evaluation training of finger dexterity, the pegs and pegboards undergo higher brain dysfunction such as unilateral spatial neglect by the process of moving the pegs to the insertion holes (also called pegholes) on the board. It is also used as training to improve visuospatial cognition, attention, and memory for patients with cerebrovascular accidents and dementia.

For example, in the "Stroke Treatment Guideline 2015" (Non-Patent Document 1), in order to improve activities of daily living (ADL) in the rehabilitation of cerebrovascular accidents, it is grade B to perform task repetitive training that repeats tasks. It is shown as. The main goal of occupational therapy is the independence of ADL using the upper limbs and fingers, and for that purpose, pegs and pegboards are standard treatment tools for repetitive training of hand gripping and pinching movements that are often performed in daily life situations. It is used as. Through peg insertion training, the upper limbs are encouraged to reach the target and improve the ability to operate the fingers. Therefore, occupational therapists perform functional recovery training using pegs and pegboards and evaluation of work ability as standard (Non-Patent Documents 2 and 3).

The difficulty level of the peg operation is to remove the peg from the peg board, insert the peg into the peg board, and invert the peg, and the shape and thickness of the peg according to the size of the patient's hand and the functional level of the hand. Since the size of the peg board can be graded, it is desirable that multiple types of peg systems suitable for the patient are prepared. However, the pegs used as standard in occupational therapy are made of wood and are uniform, and it is difficult to prepare multiple types of different peg systems. In addition, training with the conventional peg system is to repeat simple repetitive movements according to the instructions of the occupational therapist. Therefore, since a specialized inspector repeatedly performs the same inspection face-to-face, it is necessary to carry out training in the presence of the inspector, which causes restrictions on time and place. Furthermore, from the position of examination, it is not an attractive system to fully motivate patients to train independently.

In addition, feedback on movements to patients was limited to appropriate advice and voices from occupational therapists during and immediately after the training, and feedback in language. This made it difficult for patients to recognize the status of functional improvement as an objective evaluation in long-term rehabilitation on a monthly or yearly basis, making it difficult to maintain and improve their motivation for daily training. Usually, a patient's performance evaluation is performed by measuring the time required to move or flip a certain number of pegs placed on one board onto another board with a stopwatch, or from an observational evaluation by an occupational therapist. -It was used to determine the smoothness of hand movements, tremors, and the presence or absence of abnormal compensatory movements induced in other body parts.

Training with a conventional pegboard system is premised on one-on-one training with an occupational therapist, inserting the peg into the board to create an initial state of training, instructing the patient where to insert the peg, into the hole. The therapist must do all the work, such as assessing how long it took to insert. In addition, it is necessary to prepare pegs having different thicknesses according to the skill of the patient and boards with holes corresponding to each peg, and the storability and transportability are extremely low.

In order to improve these, there are systems that have been made multifunctional by digitization (Patent Documents 1-4). For example, in Patent Document 1, a detachable peg and a board arranged at equal intervals in the vertical and horizontal directions are used, the time for moving and inserting the peg is measured, and the comparison with a reference value obtained in advance for a healthy person is performed. , A method of calculating the fingertip delicate movement ability is disclosed. Further, Patent Document 2 discloses a rehabilitation support system including a sensor that outputs the position information of the peg and a position information acquisition unit that acquires the position information, and more accurately and objectively evaluates the degree of recovery of the finger function of the subject. There is. Further, Patent Document 3 includes a detection means for detecting the movement of the upper limb of the patient, a control means for analyzing and recording the information detected by the detection means, and a display means for displaying the analysis information, quantitatively and. An occupational therapy support device that can reduce the burden on an occupational therapist is disclosed. Further, Patent Document 4 discloses a technique for evaluating the progress of rehabilitation of a subject in more detail and objectively by means of communication.

All of these devices only quantify, display, and evaluate motion information such as the time to insert the peg and the position of the peg, and are mainly aimed at reducing the workload and improving efficiency of occupational therapists. Not too much. In addition, the provision of many sensors and peripheral devices causes the training device to have a large and complicated configuration, which makes handling and maintenance difficult. In order for the subject to maintain a high level of training motivation and work on it, a training device that is easy to use, simple, and has excellent usability is desirable.

In this way, although the peg system consisting of pegs and pegboards has been improved, it is a mechanism to increase the motivation to work on automatic recording of test results by ICT (Information and Communication Technology) and patient rehabilitation. , The need to improve usability has been pointed out.

Japanese Patent No. 443172 JP 2015-202341 JP-A-2017-086520 JP-A-2018-033692

Akira Ogawa, Shinichi Idee et al. Stroke Guidelines Committee, Japan Stroke Society: Stroke Treatment Guidelines 2015, Kyowa Planning, 2015. Yoko Sugawara: Treatment training tool for occupational therapy. Hokkaido Occupational Therapy 31 (2), 50-56, 2014. Takeshi Fukui: Why use a pegboard? Furukawa, Nagao, Noda, Four Volumes, Written by: Occupational Therapy, Bunkodo, 47-59, 2012.

The present invention provides a training task suitable for the patient's level, maintains the patient's motivation by motivating the training, and enables the training to be continued by one patient without facing each other. An object of the present invention is to provide an evaluation training system for cognitive function and finger movement function, which is composed of pegs and is more useful by eliminating time constraints. Another object of the present invention is to provide a system that can not only induce the motivation of the subject by the response by light or sound, but also induce the multi-functionality and the spontaneity of the subject in the training of cognitive rehabilitation and motor learning function. Furthermore, we will provide a system that can easily obtain the necessary information for the inspector by detecting the insertion of the peg into the detection hole, determining the correctness, analyzing the execution result, and accumulating data electronically. Make it an issue.

The present invention provides a peg system having the following features that solves the problems of the conventional peg system.
(1) An evaluation training system for cognitive function and finger movement function, which consists of a magnetic peg, a punch board equipped with a plurality of peg holes, and a peg board equipped with a base unit that senses magnetism. Evaluation training characterized by having an indicator that indicates the part of the detection hole into which the peg should be inserted with light, a detection unit that detects the correctness of the inserted peg, and a notification unit that notifies the correctness with light and sound. system.
(2) The base unit is provided with a base board, the detection unit and the indication unit are arranged on the base board, and the detection unit is composed of magnetic sensors arranged in an array and is arranged on the base board. The spatial coordinate position of the peg by the magnetic sensor is detected and / or measured by the detection unit, and the matching rate between the peg insertion direction indicated by the indication unit and the peg insertion direction detected by the detection unit is calculated. The evaluation training system according to (1), characterized in that it includes a control unit for storing and analyzing and a display unit for displaying the calculated result.
(3) A program is provided in which the difficulty level of the task is determined by instructing the position and / or order of the detection holes into which the pegs should be inserted, from the instruction of the task by the light of the indicator to the completion of the peg insertion by the subject. It is possible to set the required time target value for each subject, and the control unit calculates, stores, and analyzes the task set before the peg insertion operation and the achievement rate for the required time target value, and displays it on the display unit. The evaluation training system according to (1) or (2), which comprises displaying.
(4) The evaluation training system according to any one of (1) to (3), wherein power supply to the pegboard and control by the control unit can be performed by connecting to a portable computer having a built-in battery.
(5) A peg arrangement board that can be stored in the base unit is provided, the peg arrangement board has magnetism, and the pegs are automatically arranged and fixed in the direction and spacing by magnetism in the peg arrangement board. The evaluation training system according to any one of (1) to (4).
(6) The evaluation training system according to any one of (1) to (5), wherein the surface of the peg and the peg board is made of an antibacterial material or is subjected to an antibacterial treatment to maintain a hygienic condition.
(7) The evaluation training system according to any one of (1) to (6), which is used for rehabilitation of motor dysfunction and / or cognitive function due to cerebrovascular accident and / or sequelae of dementia.
(8) The evaluation training system according to any one of (1) to (6), which is a system used for learning training of cognitive function and / or finger motor function of an infant.

Since this system can maintain the motivation of patients, it can be used not only as a training scene with an occupational therapist but also as a tool for self-training in a hospital room or at home. As a result, it is possible to repeatedly train the hands frequently in addition to the training time. This makes it easier to continuously engage in self-training for a certain period of time while maintaining motivation, and promotes recovery of hand function, compared to when using conventional pegs.

External perspective view showing pegs and pegboards. FIG. 1 (A) shows a peg system, and FIG. 1 (B) shows a peg. The figure which shows the mode at the start of use of a peg system. The state in which the peg arrangement board is pulled out and the pegs are arranged is shown in (A). (B) shows a side view of a peg system. The figure which shows one aspect of training using the peg system of this invention. The figure which shows another aspect of training using the peg system of this invention.

The present invention is a device developed for the rehabilitation of patients with upper limb paralysis, unilateral spatial neglect, etc. who require upper limb training, but the task and correctness are notified by light and sound, and the game is highly playable. Therefore, it can be used to prevent cognitive decline in the elderly and as an educational toy for young children.

The present invention is provided with a punch board provided with a peg hole and a peg board that senses magnetism while maintaining the functions and forms of the conventional peg and peg board, and notifies the correctness of the peg inserted in the detection hole by light and sound. This motivates training by adding gameplay with sound and light. Here, the detection hole refers to a hole whose position is specified by a peg hole and which can detect the direction of a peg inserted by a base board provided with a sensor for detecting magnetism, that is, a functional configuration consisting of a punch board and a base board. Such a functional configuration is not found in traditional wooden pegs.

In addition, by digitizing wooden analog equipment, it is not only possible to eliminate the time and space constraints of training, such as training patients and examiners at a distance and keeping records electronically. It is possible to objectively evaluate the effect of training over time. At the same time, it can be expected to reduce the burden on occupational therapists and contribute to medical economics by automating training preparations.

Even when used by infants as educational toys, the gameplay is added by sound and light, so it is possible to improve the skill and cognitive function without getting tired. When the task is achieved, the mode can be adapted to the infant, such as playing music that the infant likes. By using multicolored pegs and multicolored LEDs, the instruction by light can be made more complicated.

In addition, when used by an infant, it is preferable that the size and material are safe for the infant to put in the mouth, and the size and weight are suitable for the infant's hand. The shape of the peg is not limited to a cylinder, but the cross section has various shapes such as a triangle, a square, and a star, so that higher cognitive function can be trained. In addition, the texture of the peg may be changed to be smooth or rough.

Hereinafter, the present invention will be described in detail with reference to the drawings. The following explanation focuses on pegs for patients undergoing rehabilitation, but even a peg system for infants may be constructed as basically the same system.

[Phase 1]
The peg system 1 shown in FIG. 1 (A) includes a peg board 2 and a peg 3. The peg board 2 is composed of a punch board 5 provided with a plurality of peg holes 4 and a base unit 6. Here, a punch board 5 provided with 5 rows and 5 rows of peg holes 4 is shown, but punch boards with different hole sizes and numbers are prepared so that pegs of different thickness can be inserted according to the patient's level. ing. Since the punch board is relatively thin, it is possible to save space. Also, the punchboard can be removed for easier cleaning and keep the peg system clean. In addition, the surface of the peg or punch board can be kept clean by applying an antibacterial material or antibacterial treatment.

Magnets are arranged at both ends of the peg 3 (FIG. 1 (B)). If the end faces 7a and 7b of the peg 3 are configured to have magnetism different from that of the north and south poles, the peg itself is magnetic regardless of whether the magnet is built in or attached to both ends of the non-magnetic material. It may be a metal rod having. Further, both ends of the peg are colored with different colors to distinguish between the north pole and the south pole. The magnets provided on the pegs are used for both position detection to confirm that the pegs have been inserted in the correct positions through the holes in the punchboard 5 and for the initial placement described below.

A base board 8 having a built-in magnetic sensor is arranged on the base unit 6, and a punch board 5 is placed on the base board 8. The magnetic sensor functions as a detector that detects the orientation of the peg when it is inserted. There are several types of punch boards, from low difficulty to high difficulty, which can be replaced according to the patient's level. Fixtures 9a and 9b for fixing the punchboard to the baseboard are provided at the four corners of the punchboard 5 and the baseboard 8. Here, the fixtures 9a and 9b are configured to have at least one magnet as a magnet so that they can be easily attached and detached by magnetic force, but any configuration may be used as long as the punch board can be fixed to the base board. For example, a hole may be provided on the punch board, and a corresponding convex member may be provided on the base board. In addition, the difficulty level based on the size and number of holes in the punch board can be automatically recognized by the control unit of the base unit based on the shape of the punch board fixture or a sign such as a barcode provided on the punch board. It can be a system.

Further, here, the shapes of the base unit 6, and the punch boards 5 and the base board 8 set therein are shown to be flat, but these may be curved or three-dimensional. Good. In daily life, the range of movement of the upper arm of the consumer is a three-dimensional three-dimensional range. Therefore, in order to sufficiently train the range of movement of the operator's arm, it is not necessary to train only by plane operation. It is insufficient, and a peg system that supports three-dimensional movement is required. By using a curved or three-dimensional board with peg holes arranged three-dimensionally, it is possible to support training for high-performance three-dimensional movements compared to a peg system equipped with a conventional flat board. Can be done.

The base unit 6 is provided with a liquid crystal display (LCD) 10, an operation button 11, and a speaker 12, and is controlled by a control unit provided inside the base unit. The liquid crystal display 10 displays instructions and messages for the next action to the patient and the therapist, and the operation buttons 11 are used to perform actions such as starting training, registering results, and ending work according to the instructions. You can choose. Further, the speaker 12 is designed to output a sound (music, etc.) according to the training result of the patient, that is, the correct answer rate, the time required to complete the task, and the like. The feedback to the patient after the task is completed is not only by sound but also by stimulation by light such as blinking of the LED arranged on the base board.

At the time of use, the drawer-shaped peg arrangement board 13 is pulled out from the side surface of the base unit and used (FIG. 2). Magnets are arranged in a grid pattern on the peg arrangement board 13, and the pegs can be arranged upright (FIG. 2A). The peg arrangement board 13 is housed so as to be retractable from the side surface of the base unit (FIG. 2B). The pegs are automatically arranged in a grid pattern in the same direction by the magnetic force from the peg arrangement board 13. As a result, the time to start training can be significantly shortened and the burden on the occupational therapist can be reduced. Further, at the time of storage, the pegs and punch boards can be placed on the peg arrangement board and slid and stored in the main body portion, so that it does not take up much space and is excellent in transportability.

At the time of training, a punch board 5 suitable for the patient's level is selected, and the peg 3 is made to stand upright on the base board 8 equipped with the magnetic sensor through the peg hole 4 opened in the punch board 5. On the base board 8, magnetic sensors and two-color LEDs are arranged in a grid pattern. The color of the LED is configured so that light of the same color as the coloring of both ends of the peg is lit, and functions as an indicator portion indicating the portion of the detection hole and the insertion direction of the peg.

By turning on the LED of the indicator, the detection hole into which the peg should be inserted and the insertion direction thereof are indicated. Depending on the color of the light lit on the LED, it is possible to instruct the peg 3 to stand upright on the base board 8 in the same direction from the peg arrangement board 13 or upside down. The action of turning the peg upside down is an application that requires more complicated skill, even in normal rehabilitation, for people with mildly impaired hand motor function or for those who have recovered from paralysis to some extent. This training menu is used by people who have difficulty moving. Therefore, it is possible to devise a program such as incorporating many movements of reversing the pegs at a later stage of rehabilitation, such as training of applied movements that require skill.

Insertion into the detection hole is detected by a magnetic sensor, and if the answer is correct, the LED blinks and the correct answer sounds. In the case of an incorrect answer, the LED lights up in a color different from the correct answer and sounds an incorrect answer. After the training is completed, the grades are displayed on the liquid crystal display, and the sounds and displayed characters change according to the grades. This feedback keeps the patient motivated. Multiple parts on the base unit function as notification units, such as blinking LEDs and notifications by sounds heard from speakers.

Since the magnetic sensors are arranged in an array on the base board 8, it is possible to calculate the coordinates of the pegs in addition to detecting the insertion of the pegs. The insertion position of the peg, its correctness, the time required for insertion, and the movement of the hand until insertion are registered in the database at the end of training. The accumulated data will be useful for long-term follow-up of patients.

Next, the operation procedure of the training will be described (Fig. 3). When the occupational therapist or the subject turns on the switch of the peg system main body, the liquid crystal display which is the display unit indicates that the training is started. If the subject is already registered, the corresponding name is selected from the registrant names displayed on the screen by the operation button 11. In the case of a registered subject, since the training level has already been registered based on the training results up to the previous time, the task suitable for the level is selected. The difficulty level of the task is selected according to the subject, such as the size of the hole in the punch board and the complexity of the peg insertion position. In the case of an unregistered subject, that is, a guest subject, an occupational therapist or the like selects a level considered to be suitable and a task is selected.

When the task is set, the LED lights up at a location that coincides with the peg hole on the baseboard, that is, at the location of the detection hole. Since the color of the LED matches the color of either end of the peg, the color of the light gives the subject an instruction as to which direction the peg should be inserted. Time measurement starts at the same time as the LED lights up. The subject inserts a peg according to the color of the LED. When the peg is inserted, the magnetic sensor determines whether the subject has inserted the peg in the correct direction according to the color of the LED. Also, the time measurement ends when the subject inserts all the pegs. When one task is completed, sound and light feedback is given according to the correct answer rate of the position of the inserted peg and the time required to complete the task. By notifying the achievement of a task such as judgment of correctness with light and sound, it can be recognized simultaneously by eyes and ears, and it can contribute to improvement of cognitive function.

Further, when proceeding to the next training, a similar task or a more difficult task is provided depending on the subject's performance. At the end of the training, in the case of registered subjects, the training date, work content (task), and grades are registered in the database. In addition to the magnetic sensor and LED, the base unit 6 main body is provided with a calculation unit, a storage unit, an analysis unit, a control unit for controlling these functions, a battery, and the like for performing these operations. The control unit calculates, stores, and analyzes the subject's grades, and next tasks to be provided, such as program selection, light instructions in the instruction unit, and notifications of the subject's grades by sound and light, etc. Controls the sequence of operations of the peg system. In order to reduce the weight of the pegboard, the battery and the control unit may be connected to a portable computer and supplied from the connected portable computer.

Since the data is registered, the subject can start from the same level of task as at the end of the previous training at the next training. In addition, when the training is repeated for one month, two months, and half a year, the recovery of the subject by the training can be shown as an objective index, so that the change in hand performance can be visually presented in chronological order. It can support the motivation of patients for training and voluntary training. In addition, by accumulating the records of a plurality of patients, it is possible to analyze by an occupational therapist or the like and use it for prognosis prediction, and to provide feedback to the patient himself / herself based on the data. In addition, even when training is conducted at home, since the data is registered, the results of voluntary training can be shared with the occupational therapist.

Next, an aspect in which the occupational therapist who is the evaluator is more actively involved will be described (Fig. 4). Peg insertion work, grade display and feedback are performed in the same way as above, but rehabilitation grades such as patient training results, that is, correct answer rate, time required to complete the task, etc. are installed in the control unit as electronic information. After being stored in the memory circuit, it is transmitted to occupational therapists and family members' smartphones, electronic terminal display devices, personal computers, etc. via wireless communication standards for digital devices such as Bluetooth (registered trademark) and the Internet. .. As a result, even when the evaluator is absent at home or the like for voluntary training, the achievement level can be evaluated by an occupational therapist or the like, and the training results over time can be saved at the same time. Such a peg system that supports training support and training result management greatly contributes to increasing the motivation of trained patients and enhancing the training effect (Fig. 4).

In addition, an evaluator such as an occupational therapist comprehensively judges cognitive function and motor function by analyzing with two parameters, the correct answer rate of the position of the inserted peg and the time required to complete the task. be able to. It is considered that the correct answer rate reflects cognitive function, and the required time reflects both motor function and cognitive function. Further, when it is desired to measure the motor function independently, it is sufficient to set the task of measuring only the speed by using the instruction by the LED as one color. By analyzing the percentage of correct answers and the required time for some tasks, it is possible to set a menu that suits the patient as to what kind of task should be set next for more effective rehabilitation. In addition, depending on the patient's condition, it is possible to propose rehabilitation not only with the peg system but also with other instruments. Until now, it will be possible to provide training menus that occupational therapists have devised based on experience with more objective indicators.

Even when used by young children, tasks are automatically set to be difficult, so it is possible to improve dexterity and cognitive function reasonably. Also, compared to wooden pegs, the gameplay with sound and light is enhanced, so you can play without getting bored.

1 ... peg system, 2 ... peg board, 3 ... peg, 4 ... peg hole, 5 ... punch board, 6 ... base unit, 8 ... base board, 10 ... liquid crystal display, 11 ... operation buttons, 12 ... speaker, 13 ... peg Placement board,

Claims (8)

It is an evaluation training system for cognitive function and finger movement function.
With magnetic pegs
It consists of a punch board with multiple peg holes and a peg board with a base unit that senses magnetism.
The peg board has an indicator that indicates the part of the detection hole where the subject should insert the peg with light.
An evaluation training system characterized by having a detection unit that detects the correctness of the inserted peg and a notification unit that notifies the correctness with light and sound. The base unit is provided with a base board.
The detection unit and the indicator unit are arranged on the base board.
The detection unit consists of magnetic sensors arranged in an array.
The spatial coordinate position of the peg placed on the base board by the magnetic sensor is detected and / or measured by the detection unit.
A control unit that calculates, stores, and analyzes the matching rate between the peg insertion direction specified by the instruction unit and the peg insertion direction detected by the detection unit.
The evaluation training system according to claim 1, further comprising a display unit for displaying the calculated result. Provided with a program in which the difficulty of the task is determined by indicating the position and / or order of the detection holes into which the pegs should be inserted.
It is possible to set a target value for the time required from the instruction of the task by the light of the instruction unit to the completion of the peg insertion by the subject for each subject.
The evaluation according to claim 1 or 2, wherein the task set before the peg insertion operation and the achievement rate with respect to the required time target value are calculated, stored, and analyzed by the control unit and displayed on the display unit. Training system. The power supply to the pegboard and the control by the control unit
The evaluation training system according to any one of claims 1 to 3, which can be performed by connecting to a portable computer having a built-in battery. Equipped with a peg placement board that can be stored in the base unit
The peg placement board is magnetic and
The evaluation training system according to any one of claims 1 to 4, wherein the pegs are automatically arranged and fixed in the direction and interval by magnetism on the peg arrangement board. The surfaces of the pegs and pegboards are either antibacterial or antibacterial treated.
The evaluation training system according to any one of claims 1 to 5, which can maintain hygiene. The evaluation training system according to any one of claims 1 to 6, characterized in that it is used for rehabilitation of motor dysfunction and / or cognitive function due to cerebrovascular accident and / or sequelae of dementia. The evaluation training system according to any one of claims 1 to 6, wherein the system is used for learning training of cognitive function and / or finger motor function of an infant.