JP2821525B2 - Stimulator and environment controller - Google Patents

Description

Description: TECHNICAL FIELD The present invention relates to a stimulating device and an environment control device for a paralyzed patient.

[Conventional technology]

Conventionally, in order to recover a paralyzed limb of a severely paralyzed motor paralyzed patient, a voluntary biological signal such as an electromyogram, an electroencephalogram, a mechanical displacement of a chin, a shoulder, a neck and the like, and an operation command signal. The signal from the sensor attached to each part described above is used as the source and the functional electrical stimulation (FUNCTIONAL ELECTRICAL STIMULATIO
N: hereinafter referred to as FES) is processed using a computer, and the electrodes implanted in the vicinity of muscles or nerves are subjected to electrical stimulation programmed by the above-mentioned FES computer, thereby causing muscle contraction of the patient. Japanese Patent Application Laid-Open No. Sho 59-160455 discloses a stimulator for performing intended limb movements. A stimulator using such a FES computer can exercise not only limbs but also motor functions of respiratory muscles, trunk muscles, genitourinary organs, etc., especially muscle atrophy and muscle caused by motor paralysis caused by stroke or spinal cord injury. It has remarkable therapeutic effects on shortening, muscle and joint contracture, bone atrophy, muscle spasticity and circulatory disorders.

Various types of stimulators as described above have been proposed. For example, Japanese Patent Application Laid-Open No. 61-217174 discloses a stimulator as described below. Therefore,
With reference to FIG. 6, such a conventional stimulator will be described. In FIG. 6, (28 ₁ ), (28 ₂ ), (28 ₃ ),
‥‥, (28n) shows the remaining speech, joints,
Detection means for detecting muscle displacement, respiration, biopotentials (brain waves, electromyograms, bioaction potentials), and other biological signals obtained from the living body. Detection from these detection means (28 ₁ ) to (28n) The signal is converted into a control signal by digitizing the detection signal with the A / D converter that constitutes the signal processing means (29).
S Supply to the computer (30). FES Computer (3
0) selects the stimulus data stored in the storage means (34) in the computer for the stimulus data for each control signal. The stimulus data stored in the storage means (34) is a large development computer (32) for each patient. The stimulus data written in the ROM is stored in the storage means (34) of the FES computer (30).
It is made to plug in.

Based on the stimulus data selected by the above-mentioned FES computer (33), a stimulus pulse train is created and a plurality of electrodes (31) embedded in a living body are stimulated to activate a paralyzed portion.

Further, Japanese Patent Application No. 62-302412 filed earlier by the present applicant proposes a stimulator as described below. That is, in such a stimulating apparatus, an electromyogram waveform that detects joints, muscle displacements, and the like of a healthy person (normal person without paralysis) is envelope-detected, a pulse train obtained by sampling the envelope waveform is obtained, and each pulse of the pulse train is obtained. The stimulus pattern data in which the voltage amplitude or pulse width of the stimulus is digitally stored is stored in a storage means, and after reading out the stimulus pattern data, the stimulus pulse is obtained by D / A conversion. Then, the stimulation pulse is supplied to a stimulation electrode implanted in the vicinity of a muscle or a nerve related to the remaining functional operation of the paralyzed patient, and the amplitude or pulse width of the stimulation pulse is changed so that individual muscles are changed. By determining the threshold level of the group with reference to the threshold level of the muscle group of a healthy person, correcting the individual patient to a pattern suitable for and storing this in the storage means,
A stimulation pulse suitable for the patient is supplied to a stimulation electrode embedded in the body of the patient.

[Problems to be solved by the invention]

Now, using the above-described stimulator, a patient with quadriplegia due to spinal cord injury performs an operation such as vocalization using the remaining function, and causes the voice detection unit to detect this, and based on this, for example, paralysis When a stimulus pulse is given to the electrode attached to the hand that is holding it and the hand is moved and the cup is grabbed by this, the action of making a voice and the action of grabbing the cup are actions that are not directly related to It takes a long time to learn the program, and the patient feels annoyed. In addition, a great burden is imposed on the patient that several or dozens of other actions corresponding to a desired action must be learned.

Therefore, it is desirable to mount the detection means as close to the part of the body as the patient wants to move. Therefore, if the remaining function of the patient is, for example, the shoulder, the electrode is attached to the shoulder by the bioelectric potential detection means, that is, the electrode attached to the patient's epidermis, and the patient moves the shoulder or applies a force to the shoulder. When it is inserted, the electrode attached to the shoulder detects the bioelectric potential, and based on this, a stimulation pulse is applied to the electrode attached to the hand so that the hand can grasp the cup.
However, since this electrode is attached to the epidermis of the hand, the biopotential of the entire muscle under the attached electrode is detected, and each time the electrode needs to be attached, it is complicated. However, it becomes difficult to stably detect biological signals over a long period of time, and if the gripping strength is controlled by the force applied to the shoulder, if the gripping cup is not glass,
If it is made of paper, it may be possible to grab the cup and crush it. Furthermore, it is difficult to selectively stimulate a paralyzed part by utilizing the bioelectric potential of each muscle.

In addition, even if there is an impulse in the nerve bundle, patients with myasthenia gravis or severe quadriplegia who cannot perform muscular activity due to a decrease in the function of the neuromuscular junction can communicate with external objects or people. It is difficult to apply the stimulator described above when performing.

In view of such a point, the present invention can detect a stable biological signal over a long period of time from muscles or nerves associated with the residual functional operation of a paralyzed patient, and based on the detected biological signal, paralyze the paralyzed patient. An object of the present invention is to propose a stimulator capable of stimulating muscles with high selectivity, high function and high accuracy.

Further, the present invention can detect a stable biological signal over a long period of time from muscles or nerves associated with the residual functional operation of a paralyzed patient, and based on the detected biological signal, select a controlled device with high selectivity. Accordingly, an environmental control device that can be controlled easily and with high accuracy is proposed.

[Means for solving the problem]

A first invention is a biological signal detection electrode (1) implanted in the vicinity of a muscle (19) or a nerve (18) related to a remaining functional operation of a paralyzed patient (3), and a paralysis of the paralyzed patient (3). Storage means (7) for storing stimulation pulses for muscle stimulation, and a paralyzed muscle stimulation electrode (2) of a paralyzed patient (3) to which the stimulation pulses read from the storage means (7) are supplied. ,
When a biological signal is detected by the biological signal detection electrode (1), a stimulus pulse is read from the storage means (7),
This is a stimulator that is supplied to the paralyzed muscle stimulation electrode (2).

A second aspect of the present invention relates to a biological signal detection electrode (1) implanted in the vicinity of a muscle (19) or a nerve (18) related to a remaining functional operation of a paralyzed patient (3), and the biological signal detection electrode (1). A control signal forming circuit (6, 7, 8, 10) for forming a control signal to be supplied to controlled devices (21 _{1 to} 21 n) to be operated by the paralyzed patient (3) based on the biological signal from 1) It has.

[Action]

According to the first aspect of the present invention, when a biological signal is detected by the biological signal detection electrode (1), a stimulation pulse is read from the storage means (7) and supplied to the paralyzed muscle stimulation electrode (2).

According to the second aspect of the present invention, based on a biological signal from a biological signal detection electrode (1) implanted in the vicinity of a muscle (19) or a nerve (18) related to a remaining functional operation of a paralyzed patient (3). Then, the control signals from the control signal forming circuits (6, 7, 8, 10) are supplied to the controlled devices (21 _{1 to} 21 n).

〔Example〕

Hereinafter, a first embodiment of the present invention will be described in detail with reference to FIG. FIG. 1 shows a stimulator according to a first embodiment of the present invention. (3) shows a paralyzed patient, that is, a motor paralysis caused by stroke, spinal cord injury, myasthenia gravis and other causes. Patient.

(1) is a detection electrode, which is implanted in the vicinity of the shoulder muscle or nerve of the paralyzed patient (3), that is, in the motor point (20) (see FIG. 4) as shown in FIG. A biological signal, that is, an action potential (impulse) is detected.
(2) is a stimulation electrode, near the muscle or nerve of the hand of a paralyzed patient (3), that is, a motor point (20) (see FIG. 4).
Embedded in The detection electrode (1) and the stimulation electrode (2) use, for example, a multi-stranded wire, and as shown in FIG. 2, a key-shaped fixing part (11), a spiral fixing part (12), and a bioelectric potential introduction. Alternatively, it is composed of a deriving unit (13). And
The biopotential deriving unit (13) of the detection electrode (1) is connected to an input terminal of an isolation amplifier (4) described later, and the biopotential introducing unit (13) of the stimulating electrode (2) is connected via a capacitor C. It is connected to an output terminal of a D / A converter (8) described later.

The above-mentioned key-shaped fixing portions (1) of the electrodes (1) and (2)
The helical fixing part (12) and the bioelectric potential deriving or introducing part (13) other than 1) are many, for example, as shown in the cross-sectional view of FIG.
Twenty nineteen lead wires (14) are twisted to form a stranded wire, and the periphery thereof is coated with an insulating material, for example, Teflon. (15) shows the coating part.

In addition, the coating portion (15) is removed only from the portions of the key-like fixing portions (11) and the bioelectric potential introducing or extracting portions (13) of the electrodes (1) and (2). In addition, hook-shaped fixing part (11)
Is formed by simply bending the tip of a stranded wire at an acute angle.

The above-mentioned electrodes (1) and (2) are constructed by bundling or twisting a plurality of stranded wires composed of a plurality of lead wires (14) shown in FIG. 3 and coating them with Teflon or the like. You may do it.

Then, as shown in FIG. 4A, the detecting electrode (1) or the stimulating electrode (2) is passed through the inside of the vena needle (16) and pierced into a predetermined part of the body, and the nerve (18) and the muscle (19) are punctured. ) Motor point (indicated by the dashed circle in the figure)
When reaching (20), as shown in FIG.
6) is withdrawn, the sensing electrode (1) or the stimulating electrode (2) remains in the body of the paralyzed patient (3), and its helical fixation (12) is tightly connected to the tissue over time. .

Referring back to FIG. 1, reference numeral (4) denotes an isolation amplifier having a built-in photocoupler, to which the biopotential deriving unit (13) of the detection electrode (1) is connected. (5) is an isolation power supply, which is a power supply dedicated to the isolation amplifier (4). (6) is an A / D converter, which converts an analog signal supplied from the isolation amplifier (4) into a digital signal and provides a bus (consisting of a data bus, an address bus and a control bus).
The data is supplied to the memory (7) via (11). The memory (7) stores various stimulus pattern data obtained by modifying data sampled from a healthy person, such as "grasping a glass", so as to match the paralyzed patient (3). The digital data read from the memory (7) is supplied to a D / A converter (8) via a data bus (11), thereby being converted into an analog stimulus pulse. 2). A power supply (9) supplies an operating voltage to the A / D converter (6), the memory (7), and the D / A converter (8). CPU (10) is bus (1
1) Via A / D converter (6), memory (7) and
The D / A converter (8) is controlled.

Next, the operation of the above-described stimulating device will be described, taking as an example a case where a paralyzed patient wants to perform an operation of “grabbing a cup”. In addition, it is necessary to use a plurality of stimulation electrodes (2) necessary for the operation of “grabbing a cup” and pierce each part of the hand, but here, for simplicity of description, this will be described by one.

First, under the control of the CPU (10), the stimulus pattern data related to the operation of "grabbing a cup" of a healthy person stored in the memory (7) is transferred to the D / A converter via the bus (11). Supplied to (8), the stimulus pattern data is converted into an analog signal (stimulus pulse), and the vicinity of muscles or nerves related to the action of “grab a cup” of the paralyzed patient (3) via the capacitor C, that is, , Are supplied to a stimulation electrode (2) embedded in a motor point (20) (see FIG. 4). Then, the level of the stimulation pulse is gradually changed (by a program), and the stimulus pattern data at the time when the paralyzed patient (3) accurately performs the operation of “grabbing a cup” is stored in the memory (7).

Next, when the left shoulder is pressed or moved in the paralyzed patient (3), or when these operations are attempted, the detection electrode (1) embedded in the motor point (20) (see FIG. 4) is used. ) Is supplied with a biological voltage from the muscle (19) and the nerve (18). Then, the biovoltage is supplied to the isolation amplifier (4) and amplified to a predetermined level.
It is supplied to the A / D converter (6). When the biovoltage is supplied from the isolation amplifier (4), the A / D converter (6) converts the biovoltage into digital data and supplies the digital data to the CPU (10) via the data bus (11). The CPU (10) supplied with digital data from the A / D converter via the data bus (11) supplies a stimulation pulse corresponding to the digital data to the stimulation electrode (2).

Therefore, the muscle (19) related to the action of "grasping a cup" or the nerve (18) that controls the muscle (19) is used to adjust the strength of the potential generated by the muscle (19) or the shoulder muscle (19) of the paralyzed patient (3). By matching the potential generated by the nerve (18) that holds the muscle (19), the paralyzed patient (3) can adjust the force applied to the shoulder according to the material of the cup to be gripped, for example, crushing a paper cup You can grab without.

When the detection electrode (1) and the stimulation electrode (2) are close to the implanted position in the body, the biological signal from the detection electrode (1) is taken in using a gate, and the stimulation pulse from the stimulation electrode (2) is taken. To eliminate the effects of

Next, a second embodiment of the present invention will be described with reference to FIG. FIG. 5 shows an environment control apparatus according to a second embodiment of the present invention. In FIG. 5, parts corresponding to those in FIG. In FIG. 5, (21) ｛(21 ₁ ), (21 ₂ ), (21 ₃ ), ‥‥, (21
n) is a controlled device, and the controlled device (21) is, for example, a telephone, an AV (AUDIO VISUAL) device (eg, a stereo playback device, a television receiver, etc.), a lighting device, an intercom, a word processor, a bed, etc. And to enrich the living environment of paralyzed patients (3). Each controlled device (21) is controlled by a control signal output from the D / A converter (8) according to the control mode, different from the controlled device. Also in the case of the second embodiment, the same detection electrode (1) as that of the first embodiment is used.
Is fixed to the motor point (20) on the shoulder of the paralyzed patient (3).

Next, the controlled device (21) is detected by the biological signal detected by the detection electrode (1) embedded in the shoulder of the paralyzed patient (3).
Will be described.

For example, the strength of the force that the paralyzed patient (3) puts on the shoulder, whether the left and right shoulders are pressed (in this case, it is necessary to embed detection electrodes in both shoulders), and apply a force to the shoulder for a predetermined period Selection of the controlled device (21) to be controlled, selection of the control mode, and the like are performed according to the number of insertions, etc., and accordingly, the controlled device (21) to be controlled by the CPU (10) is selected. A control signal according to the mode is output from the D / A converter (8), whereby the control signal is supplied to one of the controlled devices (21).

In the above-mentioned environment control device, the paralyzed patient (3) has one detection electrode (1) embedded in the left shoulder of the paralyzed patient (3).
In the above, the case where one controlled device (21) is controlled has been described. However, the paralyzed patient (3) is controlled based on the biological signals detected from the plurality of detection electrodes (1) embedded in a plurality of places of the own body. Thus, a plurality of controlled devices (21) may be controlled.

If the control of the controlled device (21) is simple,
A circuit for forming a control signal based on a biological signal from the detection electrode (1) is provided without providing a CPU (10), a memory (7), and the like, and a controlled device is provided based on a control signal from the circuit. May be directly controlled.

〔The invention's effect〕

According to the first aspect of the present invention described above, a stable biological signal can be detected for a long period of time from muscles or nerves associated with the residual functional operation of a paralyzed patient, and based on the detected biological signal, a paralyzed patient can be detected. And a stimulator capable of stimulating the paralyzed muscles of the subject with high selectivity and high function and high accuracy.

According to the second aspect of the present invention described above, a stable biological signal can be detected for a long period of time from muscles or nerves associated with the residual functional operation of a paralyzed patient, and a controlled object can be detected based on the detected biological signal. An environment control device that can easily and accurately control devices with high selectivity can be obtained.

In addition, in patients with myasthenia gravis, where the possibility of communication with the outside was low, even if there was an impulse in the nerve bundle, the muscle activity was performed due to a decrease in the function of the junction (motor point) between the nerve and the muscle. However, in the case of the stimulating device and the environment control device according to the present invention, since the impulse of the nerve can also be detected, the possibility of stimulating the paralyzed muscle of the patient and controlling the controlled device based on this can be increased, Increase the possibility of communication with the outside.

[Brief description of the drawings]

FIG. 1 is a block diagram showing a stimulating device according to a first embodiment of the present invention, FIG. 2 is a diagram showing a detecting electrode or a stimulating electrode, FIG. FIG. 4 is a diagram showing a method of implanting the detection electrode or the stimulation electrode into a living body,
FIG. 5 is a block diagram showing an environment control device according to a second embodiment of the present invention, and FIG. 6 is a block diagram showing a conventional stimulator. (1) is a detection electrode, (2) is a stimulation electrode, (3) is a paralyzed patient, (4) is an isolator amplifier, (5) is an isolator power supply, (6) is an A / D converter, (7) is a memory,
(8) D / A converter, (9) power supply, (10) CPU,
(11) Hook-shaped fixing part, (12) Spiral fixing part, (13)
Is a bioelectric potential derivation or introduction part, (14) is a lead wire, (15)
Is the coating, (16) is the needle, (17) is the skin, (18) is the nerve, (19) is the muscle, (20) is the motor point, (21) ｛(21 ₁ ) to (21n)｝ It is a controlled device.

──────────────────────────────────────────────────続 き Continued on the front page (72) Inventor Nozomu Hoshimiya 11-106 Kawauchi Housing, Kawauchi, Aoba-ku, Sendai City, Miyagi Prefecture (72) Inventor Yasunori Handa 2-1 Yamato-cho, Wakabayashi-ku, Sendai City, Miyagi Prefecture -9 (72) Inventor Masahiko Tanaka 1-57 Tenjin-cho, Kodaira-shi, Tokyo Inside the Tokyo Plant of NEC Sanei Co., Ltd. (72) Inventor Takashi Hisamoto 1-57 Tenjin-cho, Kodaira-shi, Tokyo NEC Sankyo Tokyo Inside the factory (72) Inventor Seiichi Ishikawa 1-57 Tenjin-cho, Kodaira-shi, Tokyo Inside the Tokyo factory of NEC Sanei Co., Ltd. (56) References JP-A-64-64651 (JP, A) JP-A-60-153856 (JP, A) JP-A-60-108054 (JP, A) JP-A-61-265151 (JP, A) JP-A-4-503462 (JP, A) JP-A-58-41570 (JP, A) 1-87748 (JP, U) 1-87750 (JP, U) Japanese Utility Model Application Hei 1-87752 (JP, U) Japanese Utility Model Application Hei 2-91558 (JP, U) (58) Fields investigated (Int.Cl. ⁶ , DB name) A61N 1/36 A61N 1 / 18 A61F 4/00

Claims (2)

(57) [Claims] 1. A biological signal detection electrode implanted in the vicinity of a muscle or a nerve related to a remaining functional operation of a paralyzed patient, storage means for storing a stimulation pulse for stimulating a paralyzed muscle of the paralyzed patient, and the storage. Having a paralyzed muscle stimulation electrode of the paralyzed patient to which the stimulation pulse read from the means is supplied, and when a biosignal is detected by the biosignal detection electrode, the stimulation pulse is read from the storage means. A stimulating device for supplying the paralyzed muscle stimulating electrode. 2. A biological signal detecting electrode to be implanted in the vicinity of a muscle or a nerve related to the remaining functional operation of the paralyzed patient, and the paralyzed patient should operate based on the biological signal from the biological signal detecting electrode. A control signal forming circuit for forming a control signal to be supplied to a controlled device.