JP5569923B2 - Upper limb motor function combined diagnosis device - Google Patents

Description

  The present invention relates to an upper limb motor function combined diagnosis apparatus, and more particularly to an apparatus capable of objectively and quantitatively diagnosing a plurality of upper limb motor functions as numerical values.

  Diagnosis of upper limb motor function is very important, for example, to grasp the current state of the brain function of the subject and perform rehabilitation. Usually, the diagnosis of the upper limb motor function is generally evaluated by a doctor performing various actions on the person to be diagnosed (subject). However, in actual medical practice, there is a limit to the evaluation time that can be allocated to one person, and the time and place are greatly limited.

In general, for example, Patent Documents 1 and 2 below describe techniques for quickly performing motor functions.

JP 2003-052770 A JP 2004-057357 A

However, the techniques described in Patent Documents 1 and 2 require a plurality of devices and cannot evaluate a specific functional unit, that is, a repetitive alternating motion function, a rhythm formation function, a scale function, and the like in a short time. There is. Be evaluated to determine these features in a short time has not been realized in the device so far.

  As described above, in view of the above problems, the present invention is an upper limb motor function composite diagnostic apparatus that can perform an upper limb motor function composite diagnosis objectively and quantitatively by function as a numerical value in a simple and simple manner. The purpose is to provide.

  An upper limb motor function composite diagnosis device according to a first aspect of the present invention includes an input device in which a plurality of buttons are arranged, an information processing device that receives an output from the input device, and a display that displays the output of the information processing device The information processing device includes an instruction display unit for causing the display device to display a button for pressing the button on the input device, and an output based on the button pressing on the input device as button pressing data. Button hitting data recording unit for recording, database unit for recording button hitting reference data as a reference, button hitting data recorded in the pressing button data recording unit, and recorded in the database unit A comparison processing unit that performs comparison processing with the button press reference data; and a result display unit that displays a result of the comparison processing unit on a display device.

  Moreover, although not necessarily limited in this aspect, the instruction display unit continuously presses one button on the input device and continuously presses two buttons at close positions. It is preferable that the display and the display in which the two buttons at distant positions are successively pressed alternately are sequentially performed.

  As described above, this simple apparatus can be performed in a current medical space spatially, and can provide a medical test that can be performed and used in a short time, for example, about 1 minute. Furthermore, not only quantitative diagnosis but also therapeutic effect determination and follow-up observation can be performed objectively, and can contribute to the provision of better medical care without being greatly influenced by regional differences in medical treatment or differences in specialist skills of doctors. That is, it is possible to provide an upper limb motor function composite diagnosis apparatus that can perform an upper limb motor function composite diagnosis objectively and quantitatively by function as a numerical value in a simple and simple manner.

It is the schematic of the upper limb motor function combined diagnosis apparatus which concerns on embodiment. 1 is a schematic configuration diagram of an information processing apparatus according to an embodiment. It is a functional block diagram of the information processor concerning an embodiment. It is a figure which shows an example of the normal person's button press data which is an example of embodiment. It is a figure which shows an example of the normal person's button press data which is an example of embodiment. It is a figure which shows an example of the normal person's button press data which is an example of embodiment. It is a figure which shows an example of the normal person's button press data which is an example of embodiment. It is a figure which shows an example of the normal person's button press data which is an example of embodiment. It is a figure which shows an example of the normal person's button press data which is an example of embodiment. It is a figure which shows the flow of the upper limb motor function composite diagnosis program which concerns on embodiment. It is a figure which shows the outline of the 1st button press reference | standard data concerning an Example. It is a figure which shows the outline of the 2nd button press reference | standard data based on an Example. It is a figure which shows the outline of the 3rd button press reference | standard data based on an Example. It is a figure which shows the outline of the 4th button press reference | standard data based on an Example. It is a figure which shows the outline of the 5th button press reference | standard data based on an Example. It is a figure which shows the outline of the 6th button press reference | standard data concerning an Example.

  Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings. However, the present invention can be implemented in many different forms and is limited only to the description of the following embodiments and examples. It goes without saying that there is nothing.

  FIG. 1 is a schematic view of an upper limb motor function combined diagnosis apparatus (hereinafter also referred to as “this apparatus”) 1 according to the present embodiment. As illustrated in FIG. 1, the apparatus 1 includes an input device 2 in which a plurality of buttons are arranged, an information processing device 3 that receives an output from the input device 2, and a display that displays the output of the information processing device 3. The information processing apparatus 3 includes an apparatus 4 and a printing apparatus 5, and the information processing apparatus 3 performs an instruction display unit 31 that causes the display apparatus 4 to display a button for pressing the button on the input apparatus, and presses the button on the input apparatus. The button press data recording unit 32 that records the output based on the button press data, the database unit 33 that records the button press reference data in advance, and the button press data and the data press reference data are compared. It has the comparison process part 34 and the result display part 35 which displays the result of the comparison process part 34 on a display apparatus.

  In the present embodiment, the input device 2 can output various types of information to the information processing device 3, and can employ a device dedicated to a device in which a plurality of buttons are arranged. It is also possible to make a mouse or the like have a function. In the input device, in addition to the dedicated device, the keyboard, and the mouse, a touch sensor such as a touch panel, an acceleration sensor, a torque center, and a position sensor can be used alone or in combination. In this way, it is possible to measure not only the button pressing time but also the acceleration, torque, etc. at that time.

  The information processing apparatus 3 in this apparatus can process the result input by the input device and output the result. FIG. 2 shows an outline of the device configuration of the information processing device 3. As shown in the figure, the information processing apparatus 3 includes an I / O port 301 for transmitting and receiving signals from peripheral devices such as an input device, a memory 302 such as a RAM, a CPU 303 as a central processing unit, a hard disk And the like, and these are connected via a bus 305.

  The display device 4 is connected to the information processing device 3, displays the result of the processing performed by the information processing device 3, and further causes the information processing device 3 to perform an operation necessary for diagnosis on the subject. For example, a general display device such as a liquid crystal display can be used.

  The printing device 5 is connected to the information processing device 3 and can print and display the result of diagnosis on a medium such as paper. A commercially available printer can be widely applied as this printing apparatus. Further, the printing device 5 can be omitted as a configuration requirement when it is determined that only display by the display device 4 is sufficient.

  Next, the operation of this apparatus will be described. FIG. 3 is a diagram illustrating functional blocks of the information processing apparatus 3 in the present apparatus.

  As shown in the figure, the information processing apparatus 3 includes, as a function block, an instruction display unit 31 that causes the display device 4 to display a button for pressing the button on the input device, and an output based on the button pressing on the input device. Button pressing data recording unit 32 for recording the button pressing data, a database unit 33 for recording button pressing reference data in advance, and a comparison processing unit for comparing and processing the button pressing data and the button pressing reference data 34 and a result display unit 35 for displaying the result of the comparison processing on the display device. The information processing apparatus 3 is not limited to the above, but for example, a program is stored in a recording medium such as a hard disk, and the program is executed to be realized as a unit having the above functions. be able to.

  In the present embodiment, the instruction display unit 31 is a unit that can cause the display device to perform a display prompting the subject to press the button of the input device. This display is not particularly limited, but an instruction display for hitting the same button (key) as soon as possible for a certain period of time, and two buttons (preferably adjacent) in relatively close positions as long as possible for a certain period of time. It is preferable to perform an instruction display for quickly pressing and an instruction display for pressing two keys at relatively distant positions as quickly as possible for a certain period of time. By arranging a plurality of different buttons in this way and alternately pressing them, it is possible to perform a composite diagnosis of upper limb motor function, especially as to whether or not you are suffering from Parkinson's disease as will be clear from the examples described later Judgment can be made. The instruction display unit 31 is preferably provided with a voice guide function for guiding voice simultaneously with the display. In the present embodiment, Asian docokinesis, which is a repetitive alternating motion test, is adopted, and quantitative measurement can be objectively performed as numerical values.

  Prior to this instruction display, an attribute recording unit may be provided to display the attribute input instruction and record the subject's attribute data so that the attribute information such as the subject's name, sex, age, and disease name can be input. preferable. In this way, more detailed diagnosis and determination are possible. This input can be performed using an input device such as a keyboard.

  The button hitting data recording unit 32 is a unit for recording an output based on the button hitting of the input device as button hitting data as described above. The frequency of hitting) is recorded as the number of hits data, or the time from pressing one button until the next button is pressed is measured and recorded in time series as hitting interval data. For example, the subject can press a predetermined button for 10 seconds, and the average number of times the button is pressed per second can be used as the pressing data. Further, the average time between button pressings, the standard deviation, The coefficient of variation, its distribution, etc. can also be used as data.

  In the present embodiment, the database unit 33 records button hitting reference data in advance. Here, the “button press reference data” is button press data serving as a reference for processing in the comparison processing unit described later. For example, a set of the button press data of a number of healthy persons, an average value thereof, Can adopt a regression line, standard deviation, coefficient of variation, etc. created based on these. Further, the button hitting reference data can be not only button hitting data of a healthy person and data obtained based thereon, but also button hitting data of a subject suspected of a specific disease and various data obtained based thereon. It is also preferable to divide these into groups by age, generation, and gender. In addition, as an example of a simple method, regression line data that can be created when the number of button presses per second (pressing frequency) of healthy persons is set as button press data with respect to age as button press reference data In addition, the variation coefficient of the time between button presses of healthy persons can be set as the button press reference data with respect to the age. The button hitting reference data used for one diagnosis process does not need to be one, and it is preferable to use a plurality of button hitting reference data in order to further improve the accuracy of diagnosis.

  4 to 6 are diagrams showing examples of button pressing reference data. FIG. 4 shows an example of a 60-year-old healthy male who displays the time interval of button presses when the same button is repeatedly hit for 10 seconds in a time series. FIG. FIG. 6 is a time series display of time intervals of button presses in the case of alternately hitting for 10 seconds, and FIG. 6 shows the time of button presses in the case where buttons at a distant distance are alternately displayed for 10 seconds. The intervals are displayed in time series. When the same button is repeatedly hit, the average pressing interval (hereinafter referred to as “M”) is 0.18 seconds, the standard deviation value (hereinafter referred to as “SD”) is 0.02, and the coefficient of variation (hereinafter referred to as “CV”). Was 0.09. The adjacent button stroke M was 0.19 seconds, SD was 0.01, and CV was 0.06. When the adjacent buttons were alternately hit, M was 0.51 seconds, SD was 0.03, and CV was 0.05. Further, the M of the button hits at a distant distance was 0.51 second, the SD was 0.03, and the CV was 0.05.

  Similarly, another example of a healthy 73-year-old female is shown in FIGS. FIG. 7 shows the time interval of button press when the same button is repeatedly hit for 10 seconds, and FIG. 8 shows button press hits when adjacent buttons are alternately hit for 10 seconds. The time intervals are displayed in time series. FIG. 9 shows the time intervals of button presses in the case where buttons at a distant distance are alternately displayed for 10 seconds. When the same button was repeatedly hit, M was 0.21 seconds, SD was 0.02, and CV was 0.10. On the other hand, M of the adjacent button hits was 0.28 seconds, SD was 0.11, and CV was 0.41. When the remote button was repeatedly hit, M was 0.63, SD was 0.05, and CV was 0.08.

  In the present embodiment, the comparison processing unit 34 compares the button press data recorded in the button press data recording unit with the button press reference data recorded in the database unit. For example, when the subject's button press data is significantly delayed compared to the button press reference data in the group to which the subject belongs, it is determined that there may be a problem in the upper limb motor function state and If it is within the range, it may be determined that no problem has occurred. In the above example of the regression line, if the subject's button press data is more than a predetermined value away from this regression line, there is a possibility that a problem has occurred, and if it is not, there is no problem. Each output can be exemplified as a result.

  And the result display part 35 displays the result of the said comparison process part 34 on a display apparatus. As a result, the subject can confirm his / her results and can be used for later treatment. The result display unit 35 preferably has a function of causing the printing apparatus 5 to print the result on paper or the like after completion of the comparison process. By doing so, it can be effectively used for later diagnosis and treatment.

  Next, measurement using the upper limb motor function combined diagnosis apparatus according to the embodiment will be described with reference to the flowchart of FIG. This flow shows an outline of steps executed after a program stored in the storage device 304 of the information processing apparatus 3 (hereinafter also referred to as “this program”) is read into the memory 302. Specifically, (1) a step of requesting input of attribute information of a subject and recording the input attribute information as attribute data, and (2) a step of performing a display prompting the user to press a button on the input device. (3) a step of recording an output based on a button press of the input device as a button press data, and (4) a step of comparing the button press data with a pre-recorded button press reference data. And (5) displaying the result of the comparison process on the display device.

  After execution, the program first requests (1) input of subject attribute information, and records the input attribute information as attribute data (S1). In addition, various data can be adopted as the attribute here, for example, name, sex, age, disease name, and the like. Information regarding the accepted attribute is stored as attribute data in a partial area of the memory 302 or the storage device 304.

  Next, (2) a display for prompting the button of the input device to be pressed is displayed on the display device (S2). This display is not particularly limited as described above, but an instruction display for pressing the same button (key) as quickly as possible for a certain period of time, and two buttons at relatively close positions as early as possible for a certain period of time. It is preferable to perform an instruction display for pressing and an instruction display for pressing two keys at relatively distant positions as quickly as possible for a certain time. It is also useful to use a display that requires separate input of the right hand and the left hand when pressing a key.

  Next, (3) an output based on pressing of the button of the input device is recorded as button pressing data (S3). As a specific example of this step, for example, the number of times a button is pressed is recorded as the number of hits data, or the time from pressing one button until the next button is measured is measured. And recorded as tapping interval data. For example, the subject can press a predetermined button for 10 seconds, and can hold data that records the average number of times the button is pressed per second in time series as the pressing data. Here, the button press data is stored in a partial area of the memory 302 or the storage device 304. In this step, it is useful to store the right hand and left hand button press data as separate data.

  Next, (4) the button press data is compared with the previously recorded button press reference data (S4). Here, the button hitting reference data needs to be stored in advance in a partial area of the memory 302 or the storage device 304. Then, the difference with the recorded button press data is compared, and if the difference exceeds a predetermined value, it is determined that there is a problem with the upper limb motor function, and is suppressed within the predetermined value. In this case, it is determined that there is no problem in the upper limb motor function. It is useful to store this result in a partial area of the memory 302 or the storage device 304.

  Then, (5) the result of the comparison process is displayed on the display device (S5). As a result, the test subject can confirm his / her own result and can be used for later treatment.

  In addition, after performing the comparison process, it is also preferable that the diagnostic result is displayed on the display device 4 and simultaneously printed on the printing device 5. In this process, it is useful to output a detailed result of the item to the printer so that the diagnosis subject can be diagnosed by a specialist doctor for an item determined to require reexamination later.

(Example)
Hereinafter, the upper limb motor function composite diagnosis apparatus according to the above-described embodiment was actually produced and the effect thereof was confirmed. This will be described in detail below.

  First, an acceleration sensor was attached to the finger of a cerebellar dysfunction patient (a 73-year-old woman), and a diagnosis process was performed using the finger with the acceleration sensor.

  First, on the LCD monitor as a display device, one “O” key of the keyboard is displayed as fast and accurate as possible for 10 seconds, and the subject is made to perform the same operation. The average value was recorded as the first button press data D1, and the variation coefficient of the time between button presses was recorded as the second button press data D2. Next, two adjacent keys “P” and “O” are alternately pressed as quickly as possible for exactly 10 seconds, and the average number of hits per second during this period is determined by pressing the third button. The variation data of the hit data D3 and the time between button presses was recorded as the fourth button press data D4. Finally, the two separated keys “Q” and “O” are alternately pressed as quickly and accurately as possible for 10 seconds, and the average number of hits per second during this period is the fifth button. The variation data of the press data D5 and the time between button presses was recorded as the sixth button press data D6. This operation was performed in the same way for both the left hand and the right hand.

  In this example, prior to the combined diagnosis of motor function of upper limbs, the same display as described above is given to 14 healthy men and 25 healthy women (average age 51 years ± 26.1) of 13 to 88 years old. The first to sixth button press reference data were created. Here, the first button press reference data is the first button press data for the age and the regression line obtained based on the first button press data, and the second button press reference data is the second button press reference data for the age. The data and the regression line obtained based on the data were used, and the third button press reference data was the third button press data with respect to age and the regression line obtained based on the third button press data. The fourth button pressing reference data is the fourth button pressing data for the age and the regression line obtained based on the fourth button pressing data, and the fifth button pressing reference data is the fifth button pressing data for the age. The sixth button press reference data is the sixth button press data with respect to age and the regression line obtained based on the sixth button press reference data. The first to sixth button press reference data were created separately for the right hand and the left hand. The outline of the first button pressing reference data is shown in FIG. 11, the outline of the second button pressing reference data is shown in FIG. 12, the outline of the third button pressing reference data is shown in FIG. FIG. 14 shows an outline of button pressing reference data, FIG. 15 shows an outline of fifth button pressing reference data, and FIG. 16 shows an outline of sixth button pressing reference data. In each figure, a circle indicates button hit data of the subject's right hand or left hand.

  Then, when the first to sixth button press reference data is compared with the subject's button press reference data, the first to sixth button press data of the subject are all the button press reference data. On the other hand, it was confirmed that it was outside the confidence interval of the healthy person, and the fact was displayed on the display device.

  Next, an acceleration sensor was attached to the finger of a Parkinson patient (78-year-old male), and the same diagnostic process as that of the cerebellar dysfunction patient was performed using the finger with the acceleration sensor. Here, the data similar to that of the patient with cerebellar dysfunction was used as the button hitting reference data. Note that the Δ marks in FIGS. 11 to 16 are the button press data of the subject.

  When the first to sixth button press reference data and the subject's button press reference data are compared, the left hand data of the subject's first button press reference data is the 95% confidence interval of the healthy subject. However, the data on the right hand was outside the confidence interval for healthy subjects. Moreover, as for the 2nd button press data, neither the right hand nor the left hand was outside the confidence interval of the healthy person. Further, among the third button press data of the test subject, the left hand data was within the 95% confidence interval of the healthy person, but the right hand data was outside the healthy person confidence interval. Further, among the test subject's fourth button press data, the left hand data was within the 95% confidence interval of the healthy subject, but the right hand data was outside the healthy subject confidence interval. Further, among the fifth button press data of the test subject, the left-hand data was within the 95% confidence interval of the healthy person, but the right-hand data was outside the healthy person's confidence interval. Of the sixth button press data of the test subject, the right hand data was within the 95% confidence interval of the healthy subject, but the left hand data was outside the healthy subject confidence interval.

  As a result, it was confirmed that an upper limb motor function combined diagnosis could be performed. In particular, even if some button press data is within the confidence interval, it may be outside the confidence interval when other button press data is measured. It was confirmed that it is more preferable to measure the value and use it as a determination material in order to improve reliability.

  In this embodiment, the keyboard keys to be pressed are selected as “O”, “P”, and “Q” for convenience. However, the keys are not limited as long as the distances are different, and other keys, for example, “K” in the case of a keyboard. It may be a combination of “L” and “A”, or may not be aligned on a straight line like “K”, “M”, and “Q”.

  As described above, according to the present embodiment, it has been confirmed that the upper limb motor function composite diagnostic apparatus can provide an upper limb motor function composite diagnostic apparatus that can quantitatively diagnose the upper limb motor function quantitatively as an objective numerical value. did.

  The present invention has industrial applicability, for example, as an upper limb motor function composite diagnosis device realized by using an information processing device.

DESCRIPTION OF SYMBOLS 1 ... Upper limb motor function composite diagnostic device, 2 ... Input device, 3 ... Information processing device, 4 ... Display device, 5 ... Printing device

Claims (2)

An input device in which a plurality of buttons are arranged;
An information processing device for receiving an output from the input device;
A display device for displaying the output of the information processing device,
The information processing apparatus includes an instruction display unit that performs a display prompting the display device to press a button on the input device as soon as possible ;
A button press data recording unit for recording an output based on a button press of the input device as button press data;
A database part that records button press reference data in advance;
A comparison processing unit that compares the button press data recorded in the button press data recording unit with the button press reference data recorded in the database unit;
Have a, a result display unit for displaying the result of the comparison processing unit to said display device,
The button press data recording unit records average value data per second when the button is continuously pressed, and variation coefficient data of time between presses,
The comparison processing unit performs a comparison process on each of the average value data and the variation coefficient data, and determines that there is an abnormality when the comparison processing unit is outside the confidence interval, on the other hand . The instruction display unit is a display for continuously pressing one button on the input device as soon as possible, a display for alternately pressing two buttons in close positions as quickly as possible, and a far position In order to make the two buttons in the display alternately and as quickly as possible ,
The button hitting data recording unit has the first hit data as the average value data per second when the one button is continuously hit, and the second variation coefficient data as the second hitting data. Recorded as tap data, the average value data per second when the two buttons in the close position are pressed alternately continuously, the third press data, the coefficient of variation data of the time between hits Recorded as the fourth tapping data, and the average value data per second when tapping two buttons at distant positions in succession was the fifth tapping data, fluctuation in time between tappings Record the coefficient data as the sixth punching data,
The upper limb according to claim 1 , wherein the comparison processing unit performs a comparison process on each of the first to sixth punching data, and determines that there is an abnormality when even one of the hitting data is outside the confidence interval. Motor function combined diagnosis device.