KR20050018670A - A method and apparatus for enhancing neurophysiologic performance - Google Patents

Abstract

The present invention features methods and apparatus for enhancing neurophysiological performance, such as sensorimotor control and neuro-plasticity. Preferred methods include inputting a bias signal into the subject's sensory cells while the subject is performing pre-determined physical activity, thereby improving sensory cell function. The system used to implement the method of the present invention comprises a wearable device 500 to which at least one repositionable signal input device 510 is fixed and a signal generator 514 communicatively coupled with the signal input device. Include.

Description

Method and apparatus for enhancing neurophysiological performance {A METHOD AND APPARATUS FOR ENHANCING NEUROPHYSIOLOGIC PERFORMANCE}

The present invention combines pre-defined physical activity and certain device use with improved function of sensory cells, thereby enhancing neurophysiological performance such as sensorimotor control and neuroplasticity. A method and apparatus for the same.

The nervous system of a mammal is a complex set of inter-organizing and interacting sub-tissues. Sub-tissues are classified and named by both their anatomical location and their function. At the highest level, the nervous system is divided into a central nervous system and a peripheral nervous system. The Central Nervous System (CNS) consists of the brain and spinal cord, and the Peripheral Nervous System (PNS) contains all the remaining nervous structures found outside the CNS. In addition, the PNS is functionally divided into a somatic (voluntary) nervous system and an autonomic (involuntary) nervous system. The PNS can also be described structurally as it consists of the centripetal (sense) nerves carrying information towards the CNS and the centrifugal (motor) nerves carrying commands from the CNS.

Interconnections between afferent and centrifugal nerves have been found in the spinal cord and brain. Taken together, despite the changes in perturbation and determination will from the surroundings, certain groupings of afferent and centrifugal nerves produce sensory motor "loops" required to achieve cooperative motion. Configure. In the periphery (the trunk, upper limbs, lower limbs), afferent nerves are mechanical stimuli, such as pain, temperature, and contact and vibration on the skin surface, as well as position, force, and muscle, tendons. It carries sensory information resulting from certain neurons that are sensitive to deeper structures of stretch, such as ligaments and joint capsules. The term " proprioception " generally applies to sensory information directly related to limb position sensory and muscle contraction. In combination with tactile (touch) sensation, mechanical sensory information is collectively known as "somatosensation".

The "mechanoreceptor" neurons, described in detail, convert mechanical stimuli from interactions with the body's surroundings into electrical signals that can be transmitted and interpreted by the nervous system. Panician corpuscles in the skin fire in response to contact pressure. Muscle spindles, known to be interspersed with skeletal muscle tissue, report on the renal status of surrounding muscles. The golgi tendon organ senses the force level in the tendon. Free nerve endings in the structure surrounding the joint (ligaments, meniscus, etc.) provide additional information about the joint location. Some of these physical stimulus receptors are thought to interact directly via down-path and excitatory also inhibiting synapses to modulate the interpretation or performance of signals from receptor systems of other physical stimuli. It was.

All types of sensory cells are typically threshold-based units. That is, if the stimulus to the sensory cell is a stimulus of insufficient size, the cell will not activate and will not begin signaling. This stimulus is referred to as the "subthreshold". Stimuli higher than the threshold are called "suprathresholds."

Connections within the nervous system-the brain, spinal cord and peripheral nerves-can change significantly despite new forms of activity, pathologies and damage, which are demands placed on the body. In healthy individuals, these neurophysiological changes are allowed for the process of acquiring new physical functions, ie, "motor learning." After medical efforts such as some form of soft tissue injury (e.g., rupture of the cruciate ligament in front of the knee, a structure known as excess in the receptor of physical stimulation) and the subsequent surgical treatment used to repair the accompanying injury, The nervous system may undergo a change of reward to adapt to the loss of natural sensory neurons. Similar PNS and CNS nervous systems alter the assessment of an individual's ability to recover lost motor function after spinal cord or brain injury. Taken together, these structural alterations in the nervous system are referred to as "nerve-plastic" or "nerve-plastic change".

Recent investigations have demonstrated that afferent (sensory) activity from the periphery is one of the key drivers of neuro-plastic changes in both the PNS and CNS nervous systems.

The present invention focuses, in particular, on the sensory motor neurons and the role they act in, in sensory motor control and inducing neuro-plastic changes in the nervous system. In the present invention, Applicants combine prior art methods of improving the performance of individual sensory cells with new methods and apparatus for achieving improvements in sensorimotor control and neuro-plasticity. Importantly, the property of improved sensory cell performance is that the natural firing rate is increased in an information-in excess manner in response to stimulation of the surrounding environment. In other words, increased sensory cell excitability is coordinated with limb function, thus becoming unnecessary or unable to cooperate at all.

Tissue electrical stimulation has been used for a variety of therapeutic purposes including stimulation of muscle activity, pain relief and sensory production. As the intensity of the electrical stimulus increases, the series of effects produced by the electrical stimulus generally affects the perception of electrical sensations (such as tingling), increased sensations, fasciculation muscle contractions, pain, and then electrical burns. Or patterns such as damage to the form of cardiac arrhythmias follow.

In the past, pulsed electrical waveforms with adjustable pulse duration, intensity, and pulse width have been applied to specific areas of the human body for therapeutic purposes to suppress pain. Electrical waveform therapy as disclosed in US Pat. No. 5,487,759 (Bastyr et al.) Is used for symptomatic relief and management of chronic, postoperative and post-traumatic pain and also for inducing muscle contraction for the delay of atrophy. It became.

Stimulation below the perceptual level used to enhance the function of sensory cells (ie, sub-threshold stimulation) is described in US Pat. Nos. 5,782,873 and 6,032,074 (Collins), the entire contents of which are incorporated by reference. have. Collins discloses methods and apparatus for improving the function of sensory cells by effectively lowering the threshold of these excitability. In brief, a sub-threshold stimulus, or "bias signal", is input into the sensory neurons so that the neurons are likely to be excited without actually causing the neurons to be excited. In one preferred embodiment, the bias signal is a wideband signal that includes multiple frequencies, in many cases referred to as "noise". Since sensory cells are typically threshold-based units, lowering the sensory cell threshold reduces the level of external stimuli required for the sensory cells to respond (ie, excite). Thus, when a bias signal is present, it is expected that the sensory cells will respond to stimulus intensities where sub-thresholds are generally considered for neurons in the absence of noise. Both electrical and mechanical aspects of the bias signal, used individually or in combination, may be used to achieve sensory neuron detection threshold degradation.

1 is a flow chart of a method for enhancing the function of sensory cells.

2 is a flow chart of a method of locating an input area.

3 is a flow chart of a method of generating a bias signal.

4 is a schematic diagram of a system for enhancing the function of sensory cells.

5A-5B illustrate a system for enhancing sensory motor performance.

Figure 6 illustrates a signal generator of the present invention.

Figure 7 illustrates a wearable device as one embodiment of the present invention.

8A-8B illustrate a wearable device as another embodiment of the present invention.

9 shows a signal input device of the present invention;

In a preferred embodiment, the subject uses at least one sensory cell of the subject while the subject uses sensory cells inside the sensory cell and performs a pre-defined physical activity related to the sensorimotor performance to be enhanced. A method for enhancing sensory motor performance of a subject is provided, including inputting into an area. By inputting the bias signal in this way, the function of the sensory cells is improved. In cooperation with physical activity, the result is enhanced sensorimotor performance. Enhancements achieved using the method of the present invention include, for example, joint stability, improved gait, improved balance, improved motor learning, and improved motor function.

The bias signal applied to the subject may be modulated in response to physical variables measured from at least one body segment of the subject during pre-defined physical activity. Physical variables are selected from force, pressure, position, angle, velocity and acceleration. The bias signal may also be modulated in synchronization with pre-defined activity. In a preferred embodiment, the bias signal is a mechanical or electrical signal. Preferred displacement of the mechanical signal is from about 1 μm to about 10 mm. The frequency of the mechanical signal is preferably in the range of about 0 Hz to about 1,000 Hz. The current density of the electrical signal is preferably in the range of about 1 mA / in ² to about 1,000 mA / in ² . The frequency of the electrical signal is preferably in the range of about 0 Hz to about 10,000 Hz.

In another embodiment, a system for enhancing sensory motor performance of a subject is provided. The system preferably consists of a wearable device and a signal generator. At least one repositionable input device is secured to the wearable device. The signal generator is communicatively coupled with the signal input device and includes a power source, a signal processor and a controller. The signal generator may be repositionable or may be removably attached to the wearable device. The signal generator may include a calibration module for adjusting the bias signal generated by the signal processor. The wearable device preferably pushes the signal input device against the surface of the subject's skin. For this purpose, the wearable device is preferably made of stretchable fabric or material. The signal input device is also electrically connected to the signal generator. The means by which the signal input device is electrically connected is preferably housed inside the structure of the wearable device and thus protected by the structure of the wearable device.

Along with improved sensorimotor performance, improvements in neuroplasticity and increased growth hormone production can be achieved using the methods and apparatus of the present invention.

Preferred embodiments of the present invention provide methods and systems for improving sensory motor performance of humans, non-human mammals and non-mammalian animals (hereinafter referred to as "subjects"). Improvements in sensorimotor performance are meant to include immediate or short-term effects, such as improved mechanical joint stability, and more persistent effects, such as resulting from neuro-plastic changes in the PNS or CNS. The method according to the invention provides a bias signal into the subject's sensory cells to improve the function of these sensory cells by effectively lowering the threshold of sensory cell excitement while the subject is involved in pre-defined physical activity. It includes. Measures relating to this preferred method are preferred devices including wearable devices and other electro-mechanical components that provide a convenient and safe means of delivering bias signals to the subject. As used herein, the term "bias signal" means that, in fact, the waveform may be periodic, aperiodic, deterministic, or non-deterministic, and one or more. It is taken to mean a sub-threshold form of stimulation for sensory neurons, whether it is an electrical or mechanical signal that may include the frequency of.

Methods and systems according to preferred embodiments of the present invention are useful for enhancing sensorimotor functions, for example, in healthy individuals as well as in individuals with disorders, diseases and / or injuries. For example, the methods and systems according to the present invention can be used by healthy individuals who are trying to learn new motor skills as may be required for athletic activities. In another example, the methods and systems according to the present invention may be applied to individuals with high sensory thresholds or other neurological dysfunctions that may result from aging, peripheral neuropathies or strokes. .

1 is a flow diagram of a method for enhancing the function of sensory neurons in accordance with one embodiment of the present invention. In step 102, an area associated with the sensory cells to which the function is to be enhanced or to which a bias signal is input is located. Hereinafter, the located area is referred to as an input area. Once the input region is located, a bias signal is generated in step 104. Then, in step 106, the bias signal is input into the input region to effectively lower the threshold of sensory cells associated with the input region.

2 is a flow diagram illustrating one embodiment of locating an input region according to step 102. Positioning the input region depends, among other things, on how the sensor system may be enhanced and how bias signals may be input to sensory cells associated with the sensory system. Step 202 is a preparatory step in which an identification scheme is undertaken to identify a particular sensory system to be enhanced. The method of identification depends to some extent on the cooperation of the individual. That is, this step is similar to the diagnosis but does not require the individual to deteriorate with any disease or disorder in order to undergo the consolidation process planned herein. In one embodiment, the sensory system whose function is to be enhanced is that function is degraded by disease.

In an alternative embodiment, the sensory system to be enhanced is to function normally. In step 204, the best way to input the bias signal to the subject sensory system is determined. The optimal means of input may include the object sensory system, the properties of the transformation system with respect to the object sensory system, the current state of the object sensory system (ie whether it is damaged or to some extent impaired) and the property of the signal to be determined (e. For example, the amplitude and frequency content of the signal). Input means suitable for a given environment include, but are not limited to, neural cuffs, implanted electrodes, surface electrodes, muscle stimulators, tendon stimulators, and magnetic field stimulators.

Once the optimal input means is determined in step 204, the input area is determined in step 206. The position of the input area depends on the same factors as in the determination of the optimal input means. However, the position of the input region varies, among other things, with respect to the particular input means, which depends in part on whether the target sensory system is to some extent impaired, the predetermined cause and location of this dysfunction, and the nature of the stimulator to be used. . More specifically, if there is a dysfunction caused by some physical damage to the sensory cells in the sensory system, it may be necessary to locate the input region so that the bias signal bypasses the physical damage causing the dysfunction. In addition, some stimulators (eg, embedded electrodes) may require an invasive procedure, while others (eg, surface electrodes) only require non-invasive procedures. The fact that it is also a factor to be considered.

When the input area is determined and the input means is provided, a bias signal to be input is generated. 3 illustrates one embodiment of a method for generating a bias signal. In an initial step 302, the bias signal is corrected. In other words, the optimum level for the bias signal is determined. Depending on the determination of steps 204 and 206, a particular form of bias signal appears in which the signal detection capability of a given neuron in the subject sensory system is optimally enhanced. For example, a bias signal with a parameter of a predetermined predetermined value results in optimal enhancement. Calibration contributes to ensuring that certain parameters of the bias signal generated are adjusted to achieve optimal enhancement. Examples of signal parameters of the bias signal that may be calibrated are generally amplitude, frequency, offset (D.C. bias), intensity, variance, frequency bandwidth, and spectral characteristics. Calibration is typically accomplished prior to installation of the reinforcement system and may be achieved intermittently while the reinforcement system is installed. If calibration takes place while the reinforcement system is being installed, it may be required to install the reinforcement system so that it is accessible from outside of the body so that the calibration can be achieved non-invasively.

In one embodiment, the calibration is accomplished by inputting an interest input signal into the sensory cells associated with the bias signal generated by the enhancement system. The response of the sensory cell to the bound input is recorded as a function of the relevant parameter in the bias signal. That is, the response of the sensory cells is recorded as the relevant parameters are modulated in the bias signal. Using the record results, the coherence between the bound input and the response of the sensory cells is characterized by calculating some measures, such as the cross correlation coefficient, described below. Sensory cell responses are maximally enhanced when coherence measurements are maximized. This maximally enhanced response corresponds to some value or range of values of the associated bias signal parameter that can be determined, for example, by reviewing the record of the bias. As such, a range of values for the optimum value or related parameter of the bias signal is determined. The process can be repeated using other input signals and associated parameters, thereby determining the bias signal with the optimal parameters for the input signal with the variable parameters.

According to one embodiment of the invention, the bias signal is optimized by examining the cross correlation coefficient C1:

Where S (t) is the input signal, R (t) is the sensory neuron or output of the sensory system (e.g., the mean excitation rate signal of the nerve or the nerve spike train), and the bar at the top represents the average over time Indicates. S (t) and R (t) can be measured with any suitable transducer, for example needle electrodes can be used to measure the output of neurons. The maximum C1 corresponds to the maximum coherence between the input signal S (t) and the output R (t) of the neuron. The value of C1 for a given input signal depends on the relevant parameters of the bias signal. As such, a bias signal with parameters that produce the desired output R (t) may be determined.

The result of the calibration process may be used, for example, by modulating the bias signal in response to the input signal or by determining a set of parameter values that averages to achieve optimal enhancement for a given input signal. In a first example, the parameter values for the bias signal are tabulated against, for example, the parameters of the input signal. When an input signal is generated, a predetermined parameter of the input signal is measured, and a bias signal having a corresponding parameter is generated, for example, by referring to a tabulated result. In this way, the bias signal is modulated or optimized for each particular signal. In a second example, a single set of parameter values that achieves optimal enhancement for most signals are calibrated and used to generate a bias signal that responds to all inputs in use.

In one embodiment, after the input device is calibrated and installed, an input signal to the neuron is detected. As described in connection with FIG. 4, one embodiment of a system for enhancing the functionality of sensory neurons includes signal detection capability, such as a transducer and a signal processor. Thus, in step 304, the input signal to the neuron is detected using the signal detection capability.

If an input signal is detected in step 304, a bias signal is generated in step 306. As discussed above with respect to the calibration process, the bias signal is a constant, unmodulated set of parameters for the purpose of optimally enhancing the function of the sensory cells in response to most input signals or parameters that are modulated according to predetermined parameters of each input signal. Has parameters. If a bias signal with an unmodulated set of parameters is used, a slightly simpler input system is used. In general, the nature of the bias signal to be used (ie, modulated or unmodulated) depends on the nature of the sensory system to be enhanced. If a bias signal is generated, it is input to the neuron in step 106.

In the embodiment described above, the bias signal is only generated in response to the detection of an input signal into a neuron. In an alternative embodiment, after the input device is calibrated and installed, bias signals are generated continuously and input into the neurons. In other words, the input signal does not need to be detected. In the method according to this embodiment, the bias signal is modulated or not modulated. When the bias signal is modulated, the continuously generated bias signal is modulated as described above when the input signal is detected. If an unmodulated bias signal is used in this embodiment, a simplified input system may be used. As mentioned above, whether a modulated or unmodulated signal is used depends, among other things, on the nature of the system to be enhanced.

In another embodiment, a distributed consolidation process is used. In this embodiment, the above-described enrichment process is modified so that a bias signal is generated and input into neurons at a plurality of positions for stimulating the arrangement of sensory cells, thereby providing a distributed enrichment effect. In this distributed enhancement system, a continuous or discontinuous, modulated or unmodulated bias signal may be used, as described above. As one example, if the sensory function of the urinary tract is to be enhanced, the bias signal may be input to multiple points distributed around the bladder so that an improved fullness sensation can be obtained.

4 illustrates one embodiment of a strengthening system 400 for implementing a method for enhancing the function of sensory neurons. Enhancement system 400 includes a transducer 402, a signal processor 404, an input device 408, and a controller 410. The reinforcement system 400 operates according to an electrical signal. The input signal is typically transmitted to the sensory cells by contact with the outside world, where no contact is made in the form of an electrical signal. The input signal may be transmitted, for example, by contact, movement of a body segment, sound waves or light rays. One function of the transducer 402 is to detect an input signal carrying a contact and pass the contact generally to the enhancement system 400 and particularly to the signal processor 404. Another function of the transducer 402 is to convert the input signal carrying the contact into a signal in a form usable by the enhancement system 400. The mechanism used for the transducer 402 depends on the object sensory system. As an example, if the auditory system is to be strengthened, transducer 402 may take the form of a stimulating electrode disposed near the ear or an arrangement of stimulating electrodes. As another example, if a system that is sensitive to magnetic stimulation is being targeted for reinforcement, transducer 402 is implemented as a piezoelectric transducer and is elastic with parental muscles or tendons associated with sensory cells to be enhanced. Tendon stimulator that is installed or attached by a strap. As yet another example, if a vibration or contact-pressure sensation system is being targeted for strengthening, the transducer 402 is a surface electrode that is installed or applied across the skin of the body region containing the cells to be stimulated. These electrodes are attached using a flexible electrode / skin interface.

The signal processor 404 generates a bias signal to be input via the input device 408 to the object sensory system for enhancement. The signal processor 404 is electrically connected to the converter 402, the input device 408, and the controller 410. As mentioned above, the bias signal may be continuous or discontinuous, and may or may not be modulated. The shape of the signal processor 404 depends on the desired shape of the bias signal to be generated. In one embodiment, where a discontinuous, modulated bias signal is required, the signal processor 404 has both a signal detection capability and a look-up table capability to store parameter values for the bias signal. It is preferable to include. In another embodiment, where a constant, unmodulated bias signal is required, the signal processor 404 does not necessarily require signal detection capability and lookup table capability. In one embodiment, the signal processor 404 is a special functional IC or general microprocessor, preferably small, lightweight, and portable. Signal processor 404 also preferably includes signal conditioning and data acquisition capabilities. In one embodiment, a PCMCIA chip or card is used as the signal processor 404.

Signal processor 404 also includes a calibration module 406. The calibration module 406 may adjust the bias signal generated by the signal processor 404. For example, for optimal enhancement, the signal processor 404 generates a bias signal with predetermined parameters (eg, predetermined amplitude and frequency) in response to a particular signal received from the transducer 402. . If these predetermined parameters of the bias signal are not properly adjusted, the bias signal will not optimally enhance the functionality of the target sensory system. The calibration module 406 allows these pre-determined parameters to be adjusted such that an optimum bias signal is generated. Calibration is typically accomplished prior to installation of the reinforcement system 400 and may be achieved intermittently while the reinforcement system 400 is installed. If calibration will occur while the strengthening system 400 is installed, it may be required to install the signal processor 404 so that it can be accessed from outside of the body so that the calibration can be noninvasive. In an alternative embodiment, the signal processor 404 has a remote access capability that allows calibration to occur non-intrusively whether the signal processor is accessible from outside of the body.

The input device 408 delivers the bias signal generated by the signal processor 404 to the object sensory system. Depending on what the object sensory system is, the input device 408 may take many different forms as described above. Input devices suitable for a given environment include neural cuffs, embedded electrodes, surface electrodes, muscle stimulators, tendon stimulators and magnetic field stimulators. The manner in which the input device 408 delivers the bias signal to the object sensory system depends on the form of the input device 408 and the object sensory system. For example, neural cuffs or inserted electrodes may be suitable for use when the urinary tract is a subject sensory system, typically surgically inserted, and delivers a bias signal to sensory components of the system. Muscle or tendon stimulators, on the other hand, are more suitable for mechanically stimulating a system that responds to magnetic stimulation. Such a stimulator mechanically stimulates the system by vibrating muscles or tendons (eg, muscles near the joints) associated with the system that are sensitive to magnetic stimulation. Muscle or tendon stimulators can be applied non-invasively, for example by using elastic bands. In one embodiment, where the object sensory system is a vibration or contact-pressure sensory system, a surface electrode-based system is used as the input device 408. More specifically, armored electrodes, sock electrodes and sleeve electrodes sold under the name ELECTRO-MESH [TM] may be used as the input device 408. The surface electrode system is disposed over the relevant body part (eg hand or foot). In addition, the input device 408 may be a magnetic stimulator used non-intrusively or intrusively. For example, a magnetic field stimulator may be used to stimulate skin sensory neurons by positioning the stimulator outside of the body near the sensory cells to be stimulated using elastic bands. Magnetic field stimulators may be used intrusively, for example, by forcing a stimulator to stimulate sensory neurons in the area of the bladder.

The controller 410 controls the interaction between the transducer 402, the signal processor 404, and the input device 408. The implementation for the controller 410 depends, among other things, on the type of bias signal required. That is, if a discontinuous, modulated bias signal is required, the controller 410 may be implemented using a microprocessor. In a simpler embodiment, where a continuous, unmodulated bias signal is required, the controller 410 may simply be implemented using a switch that activates the enhancement signal. Alternatively, signal processor 404 may be sufficient, such that controller 410 may not be necessary for this embodiment. By way of example only, controller 410 includes a microprocessor or any digital controller with proper programming. In one embodiment, the controller 410 is implemented with the PCMCIA chip or card described above.

The nature and amplitude of the bias signal are controlled depending on the type of sensory cell to which the bias signal is to be applied. Types of repetitive waveforms, pulses, or DC signals commonly used for other types of damage treatment (eg, pain suppression, bone therapy) are avoided in many cases in the practice of the present invention, because This is because sensory cells can adapt to simple deterministic signals, thereby reducing or eliminating the effects of these signals on sensory cells over time. Instead, according to the present invention, non-deterministic noise signals such as random, aperiodic noise signals, or the recorded repeatability of noise signals are used to cause sensory cells to noise over an extended period of noise signal application that occurs during physical training regimens. It may be desirable not to adapt to the signal. These signals may be continuously generated signals, such as those generated by known means including computer random number generators, noise diodes, or thermal noise from resistors or other electrical components. Periodically recorded noisy signals, such as signals stored in storage devices (RAM, ROM, etc.) or sampled signals, may also be employed.

Sensory cell regions containing neurons to be affected by bias signals may be found at different depths in the human body, allowing different signal transmission filtering characteristics to exist between certain sensory cells and the signal input device. In a preferred embodiment, the bias signal can be combined with other signal types to overcome this problem. For example, a chirped signal may be formed by overlaying a noise signal with a swept frequency signal that regularly sweeps through the signal frequency range. This combined signal may be tailored to allow amplification of the frequency range normally attenuated by the transmission in the body. Thus, the signal compensates for the expected attenuation caused before it reaches the subject sensory cell at the skin-surface level. This technique may also be used to reduce the effort required to determine a valid signal since it may cover all the required frequency ranges.

Another method of the invention involves enhancing various neurophysiological functions by applying an externally generated bias signal to the sensory cell region while the subject is performing pre-defined physical activity as described above. do. Neurophysiological functions enhanced by this method of the invention include, for example, enhanced limb position sensory, increased release of growth hormone, enhanced peripheral neuro-plastic changes, and enhanced central neuro-plastic changes including the cortex. do.

Most physical training regimens are undertaken, inter alia, to induce motor learning, ie the recovery of motor function lost due to the acquisition or impairment of a new motor function or disease. While the subject performs a particular physical activity, in order to achieve the aforementioned sensory motor performance enhancement, a bias signal is applied to the sensory cells involved in the specific physical activity, such that the threshold is triggered by an external stimulus resulting from the activity. Will be lowered. By making the sensory cells more responsive, the number of action potentials generated for a given amount of external stimuli is increased, thereby improving the speed and / or quality of motor learning resulting from the activity.

Cooperative movement of the limbs requires, for example, downward determination signals from the brain, muscle contraction, precise interactions between limb movements, and interactions with the surrounding environment. This tight control relies in part on sensory feedback of the mechanical properties from the extremities involved in the movement. Somatosensory information (eg, tactile information from the sole of the foot and information responsive to magnetic stimulation from the knee joint) is clearly important for both normal gait and more energetic activities such as jumping and landing. The method of the present invention is effective to boost the cooperative sensory information from the receptor of the physical stimulus related to the limb position sensory during the movement of the limb. This added information content during exercise provides a means for improved sensorimotor control. This improvement prevents injuries by avoiding enhanced balance, corrected gait patterns and hyperextension, for example, of joints.

In one embodiment of the present invention, the bias signal is provided in a plurality of structures that participate in the stability of the joint in the subject during training curing, thereby promoting joint sensation and feedback to enhance the subject's stability. For example, at least one input device (eg, an electrode) may be disposed in or near the joint region to stimulate sensory cells in or near the ligament, joint capsule, or cartilage. The bias signal is provided at a level below the perceptual threshold of sensory cells associated with the structure and below the skin pain threshold.

In another preferred embodiment, the bias signal may be provided in at least two structures on opposite sides of the joint to maintain joint stability and enhance the performance of the sensory cells included in these structures. Preferably, the bias signal is provided at or near the joint, and at least two different antagonists on opposite sides of the joint, whose activity determines the relative flexion and extension of the joint ( antagonist muscles).

The bias signal may be provided to each structure at the same time, or it may occur sporadically in each structure. Preferably, the bias signal is repeatedly provided in each structure (eg, the bias signal is repeated so that the bias signal is provided in each structure at the same time, or the bias signal is provided so that the bias signal is sporadically provided in each structure a plurality of times. Is repeated).

Specific bias signal ranges are applicable to certain types of bias signals used in accordance with the present invention. For example, to electrical signals within the current density range of about 1㎂ / in ² to about 1,000㎂in ^2, also it is applied in the frequency range from about to about 0㎐ 10,000㎐ the skin surface of the subject (recipient) desirable. The mechanical signal preferably has a displacement at the skin surface in the range of about 1 μm to about 10 mm and a frequency in the range of about 0 Hz to about 1,000 Hz. The mechanical signal can be remotely controlled by receiving a waveform signal generated remotely from a remote transmitter and providing a mechanical actuator on the skin surface that converts these signals into a mechanical signal. In a wireless system, the electrical signal may also be transmitted from a remote transmitter to an electrode that applies the electrical signal to the subject. It is desirable for all bias signals to take into account complex constructive and / or destructive patterns.

As another example, naturally-occurring growth hormone is released by the human pituitary gland. These hormones are part of the body systems that change the structure of muscles and bones in response to changes in activity. For example, an increase in muscle volume in response to exercise is caused in part by increased amounts of circulating growth hormone in the body. Recent investigations have demonstrated that afferent signals from the periphery (more specifically, those originating from muscles) stimulate the release of certain types of growth hormones from the pituitary gland (McCall et al., 2000). According to the present invention, sensory feedback neurons are further activated by applying bias signals to lower sensory cell thresholds during physical training regimens. As a result, afferent traffic from the periphery is increased, which causes neuro-plastic changes in the brain. For example, sensory information from the root canal improves the release of growth hormone in response to activity. This is particularly beneficial for individuals (eg, fitness trainers) who work to restore original muscle volume and bone after trauma or extended inactivity cycles. In some cases, an increase in growth hormone release may be sufficient to eliminate the need for growth hormone abdominal therapy and the need for growth hormone supplementation.

The interconnection and efficiency of the sensory motor pathways in the periphery is the manifestation of the acquisition of new motor skills. In other words, an important result of training and execution is the creation of these new paths. Indeed, even the increase in physical strength is due to neurological changes as much as the increase in muscle mass, especially in the strength training regimen. Recent investigations suggest that afferent activity stimulates the production of new synapses ("synaptogenesis"), which is one of the foundations of peripheral neuro-plastic neuropathological processes (Wong et al., 2000). Applying the bias signal to the input region in accordance with the method of the present invention increases information-excess sensory traffic from peripheral drive neuronal-plastic changes in the peripheral. The common perception of fitness training is that it only involves robustness and that neurology is not a consideration. Indeed, neurological factors are focused on the development and maintenance of muscle strength. In the early stages of the fitness training regimen, muscle mass is not significantly increased, but physical strength is significantly increased as a result of the neuromuscular learning process. By applying a bias signal to the input region in accordance with the method of the present invention, the time to complete this process is significantly reduced by lowering the threshold for the sensory cells involved during this stage of fitness training. As a result, information traffic from the periphery achieves neuro-plastic changes in the periphery, among others, increasing the rate at which muscle mass is formed.

The fitness training performed in accordance with the present invention is also effective in enhancing crossover fitness changes in human outboards such as arms or legs. The fitness training survey found that when only one ear had undergone the training, the strength of the untrained one also increased to some extent. Thus, if one outer ear is fixed by a cast or brace, the physical strength of the unfixed outer body is strengthened by using the method of the present invention, so that the sensory at the opposite outer surface during the fitness training curing method for the opposite outer body Lowers the cell threshold.

Many athletic training programs seek to improve the balance required when weight is quickly transferred from side to side. Balance reinforcement training regimens include extended repetitive left and right movements to facilitate motor learning resulting in enhanced balance. Again, in combination with this left-right training regimen, the present invention involves lowering the sensory cell thresholds that are affected during training to achieve a more quickly enhanced balance.

Moreover, both the process of restoring motor function following damage such as stroke and normal acquisition of new motor function depends on the creation and removal of new connections through overall sensory and motor cortices. Recent investigations have demonstrated that sensory activity from the periphery is one of the underlying drivers of these beneficial neuro-plastic changes in the brain (McKay et al., 2002). Applying a bias signal to the input region in accordance with the method of the present invention also increases centripetal traffic, thus accelerating the improvement of motor function.

5A-5B illustrate one preferred system for applying an input signal in accordance with the method of the present invention, as applied during physical training regimens. The system includes a lower garment 500 that extends below both legs from the waist of the user. Belt 502 secures the garment to the waist, while foot strap 504 extending just below the user's foot keeps the garment comfortable against the body during lower body movement. The foot strap is preferably made of neoprene or other known elastic material. Garment 500 preferably includes a plurality of belt straps 506 positioned to surround a waist portion of garment 500. The loose end of the strap 506 fits the belt 502 and the garment 500 via Velcro or other known fastening means to form a belt-loop that effectively holds the belt 502 securely at the waist level. Is attached to.

Garment 500 is for application of an input signal at the knee and below the knee. As a result, the leg of the garment has a closure 508 that allows the input device 510 to be positioned in a selected position with respect to the knee, calf and / or lower leg muscles, while also keeping it in place with respect to the garment 500. . The outer cap 511 is secured via a garment and with a clip on the input device 510 to hold the input device 510 securely in place. Accordingly, the signal input device 510 may be disposed at a substantially predetermined position on the garment as necessary for various applications and to accommodate the human body of the test subject. In order to tailor the garment to the user, the input device 510 is first placed on the user's skin for a particular muscle, joint, or the like. The garment 500 is then carefully worn on the input device 510 and the outer cap 511 is clipped through the garment 500 to hold the input device 510 in place. The garment 500 is adapted to maintain the input device securely with respect to the subject's skin to allow the garment to be tailored to the subject and to prevent displacement of the input device 510 during extended exercise related to exercise curing. It is preferably made of neoprene or any known stretchable material.

Cable 512 electrically connects input device 510 to signal generator 514. The signal generator 514 provides power to the input device 510 on the inner surface of the garment such that a change in the position of the electrode can be adjusted within the area of the input device 510. The cable 512 is preferably secured to the garment 500 so that there are no loose cables that interfere with body movement. In a preferred embodiment, the cable 512 extending from the signal generator 514 is secured inside the side pocket 516 of the garment 500. Cable 512 extends through pocket 516 into conduit 520 extending downward along the leg portion of garment 500. Conduit 520 branches to multiple conduits at the knee level to receive input devices 510 positioned at or relative to the lower leg on the lower leg. The input device 510 may be attached at a predetermined position along the length of the cable 512. A cable guide 522 made of plastic or similar material surrounds the conduit 520 to hold the opening of the conduit with the pocket 516. The conduit opening held by the cable guide 522 allows the cable 512 to be fed into and out of the length of the conduit 520 very easily.

The cable 512 is preferably sufficient to allow the controller 514 to slide from the side of the belt 502 to the back of the belt 502. Thus, the signal generator 514 can be repositioned at various locations along the belt 502 so as not to prohibit the movement required by a particular training. Signal generator 514 may also be worn in other locations or handheld. In general, the placement of the signal generator 514 is determined based on the position of the joint to be stabilized, the pose of the subject and / or the ease of movement by the subject. To remove the cable 512, the signal generator 514 may include one or more wireless transmitters that operate to transmit signals to the signal generator 514 and / or the input device 510.

As shown in FIG. 6, signal generator 514 includes signal processor 404, controller 410, control dial 606, display 608, test button 610, and infrared port 612. . Display 608 is relevant for the user and also displays clinical graphical information such as current stimulation program, remaining battery life, stimulus level, active channel, error, and the like. Infrared port 612 (or wireless or wired, etc.) provides a link to a computer station that allows downloading of custom stimulation patterns and waveforms. The test button 610 allows the identification of proper controller function. The control dial 606 is operative to change the amplitude of the noise signal provided to the signal input device 510 to maintain the signal below the threshold level of the subject sensory cell and below the subcutaneous threshold level. The electrical current density in each signal input device 510 is determined by the size of the electrode and the current amplitude. The current density must be kept within an acceptable range. In the case of electrical stimulation, the channels may be electrically isolated from each other, or may share a common ground.

The input device 510 may apply an input signal to a structure related to joint position through the skin. As noted above, the input device 510 in a garment may be a surface electrode, muscle stimulator, tendon stimulator and magnetic field stimulator, vibratory stimulator (e.g., a small electromagnetic rotating motor or a planar motor). (Ie, pancake type motor)), piezoelectric actuators, ferrofluid magnetic actuators, or electroheologic actuators, or other known signal input devices. The signal input device is constructed and arranged in appropriate dimensions to focus the stimulus on the desired structure. For example, knee electrodes or actuators are made the same size to impede or inhibit movement and to limit (target) the stimulus to related sensory cells. Signal generator 514 may be programmed to vary the strength and timing of the signal. For example, when one or more input devices 510 are used, the position and polarity of the signal may change. Similarly, stimulation may occur simultaneously at each input device 510 or stimulation may occur sporadically between each input device 510. The power and frequency of the stimulus can also be controlled. The signal is at a level below the sensory cell's perceptual threshold associated with various structures that play a role in joint stability. Thus, the signal is below the level required to trigger sensory cells in these structures.

In addition, the level of signal supplied by signal generator 514 may be sufficient to stimulate other cells located in structures that are not directly related to joint stability. For example, sensory cells inside the skin may perceive a signal supplied through an input device 510 disposed on the skin, but the level is still associated with the stability of the knee joint, e.g. hamstring) is below the threshold required to stimulate sensory cells of such structures. Such low level signals are disclosed in US Pat. No. 5,782,873 (Collins et al.).

In another preferred embodiment, as shown in FIG. 7, a structure 700 is provided for placing the signal input device 510 in contact with the subject's skin. The plurality of arms 704 extend from the central hub 708 positioned on the opposite side of the associated joint when the structure 700 is properly worn. A portion of the arm 704 immediately adjacent the central hub 708 is made of expandable material (eg, rubber). Arm 704 is preferably biased inward at an inward angle such that the structure 700 is securely attached to the leg when positioned on the limb. Arm 704 also includes a plurality of input devices positioned such that input device 510 is positioned on these areas of the leg to which the bias signal is to be applied in accordance with the method of the present invention when structure 700 is properly positioned on the limb. 510.

At least one arm 704 includes a cable outlet 706 electrically wired to each input device 510. The outlet 706 is an electrical connector 702 of the cable 512 such that an electrical connection is established between the signal generator 514 and the input device 510 when the other end of the cable 512 is connected to the signal generator 514. Accept. The cable 512 is preferably made of a strain resistant and extensible material to reduce the likelihood that the cable 512 will escape from the outlet 706 or signal generator 514 during use.

In another aspect of the invention, a plurality of input devices 510 and a signal generator 514 preferably integrated into or positioned thereon, as shown in FIGS. 8A and 8B, on the knee joint. A joint cover structure 800 is provided. The input device 510 is positioned to ensure proper coupling of the joints and muscles to which the bias signal is to be applied in accordance with the method of the present invention. Articulation structure 800 is preferably wrapped around the joint by Velcro or other known fastening means and secured on itself. Alternatively, articulation structure 800 may be configured to slide onto and away from the articulation. The articulation structure 800 is preferably made of fabric, as long as at least a portion of the structure is made of a flexible material that allows the input device 510 to remain in place during flexion and stretching of the joint, but is preferably made of plastic, rubber or other It may be made of a material. As shown, the raised portion 802 of the structure 800 is made of thicker material that can reinforce the joint. The thinner portion 804 of the structure 800 is positioned above the joint to allow bending of the joint without displacing the input device 510.

In another aspect of the invention, as shown in Figure 9, the location of or between the signal input device 510 (e.g., skin surface electrodes) for a subject being treated in accordance with the method of the present invention. An electrode applicator 900 is provided that provides a means for customizing the distance. The area of the flexible, electrically conductive layer 902, such as conductive rubber, provides an electrically conductive means between the wire 908 and the signal input device 510. It is the non-conductive material 904 that covers and surrounds the conductive layer 902 on the outer surface of the structure. These two conductive layers 902 and the layer 904 of non-conductive material are permanently attached to each other. Also covering the conductive layer 902 inside or on the skin surface side is a non-conductive film 906 detachably attached to the conductive layer 902. By removing the non-conductive film 906, the inner surface of the conductive layer 902 is exposed, allowing the signal input device 510 to attach to the conductive layer 902. The non-conductive film 906 is scored or otherwise broken into patterns that allow removal for a portion of the non-conductive film 906 rather than the entire film. In this manner, most of the conductive layer 902 remains covered by the non-conductive film 906 during use. The signal input device 510 is made of a thin, electrically conductive material such as a hydrogel that provides an electrical interface between the conductive layer 902 and the skin of the subject.

The devices used to perform the methods of the present invention are unique to known devices used to improve sensorimotor performance (eg, motor learning), or to treat and recover from the effects of an injury. In this known unit, the electrode is mounted on a brace or knee wrap and comprises a free, non-constrained electrical conductor, all of which are required for the performance of an effective physical training regimen. Suppress

While the above-described embodiment pays attention to pants, joint stabilizers and guards, the term "wearable device" as used herein refers to a predetermined position that can hold the input device 510 in place at the desired location. Reference structure.

The embodiments described herein have been shown as lower body wearable devices for illustrative purposes only. Similar embodiments that can hold in place a signal input device designed for the upper body, including the arm and torso of an individual, are within the intent and scope of the present invention. The upper body wearable device may be combined with the lower body wearable device to allow the input device to be positioned and operated simultaneously along both the upper and lower bodies in accordance with the method of the present invention.

Although the invention has been described in detail, it should be understood that various changes, substitutions and alterations can be made therein without departing from the intended scope as defined by the appended claims.

Claims (48)

In the method of enhancing the sensory motor performance of the subject, Inputting at least one bias signal into at least one sensory cell region of the subject while the subject uses sensory cells inside the sensory cell and is performing a pre-defined physical activity related to the sensorimotor performance to be enhanced step Including, Wherein inputting the at least one bias signal improves the function of the sensory cell. Way. The method of claim 1, The sensorimotor performance is improved joint stability Way. The method of claim 1, The sensory motor performance is an improved gait Way. The method of claim 1, The sensorimotor performance is an improved balance Way. The method of claim 1, The sensory motor performance is improved motor learning Way. The method of claim 1, The sensory motor performance is an improved motor function Way. The method according to any one of claims 2 to 6, The sensorimotor performance is enhanced through improved neuroplasticity. Way. The method of claim 7, wherein The neuro-plasticity is the central neuro-plasticity Way. The method of claim 7, wherein The neuro-plasticity is peripheral neuro-plasticity Way. The method according to any one of claims 2 to 6, The sensorimotor performance is enhanced through increased growth hormone release Way. The method of claim 1, The bias signal is modulated in synchronization with the pre-defined physical activity. Way. The method of claim 1, The bias signal is modulated in response to a physical variable measured from at least one body segment of the subject during the pre-defined physical activity. Way. The method of claim 1, The bias signal is a mechanical signal having a displacement of about 1 μm to about 10 mm Way. The method of claim 1, The bias signal is a mechanical signal consisting of one or more frequencies in the range of about 0 Hz to about 1,000 Hz. Way. The method of claim 1, The bias signal is an electrical signal having a current density in the range of about 1㎂ / in ² to about 1,000㎂ / in ² Way. The method of claim 1, The bias signal is an electrical signal consisting of one or more frequencies in the range of about 0 Hz to about 10,000 Hz. Way. In the method of enhancing the sensory motor performance of the subject, Inputting at least one bias signal into at least one sensory cell region of the subject while the subject uses sensory cells inside the sensory cell and is performing a pre-defined physical activity related to the sensorimotor performance to be enhanced step Including, Wherein the inputting of the at least one bias signal improves the function of the sensory cell and the at least one bias signal is generated and input by a system for enhancing sensory motor performance, wherein the system is at least one signal. An input device comprising a wearable device fixedly repositionable and a signal generator communicatively coupled with the at least one signal input device for generating the bias signal Way. The method of claim 17, The sensorimotor performance is improved joint stability Way. The method of claim 17, The sensory motor performance is an improved gait Way. The method of claim 17, The sensorimotor performance is an improved balance Way. The method of claim 17, The sensory motor performance is improved motor learning Way. The method of claim 17, The sensory motor performance is an improved motor function Way. The method according to any one of claims 18 to 22, The sensorimotor performance is enhanced through improved neuro-plasticity Way. The method of claim 23, wherein The neuro-plasticity is the central neuro-plasticity Way. The method of claim 23, wherein The neuro-plasticity is peripheral neuro-plasticity Way. The method according to any one of claims 18 to 22, The sensorimotor performance is enhanced through increased growth hormone release Way. The method of claim 17, The bias signal is modulated in synchronization with the pre-defined physical activity. Way. The method of claim 17, The bias signal is modulated in response to a physical variable measured from at least one body segment of the subject during the pre-defined physical activity, the physical variable being from a group consisting of force, pressure, position, angle, speed and acceleration. Selected Way. The method of claim 17, The bias signal is a mechanical signal having a displacement of about 1 μm to about 10 mm Way. The method of claim 17, The bias signal is a mechanical signal consisting of one or more frequencies in the range of about 0 Hz to about 1,000 Hz. Way. The method of claim 17, The bias signal is an electrical signal having a current density in the range of about 1㎂ / in ² to about 1,000㎂ / in ² Way. The method of claim 17, The bias signal is an electrical signal consisting of one or more frequencies in the range of about 0 Hz to about 10,000 Hz. Way. In the system for enhancing the sensory motor performance of the subject, A wearable device to which at least one signal input device is fixed, wherein the at least one signal input device is repositionable on the wearable device; And A signal generator for generating a bias signal, wherein the signal generator is communicatively coupled with the signal input device; System comprising. The method of claim 33, wherein The signal generator includes a power source, a signal processor and a controller system. The method of claim 34, wherein The signal processor includes a calibration module for adjusting the bias signal generated by the signal processor. system. The method of claim 33, wherein The wearable device forcibly presses the signal input device onto the skin surface of the test subject. system. The method of claim 33, wherein The wearable device consists of a stretchable fabric system. The method of claim 33, wherein The signal generator is repositionable and removably attached from the wearable device. system. The method of claim 33, wherein The signal input device is electrically connected to the signal generator system. The method of claim 33, wherein The signal generator is communicatively coupled to the signal input device by an electrical conductor, wherein at least a portion of the electrical conductor is secured inside the wearable device and protected by the wearable device. system. In a method of improving neuro-plasticity of a subject, Inputting at least one bias signal into at least one sensory cell region of the subject while the subject uses sensory cells inside the sensory cell and is performing a pre-defined physical activity related to the sensorimotor performance to be enhanced step Including, Wherein inputting the at least one bias signal improves the function of the sensory cell. Way. The method of claim 41, wherein The neuro-plasticity is the central neuro-plasticity Way. The method of claim 41, wherein The neuro-plasticity is peripheral neuro-plasticity Way. In a method of improving neuro-plasticity of a subject, Inputting at least one bias signal into at least one sensory cell region of the subject while the subject uses sensory cells inside the sensory cell and is performing a pre-defined physical activity related to the sensorimotor performance to be enhanced step Including, Wherein the inputting of the at least one bias signal improves the function of the sensory cell and the at least one bias signal is generated and input by a system for enhancing sensory motor performance, wherein the system is at least one signal. A wearable device to which the input device is repositionably fixed and a signal generator for communicatively coupling with the at least one signal input device and for generating the bias signal Way. The method of claim 44, The neuro-plasticity is the central neuro-plasticity Way. The method of claim 44, The neuro-plasticity is peripheral neuro-plasticity Way. In the method of increasing the growth hormone release of the test subject, Inputting at least one bias signal into at least one sensory cell region of the subject while the subject uses sensory cells inside the sensory cell and is performing a pre-defined physical activity related to the sensorimotor performance to be enhanced step Including, Wherein inputting the at least one bias signal improves the function of the sensory cell. Way. In the method of increasing the growth hormone release of the test subject, Inputting at least one bias signal into at least one sensory cell region of the subject while the subject uses sensory cells inside the sensory cell and is performing a pre-defined physical activity related to the sensorimotor performance to be enhanced step Including, Wherein the inputting of the at least one bias signal improves the function of the sensory cell and the at least one bias signal is generated and input by a system for enhancing sensory motor performance, wherein the system is at least one signal. A wearable device to which the input device is repositionably secured and a signal generator for communicatively coupling with the at least one signal input device and for generating the bias signal Way.