KR101300282B1 - biofeedback method for training swallowing interval of gastrectomy patient - Google Patents

Abstract

The present invention is to prevent the occurrence of post-dumping syndrome in the gastrectomy patient, neck skip signal detection step; Signal processing through amplification, noise reduction, and conversion; A signal transmission step of outputting a peak signal when reaching an effective threshold for neck crossing; A data control step of receiving a peak signal to calculate a period value of a skipping interval, and calculating a difference value from a reference set value to determine a feedback code; And a feedback output step provided with a biofeedback means, and outputting negative feedback when the period value is smaller than the reference set value, thereby inducing a slowing down of the meal. Training biofeedback method and apparatus.

Description

Biofeedback method for training swallowing interval of gastrectomy patient

  In order to prevent dumping syndrome after surgery in a gastrectomy patient, the present invention detects a chopping signal using an electromyography sensor or a piezoelectric sensor, and provides appropriate visual, auditory, and tactile biofeedback by comparing the neck skip interval with an existing setting value. The present invention relates to a method and apparatus for dietary education biofeedback for gastrectomized patients, which induces the user to directly control the meal speed.

  Normal stomachs temporarily store ingested foods and secrete gastric juice to grind and mix solid foods. The food ingested through this process is made into an iso-osmotic gastric chyme fluid food suitable for absorption and moved to the small intestine, where the small intestine digests and absorbs it. In the process of movement, the pyloric sphincter moves to the duodenum and regulates the rate at which food is passed.

  Gastrectomy disrupts this process, speeding up the passage of fluids, and rapidly bringing large amounts of food into the small intestine. In addition, the solid food is discharged to the small intestine without being sufficiently crushed. Symptoms of gastrointestinal symptoms such as gastric resection or pyloric sphincter loss (postprandial nausea, vomiting, bloating, belching, abdominal pain, diarrhea, and tachycardia, palpitations, sweating, dizziness, flushing, hypoglycemia, vitamins) B12 deficiency, cardiovascular symptoms, etc.) is called dumping syndrome.

  Gastrectomy is used for the treatment of gastric cancer and gastric ulcer. When gastrectomy is performed, the lower ablation site inevitably leads to loss of pyloric sphincter function in the first part of the duodenum, which can lead to dumping syndrome.

  In order to prevent such dumping syndrome, dietary education is required to control the chewing and swallowing of the patient at an appropriate speed so that the above functions (controlling the storage of food and the rate of movement to the small intestine) are exerted. Dietary education is about swallowing slowly and limiting the consumption of sugary foods and formulas. Slow swallowing of food during dietary education is very important, and many patients experience a fast food intake from previous eating habits and experience difficulty adapting after surgery.

  Japanese Laid-Open Patent Publication No. 2007-48180 discloses a method for notifying when there is a problem such as the speed of meal intake by measuring the heart rate and monitoring and analyzing the data heart rate change. However, controlling the speed of meals due to changes in heart rate may vary depending on the condition or situation, and there is a limitation in that it is impossible to accurately measure the time interval of food passing through the esophagus to the stomach and duodenum. In addition, there is a disadvantage that can not reset the speed of the throat according to the change in the digestive status of the patient.

  Meanwhile, a technique for measuring throat swallowing is mainly performed for the purpose of food swallowing disorder, oral function evaluation, stuttering treatment, cough treatment, etc. using a known microphone, EMG sensor, or piezoelectric sensor, but for dietary control of gastric resection patient Examples used for this are hard to find.

  In the present invention, a method and apparatus for providing biofeedback in order to induce proper meal speed control after surgery of gastrectomy patients. In particular, it is an object of the present invention to induce to control the meal speed through the biofeedback means, if the throat speed is detected, and the meal speed is faster compared to the appropriate reference set value. In addition, the present invention provides a method for resetting an appropriate necking interval time or necking effective value according to a patient's digestive status, and provides a technology that can utilize a known mobile terminal such as a conventional smartphone in terms of device.

The present invention for solving the above problems, the signal detection step of detecting a skipping signal; A signal processing step of amplifying the chopping signal, removing noise, and converting the digital signal into a digital signal by conversion means; A signal transmitting step of transmitting a peak signal when the digital signal reaches a skipping effective value; Receiving the peak signal to calculate the period value ΔT of the skipping interval, compares the difference between the period value and the reference set value (M ₀ ) previously input as the normal skipping speed, and feedback according to the difference value A data control step of determining a code; And a feedback output step including a biofeedback means and outputted according to the feedback code determined by the data controller.

In the data control step, when the periodic value ΔT is smaller than the reference set value M ₀ , at least one biofeedback selected from visual, auditory, or tactile sense is output, thereby slowing down the meal speed. To provide a dietary education biofeedback method characterized in that it is induced to.

  Preferably, the signal detection step may be detected by any one selected from known electrocardiograph sensors or piezoelectric sensors.

  On the other hand, in the data control step, if the period value ΔT is greater than the reference set value Mo, outputting any positive feedback selected from visual, auditory, or visual and auditory, maintaining the meal speed. It may be characterized by inducing to.

  In addition, the data control step may further include a reference value reset step for correcting the reference set value (Mo) in accordance with the health state of the user, thereby actively adjusting the meal speed in accordance with the symptom change of the patient. I can do it.

  In addition, in consideration of the difference in the strength of the skip signal for each individual, prior to the signal transmission step, it may be characterized in that it further comprises an effective value optimization step for optimizing the skipping effective value for the user.

  In addition, the data control step further includes calculating a necking interval change value ΔV from the period value, when the necking interval change value ΔV is negative, increasing the blinking speed of the visual feedback means or audible feedback. Any one selected from an increase in the frequency of beeps of the means may be characterized by providing a varying negative feedback output. The visual feedback means may be an LED light emitting device or a display device.

In addition to the above method, a signal detecting unit for detecting a skipping signal; A signal filter for amplifying the chopping signal and removing noise; A signal conversion unit converting the analog signal transmitted from the signal filter unit into a digital signal; A signal transmitter which transmits a peak signal when reaching the effective value of the number of turns from the digital signal; A data control unit including a signal receiving unit which receives the peak signal, an operation unit which calculates a difference value from a preset reference set value M ₀ as a normal throating speed, and determines a feedback code; And a feedback output unit for providing biofeedback according to the feedback code, wherein the signal detection unit is used to attach and detach a neck band, a band connector for fastening both ends of the neck band, an EMG sensor, or a piezoelectric sensor. It provides a detection sensor for detecting a chopping signal by any one selected, wherein the biofeedback is at least one feedback selected from visual, auditory or tactile.

  In another specific embodiment of the structure, the data control unit and the feedback output unit of the biofeedback device are integrally provided, and are separated from the signal detection unit, the signal filter unit, the signal conversion unit, and the signal transmission unit separately from each other. A housing accommodating the feedback output unit; A reference value reset unit provided on an outer surface of the housing to correct the reference set value; And it is connected to the housing may be characterized in that it further comprises a strap to facilitate detachment to the wrist.

  In addition, as another embodiment, the data control unit and the feedback output unit utilizes the hardware of the mobile device, such as a smart phone, and the application of the mobile device, so that the weight loss, the utilization of the existing device and the software update To improve the convenience of.

  According to the present invention, patients with gastrectomy surgery can wear a simple device that can detect a necking signal on the neck and easily check the meal speed, thereby minimizing side effects such as dumping syndrome. In particular, auditory feedback such as a warning sound, visual feedback such as flickering of LED elements, and tactile feedback of a vibrating element are used to induce a proper meal speed without being disturbed during meals, and to set a threshold for skipping intervals. By resetting the value according to the change of the health condition of the patient, there is an advantage that can gradually change the meal speed. In addition, by accumulating the time interval data in the data control unit can be used as a data to determine the relationship between the swallowing rate and the occurrence of dumping syndrome in the future.

  On the other hand, it can be configured as a wrist-type device spaced apart from the signal detection unit, and can be configured by connecting to a separate mobile terminal that is easy to install application applications and equipped with a feedback means, thereby making full use of existing hardware and software. It can be improved.

1 is a flow chart showing a dietary education biofeedback method according to an embodiment of the present invention,
2 is a reference diagram schematically showing a turn-over period value according to the present invention;
3 is a block diagram showing the configuration of a dietary education biofeedback device according to the present invention;
4 is a view showing the configuration of a dietary education biofeedback device according to another embodiment of the present invention;
5 is a view showing the configuration of a dietary education biofeedback device according to another embodiment of the present invention,
6 is a view showing a state of use of the biofeedback means according to another embodiment of the present invention,
7 is a use state diagram showing a change in the reference set value of the skipping interval in the biofeedback means according to another embodiment of the present invention.

  Hereinafter, the detailed structure and operation of the present invention will be described with reference to the accompanying drawings, but the scope of the present invention is not limited thereto.

The terms or words used in this specification and claims are not to be construed as being limited to the common or dictionary meanings, and the inventors may appropriately define the concept of terms in order to explain their invention in the best way. It should be interpreted as meaning and concept corresponding to the technical idea of the present invention based on the principle that the present invention. Therefore, the embodiments described in the specification and the drawings shown in the drawings are only one of the most preferred embodiments of the present invention, and do not represent all of the technical idea of the present invention, various modifications that can be replaced at the time of the present application It should be understood that there may be equivalents and variations.

1 is a flow chart showing a dietary education biofeedback method according to an embodiment of the present invention, Figure 2 is a reference diagram schematically showing the concept of the skipping cycle value according to the present invention, Figure 3 is a dietary education biofeedback device according to the present invention 4 is a block diagram showing the configuration of a dietary education biofeedback device according to another embodiment of the present invention, Figure 5 is a view showing the configuration of a dietary education biofeedback device according to another embodiment of the present invention Figure 6 is a view showing the state of use of the visual feedback means according to another embodiment of the present invention, Figure 7 shows a change in the reference set value of the throat interval in the biofeedback means according to another embodiment of the present invention It is a state of use. Each part is demonstrated below.

  1, the dietary education biofeedback method according to an embodiment of the present invention, the signal detection step of detecting a skipping signal (S100); A signal processing step of amplifying the skipping signal, removing noise, and converting the digital signal into a digital signal by a conversion means (S200); A signal transmission step (S300) of transmitting a peak signal when the digital signal reaches a thrilling effective value; Receiving a peak signal and calculating a period value ΔT of the turn-over interval, and calculating a difference value between the period value and a reference set value Mo previously input as a normal turn-over speed, and the difference value. Determining a feedback code according to the data control step (S500); And a visual output, audible, tactile biofeedback means, and outputting according to the feedback code determined by the data control unit (S600). The data control step (S500) includes setting the reference. When the period value ΔT is smaller than the value Mo, the negative feedback selected from the visual, auditory, or visual and auditory outputs is output, thereby inducing a slower eating speed. .

Preferably, such a dietary education biofeedback method may be used for the prevention of dumping syndrome due to gastrectomy or pyloric sphincter loss.

The signal detection step (S100) is a step of detecting an analog signal for swallowing food in the neck, and preferably can detect a necking signal using an EMG sensor, a piezoelectric sensor, a microphone, and the like, which are known in the art. Electromyography (EMG) is a technique that deals with the generation, recording, and analysis of muscle electrical signals, formed by physiological changes in the muscle fibrous membrane. In the case of the EMG sensor, in addition to the conventional wired method, wireless methods such as Bluetooth and Wi-Fi, and independent sensors such as Noraxon's DTS system have been developed. Piezoelectric sensors, on the other hand, are made of ceramics (aluminum and silicon oxide as main components), which represent piezoelectric phenomena in which electrical polarization occurs when a stress is applied in a certain direction and polarization charges appear on the corresponding cross-section. It can be said that the sensor.

The sensor for detecting a necking signal may be provided in any one form selected from a neck band, a bow tie, or an attachment type detachably attached to the neck. Referring to FIG. 4, a band capable of coupling a detection sensor 101 such as an EMG sensor or a piezoelectric sensor to the neck band 120 and fastening to both ends of the neck band 120 in accordance with the size of the neck. It can be fixed by the connector (122) and the band connector (b 124). At this time, the band connector may be preferably provided by the Velcro, but is not limited thereto, and may be used as long as it can be fixed to the neck without affecting the meal when it is worn and without problems in the operation of the detection sensor. Do.

The signal processing step (S200) may include amplifying a weak analog signal detected in the signal detection step and removing noise (S210) and converting the analog signal into a digital signal using an A / D converter (S220). ). The present invention induces to slow down the meal speed by itself when the meal interval is smaller than the reference set value while eating, the noise generated during chewing food in addition to the skip signal, so the food through the throat esophagus This is because a process for selectively detecting only a signal passing through is required. The noise removing step S210 may be configured as a band stop filter, a Butterworth filter, or the like.

The signal transmitting step (S300) is a step of determining whether the digital signal processed from the signal processing step (S200) has reached the skipping effective value (S310) and transmits a peak signal when the digital signal has reached the effective value to the receiver. It comprises a step (S320). Threshold effective value may be referred to as a preset input value when necking activity is performed on the converted digital signal. When the effective value is reached, the peak signal is transmitted (S320). The peak signal may be referred to as a kind of timer that is transmitted to calculate a skipping interval. If the neck skip effective value is not reached, it is regarded as having no neck skipping activity, and the process returns to the signal detection step S100.

The data control step (S500) is a step of receiving the peak signal (S510), calculating a period value ΔT of the skipping interval from the peak signal (S520), and the reference value previously input as the period value and the normal skipping speed. Comparing the difference value with the set value (M ₀ ) (S530) and determining the feedback code according to the difference value (S540).

Referring to FIG. 2, in the step of receiving the peak signal (S510), an n th turn peak signal reception time T _n is input, and a period value ΔT _n of the n th turn interval is calculated therefrom (S520). . This operation can be done by a microprocessor or the like. For example, when the peak signals T ₄ and T ₃ are received in FIG. 2, the period value ΔT ₃ of the third skipping interval is 40 milliseconds (ms). Subsequently, when the reference set value M ₀ is set to 50, a difference value between the period value ΔT ₃ and the reference set value M ₀ of the skipping interval becomes a negative value (-10), thereby providing feedback. The code is sent to the feedback output step S600. The feedback code is an instruction to give to the feedback output step according to the difference value.

The feedback output step S600 is a step of outputting a biofeedback that induces the user to slow down the meal speed by visual, auditory or tactile feedback means according to the type of feedback code determined in the data control step S500. 4 or 5, preferably, an LED light emitting element or a display device may be used as the visual feedback means, and a speaker or the like may be used as the acoustic feedback means. As the tactile feedback means, a known piezoelectric vibrating element or the like can be used. These feedbacks may be output in a single form, but in some cases, two or more feedback means may be output at the same time. For example, when the skipping interval becomes small, the LED light emitting element 612 turns red and blinks, or a warning sound is generated from the speaker 622, or the built-in piezoelectric vibration sensor vibrates to adjust the meal speed. Can be induced to.

As another embodiment of the present invention, the data control step S500 and the feedback output step S600 may use an external mobile terminal 800 such as a smart phone. 5 to 7, when an application is operated to receive and process the digital signal transmitted in the signal transmission step S320 in a smart phone or the like, a speaker, a display device, or a built-in external mobile terminal; Feedback output means such as a vibrating element device can be shared.

On the other hand, the data control step (S500) is to output any one of the positive biofeedback selected from the visual, auditory or visual and auditory when the necking period value ΔT is greater than the reference set value (M ₀ ). It can be characterized by inducing to maintain the meal rate. Referring to FIG. 7 (b), visual feedback means 616, 618 and / or auditory feedback means 622 may be provided to guide the user to swallow more slowly when the turn-over period value becomes faster. In addition, when the turn-over period value is larger than the reference setting value, as shown in FIG. 7A, a positive biofeedback means composed of color or text indicating a positive state may be provided.

In addition, as another embodiment of the present invention, the data control step (S500) further comprises a reference value resetting step (S400) to correct the reference set value (Mo) according to the user's health state. You can do The purpose of this study is to actively control the meal speed by changing the experimental data according to the relationship between the throat swallowing interval and the dumping syndrome or by inputting an appropriate reference set value according to the user's digestive ability and health condition. Referring to FIG. 4, the reference value resetting step S400 may be adjusted up and down by manipulation of buttons 410 and 420 or the display 614 of the mobile terminal 800 as shown in FIG. 7 or 8. The reference value may be corrected by manipulating the interactive visual elements 422, 424, and 426 implemented in a user interface.

On the other hand, since the effective skip neck value may vary for each user, it may further include an effective value optimization step (S330). The effective value optimization step (S330) detects a necking signal several times and calculates an average value thereof so that the effective value of the effective value reaching determination step (S310) can be updated, thereby malfunctioning detection of the necking signal according to a user. Noise reduction due to blocking and eating habits can be achieved.

Further, the data control step (S500) may further include calculating the throat change interval value (ΔV). Throat change value (ΔV) is a value corresponding to ΔT _{n +1} -ΔT _n , when the throat change value (ΔV) is negative, increase the flashing speed of the visual feedback means 610, providing a notification message and / or The acoustic feedback means 620 may provide a negative feedback output such as an increase in the frequency of occurrence of a warning sound and an increase in the volume of the warning sound.

Figure 3 is a block diagram showing the configuration of a dietary education biofeedback device for gastrectomy patients according to the present invention. The present invention with reference to Figure 3, the signal detection unit 100 for detecting a skipping signal; A signal filter unit 210 for amplifying the chopping signal and removing noise; A signal converter 220 for converting an analog signal transmitted from the signal filter 210 into a digital signal; A signal transmitter 230 for transmitting a peak signal when the digital signal reaches an effective round neck value; A signal receiving unit 510 for receiving the peak signal, a calculating unit 520 and a memory 530 for calculating a difference value from the reference set value M _{0 previously} input as a normal throating speed and determining a feedback code; Data control section 500; And a feedback output unit 600 for providing biofeedback according to the feedback code, wherein the signal detection unit 100 is attached to or detached from a neck by using a neck band 120 and both ends of the neck band 120. A band connector 122, 124 for fastening the pressure sensor, a detection sensor 101 for detecting a chopping signal by any one selected from an EMG sensor or a piezoelectric sensor, and the feedback output unit 600 includes a visual 610 and an auditory sound. It provides a dietary education biofeedback device for gastric resection patients, characterized in that the feedback is one or more selected from 620 or tactile 630.

Since the configuration and operation of the dietary education biofeedback device for the gastrectomy patient have been largely described in the dietary education biofeedback method, the duplicated content is omitted and the following will be described.

As another embodiment of the present invention, referring to FIG. 4, the remaining components 200, 500, and 600 may be separately spaced apart from the signal detection unit 100. This is to reduce the weight of the device mounted on the neck, the housing 710 for storage, the reference set value reset unit 420 which is provided on the outer surface of the housing 710 to correct the reference set value It may be spaced apart into a wristwatch type having a strap 720 connected to a button or an effective value optimization button 410 for optimizing the effective value and the housing 710 so as to easily attach or detach the wrist. In this case, the signal detection unit 100 may be connected by a cord 140.

  As another embodiment of the present invention, referring to FIG. 5, the data control unit 500 and the biofeedback output unit 600 are integrally provided, and hardware of the separate mobile terminal 800 and the mobile terminal ( It may be a dietary education biofeedback device for patients with gastrectomy, characterized by utilizing the application of (800).

The mobile terminal is not particularly limited as long as it is easy to add an application, such as a known smartphone, and is provided with a feedback output means such as a speaker, a display device, or a vibrating element. The signal detector 100 and the mobile terminal 800 are connected by a code 240, and the signal filter 210, the signal converter 220, and the signal transmitter 230 are connected to the signal detector 100. And it is provided integrally between the mobile terminal (800). Furthermore, if a communication module (Bluetooth, etc.) capable of short-range wireless communication is provided between the signal transmitter 230 and the mobile terminal 800, the signal transmitter 230 and the mobile terminal 800 may be wirelessly connected. .

Referring to FIG. 6, the mobile terminal 800 shows one screen on which an application application according to an embodiment of the present invention is driven. In the display unit 614, a current skipping interval period value is output in real time, and a recommended reference setting value and a skipping trend trend graph 618 according to time are visually output. In addition, when the skipping interval is faster, as shown in Fig. 6 (b) to generate a warning sound from the speaker 622, or may send a warning alarm 616, although not shown in the figure, to send a vibration alarm to the vibration element It may be. In addition, a button 422 for modifying the reference set value M ₀ may be added as a touch-based interface element.

It will be understood by those skilled in the art that various changes in form and details may be made therein without departing from the spirit and scope of the invention as defined by the appended claims.

S100: signal detection step S200: signal processing step
S300: Signal transmission step S400: Reference value reset step
S500: data control step S600: feedback output step
100: signal detector
101: detection sensor 120: neck band
200: Signal processor
210: signal filter 220: signal converter 230: signal transmitter
500: data control unit
510: signal receiver 520: calculator 530: memory
600: biofeedback output unit
610: visual feedback means 612: LED element 614: display device
620: acoustic feedback means 622: speaker
630: tactile feedback means
700: Housing
710: housing body 720: strap
800: mobile terminal

Claims (10)

A signal detection step of detecting a skipping signal by the signal detection unit; A signal processing step of amplifying the chopping signal, removing noise, and converting the digital signal into a digital signal by conversion means; A signal transmitting step of transmitting a peak signal when the digital signal reaches a skipping effective value; Receiving the peak signal to calculate the period value ΔT of the skipping interval, compares the difference between the period value and the reference set value (M ₀ ) previously input as the normal skipping speed, and feedback according to the difference value A data control step of determining a code; And a biofeedback means, the feedback output step being output according to the feedback code determined by the data control unit.
In the data control step, when the periodic value ΔT is smaller than the reference set value M ₀ , one or more biofeedbacks selected from visual, auditory, or tactile senses may be output, whereby the meal speed may be increased. Prevents dumping syndrome of gastrectomy patients by inducing delay
The method further includes a reference value resetting step of allowing the user to actively correct the reference set value M ₀ according to the user's health condition.
The feedback output step may be performed through hardware and an application of a mobile terminal spaced apart from the signal detection unit, and the reference set value M ₀ and the periodic values ΔT of the throttling interval according to a predetermined time may be used for the mobile. For patients with gastrectomy, characterized in that it further comprises a graph of the neck interval interval expressed in real time in the terminal Dietary Education Biofeedback Method. delete The method of claim 1,
In the signal detection step, the signal detection unit for gastric resection patient, characterized in that detected by any one selected from the EMG sensor or piezoelectric sensor Dietary Education Biofeedback Method. The method of claim 1,
The data control step may be configured to output one or more positive feedbacks selected from visual, auditory, or tactile when the period value ΔT is greater than the reference set value M ₀ , thereby inducing to maintain a meal speed. For patients with gastrectomy Dietary Education Biofeedback Method. delete The method of claim 1,
Prior to the signal transmission step, the effective value optimization step for optimizing the effective value of the skipping neck for the patient, characterized in that further comprises Dietary Education Biofeedback Method. The method of claim 1,
The data control step may further include calculating a necking interval change value ΔV from the period value, and when the necking interval change value ΔV is negative, increasing the blinking speed of the visual feedback means or of the audio feedback means. For gastric resection patients characterized in that any one selected from the increase in the frequency of beeps provides a varying negative biofeedback output. Dietary Education Biofeedback Method. delete delete delete

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