JP6099082B2 - Training system - Google Patents

Description

  The present invention relates to a training system using a wearable movement assist device.

  The main cause of functional disorders of the motor system is cerebrovascular disorders such as stroke, and various motor dysfunctions appear depending on the symptoms. In recent years, regarding brain and nervous system diseases, it has been recognized that treatment from the viewpoint of neurorehabilitation is more important than rehabilitation of joints and muscles.

  For example, as a training system for neurorehabilitation of trainees whose hands or legs are paralyzed due to stroke, etc., it is considered to use a wearable motion assist device to train the trainee to restore motor function (For example, refer to Patent Document 1).

  The wearable movement assist device detects a biological signal (potential signal) generated when the trainee moves the muscle, and controls the driving torque of the motor based on the detected biological signal to perform the training. It is comprised so that it may transmit to a person's arm or leg. Therefore, even in the case of a trainee with paralyzed arms or legs, if a biological signal can be detected from the trainee, the neurological function of the paralyzed arm or leg can be determined by operating the wearable motion assist device based on the intention of the person. Rehabilitation can be performed effectively.

  In addition, symptoms due to paralysis of the trainee vary among individuals, and also vary due to changes in the environment such as temperature and humidity of the day, changes in the physical condition of the trainee himself, and the like. Therefore, when performing the neurorehabilitation of the trainee, the training is performed in accordance with an instruction from a doctor or a physical therapist who examines the trainee.

JP 2005-95561 A

  However, if spasticity (spasticity) occurs in the trainee, for example, even if a bioelectric potential is detected, the joint of the trainee's hand or leg is stiff and training in neurorehabilitation using the wearable motion assist device There is a problem that bioelectric potential fluctuates due to convulsions of the trainee and cannot be accurately detected due to convulsions of the trainee, making it difficult to perform training using the wearable motion assist device.

  In view of the above circumstances, an object of the present invention is to provide a training system that solves the above problems.

  In order to solve the above problems, the present invention has the following means.

The present invention includes a transmission member fastened to a trainee, a drive unit that drives the transmission member, a biological signal detection sensor that detects a biological signal according to the movement of the trainee, and the biological signal detection sensor A control unit that controls the drive unit based on a biological signal output from the wearable movement assist device;
A drug storage unit in which a drug for relieving spasticity generated in the trainee is stored, and a drug dose setting unit in which the dose of the drug to the trainee designated by a prior diagnosis result is set And a spasticity relief device comprising:
With
In the spasticity alleviating device, the waiting time after the completion of the administration of the drug to the trainee is set according to the type of the drug and the dose of the drug,
The control unit, according to a biological signal output from the biological signal detection sensor, within a period in which the waiting time has elapsed and the effect of spasticity relaxation in which the muscle of the trainee is in a relaxed state is obtained. The exercise function recovery training of the trainee is performed by controlling the drive unit to operate the transmission member .

  ADVANTAGE OF THE INVENTION According to this invention, when the spasticity generate | occur | produces in a trainee, it becomes possible to perform the neurorehabilitation training using a wearable movement assistance apparatus effectively by relieving the said spasticity.

It is a block diagram which shows the system configuration | structure of one Embodiment of the training system by this invention. It is a block diagram which shows one Embodiment of a spasticity relief device. It is a flowchart of the spasticity relaxation control process 1. FIG. It is a block diagram which shows the system configuration | structure of the control system of a mounting | wearing type movement assistance apparatus. It is a perspective view which shows one Example of a mounting | wearing type movement assistance apparatus. It is a side view which shows an operation state when a mounting | wearing type movement assistance apparatus is mounted | worn with the trainee's left leg. It is a rear view which shows an operation state when a mounting | wearing type movement assistance apparatus is mounted | worn with the trainee's left leg. It is a flowchart of standby mode (control mode 1) of a mounting | wearing type movement assistance apparatus. It is a flowchart of rehabilitation mode (control mode 2) of a mounting | wearing type movement assistance apparatus. It is a figure which shows typically the recovery process of the nervous system by neurorehabilitation. It is a block diagram which shows the modification of a spasticity relief device. It is a flowchart of the spasticity relaxation control process 2. FIG. It is a perspective view which shows the mounting state of the modification 1 of a mounting | wearing type movement assistance apparatus. It is a perspective view which shows the mounting state of the modification 2 of a mounting | wearing type movement assistance apparatus. It is a perspective view which shows the modification 3 of a mounting | wearing type movement assistance apparatus.

  Hereinafter, embodiments for carrying out the present invention will be described with reference to the drawings.

[Configuration of the training system]
FIG. 1 is a block diagram showing a system configuration of an embodiment of a training system according to the present invention.
As shown in FIG. 1, the training system 10 includes a wearable motion assisting device B (hereinafter referred to as “motion assisting device”) worn by the trainee A and a spasticity alleviating device C. For example, it is assumed that the trainee A is diagnosed with a symptom of a chronic stroke, and a motion command from the brain (upper center) is not normally sent to the muscle via the peripheral nerve. Therefore, the trainee A does not move even if he / she tries to walk by moving his / her left and right legs in the front / rear direction, so he / she cannot move, or the arm does not move even if he tries to move his / her arm. .

  In FIG. 1, a transmission path of a signal sent from the brain to the muscle in a part of the body of the trainee A is schematically shown. The command signals from the brain A1 are the spinal cord A2, the nerve A3, and the muscle spindle A4. When transmitted to the muscle A5, the joint A6 rotates by the force of the muscle A5. At that time, in the nerve A3, a nervous system biological signal as a biological signal is detected by the biological signal sensor B1. In the muscle A5, a myoelectric potential signal as a biological signal is detected by the biological signal sensor B1. The joint A6 corresponds to each joint of the extremities such as a knee joint, a hip joint, a shoulder joint, an elbow joint, and a wrist joint.

  Further, when the trainee A has a paralyzed arm or leg due to a stroke or the like, the signal is not transmitted in the signal transmission path between the nerve A3 and the spinal cord A2. For this reason, a nerve signal reflecting the intention of operation from the upper center does not reach and cannot be detected by the biological signal sensor B1.

  Further, the motion assisting device B is roughly composed of a biological signal detection sensor B1 that detects a biological signal (potential signal) of the trainee A, an angle sensor B2, a data storage unit B3, a control device B4, and a power amplification unit. B5, a drive unit B6, and a wireless communication device B7. The biological signal detected by the biological signal detection sensor B1 and the detected value of the rotation angle of the joint A6 detected by the angle sensor B2 are stored in the data storage unit B3 and input to the control device B4. As will be described later, the control device B4 generates a control signal so as to obtain a motor torque corresponding to the biological signal, and applies the electric signal amplified by the power amplification unit B5 to the motor of the drive unit B6. To do. The driving unit B6 transmits the driving force to the joint A6 of the trainee A, and rotates the joint A6 of the trainee A. As described above, the motion assisting device B can perform rehabilitation (motor function recovery training) based on the biological signal detected from the trainee A, that is, the intention of the trainee A.

  The spasticity alleviating device C includes spasticity alleviating means C1, a control unit C2, and a wireless communication device C3. When spasticity (spasticity) occurs in the trainee A, the trainee A cannot move the joint A6 as intended because of spasticity. The spasticity alleviating means C1 is means for relieving the spasticity of the trainee A. For the trainee A who is the subject before or just before the rehabilitation by the motion assisting device B according to the command of the control unit C2. To relieve spasticity. Further, when the spasticity alleviating treatment is performed by the spasticity alleviating means C1, the control unit C2 confirms the spasticity alleviating effect and transmits a neurorehabilitation permission signal from the wireless communication device C3 to the operation assisting device B. And the movement assistance apparatus B starts neurorehabilitation, when the neurorehabilitation permission signal transmitted from the spasticity alleviation apparatus C is received.

  Here, neurorehabilitation will be described. Conventionally, as a rehabilitation technique centered on the body, there is a repetitive motion assisting device that mechanically performs walking motion by fixing a body to a harness and restraining a driving portion on a leg. This type of motion assist device simply performs the task of moving the trainee's leg on behalf of the physical therapist. Such simple robot technology alone can provide rehabilitation support that moves the body through repeated movements, but there is a limit to providing neurorehabilitation support that extends to the recovery of nerve functions from the brain and nervous system to peripheral nerves. . In order to exceed the limits of such rehabilitation, it is effective to make full use of cybernics, which is a combined field of human, machine and information systems. Cybernics is a new academic field that fuses and combines brain / neuroscience, psychology, social science, ethics, law, etc. with a focus on Cybernetics, Mechatronics, and Informatics.

  Considering neurorehabilitation from the viewpoint of cybernics, weak biological signals (myoelectric potential, nerve action potential, cardiac potential, brain wave, etc.) generated by bioscience reaction in the living body, physical movement of the musculoskeletal system and the floor surface The body from the brain and nervous system from a comprehensive point of view, such as the interaction, the function of the signal from the γ neuron in the muscle spindle, the interaction between the trainee A and the motion assist device B, and various functions required for the motion assist device B It can be expected to promote functional improvement and functional maintenance up to (musculoskeletal).

  In order to actively promote neurorehabilitation, HAL (Hybrid Assistive) using bioelectrical signal (BES) as neuromuscular activity information derived from the brain / nervous system like the motion assisting device B of the present invention. Limbs) technology is required, and it is important to develop a motion assisting device B that makes full use of cybernics that captures the brain / nervous system and the body of the trainee A together.

  The symptoms of the trainee A are not limited to central nervous system diseases (hemiplegia, etc.) associated with brain damage caused by stroke, etc., for example, paraplegia due to spinal cord injury, physical motor system disorders due to cerebral palsy, Progressive motor disorders (ALS) of upper / lower neurons to the periphery, motor neuropathy (polio) due to poliovirus infection, peripheral nervous system disorders (mainly motor nervous system / limb muscle atrophy, mild Total neuro-rehabilitation brain / nervous system and musculoskeletal system for intractable neuropathy (Charcot-Marie-Tooth disease) due to sensory disorder and muscular disease (muscular dystrophy) with muscle weakness due to progressive muscle atrophy It is expected to improve functions, maintain functions, and suppress deterioration.

  In addition, by rehabilitating the motion assisting device B together with spastic relaxation therapy such as drug administration to the paralyzed muscle group for chronic stroke patients with strong spasticity (spasticity), alleviating excessive muscle tone In addition, neurorehabilitation that considers the action of γ neurons in the muscle spindle and the action of multisynaptic functions of neurons including the mechanism related to α neurons-γ neurons becomes possible. In the training system according to the present invention, the body movement of the trainee A can be supported while detecting the biological signal reflecting the motor intention from the brain / nervous system to the peripheral nerve, so that the neurorehabilitation can be effectively performed.

[Configuration of Spasticity Relief Device C]
Here, the configuration of one embodiment of the spasticity alleviating device C will be described in detail.

  FIG. 2 is a block diagram showing an embodiment of the spasticity alleviating device C. As shown in FIG. 2, the spasticity alleviating device C includes a drug storage unit C1-1, a drug metering unit C1-2, a drug injection unit C1-3, an input operation unit C4, and an authentication / drug dose setting. A section C5 and a timer C6 are included.

  The drug storage unit C1-1 stores a drug for relieving spasticity. As the drug, for example, there is a muscle relaxant that relieves muscle stiffness (over-strained state). Moreover, there exists a botulinum toxin as a muscle relaxation component, and the effect which relieves spasticity (spasticity) is acquired by using the botulinum therapy which administers a botulinum toxin to the paralysis object muscle. The dose of the muscle relaxant is set by inputting an appropriate amount designated by the input operation unit C4, based on the diagnosis result by the doctor. When the authentication data (ID / password) of the operator input by the input operation unit C4 is input to the authentication / drug setting unit C5 together with the input dose, the control unit C2 will be described later. The spasticity relaxation control process 1 is executed. As a method for obtaining authentication of the operator, an authentication method other than a method of inputting authentication data such as an ID / password, for example, a method of reading the operator's own palm or fingertip vein pattern (biometric authentication) as authentication data. good.

  When the authentication data (ID / password) of the operator matches that registered in advance, the medicine is administered according to a command from the control unit C2. That is, the drug measuring unit C1-2 extracts a liquid drug from the drug storage unit C1-1, measures a predetermined dose set in the authentication / drug dose setting unit C5, and performs the administration on the drug injection unit. Supply to C1-3. The drug injection unit C1-3 includes a piston / cylinder mechanism similar to that of a syringe. The piston is driven by an instruction from the control unit C2, and the muscle relaxant (appropriate amount) in the cylinder is paralyzed by the trainee A. Inject into the target muscle. The drug injection position is adjusted to the position of the paralysis target muscle according to the doctor's instruction. Further, as the spasticity alleviating means C1, a drug may be administered according to a command from the control unit C2, or a doctor may administer using a syringe instead of the drug injecting unit C1-3.

[Control processing of spasticity alleviation device C]
FIG. 3 is a flowchart of the spasticity relaxation control process 1. As shown in FIG. 3, the control unit C2 determines in S11 whether or not a drug administration permission signal has been input by the input operation unit C4. If the input of the permission signal is confirmed (YES) In the case), the process proceeds to S12.
In S12, the drug dosage input by the input operation unit C4 is set. Subsequently, in S13, authentication data (ID / password) of the operator (doctor) who performed the input operation is read, and registration authentication of the database is performed. Match data. In S14, it is determined whether or not the input authentication data matches with the registered authentication data in the database registered in advance.

  In S14, when the input authentication data is different from the registration authentication data in the database (in the case of NO), the process proceeds to S15, an error is notified, and the process returns to S13 to prompt the input of the authentication data again. Note that when the number of errors reaches a predetermined number (for example, 3 times), the spasticity relaxation control process 1 may be canceled.

  In S14, if the input authentication data matches the registration authentication data (in the case of YES), the process proceeds to S16, and a command for starting drug administration to the trainee A is configured in the spasticity alleviating means C1. To the medicine storage unit C1-1, the medicine metering unit C1-2, and the medicine injection unit C1-3. Thereby, the medicine measuring unit C1-2 extracts the liquid medicine from the medicine storage unit C1-1, measures the predetermined dose set in the authentication / drug dosage setting unit C5, and injects the administration into the medicine. Part C1-3. Then, the drug injection unit C1-3 injects a set predetermined dose of drug into the paralysis target muscle of the trainee A according to a command from the control unit C2.

  In S17, it is confirmed that the predetermined dose of the drug has been administered, and when it is determined that the drug injection by the drug injection unit C1-3 has been completed (in the case of YES), the process proceeds to S18, and the timer C6 Start timing. In S <b> 19, it is determined whether or not a waiting time T <b> 1 for waiting for a predetermined time until the muscle relaxation effect by the drug administered to the trainee A is obtained has elapsed. Note that the waiting time T1 is set in advance by a doctor in accordance with the type and dose of the medicine to be used.

  In S19, when the standby time T1 has elapsed (in the case of YES), the process proceeds to S20, and the biological signal detected by the biological signal detection sensor B1 is read. The biological signal detection sensor B1 is attached to the skin near the target muscle of the trainee A and detects a myoelectric potential corresponding to the movement of the muscle. The biological signal (myoelectric potential) detected by the biological signal detection sensor B1 is transmitted from the wireless communication device B7 of the motion assisting device B and received by the wireless communication device C3 of the spasticity alleviating device C.

  Subsequently, the process proceeds to S21, in which it is determined whether or not the potential level of the biological signal (BES) detected by the biological signal detection sensor B1 is less than a preset threshold value X1. In addition, when the muscle relaxation effect by a chemical | medical agent appears, since the tension | tensile_strength of the to-be-trained person's A muscle is relieve | moderated, a myoelectric potential will almost become zero. Therefore, the threshold value X1 is set to an arbitrarily low value that assumes a decrease in myoelectric potential.

  In S21, when the potential level of the biological signal detected by the biological signal detection sensor B1 is equal to or higher than the preset threshold value X1 (in the case of NO), it is determined that the muscle relaxation effect due to the drug administration is not yet sufficient, and the process proceeds to S20. Returning, the biological signal detected by the biological signal detection sensor B1 is read again. In S21, when the potential level of the biological signal detected by the biological signal detection sensor B1 is less than the preset threshold value X1 (in the case of YES), it is determined that the muscle relaxation effect by the drug administration can be sufficiently obtained. Then, the process proceeds to S22, in which it is determined whether or not the number of times that the potential level of the biological signal detected by the body signal detection sensor B1 is less than the preset threshold value X1 has reached the preset N times. The N times is an arbitrary number, but it is desirable to make it a plurality of times in order to increase the reliability of the muscle relaxation effect.

  In S22, when the number of times that the potential level of the biological signal after the drug administration becomes less than the preset threshold value X1 has reached N times (in the case of YES), the process proceeds to S23, and the trainee A who has received the drug It is determined that spasticity has been alleviated, and the determination result is notified. In S24, a neurorehabilitation permission signal is transmitted from the wireless communication device C3 to the motion assisting device B. In addition, it is also possible to replace the entire control process (from drug administration permission to neurorehabilitation permission signal transmission) by a doctor / physical therapist's examination / prescription / rehabilitation.

[Configuration of Motion Aid Device B]
Here, the motion assisting device B will be described in detail.

  FIG. 4 is a block diagram showing the system configuration of the control system of the wearable motion assisting apparatus B. As shown in FIG. 4, the control system of the motion assisting device B includes a drive unit B6 that applies assist force to the trainee A, and a joint angle (physical phenomenon) according to the motion of the trainee A. A physical phenomenon detection unit 142 that detects the biological signal, and a biological signal detection unit 144 that detects a biological signal including the biological potential of the trainee A and the like. The drive unit B6 includes a motor 30 of the drive unit 20. When a plurality of drive units 20 are mounted, the drive unit B6 includes a plurality of motors 30. The physical phenomenon detection unit 142 includes an angle sensor B2 that detects the joint rotation angle, and a floor reaction force sensor 260 (see FIGS. 13A and 13B) for a sole or a shoe sole. The biological signal detection unit 144 includes a biological signal detection sensor B1 and biological signal detection sensors 110 and 112 described later.

  The data storage unit B3 stores a reference parameter database 148 and a command signal database 150. In addition, the biological signal detected by the biological signal detection unit 144 is stored in the reference parameter database 148, and further transmitted from the wireless communication device B7 to the spasticity alleviating device C.

  The optional control unit 154 supplies a command signal corresponding to the detection signal of the biological signal detection unit 144 to the power amplification unit B5. The optional control unit 154 applies a predetermined command function f (t) or gain P to the biological signal detection unit 144 to generate a command signal. The gain P may be a preset value or function, and is adjusted via the gain changing unit 156.

  Further, when the input of the biological signal from the biological signal detection unit 144 cannot be obtained, the driving torque (the magnitude of the torque and the torque) of the motor 30 based on the angle data of the knee joint detected by the angle sensor of the physical phenomenon detection unit 142 It is also possible to select a method for controlling the rotation angle.

  The joint angle (θknee, θhip) detected by the angle sensor of the physical phenomenon detection unit 142 and the load data detected by the floor reaction force sensor 260 are input to the reference parameter database 148. The phase specifying unit 152 compares the joint angle detected by the angle sensor of the physical phenomenon detection unit 142 and the load detected by the floor reaction force sensor 260 with the joint angle of the reference parameter stored in the reference parameter database 148 and the load. Thus, the phase of the operation of the trainee A is specified.

  When the autonomous control unit 160 obtains the control data of the phase specified by the phase specifying unit 152, the autonomous control unit 160 generates a command signal according to the control data of the phase and causes the drive unit B6 to generate this power. The command signal is supplied to the power amplifier B5. The autonomous control unit 160 receives the gain adjusted by the gain changing unit 156 described above, generates a command signal corresponding to the gain, and outputs the command signal to the power amplification unit B5. The power amplifying unit B5 controls the current that drives the motor 30 of the driving unit B6, controls the magnitude of the torque of the motor 30 and the rotation angle, and gives the assisting force by the motor 30 to the trainee A. The motor 30 incorporates the angle sensor B2 described above, and is configured to be able to detect the joint operating angle θ by the angle sensor B2.

  As described above, the motion assisting device B controls the motor 30 based on the detection signals detected by the biological signal detection sensors 110 and 112 (see FIG. 6) attached to the left leg of the trainee A. The signal is amplified by the power amplifier B5 and supplied to the motor 30 of the drive unit 20 constituting the drive unit B6, and the torque of the motor 30 is transmitted to the trainee A as an assist force.

  In the motion assisting device B, an optional control system that generates a control signal according to the detection signal of the biological signal detection unit 144 and the joint angle and floor reaction force sensor 260 detected by the angle sensor of the physical phenomenon detection unit 142. Cybernic hybrid control is performed in combination with an autonomous control system that generates a control signal in accordance with phase control data based on the load movement (center of gravity position) detected by the above. That is, when the trainee A tries to move his / her body, his intention to exercise is transmitted as a weak ionic current from the brain A1 shown in FIG. 1 to the spinal cord A2, the nerve A3, the muscle spindle A4, and the muscle A5. The musculoskeletal system with A6 will move. At this time, when a weak biological signal is detected from the skin surface of the trainee A, the optional control unit 154 controls the motor 30 to operate the joint A6 according to the will of the trainee A. Since the motion assisting device B is fastened in close contact with the arm, leg (living part) of the trainee A, the driving force of the motor 30 is trained as an assisting force that rotates the joint A6. Is transmitted to person A.

  Therefore, when the body of the trainee A moves by the assist force of the motion assisting device B, the signal from the muscle spindle A4 returns to the brain A1 via the nerve A3 and the spinal cord A2. Thereby, between the trainee A, the brain A1, and the motion assisting device B, the signal transmission of “brain A1, spinal cord A2, nerve A3, muscle spindle A4, muscle A5, joint A6, motion assisting device B”. The system and biofeedback of a signal transmission system of “motion assisting device B → joint A6 → muscle A5 → muscle spindle A4 → nerve A3 → spinal cord A2 → brain A1” are configured. This is bi-directional cybernic voluntary control, and it is possible to further enhance the effect of neurological function recovery training by neurorehabilitation.

  As described above, the motion assisting device B is configured to sense a biological signal from the brain to the periphery after making a decision regarding exercise and use it for motor control, but the biological signal corresponding to the brain activity is a peripheral muscle activity. I tried to capture from. It is possible to feed back to the brain / nervous system sensed in the periphery in real time. Therefore, functional recovery in the bidirectional signal transmission system can be promoted by performing rehabilitation with the movement assisting device B attached to the trainee A.

  In addition, when a severe motor dysfunction is present, voluntary control does not function in a state in which a biological signal cannot be detected. Therefore, the motor 30 is controlled by a phase-specific control program based on the analysis results of human basic motion patterns and motion mechanisms. The control mode is switched so that the cybernic autonomous control for controlling the function is performed. In such a cybernic hybrid control system in which the voluntary control system and the autonomous control system coexist, for example, even when the body is completely paralyzed, or even in the progression of intractable neurological / muscular disease, depending on the state of the motor function of the body Since the amplitude and signal characteristics of the biological signal also change, rehabilitation can be effectively performed for these symptoms.

[Configuration of Motion Aid Device B]
FIG. 5 is a perspective view showing one embodiment of the wearable movement assist device B. FIG. In FIG. 5, the configuration of the motion assisting device B to be worn on the left leg of the trainee A is illustrated, but the same drive unit 20 (in FIG. 5, (Shown by an alternate long and short dash line) is attached, and illustration of the movement assisting device B for the right leg is omitted.

  As shown in FIG. 5, the motion assisting device B is connected to the support portion 62 of the waist belt 60 attached to the waist of the trainee A, for example, so that the drive unit 20 is attached to the knee joint of the left leg. A description will be given of the case. Further, on the rear side of the waist belt 60, a control device B4 for controlling the drive unit 20 and a battery 102 are mounted.

  The drive unit 20 includes a motor 30, a first transmission member 40, and a second transmission member 50. The motor 30 is disposed on the side of the left knee joint of the trainee A. The first transmission member 40 is fastened to the left thigh of the trainee A via fastening members 80 and 82, and the second transmission member 50 is fastened to the left shin of the trainee A by fastening members 90 and 92. It is concluded through. The fastening members 80, 82, 90, and 92 are made of cloth belts and the like, and have insertion portions 81, 83, 91, and 93 through which the transmission members 40 and 50 are inserted.

  The drive unit 20 can be selectively mounted so as to assist the operation of any joint among the joints of the arms and legs. Further, the drive unit 20 can be combined so as to assist a plurality of joints of the same trainee A, and arbitrarily assists any joint desired by the trainee A among the joints of the arms and legs. Can be mounted to

  Since the motion assisting device B can be attached only to the left knee joint of the trainee A, for example, exercise function recovery training (rehabilitation) after receiving treatment or surgery for the left knee joint can be performed. it can. In addition, since the exercise function recovery training using the motion assisting device B can be performed even when the trainee A is sleeping on the bed or the trainee A is sitting on the chair, it is impossible for the trainee A. It is possible to appropriately perform exercise function recovery training without imposing a burden.

[Motor function recovery training using motion assist device B]
FIG. 6 is a side view showing an operation state when the wearable movement assist device is worn on the left leg of the wearer. FIG. 7 is a rear view showing an operation state when the wearable movement assist device is worn on the left leg of the wearer.

  As shown in FIGS. 6 and 7, when performing exercise function recovery training of the left knee joint of the trainee A, the motion assisting device B is attached to the knee joint of the left leg. In addition, the first transmission member 40 coupled to the first coupling portion 36 of the motor 30 is attached to the left leg thigh of the trainee A with the cuffs 72 and 74 being in close contact with the fastening members 80 and 82. Fastened and integrated with the left leg thigh of the trainee A. Further, the first transmission member 40 is firmly held together with the fastening members 80 and 82 by belts 84 and 86 (see FIG. 5).

  Further, the second transmission member 50 is integrated with the outer circumference of the trainee A via the fastening member 90 and is also integrated with the ankle of the trainee A via the fastening member 92. Therefore, each of the transmission members 40 and 50 can support the weight applied to the left leg of the trainee A. Even if the muscle strength of the left leg of the trainee A is reduced by the spasticity alleviating device C, Trainer A can perform walking training.

  Further, in a state where the motion assisting device B is worn, the thigh and the first transmission member 40 are fixed so that the trainee A is sitting on the chair and the lower part is bent forward or backward from the knee. Then, since the muscle does not operate due to the action of the above-described spasticity alleviating device C, the myoelectric potential is not detected, but the nerve transmission system biological signal transmitted from the brain A1 of the trainee A to the nerve A3 is the biological signal detection sensor 110. , 112 (B1). The torque (driving force) of the motor 30 controlled based on the detection signals detected by the biological signal detection sensors 110 and 112 is transmitted to the second transmission member 50, and the knee joint angle is changed from 180 degrees to 120 degrees. Can be bent into In addition, since the movement assist device B is attached to both the left and right legs of the trainee A to perform exercise function recovery training for both legs, each biological signal sensor (not shown) is attached to the right leg as well as the left leg. .

  At this time, the control of the motor 30 is performed based on the control signal generated by the control device B4. Further, the control device B4 performs motor control processing (control program) based on biological signals (biological potentials) detected by the biological signal detection sensors 110 and 112 attached to the front and rear sides of the thigh of the left leg. Execute.

  Accordingly, the trainee A senses the state of the knee joint by himself / herself, and the torque and rotation of the motor 30 by the nerve transmission system biological signal from the brain A1 and the motor system biological signal (myoelectric potential) accompanying the movement of the muscle. The angle can be adjusted, and exercise function recovery training (rehabilitation) can be performed so as not to apply excessive force to the knee joint.

  Further, since the drive unit 20 can be appropriately mounted so that the trainee A can sleep on a bed in a hospital, for example, so as to correspond to any joint, the exercise function while assisting the motion of the joint desired by the trainee A Recovery training can be performed efficiently.

  Moreover, if the trainee A is in a standing posture, walking training can be performed using the motion assisting device B.

[Control processing of neurorehabilitation]
FIG. 8 is a flowchart of the standby mode (control mode 1) of the wearable motion assisting apparatus B. As shown in FIG. 8, when the power switch is turned on in S31, the control device B4 of the motion assisting device B proceeds to S32 and sets the standby mode. This standby mode is a control process for transmitting a neurorehabilitation permission signal, and is a control mode at a stage before transition to the rehabilitation mode.

  In S33, the biological signal detected by the biological signal detection sensors 110 and 112 is read. Since the biological signal at this time cannot operate the muscle with the intention of the trainee A due to the action of the medicine (muscle relaxant), the biological signal due to the myoelectric potential is almost lowered to a level of zero. If the trainee A does not intend to move the body, the nerve transmission system biological signal transmitted from the brain A1 of the trainee A to the nerve A3 is also at a low level.

  In the next S34, the low-level biological signal detected by the biological signal detection sensors 110 and 112 is transmitted from the wireless transmitter B7 to the spasticity alleviating device C. Then, it progresses to S35 and the request | requirement of the neurorehabilitation permission signal is transmitted to the spasticity relief apparatus C.

  In next S36, it is determined whether or not a neurorehabilitation permission signal from the spasticity alleviating device C has been received. In S36, when the neurorehabilitation permission signal cannot be received (in the case of NO), the process proceeds to S37, in which it is determined whether or not the number of unreceivable times is the Nth time which is a predetermined number. In S37, when the number of unreceivable times is less than the Nth time (in the case of NO), the process returns to S33, the biological signal is read again, and the control processing of S33 to S36 is repeated.

  In S36, when the neurorehabilitation permission signal is received from the spasticity alleviating device C (YES), the process proceeds to S39, and the control mode is set to the rehabilitation mode. In this case, since it is determined that the spasticity of the trainee A administered with the drug is in a relaxed state, neurorehabilitation using the motion assisting device B is performed.

  In S37, if the number of unreceivable times reaches the Nth time (in the case of YES), the process proceeds to S40, where it is determined that the neurorehabilitation permission signal from the spasticity alleviating device C is not transmitted, and the rehabilitation impossible is notified. In this case, since it is determined that the spasticity of the trainee A who has been administered the drug is not alleviated, the neurorehabilitation using the motion assisting device B is not performed.

  FIG. 9 is a flowchart of the rehabilitation mode (control mode 2) of the wearable motion assist device. As shown in FIG. 9, the control device B4 determines whether or not the rehabilitation mode is set in S41. If the rehabilitation mode is set in S39 described above (YES), the process proceeds to S42. The control mode is switched to the rehabilitation mode. Subsequently, in S43, the biological signal detected by the biological signal detection sensors 110 and 112 is read. At this time, since the trainee A intends to move the body, the detection level of the nerve transmission system biological signal transmitted from the brain A1 of the trainee A to the nerve A3 increases.

  In next S44, it is determined whether or not the biological signal detected by the biological signal detection sensors 110 and 112 is larger than a preset threshold value X2. In S44, when the detected biological signal is smaller than the preset threshold value X2 (in the case of NO), the process proceeds to S45, and the motor torque is reduced, so that the amplification factor of the power amplification unit B5 is increased by a predetermined percentage. In S44, when the detected biological signal is larger than the preset threshold value X2 (in the case of YES), the process proceeds to S46, and the control amount (control signal) of the motor 30 is calculated. The threshold value X2 may be lower in the biosignal level than in the case where the drug is not used due to the symptoms of the trainee A and the effectiveness of the spasticity mitigation effect due to the administered drug. Adjust as appropriate.

  In the next S47, the control signal calculated in S46 is output and the drive control of the motor 30 is started. Thereby, neurorehabilitation by the motion assisting device B is started, and the knee joint of the left leg of the trainee A is operated. Since the motor torque at this time is based on the nerve transmission system biological signal of the trainee A, the trainee A himself can adjust it according to the state of the knee joint, and at the beginning, the motor torque is operated slowly. It is also possible to gradually increase the pitch while adjusting depending on the number of operations. Therefore, even if the trainee A wears the motion assisting device B, the burden on the body is small, and rehabilitation can be performed with peace of mind even in a situation where muscle strength cannot be exerted due to the spasticity alleviating effect.

  In next S48, the joint operating angle θ detected by the angle sensor B2 is read. Subsequently, the process proceeds to S49, in which it is determined whether or not the joint operation angle θ detected by the angle sensor B2 has reached a preset target operation angle θ1. In S49, when the joint operation angle θ does not reach the target operation angle θ1 (in the case of NO), the process returns to S46, and the processes of S46 to S49 are repeated. The target operation angle θ1 is set to an arbitrary angle according to the symptom of the trainee A.

  In S49, when the joint operating angle θ reaches the target operating angle θ1 (in the case of YES), the process proceeds to S50 and the motor 30 is stopped. Subsequently, in S51, the motor 30 is reversely rotated. As a result, the joint of the trainee A returns to the initial angle from the target motion angle θ1.

  In S52, the joint operation angle θ detected by the angle sensor B2 is read to check the return of the joint. In S53, it is determined whether or not the joint operation angle θ has returned to the initial value before rehabilitation. To do. When the joint operating angle θ reaches the initial value before rehabilitation in S53, the process proceeds to S54 and the motor 30 is stopped.

  Subsequently, in S55, 1 is added to the number of rehabilitations n. In S56, when the number of rehabilitations does not reach the preset target number nmax (in the case of NO), the process returns to S43, and the processes of S43 to S56 are repeated. In S56, when the number of rehabilitations reaches a preset target number nmax (in the case of YES), the current neurorehabilitation is terminated. The target number of times nmax is set to an arbitrary number according to the symptom of the trainee A.

[Recovery process of nervous system by neurorehabilitation]
FIG. 10 is a diagram schematically showing the recovery process of the nervous system by neurorehabilitation. For example, in the case of acute stroke, there is a case where the motion command from the upper center cannot be sent normally, and the mechanism of the recovery process will be described below.

[Recovery process 1]
As shown in FIG. 10A, a muscle spindle A4 that transmits a signal from the brain A1 is formed between the nerve A3 and the extrapyramidal muscle A5-1. The muscle spindle A4 includes an α motor neuron 170, a γ motor neuron 172, a afferent group Ia fiber 174, and a afferent group II fiber 176. The proximal ends of the γ motor neuron 172, the afferent group Ia fiber 174, and the afferent group II fiber 176 are the nucleus chain fiber (intra-conical muscle) 178 formed in the extrapyramidal muscle A5-1 and the nuclear bladder fiber (intra-conical), respectively. Connected to line 180). In addition, the nucleus chain fiber (intra-conical muscle) 178 and the nuclear bladder fiber (intra-conical muscle) 180 have sensory nerve endings 182.

[Recovery process 2]
From the acute phase to the chronic phase of stroke, spasticity (spasticity) occurs due to increased stretch reflex. As shown in FIG. 10 (B), the mechanism of this spasticity (spasticity) occurs because the inhibition of the central nervous system does not work due to a disorder of the central nervous system, so that the α motor neuron 170 moves away from the nerve A3. It is considered that muscle tension is increased by connecting with the afferent group Ia fiber 174 to form a local loop, and spasticity (spasticity) is generated. In addition, the command from the superior center that suppresses the action of the γ-motor neuron 172 that contracts the nuclear bladder fiber (conical muscle) 180 is removed, and the afferent group Ia fiber 174 continues to be activated, so that it is chemically activated at the nerve ending synapse. The local loop that connects the α motor neuron 170 and the afferent group Ia fiber 174 is strengthened by the release of the transmitter substance (acetylcholine).

[Recovery process 3]
In the chronic stroke phase, for example, administration of a drug (muscle relaxant) as a spasticity alleviating means suppresses the enhancement of stretch reflex and relieves spasticity (spasticity). That is, as illustrated in FIG. 10C, when a drug (muscle relaxant) is administered during the stroke chronic phase, the drug (muscle relaxant) is administered during the chronic phase associated with spasticity (spasticity). In addition, the synapse of nerve endings inhibits the release of chemical mediators (acetylcholine) and suppresses the phenomenon of enhanced stretch reflex through α motor neurons 170 and γ motor neurons 172. As a result, the local loop connecting the α motor neuron 170 and the afferent group Ia fiber 174 is cut. In the present invention, not only spasticity-relieving means by drug administration, but also spasticity-relieving means for relieving spasticity by causing muscle contraction by functional electrical stimulation or therapeutic electrical stimulation described later can be selectively used. is there.

[Recovery process 4]
Thus, in the stroke chronic phase, administration of a drug (muscle relaxant) suppresses the phenomenon of enhanced stretch reflex through the α motor neuron 170 and γ motor neuron 172, that is, a state in which the muscle strength of the muscle decreases. Thus, exercise training by voluntary control of the motion assisting device B is possible, and the connection of the nervous system is restored by exercising with the assist force of the motion assisting device B being given to the trainee A together with spasticity relief by drug administration. The That is, as shown in FIG. 10 (D), the spasticity (spasticity) of the trainee A is relieved by the spasticity mitigating effect associated with the drug administration, but the effect of this spasticity mitigation is also accompanied by a decrease in muscle strength. By performing neurorehabilitation using the motion assisting device B within the obtained period, the α motor neuron 170 is separated from the afferent group Ia fiber 174 and connected to the nerve A4, so that the motor function of the trainee A can be recovered. It becomes. This motor function recovery can be realized by bidirectional cybernic voluntary control having biofeedback using the motion assisting device B described above, together with the spasticity alleviating effect accompanying drug administration.

[Modified example of spasticity relief device]
FIG. 11 is a block diagram showing a modification of the spasticity alleviating device. As shown in FIG. 11, the spasticity alleviating device C ′ according to the modified example has functional electrical stimulation (FES) or therapeutic electrical stimulation on the peripheral nerve of the paralysis target site (spastic site) of the trainee A. It is a physical therapy means for imparting (TES: Therapeutic Electric Stimulation), and includes an authentication / electric stimulation condition setting unit C7 and a spasticity alleviation means C8.

  The authentication / electrical stimulation condition setting unit C7 is an electrical stimulation input based on the authentication data (ID / password) of the doctor or the physical therapist input by the operation of the input operation unit C4 and the diagnosis of the doctor or the physical therapist. Set conditions (conditions such as stimulation frequency, pulse width, pulse waveform / modulation, voltage, etc.).

  The spasticity alleviating means C8 is means for relieving spasticity by causing muscle contraction by electrical stimulation, and includes a stimulation frequency adjusting unit C8-1, a pulse width adjusting unit C8-2, and a pulse waveform / modulation adjusting unit C8. -3, a voltage adjustment unit C8-4, an electrical stimulation signal generation unit C8-5, and an electrode C8-6. The stimulation frequency adjustment unit C8-1 adjusts the stimulation frequency of the electrical stimulation to the frequency set by the authentication / electrical stimulation condition setting unit C7. The pulse width adjustment unit C8-2 adjusts the pulse width of the electrical stimulation to the pulse width set by the authentication / electric stimulation condition setting unit C7. The pulse waveform / modulation adjustment unit C8-3 adjusts the pulse waveform of the electrical stimulation to the pulse waveform set by the authentication / electric stimulation condition setting unit C7. The voltage adjustment unit C8-4 adjusts the voltage of the electrical stimulation to an arbitrary voltage set by the authentication / electrical stimulation condition setting unit C7.

  The electrical stimulation signal generation unit C8-5 includes a stimulation frequency adjustment unit C8-1, a pulse width adjustment unit C8-2, a pulse waveform / modulation adjustment unit C8-3, and a voltage adjustment unit C8-4. An electric signal whose waveform, modulation, and voltage are adjusted is output to the electrode C8-6. The electrode C8-6 is affixed to the skin of the part to be paralyzed of the trainee A, and applies electrical stimulation to muscles that are considered to have spasticity (spasticity). Thereby, the spasticity due to the paralysis of the trainee A is relieved, and the symptoms of convulsions associated with the onset of spasticity (spasticity) are also relieved, so that the biosignal detection accuracy by the biosignal detection sensors 110 and 112 is improved. In addition, the electrode C8-6 is not limited to the one attached to the skin, but the electrode C8-6 penetrates the skin from outside the body and extends to the vicinity of the stimulating nerve, or the element embedded near the nerve according to the non-contact operation from outside the body. Can be selected from a plurality of methods.

[Spasticity alleviation control process 2 by modification of spasticity alleviation device]
FIG. 12 is a flowchart of the spasticity relaxation control process 2. As shown in FIG. 12, the control unit C2 of the modified example determines whether or not a permission signal for functional electrical stimulation (FES) or therapeutic electrical stimulation (TES) by a doctor or a physical therapist is input in S61. If it is determined and the permission signal is input (in the case of YES), the process proceeds to S62. In S62, the electrical stimulation conditions (stimulation frequency, pulse width, pulse waveform / modulation, voltage, and other conditions) set by operating the input operation unit C4 are read from the authentication / electric stimulation condition setting unit C7.

  Subsequently, the process proceeds to S63, in which the authentication data (ID / password) input by the operation of the input operation unit C4 is read and collated with the registered authentication data in the database. In the next S64, it is determined whether or not the input authentication data matches the registration authentication data in the database. If it is determined in S64 that the input authentication data does not match the registration authentication data in the database (in the case of NO), it is determined that the operator is an unqualified person who has not been registered in advance, and the process proceeds to S65. An error is reported. Then, the process returns to S63, and authentication data is re-input.

  If it is determined in S64 that the input authentication data matches the registration authentication data in the database (in the case of YES), the operator is determined to be a qualified person registered in advance, and the process proceeds to S66. Conditions for electrical stimulation (conditions such as stimulation frequency, pulse width, pulse waveform / modulation, voltage, etc.) are set to stimulation frequency adjustment unit C8-1, pulse width adjustment unit C8-2, pulse waveform / modulation adjustment unit C8-3, voltage adjustment. Output to part C8-4 to start electrical stimulation. That is, the stimulation frequency adjusted by the stimulation frequency adjustment unit C8-1, the pulse width adjustment unit C8-2, the pulse waveform / modulation adjustment unit C8-3, and the voltage adjustment unit C8-4 from the electrical stimulation signal generation unit C8-5. , Electrical signals of pulse width, pulse waveform / modulation, and voltage are output to the electrode C8-6. This electrical stimulation relieves spasticity caused by paralysis of the trainee A, and also relieves symptoms of convulsions associated with the onset of spasticity (spasticity).

  In the next S67, the time measurement by the timer T is started, and in S68, it is determined whether or not the count value T of the timer T has reached a predetermined time T2 (for example, several seconds to several tens of seconds). In S68, when the count value T of the timer T reaches the time T2 (in the case of YES), the process proceeds to S69, and the electrical stimulation is stopped. The time T2 is an application time of electrical stimulation, and is set in advance based on a diagnosis of a doctor or a physical therapist.

  Subsequently, in S70, the biological signal detected by the biological signal detection sensors 110 and 112 is read, and in S71, it is determined whether or not the level of the biological signal (BES) is smaller than the threshold value X3. When electrical stimulation is applied from the electrode C8-6 to the paralyzed site of the trainee A to reduce spasticity (spasticity) and suppress convulsions, the detection level of the biological signal is lowered. Therefore, in S71, when the level of the biological signal is larger than the threshold value X3 (in the case of NO), the process returns to S66, and the application of the electrical stimulation is executed again.

  In S71, when the level of the biological signal is smaller than the threshold value X3 (in the case of YES), the process proceeds to S72, and it is checked whether or not a predetermined number of times N has been reached. In S72, when the number of times that the level of the biological signal is smaller than the threshold value X3 has not reached the predetermined number N (in the case of NO), the process returns to S66 and the processes of S66 to S72 are repeated.

  In S72, when the number of times that the level of the biological signal is smaller than the threshold value X3 reaches the predetermined number N (in the case of YES), the process proceeds to S73, where it is determined that the effect of reducing spasticity is obtained by electrical stimulation. Then, it progresses to S74 and transmits the permission signal of neurorehabilitation from the radio | wireless communication apparatus C3 with respect to the movement assistance apparatus B. FIG.

  As described above, by performing neurorehabilitation by the motion assisting device B while reducing spasticity by electrical stimulation, it is possible to recover the motor function in the muscle spindle A4 shown in FIGS. 10 (A) to 10 (D).

[Variation 1 of Wearable Movement Aid Device]
FIGS. 13A and 13B are perspective views showing a mounting state of the first modification of the mounting-type motion assisting device. As illustrated in FIG. 13A, the motion assisting device 200 of the first modification has a configuration in which the first drive unit 20 and the second drive unit 220 are combined. The first drive unit 20 is for knee joint drive as in the above-described embodiment, and the second drive unit 220 is for hip joint drive. In FIG. 13A, the configuration of the motion assisting device 200 to be worn on the left leg of the trainee A is illustrated, but the same drive unit 20 (in FIG. (Shown by a one-dot chain line) may be attached. In addition, illustration of the movement assistance apparatus of a right leg is abbreviate | omitted. Further, the motion assisting device 200 can perform the walking training of the trainee A, and each transmission member can support the weight of the wearer A even when the muscle strength of both legs is reduced. The trainee A can be assisted so as not to lose his balance during walking training.

  The second drive unit 220 includes a motor 30A disposed on the side of the left hip joint, a third transmission member 230 inserted through the insertion portion 64 provided on the left side of the waist belt 60, and a first transmission member. 40 and a fourth transmission member 240 coupled to 40. The motor 30 </ b> A of the second drive unit 220 is common to the motor 30 of the first drive unit 20.

  The third transmission member 230 is formed of, for example, a metal such as stainless steel or carbon fiber (carbon fiber), and the total length is selected according to the height position of the hip joint of the trainee A. . The third transmission member 230 has a lower end coupled to the first coupling portion 36 of the motor 30 </ b> A and an upper end held by the insertion portion 64 of the waist belt 60. Therefore, the third transmission member 230 is attached so as to transmit the torque of the motor 30A to the waist (first body part) of the trainee A.

  The fourth transmission member 240 is formed in a long and narrow plate shape using, for example, a metal such as stainless steel or carbon fiber (carbon fiber), and the upper end is coupled to the second coupling portion 38 of the motor 30A. The lower end of the fourth transmission member 240 is connected to the connection member 48 of the first transmission member 40. That is, the fourth transmission member 240 is attached so as to transmit the torque of the motor 30A to the left thigh (second body part) of the trainee A.

  In the motion assisting device 200 of the first modification, the first drive unit 20 for driving the knee joint and the second drive unit 220 for driving the hip joint are coupled by the first transmission member 40 and the fourth transmission member 240. In this configuration, the plurality of motors 30 and 30A can be controlled to assist each joint. In the case of the first modification, the biological signal detection sensors 110 and 112 for assisting the operation of the left knee joint are affixed to the skin of the left thigh of the trainee A, and the operation of the left hip joint is assisted. The biological signal detection sensors 114 and 116 are also attached to the front and back portions of the left hip joint. Each biological signal sensor (not shown) is attached to the right leg as well as the left leg.

  Thereby, the motor 30 of the first drive unit 20 is controlled in magnitude and rotation angle of the torque based on the detection signal of the bioelectric potential (biological signal) detected by the biosignal detection sensors 110 and 112. In addition, the motor 30A of the second drive unit 220 has a magnitude of torque based on the detection signal of the bioelectric potential (biological signal) detected by the biosignal detection sensors 114 and 116 attached to the front and rear of the left hip joint. The rotation angle is controlled.

  As described above, the motion assisting device 200 is configured to connect the plurality of drive units 20 and 220 according to the intention of the trainee A, so that the left knee joint with the torque (assist force) of the motors 30 and 30A It is possible to perform exercise recovery of the left hip joint.

  Furthermore, the load and the gravity center position which act on a sole can also be used as control information used for motor function recovery training. As shown in FIG. 13A, a floor reaction force sensor 260 provided on the sole side (the sole side) of the fastening member 92 that is attached to the ankle and is in contact with the floor surface, or shown in FIG. 13B. As described above, the load detection signals detected by the pair of floor reaction force sensors 260 provided on the sole of the dedicated shoe 250 and the data of the center of gravity position based on each load detection signal are the reference parameter database 148 of the data storage unit 146. Stored in Then, the phase specifying unit 152 specifies the phase of movement of the trainee A by comparing the joint angle of the reference parameter acquired from the reference parameter database 148 with the load.

  Further, when walking training is performed using the dedicated shoes 250, the held portion 58 formed at the lower end of the second transmission member 50 is inserted into the side connection portion 252 of the dedicated shoes 250 from above and connected to the dedicated shoes 250. Let The floor reaction force detection signal detected by the floor reaction force sensor 260 is transmitted to the control device B4 by wire or wirelessly.

  Therefore, in the first modification, the movement assist device 200 is attached to the trainee A, and the spasticity of the trainee A is relieved by the spasticity alleviating devices C and C ′ described above. It is possible to perform neurorehabilitation. That is, by performing neurorehabilitation by the motion assisting device 200 while reducing spasticity by the spasticity alleviating devices C and C ′, it is possible to recover the nerve function in the muscle spindle A4 shown in FIGS. 10 (A) to (D). It becomes.

  Even in the case where the motion assisting device 200 of the first modification is used, the control processing shown in FIGS. 3, 8, and 9 or the control processing shown in FIGS. The control process shown in FIG. 12 is executed by the control system shown in FIG.

[Variation 2 of Wearable Movement Aid Device]
FIG. 14 is a perspective view showing a wearing state of the second modification of the wearing type movement assist device. FIG. 14 is a perspective view showing a mounting state of the second modification. As illustrated in FIG. 16, the motion assisting device 300 according to the second modification includes a drive unit 310 that assists the elbow joint of the right arm of the trainee A. The drive unit 310 includes a motor 30 disposed on the side of the right elbow joint, a first transmission member 40 disposed along the upper arm above the right elbow joint, and a lower arm below the right elbow joint. And a second transmission member 50 arranged so as to be along. The motor 30 has the same configuration as the motors of the above-described embodiment and modification 1, and is shared.

  The first transmission member 40 is fastened to the upper right arm (first body part) of the trainee A via fastening members 80 and 82, and the second transmission member 50 is the lower right arm of the trainee A ( Fastened to the second body part) via fastening members 90, 92. Moreover, the 1st transmission member 40 and the 2nd transmission member 50 are the same structures as the Example mentioned above, and the full length is formed in the dimension according to the length of the said trainee's A arm. .

  Biological signal detection sensors 118 and 119 are attached to the front and rear sides of the upper arm of the trainee A. Therefore, when the trainee A tries to rotate the right elbow joint, the biological signal detection sensors 118 and 119 output detection signals of the bioelectric potential (biological signal) of the upper arm. Then, similarly to the drive unit 20 described above, the motor 30 of the drive unit 310 generates torque based on the detection signal of the bioelectric potential (biological signal) of the upper arm detected by the biological signal detection sensors 118 and 119 by the control device B4. The size and rotation angle are controlled.

  In this manner, the motion assisting device 300 can perform exercise function recovery training for the elbow joint of the right arm using the torque (assist force) of the motor 30 of the drive unit 310 according to the intention of the trainee A. The drive unit 310 has basically the same configuration as the other drive units 20 and 220 described above, and the motor 30 is shared. Therefore, what is necessary is just to select suitably the full length of the 1st transmission member 40 and the 2nd transmission member 50 according to the length of the said trainee's A arm.

  In addition, the motion assisting device 300 according to the modified example 2 includes the drive unit 310 that drives the elbow joint, but it is also possible to connect a drive unit that drives the shoulder joint of the trainee A. It is also possible to perform exercise function recovery training of both arms by attaching the motion assisting device 300 to the left and right arms of the trainee A.

  Therefore, in the modified example 2, while attaching the said movement assistance apparatus 300 to the trainee A, and reducing the spasticity of the trainee A with the spasticity alleviating devices C and C ′ described above, the same as in the above-described embodiment. It is possible to perform neurorehabilitation. That is, by performing neurorehabilitation by the motion assisting device 300 while reducing spasticity by the spasticity alleviating devices C and C ′, it is possible to recover the nerve function in the muscle spindle A4 shown in FIGS. 10 (A) to (D). It becomes.

  Even in the case where the motion assisting device 300 according to the modified example 2 is used, the control processing shown in FIG. 3, FIG. 8, FIG. 9 or the control processing shown in FIG. The control process shown in FIG. 12 is executed by the control system shown in FIG.

[Modification 3 of Wearable Movement Aid Device]
FIG. 15 is a perspective view showing a third modification of the wearable movement assist device. As shown in FIG. 15, the motion assisting device 400 is an integrated type in which each transmission member to be attached to the left and right legs is integrally formed, and a waist support 430 to be attached to the waist of the trainee A, A right leg auxiliary transmission portion 454 provided downward from the right side of the waist support 430 and a left leg auxiliary transmission portion 455 provided downward from the left side of the waist support 430. In the movement assist device 400, the waist support 430, the right leg auxiliary transmission unit 454, and the left leg auxiliary transmission unit 455 are integrated, so that the trainee A has reduced muscle strength of both legs. Even in this case, since each of the transmission units 454 and 455 can support the weight of the wearer A, the trainee A can be assisted so as not to lose his balance during walking training. In addition, when the wearer's one leg is healthy, the so-called one leg type of the modified example 3 that is worn only on either the left or right leg can be used. Specifically, it is a state in which a partial set of any leg portion (from the waist connection mechanism 500 to the lower third transmission member 462) is removed.

  The waist support 430 has a waist support portion 410 formed of a metal material such as rigid duralumin or aluminum alloy, for example, and a gap between the back surface of the trainee A and the waist back side is formed inside the back surface. A fitting part 431 that is closely attached is attached. And the fitting part 431 consists of sponge or a low-resilience resin material, etc., contacts the trainee A's waist back side, and protects the trainee A's waist.

  The right leg auxiliary transmission part 454 and the left leg auxiliary transmission part 455 are arranged symmetrically, and a lower part connection mechanism 500 connected to the waist support 430 and a lower part of the lower part connection mechanism 500 are extended to be trained. The first transmission member 458 formed along the thigh side of the person A and the second transmission member 458 extending downward from the first transmission member 458 and formed along the side of the shin of the trainee A Transmission member 460 and a third transmission member 462 on which the back of the leg of the trainee A (a shoe sole in the case of wearing shoes) is placed.

  Between the lower end of the waist connection mechanism 500 and the upper end of the first transmission member 458, a first joint 464 having a bearing structure is interposed, and the waist connection mechanism 500 and the first transmission member 458 are rotated. It is linked movably. The first joint 464 is provided at a height position that coincides with the hip joint, the waist connection mechanism 500 is fastened to the support side of the first joint 464, and the first transmission member 458 rotates the first joint 64. Is fastened to the side. The first joint 464 constitutes a motor unit in which the drive motors 420 and 422 are built, and the first joint 64 and the drive motors 420 and 422 are integrated in appearance.

  Further, a second joint 466 having a bearing structure is interposed between the lower end of the first transmission member 458 and the upper end of the second transmission member 460, and the first transmission member 458 and the second transmission member 458 are interposed. The transmission member 460 is rotatably connected. The second joint 466 is provided at a height position that coincides with the knee joint, the first transmission member 458 is fastened to the support side of the second joint 466, and the second transmission member 460 is connected to the second joint 466. It is fastened to the rotating side. The second joint 466 constitutes a motor unit in which drive motors 424 and 426 are built, and the second joint 466 and the drive motors 424 and 426 are integrated in appearance.

  Further, a third joint 468 having a bearing structure is interposed between the lower end of the second transmission member 460 and the upper end of the third transmission member 462, and the second transmission member 460 and the third transmission member 460 are arranged. The transmission member 462 is rotatably connected. In addition, a shoe 484 for wearing the foot of the trainee A is fixed inside the third transmission member 462.

  Accordingly, the first transmission member 458 and the second transmission member 460 perform a walking motion with the first joint 464 and the second joint 466 as pivot points with respect to the waist connection mechanism 500 fixed to the waist support 430. It is attached so that it can be done. That is, the first transmission member 458 and the second transmission member 460 are configured to perform the same operation as the leg of the trainee A. The third joint 468 is provided so as to be located on the side of the ankle of the trainee A. Therefore, the angle of the shoe 484 with respect to the floor surface (or the ground) changes in the same manner as the ankle of the trainee A according to the walking motion by the turning motion of the third joint 468.

  Further, the first joint 464 and the second joint 466 are connected to the first transmission member 458 and the second transmission member 460 in which the rotation shafts of the drive motors 420, 422, 424, and 426 are driven via gears. The driving torque is transmitted.

  Further, the drive motors 420, 422, 424, and 426 have angle sensors (not shown) that detect joint rotation angles. The angle sensor includes, for example, a rotary encoder that counts the number of pulses proportional to the joint angles of the first joint 464 and the second joint 466, and outputs an electrical signal corresponding to the number of pulses corresponding to the joint rotation angle as a sensor output. Output as.

  The angle sensor of the first joint 464 detects the rotation angle between the waist support 430 and the first transmission member 458 corresponding to the joint angle of the hip joint of the trainee A. Further, the angle sensor of the second joint 466 detects a rotation angle between the lower end of the first transmission member 458 and the second transmission member 460 corresponding to the joint angle of the knee joint of the trainee A.

  A belt-like thigh fastening member 478 that is fastened to the thigh of the trainee A is attached to an intermediate position in the longitudinal direction of the first transmission member 58. On the inner surface side of the thigh fastening member 478, a fitting portion 479 that is in close contact with the thigh of the trainee A without a gap is attached.

  Further, a belt-shaped shin fastening member 480 that is fastened to the shin below the knee of the trainee A is attached to an intermediate position in the longitudinal direction of the second transmission member 460. On the inner surface side of the shin fastening member 480, a fitting portion 481 that is in close contact with the shin of the trainee A is attached.

  Accordingly, the drive torque generated by the drive motors 420, 422, 424, and 426 is transmitted to the first transmission member 458 and the second transmission member 460 via gears, and further, the thigh fastening member 478 and the shin fastening member 480. Is transmitted as an assisting force to the leg of the trainee A.

  A shoe 484 is rotatably connected to the lower end of the second transmission member 460 via a third joint 468. The first transmission member 458 and the second transmission member 460 are adjusted to the length corresponding to the length of the leg of the trainee A.

  Each transmission member 458, 460, 462 is configured to cover the periphery of a metal material reduced in weight such as duralumin with a resin material having elasticity, and the weight and waist support 430 of the trainee A, battery, It can support the mass of a control unit (both not shown). That is, the motion assisting device 400 is configured such that the masses of the waist support 430, the battery, and the control unit do not act on the trainee A.

  The waist support 430 includes a waist support portion 410 made of a metal material having a fitting portion 431 that abuts on the back waist (back) of the trainee A at the center of the inner peripheral surface, and both ends of the waist support portion 410 via hinges. The belts 520 and 521 are connected to each other, the buckle 522 is attached to the end of one belt 520, and the locking metal fitting 524 is attached to the end of the other belt 521.

  When the waist support 430 is mounted on the waist of the trainee A, the waist support 430 is locked to the insertion opening of the buckle 522 with the back side of the waist in contact with the fitting portion 431 provided inside the waist support portion 410. The metal fitting 524 is inserted and locked. Then, the lengths of the belts 520 and 521 are adjusted to the length corresponding to the size of the stomach of the trainee A. Thereby, the waist support body 430 will be in the holding state closely_contact | adhered to the outer periphery of the to-be-trained person's A waist circumference. Further, the buckle 522 has a configuration similar to that of an automobile seat belt, and is configured such that the locking of the locking metal fitting 524 can be released by operating the locking release portion.

  Therefore, in the third modification, the movement assisting device 400 is attached to the trainee A, and the spasticity of the trainee A is relieved by the spasticity alleviating devices C and C ′ described above. It is possible to perform neurorehabilitation. That is, by performing neurorehabilitation by the motion assisting device 400 while reducing spasticity by the spasticity alleviating devices C and C ′, it is possible to recover the nerve function in the muscle spindle A4 shown in FIGS. 10 (A) to (D). It becomes.

  Even in the case where the motion assisting device 400 according to the third modification is used, the control processing shown in FIG. 3, FIG. 8, FIG. 9, or FIG. The control process shown in FIG. 12 is executed by the control system shown in FIG.

A Trainee A1 Brain A2 Spinal cord A3 Nerve A4 Muscle spindle A5 Muscle A5-1 Extrapyramidal muscle A6 Joint B Wearable motion assisting device B1 Biological signal detection sensor B2 Angle sensor B3 Data storage unit B4 Control unit B5 Power amplification unit B6 Drive Part B7 Wireless communication device C, C ′ Spasticity alleviation device C1 Spasticity alleviation means C1-1 Drug storage unit C1-2 Drug measurement unit C1-3 Drug injection unit C2 Control unit C3 Wireless communication device C4 Input operation unit C5 Authentication / drug administration Quantity setting unit C6 Timer C7 Authentication / electric stimulation condition setting unit C8 Spasticity alleviation means C8-1 Stimulation frequency adjustment unit C8-2 Pulse width adjustment unit C8-3 Pulse waveform / modulation adjustment unit C8-4 Voltage adjustment unit C8-5 Electricity Stimulus signal generation unit C8-6 Electrode 10 Training system 20 Drive unit 30, 30A Motor 36 First coupling unit 38 Second coupling unit 40 First transmission member 50 First Transmission member 60 Waist belt 62 Support part 72, 74 Cuff 80, 82, 90, 92 Fastening member 81, 83, 91, 93 Insertion part 84, 86 Belt 102 Battery 110, 112, 114, 116, 118, 119 Biological signal Detection Sensor 142 Physical Phenomenon Detection Unit 144 Biological Signal Detection Unit 148 Reference Parameter Database 150 Command Signal Database 152 Phase Identification Unit 154 Optional Control Unit 156 Gain Change Unit 160 Autonomous Control Unit 170 α Motor Neuron 172 γ Motor Neuron 174 Centripetal Ia Group fiber 176 afferent group II fiber 178 nucleus fiber (conical muscle)
180 Nuclear bladder fibers (intrapyramidal muscle)
182 Sensory nerve endings 200, 300, 400 Movement assisting device 220 Second drive unit 230 Third transmission member 240 Fourth transmission member 250 Exclusive shoe 260 Floor reaction force sensor 310 Drive unit 410 Waist support unit 420, 422, 424 426 Drive motor 430 Waist support 431 Fitting unit 454 Right leg auxiliary transmission unit 455 Left leg auxiliary transmission unit 458 First transmission member 460 Second transmission member 462 Third transmission member 464 First joint 466 Second joint 468 Third joint 478 Thigh fastening members 479, 481 Fitting portion 480 Thigh fastening member 484 Shoes 500 Lumbar coupling mechanism

Claims (7)

A transmission member fastened to the trainee, a drive unit that drives the transmission member, a biological signal detection sensor that detects a biological signal according to the movement of the trainee, and the biological signal detection sensor A control unit that controls the drive unit based on a biological signal ;
A drug storage unit in which a drug for relieving spasticity generated in the trainee is stored, and a drug dose setting unit in which the dose of the drug to the trainee designated by a prior diagnosis result is set And a spasticity relief device comprising:
With
In the spasticity alleviating device, the waiting time after the completion of the administration of the drug to the trainee is set according to the type of the drug and the dose of the drug,
The control unit, according to a biological signal output from the biological signal detection sensor, within a period in which the waiting time has elapsed and the effect of spasticity relaxation in which the muscle of the trainee is in a relaxed state is obtained. A training system for performing exercise function recovery training of the trainee by controlling the drive unit to operate the transmission member . The control unit determines whether or not the potential level of the biological signal output from the biological signal detection sensor is less than a predetermined threshold, and when the number of times the biological signal is less than the threshold reaches a predetermined number, The training system according to claim 1, wherein the driving member is controlled to operate the transmission member accordingly . The wearable movement assist device has an angle sensor that detects an operation angle of the joint of the trainee,
The control unit determines whether the operation angle of the joint detected by the angle sensor has reached a target operation angle set according to the symptom of the trainee, and has reached the target operation angle 3. The training system according to claim 1 , wherein the drive unit is controlled so that the operation angle of the joint returns to an initial angle after stopping the drive unit . A transmission member fastened to the trainee, a drive unit that drives the transmission member, a biological signal detection sensor that detects a biological signal according to the movement of the trainee, and the biological signal detection sensor A control unit that controls the drive unit based on a biological signal;
A condition setting unit for setting an electrical stimulation condition for relaxing the spasticity by causing muscle contraction by electrical stimulation to the trainee based on a prior diagnosis result, and an electrical signal adjusted to the electrical stimulation condition Spasticity alleviation device as a physical therapy means, having spasticity alleviation means to generate and apply via an electrode to the spastic part of the trainee,
With
In the spasticity alleviation device, the application time of the electrical stimulation is set based on the previous diagnosis result,
The control unit is responsive to a biological signal output from the biological signal detection sensor within a period in which the application time has elapsed and a spasticity alleviating effect in which the muscle of the trainee is in a relaxed state is obtained. training system by operating the transmission member by controlling the drive unit, you and performs the trainee motor rehabilitation. The training system according to claim 4 , wherein the condition setting unit sets the electrical stimulation condition by adjusting a frequency, a pulse width, a pulse waveform, and a voltage of the electrical signal . The control unit determines whether or not the potential level of the biological signal output from the biological signal detection sensor is less than a predetermined threshold, and when the number of times the biological signal is less than the threshold reaches a predetermined number, The training system according to claim 4 or 5, wherein the transmission unit is operated by controlling the drive unit accordingly . The wearable movement assist device has an angle sensor that detects an operation angle of the joint of the trainee,
The control unit determines whether the operation angle of the joint detected by the angle sensor has reached a target operation angle set according to the symptom of the trainee, and has reached the target operation angle 7. The drive unit according to claim 4 , wherein the drive unit is controlled so that the operation angle of the joint returns to an initial state angle after the drive unit is stopped . Training system.

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