JPS61265151A - Method for allowing patient to begin re-training of weakenedmuscle group - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

DETAILED DESCRIPTION OF THE INVENTION Field of the Invention The present invention relates to an apparatus and method for retraining weakened muscle groups. In particular, the present invention utilizes electromyograms (E
MG) detecting the signal and sending an artificial stimulation signal to the weakened muscle group in response to the signal initiated by the patient;
The present invention relates to an apparatus and method for retraining weakened muscle groups through a patient-initiated response device (PIRD).

[Conventional technology]

Muscle groups in the human body become weakened in various ways. One of the most common causes of muscle weakness is stroke.
It is. Muscle weakness also occurs with neuropathy and some type of atrophy of the nerves and/or muscles. Weakened muscle groups can be restored to near normal function by retraining the muscles in response to nerve stimulation.

Weakened muscle groups have been stimulated externally by devices that deliver stimulation impulses to the muscle group through electrodes inserted into the muscle group or placed on the patient's skin close to the muscle group.

Artificial stimulation, that is, stimulation from the outside, can take various forms. One embodiment is a computerized stimulation generator configured to generate stimulation impulses in a defined pattern that produces movement of the patient's muscles. Another aspect is physical therapy.
st) 'j or patient KJ: involves generating artificial stimulation by simply completing an electrical circuit that is manually opened and closed and includes a power source and a stimulation it pole. In some respects,
This type of device may be referred to as a patient-initiated response device, and as this term is used herein:
Refers to a device that detects an electromyographic signal that is spontaneously generated by a patient and acts as a signal to trigger a device that generates an artificial stimulation signal, and sends that artificial stimulation signal to a weakened muscle group.

[Purpose of the invention]

The object of the invention is to obtain a patient-initiated response device for retraining weakened muscle groups.

Another object of the present invention is to obtain a PIPD that detects electromyographic signals in a weakened muscle group and sends an artificial stimulation signal to the same weakened muscle group.

Yet another object of the present invention is to detect electromyographic signals in muscle groups and send artificial stimulation signals to weakened muscle groups.
It is to obtain RD.

[Summary of the invention]

The present invention utilizes transcutaneous electrodes to detect electromyographic signals in weakened and non-weakened muscle groups.

The detected signal is sent to a control device. The controller analyzes the signal to determine if the signal exceeds a level set by the variable threshold detection circuit or is distorted. If that level is exceeded, the circuit generates an artificial stimulation signal and sends it to a transcutaneous electrode placed near the weakened muscle group.

Therefore, this device can be used to detect electromyographic signals spontaneously generated by a patient in a muscle group, generate an artificial stimulation signal therefrom, and send the stimulation signal to a weakened muscle group. . In some cases, the patient-initiated signal and the artificial stimulation signal do not affect the same muscle groups. In other cases, the patient artificially stimulates other muscle groups by developing spontaneous signals in one muscle group.

〔Example〕

Hereinafter, the present invention will be described in detail with reference to the drawings.

First, refer to FIG. A patient 12 undergoing treatment is connected to a patient initiated response device (PIRD) 10 by a series of electrical leads and a set of percutaneous surface electrodes. An active electrode 14, a reference electrode 16, and a ground electrode 18 are attached to the patient's left lower leg. A remote electrode force, 22, is attached to the patient's right lower leg.

The electrodes are connected to controller 11 by a series of shielded wires. The active electrode 14 is connected by a line U, the reference electrode 16 is connected by a line, the ground electrode 18 is connected by a line, and the remote electrode 22 is connected by a line.

32, respectively.

Wires 24-32 can be terminated with a miniature telephone plug.

That is, wire 24 is terminated with a Fi plug M, leads 26, 28 are terminated with a common reference/ground plug 36, and wires 24, 32 are terminated with one remote plug.

Refer now to FIG. A controller 11 is shown in this figure. Plug 3411-i is connected to controller 11 by jack 40. Plugs 36 and 38 are jacks 42
44, respectively. The remainder of FIG. 2 will be explained later with reference to FIG.

Refer now to FIG. Electrodes 14-22 are shown together with a block diagram of controller 11. Electrode 14.

The electromyogram (EMG) signal received by 16 is a pair of 1
controller 1 via megohm resistors 46 and 48, respectively.
1 preamplifier. Electrode 18 is grounded. The electrodes 14, 16, and 18 will be collectively referred to herein as signal receiving electrode means.

The amplified FiMG signal is passed through a 60Hg filter 52, another amplifier 54, and a rectifier 56.

A three position function selection switch 58 allows the patient or physical therapist to select one of three functions of the controller. Their functions are as follows. The operator simply monitors the level of the EMG signal initiated by the patient as indicated by the meter 60.

The operator can select the function of the controller 11 to operate as a transcutaneous electrical nerve stimulator (TEND) through the generation of artificial stimulation signals. Alternatively, the operator can simultaneously monitor the level of patient-initiated EMG signals and generate artificial stimulation signals.

When switch 58 is moved to the EMG position shown for the switch shown in FIG.
8a, 58b are closed, so that the signal from rectifier 56 is sent only to meter 60. Switch 58 is EMG
/ When moved to the T W N S position, contact 58a
.

58b, 58c and 58d are closed. In this position, the output from rectifier 56 is provided to meter 60 and a circuit that generates an artificial stimulation signal. switch 58 is TE
When moved to the NS position, the signal from rectifier 56 is sent only to the artificial stimulation signal generation circuit.

When switch 58 is moved to the Fi M G / T I N S or TEN8 position (thereby generating a stimulation signal), the amplified BMG signal from rectifier 56 is provided to threshold detector 62 . The threshold level of this threshold detector is set by a threshold detector adjuster 64. When a predetermined EMG threshold level is reached, the amplified BMG signal triggers the threshold detector 62 and components of the controller are activated to generate an artificial stimulation signal.

RM of sufficient strength to trigger threshold detector 62
The G signal operates other parts of the controller 11, referred to here as logic means. The rate clock 66, which determines the frequency of the artificial stimulation signal, is started. Rate clock 66 can be adjusted by stimulation rate regulator 68. A pulse width monostable circuit 70 controls the width of the individual artificial stimulation signal pulses.

The dwell logic stabilizer circuit 72 is triggered simultaneously with the rate clock 66. When the operating time of dwell-on monostable circuit 72 has elapsed, dwell-off monostable circuit 74 is triggered.

The output of the rate clock, the output of the pulse width monostable, the output of the dwell-on monostable, and the output of the dwell-off monostable are summed by summing logic 76.

The rate clock, pulse width monostable circuit, dwell-on monostable circuit, and dwell-off monostable circuit will be collectively referred to as signal generating means. When summing logic 76 receives a suitable input pattern, summing logic 76 produces a so-called logic means output. Its output controls transformer driver 78. This transformer driver controls the amplitude of the stimulation pulse via a stimulation amplitude regulator 80 and controls a step-up transformer 82 . Driver 78 and transformer 82
constitutes what is called an amplifier.

Two transformer isolation diodes 84 , 86 are inserted in the circuit between transformer 82 and stimulus selection switch 88 . The operator of controller 11 can select by switch 88 to which of the two stimulation electrodes the artificial stimulation signal is applied. In reality, the switch 88 is part of the miniature remote telephone jack 44 (FIG. 2) and has two contacts 88.
a, 88b, and a movable piece 88a. Movable piece 88
c is biased by a spring into normal contact with contact 88b. When the plug 38 is inserted into the plug of the controller 11, the movable piece 880 of the switch 88 closes the contact 88.
a, thereby sending an artificial stimulation signal to the remote stimulation electrode. When no plug is inserted into the jack 44, the movable piece B8c contacts the contact ssb and an artificial stimulation signal is applied to the active electrode.

A typical KMG signal has a voltage of 1 to 100 microvolts and a frequency of 80 to 400 Hz. The output of the controller is 2
It has a voltage of 0 to 80 volts and a frequency of 40 to 120 Hz. Its frequency is adjusted by regulator 68.

Experiments have found that a frequency of 80 Hz is most suitable for patients undergoing treatment. When crushed, human skin has been found to have a resistance value of 1000-3000 ohms. From the above explanation, the electrode f4,1
6, 181d It will be appreciated that it must be able to handle a very wide range of voltages.

Preamplifier 50 also operates in the microvolt range;
Moreover, it must be protected from voltages of 20 to 80 volts. Resistors 46, 48 and input protection diode 92) 9
The inclusion of 4.96 and 98 prevents the transformer output voltage from damaging the preamplifier. Similarly, the EM received by the electrodes by the diodes 84, 86
This prevents the impedance of the transformer 82 with respect to the G signal from becoming relatively low. Thereby, the lliiMG signal can be correctly provided to the preamplifier.

Now assume that patient 12 is undergoing retraining of the weakened left thigh muscle group, which still receives EMG signals from the nervous system and is able to move the left leg slightly. The surface electrode is attached to the patient's left leg only, as shown in FIG. The remote electrode is not attached to the patient or controller. Switch 98 to controller 11
Power is supplied by

An RMG signal is detected between active electrode 14 and reference electrode 16. The ground electrode 18 improves the performance of the device and provides a larger sensor area. The detection of EMG signals is localized by using surface electrodes in pairs.

As mentioned above, the KMG signal is amplified by the preamplifier and applied to the filter 52. Filter 52 removes unwanted ambient electrical impulses that may be applied to the device when the patient is near mains powered electrical equipment.

Threshold detector 62 can be adjusted by threshold detector adjuster 64 to allow EMG of a predetermined strength to serve as a trigger signal for the device. As previously discussed, clock 66 and monostable circuit 70.72.74 provide outputs to summing logic 76. This summing logic produces an output that ultimately functions as an artificial stimulation of the muscle group.

It will be appreciated that once the signal generating means is included, the device can enter into an oscillating state. To prevent that oscillation condition from occurring, EM() above a threshold set by regulator 64 simultaneously triggers rate clock 66 and dwell-on monostable 72 (c). The frequency is typically set around 80 Hz by stimulation rate regulator 68. Rate clock 66 and pulse width monostable circuit 70 together determine the frequency of the amplified stimulation signal.

The dwell-on monostable circuit 72 is the dwell-on time regulator 1
00 (FIG. 2). After the time determined by the dwell-on monostable circuit has elapsed, the dwell-off monostable circuit 74 establishes a second predetermined time period, which is set by the dwell-off time regulator 102 (FIG. 2).

The combination of the threshold detector and the dwell-on monostable circuit constitutes a so-called signal generation means. The dwell-off monostable circuit subsequently receives the patient-initiated EMG signal,
or substantially prevent the signal generated by the controller 11 from triggering the device within a predetermined time. Therefore, the dwell-off monostable circuit is referred to herein as a means for preventing the restart of generation of the stimulation signal.

As previously discussed, the strength or amplitude of the artificial stimulation signal can be varied between 20 and 80 volts by stimulation amplitude conditioner 80. In this way transformer 82i
The signals generated by C are sent through active electrodes 14 to the weakened muscle group being retrained. This active electrode 1
4 now functions as stimulation electric fence means or stimulation signal transmission means. In this case, the receiving and stimulating electrodes are housed within a common housing. Although a fairly small electrode is sufficient to receive the electromyographic signal initiated by the patient, a somewhat larger electrode may be used as the stimulation electrode to avoid burning the patient's skin to which the electrode is attached. Requires.

Typical artificial stimulation signals have voltages of 20 to 80 volts, currents of 2i' to 80 milliamps, and frequencies of 40 to 120 mA.
It is Hz. In that it causes the least amount of burns on the skin,
A frequency of about 80 Hz has been found to be most preferred. Typical artificial stimulation signal duration is 100-500
milliseconds, followed by a 3-10 second pause. The duration is determined by the dwell-on monostable circuit, and the rest time is determined by the dwell-off monostable time.

The human body can apply EMG signals to a given muscle group approximately 10 times per second, but if an artificial stimulation signal of the strength required to retrain a muscle group is applied at such a recirculation rate, , the patient's skin to which the electrodes are applied can easily burn. Furthermore, such rapid repetitive stimulation does not allow for the desired retraining of weakened muscles.

Referring again to Figure 1, if the patient asked to retrain a muscle group that received an insufficient EMG signal, the muscle group was detected in a non-weakened muscle group] IBMG
Can be retrained by artificially generated signals triggered by signals. In this case, electrodes 14, 16, 18 still detect EMG signals on the patient's left leg, and the remote wire forehead, 22, is connected to jack 44. If it is guessed, controller 1
1 is applied to the extensor muscles of the patient's right leg. By positioning the electrode in this manner, the patient will receive an F on the left knee.
By initiating the iMG signal, the patient can stimulate the weakened muscle groups in the left thigh. Obviously, the electrode receiving the signal can be located near any healthy muscle.

The signal receiving electrode and the stimulating electrode are housed independently in this situation.

BRIEF DESCRIPTION OF THE DRAWINGS: FIG. 1 is a schematic illustration of a patient utilizing the patient-initiated response device of the present invention; FIG. 2 is a front view of the controller of the device; FIG. 3 is a simplified block electrical circuit diagram of the apparatus of the present invention. 1]... Control □□ device, 14... Active electrode, 16...
・Reference electrode, 18... Ground electrode, 20, 22...
Remote electrode, Seki... preamplifier, 52... filter,
56... Rectifier, 58.88... Selector switch, 6
2... Threshold detector, 64... Threshold detector adjuster, 66... Rate clock, 68... Stimulation rate adjuster, 70... Pulse width monostable circuit, 72... ...Dwell-on monostable circuit, 74...Dwell-off monostable circuit,
76... Addition logic, 78... Transformer driver.

Claims (6)

[Claims] (1) The process in which a patient spontaneously generates an electromyographic signal in a muscle group consciously selected by the patient, and detection when the electromyographic signal thus generated has a predetermined strength. a process of generating a stronger stimulation signal from the detected electromyographic signal; and a process of transmitting the stimulation signal to the weakened muscle group of the patient at approximately the same time as the detection of the electromyographic signal so that the stimulation signal is perceived by the patient. generating a muscle response to a stimulation signal in response to a spontaneously initiated electromyographic signal. (2) The method according to claim 1, wherein the stimulation signal is sent for a predetermined length of transmission time, and when the transmission time elapses, there is a non-transmission pause, and is longer than the transmission time. (3) The method according to claim 1, wherein the weakened muscle group is within a patient's limb, and the patient is aware that the spontaneously initiated electromyogram signal is within the same limb. method, characterized in that the method is characterized in that the method is characterized in that: (4) The method according to claim 1, wherein the patient's weakened muscle group is included in the patient's limb, and the spontaneously initiated electromyogram signal is transmitted to another limb other than that limb. A method characterized in that it is consciously selected by the patient to be generated within the muscles within the body. (5) The method of claim 1, wherein the spontaneously initiated electromyographic signal is generated in a weakened muscle group of the patient, and the stimulation signal is transmitted to the same weakened muscle group. A method characterized by: (6) The method of claim 1, wherein the spontaneously initiated electromyographic signal is generated in non-weakened muscle groups of the patient, and the stimulation signal is generated in the patient's weakened muscle groups. A method characterized by being transmitted to a group.