JPWO2014092076A1 - Hemiplegic forearm function recovery training device - Google Patents

Abstract

A stick (16) held by the patient, a wrist support (17) that supports the patient's wrist, and a servo motor (21) that repeats forward, stop, reverse, and re-stop the stick and wrist support. , A hemiplegic forearm function recovery training device (10) is disclosed.

Description

  The present invention relates to a hemiplegic forearm function recovery training device that trains a paralyzed forearm to promote recovery of the rotational function of the forearm. The rotation includes “inward” in which the forearm is turned toward the center of the body and “outward” in which the forearm is turned outward.

When stroke occurs, paralysis may remain in one of the left and right body. Paralysis that remains in one of the left and right body is called hemiplegia.
This hemiplegia can be partially restored by rehabilitation. This rehabilitation is performed by skilled doctors or therapists, but the training takes a long time and a long period of time, so the physical burden on the doctors and therapists is great.
For the purpose of eliminating this burden, conventionally, a training apparatus has been proposed (for example, Patent Document 1).

The training device disclosed in Patent Document 1 will be described with reference to the following diagram.
As shown in FIG. 25, a conventional training apparatus 100 includes a base 101, a motor 102 provided at one end on the base 101, and a cylindrical body that is supported by the motor 102 and rotated in one of forward rotation and reverse rotation. 103, a grip portion (stick) 104 standing on the cylinder 103, a first band 105 provided at the entrance of the cylinder 103, a vertical frame 106 provided at the other end on the base 101, and the vertical frame A front receiving portion 109 and a rear receiving portion 111 that extend from 106 and support the forearm portion 107 and the upper arm portion 108, respectively, and a second band 112 and a third band 113 provided in each of the front receiving portion 109 and the rear receiving portion 111. I have.

The wrist 114 is firmly held by the first hand 105, the forearm portion 107 is firmly held by the second band 112, and the upper arm portion 108 is firmly held by the third band 113.
In this state, forward rotation and reverse rotation are repeated in such a manner that the cylinder 103 is rotated by a predetermined angle by the motor 102 and then rotated to the opposite side by a predetermined angle.

The training device 100 disclosed in Patent Document 1 has the following problems.
Patients are said to have greater emotional undulations than healthy individuals. During training, the user may be urged to remove his / her arm from the training device 100. However, in the conventional training apparatus 100, since the arm is restrained by the 1st band 105, the 2nd band 112, and the 3rd band 113, an arm cannot be removed by a patient's will. As a result, the patient is stressed and the patient becomes reluctant to train. In order to promote the spread of the training apparatus, a training apparatus that causes less stress on the patient is required.

  In this type of training, it is important to stimulate and strengthen the functions remaining in the body. In the conventional training apparatus 100, the cylinder 103 is rotated forward and backward by the driving force of the motor 102. Even in a state where the patient has pulled out of the forearm (a state of weakness), the training seems to proceed. However, the training effect cannot be obtained in a state where power is exhausted. There is a need for a training device that can restore function more reliably.

JP-A-4-261657

  It is an object of the present invention to provide a training apparatus that is less stressful to a patient and that can achieve functional recovery more reliably.

The present inventors have found that a training apparatus that can perform accelerated repeated therapy is effective in solving the above-described problems.
Accelerated repetitive therapy means that a therapist (such as a doctor or a medical practitioner) manipulates a patient's paralyzed limbs to pinpoint stimulation to the necessary neural circuits, and performs the targeted movement by stretching the reflexes of the muscles Say to trigger. It is a new rehabilitation method that reinforces and reinforces the necessary neural circuits and accelerates the recovery of paralysis by repeating this action patiently. The term “promotion” refers to a procedure for assisting exercise by giving a stimulus to a desired site so that the patient can easily perform the intended motion.

  It is difficult for hemiplegic patients to move their paralyzed limbs by their will (command from the brain). However, by applying a stimulus to the paralyzed limb, a stretch reflex is caused, and the nerve cells are excited, and the paralyzed limb can be moved by a command from the brain. Therefore, in order to transmit the stimulus to the neural circuit involved in the target movement, the target muscle is quickly stretched immediately after the target muscle is stretched and the muscle tone is increased, and the contraction of the muscle is ordered to become the target. Trigger action.

  In order to trigger the target movement of the forearm, a stretch reflex must be triggered by a pinpoint stimulus. In the current situation (prior art), pinpoint stretch reflection cannot be easily caused. In the present invention, in order to cause this extended reflection, the first angular velocity of the other dynamic rotation, the rapid acceleration, and the higher second angular velocity are developed in this order to solve the problem. Successful.

The invention according to claim 1 is a hemiplegic forearm function recovery training apparatus that trains the forearm part of the paralyzed one to promote recovery in a patient whose body is paralyzed,
An apparatus base, a half cylinder that is supported by the apparatus base so as to be rotatable about a horizontal axis and whose upper surface is open, and a stick that is provided in the half cylinder and can be grasped by a finger of the forearm, A wrist support provided in the half cylinder for supporting the wrist; a drive shaft having one end connected to the half cylinder and extending horizontally; a servo motor provided in the apparatus base for driving the drive axis; An encoder provided in the servo motor for measuring the rotation angle of the motor shaft, and rotation angle information is acquired from the encoder, and the half cylinder is rotated forward, stopped, reversed, and restarted repeatedly. In the rotation, the speed is controlled to the first angular velocity, the rapid acceleration, and the second angular velocity higher than the first angular velocity in order to stimulate the training target muscle that causes the muscle tone and the stretch reflex above, and in the reverse rotation, the muscle is stimulated. The The resistance imparting to maintain connection to muscle tone, and a control unit which forms a series of control hemiplegic forearm rehabilitation device is provided.

  In the invention according to claim 2, preferably, the wrist support portion is composed of a bracket and left and right curved members that are supported by the bracket via screws and sandwich the wrist, so that the wrist can be pulled upward. It has become.

  In the invention according to claim 3, preferably, a torque detection mechanism is provided between the half cylinder and the drive shaft so that the torque applied to the stick by the patient at the time of reverse rotation can be detected by this torque detection mechanism. It is characterized by that.

  In the invention according to claim 4, preferably, the torque detection mechanism includes a rod-shaped member extending from the outer peripheral portion of the half cylinder to the drive shaft, a constricted portion provided in the middle of the rod-shaped member, and a strain attached to the constricted portion. It consists of a gauge and a torque converter for converting strain information from the strain gauge into torque.

  In the invention according to claim 5, preferably, an extension portion extends from the apparatus base, and a platform for supporting the forearm portion is provided on the extension portion, and an elbow fixing portion for supporting the upper arm portion is attached to the forearm platform. ing.

  In the invention which concerns on Claim 6, Preferably, the extension part is connected with the apparatus base through the joint mechanism so that horizontal movement and rotation are possible.

  In the invention according to claim 1, the half cylinder is normally rotated, stopped, reversed, and stopped again. In forward rotation, the first angular velocity, the rapid acceleration, and the second angular velocity faster than the first angular velocity are used to excite the nerve cells by causing the muscles to reflex by the rapid acceleration change of the muscle stretching tension and the stretching speed for functional recovery. To give muscle stimulation. In reversal, resistance is applied to maintain muscle tone by sustaining muscle stimulation. That is, since the reversal is performed by the patient himself, the recovery of the function of the patient can be promoted.

  Further, the vehicle is accelerated rapidly during the forward rotation, and is subsequently rotated at the high second angular velocity. The muscles stretch and encourage stretch reflexes. Stretch reflex can induce muscle tone and promote reversal by the patient himself.

  The invention according to claim 2 has a structure in which the wrist can be pulled upward. The patient feels at ease that his arm can be removed from the device at any time. As a result, the patient is no longer stressed and no worries about training.

In the invention according to claim 3, a torque detection mechanism is provided between the half cylinder and the drive shaft, and the torque applied to the stick by the patient at the time of reverse rotation can be detected by this torque detection mechanism.
The resistance force at the time of reverse rotation can be corrected based on the torque applied to the stick by the patient at the time of reverse rotation by the torque detection mechanism. That is, a resistance force that matches individual differences among patients can be generated by the servo motor.

  According to a fourth aspect of the present invention, the torque detection mechanism includes a rod-like member having a constricted portion and a strain gauge attached to the constricted portion. When a strain gauge is affixed to the outer peripheral surface of the drive shaft, there is a slight amount of distortion, and an error is likely to occur in the measured torque. In this respect, in the present invention, the elastic deformation of the constricted portion is large, and a strain gauge is attached thereto, so that an error in measurement torque is small.

  In the invention which concerns on Claim 5, since a forearm part is mounted on a forearm mount and an upper arm part is fitted by an elbow fixing | fixed part, an elbow is stabilized.

In the invention according to claim 6, since the extension part provided with the forearm mount and the elbow fixing part is connected to the apparatus base through the joint mechanism so as to be horizontally movable and rotatable, the patient puts the elbow during training. The place can be moved horizontally. As a result, the muscles to be recovered are well stretched in advance.

It is a side view of the hemiplegic forearm function recovery training apparatus concerning the present invention. It is a perspective view of the hemiplegic forearm function recovery training apparatus concerning the present invention. It is a perspective view of a half cylinder. FIG. 4 is a sectional view taken along line 4 of FIG. 1. FIG. 5 is a sectional view taken along line 5 in FIG. 1. It is a disassembled perspective view of the principal part of the hemiplegic forearm function recovery training apparatus. FIG. 7 is a cross-sectional view taken along line 7-7 in FIG. 6. It is a front view of a wrist support part. It is an effect | action figure of a wrist support part. It is an action | operation figure of a hemiplegia forearm function recovery training apparatus. It is an effect | action figure of a half cylinder. It is a figure explaining other dynamic rotation motion. It is a front view of a torque detection mechanism. It is a figure explaining the principle of a torque detection mechanism. It is a figure explaining the effect | action of a control part. It is an angular velocity graph in two experiments. It is a graph which shows the maximum angular velocity obtained by two experiment. It is a graph which shows the maximum rotation angle obtained by two experiment. It is a figure which shows the example of a change of the hemiplegic forearm function recovery training apparatus shown by FIG. It is a figure explaining the effect | action of the hemiplegic forearm function recovery training apparatus shown by FIG. 19, especially the joint mechanism. It is a figure which shows the example of a change of an effect | action of the control part shown by FIG. It is a figure which shows the example of a change of the hemiplegic forearm function recovery training apparatus shown by FIG. It is a figure which shows the further example of a change of the hemiplegic forearm function recovery training apparatus shown by FIG. It is a figure which shows the further example of a change of the hemiplegic forearm function recovery training apparatus shown by FIG. It is a block diagram of the conventional training apparatus.

  Hereinafter, preferred embodiments of the present invention will be described with reference to the accompanying drawings.

  As shown in FIG. 1, the hemiplegic forearm function recovery training apparatus 10 includes a moving table 12 including casters (universal wheels) 11, a forearm mounting table 13 provided at one end on the moving table 12, and a moving table 12. The apparatus base 14 provided on the upper side, the half cylinder 15 that is supported by the apparatus base 14 so as to be rotatable around a horizontal axis and the upper surface is opened, and the stick 16 provided in the half cylinder 15 A wrist support portion 17 provided in the half cylinder 15, a drive shaft 18 having one end connected to the half cylinder 15 and extending along the horizontal axis, and a drive shaft provided in the apparatus base 14. Bearing bases 19, 19 that rotatably support 18, a servo motor 21 provided on the apparatus base 14 for driving the drive shaft 18, an encoder 23 provided on the servo motor 21 for measuring the rotation angle of the motor shaft 22, This The rotation angle information is acquired from the encoder 23, and the half cylinder 15 is rotated forward, stopped in the left and right directions, stopped, and reversely rotated. The torque converted to the torque applied to the stick 16 is calculated and sent to the control unit 24. Part 25.

  The control unit 24 obtains the rotation angle information from the encoder 23 and repeats the forward rotation, the stop, the reverse rotation, and the re-stop of the half cylinder 15 in the right and left directions. In order to excite the nerve cell by causing the muscle stretching reflex by the rapid acceleration change of the stretching tension and stretching speed of the muscle for functional recovery, in the normal rotation, the first angular velocity, the rapid acceleration, and the first angular velocity faster than the first angular velocity. The speed is switched so as to give muscle stimulation at two angular speeds. In order to match the movement of the forearm, the rotation is stopped for several tens of milliseconds from the end of the forward rotation until the reverse of the forearm starts to move due to stretch reflection. In order to sustain muscle stimulation and maintain muscle tone, reversal provides resistance.

Note that a part of the caster 11 may be a normal wheel (non-universal wheel). Further, the caster 11 may be omitted. In this case, the movable table 12 is a simple table.
As long as it is a table, an appropriate table or desk can be used instead of the table, so whether or not the movable table 12 is arranged under the apparatus base 14 is arbitrary.
However, since the servo motor 21 and the encoder 23 are heavy, it is recommended that the apparatus base 14 and the movable table 12 be integrated as in this embodiment in order to reduce the human burden.

The half cylinder 15 has a notch ratio of 50%. However, the notch ratio of the half cylinder 15 can be changed, and it is sufficient that a part of the cylinder is notched. That is, the notch ratio of the half cylinder 15 is not limited to 50%. Furthermore, the material of the half cylinder 15 is basically a cylinder, but may be a polygonal cylinder.
A torque detection mechanism 60 is provided between the half cylinder 15 and the drive shaft 18.

  As shown in FIG. 2, the movable base 12 includes a main base portion 27 supported by four columns 26, and a sub-base portion 29 extending from the main base portion 27 and having a tip supported by a single column 28. It has. The sub-base portion 29 is elongated and has spaces 31 and 32 on the left and right sides thereof. A patient can enter one of the space 31 and the space 32. It is preferable to reduce the weight of the movable table 12 by configuring the columns 26 and 28 with lightweight section steel, specifically, an aluminum sash. The other constituent elements are the same as those in FIG.

As shown in FIG. 3, the half cylinder 15 has an open top surface.
As shown in FIG. 4, the half cylinder 15 is supported by the first cam follower 31 and the second cam follower 32 so as to be rotatable around the horizontal axis.
Further, as shown in FIG. 5, the half cylinder 15 is supported by the third cam follower 33, the fourth cam follower 34, and the fifth cam follower 35 so as to be rotatable around the horizontal axis.

  The central fourth cam follower 34 can be removed. The cam followers 31 to 35 are assemblies composed of a support shaft, a needle bearing attached to the shaft, and a roller surrounding the needle bearing. However, the cam followers 31 to 35 may be so-called free rollers (free rotating rollers), and the structure is Is optional.

  As shown in FIG. 6, the drive shaft 18 is coupled to the motor shaft 22 of the servomotor 21 via a coupling 36. A belt-like bar member 38 extending upward is fixed to the drive shaft 18 at the tip. In the drive shaft 18, an angular shaft portion 39 is formed on the tip side from the rod-shaped member 38. A male screw portion 41 is formed on the drive shaft 18 on the tip side from the angular shaft portion 39.

  A disc 42 is fixed to one end of the half cylinder 15, and a square hole 43 is provided in the disc 42. The square shaft portion 39 is fitted into the square hole 43. Thereafter, as shown in FIG. 3, a nut 44 is attached to the male screw portion 41. As described above, the drive shaft 18 is connected to the half cylinder 15 and the half cylinder 15 is positioned in the axial direction. That is, there is no concern that the half cylinder 15 moves in the axial direction during rotation.

  As shown in FIG. 6, the drive shaft 18 is rotatably supported by a pair of bearing stands 19. A key 45 is fixed to the drive shaft 18 between the bearing base 19 and the bearing base 19. Further, the stopper block 46 is fixed to the apparatus base 14 between the bearing base 19 and the bearing base 19.

  As shown in FIG. 7, the stopper block 46 includes stop surfaces 47 and 48 on the upper surface, and these stop surfaces 47 and 48 are disposed below the drive shaft 18. In the neutral state, the key 45 is on the drive shaft 18. The drive shaft 18 is rotated 90 degrees left and right from the neutral position, a total of 180 degrees. That is, the key 45 moves to the position indicated by the imaginary line. Even with the key 45 indicated by the imaginary line, there is a gap α of about 1.5 mm from the stop surface 47. Therefore, normally, the key 45 does not hit the stop surface 47. The same applies to the stop surface 48.

  When the rotation amount of the drive shaft 18 changes due to a trouble in the control system, the key 45 hits one of the stop surface 47 and the stopper surface 48, and the drive shaft 18 does not rotate any more. As a result, there is no concern that the half cylinder (FIG. 3, reference numeral 15) rotates beyond a predetermined angle. That is, in the present invention, the amount of rotation is controlled by the encoder, but a mechanical stopper is provided to improve safety in preparation for a failure of the encoder.

  As shown in FIG. 8, the wrist support portion 17 includes a channel-shaped bracket 49 opened upward, and left and right sides sandwiching the wrist supported by screws 51, 52 on the wall portions 51, 51 of the bracket 49. The bending members 53 and 54 are provided. The screw 52 can be turned with the finger bar 55.

  As shown in FIG. 9, training is performed in a state where the wrist 56 is sandwiched between the left and right curved members 53 and 54 via the cushions 57 and 57, but the bracket 49 and the left and right curved members 53 and 54 are Since the upper part is open, the wrist 56 can be pulled out as shown by the arrow if the patient desires. That is, the feeling of pressure and restraint is reduced by the amount rich in the feeling of opening, and more preferable training can be performed.

As shown in FIG. 10, the patient needs to train the left hand, for example, and places the wrist 56 on the wrist support portion 17 and the forearm portion 58 on the forearm mount 13.
Turning the left wrist 56 viewed from the patient to the center of the body as indicated by the arrow (1) is called “pronation” and turning outward as indicated by the arrow (2) is called “extraversion”. Call.

The movement to turn to the arrows (1) and (2) at will is called “automatic rotation movement”. In order to cause this automatic rotational motion to a greater extent, a motion in which a force is applied from the outside and rotated to the other is called “another dynamic rotational motion”.
For example, “automatic rotational motion” can be caused in the direction of arrow (2) by performing “other dynamic rotational motion” in the direction of arrow (1).

In FIG. 11 (a), the wrist is not shown because the drawing becomes complicated, but it is in a neutral state, and training can be started from this state.
As shown in FIG. 11B, the servo motor 21 performs other dynamic rotational motion.
Specifically, as shown in FIG. 12, first, the other dynamic rotational motion is performed at the first angular velocity, the rapid acceleration is performed, and the other dynamic rotational motion is performed at the second angular velocity. For example, the first angular velocity is 2.5 radians / second, and the second angular velocity is 11.0 radians / second. That is, the second angular velocity is about 2 to 5 times the first angular velocity.

The sudden acceleration is set to the maximum acceleration that the servo motor 21 can produce. For example, the transition is made from the first angular velocity to the second angular velocity in 0.01 seconds. At this time, the angular acceleration is (11.0−2.5) /0.01=about 1000 radians / second ² .

That is, after a certain rotation by the first angular velocity, the stimulation is enhanced by a rapid acceleration change in the stretching speed and the stretching speed of the muscle that quickly rotates at the rapid acceleration and the second angular speed to restore the function. Then, stretch reflexes are excited by muscle stimulation.
Due to this stretch reflex, the contraction of the muscle is promoted, and as shown in FIG. However, a slight resistance force is generated by the servo motor 21 in order to maintain muscle tone by sustaining muscle stimulation.

  In order to generate a light resistance force with the servo motor 21, it is necessary for the patient to know the torque generated during automatic rotation. That is, if the torque is large, the resistance force (resistance torque) is increased, and if the torque is small, the resistance force is decreased, thereby avoiding a burden on the patient.

The present invention includes a torque detection mechanism for this purpose.
The shaft torque can be detected by attaching a strain gauge to the drive shaft 18. However, when the outer diameter of the drive shaft 18 is small, the amount of torsion of the shaft (see FIG. 14, reference sign θa) is small, so that measurement is difficult and measurement error increases.
In the present invention, as described below, a torque detection mechanism with good measurement accuracy is employed.

  As shown in FIG. 13, the torque detection mechanism 60 includes a pin 61 erected on the outer periphery of the disc 42 so as to extend to the drawing table, and a rod-like member that has one end fitted on the pin 61 and extends to the rotation center of the disc 42. 38, a constricted portion 62 provided in the middle of the rod-shaped member 38, a strain cage 63 attached to the constricted portion 62, and a torque converting portion 25 for converting strain information obtained by the strain cage 63 into torque. I have.

  One end of the rod-shaped member 38 is fitted into the pin 61 through a long hole 64 extending in the longitudinal direction of the rod-shaped member 38, thereby allowing the rod-shaped member 38 to move with respect to the pin 61. Further, the other end of the rod-shaped member 38 is sandwiched by another angular shaft portion 67 of the drive shaft 18 with flanges 65 and 66.

  The rod-shaped member 38 may be a round bar or a square bar in addition to the band plate, and the shape is arbitrary. However, since the width of both ends of the band plate is large, one end can be easily attached to the disc 42 by using this width, and the other end can be easily attached to the drive shaft 18.

The operation of the torque detection mechanism 60 having such a configuration will be described next.
As shown in FIG. 14A, torque Tm is applied to the disc 42 through the stick 16 by automatic rotational movement. The torque Tm is directly transmitted to the drive shaft 18 and indirectly transmitted to the drive shaft 18 through the rod-shaped member 38. If the directly transmitted torque is Ta and the indirectly transmitted torque is Ts, then Tm = Ta + Ts. The strain cage 63 is provided only on the rod-shaped member 38.

As shown in FIG. 14 (b), the rod-shaped member 38 bends in a dogleg shape with the constricted portion 62 as a bending point due to the torque Ts. As the torque Ts increases, the bending increases. Due to this regularity, the torque Ts can be calculated structurally.
Here, the length from the bending point to the drive shaft 18 is L1, the length from the bending point to the pin 61 is L2, the length of the constricted portion 62 is Lx, and the width of the constricted portion 62 is b. The thickness of the constricted part 62 (drawing front and back dimensions) is h. Further, let E be the longitudinal elastic modulus (Young's modulus) of the constricted portion 62.

As shown in FIG. 14C, when the torque Ta acts on the drive shaft 18, it is slightly twisted. The angle θa in the figure increases as the torque Ta increases. Due to this regularity, the torque Ta is calculated structurally.
Here, the drive shaft 18 has a length LL and a diameter R. Further, the lateral elastic modulus of the drive shaft 18 is G.

  Although detailed description is omitted, the torque Ta is a function of Ts as shown below.

Since the torque Ts can be obtained by the strain gauge 63, the torque conversion unit 25 obtains the torque Tm based on the strain information obtained by the strain gauge 63. Resistive torque is generated by the servo motor 21 in accordance with the torque Tm.
If an appropriate amount of resistance is applied during the automatic rotational movement, the patient's forearm can sustain stimulation and maintain muscle tone, and can rotate more greatly.

  In FIG. 14B, as the width b of the constricted portion 64 is smaller, the rod-shaped member 38 is bent more greatly, and the constricted portion 64 is greatly distorted. Since the strain gauge 63 is attached to the constricted portion 64 in this way, the torque Tm can be obtained with high accuracy. That is, it is possible to detect torque with much higher accuracy than directly attaching a strain gauge to the drive shaft 18 shown in FIG.

Next, how to obtain the resistance torque will be described.
When the current angle of the servo motor is θ, the virtual inertia is I, the virtual viscosity is C, and the virtual elasticity is K, the impedance equation for the sensed torque Tm is as follows.

At the constant speed, the magnitude of the resistance force is determined by adjusting the value of C. During acceleration / deceleration, the resistance torque can be determined by adjusting K1 and K2. In particular, when the time delay is reduced, after determining C, the value of I may be set to approach K2 = 0.
Thus, the resistance torque Tn is set to an appropriate value.

The first angular velocity, the rapid acceleration, and the second angular velocity shown in FIG. 12 are set, and the above-described resistance torque is set, and then training is performed in the following cycle. In FIG. 15, the other dynamic rotation motion is a minus (−) region.
As shown in FIG. 15, the other dynamic rotation motion including the first angular velocity, the rapid acceleration, and the second angular velocity is performed. That is, the patient's forearm is rotated by the servo motor. At this time, muscle tension increases due to the rapid acceleration and the second angular velocity.

At the point P1, the drive by the servo motor is stopped. Then, the patient tries to turn the forearm in the reverse direction at his own will (corresponding to an automatic rotational movement).
However, light resistance is applied by a servo motor after the point P1. At the point P1, the angular velocity is − (minus) due to the inertia so far, but the angular velocity is suddenly decreased by the end of the other dynamic rotation and turns to + (plus). At the end of the other dynamic rotation end process, the rotation becomes slow, and finally the angular velocity becomes zero.

  The control unit (FIG. 1, reference numeral 24) repeats this cycle several tens of times, with the other dynamic rotational motion during normal rotation and the automatic rotational motion during reverse rotation as one cycle.

In order to confirm the operation and effect of the present invention, the following comparative experiment was performed.
The following two experiments were performed on a right-sided paralytic patient (male, 50s) with a paralysis degree of 4.
○ First experiment (Example):
Experimental apparatus: apparatus shown in FIG.
Experimental conditions: first angular velocity, sudden acceleration, second angular velocity Result: shown in FIG.

In the embodiment, as shown in FIG. 16A, the automatic rotational motion is caused after the other dynamic rotational motion including the first angular velocity, the rapid acceleration, and the second angular velocity. The maximum angular velocity θa · max in the automatic rotational motion was about 6 radians / second.
Further, since the product of the angular velocity and time becomes an angle, an integral value, that is, an area Sa surrounded by the curve and the time axis becomes a rotation angle.

○ Second experiment (comparative example):
Experimental apparatus: apparatus shown in FIG.
Experimental conditions: First angular velocity only (ie, sudden acceleration, no second angular velocity)
Results: Shown in FIG. For comparison, a part of the curve in FIG.

In the comparative example, as shown in FIG. 16B, the automatic rotational motion is caused after the other dynamic rotational motion including only the first angular velocity. The maximum angular velocity θb · max in the automatic rotational motion was about 3 radians / second.
An area Sb surrounded by the curve and the time axis is a rotation angle.

The above two experiments were repeated a predetermined number of times (tens of times).
Then, as shown in FIG. 17, the maximum angular velocity θa · max in the example is 4.5 to 7.0 radians / second, and the maximum angular velocity θb · max in the comparative example is 2.5 to 5 .2 radians / second.
Further, as shown in FIG. 18, the maximum rotation angle Sa in the example is 1.9 to 2.0 radians, and the maximum rotation angle Sb in the comparative example is 1.65 to 1.75 radians. there were.

In the automatic rotational movement, the larger the maximum rotation angle, the larger the muscle contraction.
That is, as shown in FIG. 16 (a), it is confirmed that by performing other dynamic rotation including sudden acceleration, as shown in FIG. 18, the rotation angle becomes large and a large stretched reflection can be obtained. did it.

Next, a modified example of the hemiplegic forearm function recovery training device 10 will be described based on the drawings.
FIG. 19 is a side view showing a modified example of the hemiplegic forearm function recovery training device 10 shown in FIG. Changes to FIG. 1 are as follows, and the others are the same as those in FIG. 1, and thus the reference numerals in FIG.

  As shown in FIG. 19, the first change is that a joint mechanism 70 is provided on the apparatus base 14, and an extension portion 71 extends from the joint mechanism 70. 13 is attached.

  The joint mechanism 70 includes tongue pieces 14a and 14b extending horizontally from the device base 14, tongue pieces 71a and 71b extending from the extension portion 71 so as to overlap the tongue pieces 14a and 14b, and along the vertical line. And a connecting pin screw 72 extending. The tongue piece 71b is inserted between the tongue pieces 14a and 14b, and the tongue piece 71a is placed along the upper surface of the tongue piece 14a. In this state, the tongue pieces 71 a and 71 b are connected to the tongue pieces 14 a and 14 b by the connecting pin screw 72. The extension portion 71 can turn horizontally when the screw is loosened with the connecting pin screw 72 as the center of rotation. Further, when the connecting pin screw 72 is tightened, the pivoted angle can be fixed.

The second change is that an elbow fixing member 75 is attached to the forearm mount 13. The elbow fixing member 75 includes a U-shaped member 76 and a connecting member 77 that connects the U-shaped member 76 to the forearm mount 13.
In FIG. 19, the forearm portion 58 is placed on the forearm mount 13, and the upper arm portion 78 is fitted to the U-shaped member 76.

  When the forearm platform 13 moves in the drawing front and back direction around the connection pin screw 72, it is feared that the forearm portion 58 slides sideways from the forearm platform 13. In this case, if the upper arm portion 78 is fitted to the U-shaped member 76, the worry is eliminated.

The third change is that the hemiplegic forearm function recovery training device 10 includes an electrode 81 for applying electrical stimulation to the forearm 58 and a vibrator 82 for applying mechanical vibration to the forearm 58.
In the conventional function recovery training, a doctor or a medical practitioner rubs the patient's forearm 58 while rotating the patient's forearm 58 with the fingertips.
Instead of skin muscle friction in manual training, in the present invention, electrical stimulation and vibration stimulation are applied to the forearm portion 58 to stimulate the muscle. The vibration stimulus is given only from the start of the second speed of the other dynamic rotational motion to the end of the automatic rotational motion. Electrical stimulation is given continuously during training. The strength of the electrical stimulation is set so as not to exceed the joint motion threshold.

FIG. 20 is an operation explanatory diagram of the hemiplegic forearm function recovery training device 10 and the joint mechanism 70 described in FIG.
As shown in FIG. 20A, the forearm portion 58 is rotated outwardly by an angle δ1 by an articulation mechanism 70 that connects the forearm mount 13 and the extension portion 71 during an automatic pronation motion with the right arm, and an angle δ1 is obtained. The progenitor muscle to be fixed and recovered can be in a state of being well stretched in advance. As shown in FIG. 20B, the forearm portion 58 is internally inverted by the angle δ2 by the joint mechanism 70 during the automatic supination movement, and is fixed at the angle δ2, and the supination muscle to be recovered is sufficiently stretched in advance. be able to.
In order to cause stretch reflexes more efficiently, training should be done with the stretched muscles stretched well. According to the present invention, the muscle to be restored is well stretched in advance, and stretch reflection can be caused more efficiently.

FIG. 21 is a diagram showing a modification of the operation of the control unit shown in FIG.
FIG. 15 is different from FIG. 15 in that an extended reflection waiting time is placed immediately after the point P1, and the other points are the same as those in FIG.
When changing from the other dynamic rotational motion to the automatic rotational motion, it takes time until the motion due to the stretch reflex of the patient occurs. A so-called time lag occurs. Therefore, a short stretch reflection waiting time is provided in the device control before the other dynamic rotational motion ends and the automatic rotational motion starts. Thereby, the operation | movement of the training apparatus 10 can synchronize well with a patient's automatic motion and rhythm, and a training effect can be improved. The stretch reflection waiting time varies depending on the patient, but is set in the range of 0.05 to 0.10 seconds.

  FIG. 22 is a side view showing a modification of the hemiplegic forearm function recovery training device shown in FIG. The hemiplegic forearm function recovery training device 10 is a table-type device. The hemiplegic forearm function recovery training device 10 is placed on a desk 84 having a flat upper surface and fixed by clampers 85, 85. As the desk 84, a commercially available office desk or work desk is sufficient. Since it is a tabletop type, the hemiplegic forearm function recovery training device 10 becomes lighter and can be easily transported and installed. In other respects, the reference numerals in FIG.

FIG. 23 is a side view showing a further modified example of the hemiplegic forearm function recovery training device shown in FIG. 19. The coupling 36 and the servo motor 21 shown in FIG. 19 are arranged below the apparatus base 14 in FIG. For this purpose, a first drive shaft 18A coaxial with the motor shaft 22 is disposed under the apparatus base 14, and a first pulley 86 is attached to the tip of the first drive shaft 18A. A second drive shaft 18B is provided on the apparatus base 14, and a second pulley 87 is attached to the second drive shaft 18B. Then, the belt 88 was passed to the first pulley 86 and the second pulley 87.
As a result, the longitudinal dimension L3 of the hemiplegic forearm function recovery training device 10 was significantly reduced.

  The pulleys 86 and 87 and the belt 88 may be sprockets and chains. Alternatively, the type is not limited as long as it is a transmission mechanism that connects the first drive shaft 18A and the second drive shaft 18B.

FIG. 24 is a diagram showing a further modification of the hemiplegic forearm function recovery training device shown in FIG.
As shown in FIG. 24, in order to prevent the extension portion 71 from bending, a column 28A is provided at the tip of the extension portion 71, and a caster 11A is provided under the column 28A.

The tongue pieces 14 a and 14 b are provided with elongated holes extending along the extending direction of the extension portion 71. By providing the long hole, the distance between the stick 16 and the forearm mount 13 can be changed according to the length of the forearm portion 58. The elongated holes may be provided on the tongue pieces 71a and 71b side.
Also in FIG. 1, a slide mechanism may be provided on the horizontal frame of the movable table 12 to change the distance between the stick 16 and the forearm platform 13.

  Further, the forearm mount 13 is attached to the extension portion 71 so as to be vertically movable. When the screw is loosened with the lever 73, it can be moved upward or downward, and is fixed when the screw is tightened.

  The connecting member 77 includes a lower member 77a, an upper member 77b, and a screw 79. When the screw 79 is loosened, the upper member 77b is inclined in the drawing front and back direction with respect to the lower member 77a. By tightening the screw 79, the upper member 77b can be fixed to the lower member 77a. The position of the U-shaped member 76 can be adjusted to the left and right posture of the upper arm portion 78.

  The torque detection mechanism according to claim 3 may be one in which a strain gauge is directly attached to the drive shaft.

  INDUSTRIAL APPLICABILITY The present invention is suitable for a training apparatus that trains the forearm of a patient who is paralyzed in either the left half or the right half and promotes recovery.

  DESCRIPTION OF SYMBOLS 10 ... Hemiplegic forearm function recovery training apparatus, 14 ... Device base, 15 ... Half cylinder, 16 ... Stick, 17 ... Wrist support part, 18 ... Drive shaft, 19 ... Bearing stand, 21 ... Servo motor, 22 ... Motor Shaft, 23 ... encoder, 24 ... control unit, 25 ... torque conversion unit, 38 ... rod-shaped member, 49 ... bracket, 52 ... screw, 53, 54 ... curved member, 58 ... forearm portion, 60 ... torque detection mechanism, 62 ... Constriction part, 63 ... strain gauge, 70 ... joint mechanism, 71 ... extension part, 75 ... elbow fixing part, 78 ... upper arm part.

Claims (6)

A hemiplegic forearm function recovery training device that trains the paralyzed forearm and promotes recovery in a patient whose body is paralyzed,
An apparatus base, a half cylinder that is supported by the apparatus base so as to be rotatable about a horizontal axis and whose upper surface is open, and a finger of the forearm portion provided in the half cylinder is attached or grasped by a finger Stick, a wrist support portion provided in the half cylinder and supporting the wrist, a drive shaft having one end connected to the half cylinder and extending horizontally, and a servo provided on the apparatus base for driving the drive shaft A motor, an encoder provided in the servo motor for measuring the rotation angle of the motor shaft, and obtaining rotation angle information from the encoder to rotate the half cylinder forward, stop, reverse, and stop repeatedly. In the forward rotation, the speed is controlled to a first angular velocity, a rapid acceleration, and a second angular velocity that is faster than the first angular velocity in order to stimulate a muscle to be trained and a training target muscle that causes a stretch reflex on the muscle. Sustained stimulation of muscle resistant to impart to maintain muscle tone, and a control unit which forms a series of control hemiplegic forearm rehabilitation device.   The piece according to claim 1, wherein the wrist support portion includes a bracket and left and right curved members that are supported by the bracket via screws and sandwich the wrist, and has a structure that allows the wrist to be pulled upward. Paralysis forearm function recovery training device.   The torque detection mechanism is provided between the said half cylinder and the said drive shaft, The torque which the said patient gives to the said stick at the time of the said reverse rotation can be detected with this torque detection mechanism. Hemiplegic forearm function recovery training device.   The torque detection mechanism includes a rod-shaped member extending from the outer peripheral portion of the half cylinder to the drive shaft, a constricted portion provided in the middle of the rod-shaped member, a strain gauge attached to the constricted portion, and a strain gauge. The hemiplegic forearm function recovery training device according to claim 1, comprising a torque conversion unit that converts strain information into torque.   The piece according to claim 1, wherein an extension portion extends from the device base, and a forearm mount for supporting the forearm portion is provided on the extension portion, and an elbow fixing portion for supporting the upper arm portion is attached to the forearm mount. Paralysis forearm function recovery training device.   The hemiplegic forearm function recovery training device according to claim 5, wherein the extension portion is connected to the device base via a joint mechanism so as to be horizontally and rotationally movable.

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