JP7219895B2 - Pain relief system and pain relief method - Google Patents

Description

The present invention relates to techniques for reducing the pain intensity of chronic neuropathic pain such as phantom limb pain.

Conventionally, after a limb amputation, a patient has the illusion that the lost limb exists, and the phenomenon of feeling numbness in the space where the lost limb existed is called a phantom limb. It is hoped that phantom limb pain, in which pain is felt in the space where the extremities used to exist, will be alleviated.

On the other hand, today, a system for measuring and managing training of target cognitive skills for medical professionals, medical personnel, users, etc. using a game-based virtual learning curriculum has also been proposed (see, for example, Patent Document 1, etc.). . The technology of Document 1 is used for cognitive skills (for example, attention concentration, attention maintenance, cognitive suppression, behavioral suppression, selective attention, conversion attention, distributed attention, interference control, novelty suppression, satisfaction delay provide an effective and rapid video game-based training curriculum that improves resilience, inner voice, motivational inhibition, and self-regulation).

Japanese Patent Publication No. 2018-533044

However, what is disclosed in Patent Document 1 focuses on improving cognitive skills and does not achieve neuropathic pain relief.

The present invention has been made in view of such problems, and its purpose is to treat pain such as chronic neuropathic pain, nerve pullout injury (brachial plexus pullout injury), and phantom limb pain. is to reduce

In order to solve the above problems, one aspect of the present invention provides a pain relief system in which a head-mounted display device and a server device are communicably connected, wherein the server device is effective in relieving neuropathic pain. An application program that performs at least green light therapy and mirror therapy in a virtual reality space, an application selection unit that selects a shooting game, and the identification information of the selected application program is transmitted to the head-mounted display device. and the head-mounted display device comprises an application execution unit for executing the application program when one of the application programs specified by the identification information of the application is selected. .

INDUSTRIAL APPLICABILITY According to the present invention, a technique for alleviating chronic neuropathic pain can be provided.

1 is a configuration diagram of a pain relief system according to one embodiment of the present invention; FIG. 1 is a configuration diagram of a server device; FIG. 3A to 3C are diagrams showing various tables. 1 is a configuration diagram of a VR device; FIG. It is a flow chart which shows a processing procedure by a pain relief system. FIGS. 6A to 6J are diagrams showing screen transitions. FIGS. 7(a) to 7(c) are diagrams showing pain level setting scales. FIG. 4 is a diagram showing the execution procedure of the first application program; FIG. FIGS. 9A to 9F are diagrams showing screen transitions in the process of executing the first application program. It is a figure which shows the execution procedure of a 2nd application program. FIGS. 11A to 11G are diagrams showing screen transitions in the process of executing the second application program. FIG. 4 is a characteristic diagram showing pain reduction levels;

An embodiment of the present invention will be described below with reference to the drawings.

The mechanism of phantom limb pain is still not clear, and there are many opinions, such as that confusion due to changes in cerebral perception of body parts and changes in afferent information is perceived as pain. Among them, the inventor hypothesized that phantom limb pain is caused by the loss of coordination of both hands between healthy limbs and amputated limbs. was developed and found to have a strong effect on phantom limb pain. It is thought that shooting gives an illusory perception of shooting with both hands, and that shooting at the target stimulates the brain's reward system through sound effects and vision, which contributes to pain relief.

FIG. 1 shows the configuration of a pain relief system according to one embodiment of the present invention.

As shown in the figure, the pain relief system includes a server device 1, a HMD (Head Mounted Display) device 2 that realizes VR (Virtual Reality), and a doctor's terminal device 3. A network 4 such as the Internet is connected. communicatively connected and configured via

In such a configuration, the HMD device 2 is preinstalled with various application programs. When the HMD device 2 logs in to the platform of the server device 1 and inputs age, gender, answers to various questions, and the like, the information is transmitted to the server device 1 . Then, the server device 1 selects an application program suitable for alleviating the pain of the user's case. Then, in the HMD device 2, the application program selected by the user from the recommended programs selected by the server device 2 is executed, and in the process, the pain related to the case is alleviated.

The user inputs a pain scale before and after executing an application program, such as a game, on the HMD device 2 . This pain scale information is also transmitted to the server device 2 and stored in the database, so that what kind of application program was executed for a certain case and, as a result, how much the pain was alleviated can be accumulated. It will be done. This accumulated information can also be confirmed by the terminal device 3 of a remote doctor.

FIG. 2 shows the configuration of the server device, which will be described.

As shown in the figure, the server device 1 includes a control unit 11 such as a CPU (Central Processing Unit) that controls the entire system. The control unit 11 is connected to the communication unit 12 and the storage unit 13 . The communication unit 12 is a communication interface for communicating with the VR device 2, the doctor's terminal device 3, and the like via the network 4. FIG.

The storage unit 13 includes a memory such as RAM (Random Access Memory) and ROM (Read Only Memory), a hard disk drive (HDD), etc., and stores programs executed by the control unit 11. there is Furthermore, the storage unit 13 includes a user information storage unit 14, an application storage unit 15, an effect storage unit 16, and the like.

As shown in FIG. 3A, the user information storage unit 14 stores a user ID, attribute information such as the user's name, gender, age, etc., and a case (case ID) in association with each other. As shown in FIG. 3B, the application storage unit 15 stores case IDs, case details (for example, phantom limb pain, etc.), and IDs of application programs suitable for pain relief in the case. attached and stored. Then, as shown in FIG. 3C, the case ID, the ID of the executed application program, the pain level (before execution), the pain level (after execution), and the evaluation are associated with each other in the effect storage unit 16. stored. In this example, all are stored in a normalized table format.

In such a configuration, the control unit 11 functions as a reception unit 11a, an application selection unit 11b, a transmission unit 11c, a registration unit 11d, and a learning unit 11e by executing programs in the storage unit 13. FIG.

The receiving unit 11a receives the user's age, gender, name, answers to questions, etc. input by the HMD device 2 . The application selection unit 11b refers to the user information storage unit 14 and the application storage unit 15, and selects an application program suitable for alleviating the pain associated with the user's case. The transmission unit 11c transmits the ID of the application program selected by the application selection unit 11b to the VR device 2 as selection information. The registration unit 11 d registers the information received by the reception unit 11 a in the user information storage unit 14 , the application storage unit 15 and the effect storage unit 16 .

Then, based on the information stored in the effect storage unit 16, the learning unit 11e calculates the pain of the case from the case, the executed application program, and the degree of pain reduction due to execution (difference value before and after execution, etc.). An application program effective for mitigation is learned, and the learning result is reflected in the contents of the application storage unit 15. - 特許庁In other words, the contents of the table in the application storage unit 15 are updated based on the learning result. The learning by the learning unit 11e improves the accuracy of selection of an application program suitable for alleviating pain in a case as the frequency of use increases.

FIG. 4 shows the configuration of an HMD (Head Mounted Display) device that becomes a part of the pain relief system and realizes virtual reality.

As shown in the figure, the HMD device 2 includes a control section 21 such as a CPU or MPU that controls the entire device. The control unit 21 is connected to a communication unit 22 , an input interface (I/F) 23 , a display unit 24 , a storage unit 25 , a sensor unit 26 , a microphone 27 and a speaker 28 . The sensor section 26 has an angular velocity sensor 26a. The input I/F 23 can freely communicate with the controller 30 .

The communication unit 22 is a communication interface for communicating with the server device 1 and the like via the network 4 . The input I/F 23 receives operation input signals from the controller 30 . The display unit 24 is composed of a liquid crystal display or the like, and performs various displays. The storage unit 25 is composed of memories such as RAM and ROM, HDD, SSD, and the like, and stores a main program executed by the control unit 21 as well as various application programs 25a related to VR, games, and the like.

The sensor unit 26 generates position information indicating the position of the HMD device 2 and direction information indicating the direction of the HMD device 2 and transmits the position information and the direction information to the control unit 21 . The microphone 27 functions as sound collecting means, and the speaker 28 functions as sound emitting means.

In such a configuration, the control unit 21 executes the main program stored in the storage unit 25 to perform the transmission unit 21a, the reception unit 21b, the application execution unit 21c, the display control unit 21d, and the reference plane setting unit. 21e.

The transmission unit 21 a transmits information such as the user's age, gender, name, and answers to questions to the server device 1 based on the operation of the controller 30 and the speech recognition result of the voice input from the microphone 27 . The receiving unit 21b receives application selection information and the like received from the server device 1 .

The application execution unit 21c executes an application program selected by the user from the application programs 25a stored in the storage unit 25. FIG. The display control section 21 d controls display on the display section 24 .

The reference plane setting unit 21 e sets a reference plane and the like in the screen related to virtual reality based on the sensor output of the sensor unit 26 and the operation of the controller 30 . More specifically, the reference plane setting unit 21e sets the direction of gravity detected by the acceleration sensor 26a as the downward direction, and sets a plane orthogonal to the downward direction as the reference plane in the display coordinate system. Then, the speech recognition unit 21f recognizes the speech input from the microphone 27 and converts it into text.

The procedure for pain relief by the pain relief system will be described below with reference to the flowchart of FIG. Here, the screen transition diagrams of FIGS. 6(a) to 6(j) are appropriately referred to.

By operating the controller 30, the HMD device 2 moves the cursor on the screen as shown in FIG. 6A and selects "VR" to log in to the system (S1). Subsequently, by operating the controller 30, the gender is selected on the screen as shown in FIG. 6(b), the age is selected on the screen as shown in FIG. 6(c), and the A nickname is input from the microphone 27 at the bottom of the screen as shown in FIG. This voice input is voice-recognized by the voice recognition unit 21f (S2). In the HMD terminal 2, the transmission section 21a transmits the attribute information to the server device 1 (S3). In the server device 1, when the receiving unit 11a receives the attribute information, the registration unit 11d registers it in the user information storage unit 14 (S4).

Subsequently, in the HMD device 2, questions are displayed on the screen, and the questions are answered by operating the controller 30 (S5). A question may be asked by voice output from the speaker 28, and the question may be answered by voice (S5). The transmission unit 21a transmits answers to these questions to the server device 1 (S6). In the server device 1, when the reception section 11a receives the reply, the registration section 11d registers it in the user information storage section 14 (S7). Then, in the server device 1, the application selection unit 11b refers to the user information storage unit 14 and the application storage unit 15 to select an application program effective in reducing the pain of the user's case, and the transmission unit 11c The IDs of the plurality of selected application programs are transmitted to the HMD device 2 as selection information (S8).

In the HMD device 2, when the reception unit 21b receives the application selection information from the server device 1 (S9), the display control unit 21d receives the application program selected by the selection information as shown in FIG. is displayed on the display unit 24 (S10). When the cursor is moved on this screen by operating the controller 30 and one application program is selected (S11 branches to Yes), the input of the nickname is received (S12), and the transmission unit 21a transmits the nickname information. It is transmitted to the server device 1 (S13). In the server device 1, when the receiving section 11a receives the nickname, the registration section 11d registers it in the user information storage section 14 (S14).

Subsequently, in the HMD device 2, as shown in FIGS. 6(g) and 6(h), when receiving the input of the pain scale (before execution) by the operation of the controller 30 (S15), the transmission unit 21a Information on the set pain level is transmitted to the server device 1 (S16). In the server device 1, when the receiving section 11a receives the pain level information, the registration section 11d registers it in the effect storage section 16 (S14).

In the HMD device 2, the selected application program is executed as shown in FIG. 6(i) (S18). The details of this application execution will be described later with reference to the drawings.

Thus, when the execution of the application program ends, the HMD device 2 accepts input of the pain scale (after execution) by operating the controller 30 (S19), as shown in FIG. , the pain level information set by the scale is transmitted to the server device 1 (S20). In the server device 1, when the receiving section 11a receives the pain level information, the registration section 11d registers it in the effect storage section 16 (S21).

Subsequently, in the HMD device 2, questions are displayed on the screen, and the questions are answered by operating the controller 30. FIG. A question may be asked by voice output from the speaker 28, and the question may be answered by voice (S22). The transmission unit 21a transmits answers to these questions to the server device 1 (S23). In the server device 1, when the reception section 11a receives the reply, the registration section 11d registers it in the user information storage section 14 and the effect storage section 16 (S24). Thus, a series of processing ends.

Here, FIGS. 7(a) to 7(c) show other examples of the setting scale of the pain level and will be described. 5, the visual analog scale as shown in FIG. 7(a) was adopted, but as shown in FIG. 7(b), the set level of pain can be confirmed numerically. It is also possible to adopt a numerical evaluation scale attached with an index that allows the patient to feel pain, or a facial expression scale that allows the degree of pain to be felt through facial expressions, as shown in FIG. 7(c).

Next, the procedure for executing the first application program will be described with reference to the flowchart of FIG. Here, the screen transition diagrams of FIGS. 9A to 9F are appropriately referred to.

The first application program is a program related to relaxation VR that realizes green light therapy, mirror therapy, and animal therapy.

When this program is executed, the screen is switched from FIG. 9(a) to FIG. 9(b), and the amputated hand (phantom limb side) is selected by operating the controller 30 (S31). Here, if the left hand is selected, then the phantom limb side (left hand) on the VR is operated with the healthy limb (S32). The limb is used to operate the phantom limb side (right hand) on the VR (S33).

Subsequently, the display control unit 21d causes the display unit 24 to display various explanatory screens related to operations such as phantom limb operations as shown in FIGS. 9(c) and 9(d) in the VR. (S34). After this operation explanation, etc., the display control unit 21d displays a display that realizes animal therapy as shown in FIG. 9(e) and mirror therapy as shown in FIG. 9(f) based on green light therapy. These are sequentially displayed on the display unit 24 (S35). After completing the execution of the game in this manner, the process returns to step S19 in FIG.

For example, according to the above-mentioned mirror therapy on VR, some chronic neuropathic pain, including phantom limb pain, can be alleviated by manipulating a phantom limb on VR by operating a controller with a healthy limb. This has been clarified by an experiment by the inventor. In addition, green light therapy, which is the basis, constructs an environment in which the user is placed in a forest using VR, but green visible light that accounts for visual input is 520 to 530 nm (nanometers) and has a brightness of 1 cd (candela). It provides visual input by illumination at. It was found that this also reduced some of the chronic pain caused by various diseases. In addition, animal therapy on VR provides virtual opportunities to interact with animals by making them appear in the forest. It was found to contribute to pain relief.

Next, the execution procedure of the second application program will be described with reference to the flowchart of FIG. Here, the screen transition diagrams of FIGS. 11(a) to 11(g) are appropriately referred to.

A second application program is a program related to a shooting game in which the target is sunk by shooting at it.

When this program is executed, the user automatically proceeds to the depths of the VR realized by the display on the display unit 24 . Then, under the control of the display control unit 21d, as shown in FIG. 11A, a target character or object appears in VR at random or at a predetermined location. At the time of this appearance, a sound effect matching the object is output from the speaker 28 (S41).

When the user captures the target object using the physical movement function and pulls the trigger of the controller 30 (S42 branches to Yes), as shown in FIGS. 11(b) and 11(c), A bullet is fired on the display screen of the display unit 24, and a firing sound is output from the speaker 28 (S43). Then, when the fired bullet hits the target object (S44 branches to Yes), as shown in FIGS. 28 (S45). At this time, as shown in FIG. 11(f), coins and hearts symbolizing the reward system are presented among the broken objects, and the process returns to step S41 to repeat the above process (S46 branches to No). . Then, if the game is to end (S46 branches to Yes), the process returns to step S19 in FIG.

Among the above processes, the process from step S42 to step S44, that is, the process from when the trigger is pulled until the ejected bullet lands on the target object and outputs the effect, is 0. Do it for 2 seconds. As a result, it has a release effect on the brain's reward system, dopamine, and noradrenaline neural circuits, increases the user's memory consolidation and occupancy in well-being, and alleviates some of the chronic pain such as phantom limb pain. It has been clarified by the inventor's research that it is possible to

In general, among chronic diseases, serotonin/noradrenaline reuptake inhibitors (SNRI) are listed as some of the drugs of first choice for treatment of neuropathic pain, but dopamine functions as a precursor of noradrenaline. , In the subject who is in a state where the serotonin balance is maintained, it exerts an analgesic effect in combination with the action of noradrenaline. In addition, since learning is reinforced by reward, memory consolidation is further strengthened, and it has been clarified that the pain relief time can be maintained for several hours to two weeks depending on the person.

Finally, FIG. 12 shows a characteristic diagram relating to the pain reduction level.

As shown in the figure, 60% of the patients felt pain for nerve pull-out injuries, which decreased to 15% after running the application with this system. As for phantom limb pain, all patients felt pain, but this decreased to 70% after running the application with this system. For cancer resection, 35% of patients felt pain, which decreased to 15% after application by this system. For Complex Regional Pain Syndrome, 70% of patients felt pain, which decreased to 50% after running the application with this system. In benign tumor/sciatica, 20% of the patients felt pain, but it decreased to 10% after executing the application by this system. In this way, we were able to confirm the effect of reducing pain by this system for each disease.

As described above, according to the embodiments of the present invention, pain such as phantom limb pain can be effectively reduced by mirror therapy, green light therapy, animal therapy, etc. realized on VR, and by running a shooting game. It becomes possible to

Although the embodiment of the present invention has been described above, the present invention is not limited to this and, of course, various improvements and changes are possible without departing from the scope of the invention.

For example, application programs that can be selected and executed are not limited to the relaxing VR and shooting games described above, and various programs can be adopted.

DESCRIPTION OF SYMBOLS 1... Server apparatus, 2... HMD apparatus, 3... Terminal device, 4... Network, 11... Control part, 11a... Reception part, 11b... Application selection part, 11c... Transmission part, 11d... Registration part, 11e... Learning part, DESCRIPTION OF SYMBOLS 12... Communication part, 13... Storage part, 14... User information storage part, 15... Application storage part, 16... Effect storage part, 21... Control part, 21a... Transmission part, 21b... Reception part, 21c... Application execution part, 21d...Display control unit 21e...Reference plane setting unit 21f...Speech recognition unit 22...Communication unit 23...Input I/F 24...Display unit 25...Storage unit 25a...Application program 26...Sensor unit , 26a...Angular velocity sensor, 27...Microphone, 28...Speaker, 30...Controller.

Claims (7)

In a pain relief system in which a head-mounted display device and a server device are communicatively connected,
The server device
an application selection unit that selects an application program that performs at least the green light method and mirror therapy in a virtual reality space and a shooting game as application programs that are effective in alleviating neuropathic pain;
a transmission unit that transmits identification information of the selected application program to the head-mounted display device;
The head-mounted display device comprises:
an application execution unit that executes the application program when one of the application programs identified by the identification information of the application is selected. In a pain relief system in which a head-mounted display device and a server device are communicatively connected,
The server device
a user information storage unit that stores user information;
an application storage unit that stores cases in association with application programs that are effective in reducing pain in the cases;
an effect storage unit that associates and stores the case, the executed application program, and changes in the degree of pain;
an application selection unit that refers to the application storage unit based on the user information from the head-mounted display device and selects an application program that is effective in reducing pain in the case included in the user information;
a transmission unit that transmits identification information of the selected application to the head-mounted display device;
The head-mounted display device comprises:
an application execution unit that executes the application program when one of the application programs identified by the application identification information is selected;
Before and after execution of the application program, a transmission unit that receives input of the degree of pain and transmits information on the degree of pain to the server device,
The server device updates the contents of the effect storage unit based on the information on the degree of pain sent from the head-mounted display device,
The application selection unit selects an application program that performs at least the green light method and mirror therapy in a virtual reality space and a shooting game as application programs that are effective in alleviating neuropathic pain.
pain relief system. In the shooting game, the process from when the bullet is fired at the target object to when it hits the object, and when the effect is displayed and the sound effect is output, is executed within 0.2 seconds.
3. The pain relief system of claim 2 . A learning unit that learns an application program that is effective in reducing pain in a case based on the contents of the effect storage unit and updates the contents of the application storage unit based on the learning result.
4. Pain relief system according to claim 2 or 3 . In a pain relief method using a pain relief system in which a head-mounted display device and a server device are communicatively connected,
The server device stores user information in a user information storage unit, associates a case with an application program effective in reducing pain in the case, stores the application program in the application storage unit, and stores the case and the executed application program. and a step of associating changes in the degree of pain with each other and storing them in an effect storage unit;
A step in which the server device refers to the application storage unit based on the user information from the head-mounted display device and selects an application program effective in reducing pain in the case included in the user information;
the server device transmitting identification information of the selected application to the head-mounted display device;
when the head-mounted display device receives a selection of one of the application programs identified by the application identification information, executing the application program;
a step in which the head-mounted display device receives an input of the degree of pain before and after execution of the application program and transmits information on the degree of pain to the server device;
the server device updating the contents of the effect storage unit based on the information on the degree of pain sent from the head-mounted display device ;
The server device selects an application program that performs at least green light therapy and mirror therapy in a virtual reality space and a shooting game as an application program that is effective in alleviating neuropathic pain.
Pain relief method. In the shooting game, the process from when the bullet is fired at the target object to when it hits the object, and when the effect is displayed and the sound effect is output, is executed within 0.2 seconds.
6. The pain relief method of claim 5 . The server device further comprises a step of learning an application program that is effective in reducing pain in a case based on the contents of the effect storage unit, and updating the contents of the application storage unit based on the learning result.
The pain relief method according to claim 5 or 6 .

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