JP6692018B2 - 歩行トレーニングシステム及び歩行トレーニング器 - Google Patents
歩行トレーニングシステム及び歩行トレーニング器 Download PDFInfo
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Description
(1−1)歩行トレーニングシステムの全体構成
図1は本発明による歩行トレーニングシステム1を示し、下肢機能障害をもつ対象者Pが上肢を使って自立的な歩行を補助するための歩行トレーニング器2と、対象者Pが両足に履く靴であり、各靴底に装着された床反力センサ(足荷重測定部)を含むFRF(Floor Reaction Force:床反力[N])ユニット(重心位置検出部)3とから構成されている。
HRFユニット20は、図2(A)に示すように、所定サイズの棒状形状の把持部10A(10B)が、その両端に把持荷重検出部21F、21Rを介して上肢支持フレーム7の手すり7X(7Y)の上側に支持シャフト22と一体となって固定された両端支持構造 からなり、当該把持部10A(10B)に作用する力分布のうち鉛直下方向及びその逆方向に付加される力を把持荷重検出部21F、21Rが計測する。
一対のFRFユニット3において、それぞれ床反力センサ30(図4)は、対象者Pの左右の足裏にかかる荷重に対する反力を検出する。床反力センサ30は、例えば、印加された荷重に応じた電圧を出力する圧電素子、又は、荷重に応じて静電容量が変化するセンサなどからなり、体重移動に伴う荷重変化、及び対象者Pの脚と地面との接地の有無をそれぞれ検出することができる。また、左右の足裏に係る荷重のバランスから、重心位置を求めることができる。
図4は本実施形態の歩行トレーニングシステム1における歩行トレーニング器2およびFRFユニット3の制御系の構成を示すブロック図である。歩行トレーニング器2は、上述したフレーム構造(基台フレーム4、上肢支持フレーム7、免荷用フレーム5)以外に、制御系ユニット31とHRFユニット20と表示部15と無線通信部32とを有する。
(1−5−1)手すり反力マップ(HRFMAP)の設定方法
ここで本発明による歩行トレーニングシステム1における視覚フィードバック系が下肢機能障害をもつ対象者Pの手すり反力(HRF)の低減に与える影響を評価するための評価指標及び手すり反力マップ(HRFMAP)の設定方法について説明する。
続いて上述の手すり反力の評価方法の結果に基づいて、自立歩行機能の改善と手すり反力の低減との関係を考察する。下肢機能障害を有する対象者Pは、比較的重篤な状態では日常的な移動手段として車椅子に乗り、下肢機能改善に伴って、歩行トレーニング器及び杖を経て、自立歩行を獲得する。
上肢への依存低減による自立歩行機能改善に対する定量的な評価手法として、手すり反力マップ(HRFMAP)を設定する。
自立歩行機能改善のための歩行トレーニングにおいて、手すり反力の低減に対する促進するには、視覚フィードバック系により手すり反力を定量的に認識する必要がある。
ここで、歩行支援システム1による視覚フィードバック系が、下肢機能障害をもつ対象者Pの手すり反力の低減に対して効果を有することを検証し、さらに手すり反力マップHRFMAPの観点から当該歩行支援システムの効果に対して評価する。
(2−1)定トルク免荷を適用した歩行トレーニングシステム
(2−1−1)HRF免荷器を備えた歩行トレーニング器
図1との対応部分に同一符号を付して示す図14において、歩行トレーニングシステム50における歩行トレーニング器51は、免荷用フレーム5に対して上方から、対象者Pの上半身を全方向から取り囲むような枠体を構成するHRF免荷器(免荷部)52が固定して取り付けられている。
この歩行トレーニング器51を適用した歩行トレーニングシステム50において、HRF免荷部52を用いて視覚フィードバック系の効果増幅の実現可能性を検証する。
本実施の形態においては、歩行トレーニングシステム1、50における歩行トレーニング器2、51を、図1及び図12に示すような、対象者Pの歩行動作と一緒に移動する車輪付きの歩行器に適用した場合について述べたが、本発明はこれに限らず、対象者Pが自らの手を用いて体重の一部を支持することができれば良く、トレッドミルや杖などの種々の歩行トレーニング器に適用することにより、対象者Pの下肢機能障害の症状に合わせた様々なトレーニング方法にバリエーションを展開することが可能となる。
Claims (5)
- 対象者の左右の足裏面に取り付けられ、当該各足裏面に加わる荷重を測定する足荷重測定部と、
前記足荷重測定部により測定された荷重変化により、前記対象者の左右の足裏面の重心位置をそれぞれ検出する重心位置検出部と、
歩行トレーニングを行う歩行トレーニング器に取り付けられ、前記対象者が自己の体重の一部を支えるために把持する把持部と、
前記把持部に作用する力分布のうち鉛直下方向及びその逆方向のいずれか一方または両方に付加される力を検出する把持荷重検出部と、
前記重心位置検出部により検出された前記対象者の左右の足裏面の重心位置に加わる荷重の左右の切替えタイミングに同期して、前記把持荷重検出部により検出された前記把持部にかかる力の増減が周期的に繰り返す関係に基づいて、当該把持部にかかる力の低減の推移を定量的に反映するための評価指標を生成する評価指標生成部と、
前記評価指標に応じた伝達信号を前記対象者への感覚としてフィードバック伝達させる感覚伝達部と
を備え、前記評価指標生成部は、
前記対象者の前記把持部にかかる力を所定の閾値を基準に比較的大きい状態及び比較的小さい状態に分けた後、当該各状態の時間平均値を直交軸とする座標系を形成し、
当該座標系の原点を自立歩行状態である目標値として、前記把持部にかかる力の低減の推移を、現在の状態を始点に当該目標値に対する回復度合いを表すベクトルとして前記座標系にマッピングするとともに、
前記対象者の下肢機能障害の状態を重篤度合いに応じて群分けするとともに、前記ベクトルの分散及び相関の大きさに比例して前記目標値からの距離が短くなるように、当該各群を前記座標系において段階的に区分けすることにより、前記評価指標を生成する
ことを特徴とする歩行トレーニングシステム。 - 前記対象者の体重の一部を免荷する免荷部を備え、
前記免荷部は、前記対象者の左右の足裏面の重心位置に加わる荷重の左右の切替えタイミングに同期して、当該対象者の体重を基準に設定した所定量のみ免荷するように調整する
ことを特徴とする請求項1に記載の歩行トレーニングシステム。 - 前記対象者の左右の足裏面に取り付けられ、当該各足の加速度を検知する加速度センサをさらに備え、
前記加速度センサの検知結果を所定期間記録し続けることにより、前記対象者の歩行パターンの変化の度合いを検出する
ことを特徴とする請求項1または2に記載の歩行トレーニングシステム。 - 歩行トレーニング時に対象者が自己の体重の一部を支えるために把持する把持部と、
前記把持部に作用する力分布のうち鉛直下方向及びその逆方向のいずれか一方または両方に付加される力を検出する把持荷重検出部と、
前記対象者の左右の足裏面の重心位置を表すデータを外部から受信する受信部と、
前記受信部で受信した前記データに基づく前記対象者の左右の足裏面の重心位置に加わる荷重の左右の切替えタイミングに同期して、前記把持荷重検出部により検出された前記把持部にかかる力の増減が周期的に繰り返す関係に基づいて、当該把持部にかかる力の低減の推移を定量的に反映するための評価指標を生成する評価指標生成部と、
を備え、前記評価指標生成部は、
前記対象者の前記把持部にかかる力を所定の閾値を基準に比較的大きい状態及び比較的小さい状態に分けた後、当該各状態の時間平均値を直交軸とする座標系を形成し、
当該座標系の原点を自立歩行状態である目標値として、前記把持部にかかる力の低減の推移を、現在の状態を始点に当該目標値に対する回復度合いを表すベクトルとして前記座標系にマッピングするとともに、
前記対象者の下肢機能障害の状態を重篤度合いに応じて群分けするとともに、前記ベクトルの分散及び相関の大きさに比例して前記目標値からの距離が短くなるように、当該各群を前記座標系において段階的に区分けすることにより、前記評価指標を生成する
ことを特徴とする歩行トレーニング装置。 - 前記対象者の体重の一部を免荷する免荷部を備え、
前記免荷部は、前記対象者の左右の足裏面の重心位置に加わる荷重の左右の切替えタイミングに同期して、当該対象者の体重を基準に設定した所定量のみ免荷するように調整する
ことを特徴とする請求項4に記載の歩行トレーニング装置。
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