JP4611453B1 - Method and apparatus for measuring vibration sensation threshold - Google Patents

Method and apparatus for measuring vibration sensation threshold Download PDF

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JP4611453B1
JP4611453B1 JP2010174232A JP2010174232A JP4611453B1 JP 4611453 B1 JP4611453 B1 JP 4611453B1 JP 2010174232 A JP2010174232 A JP 2010174232A JP 2010174232 A JP2010174232 A JP 2010174232A JP 4611453 B1 JP4611453 B1 JP 4611453B1
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vibration
threshold value
measurement
descending
ascending
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JP2012030006A (en
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正巳 杉本
龍一 中島
真 吉田
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Rion Co Ltd
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/0048Detecting, measuring or recording by applying mechanical forces or stimuli
    • A61B5/0051Detecting, measuring or recording by applying mechanical forces or stimuli by applying vibrations
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/48Other medical applications
    • A61B5/4824Touch or pain perception evaluation

Abstract

【課題】 非特許文献1又は非特許文献2に規定した振動感覚閾値の測定方法に適合しつつ、測定確度の向上が図れる振動感覚閾値測定方法を提供する。
【解決手段】 指先における振動感覚閾値を、被検者の応答があるまで振動刺激の大きさを徐々に増加させて上昇法閾値を求める上昇法と、被検者の応答がなくなるまで振動刺激の大きさを徐々に減少させて下降法閾値を求める下降法を繰り返すことにより求める振動感覚閾値測定方法において、上昇法における開始時の振動刺激の大きさは、直前の下降法で求めた下降法閾値に対し所定の範囲(例えば、0〜−10dB)でランダムに変化させて設定するものである。更に、下降法による測定が終了してから上昇法による測定を開始するまでの間に、ステップSP9で振動刺激の停止時間を設ける。停止期間は、所定の範囲(例えば、0〜2秒間)でランダムに変化するようにするとよい。
【選択図】 図3
PROBLEM TO BE SOLVED: To provide a vibration sensation threshold measurement method capable of improving measurement accuracy while conforming to the vibration sensation threshold measurement method specified in Non-Patent Document 1 or Non-Patent Document 2.
SOLUTION: The ascending method for obtaining the ascending method threshold by gradually increasing the magnitude of the vibration stimulus until the subject responds, and the vibration sense threshold at the fingertip until the subject's response disappears. In the vibration sensation threshold measurement method obtained by repeating the descending method to obtain the descending method threshold by gradually decreasing the magnitude, the magnitude of the vibration stimulus at the start of the ascending method is the descending method threshold obtained by the immediately preceding descending method. Is set to be randomly changed within a predetermined range (for example, 0 to -10 dB). Furthermore, a stop time of vibration stimulation is provided in step SP9 after the measurement by the descending method is completed and the measurement by the ascending method is started. The stop period may be changed randomly within a predetermined range (for example, 0 to 2 seconds).
[Selection] Figure 3

Description

本発明は、指先における振動感覚閾値(VPT)を上昇法及び下降法を繰り返すことにより測定する振動感覚閾値測定方法及びその装置に関する。   The present invention relates to a vibration sensation threshold measurement method and apparatus for measuring a vibration sensation threshold (VPT) at a fingertip by repeating an ascending method and a descending method.

指先における振動感覚閾値の測定方法は、非特許文献1又は非特許文献2において規定されている。指先における振動感覚閾値を測定する方法として上昇・下降法が知られている。上昇・下降法は,それぞれが一定であるが、短時間に異なる大きさの反復刺激を被検者に与えることによって、二つの限界閾値を自動的に測定する心理物理的測定の方法である。   A method for measuring the vibration sensation threshold at the fingertip is defined in Non-Patent Document 1 or Non-Patent Document 2. An ascending / descending method is known as a method for measuring the vibration sensation threshold at the fingertip. The ascending / descending method is a psychophysical measurement method in which two limit thresholds are automatically measured by giving the subject repeated repetition stimuli of different magnitudes in a short time.

この方法は、被検者に振動刺激が知覚されるまで、振動刺激の大きさが連続的に増加する振動刺激を皮膚に与えて閾値を得る上昇法と、続いて被検者に振動刺激が知覚されなくなるまで、振動刺激の大きさが連続的に減少する振動刺激を皮膚に与えて閾値を得る下降法を組み合わせることにより、二つの閾値を求める方法である。 In this method, until the subject perceives the vibration stimulus, the skin stimulation is applied to the skin so that the magnitude of the vibration stimulus continuously increases. This is a method of obtaining two threshold values by combining a descending method of obtaining a threshold value by giving a vibration stimulus whose skin vibration magnitude continuously decreases until it is no longer perceived.

つまり、被検者は、振動刺激を感じている間は押ボタンスイッチを押した状態にし、振動刺激を感じない間は押ボタンスイッチを押さない状態にする。検査装置は、押ボタンスイッチが押されている間は振動刺激の大きさを減少させていき、押ボタンスイッチが押されていない間は振動刺激の大きさを増加させていくことで、振動刺激を感じ始める上昇法閾値と振動刺激を感じなくなる下降法閾値を測定する。 That is, the subject is in a state where the push button switch is pressed while feeling the vibration stimulus, and is in a state where the push button switch is not pushed while not feeling the vibration stimulus. The inspection device reduces the magnitude of the vibration stimulus while the pushbutton switch is pressed, and increases the magnitude of the vibration stimulus while the pushbutton switch is not pressed. Measure the rising method threshold to start feeling and the falling method threshold to stop feeling vibration stimulus.

ISO 13091−1(2003)ISO 13091-1 (2003) JIS B7763−1(2009)JIS B7763-1 (2009)

しかし、非特許文献1又は非特許文献2に規定されている上昇・下降法で振動感覚閾値を測定した場合、振動刺激の増加率・減少率が一定なので、被検者が振動刺激に一定間隔で反応して押ボタンスイッチを操作してしまい、誤応答の要因となる。 However, when the vibration sensation threshold is measured by the ascending / descending method defined in Non-Patent Document 1 or Non-Patent Document 2, the rate of increase / decrease of the vibration stimulus is constant. In response to this, the pushbutton switch is operated, which causes a false response.

本発明は、従来の技術が有するこのような問題点に鑑みてなされたものであり、その目的とするところは、非特許文献1又は非特許文献2に規定した振動感覚閾値の測定方法に適合しつつ、測定確度の向上が図れる振動感覚閾値測定方法及びその装置を提供しようとするものである。   The present invention has been made in view of such problems of the prior art, and the object of the present invention is compatible with the vibration sensation threshold measurement method defined in Non-Patent Document 1 or Non-Patent Document 2. However, it is an object of the present invention to provide a vibration sensation threshold value measuring method and apparatus capable of improving measurement accuracy.

上記課題を解決すべく請求項1に係る発明は、指先における振動感覚閾値を、被検者の応答があるまで振動刺激の大きさを徐々に増加させて上昇法閾値を求める上昇法と、被検者の応答がなくなるまで振動刺激の大きさを徐々に減少させて下降法閾値を求める下降法を繰り返すことにより求める振動感覚閾値測定方法において、前記上昇法における開始時の振動刺激の大きさは、直前の下降法で求めた下降法閾値に対し所定の範囲(例えば、0〜−10dB)でランダムに変化させて設定するものである。 In order to solve the above-mentioned problem, the invention according to claim 1 is directed to an ascending method for obtaining an ascending method threshold by gradually increasing the magnitude of the vibration stimulus until a subject's response is obtained. In the vibration sensation threshold measurement method obtained by repeating the descending method for gradually decreasing the magnitude of the vibration stimulus until the examiner's response disappears and obtaining the descending method threshold, the magnitude of the vibration stimulus at the start in the ascent method is The descending method threshold obtained by the immediately preceding descending method is set by randomly changing within a predetermined range (for example, 0 to -10 dB).

請求項2に係る発明は、請求項1に記載の振動感覚閾値測定方法において、前記下降法による測定が終了してから前記上昇法による測定を開始するまでの間に、振動刺激の停止期間を設けるものである。 According to a second aspect of the present invention, in the vibration sensation threshold value measuring method according to the first aspect, the vibration stimulation stop period is between the end of the measurement by the descending method and the start of the measurement by the ascent method. It is provided.

請求項3に係る発明は、請求項2に記載の振動感覚閾値測定方法において、前記停止期間は所定の範囲(例えば、0〜2秒間)でランダムに変化させて設定するものである。   According to a third aspect of the present invention, in the vibration sensation threshold value measuring method according to the second aspect, the stop period is set by changing randomly within a predetermined range (for example, 0 to 2 seconds).

請求項4に係る発明は、指先における振動感覚閾値を、被検者の応答があるまで振動刺激の大きさを徐々に増加させて上昇法閾値を求める上昇法と、続いて被検者の応答がなくなるまで振動刺激の大きさを徐々に減少させて下降法閾値を求める下降法を繰り返すことにより求める振動感覚閾値測定装置において、前記上昇法における開始時の振動刺激の大きさは、直前の下降法で求めた下降法閾値に対し所定の範囲(例えば、0〜−10dB)でランダムに変化させて設定する上昇法開始レベル設定手段を設けるものである。   The invention according to claim 4 is the ascending method for obtaining the ascending method threshold by gradually increasing the magnitude of the vibration stimulus until the subject's response is obtained, and the subject's response. In the vibration sensation threshold value measurement device that is obtained by repeating the descending method for obtaining the descending method threshold value by gradually decreasing the magnitude of the vibratory stimulus until there is no more, the magnitude of the vibration stimulus at the start in the ascending method is An ascending method start level setting means is provided which is set by randomly changing within a predetermined range (for example, 0 to -10 dB) with respect to the descending method threshold obtained by the method.

請求項5に係る発明は、請求項4に記載の振動感覚閾値測定装置において、前記下降法による測定が終了してから前記上昇法による測定を開始するまでの間に、振動刺激の停止期間を設定するタイマ手段を設けるものである。   According to a fifth aspect of the present invention, in the vibration sensation threshold value measuring device according to the fourth aspect, the period of the vibration stimulation is stopped after the measurement by the descending method is finished and the measurement by the ascent method is started. Timer means for setting is provided.

請求項6に係る発明は、請求項5に記載の振動感覚閾値測定装置において、前記タイマ手段に設定する停止期間は、所定の範囲(例えば、0〜2秒間)でランダムに変化させて設定するものである。   According to a sixth aspect of the present invention, in the vibration sensation threshold value measuring apparatus according to the fifth aspect, the stop period set in the timer means is set by changing randomly within a predetermined range (for example, 0 to 2 seconds). Is.

請求項7に係る発明は、請求項4乃至請求項6のいずれかに記載の振動感覚閾値測定装置において、前記上昇法閾値と前記下降法閾値の平均値を算出して振動感覚閾値を求める振動感覚閾値算出手段を設け、この振動感覚閾値算出手段が算出した振動感覚閾値に反応の一貫性があるか否かを評価する評価手段を設けるものである。   The invention according to claim 7 is the vibration sensation threshold value measuring apparatus according to any one of claims 4 to 6, wherein the vibration sense threshold value is calculated by calculating an average value of the ascending method threshold value and the descending method threshold value. A sensory threshold value calculation unit is provided, and an evaluation unit is provided for evaluating whether or not the vibration sensory threshold value calculated by the vibration sensory threshold value calculation unit is consistent in response.

請求項8に係る発明は、請求項4乃至請求項7のいずれかに記載の振動感覚閾値測定装置において、測定中は振動刺激の大きさに関する情報は画面に表示しないようにするものである。   According to an eighth aspect of the present invention, in the vibration sensation threshold value measuring apparatus according to any one of the fourth to seventh aspects, information relating to the magnitude of the vibration stimulus is not displayed on the screen during the measurement.

請求項1に係る発明によれば、上昇法における開始時の振動刺激の大きさは、直前の下降法で求めた下降法閾値に対し所定の範囲(例えば、0〜−10dB)でランダムに変化させて設定するので、誤応答を低減して測定確度を向上させることができる。 According to the first aspect of the present invention, the magnitude of the vibration stimulus at the start of the ascending method changes randomly within a predetermined range (for example, 0 to −10 dB) with respect to the descending method threshold obtained by the immediately preceding descending method. Therefore, the measurement accuracy can be improved by reducing erroneous responses.

請求項2に係る発明によれば、下降法による測定が終了してから上昇法による測定を開始するまでの間に、振動刺激の停止期間を設けたので、被検者は一定間隔で応答することができないため、測定確度が向上する。   According to the second aspect of the present invention, since the period for stopping the vibration stimulation is provided between the end of the measurement by the descending method and the start of the measurement by the ascending method, the subject responds at regular intervals. Measurement accuracy is improved.

請求項3に係る発明によれば、振動刺激の停止期間を所定の範囲(例えば、0〜2秒間)でランダムに変化させて設定するタイマ手段を設けたので,被検者は一定間隔で応答することができないため、測定確度が向上する。   According to the invention of claim 3, since the timer means for setting the vibration stimulation stop period at random within a predetermined range (for example, 0 to 2 seconds) is provided, the subject responds at regular intervals. Measurement accuracy is improved.

請求項4に係る発明によれば、上昇法における開始時の振動刺激の大きさを、直前の下降法で求めた下降法閾値に対し所定の範囲(例えば、0〜−10dB)でランダムに変化させて設定する上昇法開始レベル設定手段を設けたので、誤応答を低減して測定確度を向上させることができる。   According to the invention of claim 4, the magnitude of the vibration stimulus at the start of the ascending method is randomly changed within a predetermined range (for example, 0 to -10 dB) with respect to the descending method threshold obtained by the immediately preceding descending method. Since the ascending method start level setting means for setting is provided, erroneous response can be reduced and measurement accuracy can be improved.

請求項5に係る発明によれば、下降法による測定が終了してから上昇法による測定を開始するまでの間に、振動刺激の停止期間を設定するタイマ手段を設けたので、被検者は一定間隔で応答することができないため、測定確度が向上する。   According to the fifth aspect of the present invention, since the timer means for setting the stop period of the vibration stimulation is provided between the end of the measurement by the descending method and the start of the measurement by the ascending method, Since it is impossible to respond at regular intervals, measurement accuracy is improved.

請求項6に係る発明によれば、タイマ手段に設定する停止期間を、所定の範囲(例えば、0〜2秒間)でランダムに変化するようにしたので、被検者は一定間隔で応答することができないため、測定確度が向上する。   According to the invention according to claim 6, since the stop period set in the timer means is changed randomly within a predetermined range (for example, 0 to 2 seconds), the subject responds at regular intervals. Measurement accuracy is improved.

請求項7に係る発明によれば、上昇法閾値と下降法閾値の平均値を算出して振動感覚閾値を求める振動感覚閾値算出手段を設け、振動感覚閾値に反応の一貫性があるか否かを評価する評価手段を設けたので、振動感覚閾値の反応の一貫性について妥当な評価が得られるため、振動感覚閾値の信頼性を確保することができる。   According to the invention of claim 7, there is provided vibration sensation threshold value calculating means for calculating the vibration sensation threshold value by calculating an average value of the ascending method threshold value and the descending method threshold value, and whether or not the vibration sensation threshold value is consistent in response. Since the evaluation means for evaluating is provided, a reasonable evaluation can be obtained with respect to the consistency of the response of the vibration sensation threshold value, so that the reliability of the vibration sensation threshold value can be ensured.

請求項8に係る発明によれば、測定中は振動刺激の大きさに関する情報は画面に表示しないため、振動感覚閾値の信頼性を確保することができる。 According to the eighth aspect of the present invention, the information related to the magnitude of the vibration stimulus is not displayed on the screen during the measurement, so that the reliability of the vibration sensation threshold can be ensured.

本発明に係る振動感覚閾値測定装置のブロック構成図Block diagram of a vibration sensation threshold value measuring apparatus according to the present invention 上昇法と下降法による振動感覚閾値測定方法の説明図Explanatory diagram of vibration sensation threshold measurement method by ascending method and descending method 本発明に係る振動感覚閾値測定方法の手順を示すフローチャートThe flowchart which shows the procedure of the vibration sensation threshold value measuring method which concerns on this invention

本発明に係る振動感覚閾値測定装置は、図1に示すように、操作部・表示部・駆動回路や記憶部などを備える装置本体1と、測定時に被検者の前腕を支持するための支持台(不図示)と、装置本体1の指令に基づいて被検者の指先に振動刺激を与える加振器2と、加振器2による振動刺激を感じている間だけ被検者が押す押ボタンスイッチ3からなる。   As shown in FIG. 1, a vibration sensation threshold value measuring apparatus according to the present invention includes an apparatus main body 1 including an operation unit, a display unit, a drive circuit, a storage unit, and the like, and a support for supporting a subject's forearm during measurement. A table (not shown), an exciter 2 that applies a vibration stimulus to the fingertip of the subject based on a command from the apparatus main body 1, and a push that the subject presses while feeling the vibration stimulus by the shaker 2 It consists of a button switch 3.

また、装置本体1は、制御部11、信号生成部12、減衰器13、増幅器14、A/D変換器15、操作スイッチ16、内蔵プリンタ17、液晶ディスプレイ18、振動刺激レベルダイヤル19などを備えている。 The apparatus body 1 also includes a control unit 11, a signal generation unit 12, an attenuator 13, an amplifier 14, an A / D converter 15, an operation switch 16, a built-in printer 17, a liquid crystal display 18, a vibration stimulation level dial 19, and the like. ing.

制御部11は、装置全体を制御すると共に、各種データを記憶する。信号生成部12は、加振器2への振動信号を生成する。A/D変換器15は、加振器2からのロードセル4の出力信号と加速度計5の出力信号を夫々デジタル信号に変換する。操作スイッチ16は、スタート信号を発生したり、各種の設定値を設定したりする。内蔵プリンタ17は、測定結果などを出力する。液晶ディスプレイ18は、各種データや測定結果などを表示する。振動刺激レベルダイヤル19は、手動で振動刺激の大きさを変更するものである。 The control unit 11 controls the entire apparatus and stores various data. The signal generation unit 12 generates a vibration signal for the vibrator 2. The A / D converter 15 converts the output signal of the load cell 4 from the vibrator 2 and the output signal of the accelerometer 5 into digital signals. The operation switch 16 generates a start signal and sets various setting values. The built-in printer 17 outputs measurement results and the like. The liquid crystal display 18 displays various data and measurement results. The vibration stimulation level dial 19 is used to manually change the magnitude of vibration stimulation.

また、制御部11には、上昇法開始時のレベルを決定する上昇法開始レベル設定手段21と、下降法が終了してから上昇法を開始するまでの間、振動刺激を停止させるタイマ手段22と、上昇法閾値と下降法閾値の平均値を算出して振動感覚閾値(VPT)を求める振動感覚閾値算出手段(VPT算出手段)23と、振動感覚閾値に反応の一貫性があるか否かを評価する評価手段24が設けられている。 Further, the control unit 11 includes an ascending method start level setting means 21 for determining a level at the start of the ascending method, and a timer means 22 for stopping the vibration stimulation from the end of the descending method to the start of the ascending method. And a vibration sensation threshold value calculation means (VPT calculation means) 23 for calculating an average value of the ascending method threshold value and the descending method threshold value to obtain a vibration sensation threshold value (VPT), and whether the vibration sensation threshold value is consistent in response. Evaluation means 24 is provided for evaluating.

そして、振動感覚閾値測定装置は、タイマ手段22、振動感覚閾値算出手段23や評価手段24などを使って、被検者の応答があるまで振動刺激の大きさを徐々に増加させて上昇法閾値を求める上昇法と、被検者の応答がなくなるまで振動刺激の大きさを徐々に減少させて下降法閾値を求める下降法を繰り返すことにより、被検者の指先における振動感覚閾値を算定する。 Then, the vibration sensation threshold value measuring apparatus uses the timer means 22, the vibration sensation threshold value calculation means 23, the evaluation means 24, and the like to gradually increase the magnitude of the vibration stimulus until the subject's response is received. The vibration sensation threshold value at the fingertip of the subject is calculated by repeating the ascending method for obtaining the descent method and the descent method for obtaining the descent method threshold value by gradually decreasing the magnitude of the vibration stimulus until the subject no longer responds.

以上のように構成された振動感覚閾値測定装置を用いた上昇法と下降法による振動感覚閾値測定方法について説明する。ここでは、繰返し回数を3回とするが、限定するものではない。先ず、図2及び図3に示すように、ステップSP1において、被検者に振動感覚閾値測定に慣れてもらうためにトレーニングを行う。被検者の指先を加振器2にセットしたら、測定が開始され、加振器2による振動刺激の大きさが所定の変化速度(例えば、3dB/秒)で徐々に増加していく。   A vibration sensation threshold value measuring method using the ascending method and the descending method using the vibration sensation threshold value measuring apparatus configured as described above will be described. Here, the number of repetitions is three, but is not limited. First, as shown in FIG. 2 and FIG. 3, in step SP1, training is performed so that the subject can get used to the vibration sensation threshold measurement. When the subject's fingertip is set on the vibrator 2, the measurement is started, and the magnitude of the vibration stimulus by the vibrator 2 gradually increases at a predetermined change rate (for example, 3 dB / second).

振動刺激の大きさが増加していく過程で、被検者は、振動刺激を感じるレベルta(0)になると、押ボタンスイッチ3を押し、振動刺激を感じている間、押ボタンスイッチ3を押し続ける。押ボタンスイッチ3が押される(オン状態)と、振動刺激の大きさは増加から減少に転じ、押ボタンスイッチ3が押されている間(オン状態)は振動刺激の大きさは所定の変化速度(例えば、3dB/秒)で徐々に減少していく。被検者が振動刺激を感じなくなった時点で押ボタンスイッチ3を押すのを止める(オフ状態)と、この時点のレベルをtd(0)として制御部11に記憶し、トレーニングは終了する。ただし,トレーニングは、被検者が慣れるために数回行うこともある。 In the process of increasing the magnitude of the vibration stimulus, the subject presses the push button switch 3 when the level ta (0) at which the vibration stimulus is felt. Press and hold. When the push button switch 3 is pressed (ON state), the magnitude of the vibration stimulus changes from increasing to decreasing, and while the push button switch 3 is being pressed (ON state), the magnitude of the vibration stimulus is a predetermined change rate. It gradually decreases at (for example, 3 dB / second). When the push button switch 3 is stopped when the subject no longer feels vibration stimulation (OFF state), the level at this point is stored in the control unit 11 as td (0), and the training is ended. However, the training may be performed several times for the subject to get used to.

次いで、ステップSP2から振動感覚閾値測定が始まる。トレーニング終了から1回目の上昇法による測定までの間に、タイマ手段22により振動刺激を停止(例えば、1秒間)させる。そして、振動刺激の停止期間が経過したら、1回目の上昇法による測定が開始される。この時の振動刺激の開始レベルS1は、トレーニングで押ボタンスイッチ3がオフ状態になった時点のレベルtd(0)とする。または、より十分に低いレベルでもよい。測定が開始されると、加振器2による振動刺激の大きさが所定の変化速度(例えば、3dB/秒)で徐々に増加していく。   Next, vibration sensation threshold measurement starts from step SP2. The vibration stimulation is stopped (for example, for 1 second) by the timer means 22 between the end of the training and the measurement by the first ascending method. And when the stop period of vibration stimulation passes, the measurement by the 1st ascent method is started. The vibration stimulation start level S1 at this time is set to a level td (0) when the pushbutton switch 3 is turned off by training. Or it may be a sufficiently lower level. When the measurement is started, the magnitude of the vibration stimulus by the vibrator 2 gradually increases at a predetermined change rate (for example, 3 dB / second).

次いで、ステップSP3において、押ボタンスイッチ3がオン状態になった(応答あり)か否かが判断される。押ボタンスイッチ3がオン状態になっていないと判断されると、ステップSP2に戻って振動刺激の大きさを所定の変化速度(例えば、3dB/秒)で徐々に増加させていく。一方、押ボタンスイッチ3がオン状態になったと判断されると、ステップSP4において、押ボタンスイッチ3がオン状態になった時の振動刺激の大きさが1回目の上昇法閾値ta(1)として制御部11に記憶される。 Next, in step SP3, it is determined whether or not the push button switch 3 is turned on (response is received). If it is determined that the pushbutton switch 3 is not in the ON state, the process returns to step SP2 to gradually increase the magnitude of the vibration stimulus at a predetermined change rate (for example, 3 dB / second). On the other hand, when it is determined that the pushbutton switch 3 is turned on, in step SP4, the magnitude of the vibration stimulus when the pushbutton switch 3 is turned on is set as the first rising method threshold ta (1). It is stored in the control unit 11.

次いで、ステップSP5において、振動刺激の大きさが増加から減少に転じ、押ボタンスイッチ3がオン状態の間は振動刺激の大きさを所定の変化速度(例えば、3dB/秒)で徐々に減少させていく。   Next, in step SP5, the magnitude of the vibration stimulus changes from increase to decrease, and while the pushbutton switch 3 is in the ON state, the magnitude of the vibration stimulus is gradually reduced at a predetermined change rate (for example, 3 dB / second). To go.

次いで、ステップSP6において、押ボタンスイッチ3がオフ状態になった(応答なし)か否かが判断される。押ボタンスイッチ3がオン状態の間は、ステップSP5に戻って振動刺激の大きさを所定の変化速度(例えば、3dB/秒)で徐々に減少させていく。一方、押ボタンスイッチ3がオフ状態になったと判断されると、ステップSP7において、押ボタンスイッチ3がオフ状態になった時点の振動刺激の大きさが1回目の下降法閾値td(1)として制御部11に記憶される。 Next, in step SP6, it is determined whether or not the push button switch 3 is turned off (no response). While the pushbutton switch 3 is in the ON state, the process returns to step SP5 to gradually decrease the magnitude of the vibration stimulus at a predetermined change rate (for example, 3 dB / second). On the other hand, if it is determined that the pushbutton switch 3 is turned off, in step SP7, the magnitude of the vibration stimulus at the time when the pushbutton switch 3 is turned off is set as the first descending method threshold td (1). It is stored in the control unit 11.

次いで、ステップSP8において、上昇法による測定と下降法による測定が夫々3回行われたか否かが判断される。上昇法測定と下降法測定が夫々3回行われていないと判断されると、ステップSP9において、振動刺激を所定の停止期間だけ停止する。一方、上昇法測定と下降法測定が夫々3回行われたと判断されると、ステップSP11へ進む。 Next, in step SP8, it is determined whether or not the measurement by the ascending method and the measurement by the descending method are each performed three times. If it is determined that the ascending method measurement and the descending method measurement are not performed three times, in step SP9, the vibration stimulation is stopped for a predetermined stop period. On the other hand, if it is determined that the ascending method measurement and the descending method measurement have been performed three times, the process proceeds to step SP11.

本発明の実施の形態では、上昇法測定と下降法測定の回数を3回とするが、本発明を実施するには少なくとも3回であればよく、3回に限定されない。また、所定の停止期間は、ランダム(例えば、0〜2秒間)に変化させてもよく、または、固定(例えば、1秒間)でもよい。 In the embodiment of the present invention, the ascending method measurement and the descending method measurement are performed three times. However, in order to implement the present invention, the number of times is not limited to three. The predetermined stop period may be changed randomly (for example, 0 to 2 seconds) or may be fixed (for example, 1 second).

次いで、ステップSP9における振動刺激の停止期間が経過すると、ステップSP10において、1回目の下降法閾値td(1)に対して上昇法開始レベル設定手段21により(例えば、0〜−10dB)ランダムに変化させて、2回目の振動刺激の開始レベルS2を設定する。次いで、ステップSP2に戻って、2回目の上昇法による測定が開始され、振動刺激の大きさを開始レベルS2から所定の変化速度(例えば、3dB/秒)で徐々に増加させていく。 Next, when the vibration stimulation stop period in step SP9 has elapsed, in step SP10, the ascent method start level setting means 21 randomly changes (for example, 0 to -10 dB) with respect to the first descending method threshold value td (1). Then, the start level S2 of the second vibration stimulation is set. Next, returning to step SP2, measurement by the second ascending method is started, and the magnitude of the vibration stimulus is gradually increased from the start level S2 at a predetermined change rate (for example, 3 dB / second).

次いで、ステップSP3において、押ボタンスイッチ3がオン状態になったと判断されると、ステップSP4において、押ボタンスイッチ3がオン状態になった時点の振動刺激の大きさが2回目の上昇法閾値ta(2)として制御部11に記憶される。 Next, when it is determined in step SP3 that the pushbutton switch 3 is turned on, in step SP4, the magnitude of the vibration stimulus at the time when the pushbutton switch 3 is turned on is the second rise method threshold ta. (2) is stored in the control unit 11.

次いで、ステップSP5において、振動刺激の大きさが増加から減少に転じ、振動刺激の大きさを所定の変化速度(例えば、3dB/秒)で徐々に減少させていく。次いで、ステップSP6において、押ボタンスイッチ3がオフ状態になったと判断されると、ステップSP7において、押ボタンスイッチ3がオフ状態になった時点の振動刺激の大きさが2回目の下降法閾値td(2)として制御部11に記憶される。 Next, in step SP5, the magnitude of the vibration stimulus changes from increase to decrease, and the magnitude of the vibration stimulus is gradually reduced at a predetermined change rate (for example, 3 dB / second). Next, when it is determined in step SP6 that the pushbutton switch 3 is turned off, in step SP7, the magnitude of the vibration stimulus at the time when the pushbutton switch 3 is turned off is the second descending method threshold td. (2) is stored in the control unit 11.

次いで、ステップSP8において、上昇法測定と下降法測定が夫々3回行われていないと判断されると、ステップSP9において、振動刺激を所定の停止期間だけ停止する。次いで、振動刺激の停止期間が経過すると、ステップSP10において、2回目の下降法閾値td(2)に対して上昇法開始レベル設定手段21により(例えば、0〜−10dB)ランダムに変化させて、3回目の振動刺激の開始レベルS3を設定する。   Next, when it is determined in step SP8 that the ascending method measurement and the descending method measurement are not performed three times, in step SP9, the vibration stimulation is stopped for a predetermined stop period. Next, when the stop period of the vibration stimulation has elapsed, in step SP10, the ascent method start level setting means 21 randomly changes (for example, 0 to −10 dB) with respect to the second descending method threshold value td (2), A start level S3 of the third vibration stimulation is set.

次いで、ステップSP2に戻って、3回目以降については、2回目と同様の手順で測定が行われ、3回目の上昇法閾値ta(3)として制御部11に記憶される。 Next, returning to step SP2, for the third and subsequent times, measurement is performed in the same procedure as the second time, and stored in the control unit 11 as the third ascending method threshold ta (3).

次いで、ステップSP8において、上昇法測定と下降法測定が夫々3回行われたと判断されると、ステップSP11において、振動感覚閾値(VPT)が算定される。振動感覚閾値(VPT)は、次式(1)により算出される。ここで、nは上昇法・下降法の閾値ペアの総数(n≧3)、ta(r)はr回目の上昇法閾値、td(r)はr回目の下降法閾値である。なお、本発明の実施の形態では、n=3,r=3としている。 Next, when it is determined in step SP8 that the ascending method measurement and the descending method measurement are each performed three times, in step SP11, a vibration sensation threshold value (VPT) is calculated. The vibration sensation threshold (VPT) is calculated by the following equation (1). Here, n is the total number of threshold pairs of the ascending method / descending method (n ≧ 3), ta (r) is the rth ascending method threshold, and td (r) is the rth descending method threshold. In the embodiment of the present invention, n = 3 and r = 3.

Figure 0004611453
Figure 0004611453

次いで、ステップSP12において、ステップSP11で算定された振動感覚閾値(VPT)の反応の一貫性の評価がなされる。   Next, in step SP12, the consistency of the response of the vibration sensation threshold (VPT) calculated in step SP11 is evaluated.

反応の一貫性ありの表示がなされる条件は、以下のすべてを満たす場合である。a)上昇法で得られた3つの上昇法閾値ta(1),ta(2),ta(3)の相違が、10.0dB又は比が3.15未満であること。b)下降法で得られた3つの下降法閾値td(1),td(2),td(3)の相違が、10.0dB又は比が3.15未満であること。c)上昇・下降法による閾値の夫々の対の平均値(ta(1)+td(1))/2,(ta(2)+td(2))/2,(ta(3)+td(3))/2の相違が、6.0dB又は比が2未満であること。上記の条件が満たされない場合は、反応の一貫性なしが液晶ディスプレイ18などに表示される。 Conditions for consistent display of reactions are when all of the following are met: a) The difference between the three ascending method threshold values ta (1), ta (2), and ta (3) obtained by the ascending method is 10.0 dB or the ratio is less than 3.15. b) The difference between the three descending method threshold values td (1), td (2), td (3) obtained by the descending method is 10.0 dB or the ratio is less than 3.15. c) Average value of each pair of threshold values by the ascending / descending method (ta (1) + td (1)) / 2, (ta (2) + td (2)) / 2, (ta (3) + td (3) ) / 2 is 6.0 dB or the ratio is less than 2. If the above condition is not satisfied, the inconsistency of the reaction is displayed on the liquid crystal display 18 or the like.

そして、得られた振動感覚閾値についての反応の一貫性の評価がされると、振動感覚閾値の測定作業は終了する。また、測定中(ステップSP2〜ステップSP12)において、振動刺激の大きさに関する情報を画面に表示しなくてもよい。画面に表示しないことで、検査者の無意識の反応を防ぎ、検査者の動きに応じた被検者の誤応答を抑制する。 Then, when the consistency of the reaction with respect to the obtained vibration sensation threshold is evaluated, the measurement operation of the vibration sensation threshold ends. Further, during measurement (step SP2 to step SP12), information regarding the magnitude of the vibration stimulus may not be displayed on the screen. By not displaying on the screen, the unintentional reaction of the examiner is prevented, and the erroneous response of the subject according to the movement of the examiner is suppressed.

本発明によれば、下降法で求めた下降法閾値に対し所定の範囲でランダムに変化すること、及び/または、下降法による測定が終了してから上昇法による測定を開始するまでの間に、振動刺激の停止時間を設けたので、被検者の応答が一定間隔でなくなるため、誤応答が抑制され、測定確度の向上が図れる振動感覚閾値測定方法及びその装置を提供することができる。   According to the present invention, it changes randomly within a predetermined range with respect to the descent method threshold obtained by the descent method, and / or after the measurement by the descent method is completed and before the measurement by the ascending method is started. Since the vibration stimulus stop time is provided, the response of the subject is not at a constant interval, so that it is possible to provide a vibration sensation threshold measurement method and apparatus capable of suppressing erroneous responses and improving measurement accuracy.

1…装置本体、2…加振器、3…押ボタンスイッチ、4…ロードセル、5…加速度計、11…制御部、12…信号生成部、13…減衰器、14…増幅器、15…A/D変換器、16…操作スイッチ、17…内蔵プリンタ、18…液晶ディスプレイ、19…振動刺激レベルダイヤル、21…上昇法開始レベル設定手段、22…タイマ手段、23…振動感覚閾値算出手段(VPT算出手段)、24…評価手段。 DESCRIPTION OF SYMBOLS 1 ... Apparatus main body, 2 ... Exciter, 3 ... Pushbutton switch, 4 ... Load cell, 5 ... Accelerometer, 11 ... Control part, 12 ... Signal generation part, 13 ... Attenuator, 14 ... Amplifier, 15 ... A / D converter 16 ... operation switch 17 ... built-in printer 18 ... liquid crystal display 19 ... vibration stimulus level dial 21 ... rising method start level setting means 22 ... timer means 23 ... vibration sense threshold value calculating means (VPT calculation) Means), 24... Evaluation means.

Claims (8)

指先における振動感覚閾値を、被検者の応答があるまで振動刺激の大きさを徐々に増加させて上昇法閾値を求める上昇法と、被検者の応答がなくなるまで振動刺激の大きさを徐々に減少させて下降法閾値を求める下降法を繰り返すことにより求める振動感覚閾値測定方法において、前記上昇法における開始時の振動刺激の大きさは、直前の下降法で求めた下降法閾値に対し所定の範囲でランダムに変化させて設定することを特徴とする振動感覚閾値測定方法。 The ascending method for obtaining the ascending method threshold by gradually increasing the magnitude of the vibration stimulus until there is a response from the subject, and the magnitude of the vibration stimulus gradually until there is no response from the subject. In the vibration sensation threshold value measurement method obtained by repeating the descending method for obtaining the descending method threshold value by reducing the descending method threshold value, the magnitude of the vibration stimulus at the start in the ascending method is predetermined with respect to the descending method threshold value obtained by the immediately preceding descending method. A vibration sensation threshold value measuring method, characterized in that the vibration sensation threshold value setting method is performed by randomly changing the range. 請求項1に記載の振動感覚閾値測定方法において、前記下降法による測定が終了してから前記上昇法による測定を開始するまでの間に、振動刺激の停止期間を設けることを特徴とする振動感覚閾値測定方法。 2. The vibration sensation threshold value measuring method according to claim 1, wherein a vibration stimulation stop period is provided between the end of the measurement by the descending method and the start of the measurement by the ascending method. Threshold measurement method. 請求項2に記載の振動感覚閾値測定方法において、前記停止期間は所定の範囲でランダムに変化することを特徴とする振動感覚閾値測定方法。 The vibration sensation threshold value measuring method according to claim 2, wherein the stop period changes randomly within a predetermined range. 指先における振動感覚閾値を、被検者の応答があるまで振動刺激の大きさを徐々に増加させて上昇法閾値を求める上昇法と、続いて被検者の応答がなくなるまで振動刺激の大きさを徐々に減少させて下降法閾値を求める下降法を繰り返すことにより求める振動感覚閾値測定装置において、前記上昇法における開始時の振動刺激の大きさは、直前の下降法で求めた下降法閾値に対し所定の範囲でランダムに変化させて設定する上昇法開始レベル設定手段を設けることを特徴とする振動感覚閾値測定装置。 The ascending method to obtain the ascending method threshold by gradually increasing the magnitude of the vibration stimulus until the subject's response, and the magnitude of the vibration stimulus until the subject's response disappears. In the vibration sensation threshold value measurement apparatus obtained by repeating the descending method for obtaining the descending method threshold by gradually decreasing the descending method threshold, the magnitude of the vibration stimulus at the start of the ascending method is equal to the descending method threshold obtained by the immediately preceding descending method. An apparatus for measuring a vibration sensation threshold value, characterized in that an ascending method start level setting means is provided which is randomly changed within a predetermined range. 請求項4に記載の振動感覚閾値測定装置において、前記下降法による測定が終了してから前記上昇法による測定を開始するまでの間に、振動刺激の停止期間を設定するタイマ手段を設けることを特徴とする振動感覚閾値測定装置。 5. The vibration sensation threshold value measuring apparatus according to claim 4, further comprising a timer means for setting a period for stopping the vibration stimulation between the end of the measurement by the descending method and the start of the measurement by the ascending method. A characteristic vibration sensation threshold measuring device. 請求項5に記載の振動感覚閾値測定装置において、前記タイマ手段に設定する停止期間は、所定の範囲でランダムに変化することを特徴とする振動感覚閾値測定装置。 6. The vibration sensation threshold value measuring apparatus according to claim 5, wherein the stop period set in the timer means changes randomly within a predetermined range. 請求項4乃至請求項6のいずれかに記載の振動感覚閾値測定装置において、前記上昇法閾値と前記下降法閾値の平均値を算出して振動感覚閾値を求める振動感覚閾値算出手段を設け、この振動感覚閾値算出手段が算出した振動感覚閾値に反応の一貫性があるか否かを評価する評価手段を設けることを特徴とする振動感覚閾値測定装置。 The vibration sensation threshold value measuring device according to any one of claims 4 to 6, further comprising a vibration sensation threshold value calculating unit for calculating a vibration sensation threshold value by calculating an average value of the ascending method threshold value and the descending method threshold value. A vibration sensation threshold value measuring apparatus characterized by comprising evaluation means for evaluating whether or not the vibration sensation threshold value calculated by the vibration sensation threshold value calculation means is consistent in response. 請求項4乃至請求項7のいずれかに記載の振動感覚閾値測定装置において、測定中は振動刺激の大きさに関する情報は画面に表示しないことを特徴とする振動感覚閾値測定装置。 8. The vibration sensation threshold value measuring apparatus according to claim 4, wherein information regarding the magnitude of the vibration stimulus is not displayed on the screen during measurement.
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WO2014045339A1 (en) 2012-09-18 2014-03-27 独立行政法人産業技術総合研究所 Device for evaluating diabetic peripheral neuropathy and method therefor
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