RU2082378C1 - Method and device for imitating human walking and running in carrying out repair treatment of patients having various motor disturbances - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves exposing resting zones of foot to mechanical oscillations at frequencies (104; 52; 26) ± 5% Hz and magnetic field having frequency of 6-7 Hz gradually travelling from the calcaneal foot portion to the frontal toe tip portion. The time needed to switch following oscillation excitation unit is proportional to speed of patient walking and running. Personal computer is used as excitation parameter master device connected to mechanical oscillation and magnetic field vibroexciter units built-in into a matrix through coupling device. Control unit is made as a separate functional unit connectable to the personal computer through standard interface CENTRONIX. Working capacity of the device is supported by software providing all needed operation modes of the vibroexciter units and recording data on patients and descriptions of treatment methods applied to them. The control unit has single casing and the following parts: interface circuit (composed of 9 microcircuits, 8 operation amplifiers, 16 transistors, resisters and capacitors), network power supply source having transformer, two diode bridges, three transistors, resistors, stabilitrons, capacitors. All transistors are in common radiator having 300 cm² area. EFFECT: enhanced effectiveness of treatment. 6 cl, 13 dwg

Description

 The invention relates to medical devices and medical equipment and relates to devices for simulating the walking of a person in conditions of his limited mobility.

A known method of simulating walking in conditions of limited mobility, according to which the human body is connected to the support system by an elastic connection and reproduce short-term inertial-shock loads directed along the longitudinal axis of the body in order to overcome the elastic coupling forces [1]
It is also known a device for simulating human walking, based on dosed excitation by vibrators placed in the areas of the supporting zones of the plantar surface of the feet of a person. In accordance with a given program, the vibrators are turned on in the rhythm of the natural locomotor act of walking a person. The device complex includes platform soles with four vibrators on each and four pairs of external vibrators, which are strengthened by elastic cuffs: on the back of the thigh, on the front of the thigh, on the front surface of the lower leg and at the junction of the Achilles tendon in the calf muscle. A similar arrangement of vibrators is carried out on the right and left lower limbs [2]
The indicated method and device for simulating a person’s walking do not allow synchronization of muscle loads with the pace of walking, i.e. do not allow to simulate a locomotor act. In addition, with limited human mobility, the supporting zones of the feet are not affected by normal walking, when the supporting zones of the feet, Achilles tendon and other systems associated with motor functions are periodically excited in the rhythm of a person’s walking, the absence of excitation of mechanoreceptors ultimately leads to to violations of statokinetic regulation.

 The technical result of the invention is an imitation of a locomotor act, synchronization of muscle loads with the pace of walking and improving the rehabilitation effect.

 The technical result is achieved by the fact that the support zones of the feet are affected by mechanical vibrations and an oscillating magnetic field, and first they act on the heel support zones and gradually move to the forefoot of the foot, the impact on the support zones by mechanical vibrations is carried out with a frequency of (104; 52; 26) ± 5% Hz, with a magnetic field with a frequency of (6-7) Hz.

 The technical result is achieved by the fact that matrices of exciters of mechanical vibrations are located on supporting platforms, the cores of which are made in the form of permanent magnets and contain a core made in the form of a hollow cylinder connected to a dielectric movable core made of a dielectric material inside which the core is mounted with the possibility of movement made in the form of a permanent magnet, spring-loaded with a spring with a curved surface, and the natural vibration frequency of the die an insulating core refers to the natural frequency of the magnetic core as 1:12.

In FIG. 1 shows a diagram of the proposed device; in FIG. 2 - section of the vibration exciter; in FIG. 3 diagram of a memory tracking device (hereinafter, designations in the text); in FIG. 4 circuit analog-to-digital Converter; in FIG. 5 and 6 diagrams of an analog input module; in FIG. 7 is a diagram of a digital input-output module; in FIG. 8 spectral characteristic of the natural electromagnetic field in the Earth’s atmosphere; in FIG. 9 - averaged frequency characteristics of the oscillations of the needle at a biologically active point; in FIG. 10 threshold-frequency characteristics of Pacini bodies (designations in the text); in FIG. 11 threshold-frequency characteristics of Pacini bodies during vibration stimulation; in FIG. 12 comparative data on the influence of the excitation time on the threshold characteristics P / P _o depending on the frequency of excitation; in FIG. 13 appearance of the proposed device.

 The pulse rate and the value of muscle turgor are measured by sensors 1, 2 and converted into electrical signals, amplified by an amplifier 3, then using an active filter 4, unwanted components are removed from the signal (Fig. 1). The filtered signal enters through the analog multiplexer 5 to the tracking-memory unit 6. The use of the multiplier 5 allows the use of a single analog-to-digital converter (ADC) 7 for many channels in the time-sharing mode.

 The conversion of an analog value to a digital one always takes place over a finite period of time. During this period of time, the signal at the input of the ADC 7 must be kept constant. This function is performed by the tracking-memory unit 6, the output signal of which is proportional to the input signal until a memory command is followed, after which the output signal remains constant for the period of time necessary for converting the signal to digital form.

 An analog-to-digital Converter 7 converts the voltage level at the input to the corresponding digital value. Further, digital data through the interface interface circuit 8, 9 enter the common highway of a personal computer (PC) 10.

 From a personal computer 10 with a standard CENTRONICS interface, two reference platforms 11, 12 with matrix vibration exciters are controlled 13. The vibration exciter (Fig. 2) contains a housing 14 made of dielectric material (textolite), an excitation winding 15, the base 16 with a constant magnet 17 (samarium-cobalt). Inside the winding 15, a dielectric guide 18 is installed. It is mounted with the same poles to the permanent magnet 17 with the possibility of moving the permanent magnet 19. A hollow cylinder 20 made of dielectric material is coaxially mounted and connected to the dielectric guide 18. A core made in the form of a permanent magnet 2, spring-loaded with a spring 22 with a curved outer surface is mounted inside the hollow cylinder.

 Analog multiplexer 5 is made on MOS transistors (K590KT1). The resistance of the private key reaches thousands of megaohms, and in this respect it becomes close to the ideal key, which is in the open state. Compared to other semiconductor switches, both the field effect transistor with the pn junction and the MOS transistor are characterized by the complete absence of bias voltage in the open state. The public key in this case is similar to a linear ohmic resistor from several tens to several hundred ohms. Sources of errors for such keys are public-key resistance, leakage current, and transients.

The dynamic characteristics of an analog switch are determined by the switching time. This time for a key on MOS transistors is hundreds of nanoseconds. Under the influence of the parasite circuit of the analog input module is shown in FIG. 5 where P _d transmitter _EXAMPLE receiver T _en sign trigger DSHA, Y _ave address decoder and control signals SOP diagram polarity determination ADC analog-to-digital converter, WM control circuit and synchronizing the ADC, P _g D V _yv register output data, U amplifier, MS multiplexer, AK channel address. Consider the principle of its work. First, one of the input channels is selected using the "Record" program cycle. The address selector and decoder of the control signals generates an output signal “Output O”, which is used to record the address code of the selected channel coming from the microcomputer trunk to the output data register (bits D ₀₀ D ₀₃ ). From the output of the register, the code goes to the address input of the MC multiplexer MS. The voltage from the selected channel goes to the amplifier U and then to the ADC and the circuit for determining the polarity of the input signal of the SOP. The circuit for determining the polarity allows you to simplify the implementation of the ADC.

At the same time, the “Output O” signal triggers the ADC control and synchronization circuit. After the conversion cycle is completed, the signal "Transformation end" is set to 1 trigger T "Ready" (bit D ₁₀ ). Using the program cycle "Read" the state of the trigger "Ready" can be read by the microcomputer (enable signal "Enter 4"). The conversion result is also received in the PC 10 using the “Read” program cycle. In this case, the “Enter 2” enable signal is generated and the data code (D ₀₀ D ₀₉ ) and the sign code (D ₁₅ ) are transmitted to the microcomputer trunk via transmitters.

 To ensure galvanic isolation of the power supply system of the microcomputer and the measuring part of the module, an isolating power source is used. The galvanic isolation of the interface part of the module and its analog part is carried out using optoelectronic keys.

The analog output subsystem (Fig. 6) is based on the commercially available module 15KA-60 / 4-009. The module contains four parallel channels and is designed to convert digital data generated by a personal computer into a DC voltage. The module consists of receivers P _pr and transmitters P _d trunk, address decoder and control signals DSA and U _pr , data registers R _g D ₁ - R _g D ₄ , 10-bit DAC ₁ DAC ₄ , the voltage reference source E ₀ .

The address code A and the control signal Y _pr come from the PC 10 line through the receivers P _r to the address decoder and the control signals DSA and Y _pr , which generates one of the access signals to the selected register (Vyv). The data code (D ₀₀ D ₀₉ ) arrives at the information inputs of all the registers R _g D, however, recording is performed only in the selected register. From the outputs of the register, the code goes to the DAC, where it is converted to DC voltage. The digital and analog parts of the module are galvanically isolated using optoelectronic keys. The analog part of the module is powered by an insulating voltage source. The reference voltage source E ₀ produces two separate voltages: positive (+10.24 V) and negative (-10.24 V). Optionally, using jumpers, you can apply the corresponding reference voltage E ₀ to any of the DACs and obtain the voltage of the desired polarity at the output of the DAC.

Block tracking-memorization 6 (Fig. 3) takes the input voltage level at a precisely defined point in time and holds this voltage level at the input for the duration of one conversion of the ADC. The operation of tracking-memorizing devices is based on the principle of storing charge on a capacitor C (Fig. 3, 4). While the analog switch K _l is closed, the voltage across capacitor C exactly follows the voltage at the input. At the moment of opening the key, tracking stops and the voltage on the capacitor C remains constant and corresponds to the moment of opening the key. The input control unit ₁ and the output control unit ₂ buffer amplifiers are included according to the repeater circuit. The input amplifier BU ₁ prevents the bypass of the storage capacitor C input while the key is open. The output amplifier BU ₂ , having a high input resistance, significantly reduces the discharge rate of the storage capacitor C with the switch open.

Analog-to-digital Converter 7 (Fig. 4) is made according to the scheme of bitwise balancing, characterized by a speed of 50,000 conversions per second with a high resolution of 16 bits. His work is based on the principle of sequential comparison using a comparator of the input voltage and voltage produced by a digital-to-analog converter (DAC), which is part of the ADC (Fig. 4). The voltage is supplied to the comparator U ₁ , implemented on the chip K521CA3. At the other input of the comparator, the voltage produced by the DAC, consisting of a digital-to-analog converter U ₃ (K521PA1) and an operational amplifier U ₄ (K140UD6), is supplied. The main functions for implementing the bitwise balancing algorithm are performed by the sequential approximation register U ₂ (K155IR17). At the beginning of the conversion, level “O” (START signal) is applied to terminal 14 of register U ₂ , and positive signal is sent to terminal 13, on the leading edge of which the code 01111111111 is set on terminals 21 16, 9 5, and a voltage of 0 appears on the output 5 E ₀ . This voltage comparator U _{1 is} compared with the input voltage. The signal at the output of the comparator is fed to the data input of the register U ₂ (pin 11). Then, the control circuit produces another positive signal, which is fed to the synchronization input of register U ₂ (pin 13). In this case, the senior bit (pin 21) is set to the state in which the input of the register data is currently located (pin 11), and the next bit (pin 20) is set to 0. The synchronizing signals of the SS will be sent to pin 13 until at pin 5, 0 does not appear, which serves as a sign of the end of the conversion. At this moment, a code is read from the inverter outputs of U _5.1 U _5.10 , the numerical value of which corresponds to a given voltage.

 The system contains not only analog input and output quantities characterizing the heart rate and muscle turgor (using sensor 1, 2), but also digital values that allow the operator to set the simulated walking speed of the patient. In this case, the input signals represent the set walking pace. To pair these signals with the PC 10 they are previously converted to a standard level. Schmitt triggers and level coordinators are used as transforming circuits. V-structure field effect transistors (VMOS) are used as switching elements. As a basis for the construction of the digital I / O subsystem, the I215 KS-180-032 parallel exchange device was used.

 A simplified diagram of the device is shown in FIG. 7.

To transfer data from the computer to an external VU device, the address of the output register R _g V _yv and control signals U _pr and the receiver are fed to the address decoder and control signals DSA and U _pr , which, in turn, generates a permission signal "Pin 2". This signal is used to record data (Д ₀ Д ₁₅ ) in Р _г ДВ _Ыв (data at this moment are present on the information inputs of the register). From the findings of the register, the data goes to the communication connector of the PC with an external device WU.

If necessary, the data stored in the output register R _g DV _yv can be read out programmatically. For this purpose, the enable signal “Input 2” and the transmitters of the line are used.

 When entering data from an external device into a computer, the address of the input register and the cycle of the Read line are used. In this case, an enable signal “Input 4” is generated. Gate circuits of the transmitters are opened and the code from an external device enters the PC 10 trunk. Thus, with the help of the considered device, it is possible to organize the issuance of control signals to a monitored object, as well as to provide reception of discrete signals through input channels.

где l длина стопы пациента;
n число возбудителей в продольном направлении по длине стопы или число рецепторных точек;
V скорость переката стопы в фазе опоры.A method of simulating walking and running of a person and a device for its implementation are as follows. First, the muscle turgor and pulse rate are measured and their correspondence to the pace of walking is established. Then the patient (operator) sets his feet on the supporting platforms 11, 12, on which the matrix of vibration exciters are located 13. On the patient (operator), heart rate sensors and muscle turgor are installed and the system is turned on. From the sensors 1, 2, a signal is input to the system input, which is amplified by amplifier 3. Using an active filter 4, unwanted components are removed from the signal. The filtered signal is fed through an analog multiplexer 5 to a tracking-memory unit 6 to an analog-to-digital converter 7 and through interface circuitry they enter the common trunk of a personal computer 10 with a standard CENTRONICS interface, from which a system of exciter matrices is controlled by a specific program. When applying voltage to the field winding 15, the dielectric core performs reciprocating movements (oscillations) and acts as a hollow cylinder on the bodies of the Vater Pacini foot of the patient (operator). The role of the active spring for the dielectric core 18 is played by the repulsive force acting between the same poles of the permanent magnets 17, 18. Due to the fact that the resonant frequencies of the dielectric core 18 and the magnetic core 21 are related as 1 16, the magnetic core 21 begins to oscillate inside the hollow cylinder 20 with its frequency of mechanical vibrations and acts on the bodies of Vater Pacini, located in the supporting areas of the foot of the patient (design inversion is possible). In the matrix, the work of pathogens 13 is switched sequentially from heel to toe with a frequency corresponding to a simulated walking pace. The time of exposure to receptor points is proportional to the walking and running speeds of the patient and is determined from the ratio

where l is the foot length of the patient;
n the number of pathogens in the longitudinal direction along the length of the foot or the number of receptor points;
V the speed of the roll of the foot in the phase of support.

 To assess the required parameters of the impact on various zones of the foot, an experiment was conducted to measure the vibration frequency of needles inserted into biologically active points. In addition to the stimulation of support zones, the matrix provides for the possibility of stimulating biologically active zones of the foot in order to conduct therapeutic and preventive measures.

Theoretical calculations and experimental studies of the spectral characteristics of electromagnetic field oscillations (H field strength) of the Earth made it possible to establish the maximum amplitude of these oscillations recorded at frequencies of 6 7 Hz (Fig. 8). The data obtained correlate (And the amplitude of the oscillations) with the averaged frequency characteristics of the needle at a biologically active point (Fig. 9). With mechanical stimulation of the vibration receptor, it is essential to ensure that the rhythm of the receptor’s own biological activity coincides with the optimal frequency of mechanical stimulation (the phenomenon of biochemical resonance). The threshold frequency characteristics of Pacini bodies were obtained (Fig. 10). The curves show: 1 dependence of the generator potential on the frequency of sinusoidal mechanical stimulation, 2 period of excitability, 3 dependence of the relative threshold of excitation P / P _о on the frequency of sinusoidal vibration irritation, 4 - dependence of the threshold of irritation on the frequency of sound stimulation, 5 the same for receptors with punctured capsule.

 The threshold frequency characteristics of Pacini bodies during vibrational stimulation were also obtained (Fig. 11).

Abscissa axis stimulation frequency, ordinate axis relative thresholds P / P _o
1 characteristic of the receptor at t 27 ^o C,
2 the same at t 36 ^o C,
3 reaction of the decapsulated receptor.

Studies of the frequency characteristics of vibration receptors made it possible to establish that the resonance properties at a frequency f ₀ 102.5 104 Hz are clearly expressed in them. The resonant frequency delimits two regions of perceived frequencies at which a qualitatively different impedance arises in the receptors. The stimulus energy in the low-frequency region (f <f ₀ ) is spent on overcoming the elastic characteristics of the capsule, and in the high-frequency region (f> f ₀ ) on resistance to the forces of its inertia. A decrease in ambient temperature leads to a narrowing of the range of perceived frequencies. A vibroreceptor can be represented as a frequency filter, i.e., as a system that selectively picks up frequencies with a minimum energy loss in the range of 104 ± 5% Hz. The mechanical characteristics of the capsule and the cyclicality of ATP of the ATPase complex are responsible for resonance phenomena in the vibroceptor. When stimulating the vibroreceptor in the indicated frequency range, not only optimal excitation conditions are created that require minimal expenditure of applied energy, but the adaptation of the receptor occurs much later (Fig. 12). Acting on the Fater-Pacini bodies located in the supporting areas of the patient’s foot, successively from the heel to the toe, which, in turn, are connected with the internal systems of the body, providing the locomotor act with mechanical vibrations and a magnetic field with their frequency parameters, the effect of imitation of walking and running patients with excellent rehabilitation effect. So, the eleven-year tests of the proposed method and device for the rehabilitation of post-stroke and post-infarction patients at the clinics of the Department N 4 of the Ministry of Health of the Russian Federation allowed to reduce the time of their rehabilitation by 30 40%. The proposed method and device is also useful for healthy operators who lead a sedentary lifestyle, for example, computer operators, as a prophylactic that reduces patient inactivity.

Claims (6)

 1. A method of simulating a person’s walking and running for the rehabilitation of patients with various motor impairments, including exposure to receptor points of the support areas of the feet by mechanical vibrations synchronously with the pace of walking, characterized in that, simultaneously with mechanical vibrations, they are exposed to an oscillating magnetic field, and the combined effect is carried out with started on the heel support zones with a gradual transition to the toe of the foot.  2. The method according to claim 1, characterized in that the action of the oscillating magnetic field is carried out with a frequency of 6 7 Hz, and mechanical vibrations with a frequency of either 26 ± 5% Hz, or 52 ± 5% Hz, or 104 ± 5% Hz, this time of exposure to receptor points is determined from the ratio tl / nv, where l is the length of the foot, n is the number of receptor points, v is the rate of roll of the foot into the support phase.  3. A device for simulating walking and running of a person for the rehabilitation of patients with various motor impairments, including reference pads with matrices of exciters of mechanical vibrations associated with a driver of control signals synchronized with the pace of walking, characterized in that the causative agents of mechanical vibrations are equipped with cores in the form of permanent magnets installed with the possibility of movement, and the control signal generation unit is configured to control the magnetic oscillation frequency i.  4. The device according to p. 3, characterized in that in each of the causative agents of mechanical vibrations a permanent magnet is mounted in a hollow cylinder of dielectric material and is spring-loaded with a spring with a curved surface, while the cylinder is placed on a movable dielectric core.  5. The device according to claims 3 and 4, characterized in that the control signal generating unit includes a personal computer, the information inputs of which are connected to pulse sensors and muscle turgor values through a series-connected analog-to-digital converter, a tracking-memory unit, a multiplexer, an active filter and an amplifier, and the outputs of the personal computer are the outputs of the control signal generation unit.  6. The device according to claim 5, characterized in that for the treatment and prophylactic measures the personal computer is configured to control the inclusion of pathogens depending on the pathology of the patient.

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