JP6073709B2 - Sensor sheet, swallowing activity measuring device, and swallowing activity measuring method - Google Patents

Description

The present invention relates to a sensor sheet for measuring muscle activity in the larynx when a person swallows food and beverages, a measuring device, and a method for measuring muscle activity in the larynx.

In swallowing, where food and drink in the oral cavity are sent to the stomach, a plurality of muscles (muscle groups) related to swallowing sequentially act. The disorder of the activity sequence due to aging or the like causes aspiration, that is, food cannot be swallowed normally and food or drink enters the trachea.

In order to prevent aspiration, it is effective to take food that is easy to swallow according to the swallowing function of the person who swallows, that is, food that is difficult to cause aspiration.

In order to solve these problems, swallowing ability without imposing heavy burden on the subject by measuring the movement of the front neck when the subject swallows with various sensors such as electromyogram and vibration pickup There have been attempts to evaluate the above (for example, Patent Document 1 and Non-Patent Document 1).
As described in Patent Document 1, detection of the vertical movement of the larynx is important in evaluating the swallowing function. In order to prevent food and drink from entering the trachea during swallowing and to enter the esophagus, it is necessary to close the entrance of the trachea with a lid-shaped epiglottis before the food and drink pass through the pharynx. This is because it is necessary to raise the larynx (thyroid cartilage) as an operation. In other words, for the evaluation of the swallowing function of the subject, the muscle group for raising the larynx is activated in an appropriate order before food or drink passes through the pharynx, and You need to investigate that you are working in the proper order.

Therefore, a method for detecting the vertical movement of the larynx or the activity of the muscle group used in such an apparatus for evaluating the swallowing function of the subject will be described below. In Patent Document 1, the top and bottom of the larynx are measured by a plurality of optical sensors installed in the front neck. In Non-Patent Document 1 and the like, the activity sequence of muscle groups is calculated from the time-axis waveform of voltage measured as an electromyogram at a plurality of positions in the front neck. The basic procedure for calculating the activity sequence of muscle groups using electromyogram is to obtain a threshold voltage in advance, and at the time before or after the peak of the voltage, the time when the threshold was first exceeded before the peak time was determined. The activity start time and the time when the first time after the peak time falls below the threshold value are set as the activity end time, and the activity start time and the activity end time of each muscle group are compared. In Patent Document 2, as a feature quantity used for investigating the swallowing function of a subject, the activity time of the muscle group near the time when food and drink pass through the larynx is obtained from an electromyogram.

In addition, as described above, in order to evaluate the swallowing function, it is necessary to obtain not only the order of activity of muscle groups but also the time when food and drink pass through the larynx (passing time). In the devices and methods such as Patent Document 1, Patent Document 2 and Non-Patent Document 1, attach one microphone to measure the sound during swallowing (swallowing sound) or one vibration pickup to measure vibration to the front neck. The time at which the time axis waveform reaches a peak is calculated as the passage time.

On the other hand, as a conventional technique using a plurality of vibration pickups, Patent Document 3 describes an eating function measuring device that uses a plurality of vibration sensors to measure swallowing movement based on the movement of the front neck skin surface. Yes. This device measures the vibration of the front neck during mastication and swallowing, displays the vibration waveform and the time axis waveform of the calculation result, and tries to evaluate the function of the subject during mastication and swallowing according to the characteristics and differences of the waveform To do. However, the calculation of the passage time performed in Patent Document 1, Patent Document 2, and Non-Patent Document 1, the calculation of the activity order of muscle groups, and the presence or absence of dysphagia and the evaluation of the swallowing function based on them are described in Patent Document 3. Then I did not go.

In addition to the evaluation of the swallowing function of the test subjects, in the development of foods and beverages including foods that are difficult to swallow and foods that are easy to swallow even if swallowing function is low (easily swallowable foods) As an index indicating ease of swallowing, “throat throat”, and the like, an index based on a measurement result of muscle group movement during swallowing has been studied.
In these methods, although the purpose is different in terms of development of foods and the like, a method and an apparatus for capturing the state of muscle group activity related to swallowing are used (for example, Patent Document 4).

Japanese Patent No. 5081860 JP 2005-304890 A Japanese Patent No. 5077522 JP 2011-234758 A

Matsushige et al. “Examination of swallowing coordination with surface EMG and microphone”, IEICE Technical Report MBE 2009-85, pp. 135-142, 2010.

 The above invention has the following three problems.

The first point is a problem related to attachment of a plurality of electromyographic electrodes and a plurality of vibration pickups to a subject. In Patent Document 2, Non-Patent Document 1, and the like, the activity order of muscle groups is calculated from the time-axis waveform of voltage measured as an electromyogram at a plurality of positions in the front neck. In electromyogram measurement, it is necessary to attach one to two electrodes per location. Each attachment position needs to be attached according to the position of the muscle to be measured, so it was necessary to perform measurement by a specialist with anatomical knowledge about the muscles related to swallowing and their positions. . That is, the position of the muscle and the shape of the front neck depend on the age and gender of the subject, so to paste it according to the subject, work to determine the position to paste using specialized knowledge for each electrode is necessary. In an apparatus or method for attaching electromyographic electrodes to a plurality of locations such as Patent Document 2 and Non-Patent Document 1, determination of their positions is required. The above has described the attachment of a plurality of electromyogram electrodes, but there is a similar problem in the attachment of a plurality of vibration pickups in Patent Document 3 and the like.

The second point is a problem related to calculation of the time (passing time) when food and drink pass through the pharynx during swallowing. In the devices and methods of Patent Document 1, Patent Document 2, Non-Patent Document 1, etc., the measurement of the sound during swallowing (swallowing sound) is a vibration pickup for vibration measurement attached to the front neck or a microphone for sound measurement. It is done by. In general, the vibration pickup has a high measurement sensitivity in order to enable measurement even with a small vibration. Therefore, minute vibrations that are hardly perceptible visually, such as vibrations of the front neck during swallowing, can be detected. On the other hand, since the sensitivity is so high, for example, a small vibration caused by lightly touching the vibration pickup is detected. Therefore, when carrying food and drinks to the mouth, tilting the head or changing the direction of the head, such as when vibration (noise vibration) occurs in the front neck with movements that are not directly related to swallowing, It may be detected as vibration caused by food or drink passing through the larynx. In such a case, a time that is not actually the passage time may be erroneously calculated as the passage time, or the food or drink may actually pass through the pharynx once, but multiple times. There is a problem that it is calculated that it has passed. As a more specific example, when calculating the passage time using only one general vibration pickup in the prior art, basically the time that is the maximum value of the waveform in the vibration pickup is the passage time. And calculate. Therefore, when a time different from the actual passage time becomes the maximum value of the waveform due to noise, the maximum value is calculated as an incorrect passage time. In the above, the vibration pickup that directly measures the vibration of the front neck has been described as an example. However, the microphone that measures the vibration of the front neck via air also measures sound that is not directly related to swallowing. There is a similar problem.

The third issue is related to the calculation of muscle muscle activity time during swallowing. In Patent Document 2 and Non-Patent Document 1, the muscle group activity time is calculated from the time axis waveform of the electromyogram voltage. In that case, during the period in which the muscles are active, it is assumed that the measured electromyogram waveform data always exceeds the threshold value. However, even if the muscle activity continues, the vibration or electric potential is attenuated while reaching the sensor sheet 110, or the vibration or electrical due to the subject's movement such as a change in posture not directly related to swallowing. It is conceivable that a waveform that temporarily falls below the threshold is measured due to the presence of noise or the like. In such a case, the muscle activity may not be correctly measured because it is determined from the waveform that the muscle activity is not performed even in the time zone in which the muscle activity continues.

The present invention seeks to solve the problems of such a conventional configuration. When attaching electromyographic electrodes and vibration pickups to the anterior cervical region, even if you are not an expert with anatomical knowledge of the muscles associated with swallowing and their location, once at a position suitable for measuring muscle activity It is an object of the present invention to provide a sensor sheet capable of simultaneously attaching a plurality of electromyographic electrodes and a plurality of vibration pickups in the attaching operation.
Because the front neck shape and muscle position differ according to gender and age, the sensor sheet is sized according to gender and age so that the electromyographic electrode and vibration pickup can be attached to the appropriate position of the front neck. Realization of multiple types of sensor sheets with different mounting positions of electromyogram electrodes and vibration pickups, and even if vibrations or electrical noises are mixed in the waveform measured by the sensor sheet, the effects are prevented, The purpose is to realize a swallowing activity measuring device that can accurately calculate the presence or absence of muscle activity.

A plurality of EMG electrodes is composed of a plurality of vibration pickups and pressure-sensitive adhesive sheet, a sensor sheet for measuring muscle activity in laryngeal when swallowing food and beverage, in either sex and age of the subject as meet position of the corresponding muscle groups prior Symbol plurality of EMG electrodes and the plurality of vibration pickups are fixed in advance before Kineba adhesive sheet, the plurality of EMG electrodes and the plurality of vibration pickups The form is configured to have a circular shape, and the adhesive sheet has an attachment index that determines the position of attachment to a subject, and the attachment index is in the form of each electromyographic electrode and each vibration pickup the circular shape is configured in the shape of a triangle which is different form, provided on both sides of the adhesive sheet, wherein the plurality of EMG electrodes, said attachment indicators and test When the adhesive sheet is affixed to the subject's front neck so that the position of the thyroid cartilage of the subject coincides with the position of the pharynx and front neck muscles on the left side from the center of the subject's front neck skin surface The vibration pickup is fixed in advance to the adhesive sheet, and the vibration pickup is attached to the subject's front neck skin surface when the adhesive sheet is attached to the subject's front neck so that the attachment index matches the position of the subject's thyroid cartilage. The sensor sheet is fixed in advance to the adhesive sheet so as to coincide with the positions of the muscles of the pharynx and the front neck on the right side from the center .

Moreover, the other form of this invention is the muscle activity which calculates the time when food and drink pass a pharynx based on the vibration waveform of the several places at the time of swallowing detected with the said sensor sheet | seat and these electromyogram electrodes It is a swallowing activity measuring device characterized by having an analysis part.
Another embodiment of the present invention is based on the sensor sheet and the electromyogram waveforms at a plurality of locations during swallowing detected by the plurality of electromyogram electrodes, and each time when the waveforms exceed a certain threshold, And calculating time 2 which is lower time, and calculating at least start time, end time, duration, start order and end order of muscle activity related to swallowing based on the calculated time 1 and time 2 It is a swallowing activity measuring device characterized by having a muscle activity analyzing unit for performing.

According to another aspect of the present invention, swallowing activity measurement is performed by calculating a time at which food and drink pass through the pharynx based on vibration waveforms at a plurality of places during swallowing, which are trained by the plurality of vibration pickups in the sensor sheet. Is the method.
Another aspect of the present invention is a time when each waveform exceeds a certain threshold based on the waveforms of electromyograms at a plurality of locations during swallowing detected by the plurality of electromyogram electrodes in the sensor sheet. 1. Swallowing that calculates time 1 and time 2 that is lower, and that calculates at least the start time, end time, and duration of muscle activity related to swallowing based on the calculated time 1 and time 2 It is an activity measurement method.
In another aspect of the present invention, in the calculation process, it is assumed that muscle activity is stopped only when a state below a threshold value continues for a certain time, and the start time, the end time, and the muscle activity are stopped. A method for measuring swallowing activity characterized by calculating an activity duration.

According to the sensor sheet of the present invention, when the sensor sheet is attached to the front neck surface, the electromyogram electrode and the vibration pickup are previously placed so that the electromyogram electrode and the vibration pickup meet the position of the muscle to be measured. Since the sensor sheet fixed to the adhesive sheet is prepared, it may be pasted. The size of the adhesive sheet and the attachment of the electromyographic electrode and vibration pickup in the adhesive sheet so that the sensor sheet can be attached to the appropriate position of the front neck according to the subject's gender and age A plurality of types of sensor sheets whose positions are changed are prepared. Therefore, when measuring, the sensor sheet is selected according to either the age or sex of the subject and attached to the subject. Even if the positions of different muscle groups are not grasped in detail, the electromyographic electrode and the vibration pickup can be attached to appropriate positions.

In addition, since a plurality of electromyogram electrodes and a plurality of vibration pickups are fixed to the sensor sheet, if the sensor sheet is attached to the subject once, a plurality of electromyogram electrodes and a plurality of vibration pickups are simultaneously installed. It can be attached at a position suitable for measurement, and the conventional work of attaching a plurality of electromyogram electrodes and a plurality of vibration pickups while determining the positions one by one is unnecessary.

When affixing the sensor sheet to the front neck, the sensor sheet attachment index and the part of the cervical cartilage (throat buddha) center, etc., which is a predetermined mark of the front neck, are only attached to the subject. The operation of attaching the individual electrodes and the vibration pickup becomes unnecessary, and the electromyogram electrode and the vibration pickup can be easily attached.

In addition, for the second problem, in the swallowing activity measuring device and the swallowing activity measuring method of the present invention, when calculating the pharyngeal passage time of food and drink, a plurality of attached to a plurality of locations on the front neck Calculation is performed based on the waveform measured by the vibration pickup. According to the inventor's investigation, it is known that when food or drink passes through the pharynx, a peak occurs simultaneously in the measurement waveform of most vibration pickups among the plurality of vibration pickups attached to the front neck. In addition, for example, if the vibration occurs in the front neck even in movements that are not directly related to swallowing, such as moving food and drink from the container to the mouth or tilting the head in preparation for taking food and drink into the mouth A peak may occur in the waveform of the vibration pickup. However, in that case, it has been found that the peak is generated not in the waveform of most vibration pickups but in the measurement waveform of some vibration pickups. Therefore, if it can be calculated that a peak occurs in a certain number or more of the plurality of vibration pickups, the passage time can be accurately obtained by calculating the time as the pharyngeal passage time. According to this calculation method, although food and drink have passed the pharynx once, it is erroneously calculated that “multiple passes have occurred, that is, there is a passage time”. Can be prevented. The sensor sheet in “Effects of the Invention” has a structure in which a vibration pickup is attached in the vicinity of a soft palate that is considered to generate swallowing sound by attaching the sensor sheet to the front neck. Therefore, by attaching the sensor sheet to the front neck as described above, a plurality of vibration pickups can be attached to appropriate positions simultaneously with the electromyographic electrodes. In the swallowing activity measuring device and the swallowing activity measuring method of the present invention, it is not necessary to attach only a plurality of vibration pickups separately from the electromyographic electrode.

In addition, with respect to the third problem, the swallowing activity measuring device and the swallowing activity measuring method of the present invention determine the time of the muscle group activity start and activity end in order to calculate the sequence of muscle activity. The time zone in which the voltage of the time axis waveform of the electromyogram measurement result exceeds the threshold obtained in advance is calculated as the time zone during which the muscle activity is performed.
The time required for the swallowing movement is generally about 1 second although it varies depending on the individual and varies depending on the situation. If the waveform continues to exceed the threshold in the electromyogram, and if the waveform momentarily falls below the threshold in a time sufficiently shorter than 1 second, consider that a duration of about 1 second is common. In such a short period of time, the swallowing movement is stopped and the swallowing movement is resumed immediately after that, and it is considered that the swallowing movement is often influenced by noise or the like that is not directly related to swallowing.
Therefore, it is considered that the muscle activity is stopped only when the time below the threshold continues for a certain period of time, and the start and end times of the muscle activity are calculated. As a result, it can be expected to prevent an erroneous determination that the muscle activity is stopped when the waveform instantaneously falls below the threshold due to noise or the like even though the muscle activity continues.

It is a block block diagram of a swallowing activity measuring device. 2 is a configuration diagram of a sensor sheet 110. FIG. It is a schematic diagram which shows the data which the vibration pickup caught, and the calculation content of a muscle activity analysis part. It is a figure which shows the measurement content of a test subject by an electromyogram, and the calculation content of a muscle activity analysis part.

FIG. 1 is a block configuration diagram of a swallowing activity measuring apparatus that measures muscle activity during swallowing according to an embodiment of the present invention. The swallowing activity measuring apparatus 100 of this embodiment includes a sensor sheet 110, a recorder unit 120, a measurement data analyzing unit 130, a muscle activity analyzing unit 140, and a recording / displaying unit 150. As shown in FIG. 2, the sensor sheet 110 includes an adhesive sheet 111, n pairs of electromyogram electrodes 112, m vibration pickups (microphones) 113, and an attachment index 114. FIG. 2 shows an example where n is 4 and m is 6. At least one surface of the adhesive sheet 110 is an adhesive surface. The electromyogram electrode 112 and the vibration pickup 113 are fixed to either surface of the adhesive sheet 110 with a double-sided tape, an adhesive, or the like. This fixed position is measured by the electromyogram electrode 112 and the vibration pickup 113 when the adhesive sheet 110 is attached to the subject's front neck skin surface so that the attachment index 114 matches the predetermined position. Decide to match the streaks.

For example, when the measurement target of muscular activity is the geniohyoid muscle, the thyroid hyoid muscle, the sternohyoid muscle, and the sternum thyroid muscle, the adhesive sheet so that the attachment index 114 in FIG. 2 matches the position of the thyroid cartilage. When the 111 is attached to the front neck, the plurality of electromyographic electrodes 112 are matched with the positions of the muscles on the right side so as to match the positions of the target muscles on the left side from the center of the front neck skin surface of the subject. Thus, the vibration pickup 113 is attached to the adhesive sheet 111 in advance. When the adhesive sheet is attached to the subject, the electromyogram electrode 112 and the vibration pickup are only required to be attached with the attachment index 114 aligned with the tip of the thyroid cartilage while aligning the vertical direction of the adhesive sheet 111 with the designated direction. 113 can be pasted at a specified position. Although the attachment index on one side of the adhesive sheet 111 can be seen in FIG. 2, the attachment index is also provided at the corresponding position on the opposite side of the adhesive sheet so that the attachment index can be seen when the sensor sheet is attached to the subject. 114 is attached. Since the front neck shape and muscle position differ depending on the gender and age of the test subject, the adhesive sheet 111 of the adhesive sheet 111 can be attached according to gender and age so that the electromyographic electrode and the vibration pickup can be attached to the appropriate position of the front neck. A plurality of types of sensor sheets having different shapes and sizes, and attachment positions of electromyogram electrodes and vibration pickups are prepared.

The electromyogram electrode 112 and the vibration pickup (microphone) 113 shown in FIG. 1 are connected to the recorder unit, and output analog signals having waveforms detected by the electromyogram electrode 112 and the vibration pickup 113 to the recorder unit 120. The electromyogram electrode 112 and the vibration pickup 113 are each an amplifier 1 with a built-in recorder unit 120.
121 (for electromyogram) and amplifier 2 122 (for vibration pickup), the analog voltage output by the amplifier is stored in the storage device 123. When the measurement start signal is input to the switch 124 of the recorder unit, the measurement is started, and the signals output from the amplifiers 121 and 122 are stored in the storage device 123. The storage is continued while the measurement start signal is input. When the measurement start signal is repeatedly input, the storage in the storage device 123 is repeated as many times as input.

  The measurement data analysis unit 130 performs a filtering process such as extracting only a signal in a specific frequency band from the measurement result stored in the storage device 123 and outputs the result. A signal suitable for evaluation of swallowing activity from the measurement results stored in the storage device 123 by removing frequency components of unnecessary signals caused by vibrations and noises that are not directly related to swallowing such as shaking and movement of the entire body of the subject during measurement Filtering is required to extract the data.

The muscle activity analyzer 140 receives the signal output from the measurement data analyzer 130 as input, and calculates the activity start time, activity end time, and activity duration of the muscle group based on the measurement results of the electromyogram and vibration pickup. At the same time, the sequence of the muscle group activity start and activity end is calculated.

In addition, a method and an apparatus using a vibration pickup when measuring swallowing movement are performed in Non-Patent Document 1 and the like, and the time when food and drink passes through the pharynx at the maximum time of the output voltage of one vibration pickup. As calculated. In the present invention, the time when the food or drink passes through the pharynx, that is, the passage time is calculated using the measurement results of the plurality of vibration pickups. The time calculation unit 141 in the muscle activity analysis unit 140 performs this calculation, and the time calculation unit 141 performs a filtered waveform obtained by filtering the measurement result of the vibration pickup stored in the storage device 123 by the measurement data analysis unit 130. Data Ai (t) (i = 1, 2,..., M) is received as input, and the passage time is calculated. t represents time and takes the value of time from the start of measurement to the end of measurement. i is the number of the vibration pickup, which corresponds to the mounting position on the sensor sheet 100. As a procedure for calculating the passage time (procedure 1), there is a method of calculating the time of each peak (maximum value) from A1 (t) to A6 (t) and calculating the average time to obtain the passage time tph. is there. Further, as another calculation procedure (procedure 2), one time calculation waveform V (t) is calculated from a plurality of waveform data Ai (t), and the maximum value of V (t) is calculated as the passage time. There is. When food or drink passes through the larynx, it is considered that the output of the vibration pickup increases in many respects due to the passing sound (so-called swallowing sound). Therefore, in the latter procedure 2, V (t) becomes a large value when many waveform data Ai (t) has a larger value, and Ai (t) at many points has a smaller value. Sometimes it needs to be calculated to be a small value. As an example of the calculation procedure of V (t), the result of adding Ai (t) (i = 1, 2,..., M) at each measurement position (i = 1, 2,..., M) at time t, that is, V (t) = A1 (t) + A2 (t) +... + Am (t) and the result of calculating the product, that is, V (t) = A1 (t) .times.A2 (t) .times..times.Am (t) Conceivable. From the result of calculating V (t), the time t = tph at which V (t) is maximum is taken as the result of the passage time calculation. The calculated passage time tph is the output of the time calculation unit 141. Of the above two calculation procedures, the former procedure 1 is easy to calculate because the passage time can be calculated only by detecting the peak time and calculating its average value. On the other hand, when even one waveform having a peak at a time different from the actual passage time exists due to noise or the like, the influence can be reduced to some extent by the average value calculation, but the influence cannot be eliminated at all. The latter procedure 2 is more complicated to calculate than the former procedure 1, but there is a possibility that the influence of a waveform with a peak at a time different from the actual passage time may be completely eliminated, and an improvement in the calculation accuracy of the passage time is expected. it can.

When a muscle is active during swallowing, the value of the corresponding vibration pickup or electromyogram waveform increases. That is, during muscle activity, these waveforms increase beyond a certain value (threshold). The threshold value calculation unit 142 stores the filtered waveform data Ai (t) (i = 1, 2,..., M) obtained by filtering the vibration pickup measurement result stored in the storage device 123 by the measurement data analysis unit 130 and the same. The measurement result signal Ej (t) (j = 1, 2,..., N) obtained by filtering the measurement result of the electromyogram stored in the device 123 by the measurement data analysis unit 130 is received as an input, and each Ai ( For t) and Ej (t), a threshold for determining the presence or absence of muscle activity is calculated. i and j are numbers of the vibration pickup and the electromyogram electrode, respectively, and correspond to the mounting positions on the sensor sheet 100.

A procedure for calculating the threshold Athi will be described by taking the vibration pickup waveform Ai (t) at the position i as an example. The threshold value is calculated based on measurement data of Ai (t) at rest when no swallowing activity is performed. For example, it can be calculated based on the average value and variation (standard deviation) of measurement data at time t (t0 <t <t1) at rest, and the procedure is Athi = C1 × mean (Ai (t)) + C2. Xstd (Ai (t)) + C3 is calculated. Athi is a threshold value. Here, mean () represents the average of the measurement data in parentheses, and std () represents calculation for obtaining the standard deviation of the measurement data in parentheses.

Similarly, the threshold Ethj = C4 × mean (Ej (t)) + C5 × std (Ej (t)) + C6 can be calculated from the electromyogram waveform Ej (t) at position j. C1 to C6 are predetermined constants. The threshold value calculation unit 142 outputs a threshold value Athi of m vibration pickup waveforms and a threshold value Ethj of n electromyogram waveforms.

The start time calculation unit 143 uses the filtered vibration pickup waveform data A _i (t) (i = 1, 2,..., M) and the filtered electromyogram measurement result signal E _j (t) (i = 1, 2,..., N), the calculated passage time tph, the threshold value Ath _i of the m vibration pickup waveforms, and the threshold value Eth _{j of the} n electromyogram waveforms are received as inputs. For each measurement position (i or j) of A _{i (} t) and E _j (t), the time is before the passage time tph, and A _{i (} t) and E _j (t) are the threshold values Ath _i. And times As _i and Es _j that take values greater than or less than Eth _j are taken out. Here, As _i represents the i-th number among the m-number string of (As1, As2,..., Asm), and Es _j represents the j-th number among the n numbers. In the case where a peak appears a plurality of times, a plurality of times may be taken out as times As _i and Es _j at each measurement position. Therefore, when a plurality of times are extracted at each position, only the last time of As _i and Es _j is left. Then, the start time As _i and Es _j are output from the start time calculation unit 143. As a result, it is possible to obtain the start time when each muscle starts to act when the time is before the passage time tph, that is, when the food or drink passes the pharynx.

The end time calculation unit 144 uses the filtered vibration pickup waveform data Ai (t) (i = 1, 2,..., M) and the filtered electromyogram measurement result signal Ej (t) (i = 1). , 2,..., N), the calculated passage time tph, m vibration pickup waveform thresholds Athi, and n electromyogram waveform thresholds Ethj as inputs, and Ai (t) and Ej. For each measurement position (i or j) of (t), the first times Aei and Eej when the time is after the passage time tph and Ai (t) and Ej (t) are lower than the threshold values Athi and Ethj Take out. When a peak appears a plurality of times, a plurality of times may be taken out as times Aei and Eej at each measurement position. Therefore, when a plurality of times are taken out at each position, only the last time is left among Aei and Eej. Then, the end time calculation unit 144 outputs Aei and Eej. As a result, it is possible to obtain the time when each muscle has finished its activity after the passage time tph, that is, after the food or drink passes through the pharynx.

The calculations by the start time calculation unit 143 and the end time calculation unit 144 are performed on the assumption that the measured waveform data always exceeds the threshold during the period in which the muscle is active. However, even if the muscle activity continues, the vibration or electric potential is attenuated while reaching the sensor sheet 110, or the vibration or electrical due to the subject's movement such as a change in posture not directly related to swallowing. It is conceivable that a waveform that temporarily falls below the threshold is measured due to the presence of noise or the like. Therefore, in the time correction unit 145, when the waveform below the threshold is only for a certain period or less, it is considered that the muscle activity continues during that period, and the start time and end time of the muscle activity are corrected, and after the correction The start time and the corrected end time are calculated.

The procedure for calculating the corrected start time and the corrected end time is as follows. The time correction unit 145 includes vibration pickup and electromyogram waveform data A _i (t) and Ej (t), and start times As _i and Es _{j of the} waveforms output from the start time calculation unit 143 and the end time calculation unit 144. _The end times Ae _i and Ee _j are received as inputs.

The procedure for correcting the start time will be described by taking the start time Es _j obtained from the electromyogram waveform as an example. First, an uncorrected start time Es _j is input to the corrected start time Es ′ _j . Next, as update processing of the start time, E _j (t) is a threshold value Eth at a time t (Es ′ _j −Cs <t <Es ′ _j ) that is a predetermined time Cs before Es ′ _{j at} position j. If there are points exceeding _j , those times are taken out, and the smallest time among them is newly set as the corrected start time Es ′ _j . This update process of the start time is repeated until there is no point exceeding the threshold Eth _j between the time Es ′ _j −Cs and Es ′ _j .

Next, in the procedure for correcting the end time, Eej is input to the corrected end time Ee′j. Next, as a start time update process, a time t (Ee ′) after a predetermined time Ce from the start time Ee′j of the position j.
In j <t <Ee′j + Ce), if there are points where Ej (t) exceeds the threshold Ethj, those times are taken out, and the smallest time among them is newly set as the start time Ee′j. This updating process of the end time is repeated until there is no point exceeding the threshold Ethi between time Ee′i and Ee′i + Ce.

The calculation of the corrected start time and the corrected end time is performed on the vibration pickup at each position represented by the attachment positions i and j and the waveform data of the electromyogram. In addition, regarding the part of the procedure that is described only about the waveform data Ej (t) of the electromyogram, the waveform data Ai (t) of the vibration pickup can be similarly calculated. With respect to the waveform data Ai (t) and Ej (t), corrected start times As'i and Es'j and corrected end times Ae'i and Ee'j are calculated and output from the time correction unit 145.

FIG. 3 is a calculation example of the waveform data Ai (t) of the vibration pickup at the filtered position i, its start time, and the corrected start time. The time calculation unit 141 calculates the passage time tph, the threshold value calculation unit 142 calculates the threshold value Athi, and the start time calculation unit 143 calculates the start time Asi based on tph and Athi. In FIG. 3, since there is a portion that exceeds the threshold from Asi to Cs before, the time correction unit 145 calculates a time different from the start time Asi as the corrected start time As′i. Output.

The activity duration calculation unit 146 includes start times Asi and Esj, end times Aei and Eej of the waveforms output from the start time calculation unit 143 and the end time calculation unit 144, and a corrected start time As output from the time correction unit 145. Received as' i and Es'j, corrected end times Ae'i and E'j inputs. To describe an example in which the duration of muscle activity corresponding to the attachment position i is calculated based on the uncorrected start time and end time, the activity duration Eaj can be calculated by Eej-Esj. Eaj is output as the muscle activity continuation time corresponding to position j.

The above activity duration calculation is performed for each position represented by the attachment positions i and j. The calculation procedure is the same when the corrected start / end times are used to calculate the activity time. In addition, regarding the part of the procedure that is described only about the waveform data Ej (t) of the electromyogram, the waveform data Ai (t) of the vibration pickup can be similarly calculated. For the waveform data Ai (t) and Ej (t), the activity durations Aai and Eaj are calculated and output from the activity duration calculation unit 146.

The activity start order calculation unit 147 receives the start times Asi and Esj and the corrected start times As'i and Es'j as inputs. The case where the procedure for calculating the activity start order is performed based on Esj, which is the start time based on the waveform data of the electromyogram, will be described as an example. The start time Esj is an array composed of n numbers. This array is rearranged in ascending order of values. After the rearrangement, the numerical string Eor in which the position numbers corresponding to the numbers in the array are arranged becomes a numerical string in which the position numbers are arranged in the order in which the muscle activity starts, and Eor is output as the activity start order. As a specific example, when n = 3 and the start time (Es1, Es2, Es3) is rearranged in order of increasing values (Es2, Es1, Es3), Eor = (2, 1, 3), This Eor is output as the activity start order based on the electromyogram waveform data. The corrected start time can be calculated by the same procedure. Further, in the above procedure, for the part described only about the start / end time of the electromyogram waveform data Ej (t), the waveform data Ai (t) of the vibration pickup can be similarly calculated.

The activity end order calculation unit 148 receives the end times Aei and Eej and the corrected end times Ae′i and Ee′j as inputs. The procedure for calculating the activity end sequence is performed by replacing the start time and the corrected start time with the end time and the corrected end time in the calculation procedure of the activity start sequence calculation unit 147 described above. Outputs a string of numbers with position numbers in the order in which muscle activity ends.
The recording / display unit 150 records / displays the calculation result in the 140 muscle activity analysis unit, and records / displays the output of the result of performing the filtering process or the like in the measurement data analysis unit 130.

FIG. 4 shows an example in which the measurement waveform and the start time and end time when the electromyogram electrode and the vibration pickup are actually attached to the subject and swallowed are corrected. Here, with respect to the measurement result of the electromyogram electrode at the measurement position j = 3, a filtering process for extracting a band from 100 Hz to 200 Hz and performing full-wave rectification was performed. In the calculation of the threshold, the threshold Eth3 is calculated from the waveform at rest (t0 <t <t1), and the corrected start time Es′3 and the corrected end time Ee′3 are calculated. At the time between Es′3 and Ee′3, there is a time zone in which the voltage value is smaller than the threshold value. Therefore, according to the conventional technology, it is determined that the muscle activity is stopped in the time zone below the threshold value. Is done.
Since the time below the threshold does not continue for a time longer than the predetermined time Cs or Ce, activity is continued in those time zones according to the method of calculating the corrected start time and the corrected end time of the present invention. It is judged that As a specific example, the case where Cs is set to 0.2 seconds in advance and the muscle activity is calculated to be stopped in a time period that continuously falls below the threshold for 0.2 seconds or more will be described with reference to the waveform of FIG. The waveform from the passage time to the corrected start time in FIG. 4 has a waveform that exceeds the threshold at intervals of approximately 0.1 seconds to 0.2 seconds. In this time zone, there is no time that continuously falls below the threshold value exceeding Cs, that is, 0.2 seconds, and therefore, it is calculated in the prior art that the muscle activity intermittently repeats the activity and the stop. On the other hand, in the present invention, this time zone is calculated as a time zone in which muscle activity is continuously active. As another time zone, the time zone before the corrected start time has a waveform that continuously falls below the threshold value for at least 0.5 seconds. This time zone is calculated as a time zone in which muscle activity is stopped both in the prior art and in the present invention.

Next, a method for using the apparatus of the present invention will be described.

First, the procedure for attaching the sensor sheet to the subject will be described. The sensor sheet 110 of FIG. 1 is attached to the subject who evaluates the swallowing function. A plurality of types of sensor sheets are prepared according to the age and sex of the subject to be measured as described above. Among them, the one suitable for the subject is selected, and the adhesive sheet 111 is attached to the subject's front neck with the adhesive sheet 111 facing the subject. By aligning the position of the sensor sheet with the front neck of the subject and pressing lightly over the entire area of the sensor sheet so that the front neck and the sensor sheet are in close contact with each other, the adhesive sheet surface 111 of the sensor sheet 110 adheres and fixes itself to the front neck. At the same time, a plurality of electromyogram electrodes and a plurality of vibration pickups constituting the sensor sheet are fixed. The alignment of the sensor sheet is performed by attaching a sensor sheet attachment index and a part that serves as a mark of the front neck such as the center of the subject's thyroid cartilage (throat buddha). The above is the procedure for attaching the sensor sheet. In this procedure, the measurer does not use specialized knowledge about the position of the anterior cervical muscle group related to swallowing, and a plurality of electromyographic electrodes and A plurality of vibration pickups can be fixed.

Next, a method for measuring the electromyogram during swallowing and the waveform of the vibration pickup will be described. After attaching the sensor sheet, the measurer inputs a measurement execution signal to the switch 124 of FIG. With this input, recording of measurement waveforms of a plurality of electromyogram electrodes and a plurality of vibration pickups is started in the storage device of the recorder unit 120. At that time, the output waveform of the measurement data analysis unit can be confirmed on the recording / display unit 150. Thereafter, the subject signals the start of swallowing from the measurer, and the subject swallows. When it is confirmed that the subject has finished swallowing and the input of the measurement execution signal to the switch 124 is stopped, the recording in the recorder unit 120 is stopped. By the above measurement, the waveforms detected by the plurality of electromyogram electrodes and the plurality of vibration pickups are recorded in the recorder unit. Multiple measurements are possible by repeating the input of the measurement execution signal.

Next, calculation of muscle activity duration time, activity start order, and activity end order of muscle groups in the muscle activity analysis unit 140 of FIG. 1 will be described. The measurer selects one measurement result to be calculated from the measurement results recorded in the storage device 123. One measurement result includes measurement waveforms of a plurality of electromyograms and a plurality of vibration pickups. When the sensor sheet of FIG. 2 is used, four electromyogram waveforms and six vibration waveforms are included in one measurement result.
These measurement results are filtered by the measurement data analysis unit 130 and the muscle activity analysis unit 140 receives the results. That is, the muscular activity analyzer 140 receives as input the results of filtering processing and the like performed on the plurality of electromyogram waveforms and the plurality of vibration waveforms of the selected measurement result. Thereafter, the time calculation unit 141 calculates the passage time based on the vibration pickup waveform. Here, only with the process of detecting the peak value of a certain waveform, when the waveform contains noise, there is a possibility that the time when the noise is mixed is detected instead of the actual passage time. In order to prevent the influence of such noise, the time calculation unit 141 performs time calculation based on a plurality of waveforms. As a processing procedure of the time calculation unit 141, one time calculation waveform is calculated based on the input waveform data of each vibration pickup, and the time that is the maximum value in the time calculation waveform is calculated as the passage time. .
Next, a threshold value is calculated for each electromyogram waveform. As described above, the threshold value calculation unit 142 calculates the threshold value based on the value of the time zone designated as resting in the electromyogram waveform. In the example of FIG. 4, the time of about 0.5 seconds from time t0 to t1 is the time designated as resting.

Subsequently, based on the waveforms of electromyograms at multiple locations during swallowing, the time when a certain threshold was exceeded and the time when it fell below was calculated for each waveform, and related to swallowing based on the two calculated times A calculation process for calculating the start time, end time, and duration of muscle activity to be performed will be described. This calculation process is performed by the start time calculation unit 143, the end time calculation unit 144, the time correction unit 145, the activity duration calculation unit 146, the activity start order calculation unit 147, and the activity end order calculation unit 148 inside the muscle activity analysis unit 140. This is a process to be performed.
First, for each waveform of the electromyogram, the start time calculation unit 143 and the end time calculation unit 144 calculate the start time and end time of muscle activity, respectively. The time correction unit 145 receives each waveform of the electromyogram and the calculation result of the start time and end time of each waveform as input, performs the calculation as in the previous period in order to correct each time, and as a result, the corrected Start time and corrected end time are calculated.

The activity duration calculation unit 146 receives the output of the start time calculation unit 143, the end time calculation unit 144 and the time correction unit 145, and the waveform data output from the measurement data analysis unit 130 as inputs, and measures the waveform of each waveform. Calculate the muscle activity time. As in the previous period, the difference between the start and end times before correction and the difference between the start and end times after correction are calculated, and the respective calculation results are output.

The activity start order calculation unit 147 receives the output of the start time calculation unit 143, the end time calculation unit 144 and the time correction unit 145, and the waveform data output from the measurement data analysis unit 130 as inputs. Calculate and output the activity start sequence. Similarly, the activity end order calculation unit 148 calculates and outputs the activity end order of the muscle groups as described above.

110 Sensor sheet 111 Adhesive sheet 112 EMG electrode 113 Vibration pickup 114 Mounting index 120 Recorder unit 121 Amplifier 1
122 Amplifier 2
123 storage device 130 measurement data analysis unit 140 muscle activity analysis unit 141 time calculation unit 142 threshold calculation unit 143 start time calculation unit 144 end time calculation unit 145 time correction unit 146 activity duration calculation unit 147 activity start order calculation unit 148 activity end Order calculation unit 150 Recording / display unit

Claims (6)

A sensor sheet for measuring muscle activity in the larynx when swallowing food and drink, comprising a plurality of electromyographic electrodes, a plurality of vibration pickups and an adhesive sheet,
The plurality of electromyogram electrodes and the plurality of vibration pickups are fixed in advance to the adhesive sheet so as to meet the position of the muscle group depending on either the sex and age of the subject,
The plurality of electromyogram electrodes and the plurality of vibration pickups are configured to have a circular shape,
The adhesive sheet has an attachment index that determines the position of attachment to the subject,
The attachment index is configured in a triangular shape that is different from the circular shape that is a form of each electromyogram electrode and each vibration pickup , and is provided on both surfaces of the adhesive sheet ,
The plurality of electromyographic electrodes are arranged on the left side from the center of the subject's front neck skin surface when the adhesive sheet is attached to the subject's front neck so that the attachment index matches the position of the subject's thyroid cartilage. Pre-fixed to the adhesive sheet to match the position of the muscles of the pharynx and front neck,
The vibration pickup includes the pharynx and front neck on the right side from the center of the skin surface of the subject's front neck when the adhesive sheet is attached to the subject's front neck so that the attachment index matches the position of the subject's thyroid cartilage. A sensor sheet fixed in advance to the adhesive sheet so as to coincide with the position of the muscle group . 1 SL and mounting of the sensor sheet according to claim, based on the vibration waveform of a plurality of locations during detected swallowing by the plurality of vibration pickups, having a muscle activity analysis unit for calculating a time at which food passes through the pharynx A swallowing activity measuring device. 1 SL and mounting of the sensor sheet according to claim, based on the EMG waveforms of a plurality of locations during swallowing detected by the plurality of EMG electrodes, time 1, and below was a time that exceeds a certain threshold each waveform A time activity 2 is calculated, and based on the calculated time 1 and time 2, a muscle activity analysis unit that calculates at least a start time, an end time, and a duration of muscle activity related to swallowing is provided. A swallowing activity measuring device. Claims were detected by the plurality of vibration pickup in claim 1 Symbol placement of the sensor sheet, based on the vibration waveform of a plurality of locations during swallowing, swallowing measuring method for performing a process of calculating the time at which food passes through the pharynx. Claims were detected by the plurality of EMG electrodes of the sensor sheet of claim 1 Symbol placement, based on the waveform of the EMG plurality of locations during swallowing, time 1, and below is a time that exceeds a certain threshold each waveform A method for measuring swallowing activity, which calculates time 2 which is a measured time and performs calculation processing for calculating at least a start time, an end time and a duration of muscle activity related to swallowing based on the calculated time 1 and time 2. In the calculation process, calculating the start time, the end time, and the duration of muscle activity, assuming that muscle activity is stopped only when the state below the threshold continues for a certain time. The method for measuring swallowing muscle activity according to claim 5 , wherein the swallowing muscle activity is measured.

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