JPS5848174B2 - Muscle spasticity measuring device - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION The present invention relates to a device that measures and displays the tension or resistance that reflexively occurs in the muscles of a patient's limbs when the patient's limbs are passively flexed and extended, and in particular, the present invention relates to a device that measures and displays the tension or resistance that is reflexively generated by the muscles of the limbs when the patient's limbs are passively flexed and stretched. This invention relates to a device that medically evaluates and displays the degree and state of the force with which a limb resists the rotation of an operating rod due to its own spasticity (reflex tension).

Patients suffering from stroke, Parkinson's disease, condylar spinal cord damage, etc. experience reflexive abnormal movements during daily activities, which can be painful and dangerous.

Such an abnormal state of muscular tension also indicates an abnormality in the nervous system.
Medically, it has been studied as a problem of muscle spasms.

Recently, it has become necessary to analyze the symptoms, neurophysiology, and pathology of patients during exercise and compare them with those of healthy individuals in order to determine treatment strategies.

When a limb is passively flexed and stretched, there is a slight resistance due to the viscoelasticity of the muscles themselves.

Furthermore, there is a rigidity phenomenon in which resistance is approximately constant regardless of the speed of passive bending and stretching, or the beginning and end of the movement.

Regarding muscle spasm, when the limb is at rest, the muscles are in a relaxed state, and no tension can be seen in the electromyogram, but when the muscles are passively flexed and stretched, a reflex resistance is generated against the flexion and stretching, and the flexing and stretching Increasing the speed increases the resistance force, and the resistance force is not constant depending on the bending/extension angle range.

Although the effect organs such as skeletal muscles are under the control of the voluntary motor nerve center, the effect organs with spasticity are said to be in a contracted state mainly caused by the reflex mechanism of the motor spinal cord, and the mechanism is It is complex and diverse.

Therefore, since it is impossible to confirm which nerve part is deteriorating with an electromyography device that detects the degree of tension in the local muscle part of abnormal movement, there is no appropriate treatment strategy for spastic muscles.

The present invention is an attempt to solve the above-mentioned defective problem, and its gist is that an operating rod is pivoted to a mechanism that drives at a constant speed by setting a rotation angular velocity and a rotation angle range, and This device uses a strain gauge to detect the rotational resistance of a spastic limb worn in a relaxed state, and displays the detection results on a pen recorder.

Then, while analyzing and examining the display data of the device,
This will contribute to the elucidation of suitable treatment methods such as surgery and physical therapy.

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

Reference numeral 1 denotes a substantially rectangular base, and a pair of support columns 2 are erected from one side of the base 1, and a horizontal frame 3 is fixedly attached between the upper ends thereof.

A mounting frame 5 supporting a housing frame 4 housing a mechanical section is inserted into both columns 2 so as to be adjustable in height, and is fixed with screws 6.

The tip of a hydraulic arm 7 is fixedly installed in the center of the mounting frame 5, and the output rod 8 of the arm 7 moves reciprocally through the housing frame 4, and a rack 9 is fixedly installed in the center. .

A rotating shaft 12 having a pinion 11 that meshes with the rack 9 of the output rod 8 is rotatably mounted on bearings provided on the front wall 13 and rear wall 14 of the housing frame 4.

The rotation shaft passes through the front wall 13, and its front end is connected to the mounting ring 15.
The base end of the actuating rod 16 is fixed via the .

In this embodiment, the attachment ring 15 has a brace 1 for fixing the forearm.
The proximal end of the brace 17 is removably fixed, and the adjusting body 19 for fixing the wrist is slidably fixed to the distal end of the brace 17 via a sliding ring 18 fitted to the operating rod 16.

When fixing the forearm to the brace 17, the elbow joint axis is aligned with the rotation axis, the palm is externally rotated upward, and the upper arm tip and wrist are fixed with bands 20, 21.

Although the hydraulic arm is not shown, it is connected to an oil supply pump connected to an electric motor, and this oil supply pump sets the oil pressure that selects the torque of the rotating operating rod 16 and the amount of oil supply that determines the rotation speed. and can be supplied.

A known strain gauge 23 is provided on the rotating shaft 12 in front of the pinion 11 .

This strain gauge 23 is connected to a separately provided pen recorder.

As shown in FIG. 6, the pen recorder displays as torque the spastic resistance of the limb corresponding to the temporal rotation angle of the limb joint that passively bends and extends along the operating rod 16.

A gear 25 is provided at the rear portion of the pinion 11 of the rotating shaft 12, and the gear 25 meshes with a small gear 27 provided on a support shaft 26 protruding from the rear wall 14.

The rotation of the small gear 27 is transmitted to a coaxially provided gear 28.

The gear 28 is provided with an angle detector 30 of the rotating operating rod 16.
and a rotation range setting device 31 are provided.

In the angle detector 30, a support shaft 34 of a potentiometer 33 is rotatably inserted into a frame 32 that protrudes inward from the rear wall 14, and a gear 35 provided at the tip of the support shaft 34 is connected to the gear 28.
mesh with.

The potentiometer 33 is connected to the aforementioned pen recorder.

The graph displayed by the pen recorder displays the flexion/extension angle positions of the limb joints over time, as shown in FIG. 6b.

The rotation angle range setting device 31 is as shown in FIG. 2 and FIG.
A cylindrical casing 36 is rotatably mounted on the rear wall 14, and a gear 37 provided coaxially and integrally with the cylindrical casing 36 on the front surface meshes with the gear 28 described above. do.

Then, the cylindrical housing 3 is rotated by the same angle as the rotation angle of the operating rod 16.
6 rotates.

An internal disc 38 and an external gear 39 are fixed to both ends of a support shaft 400 and rotatably disposed in the cylindrical casing 36, and a tube shaft interposed therein is attached to the support shaft 40. A disk 42 and a gear 43 are provided at one end of the housing 41 (inside the housing 36) and are rotatably provided on the outside.

As shown in FIG. 5, an annular scale plate 45 is provided on the inner surface of the gear 43, while a scale 46 is directly engraved on the surface of the gear 39.

The reading reference marks 47 and 48 of these scales are fixedly provided on the rear wall 14, and the tips thereof are positioned at the respective scale portions.

Using this reading reference mark, the 00 positions of both gears 39 and 43 are aligned, and the set angle between the starting position and rotation stop position of the operating rod 16 is confirmed.

When the gears 39 and 43 are rotated to the start and stop positions, respectively, the stoppers 51 and 52, which are biased from the rear wall 14 in the direction of the gear axis via the mounting member 50, are engaged with the respective teeth and fixed. .

When the gears 39, 4300° position is aligned with the reading reference mark, a light emitting diode (light emitter) 53. 54 are buried respectively, and a phototransistor (
The photoreceptors 55 and 56 are attached to the cylindrical housing 4.

To explain the operation and electric circuit of the rotation angle setting device 310 having such a configuration, as shown in FIG. It is located at the dashed-dotted line portion behind the position directly above the disks 38 and 42 by an angle θ.

In order to align the light emitting body 54 with the light receiving body 56 at this rear position, the gear 43 is rotated by an angle θ and then fixed by the stopper 52.

At this time, the electric circuit which is electrically connected to the mechanically stopped state is activated by pressing the activation button (not shown) of the activation rod 16.
Rotate downward.

In order to bring the forearm integrated with the operating rod 16 into the extended position, the light emitting body 53 of the disc 38 is previously rotated forward by an angle θ2 and fixed by the stopper 51.

And the photoreceptor 55 corresponding to the rotating operating rod 16
When the light is aligned with the position of the light emitting body 53, the light receiving body 55 receives the light wave and is a sequence electric circuit that stops the rotation of the operating rod.

The operating rod 16 that has stopped further rotates back to the position of the light emitter 54 again after a desired rest period and stops.

The operation of the apparatus of the present invention constructed as above will be explained.

Set the amount and pressure of oil supplied from the oil supply pump to the hydraulic arm.

Then, in order to reciprocate the operating rod 16 on which the forearm is attached between the starting and rotation stop positions shown in FIG.
54 to the position shown in FIG.

At this time, the spastic patient is seated on a chair in a lateral position with respect to the working rod, with the right upper arm facing downward, and the elbow joint axis is the rotation axis 1.
2 and placed on the brace 17.

Then, by operating the push button, the operating rod 16 is rotated at a constant speed of 1200.
Rotate back and forth.

The movement of the forearm along with this rotational movement of the operating rod, that is, the resistance to the passive bending and stretching movement of the elbow joint is recorded on the pen recorder.

This record is shown in FIG.

FIG. 6a shows the elbow joint resistance detected by the strain gauge 23 in terms of time and torque.

The elbow joint extends from 1200° flexion to extension (left side of Figure 6a), showing the resistance to extension of the elbow flexor muscles.

Then, after a rest period, the elbow extensor stretch resistance is shown when the elbow is flexed from the extended position to l200 (right side of Figure 6a).

Graphs 60 and 60' in Fig. 6a show the resistance of the elbow joint of a healthy person without spasticity or rigidity, and are entirely flat lines, indicating the viscoelastic resistance inherent in muscles. Dew.

Graphs 61 and 61' show the resistance of patients with spastic rigidity due to after-effects of stroke, and the resistance values are high overall.

When the elbow joint is extended, the central part is low, and when it is flexed, it is 61'.
is a line with a high center.

Graphs 6 2 and 6 2' are resistance values measured after cold therapy was applied to the patient for a certain period of time, and they are lower overall than the resistance values 61 and 61', especially when the elbow joint is flexed. ′ is lowered in the center.

Figure 6b shows a detector consisting of a potentiometer at 120°.
This is a graph obtained by detecting the elapsed time of bending/extending the elbow joint and its bending/extending angle position, and displaying the results using a pen recorder.

These graphs 63, 63' can be used to check the flexion or extension angle position of the elbow joint that corresponds to the desired position in the graph of FIG. 6a.

Furthermore, if the graphs of 63 and 63' are linear, the operating rod 16
indicates that it is rotating at a constant speed, and if it is curved, the constant speed rotation is obstructed and an error will occur in the resistance value measurement evaluation.

Therefore, it is necessary to increase the oil pressure of the oil supply pump.

The device of the present invention, which has the above-described effects, quantitatively analyzes the resistance data obtained during passive bending and stretching of limb joints, measures and evaluates muscle spasticity and rigidity symptoms, and It confirms whether there is abnormal movement in the area and determines the treatment policy and method.

[Brief explanation of drawings]

Fig. 1 is an overall perspective view of the device of the present invention, Fig. 2 is an overall explanatory view showing the mechanism inside the housing frame, and Fig. 3 is an operating rod operated by a hydraulic arm, its rotation angle range setting device, and rotation. FIG. 4 is a perspective view showing the inside of the operating rod rotation angle range setting device; FIG. 5 is a perspective view of the upper limb attached to the orthosis; FIG. 6a , b are graphs displayed on a pen recorder of the bending and stretching resistance of the limb joints detected by the detector and the strain gauge. 1... Base, 4... Housing, 7...
... Hydraulic arm, 9 ... Rack, 12 ...
...Rotating axis, 16...Operating rod, 17...
・Orthosis, 23...Strain gauge, 30...
Operating rod angle detector, 31... Operating rod rotation angle range setting device, 33... Potentiometer, 3
6... Cylindrical housing, 38, 42... Disk, 53, 54... Luminous body, 54, 55...
...Photoreceptor.

Claims (1)

[Claims] 1 The pinion 11 of the rotating shaft 12 is engaged with the rack 9 provided on the output rod 8 of the hydraulic arm 7, and the base end of the operating rod 16 equipped with the limb device orthosis 17 is fixed to one end of the rotating shaft 12. A strain gauge electrically connected to a pen recorder is provided on the rotating shaft portion between the pinion 11 and the operating rod 16,
An operating rod 1 is connected to the other side of the rotating shaft 12 via an interlocking member.
In addition to providing a rotation angle range setting device 31 of No. 6, a rotation angle detector of the operating rod connected to a pen recorder is provided, and the tension resistance to passive flexion and extension of the limb joint can be measured based on the time course of the flexion and extension angle position. A muscle spasticity measuring device characterized by recording and displaying corresponding torque.