JP6653935B2 - Paralysis function recovery training device and control method of paralysis function recovery training device - Google Patents

Description

The present invention relates to a paralysis function recovery training apparatus for training and treating a patient with a paralyzed finger or forearm, and a control method of the paralysis function recovery training apparatus .

  Restoration of the paralyzed function of stroke patients is closely related to the improvement of activities of daily living (ADL) and quality of life (QOL), and the development of effective exercise therapy to restore hemiplegia itself is very important. It is an issue. As an effective rehabilitation method for recovering function from hemiplegia in a stroke patient by utilizing the plasticity of the brain, there is repetitive facilitation therapy. This method achieves early recovery from hemiplegia by using the patient's muscle stretch reflex and voluntary movement.

  In the repetitive facilitation therapy, for example, in the case of finger flexion / extension training, the exercise is first performed passively by the doctor's force, and then a tapping stimulus is applied to the first joint of the finger to perform optional automatic extension. This tapping stimulus stimulates the stretching reflex, and effective training can be expected. Similarly, in the forearm training, an optional automatic exercise is performed following the passive exercise. Here, it is important to apply a rapid acceleration stimulus to the patient's finger or forearm before performing the voluntary automatic movement.

  DESCRIPTION OF RELATED ART Conventionally, the rehabilitation training apparatus which performs a pronation / supination exercise | movement, and gives a rehabilitation so that it moves by giving an electrical stimulation to the paralyzed part of a forearm, the apparatus which trains a muscle, etc. are disclosed by following patent documents 1-3. Have been.

International Publication No. 2014/092076 Japanese Patent Publication No. 2007-520308 JP 2009-225810 A

  In a conventional rehabilitation training device or the like, a percutaneous electrical stimulation value immediately before a paralyzed limb moves is visually obtained by a doctor, and rehabilitation training is performed using the stimulation value. For this reason, there has been a problem that it is unclear whether the stimulus value is appropriate and whether effective rehabilitation training can be performed.

Accordingly, the present invention provides a paralysis function recovery training that can directly apply a percutaneous electrical stimulation for improving the rehabilitation training effect to the finger extensor or pronation / supination muscles and create a state in which muscle contraction is likely to occur. It is an object of the present invention to provide a control method for a device and a paralysis function recovery training device .

In addition, the present invention creates a state in which muscle contraction is likely to occur by using electrical stimulation in which a muscular contraction of the finger is generated and a stimulus value that starts to move passively is used as a threshold value of the transcutaneous myoelectric potential. An object of the present invention is to provide a paralysis function recovery training apparatus and a control method of the paralysis function recovery training apparatus that can be improved. Furthermore, the present invention is to elucidate the characteristics of the finger extensor and pronation / supination muscles when an electric stimulus is given, and to perform effective rehabilitation training with an electric stimulus equal to or lower than the threshold of the transcutaneous myoelectric potential. It is an object of the present invention to establish a method for specifying a stimulus value that can be performed, and to provide a paralysis function recovery training apparatus and a control method of the paralysis function recovery training apparatus that allow a user to easily handle an object.

A paralysis function recovery training device according to a first aspect of the present invention is a paralysis function recovery training device for treating paralysis of a hemiplegic patient by applying electrical muscular stimulation to the patient,
When the stimulus value for the myoelectric potential when the muscle is stiff is Ari and the stimulus value for the myoelectric potential when the joint starts to move due to muscle contraction is Ast, Ast / Ari + Ash / Ast = V (V is 1.5 Detection means for detecting the percutaneous electrical muscular stimulation value Ash given to the patient based on the relational expression of 1.6 or less)
Stimulation applying means for applying muscle electrical stimulation to the patient with the percutaneous muscle electrical stimulation value detected by the detection means,
It is characterized by having.

Further, a paralysis function recovery training device according to a second aspect of the present invention is a paralysis function recovery training device for treating paralysis of a hemiplegic patient by applying electrical muscular stimulation to the patient,
A transcutaneous electrical stimulation value that maximizes the difference in myoelectric potential between two electrodes, one on the target muscle and the other on the target muscle, and the electrical stimulation value for the patient Detection means for detecting as
Stimulation applying means for applying muscle electrical stimulation to the patient with the percutaneous muscle electrical stimulation value detected by the detection means,
It is characterized by having .

  Further, a notifying means for notifying the operator of the difference in the myoelectric potential by sound may be provided.

Further, the stimulus applying means,
The percutaneous electrical muscle stimulation whose value varies at 50 Hz may be applied to a patient.

A control method of a paralysis function recovery training device according to a third aspect of the present invention is a control method of a paralysis function recovery training device for treating paralysis of a hemiplegic patient by applying electrical muscular stimulation to the patient. ,
If the detecting means sets the stimulus value for the myoelectric potential when the muscle is stiff to Ari and the stimulus value for the myoelectric potential when the joint starts to move due to muscular contraction, Ast / Ari + Ash / Ast = V (V A detection step of detecting a percutaneous muscle electrical stimulation value Ash that satisfies the relationship of 1.5 to 1.6);
Current generating means for generating a current for electrical muscular stimulation with the percutaneous electrical stimulus value detected in the detecting step,
It is characterized by including.

A control method of a paralysis function recovery training device according to a fourth aspect of the present invention is a control method of a paralysis function recovery training device for treating paralysis of a hemiplegic patient by applying electrical muscular stimulation to the patient. ,
Detecting means, as the muscle electrical stimulation values, transdermal muscle electrostimulation value difference myoelectric potential is maximized by total two places of electrodes at one point and one point other than the muscle to the patient's stimulation purposes muscle A detecting step for detecting;
Current generating means for generating a current for electrical muscular stimulation with the percutaneous electrical stimulus value detected in the detecting step,
It is characterized by including.

In the current generating step,
The current generating means generates a current for muscle electrical stimulation based on the percutaneous muscle electrical stimulation value detected in the detection step when the patient's training posture is in a state in which the stimulation target muscle of the patient is stretched. it may be causing.

In the current generating step,
The variation frequency of the percutaneous muscle electrical stimulation value may be set to 50 Hz.

  The paralysis function recovery training apparatus according to the present invention provides a patient with a muscle electrical stimulation applied to a patient, the stimulation value corresponding to 80% of the muscle potential when the muscle is stiff, or the muscle potential when the joint starts to move due to muscle contraction. The stimulus value was equivalent to 90%. This provides a hemiplegic patient with a rehabilitation-appropriate electrical stimulus value that allows a hemiplegic patient to provide sufficient stimulus for automatic movement without muscle stiffness and passive movement. Can be.

  Also, when the muscle potential becomes 80% of the muscle potential when the muscle is stiff, the difference in the myoelectric potential between the two electrodes attached to the patient's forearm is maximized to detect the myoelectric stimulation value. Therefore, an appropriate muscle electrical stimulation value can be easily known.

Further, in the control method of the paralysis function recovery training apparatus according to the present invention, the movement of the joint is started by applying the electrical muscular stimulation applied to the patient to a stimulation value or muscle contraction corresponding to 80% of the myoelectric potential in a state where the muscle is rigid. The stimulus value was set to 90% of the myoelectric potential in the state. This provides a hemiplegic patient with a rehabilitation-appropriate electrical stimulus value that allows a hemiplegic patient to provide sufficient stimulus for automatic movement without muscle stiffness and passive movement. Can be.

  Further, since the strength of the myoelectric potential difference is notified by sound, the operator can easily detect the myoelectric potential stimulus value by utilizing the fact that the myoelectric potential difference is maximized.

It is a perspective view showing the whole composition of the paralysis function recovery training device concerning Embodiment 1 of the present invention. FIG. 3 is a block diagram illustrating a configuration of a control unit. It is a figure which shows the relationship between the myoelectric potential in the state where the movement of the joint starts by the muscle rigidity and the muscle contraction, and the myoelectric potential corresponding to the stimulation value actually given. It is the graph which plotted the stimulus value with respect to the myoelectric potential in the state where the muscle is stiff, the stimulus value with respect to the myoelectric potential in the state where the joint starts to move due to muscle contraction, and the stimulus value with respect to the myoelectric potential actually applied. It is a flowchart which shows the control method of the paralysis function recovery training apparatus which concerns on Embodiment 1 of this invention. It is a figure showing the relation between the pulse frequency and the peak value of the transcutaneous electrical stimulation value. It is a block diagram which shows the structure of the control part of the paralysis function recovery training apparatus which concerns on Embodiment 2 of this invention. It is a flowchart which shows the control method of the paralysis function recovery training apparatus which concerns on Embodiment 2 of this invention. It is a schematic diagram which shows the structure of skeletal muscle. It is a figure which shows one sarcomere. It is a figure showing signs that muscle contraction occurs. It is a figure showing signs that electric stimulation (Electrical Stimulation) by a pulse current is given to both ends of a muscle. It is a figure showing an example of a waveform of a pulse signal as electric stimulation. FIGS. 14A to 14D are diagrams illustrating measurement postures. It is a figure which shows the attachment position of a myoelectric potential electrode. It is a graph which shows the difference of a myoelectric potential. It is a graph which shows the result of Fourier transform of RMS value data of myoelectric potential. 15 is a graph showing changes in myoelectric potential due to electrical stimulation in the posture of FIG. 16 is a graph showing a result of a frequency analysis at a location of the instep of FIG. 15. 6 is a graph showing the relationship between time and speed for each current value. It is a graph which shows the finger extension degree for every electric current value. 6 is a graph showing finger agility for each current value. It is a graph which shows the myoelectric potential in the state where the muscle in FIG.14 (C) is loose. It is a graph which shows the myoelectric potential of the state where the muscle in FIG. 14 (D) is stretched. FIG. 7 is a diagram showing an actual myoelectric potential measurement screen by LabVIEW.

Embodiment 1
First, a paralysis function recovery training device which is a premise for carrying out the present invention will be described. FIG. 1 shows the overall configuration of a paralysis function recovery training apparatus 10 according to Embodiment 1 of the present invention.

  The paralysis function recovery training device 10 includes a movable movable table 12, a forearm platform 13 provided at one end on the movable table 12, and a rotatable support provided on the movable table 12 so as to be rotatable around a horizontal axis. The opened half cylinder 15, a stick 16 provided in the half cylinder 15, a wrist support 17 provided in the half cylinder 15, and one end connected to the half cylinder 15. It includes a drive shaft 14 extending along the horizontal axis, and a servomotor 21 for driving the drive shaft 14. These components constitute the movement means. The movable base 12 is composed of columns 26, 28 and the like, and can be moved back and forth and right and left by wheels attached to a lower part. Further, the stick 16 is provided with a light emitting element 71 which is one form of a notification unit.

  The paralysis function recovery training device 10 includes an encoder 23 and a control unit 24. The encoder 23 is attached to the servomotor 21 and measures a rotation angle of a motor shaft of the servomotor 21 (an axis connected to the drive shaft 14). The control unit 24 is a controller including a computer having a CPU and a memory, and performs various controls by executing a program stored in the memory by the CPU. The control unit 24 obtains the rotation angle information from the encoder 23, drives the servo motor 21, and rotates the half-cylindrical body 15 in one direction on the left and right, stops, reverses, and stops. . The control unit 24 controls the speed at which the muscle is stimulated to recover the function in the normal rotation, causes the muscle to undergo reflex reflex, and stimulates the muscle to excite the nerve cells. A series of controls are provided to provide resistance to maintain tension. The control unit 24 is provided with a speaker 72 which is one form of a notification unit.

  The target of training of the paralysis function recovery training apparatus 10 according to the present embodiment is the forearm 58 of the patient. The patient's forearm 58 is placed on the forearm platform 13, and the patient's wrist 56 is placed on a cushion 57. The patient's hand is holding the stick 16.

  The electrode pads 74 and 75 are attached to the inside and outside of the forearm 58 of the patient. The electrode pads 74 and 75 are connected to the control unit 24 via the wiring 73. The control unit 24 applies a voltage to the electrode pads 74 and 75 at a predetermined timing, and applies electrical stimulation to the pronator and circumflex muscles of the forearm 58 of the patient.

  When performing electrical muscle stimulation to assist the hemiplegic patient's autonomic movement on the paralyzed side, there are places (motor pointers) where the stimulation effect is good in the stimulation muscle. However, if the amount of electrical stimulation applied to a given location is too strong, the muscles will passively contract (which will passively move the joints), and the exercise will not be able to automatically exercise the paralyzed limbs. Can not be obtained.

  Therefore, in the paralysis function recovery training device 10 according to the embodiment of the present invention, in order to perform more effective training, the appropriate range of the amount of the electrical muscular stimulation applied to the patient's forearm 58 for the location and the amount of the electrical muscular stimulation. The present invention has been made to provide an apparatus provided with a mechanism for applying such an electrical muscle stimulation amount in an appropriate range.

In the present embodiment, a control method of such a paralysis function recovery training apparatus is also provided.

  As shown in FIG. 2, the control unit 24 includes a detection unit 30 and a stimulus application unit 31. The detection unit 30 detects an appropriate transcutaneous muscle electrical stimulation value (current value) to be given to the patient via the stimulation giving unit 31. The stimulus applying section 31 applies the myoelectric stimulation at the percutaneous myoelectric stimulus value detected by the detection section 30 to the patient T, and also outputs the myoelectric potential of the site T1 on the stimulus target muscle as the target of the patient T. It can be measured.

  As shown in FIG. 3, an appropriate transcutaneous muscle electrical stimulation value (current value) given to the patient T by the detection unit 30 is a muscle potential (Muscle Potential) (rigidity) in a state where the muscle is rigid. : Stimulation value (XmA) for 80% of potential (A) of E1) or stimulation value (XmA) for 90% of potential (A) of muscle potential (starting: E2) in a state where joint movement starts due to muscle contraction It is. The two stimulus values generally match, as described below.

  Here, “80%” and “90%” are average values obtained when the measurement results of the appropriate stimulus values are obtained for a large number of patients, and the values are determined by individual differences between patients. This is a value having variation. Actually, it includes a range represented by a statistical distribution centered on “80%” and “90%”.

For example, a stimulus value corresponding to the myoelectric potential in a state in which the muscle is stiff is Ari, and a stimulus value corresponding to the myoelectric potential in a state in which the joint starts to move due to muscular contraction is Ast. Let the value be Ash. In this case, the control unit 24 (the detection unit 30)
Ast / Ari + Ash / Ast = V (V is 1.5 or more and 1.6 or less) (1)
Is detected. This value is, as described above, a stimulation value corresponding to 80% of the myoelectric potential when the muscle is stiff, or 90% of the myoelectric potential when the joint starts to move due to muscle contraction. Matches the corresponding stimulus value.

  FIG. 4 is a plot of actual measured values when Ash / Ast is plotted on the horizontal axis and Ast / Ari is plotted on the vertical axis. As shown in FIG. 4, the value of V is limited to 1.5 or more and 1.6 or less in the ellipse from the plot point.

  The operation of the paralysis recovery training apparatus 10 (control unit 24) will be described. First, as shown in FIG. 5, the control unit 24 (detection unit 30) corresponds to the stimulus value Ari corresponding to the myoelectric potential when the muscle is stiff and the myoelectric potential when the joint starts to move due to muscle contraction. The stimulus value Ast is actually measured (step S1). Then, the control unit 24 (the detection unit 30) calculates the percutaneous electrical muscular stimulation value Ash to be given to the patient using the above equation (1) (step S2). Further, the control unit 24 (stimulation applying unit 31) applies the percutaneous electrical muscle stimulation value Ash to the patient (Step S3). In this state, rehabilitation is started. Then, exercise using the exercise means is performed (step S4).

  In addition, the fluctuation frequency (pulse frequency) of the percutaneous muscle electrical stimulation value provided to the patient by the paraplegic function recovery training device 10 (control unit 24 (stimulation applying unit 31)) is 50 Hz. This is because an appropriate rehabilitation effect can be obtained for the percutaneous muscle electrical stimulation value as described above. FIG. 6 shows the peak value (PS value) of the muscle frequency spectrum when the pulse frequency of the percutaneous muscle electrical stimulation value is 30 Hz, 50 Hz, 80 Hz, and 125 Hz. As shown in FIG. 6, among the 30 Hz, 50 Hz, 80 Hz, and 125 Hz, the largest PS value was 50 Hz. This indicates that the largest energy is given to the muscle at 50 Hz among 30 Hz, 50 Hz, 80 Hz, and 125 Hz. Therefore, the frequency of the percutaneous electrical stimulation value appropriate for rehabilitation training is 50 Hz.

  The basic configuration of the paralysis function recovery training device 10 according to the present embodiment is not limited to the forearm portion 58. It is also applicable to rehabilitation of patients' fingers.

Embodiment 2
Next, a second embodiment of the present invention will be described.

  The paralysis function recovery training apparatus 10 according to the present embodiment differs from the first embodiment in the configuration of the control unit 24. As shown in FIG. 7, the control unit 24 includes a detection unit 32 and a stimulus application unit 33. The paralysis recovery training apparatus 10 further includes a notification unit 34.

  The detection unit 32 performs a transcutaneous electromyography in which a difference in a myoelectric potential by a total of two electrodes of a portion T1 on the target muscle of the patient T and a portion T2 other than the muscle is maximized via the stimulation applying unit 33. The stimulus value (current value) is detected as a muscle electrical stimulus value to be applied to the patient T. The stimulus applying section 33 applies a percutaneous muscle electrical stimulation value (current value) to the site T1 and the site T2. The notification unit 34 outputs a sound or light having an intensity corresponding to the difference in the myoelectric potential detected by the detection unit 32. The notification unit 34 corresponds to the light emitting element 71 or the speaker 72 in FIG.

  The operation of the paralysis recovery training apparatus 10 (control unit 24) will be described. First, as shown in FIG. 8, the control unit 24 (detection unit 32) changes the stimulus value (current value) given to the parts T1 and T2, and measures the myoelectric potential difference between the parts T1 and T2 at that time. (Step S11). At this time, the notification unit 34 outputs a sound or light having an intensity corresponding to the myoelectric potential difference. Then, the control unit 24 (the detection unit 32) detects the stimulus value at which the myoelectric potential difference becomes maximum using the above equation (1) (step S12). Further, the control unit 24 (the stimulus applying unit 33) applies the stimulus value at which the detected myoelectric potential difference becomes the maximum to the site T1 of the patient T as the percutaneous myoelectric stimulus value Ash to be applied to the patient (Step S3). ). In this state, rehabilitation is started. Then, exercise using the exercise means is performed (step S4).

  In the first and second embodiments, the movement of the joint is started by a percutaneous muscle electrical stimulation value corresponding to 80% of the myoelectric potential in a state in which the muscle is stiff or a muscle contraction using two methods. Although the percutaneous myoelectric stimulation value corresponding to 90% of the myoelectric potential in the state has been obtained, another method may be used. Simply, the myoelectric potential in a state in which the muscle is rigid may be obtained, and a percutaneous electromyographic stimulation value corresponding to 80% of the electrons may be detected, or the myoelectric potential in a state in which the joint starts to move due to muscle contraction. , A transcutaneous muscle electrical stimulation value corresponding to 90% of the potential may be obtained.

  In order to clarify the effects of the present invention, the characteristics of muscles when the muscles were stiffened while electrical stimulation (50 Hz) was applied to the extensor muscles of the middle finger of the right hand of 10 healthy subjects while increasing the stimuli. The same analysis was performed for the pronation and supination muscles of the forearm. Hereinafter, an experiment which led to the effect of the present invention and the result thereof will be described.

  In this experiment, we focused on the point that muscle contraction can be induced by applying electrical stimulation during rehabilitation to create a state in which muscle contraction is likely to occur, and to apply electric stimulation directly to the finger extension muscles to improve the rehabilitation training effect. . Further, a stimulus value at which the muscle contraction of the finger is caused by the electric stimulation and starts to move passively is set as a threshold value by the electric stimulation.

  FIG. 9 shows the structure of a human skeletal muscle (Muscle). Muscle fibers include fast muscle fibers and slow muscle fibers, but in this experiment, we focus on fast muscle fibers. Muscle fibers are composed of sarcomere (Sarcomere). As an example, one sarcomere is shown in FIG. The sarcomere has a thick filament and a thin filament. The center of the sarcomere is defined as the M line, and the end of one sarcomere is defined as the Z line.

  As shown in FIG. 11, in the case of a healthy person, when an action potential is transmitted to a nerve ending that is a terminal of a motor nerve, a thick filament and a thin filament react with each other, and the muscles contract with each other by sliding with each other. This results in contraction of all sarcomerees where muscle contraction occurs, thereby extending the finger.

  In a muscle easily contracted state, some muscle fibers are contracted, but not all muscle fibers are in a muscle contracted state. In other words, in the easily contracted state in which the finger joint is not moving, all the muscle fibers tend to be sensitive to the contracted state due to some kind of stimulation, and the finger is likely to move. Here, as shown in FIG. 12, electrical stimulation (Electrical Stimulation) is applied to both ends of the muscle by a pulse current, and some of the fast muscle fibers of the finger extensor muscles are contracted. The electrical stimulation value at this time is referred to as easily contractible electrical stimulation.

  Hereinafter, the measurement method of this experiment will be described. In this experiment, a low-frequency treatment device trio 300 (Ito Ultrashort Corporation) was used. In the measurement, an electrical stimulus was applied to the finger extensor muscle using a 50 × 50 mm surface electrode. As shown in FIG. 13, the waveform of the electrical stimulation was set to an input frequency of 50 Hz, the pulse width was fixed to 150 μs, and only the current value was changed in the range of 0.0 to 20 mA.

  In this experiment, the myoelectric potential, which is the EMG signal of the muscle when the electrostimulation was applied by an electrocardiogram electrode having a diameter of about 33 mm, was measured.

  Next, the subject of this experiment will be described. This experiment was performed on 10 healthy subjects (male in their 20s to 50s) and on the right middle finger of the subject.

  First, the posture of the subject at the time of measurement in this experiment will be described. In this experiment, measurement was performed in the postures shown in FIGS. 14 (A) to 14 (D). 14 (A) to 14 (D), FIG. 14 (A) shows a state of a model having the same posture as the rehabilitation training device. FIG. 14B shows a state where measurement is performed by the rehabilitation training device. FIG. 14C shows a state in which the muscle is loose, and FIG. 14D shows a state in which the muscle is taut. Here, in FIGS. 14A, 14C, and 14D, the myoelectric potential was measured, and in FIG. 14B, the finger extension and finger agility in the rehabilitation training device were measured.

  Next, the mounting position of the myoelectric potential electrode in this experiment will be described. In this experiment, myoelectric potentials at two locations are measured as shown in FIG. In other words, the first is on the muscle (the instep) for the purpose of applying electrical stimulation, and the second is about 20% of the thickness of the arm at the location where the first myoelectric potential is attached, for example, the muscle other than the target muscle. Attach to a remote location (B). The position A corresponds to the part T1 according to the second embodiment, and the position B corresponds to the part T2.

  Next, a method for measuring myoelectric potential will be described. The electric stimulation (current) is increased by 1 mA at a time until the middle finger moves passively and the muscle is completely rigid, and the myoelectric potential is measured for 30 seconds for each stimulation value. During the measurement, a rest period of 2 minutes is provided to eliminate the dependence of the muscle on electrical stimulation.

  Then, the myoelectric potential was measured at each of the positions shown in FIGS. 14A, 14C, and 14D, and the RMS value of the measured myoelectric potential was obtained every 0.01 s (every 100 data). The average value of the myoelectric potential RMS value data for 10 to 15 seconds is plotted. Here, the difference between the myoelectric potentials at the positions of the insteps and the positions shown in FIG. 15 is shown by a bar graph in FIG.

  Next, an analysis method based on the frequency from the measured myoelectric potential will be described. The RMS value of the myoelectric potential measured in the postures of FIGS. 14A, 14C, and 14D is obtained every 0.01 s (every 100 data), and the myoelectric potential RMS for 10 to 15 seconds is obtained. Use the value data for analysis. As shown in FIG. 17, the magnitude of the PS value of the peak frequency (PS Value) is compared by Fourier transform using 4096 pieces of the data.

  Next, an evaluation method using the rehabilitation training device will be described. In FIG. 14 (B), at the time of stretching reflection in which the degree of finger extensibility and agility are obtained from the average value of the speed data of 3 to 8 times out of 10 trainings, the speed of each sampling time is multiplied by the sampling time of 9 msec. The area is determined by adding, and this area is defined as the finger extensibility. The maximum speed at the peak of the stretched reflection is defined as finger agility.

  Hereinafter, the measurement results will be described. Regarding the characteristic analysis based on the results of the myoelectric potential and the frequency, the results of healthy male A in their 20s are shown below. That is, FIG. 18 shows changes in myoelectric potential due to electrical stimulation in the posture of FIG. In FIG. 18, the myopotential (positive) (Muscle Potential (true)) shows the result at the location of the instep shown in FIG. 15, and the myoelectric potential (out) (Muscle Potential (out)) shows the result at the location of Otsu shown in FIG. The results are shown.

  Further, the difference between the two myoelectric potentials is shown in a bar graph (Muscle potential difference) in FIG. FIG. 19 shows the result of the frequency analysis at the instep shown in FIG. More specifically, FIG. 19 shows the relationship between the frequency (Hz) and the PS value (PS Value) for each current value from 1 mA to 13 mA. FIG. 20 shows a result of finger movement by rehabilitation in the rehabilitation training device, and shows a relationship between time and finger speed for each current value from 1 mA to 11 mA. FIGS. 21 and 22 show the finger extensibility (Extensibility) and the finger agility (Extension agility) for each current value.

  At the time of measurement, the middle finger began to move passively at 11 mA. In addition, referring to the results of the potential measurement in FIG. 18, the increase in the myoelectric potential is less seen than 11 mA. Such a result indicates that 11 mA is a threshold value due to electrical stimulation. Further, from the frequency analysis shown in FIG. 19, looking at the PS values around 5 Hz and 15 Hz where the frequencies are concentrated, the maximum of the PS value around 5 Hz was 7 mA, and the maximum at around 15 Hz was 10 mA. Also, as shown in FIG. 18, the myoelectric potential at 7 mA is 80% of the myoelectric potential of 13 mA where the muscle is completely rigid, and the myoelectric potential of 10 mA is 90% of the myoelectric potential of 13 mA. In addition, 7 mA was also the portion where the difference in the myoelectric potential was the largest.

In addition, the results shown in FIGS. 21 and 22 were obtained from the speed data obtained by the rehabilitation training apparatus shown in FIG. The finger extensibility (Extensibility) shown in FIG. 21 was the maximum at 7 mA, and the finger agility (Extension agility) shown in FIG. 22 was the maximum at 7 mA. Therefore, the result that this 7 mA was a stimulus value suitable for rehabilitation training was obtained. Similar results were obtained for the other subjects B, C, D, and E. The situation is shown in Table 1.

  Next, the influence of the measurement posture will be considered. In this experiment, the difference in muscle potential (Muscle potential difference (mv)) between the state in which the muscle shown in FIG. 14C is loose and the state in which the muscle shown in FIG. FIG. 23 shows the result of the healthy person A with the muscles loosened, and FIG. 24 shows the result of the healthy person A with the muscles stretched. As shown in FIG. 23, when the muscle was loose, the muscle became completely rigid at a current value of 15 mA. On the other hand, as shown in FIG. 24, in the state where the streaks were stretched, the streaks were completely rigid at a current value of 13 mA. In other words, it has been found that a larger stimulus value is necessary in a state where the muscle is loose compared to a state where the muscle is taut. Also, the state where the potential difference becomes maximum is 9 mA when the part is loose, the state where the part is stretched is 7 mA, and it can be seen that the stimulus value is larger when the part is loose.

When the stimulus value increases, the strain on the muscles also increases, and the patient feels pain and leads to muscle fatigue. This does not allow effective training. From this, it is understood that the posture suitable for the rehabilitation training is a state in which the muscles are tight. Table 2 shows the results. As shown in Table 2, it can be seen that similar results were obtained for the other subjects B, C, D, and E.

  Next, a method for simplifying the specification of the easily contracted state by sound or the like will be described. It is difficult to measure the myoelectric potential at the actual site, analyze the frequency, and determine the electrical stimulation value suitable for rehabilitation training below the threshold value. Therefore, an electrical stimulus value is obtained using the difference in the myoelectric potential. This is because the portion where the difference in the myoelectric potential is the largest matches the electrical stimulation value suitable for rehabilitation. LabVIEW (National Instruments) was used as a device for displaying the difference of myoelectric potential on the spot, and NlUSB-6341 X SERlES DAQ (National Instruments) was used as a device for data collection. FIG. 25 shows an actual myoelectric potential measurement screen by LabVIEW.

  The RMS value of the myoelectric potential at the instep shown in FIG. 12 is displayed on the upper left portion of the screen in FIG. 25, and the RMS value of the myoelectric potential at the location B shown in FIG. 15 is displayed on the upper right portion. The difference between the RMS values of the two myoelectric potentials is indicated by a horizontal pointer at the bottom of the screen. It can be said that the electrical stimulus value with the maximum horizontal pointer is a stimulus value suitable for rehabilitation. Further, a sine shape can be generated from the difference between the RMS values, and the magnitude of the difference can be represented by sound from the speaker 72 or light emission of the light emitting element 71. When the difference increases, the wavelength of the sine wave is shortened, a high sound is generated, and the light emission intensity of the light emitting element 71 is increased. This makes it possible to easily determine the electrical stimulus value in the easily contracted state using both the horizontal pointer, sound, light, and the like.

  Hereinafter, the experiments described in this example will be summarized. In this experiment, the characteristics of muscles when the electrical stimulus (50 Hz) was applied to the extensor muscles of the right middle finger of the 10 healthy subjects while increasing the muscle stiffness were analyzed. As a result, the following results were obtained.

  First, when the finger began to passively move, no increase in myoelectric potential was observed, and it was clarified that the stimulus value immediately before that was the threshold value of the muscle due to electrical stimulation.

  Secondly, from the frequency analysis, the maximum stimulus value of the PS value around 5 Hz is the stimulus value for 80% of the myoelectric potential in the rigid state of the myoelectric potential, or 9 of the myoelectric potential in the state where the joint movement starts due to muscle contraction. This is a stimulus value for a given potential.

  Third, both the finger extension and the finger agility in the rehabilitation training apparatus are stimulus values for 80% of the myoelectric potential of the muscle in a stiff state or 9% of the myoelectric potential in a state where joint movement starts due to muscle contraction. The maximum value is obtained when the stimulus value is relative to the potential, and the best effect is obtained.

  Fourth, the easily contracted state is a stimulus value for an electric potential of 80% of a myoelectric potential in a state where the muscle is completely contracted and stiffened by electrical stimulation, or a stimulus for 90% of a myoelectric potential in a state where movement of a joint starts due to muscle contraction. Value, and the greatest rehabilitation training effect is obtained in this state. That is, it can be said that a value considered appropriate for the easily contractible electrical stimulation could be specified.

  Fifth, the posture of rehabilitation training can be performed with a smaller electrical stimulus value when the muscles are tighter than when the muscles are loose. It turned out to be correct.

  Sixth, the stimulus value suitable for rehabilitation coincides with the point where the difference between the two myoelectric potentials is maximized. For this reason, it turned out that it can be easily judged from the difference of the myoelectric potential in the actual spot.

  Seventh, since the strength of the myoelectric potential difference is notified by sound, the training worker can easily know the strength of the myoelectric potential.

  Various embodiments and modifications of the present invention can be made without departing from the broad spirit and scope of the present invention. Further, the above-described embodiment is for describing the present invention, and does not limit the scope of the present invention. That is, the scope of the present invention is shown not by the embodiments but by the claims. Various modifications made within the scope of the claims and the scope of the invention equivalent thereto are considered to be within the scope of the present invention.

  The present invention is used for recovery training of hemiplegic patients.

  DESCRIPTION OF REFERENCE NUMERALS 10 paralyzed function recovery training device, 12 movable platform, 13 forearm platform, 14 drive shaft, 15 half cylinder, 16 stick, 17 wrist support, 18 drive shaft, 19 bearing stand, 21 servo motor, 23 encoder, 24 Control part, 26, 28 prop, 30, 32 detecting part, 31, 33 stimulating part, 34 notifying part, 56 wrist, 57 cushion, 58 forearm part, 71 light emitting element, 72 speaker, 73 wiring, 74, 75 electrode pad , T patient, T1, T2 site

Claims (8)

A paralysis function recovery training device that treats paralysis of a hemiplegic patient by applying muscle electrical stimulation to the patient,
When the stimulus value for the myoelectric potential when the muscle is stiff is Ari and the stimulus value for the myoelectric potential when the joint starts to move due to muscle contraction is Ast, Ast / Ari + Ash / Ast = V (V is 1.5 Detection means for detecting the percutaneous electrical muscular stimulation value Ash given to the patient based on the relational expression of 1.6 or less)
Stimulation applying means for applying muscle electrical stimulation to the patient with the percutaneous muscle electrical stimulation value detected by the detection means,
Paralysis function recovery training device characterized by comprising: A paralysis function recovery training device that treats paralysis of a hemiplegic patient by applying muscle electrical stimulation to the patient,
A transcutaneous electrical stimulation value that maximizes the difference in myoelectric potential between two electrodes, one on the target muscle and the other on the target muscle, and the electrical stimulation value for the patient Detection means for detecting as
Stimulation applying means for applying muscle electrical stimulation to the patient with the percutaneous muscle electrical stimulation value detected by the detection means,
Paralysis function recovery training device characterized by comprising:   The paralysis function recovery training device according to claim 2, further comprising a notification unit that notifies an operator of the strength of the difference in the myoelectric potential by sound. The stimulus applying means,
Applying the percutaneous muscle electrical stimulation varying in value at 50 Hz to a patient,
The paralysis function recovery training device according to any one of claims 1 to 3. A method of controlling a paralysis function recovery training device for treating paralysis of a hemiplegic patient by applying a muscle electrical stimulation to the patient,
If the detecting means sets the stimulus value for the myoelectric potential when the muscle is stiff to Ari and the stimulus value for the myoelectric potential when the joint starts to move due to muscular contraction, Ast / Ari + Ash / Ast = V (V A detection step of detecting a percutaneous muscle electrical stimulation value Ash that satisfies the relationship of 1.5 to 1.6);
Current generating means for generating a current for electrical muscular stimulation with the percutaneous electrical stimulus value detected in the detecting step,
A method for controlling a paralyzed function recovery training device, comprising : A method for controlling a paralysis function recovery training apparatus for treating paralysis of a hemiplegic patient by applying a muscle electrical stimulation to the patient,
Detecting means, as the muscle electrical stimulation values, transdermal muscle electrostimulation value difference myoelectric potential is maximized by total two places of electrodes at one point and one point other than the muscle to the patient's stimulation purposes muscle A detecting step for detecting;
Current generating means for generating a current for electrical muscular stimulation with the percutaneous electrical stimulus value detected in the detecting step,
A method for controlling a paralyzed function recovery training device, comprising : In the current generating step,
The current generating means generates a current for muscle electrical stimulation based on the percutaneous muscle electrical stimulation value detected in the detection step when the patient's training posture is in a state in which the stimulation target muscle of the patient is stretched. the method paralysis rehabilitation apparatus according to claim 5 or 6, characterized in that cause. In the current generating step,
The variation frequency of the percutaneous muscle electrical stimulation value is 50 Hz,
A control method for the paralysis function recovery training apparatus according to any one of claims 5 to 7.