KR20030039567A - Intramuscular stimulator having a puncture aid - Google Patents

Abstract

PURPOSE: An intramuscular stimulation needling apparatus is provided to automate the treatment of muscle pain by the intramuscular stimulation and facilitate inserting a needle firstly into a wound muscle. CONSTITUTION: The motor-operated intramuscular stimulation needling apparatus including an electricity operated motor(110), an energy source and a mechanical connecting unit is characterized by comprising a punching unit(102) bonded to the needling apparatus so as to punch the skin located over a wound muscle; and a unit to operate the punching unit(102) for the needle(111) to punch skin automatically.

Description

Intramuscular stimulator having a puncture aid

The present invention relates to a device for automating the treatment of myalgia by intramuscular stimulation, and in particular to a modification of the above device to facilitate the initial insertion of saliva into affected muscles.

Intramuscular stimulation (IMS) is known as a method used to treat myalgia by inserting saliva into the affected muscles. Intramuscular stimulation was first developed and described for the first time by Gunn ("Dry Needling of Muscle Motor Points for Chronic Low-Back Pain: A Randomized Clincal Trial With Long Term Follow-up" Spine, 1980 Vol. 5, No. 3, pp. 279-291 (1980)). This method of intramuscular stimulation has been used by others [see, for example, Chu's "Dry Needling in Myofascial Pain Related to Lumbosacral Radiculopathy", European Journal of Physical Medicine and Rehabilitation, Vol. 5, No. 4, pp 106-121 (1995). For detailed IMS therapy, see Gunn's book "Treating Myofascial Pain: Intramuscular Stimulation for Myofascial Pain Syndrome of Neuropathic Origin" (Issue 1-55910-003-6, published by the Center for Health Sciences, University of Washington, Seattle, Washington, USA). It is described in

In summary, this method involves stimulating the muscles by inserting fine needles similar to the acupuncture needles into the muscle and repeatedly moving the needle back and forth in the muscle. Here, "back and forth" movement refers to pushing the saliva straight into the muscle first, then partially retracting it and then pushing it back along the same path of penetration. This operation is repeated several times each in several muscle areas. For simplicity, in the present specification, such needle manipulation is referred to as "poking".

The affected muscles are usually tightly constricted. Such muscle stiffness causes chronic pain due to severe pressure on nerve fibers in the muscles or tightness of muscle fibers in the muscles. Repetitive intramuscular stimulation treatments relieve contracted muscles, resulting in less pain. The frequency of treatment depends on the severity of muscle contraction. The more severely contracted muscles will require more frequent treatment over a longer period of time, while the more injured muscles will have a much lower frequency of treatment. The intramuscular stimulation therapy is usually most effective at several points.

Although the method developed by Gunn and used by others is very effective in treating patients with chronic myalgia, the therapy has its own limitations due to the adverse effects on the operator. In order to treat the patient, it is necessary to place the hand on the damaged muscle at about 1 or 2 speeds per second. Usually, the treatment period lasts about 45 minutes, so the total number of manual punches performed in one treatment period is 2,700 to 5,400 times. For a person treating 8 patients a day, assuming that each treatment time is 45 minutes, this means that the total number of manual punches per day amounts to 21,600 to 43,200 times. This tremendous number of manual punchings often causes severe strain and pain in the neck and shoulder muscles of the operator and eventually requires the IMS treatment.

Another factor to consider is that manual punching itself is very painful for the patient. This is presumably due to the constant acceleration and deceleration of the needle during the treatment process. For this reason, patients usually had to be treated with anesthetics beforehand to avoid excessive pain during treatment.

In order to overcome this problem associated with conventional IMS therapy, prior patent no. 10-197333-0000 discloses an automated motor-driven needling instrument for performing intramuscular stimulation therapy to patients suffering from chronic myalgia. Explaining. The device replaces the passive stimulation sphere with muscle stimulation sphere mechanically connected to an electrically driven motor that is electrically connected to a programmable control device. In a preferred mode, it is mechanically connected to a linear motion motor, causing the motor to continuously drive the needle back and forth in a controllable manner within the muscle. While the motor is controlled and provides uniform back and forth linear motion to a constant penetration depth into the intramuscular stimulation needle, the operator can continue to hold the instrument at the desired treatment area. This has been found to relieve the physical burden of the operator by significantly eliminating the tedious muscle strain labor caused by conventional manual needle-stroke treatment.

When the duration of intramuscular stimulation treatment is extended, mechanical pivotal arms support the stimulator hour hand and foot switches are installed to remotely turn the motor on and off. In this way, intramuscular stimulation therapy can be performed with minimal physical effort, thereby avoiding muscle damage to the operator.

Another major advantage of using such a device is that the pain experienced by the patient during the treatment period is significantly reduced. In the conventional manual needle treatment, the needle is frequently accelerated and decelerated because of the inhomogeneous needle movement that is inherent to manual labor. This temporary shearing operation was very painful for the patient. Automated styling devices have been found to eliminate this pain significantly, even at constant speeds (for example, clinical trials have shown that it reduces 75% of the pain experienced by patients during treatment). In fact, prior patent 10-197333-0000 has been shown to work very well in carrying out the desired treatment. However, the device can be further refined to make the treatment process more comfortable for the patient and more convenient for the operator. For example, saliva must penetrate the skin before starting IMS therapy. However, the skin is usually stiff, especially on the affected muscles, which are difficult to penetrate even with very fine saliva. In order to minimize pain during treatment, the step of skin puncture should be done as quickly as possible, but the patient can still feel uncomfortable.

Therefore, the main object of the present invention is to provide an automated intramuscular stimulating hour hand device that not only can operate the stimulus needles back and forth mechanically uniformly, but also facilitate the initial insertion of the needles to puncture the skin of the treatment site. will be.

It is also an object of the present invention to provide an automated intramuscular tacking device that can minimize the discomfort of the patient in this process while facilitating the initial insertion of the needle to puncture the skin of the treatment site.

This invention for achieving the above and other objects provides an automated intramuscular stimulation instrument with a device that assists the drilling step with respect to the remaining automated functions of the instrument. This function is preferably realized by combining the sole receiving structure of the device with the solenoid so that the initial drilling step can be performed by the solenoid in response to an appropriate control signal.

1 is a side view illustrating an embodiment of an automated intramuscular stimulation needle that does not include a puncture aid of the present invention.

2 is a block diagram illustrating a speed / depth control device of the automated intramuscular stimulation needle of the present invention.

3 is a graph showing the timing logic of the speed depth control device of FIG.

Figure 4 is a side view showing the entire arrangement for holding the intramuscular stimulation needle in a desired position.

FIG. 5 is a side view similar to FIG. 1 showing an embodiment of an automated intramuscular stimulation pointer, in which a puncture aid is constructed in accordance with this invention.

6 is a schematic diagram showing a control device for manipulating the automated intramuscular stimulation needle of FIG. 5.

Figure 1 shows the structure of a motor-driven intramuscular stimulation (IMS) needle connected to the controller to adjust the speed and depth of the styling process.

To treat the patient, the operator places the syringe body over the patient's skin just above the affected muscle. The syringe body has an opening that allows the needle to pass freely in and out. The needle starts to move when the control is activated. The needle moves back and forth according to the frequency and rudder depth set by the controller. As a result, saliva penetrates the skin and begins to irritate the muscles, which occur repeatedly until the saliva is released.

The IMS metering device comprises six major components including a linear motor 10, syringe holder 16, syringe body 34, plunger 22, immersion cap 26, and needle 32. It is made of. The linear motor 10 has an internal gear (not shown) that converts the rotational motion of the motor into a linear motion that can be transmitted to the shaft 18. Linear motors that provide this behavior are manufactured by Philips Technologies of Cheshire, Connecticut. The direction of rotation of the motor determines the direction of linear movement of the needle 32. For example, when the motor rotates clockwise, the shaft 18 moves down and when the motor rotates counterclockwise, the shaft 18 moves up. The controller 38 sends both the movement signal and the direction signal to the motor 10 via the wire 36.

The syringe holder 16 houses the syringe body 34. To this end, the syringe holder 16 is a machined part that is secured to the substrate 12 of the motor 10 by two retaining screws 14 and forms a housing for the syringe substrate 20 associated with the syringe body 34. It is advantageous to be implemented. The syringe holder 16 is preferably made of a material "Plexiglas" and the machine is adapted to allow the syringe body 34 to be easily attached and detached from the syringe holder 16 by, for example, a twist lock mechanism. Can be processed. The syringe body 34 is made of a transparent polymer material so that the internal movement of the needle 32 can be seen from the outside of the syringe body 34. For example, a commercial 10cc disposable syringe may be used as the syringe body 34. The plunger 22 is implemented with machined parts made of suitable plastic materials, such as the trademarks "Lexan", "Nylon", "Teflon", and serves to connect the motor 10 and the needle 32. As shown in FIG. 1, one side of the plunger 22 is attached to the motor shaft 18 by a set screw. The opposite side of the plunger 22 has a retaining pin 28 for retaining the needle fixation cap 26 by, for example, a twist lock mechanism.

The needle fixing cap 26 is preferably implemented with machined parts and serves to secure the needle 32 in place so that the needle 32 is aligned along the axis of the shaft 18 during the treatment of the patient. do. The upper end of the cap 26 has a twistlock slot for quick needle replacement. At the lower end of the cap 26 is a machined hole for receiving the head 30 of the needle 32.

The needle is preferably of very small diameter, such as acupuncture needles, for effective insertion into skin and muscle tissue. The needle has a plastic head 30 to make it more convenient to fix.

The syringe body 34, the needle cap 26 and the needle 32 of the styling device must be made replaceable so that these parts can be disinfected each time before being used to treat a new patient. To replace the needle 32, first twist the syringe body 34 to separate it from the syringe holder housing 16. The needle clamping cap 26 is then twisted to separate it from the plunger body 22 and finally to remove the needle 32 from the needle clamping cap 26. These steps are reversed when installing a new needle.

The speed and depth control device 38 is a battery driven or electrically driven electronic device having the function of controlling the linear movement of the motor in terms of the speed and depth of the stroke. As shown in FIG. 2, the control device includes five main circuit elements including a variable oscillator 40, a motor driver 42, a programmable counter 44, a flip-flop 46, and a power-on detector 48. Consists of The variable oscillator 40 generates a square wave shown at 50 in FIG. The frequency of the clock signal which develops this square wave signal is preferably adjustable. This variable oscillator 40 can be implemented using a crystal based oscillator circuit or a timer integrated circuit chip (eg, a conventional 555 timer chip).

The motor driver 42 serves to supply the electric power necessary for the motor 10 to linearly move the shaft 18. To do this, the motor driver 42 needs a clock input and a direction input. Preferably this clock input is a pulse train as shown in FIG. Each pulse moves the shaft 18 by a distance. Therefore, if one pulse moves 0.02 inches of motor shaft 18, 20 pulses will be required to move 0.4 inches of motor shaft. The frequency of the clock pulse determines the speed of movement. For example, if the clock rate generated by the variable oscillator 40 is 100 Hz, when one pulse moves the shaft 0.02 inches, the motor shaft 18 moves 2 inches per second. Motor driver 42 also requires a direction input. The direction input is a logic signal that determines the moving direction of the motor shaft 18. For example, the motor shaft 18 moves forward when the logic signal is high and the motor shaft 18 moves in the opposite direction when the logic signal is low.

The programmable counter 44 functions as a generation source of the direction signal input to the motor driver 42. The counter 44 has a preset count value, which is decremented by one as each clock pulse is counted by the counter 44. When the final count is reached, the programmable counter 44 generates a logic pulse corresponding to the clock pulse shown at 50 in FIG. This logic pulse signal is input to the flip-flop circuit 46. After reaching the final count, the programmable counter 44 re-enters the preset count value and repeats the same operation to generate the next pulse signal. The preset count value is programmed and selectable by the operator.

The flip-flop circuit 46 is a logic circuit that changes the output logic level upon receiving an input pulse signal, as schematically shown in FIG. If there is no pulse signal input from the programmable counter 44, the output of the flip-flop 46 is low level, as shown at 54 in FIG. When flip-flop 46 receives the logic signal, its output changes the logic state as shown at 56 in FIG. Since programmable counter 44 generates a clock pulse at the last count, the output of flip-flop 46 changes the logic state at the end of each final count. This means that the direction input to the motor driver 42 is changed at the last count of the programmable counter 44. In turn this changes the direction of movement of the motor shaft 18.

When the power is turned on, the power on detector 48 generates a logic pulse. This pulse is input to the reset input of the programmable counter 44 and flip-flop 46. Upon receiving this pulse, the programmable counter 44 and flip-flop 46 reset their outputs so that the controller 38 starts operating in the same logic state each time the power is turned on.

To perform intramuscular stimulation therapy, the hour hand device may be gripped by squeezing the syringe body 34. However, it is burdensome for the operator to hold the bedding device in a fixed position for a long time. This physical effort can be greatly alleviated by holding the bedding device using a mechanical swing arm while the operator places the bedding device at the desired treatment position. One such arrangement is shown in FIG. 4. In this structure the syringe body 34 is supported by a mechanical pivot arm consisting of parts 60 to 82. For this purpose, the hour hand device is attached to the tool holder assembly 80 by the motor holder housing 86. The holder housing 86 is preferably a mechanical part made of aluminum. The head of the motor 10 is disposed in the holder housing 86 and fixed in place with a set screw 88. The holder housing 86 has a short handle 84 attached to the toolholder assembly 80 by a set screw 82.

The pivot arm allows positioning of the hour hand device in all directions within the arm's reach. To this end, the arm has three joints including a base joint 64, a middle joint 70, and an end joint 78. Between the base joint 64 and the middle joint 70 two beams, including an upper arm beam 66 and a lower arm beam 68, extend. In addition, two beams of the upper front arm beam 74 and the lower front arm beam 76 extend between the middle joint 70 and the end joint 78. The joints 64, 70, 78 allow bending and stretching of the arm beams 66, 68 and the arm beams 74, 76. The rigidity of the assembly, represented by bending and stretching, is adjusted by tightening or loosening the adjusting screw 72. The pivot arm is secured to a rigid surface 58 by a mounting base 60. The base 60 has a groove for receiving the base pin 62. This arrangement allows for a 360 degree rotation of the swing arm. The swing arm is preferably made of a material such as steel.

The arm beam 76 and the arm beam 66 are preferably hollow to carry wires from the motor 10. As shown in FIG. 4, an electrical connection is made from the base 60 of the turning rock to the control device 38. A foot switch 90 for remotely starting and stopping the motor is connected to the control device 38.

As shown in Fig. 4, when the IMS hour hand is attached to the swivel, the needle 32 moves freely in all directions. To treat a patient, the mechanical pivotal cancer is extended to first move the saliva 32 to a location on the patient's skin above the muscle to be treated. In this way, the position is adjusted, and the foot switch 90 is pressed to operate the controller 38. In this way, minimizing the use of the operator's hands and muscles allows the operator to perform intramuscular stimulation treatment for long periods of time without fear of injury.

In practice, particular care is needed to first insert the needle 32 into the patient's skin after positioning the swirling rock as described above. Such caution also applies to treatments using the hour hand without the aid of swivel rock. This is because the saliva 32 must first puncture the skin to begin the IMS treatment. However, especially when the affected muscle is located under the perforated skin, the skin is usually very hard, making it difficult to perforate even a very fine saliva. In order to minimize the likelihood of pain with respect to this aspect of the treatment procedure, the initial drilling step should be made as soon as possible.

In order to further minimize the likelihood of pain during initial insertion of the needle, other embodiment bedding devices of FIG. 5 may be used. The needle device of FIG. 5 includes all the basic components of the needle device of FIG. 1 and additionally includes an initial skin puncture aid to reduce the likelihood of pain during IMS treatment.

The puncture aid is mounted within the cylindrical column 101 and includes a solenoid 102 located in series with the intramuscular stimulator 103 shown in FIG. To this end, the solenoid 102 is fixed to the disc 104 formed on the upper portion of the column 101 using a stop screw 113 or the like. This intramuscular stimulator 103 rests on the underside of the cylindrical column 101 and is biased to engage the solenoid 102 by a spring 105. Pillar 101 has a cylindrical handle 106 that can be secured to a mechanical arm such as the arm shown in FIG. 4 if desired. Preferably the guide 112 is installed to receive the shaft 107 of the solenoid 102.

In order to start the perforation of the skin, first the saliva 111 is first placed in close proximity to the skin. Solenoid 102 is then activated to suddenly push down shaft 107 of solenoid 102. This action pushes down the entire intramuscular stimulus 103 and then the needle 111 punctures the skin. At this time, the spring 105 is compressed between the mounting plate 108 and the bottom 109 of the pillar 101 coupled to the motor 110 (preferably stepper motor).

Before solenoid 102 is deactivated, motor 110 is turned on to further advance saliva 111 down into the skin (and affected muscles), so solenoid 107 is deactivated and shaft 107 is returned to its original position. When the saliva 111 will remain inside the skin. In this anterior position normal treatment with the intramuscular stimulator 103 begins and proceeds as described above. At the end of the desired single course of treatment, solenoid 102 is de-excited.

The timing of activation or deactivation of solenoid 102 is preferably set in a microprocessor such as controller 114 shown in FIG. The stepper motor 110 is also controlled by the controller 114. A preferred implementation for such a controller utilizes a STAMP2 microcontroller chip from Digi Key, Minnesota, USA, as shown in FIG. However, other microcontroller chips may be used to develop a controller 114 having equivalent functionality.

In the configuration of FIG. 6, the controller 114 operates in response to the STAMP2 microprocessor 115 described above. The microprocessor 115 preferably communicates with a computer, such as a PC, to establish the desired programming associated with the desired intramuscular stimulation treatment by the serial port connection 116. Also, various controllers for communicating with the acupuncture device described above are in communication with the microprocessor 115. For example, the first group of controllers 117 includes switches 118 and 119 and a foot switch 90 for moving the hour hand up and down. The second group of controllers includes switches S1 and S2 provided so that operating parameters of the hour hand apparatus, such as the speed of the hour hand treatment and the stroke, can be adjusted. Further, the microprocessor 115 is coupled to the driver circuit 120 coupled to the stepper motor 110 and the second to excite the solenoid 102 and the first drive circuit 121 to excite the stepper motor 110. It is coupled to a pair of relay drive circuits including a drive circuit 122. In order to perform the desired IMS treatment, the circuit elements shown in FIG. 6 operate in a known manner to effectively control the stepper motor 110 and solenoid 102 as described above.

Although the foregoing description contains many specific details, it does not limit the scope of the invention, but merely illustrates some of the preferred embodiments of the invention. Accordingly, the scope of the invention should be determined by the appended claims and their legal equivalents, rather than by the examples given.

Conventional non-uniform manual punching caused great pain for the patient due to frequent acceleration and deceleration of the needle, whereas using an intramuscular stimulator with a motor was able to reduce the pain of the patient and the burden on the healer's muscle. However, the use of the intramuscular stimulator provided with the puncture aid of the present invention makes the initial skin insertion of the acupuncture faster, thereby further reducing the pain of the patient due to the constant speed and uniform motion of the acupuncture needle. Can be maximized.

Claims (15)

spit; An electric drive motor for inserting the needle into the affected muscles to cause the needle to produce a before and after repetition of the motor; An energy source to excite the motor; In the motor-driven intramuscular stimulation device for relieving chronic muscle pain, including; mechanical connection means for connecting the needle to the motor so that the needle can perform a linear forward and backward movement when the motor is excited, Puncturing means associated with the hour hand device such that the saliva punctures the skin located above the affected muscle; And Means for operating the puncturing means such that the saliva punctures the skin automatically; Motor-driven intramuscular stimulation hour hand further comprising a. The intramuscular stimulation hourglass apparatus according to claim 1, wherein said puncturing means is a solenoid. The method of claim 1, The mechanical connecting means includes a shaft for accommodating the needle and connected in a linear arrangement to the motor such that the motor moves the shaft back and forth in a controlled linear motion manner to impart the linear forward and backward motion to the needle. A tubular housing receiving the needle and the shaft, one end of the tubular housing being attached to the motor, an inlet at the other end passing the needle into and out of the tubular housing, and the device receiving the tubular housing. And a cylindrical pillar, wherein the needle further comprises a cylindrical pillar extending from the opening in the cylindrical pillar, and a solenoid extending between the cylindrical pillar and the tubular housing and attached to the cylindrical pillar. 4. The intramuscular stimulation device of claim 3, further comprising a spring positioned between the cylindrical column and the tubular housing and biasing the hour hand device away from the opening of the cylindrical column. The intramuscular stimulation device according to claim 1, further comprising a control device coupled to the operating means and electrically controlling the motor. 6. The intramuscular stimulation device of claim 5, wherein the control device includes programmable means for controlling the operating timings of the puncturing means. 2. The intramuscular stimulation hourglass apparatus of claim 1, further comprising a mechanical pivot arm supporting the intramuscular stimulation hourglass device in a fixed position at the treatment site. 8. The intramuscular stimulation hourglass device of claim 7, wherein the pivot arm is movable in all directions. spit; An electric drive motor for inserting the needle into the affected muscles so that the needle produces a before-and-after stroke of the muscles; An energy source to excite the motor; In the motor-driven intramuscular stimulation device for relieving chronic muscle pain, including; and the mechanical connecting means for connecting the needle to the motor so that the needle can perform a linear movement forward and backward when the motor is excited, And a solenoid associated with the needle device to cause the needle to puncture the skin located above the affected muscle. A method for reducing chronic muscle pain by using intramuscular stimulation therapy in which acupuncture is inserted into the affected muscle and the needle is repeatedly spit on the muscle, A needle-driven acupuncture stimulator comprising a needle and an electrically driven motor that drives the needle in a uniform controlled longitudinal linear motion with a fixed depth and frequency and repeatedly inserts the needle into the muscle, In the chronic muscle pain relief method that makes the patient less uncomfortable and less tension by the operator while supporting the stimulator device at the treatment site for the required treatment time, Providing the stimulator device with a piercing device for puncturing the skin located above the affected muscles, and operating the piercing device to automatically puncture the skin located over the affected muscles. How to reduce chronic muscle pain characterized in. 12. The method of claim 10, wherein the puncture is a solenoid and the method further comprises operating the solenoid to cause the saliva to puncture the skin. 12. The method of claim 11 further comprising normally biasing the fabricator in a direction away from the skin. 12. The method of claim 11 further comprising operating the stimulator device prior to deactivating the solenoid. 11. The method of claim 10, further comprising: providing the motor-driven stimulator device with an adjustable pivotal arm supporting the stimulator device in a fixed position at the treatment site, and placing the stimulator device at the treatment site during the required treatment time. And holding the stimulator device with the pivotal rock. 11. The method of claim 10, further comprising programming the operations of the drilling device to control the timing of operation of the drilling device.