JP4852741B2 - Vibration stimulation therapy apparatus and computer program - Google Patents

Description

The present invention relates to a vibration stimulation therapy apparatus and a computer program suitable for use in rehabilitation of a central nervous disease.

  Rehabilitation is defined as “recovering a person with a disability to the maximum physical, social, professional, and economic abilities that the person can do” (National Rehabilitation Council, 1942). Rehabilitation is one of the most social issues for Japan today, which is facing rapid aging and declining birthrate. Among them, the development of a device for medical rehabilitation is a problem that requires not only medical knowledge but also engineering knowledge, and the linkage between medicine and engineering is important.

  The number of stroke patients nationwide is estimated at 1.73 million (1996 patient survey). Stroke is a general term for brain disorders caused by vascular lesions, and one of the symptoms is hemiplegia (half-body paralysis, half-body paralysis). Hemiplegia is a disorder in which voluntary movement becomes difficult because of damage to the nerve pathways that travel from the nerve cells in the cerebrum to the spinal cord due to a stroke. In order to recover the patient's QOL (quality of life), it is important to provide effective rehabilitation therapy for hemiplegia due to stroke.

  The purpose of rehabilitation therapy for hemiplegia is to induce exercise in the affected area and repeat the exercise to reshape the neural circuit and restore the motor function. And as the method, the functional electrical stimulation method and the facilitating repeated therapy are known. Functional electrical stimulation is a method of inducing exercise by applying electrical stimulation to an affected area. On the other hand, the facilitating repeated therapy is a method of inducing exercise by giving an external operation (stimulation) by a therapist to the affected part.

Yoshihiro Muraoka, 3 others, “Electric stimulation device development”, Rehabilitation, Vol. 31, No. 4, 315-321, April 2003 JP 2004-313555 A JP 2003-144556 A JP 2001-293097 A Utility Model Registration No. 3041871 JP 2004-275422 A JP 2003-52769 A JP 2003-52770 A JP 2003-79683 A

  However, functional electrical stimulation is a technique that directly stimulates muscles to cause movement of the paralyzed limbs regardless of the patient's intention, and is effective in repeatedly transmitting excitement to the nerve path from the cerebrum to the muscles. It's not a method.

  On the other hand, facilitating repeated therapy provides effective stimulation to the deep sense of the muscles and assists the voluntary movement intended by the patient. Voluntary movement is physical movement controlled through nerves by the cerebrum, and repetition of voluntary movement is effective as rehabilitation for stroke patients. However, since the therapist performs one-on-one with respect to the patient in the repeated delivery therapy, manpower and time are required.

  The following is a list of literatures that disclose techniques for promoting exercise that have been proposed in the past.

  As described in Non-Patent Document 1, etc., electrical stimulation devices are used in the field of rehabilitation medicine. Functional electrical stimulation by these devices is a method of realizing a function by applying electrical stimulation so that a desired action can be performed on a paralyzed limb with reduced voluntaryness. However, there is a need to constantly provide electrical stimulation (functional electrical stimulation walking assist device (Patent Document 1) and stepping motion assist functional electrical stimulation device (Patent Document 2)), and the neural circuit aimed at by the present invention is regenerated. It is difficult to use for the purpose of forming and restoring motor function.

  Moreover, although development of a low frequency treatment apparatus is also active (Patent Document 3 etc.), it is for analgesic purposes and is difficult to use for the purpose of restoring motor function as in the present invention.

  As a vibration device, a commercially available massager or the like is well known. For example, there is a massage device incorporating a vibration mechanism disclosed in Patent Document 4. They are used to reduce muscle stiffness and adjust muscle tension in paralyzed limbs, but have no use in upper and lower limb movements. Moreover, many vibration devices are relatively large, and there is no size that can directly act only on muscles involved in exercise. When a vibration stimulus is given for the purpose of treatment, including the purpose of raising attention to the neglected direction of the hemiplegic patient, it is performed in a stationary state.

  Moreover, in the control method (Patent Document 5) of the device for simultaneous use of exercise therapy and physical therapy, there is a means for giving pressure stimulation or vibration stimulation to human muscles. It does not provide a means to reshape the target neural circuit and restore motor function.

  Moreover, although there exists what was disclosed by patent documents 6-8 as an exercise therapy apparatus of an upper limb and a lower limb, the vibration stimulus is not given in order to induce voluntary movement.

  As described above, the conventional technique cannot be used for the purpose of inducing voluntary movement by functionally applying vibration stimulation to each part of the muscle group involved in the movement during the movement of the upper limb or the lower limb. In addition, electrical stimulation is not appropriate as a means for inducing voluntary movements, and is not appropriate, and there is no means that directly acts on the deep sense as safely as vibration stimulation.

  The present invention has been made in view of the above points, and can provide effective stimulation to the deep sense of the muscles involved in exercise in order to adjust the excitement level of the nerve tract from the cerebrum to the muscle. It is an object to provide a device capable of supplementing the role of a therapist who can perform external operations.

A vibration stimulation therapy apparatus according to the present invention includes a plurality of vibration stimulation apparatuses for applying vibration stimulation to a predetermined part of a patient for the purpose of inducing voluntary movement, and control means for controlling activation and stop of each of the vibration stimulation apparatuses. detects the movement information of the predetermined portion of the patient, and a detection device for transmitting to the control means, so that said control means controls the start and stop independently with a time difference to each of the vibration stimulation device Further, the present invention is characterized in that the timing for starting and stopping each of the vibration stimulation devices can be set .
A computer program according to the present invention uses a plurality of vibration stimulation apparatuses for applying vibration stimulation to a predetermined part of a patient for the purpose of inducing voluntary movement, and a detection device for detecting movement information of the predetermined part of the patient. A computer program for performing vibration stimulation therapy , wherein the timing of starting and stopping each vibration stimulation device is controlled so that the control means controls the activation and stop independently with a time difference between the vibration stimulation devices. It is characterized in that it causes a computer to execute processing to be set by the user .

  According to the present invention, by one or a plurality of vibration stimulation devices for applying vibration stimulation to a predetermined part of a patient for the purpose of inducing voluntary movement, for example, the deep part of a muscle involved in the movement of a hemiplegic upper limb or a hemiplegic lower limb An effective stimulus can be given to the senses, the neural circuit can be reformed, and the motor function can be restored. Thereby, while supplementing the role of the therapist who gives external operation, the apparatus which can perform new fascinating repeated training can be provided.

  Preferred embodiments of the present invention will be described below with reference to the accompanying drawings. In this embodiment, the extension and flexion movements of the upper limbs will be described as an example, but the present invention is also applied to the extension and flexion movements, adduction and abduction movements, and internal and external rotation movements of the upper or lower limbs. It is possible.

<Hardware configuration>
In FIG. 1, schematic structure of the vibration stimulation therapy apparatus of this embodiment is shown. In the figure, reference numeral 1 denotes a small vibration stimulation apparatus, which is detachably fixed to a part involved in the movement of the patient's upper limb 101, and applies vibration stimulation for the purpose of inducing voluntary movement. The vibration stimulating apparatus 1 is provided with a circular aluminum plate having a diameter of about 2 cm and a thickness of about 1.5 mm to a small vibration motor (frequency around 100 Hz, in this embodiment, 116 Hz) used for a mobile phone, for example. It is a thing. In this embodiment, the vibration stimulation apparatus 1 has a total of 8 channels from 0 to 7.

  Reference numeral 2 denotes a power source for the vibration stimulating device 1, and for example, a DC power source is used.

  Reference numeral 3 denotes a personal computer PC having a display 3a, which outputs a switch open / close signal in accordance with a vibration stimulus generation program.

  4 is an A / D converter connected to a detection device for detecting movement information of the upper limb 101 such as two touch switches 5a and 5b and an EMG measuring device 8, 6 is a switch circuit connected to the vibration stimulation device 1, and 7 is a switch circuit. 6 is a D / A converter connected to 6. The switch circuit 6 turns off the state of the vibration motor of the vibration stimulation device 1 when the voltage of the switch opening / closing signal output from the D / A converter 7 is 0V, for example, and turns it on when the voltage is 5V. The switch circuit 6 can control the start and stop of each vibration stimulator 1.

  Reference numerals 5a and 5b denote rehabilitation touch switches (big switches), which are used that operate with a light force regardless of which part of the circular pressing portions 51a and 51b is pressed. The touch switches 5a and 5b are color-coded, for example, blue and yellow. In addition, touch switches 5a and 5b have a plurality of types of touch switches 5a and 5b, for example, pushers 51a and 51b having a diameter of 13 cm, and a half of 6.5 cm so that training and examination can be performed according to the symptoms of the patient's paralysis. Prepare things. In the case of a diameter of 6.5 cm, a pressing portion having a diameter of 3 cm is further fixed on the pressing portion 51a (51b).

  Reference numeral 8 denotes an EMG measuring instrument, which measures myoelectric potential with an electrode fixed to the patient's upper limb 101 and transmits the measured value to the personal computer 3 via the A / D converter 4. Since the myoelectric potential is generated according to the operation of the upper limb 101, the personal computer 3 can detect the operation information of the upper limb 101 based on the signal waveform of the myoelectric potential. Based on this EMG signal, the activation and stop of the vibration stimulation apparatus 1 may be controlled.

  In the vibration stimulation therapy apparatus thus configured, the switch opening / closing signal output from the personal computer 3 is converted into analog data by the D / A converter 7 and input to the switch circuit 6 to start and stop the vibration stimulation apparatus 1. Can be controlled. The vibration stimulation generation program on the personal computer 3 can create a complicated activation and stop pattern of the vibration stimulation apparatus 1 based on the motion information of the upper limb 101.

  In addition, the voltage generated by turning on / off the touch switches 5 a and 5 b can be converted into digital data by the A / D converter 4 and input to the personal computer 3. The touch switches 5a and 5b are turned on by the extension and bending motion of the upper limb 101, detect the extension state and the bending state, measure and record the time required for the extension and bending motion, and each vibration stimulation device 1 Is used to put the device in the active state or standby state.

  In FIG. 2, the relationship of each part of the vibration stimulation therapy apparatus of this embodiment is shown. As shown in the figure, a vibration stimulation apparatus 1 for applying vibration stimulation to a part involved in the movement of the patient's upper limb 101 for the purpose of inducing voluntary movement, and detection apparatuses 5a and 5b for detecting movement information of the upper limb 101. (8) and the personal computer 3 which is a control means for controlling the activation and stop of each vibration stimulating device 1 based on the motion information of the upper limb 101 transmitted from the detection devices 5a and 5b (8) constitutes a closed loop. Is done.

  In the present embodiment, the personal computer 3, the switch circuit 6 and the like together constitute the control means referred to in the present invention.

<Training and inspection methods>
As shown in FIG. 1, the vibration stimulating apparatus 1 is directly fixed to the skin of the upper limb 101 on, for example, a medical tape on the muscle involved in the extension and bending motion of the upper limb 101.

  When training or inspection is performed, the positions of the touch switches 5a (blue) and 5b (yellow) are set first. That is, as shown in FIG. 3, with the patient sitting on a chair, the touch switch 5b (yellow) is placed on the back side of the desk and the touch switch 5a (blue) is placed on the front side. The position of the touch switch 5b (yellow) is determined within the maximum range of motion that can be reached by fingers. Based on the position of the touch switch 5b (yellow), the shortest distance L of the pressing portions 51a and 51b between the touch switches 5a and 5b is determined according to the symptoms of the patient's paralysis, and the position of the touch switch 5a (blue) Set. During training or examination, the patient's trunk is fixed to a chair in order to limit other than extension and flexion movements of the upper limbs.

  Subsequently, on the mode setting screen of the vibration stimulus generation program on the personal computer 3, (1) the patient ID and the distance L between the touch switches 5a and 5b are input, and (2) the vibration of each vibration stimulator 1 having 8 channels. Set the pattern. Thereafter, (3) the setting end button is used to move to the training / inspection screen, and (4) the start button of the training / inspection screen is operated to start training or inspection. The patient is instructed to “press the touch switches 5a (blue) and 5b (yellow) quickly and smoothly alternately”. During training or examination, the display 3a is not shown so that the patient can concentrate, and this is notified to the patient by a beep sound when the touch switches 5a and 5b are pressed.

  Training or examination begins with the flexion of the upper limb. First, the patient starts the extension movement, and then repeats the extension movement and the bending movement alternately in the order of the bending movement. The end condition is that when the specified number of performances is completed (for example, 50 times each of stretching and bending movements), or when the specified performance time has elapsed (for example, 30 seconds), or the end button on the training / examination screen is displayed. It will be operated.

<Vibration stimulus generation program>
The vibration stimulation generation program on the personal computer 3 can be activated and stopped independently with a time difference between the plurality of vibration stimulation apparatuses 1 based on information obtained by detecting the extension and flexion movements of the upper limbs.

  Further, as will be described in detail later, training modes 1, 2, and 3 can be set so that training can be performed according to the symptoms of the patient's paralysis, and an inspection mode for evaluating the training result can be set. It can be done.

  FIG. 4 is a flowchart showing the processing operation by the vibration stimulus generation program on the personal computer 3. With the training modes 1, 2, 3, and examination mode selected (step S401), the patient ID and, if necessary, the distance L between the touch switches 5a, 5b are input (steps S402, S403). Then, the vibration pattern of each vibration stimulation apparatus 1 (period and time difference between the vibration stimulation apparatuses 1 having 8 channels) is set (steps S404 and S405).

  The setting method is common to all modes. FIG. 5 is a diagram showing a mode setting screen 500. The patient ID is entered in the ID entry field 501 and the distance L between the touch switches 5a and 5b is entered in the distance entry field 502.

  In the period input field 503, the sum of the time required for one extension movement and bending movement is input as a period (seconds). The period is common to all channels, and the first half of the period is used for the extension movement and the second half for the bending movement. In the inspection mode, conditions without vibration stimulation can be selected and set.

  In the time difference input field 504, the timing (seconds) at which the vibration stimulation apparatus 1 corresponding to each channel is activated and stopped in the set cycle is input.

  When setting these periods and time differences, it is possible to refer to previously set values for training and inspection. As a reference method, after the ID is input, the setting reference button 505 is operated to display the file name on the selection item display section. In the file to be displayed, setting values used in the training and examination performed by the patient before are stored. By selecting a file to be set from the displayed file names and operating the setting button 506, previous setting values are input to the period input field 503 and the time difference input field 504.

  Further, by operating the graph display button 507, the set cycle and time difference can be visually displayed (reference numeral 509 in the figure).

  Furthermore, the channel to be used can be selected by selecting the check box 510.

  After the setting is completed (step S406), if the setting end button 508 is operated, the training / inspection screen is displayed and training or inspection is started (step S407). The termination condition can be determined separately. FIG. 6 is a diagram showing a training / inspection screen.

Here, the details of the training modes 1, 2, 3 and the inspection mode will be described.
(Training mode 1)
In FIG. 7, the example of the state of starting and a stop of the vibration stimulation apparatus 1 in training mode 1 is shown. In training mode 1, after the training starts, the set cycle is repeated until the specified number of performances is completed, the specified performance time has elapsed, or the training stop button on the training screen is operated. It is. In the training mode 1, the touch switches 5a and 5b are used only to detect upper limb movement information.

(Training mode 2)
In FIG. 8, the example of the state of starting and a stop of the vibration stimulation apparatus in training mode 2 is shown. The training mode 2 starts from the standby state after the training is started, and one cycle starts by pressing the touch switch 5a (blue). When one cycle is finished, the state returns to the standby state, and one cycle does not start until the touch switch 5a (blue) is pressed next time. In the training mode 2, the design of the touch switch 5a (blue) is displayed on the display 3a, and the display blinks in the standby state. The training mode 2 ends when the designated number of performances is completed, when the designated performance time has elapsed, or when a training stop button on the training screen is operated.

(Training mode 3)
FIG. 9 shows an example of the activation and stop states of the vibration stimulation device 1 in the training mode 3. The training mode 3 starts from the standby state after the training is started, and the first half cycle (for extension) is started by pressing the touch switch 5a (blue). When the first half cycle is completed, the camera enters a standby state. The second half cycle (for bending) is started by pressing the touch switch 5b (yellow), and when the second half cycle is finished, the same standby state as after the start of training is returned. The touch switches 5a and 5b do not react even if the same switch is continuously pressed, and switches to the next half cycle only when blue and yellow are alternately pressed. In the training mode 3, the symbols of the touch switches 5a (blue) and 5b (yellow) are displayed on the display 3a, and the display of the touch switch to be pressed next is blinking. In the training mode 3, when the touch switch for starting the next half cycle is pressed during the half cycle before the standby state, the next half cycle starts. The training mode 3 ends when the designated number of performances is completed, when the designated performance time has elapsed, or when a training stop button on the training screen is operated.

(Inspection mode)
An example of the activation and stop states of the vibration stimulation apparatus 1 in the examination mode is the same as that in the training mode 3 (FIG. 9). The difference from the training mode 3 is that the end condition is 50 performance times or the execution time is 30 seconds, and the condition without vibration stimulation can be set.

  Returning to FIG. 4, data is acquired by the training and inspection described so far (step S <b> 408), and after the training and inspection are completed by the end determination (steps S <b> 409 and S <b> 410), the data is obtained by these training and inspection. The data is saved (step S411). By operating the data save button, a folder having the ID name input on the setting screen is created (step S412), and a folder is created for each mode in the ID folder (step S413). The data is recorded, for example, in the EXCEL file format in the mode folder (step S414). The file name is the date and time when the training or inspection was started.

  The stored data includes the period, the time difference of each vibration stimulating device 1, the number of times of performing extension / bending motion, the performance time, and the like. In addition to these contents, the extension time (the time required from pressing the touch switch 5a (blue) to pressing the touch switch 5b (yellow)), the bending time (pressing the touch switch 5b (yellow)) Time required until the touch switch 5a (blue) is pressed), bending time (extension time and bending time). Further, in the case of the inspection mode, the average value, median, standard deviation, and the like may be calculated and stored as data corresponding to the number of times of extension time, bending time, and bending time, and evaluation values.

  In the above example, the extension and bending motions of the upper limbs are detected by pressing the touch switches 5a and 5b, but the EMG measuring device 8 shown in FIG. 1 may be used. Further, when detecting the extension and flexion movement of the upper limb, it may be detected using a position measuring means such as a goniometer or may be detected by imaging with a CCD camera. Moreover, you may use the positional information on the limbs in the training apparatus of the upper limbs or the lower limbs as disclosed in Patent Documents 6 to 8, for example. When using the EMG measuring instrument 8 or the like, not only the result of extension and flexion of the upper limb, but also the movement of the upper limb during that time can be detected, so that data may be stored.

  In the vibration stimulation therapy apparatus described above, the patient can easily perform extension and flexion movements of the hemiplegic upper limbs with the assistance of vibration stimulation, and by repeatedly repeating the target movement pattern, Paralysis of the paralyzed upper limb is restored, allowing the upper limb to be extended and flexed at will.

  For such deep sensation stimulation of the upper limb motor muscles, low-frequency electrical stimulation is not effective, and vibration stimulation is also reliable and effective. So far, vibration stimulation has not been given to the subject in motion to assist or facilitate the movement of the paralyzed limb. Currently, only large vibrators with a diameter of several tens of centimeters are used for vibration stimulation, and it is difficult to give vibration stimulation to the extremities during exercise, and vibration stimulation can be given to subjects at rest or standing. It wasn't too much. In addition, when stimulating vibrations for therapeutic purposes, such as reducing muscle stiffness, adjusting muscle tone of paralyzed muscles, or raising the attention to the left of patients with neglected left half, it is performed in a static state. .

  On the other hand, by applying the present invention, by using a small vibration stimulating apparatus 1 having a diameter less than or equal to the diameter of the coin, the patient is subjected to the extension and bending motions of the hemiplegic upper limb by the assistance and promotion by vibration stimulation. However, it can be easily performed.

<Example 1>
As an effect obtained by training using the present apparatus, improvement of upper limb motor function and reduction of hypertension and spasticity caused by continued exercise are assumed. The inspection for that purpose was performed in the sequence shown in FIG. 10, and the changes in the extension and bending time and the transition of the number of executions for each inspection were evaluated in the inspection examples 1 and 2 from the evaluation values obtained thereby.

  There are two types of inspection conditions: (i) no vibration stimulation and (ii) vibration stimulation with the vibration stimulation apparatus 1 fixed to the upper limb. First, the examination under the condition without vibration stimulation was performed a plurality of times until the time required for extension / flexion was stabilized or the time required for extension / flexion was increased due to muscle tension. Next, the test was performed twice under the condition with vibration stimulus, and immediately after that, the test was performed under the condition without vibration stimulus. Between the tests so far, we took a two-minute break. Finally, 5 minutes after the inspection under the condition with vibration stimulation, the inspection was performed under the condition without vibration stimulation.

(Inspection example 1)
Test example 1 shows test subject A (female, 71 years old, right hemiplegia) extended for the third test under the condition without vibration and the test performed under the condition with vibration two minutes later. Compare about time. FIG. 11 shows the transition of the extension time for 50 times obtained in each examination. As shown in FIG. 12, the vibration stimulating apparatus 1 was fixed to the front of the finger extensor, triceps and deltoid muscles among the muscle groups used for extension. In the examination of the condition with vibration stimulus, the time series was set so that the vibration stimulus was continuously given only during the extension movement. The touch switch used push parts 52a and 52b with a diameter of 3 cm, and the shortest distance L was 15 cm. Compared to the test performed under the condition without vibration stimulus, the time required for the test performed under the condition with vibration stimulus is generally low.

(Inspection example 2)
FIG. 13 shows the transition of the number of performances in the 2-minute examination of the subject B (female, 56 years old, right hemiplegia) and the subject C (male, 56 years old, right hemiplegia). Since both the subject B and the subject C have severe symptoms of upper limb paralysis, an auxiliary instrument was used when the examination was performed.

  The inspection was performed 6 times. In Exams 1-4, there was a 2-minute break between each exam. Then, after a 5-minute break, Exam 5 was performed. Finally, test 6 was performed after the subject was given 2 minutes of facilitating repeated therapy. The inspection end condition was 50 times or when 2 minutes had elapsed from the start of the inspection. As shown in FIG. 14, the muscle group to which the vibration stimulation device is fixed is the triceps surae and the anterior part of the deltoid. In the examination of the condition with vibration stimulus, the time series was set so as to keep giving vibration stimulus only during the extension movement. The touch switch used push parts 52a and 52b with a diameter of 3 cm, and the shortest distance L was 10 cm.

  Subject B has reduced the number of performances up to Exam 2 performed under conditions without vibration stimulation, but in Test 3 performed under conditions with vibration stimulation, the decrease in the number of performances stopped and performed under conditions with vibration stimulation. In inspection 4, the number of performances increased. After 5 minutes, the number of times that the test 5 performed under the condition without vibration stimulation was decreased as compared with the test 4, but the numerical value was higher than that of the test 2 performed without vibration stimulation. In the test 6, after performing the facilitating repeated therapy, the test was performed under the condition with the vibration stimulus, but the number of performance was higher than that of the previous five tests.

  The number of times subject C performed was higher in Test 3 and Test 4 performed under conditions with vibration stimulation than in Test 1 and Test 2 performed under conditions without vibration stimulation. The number of performances from examination 3 to examination 5 has decreased, but the number of performances has stopped decreasing in examination 6 performed under conditions with vibration stimulation after repeated facilitation therapy.

  Based on the above results, we will consider the improvement of upper limb motor function and the relaxation of overtension caused by continued exercise.

(Improved upper limb motor function)
In FIG. 11 shown in Test Example 1, the overall extension time of the test performed under the condition with vibration stimulus was reduced as compared with the test performed under the condition without vibration stimulus. This can be inferred from the fact that, when performing voluntary exercise, excitement from the cerebral cortex, which was difficult to be transmitted due to neuropathy of stroke, was transmitted more smoothly due to an increase in the excitement level of the motor lowering path due to vibration stimulation. It can be said that the voluntary movement of the test subject was induced by this apparatus, and the upper limb motor function was improved.

  In FIG. 13 shown in Test Example 2, the number of performances that can be performed in 2 minutes is increased in the test performed under the condition with vibration stimulus compared to the test performed under the condition without vibration stimulus. . This is because the paralysis symptom of subjects B and C of Test Example 2 was severe and the excitement level of the motor descending path to the elbow extensor was low. This is thought to be because the excitement level of the motility descending path to the muscle group was increased and the excitement from the cerebrum was transmitted. This also applies to the subject A in Test Example 1.

(Relieving muscle over-tension)
In FIG. 13 shown in the test example 2, the subject B decreases the number of performances until the test 2 performed under the condition without the vibration stimulus, but the decrease in the number of performances in the test 3 performed under the condition with the vibration stimulus. Stopped. It can be inferred that this is because the muscular overstrain caused by continued exercise has been alleviated by vibration stimulation.

  In addition, the test performed under the condition of vibration stimulation after the repeated facilitation therapy for the subject B recorded a higher number of performances than the previous five tests. This is thought to be because the muscle over-tension caused by the previous examination was reduced by the repeated push therapy, and further, the vibration stimulation stimulated the over-tension performed during the examination.

  After subject B and subject C gave vibration stimulation, test 5 performed under the condition without vibration stimulus increased the number of executions compared with test 1 and test 2 performed without the first vibration stimulus. is doing. This is because the increase in excitement level of the motor path following vibration stimulation continues or the transmission efficiency of nerve path increases due to repeated excitement. It is thought that it was done.

<Example 2>
In order to examine the effect of training under the functional vibration stimulation method, functional vibration stimulation is applied to the anterior deltoid and triceps muscles during extension of the elbow shown in FIG. 14, and vibration stimulation is not applied during flexion of the elbow. Bending and stretching training was conducted. Examinations were conducted before and after the exercise to examine whether the elbow flexion / extension movement was improved even without functional vibration stimulation. The training period under functional vibration stimulation conditions is 4 days, and the total flexion and extension movement is 1000 times. The subjects are three stroke patients, and the elbow can bend and stretch without assistance in the sitting position.

  As evaluation before and after the training under the functional vibration stimulation method, three times under the condition without functional vibration stimulation (Examination 1, inspection 2, inspection 3), twice under the condition with functional vibration stimulation (Inspection 4, Examination 5) Finally, one measurement (examination 6) was performed continuously with a break of 1 minute each in the absence of vibration stimulation. The examination is a bending and stretching exercise for 30 seconds, and the exercise data is automatically recorded in a personal computer. In the analysis, the first inspection under each inspection condition, that is, the measurement results of inspection 1, inspection 4, and inspection 6 were used. Among the evaluation indices, here, the median (median value) of the required time (seconds) of bending and stretching exercises was adopted as the evaluation index.

  In the result of case D in FIG. 15, the elbow flexion / extension time before the training under the functional vibration stimulation method is shortened in the condition of the test 4 with the functional vibration stimulation compared to the condition of the examination 1 without the vibration stimulation. It was shortened even after returning to the condition of 6 without vibration stimulation, and the acute effect and carry-over effect of the functional vibration stimulation method were shown. In the re-evaluation after training under the functional vibration stimulation method, the elbow flexion / extension time is remarkably shortened even before the training without functional vibration stimulation, and further shortened under the condition with vibration stimulation.

  In the result of Case E in FIG. 15, the elbow flexion / extension time was shortened under the condition with the vibration stimulus in the examination 4 and slightly extended again under the condition without the vibration stimulus in the examination 6 before the training under the functional vibration stimulation method. . The elbow flexion / extension time after training under the functional vibration stimulation method is shorter than before training even under the condition without functional vibration stimulation, and further shortened under the condition with vibration stimulation. Extended again. That is, it was shown that functional vibration stimulation brings about improvement of paralysis even in the absence of functional vibration stimulation by training under the functional vibration stimulation method 1000 times together with acute effects.

  Case F in FIG. 15 is the result of a case of mild paralysis. Like the effects observed in Case D and Case E, the elbow flexion extension time was shortened under conditions with vibration stimulation, and training under the functional vibration stimulation method was performed. The rest was shorter than before training.

  In all cases, elbow flexion and extension time is shortened under the condition with functional vibration stimulation, and after 1000 trainings under the functional vibration stimulation method, it is also shortened under conditions without functional vibration stimulation. It was shown that training under the functional vibration stimulation method leads to improvement of paralysis.

  As mentioned above, although this invention was demonstrated with various embodiment, this invention is not limited only to these embodiment, A change etc. are possible within the scope of the present invention. For example, in the above-described embodiment, the period of each vibration stimulation apparatus 1 and the time difference of each of the vibration stimulation apparatuses 1 having 8 channels can be arbitrarily set. In addition, the strength of vibration stimulation can be arbitrarily set. Also good. If excessive vibration stimulation is given to a patient with mild symptoms of paralysis, for example, the tension of the muscle group used for flexion movement increases for vibration stimulation for extension movement, and the reaction may interfere with the extension movement. Therefore, the intensity of the vibration stimulation is appropriately set so that no stimulation is given to other than the intended muscle group.

  In the above embodiment, the upper limb rehabilitation has been described as an example. In addition, the same effect can be expected in the lower limb and finger rehabilitation. In addition, in the above embodiment, an example has been described in which the purpose is to promote the recovery of hemiplegia due to stroke, but in addition, muscle tension is also adjusted in extrapyramidal diseases and cerebellar diseases with abnormal muscle tone This is expected to greatly improve exercise.

It is a figure which shows schematic structure of the vibration stimulation therapy apparatus of this embodiment. It is a figure which shows the relationship of each part of the vibration stimulation therapy apparatus of this embodiment. It is a figure for demonstrating the example of arrangement | positioning of a touch switch. It is a flowchart which shows the processing operation by a vibration stimulus generation program. It is a figure which shows the example of a mode setting screen. It is a figure which shows the example of a training and test | inspection screen. It is a figure which shows the example of the state of starting and a stop of the vibration stimulation apparatus in training mode. It is a figure which shows the example of the state of starting and a stop of the vibration stimulation apparatus in training mode. It is a figure which shows the example of the state of starting and a stop of the vibration stimulation apparatus in training mode 3 and test | inspection mode. FIG. 3 is a diagram illustrating an inspection sequence according to the first embodiment. It is a figure which shows the result in the test example 1 in Example 1. FIG. It is a figure which shows the fixed position of the vibration stimulation apparatus 1 in the test example 1 in Example 1. FIG. It is a figure which shows the result in the test example 2 in Example 1. FIG. It is a figure which shows the fixed position of the vibration stimulation apparatus 1 in Example 2 and Example 2 in Example 1. FIG. It is a figure which shows the result in Example 2. FIG.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Vibration stimulator 2 Power supply 3 Personal computer 3a Display 4 A / D converter 5a, 5b Touch switch 6 Switch circuit 7 D / A converter 8 EMG measuring device

Claims (5)

A plurality of vibration stimulation devices for applying vibration stimulation to a predetermined part of a patient for the purpose of inducing voluntary movement;
Control means for controlling the start and stop of each vibration stimulator;
A detection device that detects movement information of a predetermined part of the patient and transmits it to the control means;
As the control means controls the start and stop independently with a time difference to each of the vibration stimulation device, the vibration stimulation therapy apparatus characterized by timing to start and stop the vibratory stimulation device can be set .   The predetermined part is a part related to the movement of the upper limb or a part related to the movement of the lower limb, and the voluntary movement includes extension and bending movements of the upper limb or the lower limbs, adduction and abduction movements, and internal rotation and external movements. The vibration stimulation therapy apparatus according to claim 1, wherein the vibration stimulation therapy apparatus is one of rotational movements.   Each of the vibration stimulation devices is of a size capable of voluntary movement of the upper limb or the lower limb in a state fixed to a portion involved in the movement of the upper limb or a portion involved in the movement of the lower limb. The vibration stimulation therapy apparatus according to claim 2. The period common to all the vibration stimulation apparatuses can be set, and the timing for starting and stopping each vibration stimulation apparatus in the set period is set . The vibration stimulation therapy apparatus according to Item 1. To perform vibration stimulation therapy using a plurality of vibration stimulation devices for applying vibration stimulation to a predetermined part of a patient for the purpose of inducing voluntary movement and a detection device for detecting movement information of the predetermined part of the patient Computer program,
A control unit causes a computer to execute a process for setting a timing at which each vibration stimulation device is activated and stopped so that each vibration stimulation device independently controls activation and deactivation with a time difference. Computer program.

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