JPH0360676A - Stimulating device and environment control device - Google Patents

Abstract

PURPOSE:To enable to detect a survival signal stably for a long time from the muscle or nerve associating a remaining functional ability of a patient with paralysis by furnishing an electrode embedded in the neighborhood of the muscle or nerve of the paralytic patient and detecting a survival signal, a memory means to store pulses to stimulate the paralytic muscle and an electrode to stimulate the paralytic muscle. CONSTITUTION:In case for ex. a patient under a paralysis wants to conduct a motion of grasping a glass, the stimulate pattern data associating with the relevant motion of a healthy person which has been stored in a memory 7, is supplied to a stimulating electrode 2 embedded in the neighborhood of the nerve or muscle associate with the same motion of a patient under paralysis 3. The level of the stimulance pulses thus emitted is varied gradually, and the stimulance pattern data when the patient 3 has conducted that motion precisely is stored in the memory 7. If the patient 3 tries for ex. a motion of putting a force in his left shoulder, a living body voltage is supplied to a sensing electrode 1 from nerve 18 or muscle 19. When this survival signal is sensed by the sensing electrode 1, stimulance pluses are read-out of the memory means 7 and fed to the stimulating electrode 2.

Description

DETAILED DESCRIPTION OF THE INVENTION [Field of Industrial Application] The present invention relates to a stimulation device and an environment control device for paralyzed patients.

[, Conventional technology]

Traditionally, electromyograms and electroencephalograms have been used to recover the paralyzed limbs of motor paralyzed patients with severe limb paralysis.

Mechanical displacement of the jaw, shoulders, neck, etc. and voluntary biological signals such as voice are used as movement command signal sources, and signals from sensors attached to the above-mentioned parts are used as functional electrical stimulation (FUNCTIONAL).
ELECTRICAL STIMULATION:
(hereinafter referred to as FES) is processed using a computer, and electrical stimulation programmed by the FES computer described above is applied to electrodes implanted near muscles or nerves, and the muscular contractions caused thereby produce the patient's intention. A stimulation device designed to perform limb movements was disclosed in Japanese Patent Application Laid-Open No. 59-160455.
It is disclosed in the publication No. This kind of FES computer-based stimulation device can activate the motor functions of not only the limbs, but also the respiratory muscles, trunk muscles, genitourinary organs, etc., and is particularly effective against muscle atrophy caused by motor paralysis caused by stroke, spinal cord injury, etc. Muscle shortening.

It has remarkable therapeutic effects on muscle and joint contractures, bone atrophy, muscle spasticity, and circulation disorders.

Various configurations of stimulation devices as described above have been proposed, and for example, Japanese Patent Laid-Open No. 61-217174 discloses a stimulation device as described below. Therefore, such a conventional stimulation device will be explained with reference to FIG. In Figure 6, (28+), (28
ri, (283),..., (28n) are obtained from the remaining sounds, joints, muscle displacements, respiration, biopotentials (electroencephalogram, electromyogram, bioactivity potential), and other living organisms of patients with motor paralysis. It is a detection means for detecting various biological signals, and the detection signals from these detection means (28,) to (28n) are control signals that are digitized by the A/D converter that constitutes the signal processing means (29). It is supplied to the FES computer (30) as FES computer (3
0) selects the stimulation data stored in the storage means (34) in the computer as the stimulation data for each control signal. The stimulation data to be stored in this storage means (34) is stored in the storage means (34) of the FES computer (30) for each patient using a large-sized development computer (32). has been done.

A stimulation pulse train is created based on the stimulation data selected by the above-mentioned FES computer 33), and a plurality of electrodes (31) implanted in the living body are stimulated to activate the paralyzed part.

Also, the patent application No. 62-3024 filed earlier by the present applicant
No. 12 proposes a stimulation device as described below. That is, in such a stimulator, envelope detection is performed on an electromyogram waveform that detects the joint, muscle displacement, etc. of a healthy person (a normal person who is not paralyzed), a pulse train is obtained by sampling this envelope waveform, and each pulse of this pulse train is Stimulation pattern data in which the voltage amplitude or pulse width of is a digital value is stored in the storage means, and after reading out the stimulation pattern data, it is D/A converted to obtain stimulation pulses. The stimulation pulses are then delivered to stimulation electrodes implanted near the muscles or nerves associated with the paralyzed patient's remaining functional movements, and the amplitude or pulse width of the stimulation pulses is varied to produce individual droplets. The threshold level of the group is determined by referring to the threshold level of the droplet group of healthy subjects, and by modifying the pattern to suit the individual patient and storing this in the memory means, the stimulation pulse suitable for that patient can be generated. The energy is supplied to stimulation electrodes implanted inside the patient's body.

[Problem to be solved by the invention]

Now, using the above-mentioned stimulation device, a patient with quadriplegia due to spinal cord injury performs an action, such as making a sound, using his or her remaining functions, and this is detected by the sound detection means, and based on this, e.g. When a stimulation pulse is applied to an electrode attached to a paralyzed hand and the patient uses this to move the hand to grasp the tip, the action of making a sound and the action of grasping the tip are not directly related. It takes a long time to learn these techniques, and it is bothersome for the patient, as well as placing a heavy burden on the patient as he or she has to remember several or even dozens of other movements that correspond to a certain desired movement.

Therefore, it is desirable to install the detection means as close as possible to the part of the body that the patient wants to move.

Therefore, by using a biopotential detection means, that is, an electrode attached to the patient's epidermis, if the patient's remaining function is the shoulder, for example, the electrode is attached to the shoulder and the patient moves the shoulder or applies force to the shoulder. When the patient puts the tip in, the electrode attached to the shoulder detects the bioelectrical potential, and based on this, a stimulation pulse is applied to the electrode attached to the hand, causing the hand to grasp the tip.

However, since this electrode is attached to the epidermis of the hand, the biopotential of the entire muscle under the skin of the attached electrode is detected, which is cumbersome as it requires attaching the electrode each time. In addition to making it difficult to stably detect biosignals over a long period of time, controlling the strength of the grip using the force applied to the shoulder makes it difficult to detect biological signals stably over long periods of time. If you do, you may end up grabbing the tip and crushing it. Furthermore, it is difficult to selectively stimulate the paralyzed area by utilizing the biopotential of individual muscles.

Furthermore, even if impulses are present in the nerve bundles, patients with myasthenia gravis or severe quadriplegia who are unable to perform muscle activity due to decreased function of the neuromuscular junction may not be able to communicate with external objects or people. It is difficult to apply the above-mentioned stimulation device when performing gon.

In view of this, the present invention is capable of detecting stable biological signals over a long period of time from muscles or nerves associated with the remaining functional movements of paralyzed patients, and based on the detected biological signals,
The present invention aims to propose a stimulation device that can stimulate the paralyzed muscles of paralyzed patients with high selectivity, high functionality, and high accuracy.

Furthermore, the present invention can detect stable biological signals over a long period of time from muscles or nerves associated with the remaining functional movements of paralyzed patients, and based on the detected biological signals, control the controlled equipment with high selectivity. The present invention aims to propose an environmental control device that can be controlled easily and with high precision.

[Means to solve the problem]

A first aspect of the present invention comprises a biological signal detection electrode (1) that is implanted near a muscle (19) or nerve (18) related to the remaining functional movements of a paralyzed patient (3), and memory means (7) for storing stimulation pulses for stimulating paralyzed muscles;
and a paralyzed muscle stimulation electrode (2) of a paralyzed patient (3) to which stimulation pulses read from the storage means (7) are supplied, and when a biological signal is detected by the biological signal detection electrode (1). is a stimulation device which reads stimulation pulses from a storage means (7) and supplies them to a paralysis muscle stimulation electrode (2).

A second aspect of the present invention provides a biosignal detection electrode (1) to be implanted in the vicinity of a muscle (19) or nerve (18) related to the remaining functional movements of a paralyzed patient (3), and a biosignal detection electrode ( Control signal forming circuits (6, 7, 8, 10) that form control signals to be supplied to controlled devices (211 to 21n) to be operated by the paralyzed patient (3) based on biological signals from 1).
It has the following.

[Operation] According to the first invention, when a biological signal is detected by the biological signal detection electrode (1), a stimulation pulse is read out from the storage means (7) and supplied to the paralyzed muscle stimulation electrode (2). .

According to the second invention, based on the biosignal from the biosignal detection electrode (1) implanted near the muscle (19) or nerve (18) related to the remaining functional movements of the paralyzed patient (3). Then, the control signals from the control signal forming circuits (6, 7, 8, 10) are supplied to the controlled devices (211 to 21n).

〔Example〕

A first embodiment of the present invention will now be described in detail with reference to FIG. FIG. 1 shows a stimulator which is a first embodiment of the present invention, and (3) shows a stimulation device for a paralyzed patient, that is, a stroke patient,
This is a patient with spinal cord injury and motor paralysis due to myasthenia gravis and other causes.

(1) is the detection electrode, and as shown in the figure, the paralyzed patient (3)
(near the shoulder muscles or nerves, i.e., motor points) (
20) (see Figure 4) to detect biological signals of muscles or nerves, that is, action potentials (impulses). (2
) is a stimulation electrode near the muscle or nerve of the hand of the paralyzed patient (3), that is, the motor point l-(20) (see Figure 4).
embedded in. The detection electrode (1) and the stimulation electrode (2) are made of, for example, multiple stranded wires, and as shown in FIG. Alternatively, it is composed of a deriving section (13). The biopotential derivation section (13) of the detection electrode (1) is connected to the input terminal of an isolation amplifier (4), which will be described later, and the biopotential introduction section (13) of the stimulation electrode (2) is connected via a capacitor C. and is connected to an output terminal of a D/A converter (8), which will be described later.

The hook-shaped fixing part (11) of each electrode (1) and (2) described above
) and the biopotential deriving or introducing part (13) are made by twisting a large number of lead wires (14), for example 19, into twisted wires, as shown in the cross-sectional view of FIG. It is shaped and its surroundings are coated with an insulating material, such as Teflon. (15) shows the coating part.

Further, the coating portion (15) is removed only from the hook-shaped fixing portion (11) and the biopotential introducing or deriving portion (13) of the electrodes (1) and (2). In addition, the hook-shaped fixing part (
11) is formed by simply bending the tips of the stranded wires at an acute angle.

Incidentally, the above-mentioned electrode (1) is made by bundling a plurality of stranded wires consisting of a plurality of lead wires (14) shown in FIG. 3 or further twisting them and coating them with Teflon or the like.

(2) may be configured.

Then, as shown in FIG. 4A, the detection electrode (1) or the stimulation electrode (2) is passed through the inside of the venular needle (16) and inserted into a predetermined part of the body, and the nerve (18) and muscle (19) are inserted into the body. )
When it reaches the motor point (20) (indicated by the broken line circle in the figure), which is the junction of the remains in the body of the paralyzed patient (3), and its helical fixation part (12) becomes intimately connected to the tissue over time.

Returning to FIG. 1 again, reference numeral (4) is an isolation amplifier incorporating a photocoupler, to which the biopotential derivation section (13) of the above-mentioned detection electrode (1) is connected. (5) is an isolation power supply, which is dedicated to the isolation amplifier (4). (6) is an A/D converter that converts the analog signal supplied from the isolation amplifier (4) into a digital signal and converts it to a bus (consisting of a data bus, an address bus, and a control bus).
(11) to the memory (7). The memory (7) stores various stimulation pattern data, such as "grabbing a tip", which is data sampled from a healthy person and modified to suit a paralyzed patient (3). memory(
The digital data read out from 7) is converted into analog stimulation pulses by being supplied to the D/A converter (8) via the data bus (11), and then sent to the stimulation electrode (2) via the capacitor C. is supplied to (9) is the power supply, A/D converter (6), memory (7), D/D converter (6),
Supply operating voltage to the A converter (8). CPU
(10) connects the A/D converter (
6), the memory (7) and the D/A converter (8).

Next, the operation of the above-mentioned stimulator will be explained by taking as an example a case where a paralyzed patient wants to perform the action of "grabbing a tip." In addition, the stimulation electrode (
In 2), it is necessary to use multiple needles to pierce each part of the hand, but for the sake of simplicity, this will be explained here using one needle.

First, under the control of the CPU (10), the memory (7)
Stimulation pattern data related to the movement of "grasping the tip" of a healthy person, which is stored in Stimulus pulses) are converted into pulses (stimulation pulses) and implanted via a capacitor C into the paralyzed patient (3) near the muscles or nerves associated with the "grasp" action, i.e. motor points) (20) (see Figure 4). The stimulation electrode (2) is supplied with the stimulation electrode (2).

Then, the level of the stimulation pulse is gradually changed (by program), and the stimulation pattern data at the time when the paralyzed patient (3) accurately performs the action of "grabbing the tip" is stored in the memory (7).

Next, when the paralyzed patient (3) applies force to his left shoulder, moves his left shoulder, or attempts these movements, the detection electrode embedded in motor point 1-(20) (see Figure 4) (
1) is supplied with biological voltage from muscles (19) and nerves (18). This biological voltage is then supplied to an isolation amplifier (4), amplified to a predetermined level, and then supplied to an A/D converter [6].

The A/D converter (6) is an isolation amplifier (
When the biological voltage is supplied from 4), this biological voltage is converted into digital data and sent to C via the data bus (11).
PU (10). The CPU (10) supplied with digital data from the A/D converter via the data bus (11) instructs the stimulation electrode (2) to supply stimulation pulses in accordance with the digital data.

Therefore, the muscles related to the action of “grabbing the tip” (1
9) Or the strength of the potential generated by the nerve (18) that connects the muscle (19) to the electric potential generated by the shoulder muscle (19) of the paralyzed patient (3) or the nerve (18) that connects the muscle (19). By adjusting the strength of the grip, the paralyzed patient (3) can adjust the force applied to his shoulder depending on the material of the grip, and can, for example, grasp the grip without crushing it.

If the detection electrode (1) and stimulation electrode (2) are implanted close to each other in the body, the biosignal from the detection electrode (1) is taken in using a gate, and the stimulation electrode (2)
to remove the influence of stimulation pulses from

Next, a second embodiment of the present invention will be described with reference to FIG. FIG. 5 shows an environment control device according to a second embodiment of the present invention. In FIG. 5, parts corresponding to those in FIG. In Figure 5, (21) ((21+), (21ri).

(213), ..., (2In)) are controlled devices, and this controlled device (21) is, for example, a telephone, an AV
(A [ID10 VISUAL: audio/visual) equipment (e.g. stereo playback device, television receiver, etc.)
, lighting devices, intercoms, word processors, beds, etc., which enrich the living environment of paralyzed patients (3). Each controlled device (21) has a different type of controlled device.
It is controlled by a control signal output from a D/A converter (8) depending on the mode of control.

In the case of this second embodiment, the same detection electrode (1) as in the first embodiment is used as a motor point on the shoulder of a paralyzed patient (3).
(20) is fixed.

Next, the detection electrode (
1), the controlled device (21)
The operation to control will be explained.

For example, the strength of the force applied to the shoulder by a paralyzed patient (3), whether the force is applied to the left or right side of the shoulder (in this case, detection electrodes must be implanted in each shoulder), and the force applied to the shoulder over a predetermined period of time. Depending on the number of inputs, etc., the controlled device (21) to be controlled and the mode of control are selected, and the CPU (10
) outputs a control signal from the D/A converter (8) depending on the controlled device (21) to be controlled and the mode of control, thereby outputting a control signal to any of the controlled devices (21). supply.

In the above-mentioned environmental control device, a case will be explained in which a paralyzed patient (3) controls one controlled device (21) with one detection electrode (1) implanted in the left shoulder of the paralyzed patient (3). However, a paralyzed patient (3) controls a plurality of controlled devices (21) based on biological signals detected from a plurality of detection electrodes (1) implanted in multiple locations on his/her body. It's okay.

In addition, if the controlled device (2I) is easy to control,
Without providing a CPU (10), memory (7), etc., a circuit is provided to form a control signal based on the biological signal from the detection electrode (1), and the controlled device is activated based on the control signal from this circuit. may be controlled directly.

〔Effect of the invention〕

According to the first aspect of the present invention described above, stable biological signals can be detected over a long period of time from the muscles or nerves associated with the remaining functional movements of a paralyzed patient, and based on the detected biological signals, the paralyzed patient It is possible to obtain a stimulation device that can stimulate paralyzed muscles with high selectivity, high functionality, and high accuracy.

According to the second invention described above, it is possible to detect stable biological signals over a long period of time from the muscles or nerves associated with the remaining functional movements of a paralyzed patient, and based on the detected biological signals, the controlled It is possible to obtain an environmental control device that can easily and accurately control equipment with high selectivity.

Furthermore, in the case of patients with myasthenia gravis, who have a low possibility of communication with the outside world, even if impulses are present in the nerve bundle, muscle activity is not performed due to a decline in the function of the junction between the nerve and muscle (motor point). However, in the case of the stimulation device and environment control device according to the present invention, nerve impulses can also be detected, which increases the possibility of stimulating the patient's paralyzed muscles and controlling the controlled equipment based on this. The possibility of communication with the outside world increases.

[Brief explanation of drawings]

FIG. 1 is a block diagram showing a stimulation device according to a first embodiment of the present invention, FIG. 2 is a diagram showing detection electrodes or stimulation electrodes,
FIG. 3 is a cross-sectional view of the detection electrode or stimulation electrode, FIG. 4 is a diagram showing a method of implanting the detection electrode or stimulation electrode into a living body, and FIG. 5 is a second embodiment of the environmental control device according to the present invention. FIG. 6 is a block diagram showing a conventional stimulation device. (1) is a detection electrode, (2) is a stimulation electrode, (3) is a paralyzed patient, (4) is an isolator amplifier, (5) is an isolator power supply, (6) is an A/D converter, (7) is a memory,
(8) is a D/A converter, (9) is a power supply, (10) is a CPU, (11) is a hook-shaped fixing part, (12) is a spiral fixing part, (13) is a biopotential derivation or introduction part, (14) is the lead wire, (15) is the coating part, (16) is the venular needle, (17) is the skin, (18) is the nerve, (19)
is the muscle, (20) is the motor point, (21) ((2
1,) to (21n)) are controlled devices. Agent Hidemori Matsukuma Figure 6

Claims (1)

[Scope of Claims] 1. A biological signal detection electrode implanted near the muscles or nerves related to the remaining functional movements of a paralyzed patient; and a storage means for storing stimulation pulses for stimulating the paralyzed muscles of the paralyzed patient. and a paralyzed muscle stimulating electrode of the paralyzed patient to which the stimulation pulse read from the storage means is supplied, and when a biological signal is detected by the biological signal detection electrode, the stimulation pulse is read from the storage means. A stimulator characterized in that the stimulator is configured to read out and supply the readout information to the paralysis muscle stimulation electrode. 2. A biosignal detection electrode implanted near the muscles or nerves related to the remaining functional movements of the paralyzed patient, and a controlled device to be operated by the paralyzed patient based on the biosignal from the biosignal detection electrode. An environment control device comprising: a control signal forming circuit that forms a control signal to be supplied to an environment control device.