JP5184599B2 - Electrical stimulator - Google Patents

Description

The present invention relates to an electrical stimulation device such as a low frequency treatment device.

For example, in a low frequency treatment device as an electrical stimulation device, as shown in Patent Document 1, an electrical signal for treatment is applied to an electrode (conductor) attached to the surface of a patient body. Then, the intensity of the applied stimulus is performed by changing the output current by adjusting the output voltage. Patent Documents 2 to 4 disclose variously changing the application mode of the therapeutic electrical signal. Then, the output voltage of the therapeutic electrical signal is changed according to the manually operated volume.

The output voltage of the electrical signal for treatment greatly affects the feeling of stimulation given to the patient. For this reason, at the time of preparation prior to the start of treatment, the command value of the output voltage by the volume (which is the volume operation amount or operation position) is first set to a certain small value so as not to give the patient an excessive sense of irritation. Then, while confirming the feeling of stimulation (stimulation intensity) while interacting with the patient, gradually increase the volume command value (increase the output voltage gradually), and the command value corresponding to the stimulation feeling preferred by the patient At this point, the setting operation of the output voltage is terminated, and thereafter, the treatment is started with the set output voltage.

In addition, in the electrical signal for treatment, the carrier frequency is variously changed from the viewpoint of enhancing the therapeutic effect. For example, four types of carrier frequencies such as 2.5 kHz, 5 kHz, 10 kHz, and 16 kHz are set, and any one of these carrier frequencies can be selected by a manually operated carrier frequency selection switch. It is also generally done.

Japanese Utility Model Publication No. 2-55966 JP 54-1119792 A JP-A-55-143168 Japanese Utility Model Publication No. 55-151346

When the carrier frequency can be changed as described above, the patient's feeling of irritation varies considerably depending on the difference in the carrier frequency. Therefore, at the initial stage of setting the output voltage (during treatment preparation), It was easy to cause a situation where the patient suddenly gave a great stimulus. To elaborate on this point, on the assumption that the output voltage increases as the volume command value for changing the output voltage increases, the volume command value when the patient feels an appropriate stimulus is, for example, larger When the frequency is 16 kHz, the value is “4”, while when the carrier frequency is 2.5 kHz, the value is “1”. As the carrier frequency is smaller, the sense of stimulation becomes stronger. Therefore, if the operator who sets the output voltage mistakenly selects an appropriate volume command value “4” when the carrier frequency is high, even when the carrier frequency is low, an excessively large stimulus is given to the patient. Will be given suddenly.

In other words, when the carrier frequency is high, the volume command value may be gradually changed from a state in which a relatively large volume command value is given as an initial value. However, when the carrier frequency is low, a relatively small volume command value is used. This means that it is necessary to gradually change the volume command value from the state where the value is given as the initial value. Conversely, if a small volume command value is given as the initial value even though the carrier frequency is high, the amount of change in the volume command value that is necessary for the patient to feel an appropriate feeling of stimulation becomes large. Therefore, it takes a long time to finally set the output voltage.

The above-mentioned difference in the feeling of stimulation given to the patient is caused not only by the difference in the carrier frequency but also by the difference in the treatment environment such as the type of electrode, the treatment site, the treatment frequency of the electrical signal for treatment. is there. In particular, the difference in carrier frequency and the difference in the type of electrode cause a considerable difference in the feeling of stimulation given to the patient.

The present invention has been made in view of the above circumstances, and an object of the present invention is to provide an electrical stimulation device that can quickly set an appropriate output voltage regardless of differences in treatment environments. .

In order to achieve the above object, the present invention provides the following solutions. That is, as described in claim 1 in the claims,
In an electrical stimulation device for applying a therapeutic electrical signal to an electrode mounted on the surface of a patient body,
A treatment environment input means for inputting information about all four parameters of the carrier frequency of the treatment electrical signal, the treatment frequency of the treatment electrical signal, the electrode to be used, and the treatment site by manual operation;
Command value input means for inputting the command value of the output voltage of the electrical signal for treatment by manual operation;
Voltage characteristic changing means for changing a voltage characteristic corresponding to a correspondence between the command value and the output voltage of the electrical signal for treatment according to a treatment environment which is a combination of the four parameters input by the treatment environment input means; ,
With
The voltage characteristic set by the voltage characteristic changing means is set such that when the command value is in a predetermined fixed range, almost the same degree of stimulation can be obtained regardless of the difference in the treatment environment.
It is like that. According to the above solution, by setting the command value within a predetermined fixed range at the initial stage of treatment preparation, an excessively strong stimulus can be given to the patient regardless of various differences in the treatment environment. It is possible to immediately ensure that there is no state, and to shorten the adjustment time until the final output voltage is set appropriately for treatment.

A preferred mode based on the above solution is as described in claim 2 and the following. That is,
Reference voltage characteristics are preset and stored,
The voltage characteristic changing means determines the voltage characteristic according to the inputted treatment environment by correcting the reference voltage characteristic according to the treatment environment inputted by the treatment environment input means.
(Claim 2). In this case, the reference characteristics to be stored are reduced as much as possible, which is preferable for reducing the burden on the control system.
As the reference characteristic, an intermediate reference characteristic that is a voltage characteristic corresponding to a case where the feeling of stimulation is intermediate among the combinations of the four parameters, and an output voltage that is smaller than the intermediate reference characteristic are set. A combination of the four parameters is set such that the output voltage is set to be larger than the lower limit reference characteristic corresponding to the strongest sense of stimulation among the combinations of the four parameters and the intermediate reference characteristic. The three reference characteristics are stored, the upper reference characteristic, which is the voltage characteristic corresponding to the weakest sense of stimulation,
When the total value of the weight values set for each of the four parameters is between the intermediate reference characteristic and the lower limit reference characteristic, treatment is performed by correction based on the intermediate reference characteristic and the lower limit reference characteristic. Voltage characteristics are determined according to the environment,
When the total value of the weight values set for each of the four parameters is between the intermediate reference characteristic and the upper reference characteristic, treatment is performed by correction based on the intermediate reference characteristic and the upper reference characteristic. Voltage characteristics are determined according to the environment.
(Corresponding to claim 3).
After the treatment is completed, the lower limit reference characteristic is automatically restored (corresponding to claim 4). in this case,

Conductivity as pressure characteristic, setting a lower limit reference characteristics corresponding to the most likely feel the stimulation treatment environment beforehand, be stored, after the end of treatment is automatically returned to the lower limit reference characteristic can be so (claim 5 correspondence). In this case, at the end of the treatment, the output voltage is automatically restored to the lowest reference characteristic at which the output voltage becomes the smallest. Therefore, it is ensured that the output voltage will be inadvertently excessively large at the initial stage of setting the output voltage for the next treatment. Therefore, it is preferable to prevent it.

According to the present invention, by setting the command value within a predetermined fixed range at the initial stage of preparation for treatment, an excessively strong stimulus is not given to the patient regardless of various differences in the treatment environment. The condition can be secured immediately, and the adjustment time to the final output voltage setting appropriate for treatment can be shortened.

The simplified perspective view which shows an example of the state which is giving the electric signal for treatment to a patient with a low frequency treatment device. 1 is an overall system diagram showing an embodiment of the present invention. The figure which shows an example of a reference voltage characteristic. The flowchart which shows the example of control of this invention.

In FIG. 1, K is a patient and TC is a low frequency treatment device as an electrical stimulator. In FIG. 1, two pairs of suction electrode devices D are attached to the arm of the patient K. For the pair of suction type electrode devices D, a therapeutic electrical signal is applied from the low frequency treatment device TC via the cable C, and the region between the pair of suction type electrode devices D (particularly the electrode mounting site) is applied. Treatment is performed. The cable C has a hollow structure and also has a function of transmitting the suction negative pressure from the low-frequency treatment device body TC to the suction electrode device D.

FIG. 2 shows a circuit example of a portion related to control of an electrical signal for treatment in the low frequency treatment device TC. In FIG. 2, U is a controller (control unit) configured using a microcomputer, which has a CPU as a calculation means, ROM, RAM, etc. as storage means, and constitutes the control means in the present invention. To do.

Reference numeral 1 denotes a basic frequency generation circuit that generates a low-frequency frequency, and can generate a plurality of types of low-frequency frequencies. For example, one specific frequency (waveform α) instructed by the controller U among a plurality of types, for example, five types of frequencies set in advance from low frequency frequencies of 3HZ to 20HZ is generated. Yes. In addition, although the numerical value of the low frequency is determined by comparison with the high frequency treatment device and is not absolute, it generally refers to about 300 Hz or less in the field of the low frequency treatment device. The frequency in the fundamental frequency generation circuit 1 is a treatment frequency.

Reference numeral 2 denotes a therapeutic pulse signal generation circuit, which generates a positive voltage waveform β for a predetermined time (for example, 1 msec) in the embodiment. The voltage waveform β and the waveform α having the above-described frequency generated by the basic frequency generation circuit 1 are synthesized by the therapeutic signal generation circuit 3. That is, the treatment signal synthesis circuit 3 generates a basic treatment electrical signal γ that outputs a voltage waveform β at every generation timing of one waveform of the fundamental frequency (for example, at the rise or fall of one waveform). Is done.

Reference numeral 4 denotes a carrier frequency generation circuit. For example, four types of 2.5 kHz, 5 kHz, 10 kHz, and 16 kHz can be set (changed). The carrier frequency δ generated by the carrier frequency generation circuit 4 is superimposed by the synthesis circuit 5 on the treatment signal γ formed by the treatment signal generation circuit 3, and the final treatment electrical signal ε before voltage adjustment and Is done. The output from the synthesizing circuit 5 is voltage-adjusted by the voltage adjusting circuit 6 to be the final therapeutic electrical signal η, and then output to the electrode device D.

The controller U receives signals from the manually operated volume SV as command value input means for commanding the magnitude of the output voltage, as well as signals from the switches S1 to S4. Each of the switches S1 to S4 is also manually operated, S1 is for selecting a carrier frequency, and switch S2 is for selecting a treatment frequency. S3 is for inputting the type of the electrode D. The switch S4 inputs a treatment site.

The volume SV can have a command value ranging from 0 to 10, for example, by a turning operation, and the output voltage is increased as the command value is increased. The types of electrodes D are, for example, HS (a conductive sponge on a rubber conductive plate), small HS (same structure as HS and half the size), WE (cellulose conductive plate on a rubber conductive plate). And a gel (a conductive sheet attached to a conductive gel). For example, there are three types of treatment sites: arms, hips, and calves. As described above, in the embodiment, four types of the carrier frequency, the treatment frequency, the electrode type, and the treatment site are set as parameters indicating the treatment environment.

FIG. 3 shows voltage characteristics for setting the output voltage in accordance with the command value SX of the volume SV. In FIG. 3, α1 is an intermediate reference characteristic, which is set linearly, and the output voltage is changed from the minimum value 0 to the upper limit voltage (the embodiment) with respect to a change in the range from the minimum value 0 to the maximum value 10 of the command value SX. In this case, a voltage in the range up to 300V) can be set. In the intermediate reference characteristic α1, the change amount of the output voltage with respect to the change amount of the command value SX for a unit is always constant (the change of the command value SX by 1 changes the output voltage by 30V).

In FIG. 3, α2 is a lower limit reference characteristic, and corresponds to the strongest stimulation among all the combinations of the treatment environments composed of the four types of parameters described above (the smallest to obtain the same stimulation feeling). For the combination of output voltage). This lower limit reference characteristic is an output voltage smaller than the intermediate reference characteristic, and is set linearly from the command value 0 to 5, but is non-linear toward the upper limit voltage when the command value is 5 or more. (Hyperbolic).

In FIG. 3, α3 is an upper limit reference characteristic, and corresponds to the case where the stimulation feeling is the weakest among all the combinations of the treatment environments including the four types of parameters described above (the largest value for obtaining the same stimulation feeling). Combination setting that requires output voltage). This upper reference characteristic is an output voltage larger than that of the intermediate reference characteristic, and is set linearly from the command value 0 to 5, but is non-linear toward the upper limit voltage when the command value is 5 or more. (Hyperbolic). As described above, each of the voltage characteristics α1, α2, and α3 is set so that the output voltage can be determined from 0 to the upper limit voltage in the range from the command value 0 to the maximum value.

Here, the following points are taken into consideration when setting the voltage characteristics α2 and α3. First, an initial value of a command value at the time of treatment preparation, that is, a predetermined fixed range is slightly smaller than an intermediate value (5 in the embodiment) of a general command value for an operator (the command value is intermediate between a minimum value 0 and an intermediate value). More specifically, the command value is in the range of 3 to 4 so that the intermediate value is 2.5 (a range closer to the intermediate value 5 than the intermediate value 2.5 between the value 5). This is because the adjustment amount in the direction of increasing the output voltage is larger than the adjustment amount in the direction of decreasing the output voltage than the predetermined fixed range set at the initial stage of treatment. This is because the range of command values 3 to 4 is often selected.

Based on the experimental results, the output voltage when giving an appropriate stimulus to the patient in the combination that is most likely to feel the stimulus among all the combinations in the treatment environment, the command value is 1 when based on the intermediate reference characteristic value α1. 5. At this time, the output voltage corresponding to the command value 1.5 based on the intermediate reference characteristic α1 was 45V. For this reason, the lower limit voltage characteristic α2 is set such that 45 V is obtained when the intermediate value of the command values 3 to 4 in a predetermined constant range is 3.5, and the output voltage 0 is a predetermined constant value. The range up to the command value 5 slightly exceeding the range is made linear, and the output voltage becomes the upper limit voltage 300V with the maximum value of the command value. is there.

From the experimental results, the output voltage when giving an appropriate stimulus to the patient when the combination is the most difficult to feel the stimulus among all the combinations in the treatment environment, the command value is 6 based on the intermediate reference characteristic value α1. At this time, the output voltage corresponding to the command value 6 based on the intermediate reference characteristic α1 was 180V. For this reason, the upper limit voltage characteristic α3 is set so that 180 V is obtained when the value is 3.5, which is an intermediate value between the command values 3 to 4 within a predetermined constant range, and the output voltage 0 is set to a predetermined constant value. The range up to the command value 5 slightly exceeding the range is made linear, and the output voltage becomes the upper limit voltage 300V with the maximum value of the command value. is there.

If voltage characteristics such as α1, α2, and α3 are created and stored in advance for all combinations of parameters indicating the treatment environment, the optimum voltage characteristics are determined for each combination of parameters input by the switches S1 to S4. Will be. That is, there are 4 types of carrier frequencies, 4 types of electrodes D, 3 types of treatment sites, and 5 types of treatment frequencies, so there are 240 combinations of 4 × 4 × 3 × 5, and all these 240 combinations. Since the storage of the voltage characteristics of the memory cell increases the storage capacity and becomes a heavy burden on the control system, only the three voltage characteristics α1 to α3 shown in FIG. The voltage characteristic can be determined by interpolation (calculation).

A method of determining suitable voltage characteristics for all combinations using interpolation will be described below. First, the following weight value is used as a parameter indicating the ease (feeling difficulty) of the stimulus. The greater the weight value, the more difficult it is to feel the stimulus. For example, the determination is made as follows.

For the carrier frequency, the weight value MA is “1.0” for 2.5 kHz, “1.5” for 5 kHz, “2.5” for 10 kHz, and “3.5” for 16 kHz. Set to
As for the treatment frequency, the weight value MB is set to “2.0” when the frequency is 150 HZ or higher, “2.2” for the range from 10 to 150 HZ, and “2.5” when the frequency is 10 HZ or lower.
For the type of the electrode D, the weight value MC is “1.5” for the small HS, “2.0” for the HS, “3.0” for the WE, and “4. 0 ”.
For the treatment site, the weight value MD is set to “2.0” for the arm, “2.5” for the waist, and “3.5” for the calf.

As a result of the experiment, the combination that hardly feels stimulation is when the carrier frequency is 16 kHz, the treatment frequency is 3 Hz, the electrode D is gel, and the treatment site is calf. The total value SM of weight values at this time is It becomes 13.5 of 3.0 + 2.5 + 4.0 + 3.5. The total weight value SM = 13.5 corresponds to the upper limit reference characteristic α3 in FIG. Moreover, the combination that is most likely to feel stimulation is when the carrier frequency is 2.5 kHz, the treatment frequency is 200 Hz, the electrode D is a small HS, and the treatment site is an arm. The total value SM of weight values at this time is 1.0 + 2.0 + 1.5 + 2.0, 6.5. The total value SM of the weight values SM = 6.5 corresponds to the lower limit reference characteristic α2 in FIG. The intermediate value between SM = 13.5 and 6.5 is 10.0, and the weight value is 10.0, which corresponds to the intermediate reference characteristic α1 in FIG.

A total value SM of the weight values is obtained from each parameter indicating the input treatment environment. If this total value SM exceeds 10.0, interpolation is performed from the intermediate reference characteristic α1 and the upper limit reference characteristic α3. Calculate it. If the total value SM is less than 10.0, it may be calculated by interpolation from the intermediate reference characteristic α1 and the lower limit reference characteristic α2.

FIG. 4 shows a flowchart for determining the voltage characteristic according to the current treatment environment by the above-described interpolation, and the control contents in the control circuit U are shown. First, in step P1, in addition to the command value VX of the volume SV, the set carrier frequency, treatment frequency, electrode type, and treatment site are read based on the inputs from the switches S1 to S4. Next, in step P2, weight values MA, MB, MC, MD for the carrier frequency, the treatment frequency, the electrode type, and the treatment site are determined. Thereafter, in step P3, a total value SM of the weight values MA, MB, MC, MD is calculated.

After P3, at P4, it is determined whether or not the total value SM is larger than the above-described intermediate value (10.0 in the embodiment). If YES in P4, α1 and α3 are selected as reference characteristics to be used in P5. Next, at P6, a voltage characteristic corresponding to the sum and SM is determined from the value of the sum SM by interpolation using the reference characteristics α1 and α3. Thereafter, a voltage obtained by comparing the command value VX with the voltage characteristic determined in P6 is set as a final output voltage.

When the determination at P4 is NO, selection of reference characteristics α1 and α2 at P8 (corresponding to P5), determination of voltage characteristics by interpolation using α1 and α2 with respect to the total value SM at P9 (corresponding to P6), P10 The final output voltage is determined (corresponding to P7).

Although the embodiment has been described above, the present invention is not limited to the embodiment, and can be appropriately changed within the scope described in the scope of claims. For example, the invention includes the following cases. . The electrical stimulation device is not limited to a low-frequency treatment device, and includes an appropriate device such as a device that performs low-frequency treatment by interference of a high-frequency treatment electrical signal. Carrier frequency, treatment frequency, type of electrodes, the treatment site, etc. may be those classified more finely or coarsely than embodiments, but it may also be one including the other therapeutic environment.

The voltage characteristics as shown in FIG. 3 may be non-linearly set over the entire range from the minimum value to the maximum value of the output voltage. However, in a small range of command values, where the command value is often finely adjusted, the voltage characteristics are set to be linear or nearly linear. If the amount of change in the output voltage relative to the amount of change in the command value is constant or almost constant, Thus, it is preferable for finely adjusting the output voltage. Only one reference characteristic corresponding to a specific treatment environment may be set, and different treatment environments may be determined by correcting this one reference characteristic. In this case, for example, when one reference characteristic is set as α1 in FIG. 3 and the slope of the reference characteristic α1 is set to 1, the voltage characteristic for other treatment environments is inclined from the reference characteristic α1. May be corrected (it may be linear in the range where the command value is small and non-linear in the range where the command value is large). Of the reference characteristics shown in FIG. 3, α2 and α3 may be linear even in a large range of command values (may have a break point in the middle).

The voltage characteristic may be set such that the upper limit voltage cannot be obtained when the command value VX of the output voltage is set to the maximum value (for example, the lower limit reference characteristic α2 in FIG. The linear state is extended to a range where the command value VX is large). After the treatment is finished (when the treatment time set by the timer has elapsed), it is automatically restored to the intermediate reference characteristic α1 and the lower limit reference characteristic α2, particularly to the lower limit voltage characteristic α2 at which the output voltage is reduced. (Although it may not be the optimum voltage characteristic at the time of the next treatment, for example, when it is preferable to set the output voltage based on the lower limit reference characteristic α2, the output will be based on the upper limit reference characteristic α3. Etc. to prevent a situation in which a large output voltage is inadvertently output). An appropriate voltage characteristic may be set each time depending on the treatment environment without setting and storing the reference voltage characteristic in advance (for example, a voltage that is linear from a command value of 0 to a predetermined fixed range). The “slope” of the characteristic is set each time depending on the treatment environment—command values exceeding a certain fixed range can be linear or non-linear). Of course, the object of the present invention is not limited to what is explicitly stated, but also implicitly includes providing what is substantially preferred or expressed as an advantage.

The present invention can be used for an electrical stimulation device such as a low-frequency treatment device.

1: Basic frequency generation circuit (treatment frequency setting)
4: Carrier frequency generation circuit (carrier frequency setting)
6: Voltage adjustment circuit (change output voltage)
U: Control circuit SV: Volume (command value input means)
S1: Switch (for carrier frequency setting)
S2: Switch (for treatment frequency setting)
S3: Switch (for electrode type input)
S4: Switch (for treatment site input)
α1: Intermediate reference characteristic α2: Lower limit reference characteristic α3: Upper limit reference characteristic SM: Weight value total value MA, MB, MC, MD: Weight value (degree indicating ease of feeling of stimulus)

Claims (5)

In an electrical stimulation device for applying a therapeutic electrical signal to an electrode mounted on the surface of a patient body,
A treatment environment input means for inputting information about all four parameters of the carrier frequency of the treatment electrical signal, the treatment frequency of the treatment electrical signal, the electrode to be used, and the treatment site by manual operation;
Command value input means for inputting the command value of the output voltage of the electrical signal for treatment by manual operation;
Voltage characteristic changing means for changing a voltage characteristic corresponding to a correspondence between the command value and the output voltage of the electrical signal for treatment according to a treatment environment which is a combination of the four parameters input by the treatment environment input means; ,
With
The voltage characteristic set by the voltage characteristic changing means is set such that when the command value is in a predetermined fixed range, almost the same degree of stimulation can be obtained regardless of the difference in the treatment environment.
An electrical stimulator characterized by that. In claim 1,
Reference voltage characteristics are preset and stored,
The voltage characteristic changing means determines the voltage characteristic according to the inputted treatment environment by correcting the reference voltage characteristic according to the treatment environment inputted by the treatment environment input means.
An electrical stimulator characterized by that. In claim 2
  As the reference characteristic, an intermediate reference characteristic that is a voltage characteristic corresponding to a case where the feeling of stimulation is intermediate among the combinations of the four parameters, and an output voltage that is smaller than the intermediate reference characteristic are set. A combination of the four parameters is set such that the output voltage is set to be larger than the lower limit reference characteristic corresponding to the strongest sense of stimulation among the combinations of the four parameters and the intermediate reference characteristic. The three reference characteristics are stored, the upper reference characteristic, which is the voltage characteristic corresponding to the weakest sense of stimulation,
  When the total value of the weight values set for each of the four parameters is between the intermediate reference characteristic and the lower limit reference characteristic, treatment is performed by correction based on the intermediate reference characteristic and the lower limit reference characteristic. Voltage characteristics are determined according to the environment,
  When the total value of the weight values set for each of the four parameters is between the intermediate reference characteristic and the upper reference characteristic, treatment is performed by correction based on the intermediate reference characteristic and the upper reference characteristic. Voltage characteristics are determined according to the environment.
An electrical stimulator characterized by that. In claim 3,
  An electrical stimulation device, wherein after the treatment is completed, the lower limit reference characteristic is automatically restored. In claim 1 or claim 2,
An electrical stimulation device characterized in that, as voltage characteristics, a lower limit reference characteristic corresponding to a treatment environment in which stimulation is most easily felt is set and stored in advance, and automatically restored to the lower limit reference characteristic after the treatment is completed.

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