JP6815580B2 - Tongue function evaluation method, tongue function training method, tongue function evaluation device, and tongue function training device - Google Patents

Description

The present invention relates to a tongue function evaluation method for evaluating tongue function, a tongue function training method for training tongue function, a tongue function evaluation device for evaluating tongue function, and a tongue function training for training tongue function. Regarding the device.

In 2011, the third leading cause of death in Japan changed from cerebrovascular disease to "pneumonia". Of the 124,652 deaths from pneumonia, 96.5% are elderly people aged 65 and over, and about half of them are said to have died from "aspiration pneumonia due to dysphagia." In addition, it is said that about 30% of the elderly have dysphagia, and at least 5 million people are at risk of dying from pneumonia. Even in Iwate Prefecture, the problem of dysphagia is becoming more serious, with 1,666 deaths from pneumonia annually.
In order to effectively perform swallowing rehabilitation, it is important to accurately grasp the swallowing function and to carry out training suitable for the individual. Evaluation of swallowing function directly / indirectly contributes to the formation of bolus (creating a lump that is easy to swallow), delivery to the pharynx, closure of the larynx (covering the trachea to prevent aspiration), etc. It is often done by focusing on "exercise ability". At present, the force with which the tongue crushes the food taken into the mouth between the anterior part of the palate and between them is defined as tongue pressure (Non-Patent Document 1), and by focusing on the maximum value, evaluation of tongue function deterioration and training effect can be made. However, with this method, the motor ability of each part such as the tip of the tongue, the body of the tongue, and the base of the tongue, and the motor ability of the paralyzed side and the non-paralyzed side cannot be evaluated individually, and the motor ability of the tongue cannot be evaluated. It has the problem that it can only be evaluated from a macro perspective.
Patent Documents 1 to 4 disclose a method for measuring tongue pressure using a balloon.
Further, Patent Document 5 and Patent Document 6 disclose that a pressure sensor sheet is attached to the palate and the pressure at an arbitrary point on the palate is measured.
On the other hand, in the training of swallowing function, as described above, the tongue motor ability cannot be evaluated in detail. Therefore, the training for manually expanding the range of motion, the training for strengthening the muscle by pressing the tongue against the tongue depressor or the spoon, and the balloon-type tongue pressure. Simple training methods such as training to increase the oral pressure with a measuring instrument are adopted. However, it is physiologically clear that the training site and effect differ greatly depending on the magnitude, direction, and time of the load applied to the tongue, and it can be said that the realization of training suitable for the tongue function of each individual is indispensable. In addition, there are various pathological conditions of tongue movement disorder, and it is required to deal with them. A more detailed and accurate assessment is essential for proper training and outcomes.
Patent Document 7 discloses a device in which a plurality of pressure sensors are arranged on a mouthpiece to measure tongue pressure, cheek pressure, and the like.
Patent Document 8 discloses a tongue measuring device capable of easily evaluating the tongue motor function without causing the tongue to move.
According to Patent Document 9, even for a patient who cannot move the tongue spontaneously, the tongue can be moved back and forth, up, down, left and right, etc. without damaging the patient's tongue and without burdening the operator. A possible tongue suction rehabilitation tool is disclosed.
Further, tongue pressure measuring devices and training devices as described in Patent Documents 10 and 11 have been proposed.

Japanese Unexamined Patent Publication No. 2006-204940 Japanese Unexamined Patent Publication No. 2005-013679 Japanese Unexamined Patent Publication No. 2001-275994 Japanese Unexamined Patent Publication No. 2005-296281 Japanese Unexamined Patent Publication No. 2010-273840 Japanese Unexamined Patent Publication No. 2006-000234 JP-A-2015-144695 Japanese Unexamined Patent Publication No. 2014-188029 Utility Model Registration No. 3204772 JP-A-2007-202922 Special Table 2013-544603

Hayashi R, Tsuga K et al., A novel handy probe for tongue pressure measurement. Int J Prosthodont, 15: 385-388, 2002.

However, Patent Documents 1 to 4 evaluate the pressure inside the balloon when the balloon is pressed against the palate with the entire tongue, and the motor ability of each part such as the tip of the tongue, the body of the tongue, and the base of the tongue. In addition, the motor ability of the paralyzed side and the non-paralyzed side cannot be evaluated individually. Moreover, the magnitude and direction of the force applied by the tongue (that is, the three-dimensional force vector) and the point of action thereof cannot be evaluated. In addition, since the size of the balloon is constant and the measured value changes depending on the oral volume, there is an aspect that it cannot be simply regarded as a difference in tongue movement when evaluating between individuals. Furthermore, the target value and the tongue pressure actually exerted can be visualized at the same time, and the ability to adjust the force that can be exerted while using visual feedback cannot be evaluated. Further, for example, it is not possible to evaluate the ability of a force that can be exerted in any direction other than the direction in which the tongue is pressed against the palate, such as a force that tries to move the tongue left and right and a force that pushes the tongue forward.
Further, in Patent Document 5 and Patent Document 6, since the pressure sensor sheet is installed on the palate in principle, the shear force cannot be measured, and the magnitude and direction of the force applied by the tongue (that is, the three-dimensional force vector) The point of action cannot be evaluated either. Further, for example, it is not possible to evaluate the ability of a force that can be exerted in any direction other than the direction in which the tongue is pressed against the palate, such as a force that tries to move the tongue left and right and a force that pushes the tongue forward.
Further, since Patent Document 7 uses a pressure sensor, the magnitude and direction of the force applied by the tongue, that is, the three-dimensional force vector cannot be evaluated.
Further, Patent Document 8 is a method of predicting the ability to move the tongue from the muscle cross-sectional area calculated from the impedance of the tongue, and the force that can be exerted in any direction cannot be predicted from any part, and the paralyzed side and non-paralyzed side. The ability of the side cannot be evaluated individually.
Further, Patent Document 9 discloses a tongue suction rehabilitation tool capable of pulling the tongue, Patent Document 10 discloses a pressure detector different from a balloon, and Patent Document 11 discloses a further different force sensing unit, but proposes a tongue function evaluation method. It's not something to do.

In the present invention, the target value and the information of the force actually exerted are visualized at the same time, and the tongue part that can be exerted while using the visualized visual information (visual feedback) (the tongue part is the tip of the tongue and the tongue body part). Provided is a tongue function evaluation method capable of evaluating the ability to adjust the force of (a collection of each part of the tongue such as the base of the tongue), and capable of multifaceted quantitative evaluation of functional deterioration such as swallowing disorder. The purpose is.
INDUSTRIAL APPLICABILITY The present invention can evaluate the ability of the evaluated person to adjust the force of the tongue according to a target value by visual feedback, and can evaluate the ability to adjust the force of the tongue, for example, a function such as dysphagia. It is an object of the present invention to provide a tongue function evaluation device capable of quantitatively evaluating a decrease from various aspects.
The present invention can encourage the trainee to adjust the tongue force according to the target value by visual feedback, and effectively perform training to enhance instantaneous force, dexterity, muscular strength, or endurance. It is an object of the present invention to provide a training method and a training device capable of performing tongue function training.
An object of the present invention is to provide a tongue function evaluation device capable of measuring a vector value of a force with each part of the tongue as an action point and identifying a part of functional deterioration.
The present invention provides a tongue function training device capable of measuring a vector value of a force with each part of the tongue as a point of action, and effectively performing training to enhance instantaneous force, dexterity, muscular strength, or endurance. The purpose is to do.

The tongue function evaluation method of the present invention according to claim 1 measures the force in an arbitrary direction that the tongue can exert at an arbitrary position and posture of the tongue to evaluate the function of the tongue. It is a method, in which the endurance evaluation step of measuring the duration during which the target value can be continuously exerted and determining the endurance from the duration, and the first target value and the second target value as the target value are set. When it is set and changed from the first target value to the second target value, the excessive response from the first target value to the second target value is measured, and the instantaneous force is obtained from the characteristic value of the excessive response. The instantaneous force evaluation step for determining the above, and when the target value is continuously changed, the follow-up response to the continuous change is measured, and the dexterity is judged from the error from the target value in the follow-up response. It is characterized by having a skill evaluation step.
The present invention according to claim 2 has a muscle strength evaluation step in which the maximum exerted force of the tongue portion is measured and the measured maximum measured value is determined as muscle strength in the tongue function evaluation method according to claim 1. It is a feature.
According to the third aspect of the present invention, in the tongue function evaluation method according to the second aspect, the endurance evaluation step, the instantaneous force evaluation step, and the instantaneous force evaluation step are based on the maximum measured value measured in the muscle strength evaluation step. It is characterized in that the target value in the skill evaluation step is set.
The present invention according to claim 4 is the target in the endurance evaluation step, the instantaneous force evaluation step, and the dexterity evaluation step in the tongue function evaluation method according to any one of claims 1 to 3. It is characterized in that the value and the measured value to be measured are displayed, and the displayed measured value is urged to match the displayed target value.
The present invention according to claim 5 applies the force to be measured in the tongue function evaluation method according to any one of claims 1 to 4 at the tongue tip, tongue body, tongue base and the like in the tongue. , At least one or more arbitrary measurement points or vector values acting on any measurement surface.
The present invention according to claim 6 is characterized in that, in the tongue function evaluation method according to any one of claims 1 to 4, the force to be measured is tongue pressure within a predetermined range of the tongue portion. ..
The present invention according to claim 7 is the endurance determined in the endurance evaluation step and the instantaneous force determined in the instantaneous force evaluation step in the tongue function evaluation method according to any one of claims 1 to 6. It is characterized in that the force and the evaluation result of the dexterity determined in the dexterity evaluation step are displayed together with the measurement point or the measurement surface in the tongue image diagram showing the tongue.
The tongue function training method of the present invention according to claim 8 measures a force exerted by the tongue in an arbitrary direction at an arbitrary position and posture of the tongue, and measures a target value exerted by the tongue. This is a tongue function training method for training the function of the tongue by displaying the measured value and prompting the displayed measured value to match the displayed target value. By setting the first target value and the second target value as, and changing from the first target value to the second target value, an excessive response from the first target value to the second target value is trained. It is characterized by having an instantaneous force training step for training and a skill training step for training a follow-up response to a continuous change by continuously changing the target value.
The present invention according to claim 9 measures the maximum exerted force of the tongue portion in the tongue function training method according to claim 8, and based on the measured maximum measured value, the instantaneous force training step and the said It is characterized by setting the target value in the skill training step.
The tongue function evaluation device of the present invention according to claim 10 measures the force in an arbitrary direction that the tongue can exert at an arbitrary position and posture of the tongue to evaluate the function of the tongue. A device that holds the tongue tip, a strain sensor that detects the force applied to the tongue tip holding portion, a target value that receives a signal from the strain sensor and exerts it on the tongue, and measures. A control unit that displays the measured value to be measured on the display unit is provided, and the control unit measures the duration during which the target value can be continuously exerted, and determines the endurance from the duration. When the evaluation means and the first target value and the second target value are set as the target value and the first target value is changed to the second target value, the first target value is changed to the second target value. An instantaneous force evaluation means that measures an excessive response to a target value and determines the instantaneous force from the characteristic value of the excessive response, and a follow-up response to the continuous change when the target value is continuously changed. It is characterized by having a skill evaluation means for measuring and determining the skill from an error from the target value in the follow-up response.
The present invention according to claim 11 has the tongue function evaluation device according to claim 10, which has a muscular strength evaluation means for measuring the maximum exerted force of the tongue portion and determining the measured maximum measured value as muscular strength. It is a feature.
The tongue function training device of the present invention according to claim 12 measures a force exerted by the tongue in an arbitrary direction at an arbitrary position and posture of the tongue, and is measured with a target value exerted by the tongue. It is a tongue function training device that trains the function of the tongue by displaying the measured value and prompting the displayed measured value to match the displayed target value, and holds the tip of the tongue. The tongue tip holding portion, the strain sensor that detects the force applied to the tongue tip holding portion, the target value that receives a signal from the strain sensor and exerts on the tongue, and the measured value to be measured. The control unit includes a control unit for displaying on the display unit, and the control unit measures the duration during which the target value can be continuously exerted, and determines the endurance from the duration, and the target. When a first target value and a second target value are set as values and the first target value is changed to the second target value, an excessive response from the first target value to the second target value is performed. And the instantaneous force evaluation means for determining the instantaneous force from the characteristic value of the transient response, and when the target value is continuously changed, the follow-up response to the continuous change is measured and the follow-up response is measured. It is characterized by having a skill evaluation means for determining the skill from an error from the target value in the above.
The present invention according to claim 13 measures the maximum exerted force of the tongue portion in the tongue function training device according to claim 12, and based on the measured maximum measured value, the instantaneous force evaluation means and the instantaneous force evaluation means. It is characterized in that the target value in the skill evaluation means is set.
The tongue function evaluation device of the present invention according to claim 14 measures the force in an arbitrary direction that the tongue can exert at an arbitrary position and posture of the tongue to evaluate the function of the tongue. A device that holds the tongue tip, a strain sensor that detects the force applied to the tongue tip holding portion, a target value that receives a signal from the strain sensor and exerts it on the tongue tip, and measures. A control unit for displaying the measured value to be measured is displayed on the display unit, and the force to be measured is applied to at least one or more arbitrary measurement points at the tip of the tongue, the body of the tongue, the base of the tongue, etc. It is a vector value that acts on an arbitrary measurement surface, and a 6-axis force sensor is used as the strain sensor.
The tongue function training device of the present invention according to claim 15 measures the force exerted by the tongue in an arbitrary direction at an arbitrary position and posture of the tongue, and measures the target value exerted by the tongue. It is a tongue function training device that trains the function of the tongue by displaying the measured value and prompting the displayed measured value to match the displayed target value, and holds the tip of the tongue. The tongue tip holding portion, the strain sensor that detects the force applied to the tongue tip holding portion, the target value that receives the signal from the strain sensor and exerts on the tongue tip, and the measured value to be measured. A control unit for displaying on the display unit is provided, and the force to be measured acts on at least one or more arbitrary measurement points or any measurement surface at the tongue tip, tongue body, tongue base, etc. in the tongue. It is characterized in that a 6-axis force sensor is used as the strain sensor.

According to the tongue function evaluation method of the present invention, the ability to exert the force of the tongue and the ability to adjust can be evaluated, and functional deterioration such as dysphagia can be quantitatively evaluated from various aspects.
According to the tongue function training method of the present invention, visual feedback can encourage the trainee to adjust the tongue force according to the target value, and enhances instantaneous power, dexterity, muscle strength, or endurance. Training can be done effectively.
According to the tongue function evaluation device of the present invention, it is possible to evaluate the ability of the tongue to adjust the force of the tongue by prompting the evaluated person to adjust the force of the tongue according to the target value by visual feedback, for example, swallowing. It is possible to quantitatively evaluate functional deterioration such as disability from multiple aspects.
According to the tongue function training device of the present invention, visual feedback can encourage the trainee to adjust the tongue force according to the target value, and enhances instantaneous force, dexterity, muscular strength, or endurance. Training can be done effectively.
According to the tongue function evaluation device of the present invention, by using the 6-axis force sensor, it is possible to measure the vector value of the force with each part of the tongue as the point of action, and it is possible to identify the part of functional deterioration.
According to the tongue function training device of the present invention, the vector value of the force with each part of the tongue as the point of action can be measured by using the 6-axis force sensor, and the instantaneous force, dexterity, muscular strength, or endurance can be measured. Can be effectively trained to improve.

A block diagram showing a tongue function evaluation device according to an embodiment of the present invention as a function realizing means. A flowchart showing a tongue function evaluation method and a tongue function training method according to an embodiment of the present invention. Graph explaining the evaluation by this example The figure which shows the display image of the target value image data to be displayed in the display part of this Example. The figure which shows the display image of the target value image data to be displayed in the display part of this Example. The figure which shows the other display image of the target value image data to be displayed by the display part of this Example. The figure which shows the other display image of the target value image data to be displayed by the display part of this Example. Configuration diagram showing the tongue tip holding part and the strain sensor used in this embodiment Configuration diagram of the tongue tip holder and the strain sensor according to another embodiment The figure which shows the display image used for the training and evaluation based on the Example of this invention. Graph showing the training result based on the embodiment of the present invention Graph showing the training result based on the embodiment of the present invention Graph showing the training result based on the embodiment of the present invention

The tongue function evaluation method according to the first embodiment of the present invention has an endurance evaluation step of measuring the duration during which the target value can be continuously exerted and determining the endurance from the duration, and the first target value. When the target value and the second target value are set and the first target value is changed to the second target value, the excessive response from the first target value to the second target value is measured, and the characteristic of the excessive response. The instantaneous force evaluation step that determines the instantaneous force from the value, and when the target value is continuously changed, the follow-up response to the continuous change is measured, and the dexterity is judged from the error from the target value in the follow-up response. It has a skill evaluation step to be performed. According to the present embodiment, the ability to exert the force of the tongue and the ability to adjust can be evaluated, and functional deterioration such as dysphagia can be quantitatively evaluated from various aspects.

The second embodiment of the present invention has a muscle strength evaluation step of measuring the maximum exerted force of the tongue portion and determining the measured maximum measured value as muscle strength in the tongue function evaluation method according to the first embodiment. It is a thing. According to the present embodiment, the ability to exert the force of the tongue and the ability to adjust can be evaluated by evaluating the muscle strength in addition to the endurance, the instantaneous force, and the dexterity.

In the third embodiment of the present invention, in the tongue function evaluation method according to the second embodiment, the endurance evaluation step, the instantaneous force evaluation step, and the elaborateness are based on the maximum measured value measured in the muscle strength evaluation step. It sets a target value in the sex evaluation step. According to this embodiment, endurance, instantaneous power, and dexterity can be evaluated in consideration of individual differences of the evaluated person, so that more accurate quantitative evaluation can be performed.

A fourth embodiment of the present invention includes a target value in the endurance evaluation step, the instantaneous force evaluation step, and the dexterity evaluation step in the tongue function evaluation method according to any one of the first to third embodiments. , The measured value to be measured is displayed, and it is urged to match the displayed measured value with the displayed target value. According to this embodiment, visual feedback can be used to encourage the evaluated person to adjust the force of the tongue.

In the fifth embodiment of the present invention, in the method for evaluating tongue function according to any one of the first to fourth embodiments, the force to be measured is measured at the tip of the tongue, the body of the tongue, the base of the tongue, and the like. , At least one or more arbitrary measurement points or vector values acting on any measurement surface. According to this embodiment, each part of the tongue can be evaluated, and a part of functional deterioration such as paralysis can be identified.

In the sixth embodiment of the present invention, the force to be measured in the tongue function evaluation method according to any one of the first to fourth embodiments is the tongue pressure in a predetermined range of the tongue portion. According to the present embodiment, the ability to exert the force of the tongue and the ability to adjust can be measured by the tongue pressure measurement, which has already become widespread, and a multifaceted quantitative evaluation can be performed.

In the seventh embodiment of the present invention, in the tongue function evaluation method according to any one of the first to sixth embodiments, the endurance determined in the endurance evaluation step, the instantaneous force determined in the instantaneous force evaluation step, And, the evaluation result of the dexterity judged in the dexterity evaluation step is displayed together with the measurement point or the measurement surface in the tongue portion image diagram showing the tongue portion. According to this embodiment, it is possible to visually feed back the exertion characteristics and adjustment ability of the force of the tongue.

In the tongue function training method according to the eighth embodiment of the present invention, a first target value and a second target value are set as target values, and the first target value is changed to the second target value. An instantaneous force training step that trains an excessive response from one target value to a second target value, and a dexterity training step that trains a follow-up response to a continuous change by continuously changing the target value. To have. According to the present embodiment, it is possible to encourage the trainee to adjust the force of the tongue by visual feedback, and it is possible to effectively perform the training to enhance the instantaneous force and the dexterity. And endurance can be trained.

In the ninth embodiment of the present invention, in the tongue function training method according to the eighth embodiment, the maximum exerted force of the tongue portion is measured, and the instantaneous force training step and the instantaneous force training step and the instantaneous force training step based on the measured maximum measured value are used. It sets the target value in the skill training step. According to this embodiment, since the training of instantaneous power and dexterity can be performed in consideration of individual differences of the trainee, more effective training can be performed, and muscular strength and endurance can also be trained by this training.

The tongue function evaluation device according to the tenth embodiment of the present invention receives signals from the tongue tip holding portion that holds the tongue tip, the strain sensor that detects the force applied to the tongue tip holding portion, and the tongue portion. It is equipped with a control unit that displays the target value to be exerted in the above and the measured value to be measured on the display unit, and the control unit measures the duration during which the target value can be continuously exerted, and the endurance is increased from the duration. When the endurance evaluation means for determining the above and the first target value and the second target value are set as the target values and the first target value is changed to the second target value, the first target value to the second target value are changed. An instantaneous force evaluation means that measures the excessive response to the target value and determines the instantaneous force from the characteristic value of the excessive response, and measures the follow-up response to the continuous change when the target value is continuously changed. It has a skill evaluation means for determining the skill from an error from the target value in the follow-up response. According to the present embodiment, visual feedback can be used to encourage the evaluated person to adjust the force of the tongue and evaluate the ability to adjust the force of the tongue. For example, functional deterioration such as dysphagia can be multifaceted. Can be quantitatively evaluated.

The eleventh embodiment of the present invention has a muscular strength evaluation means for measuring the maximum exerted force of the tongue portion and determining the measured maximum measured value as muscular strength in the tongue function evaluation device according to the tenth embodiment. It is a thing. According to the present embodiment, the ability to exert the force of the tongue and the ability to adjust can be evaluated by evaluating the muscle strength in addition to the endurance, the instantaneous force, and the dexterity.

The tongue function training device according to the twelfth embodiment of the present invention receives signals from the tongue tip holding portion that holds the tongue tip, the strain sensor that detects the force applied to the tongue tip holding portion, and the tongue portion. It is equipped with a control unit that displays the target value to be exerted in the above and the measured value to be measured on the display unit. When the endurance evaluation means for determining the above and the first target value and the second target value are set as the target values and the first target value is changed to the second target value, the first target value to the second target value are changed. An instantaneous force evaluation means that measures the excessive response to the target value and determines the instantaneous force from the characteristic value of the excessive response, and measures the follow-up response to the continuous change when the target value is continuously changed. It has a skill evaluation means for determining the skill from an error from the target value in the follow-up response. According to the present embodiment, visual feedback can be used to encourage the trainee to adjust the force of the tongue, and it is possible to effectively perform training to improve the force and dexterity, as well as the muscle strength and endurance. it can.

In the thirteenth embodiment of the present invention, in the tongue function training device according to the twelfth embodiment, the maximum exerted force of the tongue portion is measured, and the instantaneous force evaluation means and the instantaneous force evaluation means based on the measured maximum measured value. It sets a target value in the skill evaluation means. According to the present embodiment, since the training of instantaneous power and skill can be performed in consideration of the individual difference of the trainee, more effective training can be performed.

The tongue function evaluation device according to the 14th embodiment of the present invention receives signals from the tongue tip holding portion that holds the tongue tip, the strain sensor that detects the force applied to the tongue tip holding portion, and the strain sensor, and exerts it on the tongue portion. It is equipped with a control unit that displays a target value to be measured and a measured value to be measured on a display unit, and at least one or more arbitrary force to be measured at the tip of the tongue, the body of the tongue, the base of the tongue, etc. A 6-axis force sensor is used as the strain sensor, which is a vector value acting on the measurement point or an arbitrary measurement surface. According to the present embodiment, by using the 6-axis force sensor, it is possible to measure the vector value of the force with each part of the tongue as the point of action, and it is possible to identify the part of functional deterioration.

The tongue function training device according to the fifteenth embodiment of the present invention receives signals from the tongue tip holding portion that holds the tongue tip, the strain sensor that detects the force applied to the tongue tip holding portion, and the strain sensor, and exerts it on the tongue portion. It is equipped with a control unit that displays a target value to be measured and a measured value to be measured on a display unit, and at least one or more arbitrary force to be measured at the tip of the tongue, the body of the tongue, the base of the tongue, etc. A 6-axis force sensor is used as the strain sensor, which is a vector value acting on the measurement point or an arbitrary measurement surface. According to this embodiment, by using a 6-axis force sensor, it is possible to measure the vector value of the force with each part of the tongue as the point of action, and training to improve instantaneous force, dexterity, muscular strength, and endurance. It can be done effectively.

Hereinafter, examples of the present invention will be described with reference to the drawings.
FIG. 1 is a block diagram showing a tongue function evaluation device according to an embodiment of the present invention as a function realizing means.
The tongue function evaluation device according to the present embodiment includes a tongue tip holding portion 11 that holds the tongue tip of the evaluated person, a strain sensor 12 that detects a force applied to the tongue tip holding portion 11, an input unit 13, and signals from the strain sensor 12. A control unit 30 for receiving and displaying the measured value and the target value on the display unit 20, and a storage unit 40 for storing the measured value of at least one evaluation time required, and an arbitrary position and posture of the tongue portion. In, the function of the tongue is evaluated by measuring the force of the tongue that can be exerted.
When the force to be measured is a vector value acting on an arbitrary measurement point or an arbitrary measurement surface at the tip of the tongue, the body of the tongue, the base of the tongue, etc., the strain sensor 12 is a 6-axis force sensor. Is preferably used. By using the 6-axis force sensor, it is possible to measure the vector value of the force with each part of the tongue as the point of action, and it is possible to identify the part of functional deterioration.
When the force to be measured is the tongue pressure within a predetermined range of the tongue portion, the balloons described in Patent Documents 1 to 4 can be used instead of the tongue tip holding portion 11 and the strain sensor 12. ..

The control unit 30 includes a measured value receiving means 31 that receives the measured value detected by the strain sensor 12, a measured value matching means 32 that matches the measured value received by the measured value receiving means 31 with the target value image data, and muscle strength. It has an evaluation means 33, an endurance evaluation means 34, an instantaneous force evaluation means 35, and an evaluation result matching means 37 for matching the evaluation results of the dexterity evaluation means 36 with the evaluation image data.

The measured value matching means 32 matches the measured measured value with the target value image data in real time, and the matched target value image data is displayed on the display unit 20 in real time.
The muscular strength evaluation means 33 measures the maximum exerted force of the tongue after the end of at least one muscular strength evaluation time, determines that the measured maximum measured value is muscular strength, and stores the muscular strength stored in the storage unit 40. Inquire the evaluation table and evaluate the muscle strength.
The endurance evaluation means 34 measures the duration during which the target value can be continuously exerted, determines the endurance from the measured duration after the end of at least one endurance evaluation time, and stores the storage unit 40. Inquire the endurance evaluation table stored in and evaluate the endurance.
The instantaneous force evaluation means 35 sets a first target value and a second target value as target values, and when the first target value is changed to the second target value, the first target value to the second target value are changed. After the time required for at least one instantaneous force evaluation is completed, the excessive response to is measured, the instantaneous force is determined from the characteristic value of the excessive response, and the instantaneous force evaluation table stored in the storage unit 40 is queried. Instantaneous power evaluation is performed.
When the target value is continuously changed, the dexterity evaluation means 36 measures the follow-up response to the continuous change, and after the end of at least one dexterity evaluation time, sets the target value in the follow-up response. The dexterity is determined from the error of the above, and the dexterity evaluation table stored in the storage unit 40 is queried to perform the instantaneous force evaluation.
In the evaluation result matching means 37, the evaluation results of the instantaneous force evaluation means 35 and the dexterity evaluation means 36 are matched and matched with the evaluation image data together with the measurement points or measurement surfaces input by the input unit 13. The image data is displayed on the display unit 20 after each evaluation has been performed or after all the evaluations have been performed.

The target value image data stored in the storage unit 40 displays the target value as an image with the passage of time, and the target value can be changed by the input unit 13. Further, the target value may be set based on the measured maximum measured value. When setting the target value based on the measured maximum measured value, set the target value to the maximum measured value or less. For example, when the first target value and the second target value are set as the target values, the first target value is set to 70% of the maximum measured value and the second target value is set to 35% of the maximum measured value. Further, when the target value is changed with the passage of time, the change speed can be changed by the input unit 13.
The display image 21 matches the measured value to be measured with the target value image data. When instructing the direction to be evaluated, the measured three-dimensional force vector is matched with the target value while displaying only the instructed force component in the arbitrary direction.
The evaluation image data stored in the storage unit 40 is a tongue portion image diagram showing the tongue portion.
The display image 22 matches the measurement points input by the input unit 13 with the tongue image diagram, and displays the evaluation results of muscle strength, endurance, instantaneous force, and dexterity at the measurement points. When the measurement range is a predetermined area of the tongue, the measurement surface is displayed instead of the measurement point.
As shown by the arrow of the display image 22, the evaluation result preferably indicates the direction of the force to be inspected, such as from the tip of the tongue to the front, sideways, and diagonally, and visually feeds back the spatial force exertion characteristic. Further, regarding the instantaneous force, it is preferable to display the rise time, overshoot, settling time, overshoot time, damping ratio, steady deviation, and the like. Regarding dexterity, the error from the target value is displayed as steady position deviation, steady velocity deviation, steady acceleration deviation, maximum error, average error, etc., or is displayed using correlation coefficient, amplitude ratio, phase lag, etc. Is preferable.

According to this embodiment, it is possible to urge the evaluated person to adjust the force of the tongue by visual feedback using the displayed image data, and evaluate the ability to exert the force of the tongue and the adjustment ability. For example, functional deterioration such as dysphagia can be quantitatively evaluated from various aspects.
Further, according to this embodiment, by evaluating muscular strength, endurance, instantaneous force, and dexterity, a multifaceted quantitative evaluation can be performed according to the magnitude and change of the force of the tongue.

Next, a tongue function training device according to an embodiment of the present invention will be described.
The tongue function training device according to the present embodiment can be realized by the same function realization means as the tongue function evaluation device shown in FIG. Therefore, the same reference numerals are given to the respective configurations, and the description thereof will be omitted.
The tongue function training device according to the present embodiment trains the function of the tongue by encouraging the displayed measured value to match the displayed target value at an arbitrary position and posture of the tongue.
According to this embodiment, visual feedback can be used to encourage the trainee to adjust the force of the tongue, and it is possible to effectively perform training to enhance instantaneous force and dexterity. You can also train your endurance.
Further, according to this embodiment, the maximum exerted force of the tongue is measured, and the target values in the endurance evaluation means, the instantaneous force evaluation means, and the dexterity evaluation means are set based on the measured maximum measurement value. Can be done.
Further, according to this embodiment, since the training of instantaneous power and skill can be performed in consideration of the individual difference of the trainee, more effective training can be performed, and the muscle strength and endurance can be trained by this training.

FIG. 2 is a flowchart showing a tongue function evaluation method and a tongue function training method according to an embodiment of the present invention, and FIG. 3 is a graph for explaining the evaluation.
The tongue function evaluation method according to this embodiment includes a muscle strength evaluation step (step 1), an endurance evaluation step (step 2), an instantaneous force evaluation step (step 3), and a dexterity evaluation step (step 4). The function of the tongue is evaluated by measuring the force that the tongue can exert in any position and posture. Further, the evaluation result is displayed after the muscle strength evaluation step in step 1 to the skill evaluation step in step 4 (step 5).

In the muscle strength evaluation step in step 1, the maximum exerted force of the tongue is measured, and the measured maximum measured value is determined to be muscle strength. In the muscle strength evaluation step, it is a condition that the maximum measured value is maintained for a predetermined time.
The endurance evaluation step in step 2 measures the duration during which the target value can be continuously exerted, and determines the endurance from the duration.
In the instantaneous force evaluation step in step 3, when the first target value and the second target value are set as the target values and the first target value is changed to the second target value, the first target value to the second target value are changed. The excessive response to the target value is measured, and the instantaneous force is judged from the characteristic value of the excessive response.

In this embodiment, the instantaneous force can be evaluated by any of the stationary characteristics and the transient characteristics described below.
FIG. 3A is a graph illustrating the evaluation of steady-state characteristics.
FIG. 3A shows a case where the second target value is y (t) = 1, and is in a steady state (for example, after t = 10 where the error from the target value converges within ± 2%). , or force coincides with the second target value, evaluated at steady-state error e _s.
FIG. 3B is a graph illustrating the evaluation of transient characteristics.
FIG. 3B shows a case where the second target value is y (t) = 1, and the followability or quick response to the rise to the second target value is determined by the rise time _Tr and the delay time T _d. , Settling time T _s , overshoot time T _p , overshoot A _max , and attenuation ratio b / a.
Rise time _Tr , delay time T _d , settling time T _s , and overshoot time T _p can be used for evaluation of quick response, and overshoot A _max and attenuation ratio b / a are used for evaluation of damping characteristics. Can be used.

In the skill evaluation step in step 4, when the target value is continuously changed, the follow-up response to the continuous change is measured, and the skill is judged from the error from the target value in the follow-up response.
Sophistication is evaluated from the ability to follow the target value. In the evaluation of dexterity, especially when a sine wave is set as the target value, the frequency response (frequency characteristic), that is, the ratio of the amplitude given as the target value to the amplitude of the force applied by the evaluated person (measured value), And evaluate the phase shift between the target value and the measured value.
The steady position deviation, the steady velocity deviation, and the steady acceleration deviation shown in FIG. 3C may be used for the evaluation of the error from the target value.
According to this embodiment, the ability to exert the force of the tongue and the ability to adjust can be evaluated, and functional deterioration such as dysphagia can be quantitatively evaluated from various aspects.
Further, according to this embodiment, by evaluating muscular strength, endurance, instantaneous force, and dexterity, a multifaceted quantitative evaluation can be performed according to the magnitude and change of the force of the tongue.

It is preferable that the target values in the endurance evaluation step in step 2, the instantaneous force evaluation step in step 3, and the skill evaluation step in step 4 are set based on the maximum measured value measured in the muscle strength evaluation step in step 1. ..
According to this embodiment, by setting the target value based on the maximum measured value, the endurance, the instantaneous power, and the dexterity can be evaluated in consideration of the individual difference of the evaluated person, so that the quantification is more accurate. You can evaluate.

In the endurance evaluation step in step 2, the instantaneous force evaluation step in step 3, and the skill evaluation step in step 4, the target value and the measured value to be measured are displayed on the display unit 20 in real time, and the displayed measurement is performed. Encourage the value to match the displayed target value.
According to this embodiment, visual feedback can be used to encourage the evaluated person to adjust the force of the tongue.

It is preferable that the force to be measured is a vector value acting on at least one or more arbitrary measurement points or arbitrary measurement surfaces at the tip of the tongue, the body of the tongue, the base of the tongue, and the like. By using a vector value, the force in any direction can be measured.
According to this embodiment, it is possible to evaluate each part of the tongue and identify the part of functional deterioration.
The force to be measured may be the tongue pressure in a predetermined range of the tongue portion. The tongue pressure measurement, which is already becoming widespread, can also measure the ability to exert and adjust the force of the tongue, and can perform multifaceted quantitative evaluation.

The endurance determined in the endurance evaluation step in step 2, the instantaneous force determined in the instantaneous force evaluation step in step 3, and the evaluation result of the dexterity determined in the dexterity evaluation step in step 4, the tongue representing the tongue. By displaying the image together with the measurement point or the measurement surface, the spatial force exerting characteristic of the tongue, that is, the force in an arbitrary direction can be visually grasped.

In the tongue function training method according to this embodiment, the first target value and the second target value are set as the target values, and the first target value is changed to the second target value to change the first target value to the second target value. An instantaneous force training step (step 6) that trains an excessive response to a target value, and a skill training step (step 7) that trains a follow-up response to a continuous change by continuously changing the target value. At any position and posture of the tongue, the force exerted by the tongue in any direction is measured, the target value exerted by the tongue and the measured value to be measured are displayed, and the displayed measured value is displayed. To train the function of the tongue by encouraging them to match the displayed target value. Further, the training result is displayed after the instantaneous force training step in step 6 or the skill training step in step 7 (step 8).
According to this embodiment, it is possible to encourage the trainee to adjust the force of the tongue by visual feedback, and it is possible to effectively perform the training to enhance the instantaneous force and the skill.

It is preferable that the target values in the instantaneous force training step in step 6 and the skill training step in step 7 are set based on the maximum measured value measured in the muscle strength evaluation step in step 1. The target value in the training step can also be based on other evaluations.
According to this embodiment, by setting the target value based on the maximum measured value, it is possible to perform training on instantaneous power and dexterity in consideration of individual differences of the evaluated person, so that more effective training can be performed. , This training also strengthens muscle strength and endurance. By the way, as a general theory for muscles, when the purpose is to strengthen muscle strength, a load of 85% or more of the maximum muscle strength is repeated training 6 times or less, and when the purpose is to strengthen endurance, a load of 65% or less. It has been found that it is good to repeat 12 times or more (Thomas RB, Roger WE (Naokata Ishii): Strength Training & Conditioning. Bookhouse H.D., Tokyo, 2004).
Based on the evaluation result in the tongue function evaluation step, the target value in the instantaneous force training step in step 6 and the skill training step in step 7 and the training content are determined to consider the individual difference of the trainee. You can do effective training. In addition, after the training of the tongue function, the training effect can be evaluated by evaluating the tongue function again.

In the instantaneous force training step in step 6 and the skill training step in step 7, the target value and the measured value to be measured are displayed on the display unit 20 in real time, and the displayed measured value is displayed as the displayed target value. Encourage them to match.
According to this embodiment, visual feedback can be used to encourage the trainee to adjust the force of the tongue.

It is preferable that the force to be measured is a vector value in an arbitrary direction acting on at least one or more arbitrary measurement points or any measurement surface at the tip of the tongue, the body of the tongue, the base of the tongue, and the like.
According to this embodiment, it is possible to train each part of the tongue, and more effective training can be performed.
The training target site may be a predetermined range of the tongue portion, and the measurement target may be the tongue pressure. Tongue pressure measurement, which is already widespread, can also be used to train the strength of the tongue.

By displaying the training result in the instantaneous force training step in step 6 and the evaluation result of the skill evaluation in the skill training step in step 7 together with the measurement point or the measurement surface in the tongue image diagram showing the tongue. You can visually grasp the training results.
Although FIG. 2 shows the instantaneous force training step and the dexterity training step as the tongue function training step, it may have an endurance training step corresponding to the endurance evaluation step.

4 and 5 are display images of target value image data to be displayed on the display unit of this embodiment.
In the display image 21 shown in FIGS. 4 and 5, the measured value to be measured is displayed at the point 21a, and the target value is displayed at the line 21b. Further, the display image 21 has an ability display 21c of the force exerted on the tongue portion and an elapsed time display 21d from the start.
The point 21a or the line 21b moves in either the left or right direction with the passage of time. Either the version in which the point 21a moves left or right or the version in which the line 21b moves may be used. The height of the point 21a is changed by the force exerted on the tongue. In this embodiment, the point 21a moves upward when the force is large, and moves downward when the force is small.
Point 21a is an image of a car, line 21b is an image of a road, and the vertical position of the car traveling from the left edge to the right edge of the screen is associated with the magnitude of the force of the tongue, and the vehicle travels along the road (target value). As such, have the evaluated person or the trainee adjust the force of the tongue.
The height of the line 21b and the pattern of time change, which are the target values, can be set according to the evaluation step and the training step.

FIG. 4A is a display image used in the endurance evaluation step. In the display image 21 shown in FIG. 4A, the lines 21b are positioned at the same height in order to encourage the continuous exertion of a certain target value.
The target value (height of the line 21b) used in the endurance evaluation step is preferably set according to the muscular strength of the evaluated person or the trainee, and the target value is preferably set to be muscular strength or less. Muscle strength is the maximum measured value measured in the muscle strength evaluation step.

FIG. 4B is a display image used in the instantaneous force evaluation step or the instantaneous force training step. In the display image 21 shown in FIG. 4B, a first target value and a second target value are set as target values. The line 21b displayed at the low position (left portion) is the first target value, and the line 21b displayed at the high position (right portion) is the second target value. In order to promote the change from the first target value to the second target value, the line 21b is a two-step height line and a vertical line connecting the two-step heights.
By setting the first target value to zero (no load), it is possible to judge or train the instantaneous force from the weakened state. Further, the load state in which the first target value is lower than the second target value can be set.

FIG. 4C is a display image used in the instantaneous force evaluation step or the instantaneous force training step. In the display image 21 shown in FIG. 4C, the line 21b displayed at the high position (left portion) is the first target value, and the line 21b displayed at the low position (right portion) is the second target value. The second target value is a weaker force than the first target value.

5 (a) to 5 (g) are display images used in the skill evaluation step or the skill training step, and show different course patterns.
The target value (height of line 21b) and the rate of change used in the skill evaluation step or the skill training step may be set according to the muscle strength of the evaluated person or the trainee, and the target value may be set below the muscle strength. preferable. Muscle strength is the maximum measured value measured in the muscle strength evaluation step.
For example, the display image 21 shown in FIG. 5A has a line 21b as a sine wave, and the display image 21 shown in FIG. 5F has a line 21b as a square wave. The display image 21 shown in FIGS. 5A and 5F sets the minimum target value, the maximum target value, the speed of one wave, that is, the frequency, and the time from the left edge to the right edge of the screen. .. These set values can be set according to the muscle strength of the evaluated person or the trainee.
The display image 21 shown in FIG. 5 (e) has a line 21b as a triangular wave. The display image 21 shown in FIG. 5 (e) sets the minimum target value, the maximum target value, the speed of one wave, the time between waves, and the time from the left edge to the right edge of the screen. .. These set values can be set according to the muscle strength of the evaluated person or the trainee.
The display image 21 shown in FIGS. 5 (b), 5 (c), and 5 (d) is a modification of the display image 21 shown in FIG. 5 (e).
In the display image 21 shown in FIG. 5 (g), the speed of the wave is gradually increased with the passage of time, that is, the period of the wave is gradually shortened. In the display image 21 shown in FIG. 5 (g), it is possible to evaluate or train to what stage the follow-up can be performed. In addition, the wave cycle can be lengthened stepwise.

FIG. 6 is another display image of the target value image data displayed on the display unit of this embodiment.
In the display image 21 shown in FIG. 6A, the measured value is displayed at the first point 21a, which is an image of pointing, and the target value is displayed at the second point 21b, which is an image of germs. Further, the display image 21 has an ability display 21c of the force exerted on the tongue, an elapsed time display 21d from the start, and a score 21e.
The height of the first point 21a is changed by the force exerted on the tongue. In this embodiment, the point 21a moves upward when the force is large, and moves downward when the force is small.
The height of the second point 21b is changed between the preset maximum target value and the minimum target value. The fluctuation height and fluctuation speed of the second point 21b are preferably set according to the muscle strength of the evaluated person or the trainee, and the maximum target value is preferably set to the muscle strength or less. Muscle strength is the maximum measured value measured in the muscle strength evaluation step.
In the display image 21 shown in FIG. 6A, bullets are set to be periodically fired from the first point 21a, the first point 21a coincides with the height of the second point 21b, and the bullets are fired from the first point 21a. This is a game in which points with a score of 21e are added when the bullet to be fired hits the second point 21b.
The display image 21 shown in FIG. 6A is suitable for the instantaneous force evaluation step, the instantaneous force training step, the dexterity evaluation step, or the dexterity training step, but maintains the height position of the second point 21b for a predetermined time. It can be used in the endurance evaluation step by setting the action to be performed.

In the display image 21 shown in FIG. 6B, the measured value is displayed at the first point 21a, which is the image of a piggy bank, and the target value is displayed at the second point 21b, which is the image of a coin. There is. Further, the display image 21 has an ability display 21c of the force exerted on the tongue, an elapsed time display 21d from the start, and a score 21e.
The height of the first point 21a is changed by the force exerted on the tongue. In this embodiment, the point 21a moves upward when the force is large, and moves downward when the force is small.
The height of the second point 21b is changed between the preset maximum target value and the minimum target value. The fluctuation height and fluctuation speed of the second point 21b are preferably set according to the muscle strength of the evaluated person or the trainee, and the maximum target value is preferably set to the muscle strength or less. Muscle strength is the maximum measured value measured in the muscle strength evaluation step.
In the display image 21 shown in FIG. 6B, the second point 21b is set to fly in the direction of the first point (leftward) while changing the height, and the first point 21a is the second point. This is a game in which points with a score of 21e are added when the second point 21b that matches the height of 21b is received at the first point 21a.
The display image 21 shown in FIG. 6B is suitable for the instantaneous force evaluation step, the instantaneous force training step, the dexterity evaluation step, or the dexterity training step, but maintains the height position of the second point 21b for a predetermined time. It can be used in the endurance evaluation step by setting the action to be performed.

In the display image 21 shown in FIG. 6C, the measured value is displayed at the first point 21a that images the facial expression of one face, and the target value is the second point that images the facial expression of the other face. It is displayed at 21b. Further, the display image 21 has an ability display 21c of the force exerted on the tongue portion and an elapsed time display 21d from the start.
At the first point 21a, the facial expression is changed by the force exerted on the tongue.
The second point 21b changes the facial expression between the preset maximum target value and the minimum target value. The change and change speed of the facial expression of the second point 21b are preferably set according to the muscular strength of the evaluated person or the trainee, and the maximum target value is preferably set to the muscular strength or less. Muscle strength is the maximum measured value measured in the muscle strength evaluation step.
In the display image 21 shown in FIG. 6C, the facial expression at the second point 21b is changed so that the facial expression at the first point 21a matches the facial expression at the second point 21b.
The display image 21 shown in FIG. 6C is suitable for the instantaneous force evaluation step, the instantaneous force training step, the dexterity evaluation step, or the dexterity training step, but maintains the facial expression at the second point 21b for a predetermined time. By setting the movement, it can be used in the endurance evaluation step.

FIG. 7 is still another display image of the target value image data displayed on the display unit of this embodiment.
FIG. 7A is a display image used in the instantaneous force evaluation step or the instantaneous force training step. The display image shown in FIG. 7A displays a target vector (target value) and a measured vector (measured value), and the direction of the measured force coincides with the direction of the target force. Encourage them to do it.
FIG. 7B is a display image used in the skill evaluation step or the skill training step. The display image shown in FIG. 7B displays a continuously changing target vector (target value) and a measured vector (measured value), and the direction of the force, which is the measured value, is the target value. Encourage them to match the direction of force. In FIG. 7B, the vertical axis in FIG. 5 is replaced with the target angle θr, and the direction of the target vector is continuously changed.
As shown in FIG. 7, the target value and the measured value can be visualized (displayed) as a vector for evaluation and training.
In FIG. 7, since the vector which is the target value and the measured value is converted into a unit vector and displayed, only the direction of the force is changed while keeping the length of the vector shown constant, but the magnitude of the force. May be displayed as the vector length.

FIG. 8 is a configuration diagram showing a tongue tip holding portion and a strain sensor used in this embodiment.
The tongue tip holding portion 11 is held so as to cover the tongue tip of the evaluated person or the trainee, and a strain sensor 12 is provided at the bottom of the tongue tip holding portion 11. The strain sensor 12 has a signal line 12a connected to the control unit 30. The strain sensor 12 shown in FIG. 8 is a 6-axis force sensor using a thin film strain gauge.

FIG. 9 is a configuration diagram of the tongue tip holding portion and the strain sensor according to another embodiment.
9 (a) is a plan view with the tongue tip holding portion and the strain sensor attached, FIG. 9 (b) is a plan view with the tongue tip holding portion removed, and FIGS. 9 (c) and 9 (d) are. FIG. 9 (e) is a diagram showing a force detection direction by the strain sensor, and FIG. 9 (e) is an explanatory diagram showing a measurement state at the tip of the tongue.
In this embodiment, a tongue contact plate is used as the tongue tip holding portion 11, and three 3-axis force sensors are used as the strain sensor 12.
By using the tongue contact plate as the tongue tip holding portion 11 as in this embodiment, the vector value of the force acting on an arbitrary measurement surface at the tongue tip, the tongue body, the tongue base, etc., and the point of action thereof. Can be measured.
In this embodiment, the vector was calculated using a plurality of force sense sensors, but by using one force sense sensor and using the tongue tip holding portion 11 having a spherical tip instead of the tongue contact plate, the tongue portion It is possible to measure the vector value of the force with any measurement point at the tip of the tongue, the body of the tongue, the base of the tongue, etc. as the point of action. Further, if the tongue contact plate is provided with a protrusion so that the tongue contact plate makes contact only at the point of the protrusion, measurement at an arbitrary point is possible even if a plurality of force sensors are used. In addition, the force vector and the point of action can be measured by devising the arrangement and number of sensors using only the pressure sensor and strain gauge.

The training results based on the examples of the present invention will be described below.
10 (a) is a display image used for training and evaluation, FIG. 10 (a) is a display image of the game used for training, FIG. 10 (b) is a graph showing data at the end of the game, FIG. 10 (c), (D) is a display image used for evaluation.
For the training, a target value was set based on the maximum tongue pressure of each individual, and the training was carried out according to the ability of the individual.
The subjects were 10 healthy adult males (age 22.8 ± 0.6 years, height 168.8 ± 4.1 cm, weight 56.5 ± 3.5 kg, mean ± SD). The training was conducted for 2 weeks (10 days only on weekdays) and 10 minutes a day (1 minute x 10 sets). The target value of the training game was 70% of the maximum tongue pressure measured before the start of training. The evaluation was performed once a week, and the evaluation was started one week before the start of the training in order to acquire the data before the start of the training. The training conditions were set under the guidance of a speech therapist.
The evaluation items include maximum tongue pressure as muscle strength, constant force as endurance (70% and 35% of maximum tongue pressure before the start of training), duration (FIGS. 10 (c), (d)), and dexterity. The recorded data of the training game (Root mean square error of target value and measured value: RMSE, Fig. 10 (b)) is used as a method, and it is used for oral function evaluation in clinical practice for comparison with the conventional method. RSST (repeated saliva swallowing test, measuring how many times you can swallow in 30 seconds) and oral diadcokinesis (measuring how many times you can pronounce "pa", "ta", and "ka" in 5 seconds each) Added to the evaluation items. RSST assesses the voluntary evoking ability of the swallowing reflex. Oral diad cokinesis evaluates the speed and dexterity of movements of the tongue, lips, soft palate, etc. by pronunciation. "Pa" is used to evaluate the movement of the lips, "ta" is used to evaluate the movement of the front of the tongue, and "ka" is used to evaluate the movement of the back of the tongue. Kenguchi-kun (TK3350, Takei Kikai Kogyo) was used to measure oral diadocokinesis.
To measure the maximum tongue pressure, the sensor of the tongue pressure measuring device was sandwiched between the palate and the tongue, and it was instructed to crush it with the maximum force for 5 seconds. The duration measurement fixed the height of the road on the game screen to 70% or 35% of the maximum tongue pressure, and instructed to keep tracing on the road with maximum effort. The recorded data of the training game recorded the trajectory of the car at the time of training, and calculated the error (RMSE) from the target value imitating the road.

As a result of the training, FIGS. 11 to 13 show a summary of the average transition of the 10 subjects and the measurement results of the evaluation items.
FIG. 11A is a graph showing the result of maximum tongue pressure, FIG. 11B is a graph showing the result of force duration of 70% of maximum tongue pressure, and FIG. 11C is 35% of maximum tongue pressure. It is a graph which shows the result of the duration of the force of.
FIG. 12A is a graph showing the result of RMS error between the target value and the measured value of the training game, FIG. 12B is a graph showing the result of RSST, and FIG. 12C is a graph showing the result of oral diadcokinesis. It is a graph.
FIG. 13 is a graph showing the correlation between the maximum tongue pressure (muscle strength) and the RMS error (skillfulness) of the training data.
As shown in FIGS. 11 and 12, the maximum tongue pressure and the duration of tongue pressure tended to increase from the start of the training to the end of the training, although there were individual differences. The same was true for RSST and Oral Diad Cokinesis. On the other hand, the RMS error between the target value and the measured value in the training game showed a decreasing tendency.
As a result, improvement in muscle strength, endurance, and dexterity was observed.
Further, as shown in FIG. 13, the higher the maximum tongue pressure, the lower the RMS error of the training data, and it was shown that there is a significant correlation between the maximum tongue pressure and the ability to adjust the tongue pressure. The correlation coefficient was 0.54.

The present invention is particularly suitable for evaluation and training of swallowing rehabilitation.

11 Tongue tip holding part 12 Strain sensor 13 Input part 20 Display part 21 Display image 22 Display image 30 Control part 31 Measured value receiving means 32 Measured value matching means 33 Muscle strength evaluation means 34 Endurance evaluation means 35 Instantaneous force evaluation means 36 Skill evaluation Means 37 Evaluation result matching means 40 Storage unit

Claims (15)

A tongue function evaluation method for evaluating the function of the tongue by measuring a force in an arbitrary direction that the tongue can exert at an arbitrary position and posture of the tongue.
An endurance evaluation step that measures the duration at which the target value can be continuously exerted and determines the endurance from the above duration.
When a first target value and a second target value are set as the target value and the first target value is changed to the second target value, the first target value is changed to the second target value. An instantaneous force evaluation step that measures the excessive response and determines the instantaneous force from the characteristic value of the excessive response,
When the target value is continuously changed, the skill evaluation step of measuring the follow-up response to the continuous change and determining the skill from the error from the target value in the follow-up response, and
A method for evaluating tongue function, which comprises having. The tongue function evaluation method according to claim 1, further comprising a muscle strength evaluation step of measuring the maximum exerted force of the tongue portion and determining the measured maximum measured value as muscle strength. The second aspect of the present invention is characterized in that the target value in the endurance evaluation step, the instantaneous force evaluation step, and the dexterity evaluation step is set with reference to the maximum measured value measured in the muscle strength evaluation step. The described tongue function evaluation method. In the endurance evaluation step, the instantaneous force evaluation step, and the dexterity evaluation step, the target value and the measured value to be measured are displayed, and the displayed measured value is set to the displayed target value. The tongue function evaluation method according to any one of claims 1 to 3, wherein the matching is promoted. A claim characterized in that the force to be measured is a vector value acting on at least one or more arbitrary measurement points or arbitrary measurement surfaces at the tip of the tongue, the body of the tongue, the base of the tongue, etc. in the tongue. The tongue function evaluation method according to any one of items 1 to 4. The tongue function evaluation method according to any one of claims 1 to 4, wherein the force to be measured is a tongue pressure within a predetermined range of the tongue portion. The endurance determined in the endurance evaluation step, the instantaneous force determined in the instantaneous force evaluation step, and the evaluation result of the dexterity determined in the dexterity evaluation step are shown in a tongue image diagram representing the tongue. The tongue function evaluation method according to any one of claims 1 to 6, wherein the measurement point or the measurement surface is displayed together with the measurement point. At an arbitrary position and posture of the tongue portion, the force exerted by the tongue portion in an arbitrary direction is measured, the target value exerted by the tongue portion and the measured measured value are displayed, and the displayed measured value is displayed. Is a tongue function training method for training the function of the tongue by encouraging the display to match the displayed target value.
By setting a first target value and a second target value as the target value and changing from the first target value to the second target value, the excess from the first target value to the second target value is achieved. Instantaneous training steps to train the response and
A skill training step that trains a follow-up response to a continuous change by continuously changing the target value, and
A tongue function training method characterized by having. The eighth aspect of the present invention, wherein the maximum exerted force of the tongue portion is measured, and the target value in the instantaneous force training step and the dexterity training step is set based on the measured maximum measured value. Tongue function training method. A tongue function evaluation device that evaluates the function of the tongue by measuring the force in an arbitrary direction that the tongue can exert at an arbitrary position and posture of the tongue.
The tongue tip holding part that holds the tongue tip,
A strain sensor that detects the force applied to the tongue tip holding portion, and
A control unit that receives a signal from the strain sensor and displays a target value to be exerted on the tongue portion and a measured value to be measured on the display unit.
With
In the control unit
An endurance evaluation means that measures the duration during which the target value can be continuously exerted and determines the endurance from the duration.
When a first target value and a second target value are set as the target value and the first target value is changed to the second target value, the first target value is changed to the second target value. An instantaneous force evaluation means that measures an excessive response and determines the instantaneous force from the characteristic value of the excessive response.
When the target value is continuously changed, a skill evaluation means for measuring the follow-up response to the continuous change and determining the skill from the error from the target value in the follow-up response,
A tongue function evaluation device characterized by having. The tongue function evaluation device according to claim 10, further comprising a muscular strength evaluation means for measuring the maximum exerted force of the tongue portion and determining the measured maximum measured value as muscular strength. At an arbitrary position and posture of the tongue portion, the force exerted by the tongue portion in an arbitrary direction is measured, the target value exerted by the tongue portion and the measured measured value are displayed, and the displayed measured value is displayed. Is a tongue function training device that trains the function of the tongue by encouraging the display to match the displayed target value.
The tongue tip holding part that holds the tongue tip,
A strain sensor that detects the force applied to the tongue tip holding portion, and
A control unit that receives a signal from the strain sensor and displays the target value to be exerted on the tongue portion and the measured value to be measured on the display unit.
With
In the control unit
An endurance evaluation means that measures the duration during which the target value can be continuously exerted and determines the endurance from the duration.
When a first target value and a second target value are set as the target value and the first target value is changed to the second target value, an excessive response from the first target value to the second target value is performed. And the instantaneous force evaluation means for determining the instantaneous force from the characteristic value of the transient response.
When the target value is continuously changed, a skill evaluation means for measuring the follow-up response to the continuous change and determining the skill from the error from the target value in the follow-up response,
A tongue function training device characterized by having. The twelfth aspect of claim 12 is characterized in that the maximum exerted force of the tongue portion is measured, and the target value in the instantaneous force evaluation means and the dexterity evaluation means is set with reference to the measured maximum measured value. The tongue function training device described. A tongue function evaluation device that evaluates the function of the tongue by measuring the force in an arbitrary direction that the tongue can exert at an arbitrary position and posture of the tongue.
The tongue tip holding part that holds the tongue tip,
A strain sensor that detects the force applied to the tongue tip holding portion, and
A control unit that receives a signal from the strain sensor and displays a target value to be exerted on the tongue portion and a measured value to be measured on the display unit.
With
The force to be measured is a vector value acting on at least one or more arbitrary measurement points or arbitrary measurement surfaces at the tip of the tongue, the body of the tongue, the base of the tongue, etc. in the tongue.
A tongue function evaluation device characterized by using a 6-axis force sensor as the strain sensor. At an arbitrary position and posture of the tongue portion, the force exerted by the tongue portion in an arbitrary direction is measured, the target value exerted by the tongue portion and the measured measured value are displayed, and the displayed measured value is displayed. Is a tongue function training device that trains the function of the tongue by encouraging the display to match the displayed target value.
The tongue tip holding part that holds the tongue tip,
A strain sensor that detects the force applied to the tongue tip holding portion, and
A control unit that receives a signal from the strain sensor and displays the target value to be exerted on the tongue portion and the measured value to be measured on the display unit.
With
The force to be measured is a vector value acting on at least one or more arbitrary measurement points or arbitrary measurement surfaces at the tip of the tongue, the body of the tongue, the base of the tongue, etc. in the tongue.
A tongue function training device characterized in that a 6-axis force sensor is used as the strain sensor.