JP6604567B2 - Upper limb rehabilitation support device - Google Patents

Description

  The present invention relates to an upper limb rehabilitation support device having a pair of exercise presentation units that can move forward, backward, left and right on a plane.

  According to a 2011 survey by the Ministry of Health, Labor and Welfare, there are 1.11 million stroke patients in Japan. In addition, the estimated number of stroke sequelae patients is about 1.6 million, which is the leading cause of need for nursing care. Hemiplegia is the most common sequelae after the onset of stroke, and the basic movement of standing and walking is often hindered. Thereby, troubles occur in daily operations that are indispensable in life such as eating, changing clothes, and moving. Therefore, the improvement of the paralyzed function is greatly related to the quality of life thereafter. Rehabilitation is currently performed by various methods, for example, as shown in Non-Patent Document 1, with the fact that the paralyzed function has been proved to be recoverable by rehabilitation due to the plasticity of the brain.

  Among them, there is a method shown in Non-Patent Document 2 that uses the illusion of movement such as moving a paralyzed limb to restore motor function. This is a mirror that puts a mirror between the non-paralyzed limbs of the upper limbs and tries to move the paralyzed limbs in the same way as the non-paralyzed limbs while looking at the image of the non-paralyzed limbs reflected in the mirror It is a training method called therapy.

  In the conventional mirror therapy shown in Non-Patent Document 2, a mirror box in which a mirror is installed in a box is used, and a subject moves a non-paralyzed limb in the mirror box. For this reason, the forearm pronation and extension, flexion and extension of the wrist joint and fingers, thumb internal and external rotation, and opposing movements can be performed, but the entire upper limb including the shoulder joint cannot be operated.

  There are also exercises to grip sponges, blocks, etc., but these exercises are performed only on non-paralyzed limbs, and the paralyzed limbs are taught to behave as much as possible. There is no movement to grip sponges.

  In addition, mirror therapy is performed by two people, and a collaborator is also trained to move the paralyzed limb of the subject dynamically according to the movement of the non-paralyzed limb of the subject. At this time, stimulation is applied to the subject's paralyzed limb, but in this case there is no mechanism or part that presents tactile stimulation as a training device, and active touch in which the subject operates and perceives tactile sensation cannot be realized. Not.

  In addition, the conventional health device shown in Patent Document 1 has two grip bags that can be gripped by a palm made of a flexible material on both sides of the mirror, and the subject has a hand for each of the non-paralyzed limb and the paralyzed limb. Do the gripping movement of the bag with. Since the two handgrips are connected by a flexible tube, when one handgrip is gripped by a non-paralyzed side limb, the other handbag swells and stimulation is presented to the paralyzed side limb. With this device, if the hand of the non-paralyzed limb is grasped, the hand of the paralyzed limb is pushed and spread, so the same stimulus cannot be applied to the hands of the non-paralyzed limb and the paralyzed limb.

  In the conventional upper limb rehabilitation support apparatus shown in Patent Document 2, the forearm portion is placed on the armrest of the stage, and the left and right specular movements are performed by gripping the grip by hand. With this device, exercise training for upper limbs and wrist joints can be performed.

  Non-Patent Document 3 also shows some robots that can be used for rehabilitation, but these devices also have a subject holding a rod-like or spherical grip or wearing the subject's upper limb on the device. The hand is nothing but a gripping object, and has no mechanism or part for presenting a tactile sensation in the rehabilitation of upper limb movement.

  As described above, in the conventional physiology, the motor system and the sensory system are described separately, and the motor training and sensory training in rehabilitation are performed separately. However, the actual movement of a healthy person is, for example, when peeling the fruit, picking the fruit by the arm muscles, grasping the size and shape of the fruit by touching the fingertips of the hand, and moving the knife when peeling the fruit To control. When reading a book, the book is taken by the arm muscles, and the force of holding the book and the movement of the finger to turn the page are controlled by the sense of touch of the fingertips. Thus, although movement and sensation are closely related to upper limb function, the conventional upper limb rehabilitation support device is only exercise training by muscles, not training using the tactile sensation of the fingertips of the hand, There was a problem that the rehabilitation effect was not sufficiently brought out to the patient.

JP 2007-105411 A JP 2010-201111 A

Hiroaki Sugawara and Eriko Tsukada: Current Status and Prospects of Neurorehabilitation, Bulletin of Teikyo University of Science, Vol. 8, pp.1-10, 2012. Naohira Hirayama, Yu Inoue, Yukari Sato, Kazuhiro Harada, Kojiro Kagawa: Effect of mirror therapy on hand movement dysfunction in stroke hemiplegic patients, Physical Therapy, Vol. 39, No. 5, pp. 330-337, 2012. Bruce TV et al .: Robotic Devices as Therapeutic and Diagnostic Tools for Stroke Recovery, Archives of Neurology 2009, 66 (9), pp.1086-1090.

  The present invention solves the problem of the training method using only the arm muscles in the above-described upper limb rehabilitation support device, and provides an upper limb rehabilitation support device having a large rehabilitation effect using the tactile sensation of the fingertip of the hand in addition to the muscles. The purpose is to provide.

  Specific cases can be expected to have effects especially on hemiplegia of stroke, unilateral spatial neglect, attention deficit, Parkinson's disease, and phantom limb pain.

  In order to solve the above problems, the present invention is as follows.

  Invention 1 is an upper limb rehabilitation support device having a pair of motion presenting units that can move back and forth and right and left on a plane and a tactile sense presenting unit as a contact object with respect to the finger of the subject. And rehabilitation training, wherein at least one finger included in the left hand and at least one finger included in the right hand are brought into contact with each other on the tactile sense presentation unit. Device.

  A second aspect of the present invention is the upper limb rehabilitation support device according to the first aspect, wherein the pair of motion presentation units are movable so as to be in a mirror-symmetrical position.

  A third aspect of the present invention is the upper limb rehabilitation support device according to the first or second aspect, wherein the tactile sense providing unit includes a contact surface that can be touched by a subject's finger and can give a stimulus to the finger. It is.

  Invention 4 is the invention 1 or 2, characterized in that the tactile sensation presentation unit has a contact surface with which a subject's finger comes into contact, and the contact surface is composed of a surface having two or more patterns having different unevenness sizes. It is an upper limb rehabilitation assistance apparatus of description.

  In the fifth aspect of the present invention, the tactile sense providing unit includes a contact surface with which the finger of the subject contacts, and the contact surface includes a first uneven surface and a second uneven surface having a larger unevenness than the first uneven surface. The upper limb rehabilitation support apparatus according to the first or second aspect, wherein the upper limb rehabilitation support apparatus includes the upper limb rehabilitation support apparatus.

  A sixth aspect of the present invention is the upper limb rehabilitation support device according to any one of the first to fifth aspects, wherein the tactile sense presenting portion is planar and is installed on a flat plate inclined with respect to the vertical direction.

  The invention 7 includes a mirror disposed between the pair of motion presentation units, and the mirror faces a direction intersecting a virtual straight line connecting the pair of motion presentation units to each other, and The upper limb rehabilitation support device according to any one of inventions 1 to 6, wherein a mirror image of one of the left and right palms placed is shown to a subject.

  Invention 8 is an upper limb rehabilitation support device used when a subject performs upper limb rehabilitation training, wherein at least one finger included in the subject's left hand and at least one finger included in the subject's right hand are each A tactile sensation presentation unit that makes contact, and a pair of exercise presentation units that make contact with the same left and right contact parts of the left and right upper limbs of the subject. An upper limb rehabilitation assisting device that guides a contact site in front, back, left, and right on a plane in a state of being in contact with a presentation unit.

  In the first aspect, the subject can perform rehabilitation training by placing the left and right palms on the exercise presentation unit, and at least one finger of the left and right hand contacts on the horizontal plane. The hand is a sensory organ that touches an object and recognizes the object and the environment for a human, and the fingertip is a sensitive part such as a high resolution of a two-point discrimination threshold. For this reason, tactile feedback to the fingertip is necessary for upper limb movement, and the rehabilitation effect can be increased by presenting the tactile sensation to the fingertip sensitive to stimulation in addition to the movement of the arm. Moreover, after the training of the invention 2, it is possible to confirm whether the paralyzed side limb can perform the same movement as the non-paralyzed side limb.

  Furthermore, since the upper limb rehabilitation support device can be installed and used on a horizontal surface (flat plate), the strength members of the upper limb rehabilitation support device can be reduced, the weight can be reduced, and the structure can be simplified. As a result, the cost can be reduced, so that the upper limb rehabilitation support device can be provided at an appropriate price.

  The invention 2 has a mirror therapy effect because the pair of motion presentation units can move so as to be in a mirror-symmetrical position on the left and right. Therefore, while feeding back the somatosensory sensation by the left and right mirror surface upper limb movements of the paralyzed limb and the non-paralyzed limb, and simultaneously presenting the same tactile stimulus to the fingertips of the paralyzed limb and the non-paralyzed limb, the effect of promoting the rehabilitation effect is there.

  The invention 3 is characterized in that the tactile sense presentation unit can give a stimulus to the finger of the subject. The tactile sensation presentation unit reinforces the stimulation of the finger tactile sense by using various materials on the surface or providing irregularities. The rehabilitation effect can be increased by forming the tactile sense presentation unit in a planar shape and using it in the upper limb rehabilitation support device.

  In the invention 4, the tactile sense presenting section has two or more patterns having different finger tactile sizes. By changing the size of the finger touch, the operation can be performed in accordance with the symptoms of the patient as the subject, so that the rehabilitation effect can be increased.

  In the fifth aspect of the present invention, the tactile sense providing unit includes a contact surface with which the finger of the subject contacts, and the contact surface includes a first uneven surface and a second uneven surface having a larger unevenness than the first uneven surface. Since it is comprised including, a different stimulus can be given to a test subject's finger | toe and a rehabilitation effect can be increased.

  According to the sixth aspect of the present invention, since the tactile sense presenting portion is flat and is installed on a flat plate inclined with respect to the vertical direction, the rehabilitation effect can be increased because the upper limb can be exercised like sanding. .

  The invention 7 is characterized in that a mirror is installed and used between the motion presentation units, that is, between the left and right palms of the subject. By looking into the mirror from the side of the non-paralyzed limb, the left and right images of the non-paralyzed limb are reflected in the place where the paralyzed limb is present, and the reverse image of the non-paralyzed limb feels like your own paralyzed limb Create an illusion. At this time, the intensity of the numbness caused by the feedback of somatic sensation in which the paralyzed limb also performs the right and left mirror movement of the non-paralyzed limb and the same tactile stimulation as the non-paralyzed limb is presented to the fingertip of the paralyzed limb Can increase the rehabilitation effect.

  Invention 8 can present a motion not only on the palm but also on other parts of the upper limb by bringing the pair of motion presentation units into contact with the same left and right parts of the left and right upper limbs of the subject. .

The perspective view of the assistance apparatus main body 2 of the upper limb rehabilitation assistance apparatus 1 which is 1st Embodiment of this invention is shown. The (a) top view and (b) front view of the support apparatus main body 2 are shown. The schematic diagram of the mechanism of the support apparatus main body 2 is shown. It is a front view of the upper limb rehabilitation assistance apparatus 1 of 2nd Embodiment, Comprising: The assistance apparatus main body 2 is set | placed on the flat plate 40, and the figure which arrange | positioned the tactile sense presentation part 30 left-right symmetrically with respect to centerline AA is shown. . It is a perspective view of the upper limb rehabilitation assistance apparatus 1 which is 2nd Embodiment, Comprising: The figure which has arrange | positioned the assistance apparatus main body 2 on the flat plate 40, and arrange | positioned the tactile sense presentation part 30 left-right symmetrically with respect to centerline AA. Show. The tactile sense presentation part 30 of 2nd Embodiment is shown. The tactile sense presentation unit 30 has a flat surface 32, a small uneven surface 34, and a large uneven surface 36, and is arranged symmetrically with respect to the center line AA. The top view which has arrange | positioned the tactile sense presentation part 30 of the upper limb rehabilitation assistance apparatus 1 which is 2nd Embodiment symmetrically with respect to the centerline AA at the flat surface 32, the small uneven surface 34, and the large uneven surface 36 is shown. . The arrangement | positioning pattern of the flat surface 32 of the tactile sense presentation part 30 of the upper limb rehabilitation assistance apparatus 1 which is 2nd Embodiment, and the small uneven surface 34 is shown, (a) arrange | positions the small uneven surface 34 circularly, (b) A small uneven surface 34 is arranged in a quadrangle, (c) is a small uneven surface 34 is arranged in a triangle, (d) is a small uneven surface 34 arranged symmetrically in the shape of a plurality of concentric arcs, (e) A plurality of strips are arranged symmetrically. The whole state where the subject A is using the upper limb rehabilitation support apparatus 1 according to the second embodiment is shown. The test subject i shows the state which is using the upper limb rehabilitation assistance apparatus 1 which is 2nd Embodiment. The test subject i shows the state where the fingertip (abdomen) using the upper limb rehabilitation support device 1 according to the second embodiment is in contact with the tactile sense presentation unit 30. The test subject i shows a state in which the fingertip (including the nail part) using the upper limb rehabilitation support device 1 according to the second embodiment is in contact with the tactile sense providing unit 30. The test subject i shows a state in which the upper limb rehabilitation support apparatus 1 according to the third embodiment is used while being tilted. The state which installed the mirror 50 in the center upper part of the upper limb rehabilitation assistance apparatus 1 which is 4th Embodiment is shown. The test subject i shows the state which is using the upper limb rehabilitation assistance apparatus 1 which is 4th Embodiment. The upper limb rehabilitation support device 1 shows a state where the fingertip is not brought into contact with the tactile sense presentation unit 30.

  Hereinafter, embodiments of the present invention will be described with reference to the drawings. The present invention is not limited to the following embodiments, and changes, modifications, and improvements can be added without departing from the scope of the invention.

(First embodiment)
In FIG. 1, the perspective view of the assistance apparatus main body 2 of the upper limb rehabilitation assistance apparatus 1 which is 1st Embodiment of this invention is shown. Two wheels 20 are installed at both ends of the support device main body 2 and at the lower part of the central portion, and can be moved back and forth on a flat plate 40 such as a desk 42. A linear guide 18 is provided on the wheel 20, and a pair of motion presentation units 10 are attached to the linear guide so as to be linearly movable. A pair of pulleys 12 is disposed at both ends of the linear guide 18, and a belt 14 is stretched between the pulleys 12.

  The support apparatus main body 2 does not use a motor and realizes mirror image movement only by a mechanical mechanism, and therefore does not require power supply or a control computer.

FIG. 2 shows a top view and a front view of the support apparatus body 2.
The size of the upper limb rehabilitation support apparatus 1 is 825 mm in width, 120 mm in length, and 62 mm in height. Two wheels 20 are installed at both ends and the center of the support device body 2 and can move back and forth on a flat plate 40 such as a desk 42. Therefore, since the linear guide 18 moves in the front-rear direction, the motion presentation unit 10 can move in the front-rear direction and the right-angle direction along the linear guide, respectively.

  In the support apparatus main body 2, the height to the motion presentation unit 10 on which a hand is placed is 33 mm, and the movable range of one hand is about 230 mm on the left and right. The movable range before and after the support device main body 2 is determined by the size of the desk or the like, and the support device main body 2 can move freely within the movable range. The material is reduced in weight by using an aluminum alloy (A2017), and the weight is 1.9 kg. Although it is an elongated shape, it is light enough to carry and easy to assemble and disassemble. The support device body 2 uses a linear guide 18 and a belt 14 in order to realize a mirror image motion.

  FIG. 3 shows a schematic diagram of the mechanism of the support apparatus main body 2. A belt 14 is stretched on pulleys 12 installed at both ends, the left motion presentation unit 10 is fixed with a front belt 14 and a pin 16, and the right motion presentation unit 10 is fixed with a back belt 14 and a pin 16. Thereby, the support apparatus main body 2 implement | achieved the symmetrical mirror image motion. Moreover, the exercise | movement which synchronized left and right is also realizable by changing the fixed place by the pin 16 of the exercise | movement presentation part 10 and the belt 14. FIG. Further, when the pin 16 is removed, the exercise presentation unit 10 and the belt 14 are not fixed and are free, and an exercise that is not synchronized between the left and right can be performed.

  When a hemiplegic patient places his / her paralyzed and non-paralyzed hands on the motion presentation unit 10 and moves the non-paralyzed hand back and forth or left and right, the paralyzed hand performs a mirror image motion that is symmetrical. Friction is reduced by using a linear guide 18 and a bearing on the pulley shaft. However, since power such as a motor is not used, some force is required to operate the instrument. The front-rear direction can be moved lightly by the effect of the wheel 20, but the left-right direction requires a force of about 2N for the operation due to the tension of the linear guide 18 and the belt 14.

(Second Embodiment)
In FIG. 4, the front view of the upper limb rehabilitation assistance apparatus 1 of 2nd Embodiment is shown. As shown in FIG. 4, the support device main body 2 is placed on the flat plate 40, and the tactile sense presentation unit 30 is arranged symmetrically with respect to the center line AA. That is, the upper limb rehabilitation support apparatus 1 is used by being installed on the flat plate 40. The flat plate 40 has a width of 740 mm and a depth of 500 mm.

  FIG. 5 shows an upper limb rehabilitation support apparatus 1 according to the second embodiment. The flat plate 40 is placed on the desk 42, and the support apparatus main body 2 is arranged symmetrically with respect to the center line AA of the flat plate 40. Further, the tactile sense providing unit 30 is disposed on the flat plate 40 symmetrically with respect to the center line AA. The center line AA may be a line that passes through the midpoint of the pair of pulleys 12 of the upper limb rehabilitation support apparatus 1 and is perpendicular to the linear guide 18. The center line AA of the flat plate 40 and the center line AA of the line perpendicular to the linear guide 18 do not have to be completely coincident with each other, and may be substantially parallel.

  FIG. 6 shows a haptic presentation unit 30 according to the second embodiment. The tactile sense presenting unit 30 functions as a contact object for the subject's finger D, in other words, a finger contact portion that contacts the subject's finger D. The tactile sense providing unit 30 has a flat surface 32, a small uneven surface 34 as a first uneven surface, and a large uneven surface 36 as a second uneven surface, and is symmetrical with respect to the center line AA. Has been placed. These surfaces 32, 34, 36 as a whole are contact surfaces with which the finger D of the subject A (see FIG. 11) comes into contact. Since the contact surface of the tactile sense presentation unit 30 includes the surfaces 32, 34, and 36 having different surface patterns, it is possible to give a stimulus to the finger that contacts the contact surface. .

  The fingertip is the part where tactile sensation is particularly developed. This is because the tactile sensation of the fingertip is not only sensitive but also excellent in discrimination ability. For example, Braille is read with a fingertip, and the two-point discrimination threshold, which is spatial resolution, is said to be 1/3 or less of the palm.

  Therefore, the tactile sense presentation unit 30 uses three types of flat surface 32 as a flat portion, small uneven surface 34, and large uneven surface 36 in ascending order of stimulus to the fingertip. The tactile sense presentation unit 30 is disposed symmetrically with respect to the center line AA.

  In addition, the tactile sense providing unit 30 can not only change the cross-sectional shape and size of the unevenness, but also can make the shape of the unevenness a circular shape, a square shape, a triangular shape, or the unevenness portions can be arranged in an arc shape or a radial shape. Various materials such as paper, cloth, wood, resin, metal, and glass can be used for the surface of the tactile sense providing unit 30.

  In FIG. 7, the tactile sense providing unit 30 of the upper limb rehabilitation assisting apparatus 1 according to the second embodiment is arranged with a flat surface 32, a small uneven surface 34, and a large uneven surface 36 symmetrically with respect to the center line AA. A plan view is shown. 7 is upside down with respect to FIG.

  In FIG. 8, the arrangement pattern of the flat surface 32 of the tactile sense presentation part 30 of the upper limb rehabilitation assistance apparatus 1 which is 2nd Embodiment, and the small uneven surface 34 is shown.

  In FIG. 8A, small uneven surfaces 34 are arranged in a circle, and the others are flat surfaces 32.

  Similarly, in FIG. 8B, the small uneven surface 34 is arranged in a square, and in FIG. 8C, the small uneven surface 34 is arranged in a triangle, and the others are flat surfaces 32. 8B and 8C, only one side with respect to the center line AA is illustrated.

  By making the shape of the concavo-convex part circular, quadrangular, or triangular, the subject A can perform rehabilitation training by tracing the concavo-convex part with a fingertip. Therefore, the same movement of the circular movement, the square movement, the triangular movement, or the repetitive movement in the opposite direction can be performed.

  In FIG. 8D, the small uneven surfaces 34 are arranged symmetrically in a plurality of concentric arcs, and in FIG. 8E, the small uneven surfaces 34 are arranged symmetrically in a plurality of strips, The flat surface 32 is used.

  By following the small concave / convex surface 34 of a circular arc or the small concave / convex surface 34 having a strip shape with a fingertip, it is possible to perform a motion of a large arc or a small arc, or a linear motion with different inclination angles.

  Here, the small uneven surface 34 may be a large uneven surface 36, and may be various shapes.

  FIG. 9 shows the entire state where the subject A is using the upper limb rehabilitation support apparatus 1 according to the second embodiment.

  The subject A sits on the chair 44 and performs rehabilitation training.

  In FIG. 10, the test subject i shows the state which is using the upper limb rehabilitation assistance apparatus 1 which is 2nd Embodiment.

  The subject A sits on the chair 44 so as to be symmetric with respect to the center line AA of the upper limb rehabilitation support apparatus 1. Left and right palms (see FIG. 11) as contact parts that contact the motion presentation unit 10 in the upper limbs are placed on the motion presentation unit 10, and at least one of the left finger and the right finger At least one of the two is placed in contact with the tactile sense presentation unit 30. This is to perform the same left-right mirror image movement training as mirror therapy. Each of the pair of motion presentation units 10 guides the palm placed on the motion presentation unit 10 to the front, back, left, and right on the plane in a state where the left and right fingers of the subject A are in contact with the tactile presentation unit 30. To do.

  FIG. 11 shows a state in which the fingertip D (abdomen) using the upper limb rehabilitation support device 1 according to the second embodiment is in contact with the tactile sense providing unit 30.

  The size of the exercise presentation unit 10 is 100 mm wide × 100 mm long so that only the palm can be placed and the fingertip can touch the floor surface. Since there is a gap of about 10 mm below the upper limb rehabilitation support device 1, the same tactile stimulation is applied to both the healthy side and the paralyzed hand while mirror moving the upper limb by arranging the tactile sense presentation unit 30 symmetrically. Can be given.

  FIG. 12 shows a state where the fingertip (including the nail part) using the upper limb rehabilitation support device 1 according to the second embodiment is in contact with the tactile sense providing unit 30.

  The fingertip including the nail part is also a tactile sensitive part.

(Third embodiment)
FIG. 13 shows a state in which the subject A is using the upper limb rehabilitation support apparatus 1 according to the third embodiment tilted.

  Although the use on the horizontal flat plate 40 is assumed, depending on the case, by using it on the flat plate 40 inclined with respect to the vertical direction, movement like sanding is also possible.

  For this reason, it can be operated by a person who can perform an automatic assistance exercise by the patient (subject A).

(Fourth embodiment)
In FIG. 14, the state which installs and uses the mirror 50 in the center upper part of the upper limb rehabilitation assistance apparatus 1 which is 4th Embodiment is shown.

  FIG. 15 shows a state in which the subject A uses the mirror 50 installed at the upper center of the upper limb rehabilitation support apparatus 1 according to the fourth embodiment. When the mirror 50 is looked into from the non-paralyzed limb side, the position of the subject's head and the position and angle of the mirror 50 are adjusted so that an image of the non-paralyzed limb can be seen where the paralyzed limb should be. For example, the mirror 50 is installed so as to face a direction (for example, a direction substantially orthogonal to the virtual straight line L1) intersecting a virtual straight line L1 (see FIG. 2) that connects the pair of motion presentation units 10 to each other. Then, the mirror 50 causes the subject A to see a mirror image of one of the left and right palms placed on the pair of motion presentation units 10. The one mirror image is specifically a mirror image on the non-paralyzed limb side (healthy side). The mirror 50 hides the other of the left and right palms so that the subject cannot see it. When carrying out the same training as this mirror therapy, the paralyzed limb is hidden so that it cannot be seen by the subject.

(Action and effect of stimulating fingertips)
Conventional mirror therapy is performed using a mirror box in which a mirror is placed in a box. The subject A moves a non-paralyzed limb in the mirror box and sees the movement of the non-paralyzed limb reflected in the mirror 50. Imagine the paralyzed limbs moving in the same way. At this time, if the somatic sensation of the paralyzed limb is completely lost and the movement of the paralyzed limb cannot be perceived at all, or if the paralyzed limb can behave exactly the same as the non-paralyzed limb like a normal person, the visual information and There is no sense of incongruity due to the disagreement of the system.

  On the other hand, if the sense of the paralyzed limb remains and the motion of the paralyzed limb does not match the behavior of the non-paralyzed limb, The discrepancy in sensation decreased the illusion intensity, leading to a reduction in rehabilitation effects.

  In the present invention, firstly, a paralyzed limb with insufficient motor function can be operated in the same manner as a non-paralyzed limb by the left and right mirror image movement of the exercise presentation unit 10, and is further presented to the fingertip of the non-paralyzed limb Since the same stimulus as that of the tactile sensation can be presented, there is no factor that reduces the occurrence of illusion and the rehabilitation effect in the prior art.

  In addition, the hand is a perceptive organ that touches an object and recognizes the object and the environment, and the fingertip is a sensitive part, especially because the resolution of the two-point discrimination threshold is high. Although technologies for presenting pseudo-tactile sensations have been developed in other fields, the tactile presentation in the present invention is the same as the operation of daily human touching an object. Presenting tactile sensation, and generating the strong illusion that the paralyzed limb can realize the same movement as the non-paralyzed limb because the tactile stimulation presented to the fingertip of the non-paralyzed limb is exactly the same as the fingertip of the paralyzed limb And a very high rehabilitation effect can be obtained compared to the conventional case.

  After the mirror therapy training is performed by the upper limb rehabilitation support device 1, the left and right movements of the pair of exercise presentation units 10 are made free except for the pins 16. In this state, it is trained whether mirror therapy training can be reproduced. If the paralyzed arm can move the same way as the healthy arm, it would have been effective.

  If the upper limb rehabilitation assisting apparatus 1 is used in a state where the fingertip is not in contact with the tactile sense providing unit 30, the palm of the subject A is placed on the motion presenting unit 10 as shown in FIG.

(Other embodiments)
(1) In the above-described second to fourth embodiments, the tactile sense providing unit 30 includes the flat surface 32, the small uneven surface 34, and the large uneven surface 36 as contact surfaces, but does not include the uneven surface. For example, it may be configured only by the flat surface 32.

  (2) In each of the above-described embodiments, the rehabilitation training is performed by placing the palm of the subject A on the exercise presentation unit 10, but the support device body 2 is not limited to the palm and the pair of left and right upper limbs of the subject A Of these, the same left and right parts may be in contact with the pair of exercise presentation units 10 respectively. Here, the upper limb is a motor organ attached to the shoulder, and refers to from the shoulder joint to the fingertip.

DESCRIPTION OF SYMBOLS 1 Upper limb rehabilitation support apparatus 2 Support apparatus main body 10 Movement presentation part 12 Pulley 14 Belt 16 Pin 18 Linear guide 20 Wheel 30 Tactile sense presentation part 32 Flat surface 34 Small uneven surface 36 Large uneven surface 40 Flat plate 42 Desk 44 Chair 50 Subject's hand C Palm D Finger

Claims (7)

In an upper limb rehabilitation support device having a pair of motion presenting units that can move back and forth and right and left on a plane, and a tactile sense presenting unit as a contact target for a subject's finger,
The subject places left and right palms on the pair of motion presentation units, and causes at least one finger included in the left hand and at least one finger included in the right hand to contact each other on the tactile presentation unit. , have line rehabilitation training,
The upper limb rehabilitation support device, wherein the tactile sense presentation unit is flat and is installed on a flat plate inclined with respect to the vertical direction . A mirror disposed between the pair of motion presentation units;
The mirror is directed in a direction crossing a virtual straight line connecting the pair of motion presentation units, and shows the subject a mirror image of one of the left and right palms placed on the pair of motion presentation units. The upper limb rehabilitation support device according to claim 1 . In an upper limb rehabilitation support device having a pair of motion presenting units that can move back and forth and right and left on a plane, and a tactile sense presenting unit as a contact target for a subject's finger,
A mirror disposed between the pair of motion presentation units;
The subject places left and right palms on the pair of motion presentation units, and causes at least one finger included in the left hand and at least one finger included in the right hand to contact each other on the tactile presentation unit. , have line rehabilitation training,
The mirror is directed in a direction crossing a virtual straight line connecting the pair of motion presentation units, and shows the subject a mirror image of one of the left and right palms placed on the pair of motion presentation units. Upper limb rehabilitation support device characterized by that. The upper limb rehabilitation support device according to any one of claims 1 to 3 , wherein the pair of exercise presentation units are movable so as to be in a mirror-symmetrical position. 5. The tactile sense presentation unit includes a contact surface that can be touched by the subject's finger to apply a stimulus to the finger, according to claim 1 . Upper limb rehabilitation support device. The tactile sense presentation unit includes a contact surface with which the subject's finger contacts,
The upper limb rehabilitation support device according to any one of claims 1 to 4, wherein the contact surface includes a surface having two or more patterns having different unevenness sizes. The tactile sense presentation unit includes a contact surface with which the subject's finger contacts,
The contact surface has a first uneven surface, one of the claims 1 to 4, characterized in that it is configured to include a second concave-convex surface is greater irregularities than uneven surfaces of the first 1 Upper limb rehabilitation support device described in one .