RU2123803C1 - Device for diagnostics of crus triceps functional state - Google Patents

Abstract

FIELD: traumatology, orthopedics, surgery; neurology. SUBSTANCE: device has appliance for fixing the limb in middle physiological position, in hip and knee joints. Device also includes bearing area for fixing the foot, force transducer, transducer in the form of receiver-accelerometer, and turning mechanism. Device allows positioning of limb at different angles in ankle joint in fixed middle physiological position, in hip and knee joints. It also allows performance of examination during application of recorded static load on foot flexors and during vibration effect, as well as when taking information in resonance condition directly from limb segment section being examined. EFFECT: objective estimation of crus triceps functional state, enhanced efficiency of treatment process. 4 dwg

Description

 The invention relates to medicine, namely to devices for diagnostics, and can be used for functional research in traumatology, orthopedics, surgery, neurology, sports medicine, in the process of rehabilitation, for professional selection, research in the physiology of work, sports, examinations of working capacity, etc.

 There is a method of studying the biomechanical properties of the lower extremities by the method of vibration tests (A.S. Aruin, V.M. on problems of biomechanics, volume 4. Medical biomechanics. - Riga, 1979. - P. 36-37), which describes a device for vibration testing of the lower extremities, with which the amplitude-frequency characteristics (AFC) of various segments were determined bodies with vertical vibrational excitation. The subjects were located on the table of the VEDS-400 electrodynamic vibrator, excited by a harmonic signal in the frequency range 2-70 Hz at a vibration speed of 0.02-0.1 m / s. The constancy of the level of excitation was maintained by a feedback system. Oscillations of the vibrator table, as well as forced vibrations of the human body, determined in the distal part of the lower leg, knee joint, in the sacrum, interscapular region (at the level of 4 thoracic vertebrae) and on the subjects' heads, were measured using RFT piezo-accelerometric sensors.

 The well-known "Method of research of the foot" (MKI A 61 B 5/00 AS 584842, BI N 47, 1977), which describes a device for studying the depreciation (spring) properties of the foot. To do this, when implementing the method, the foot is placed on the vibrator platform, an electric signal is supplied from the generator in the form of sinusoidal oscillations, the signal passed through the foot, which is subjected to vibration, is recorded using an induction-type acceleration sensor, and a signal of the same type is transmitted to the recorder.

Significant disadvantages of the known device are:
1) the inability to study the state of the triceps muscle of the leg in the process of a given and controlled static effort;
2) the impossibility of studying the state of the muscle at various angles of flexion in the ankle joint;
3) the inability to produce vibration directly on the Achilles tendon;
4) the inability to conduct a study of the muscles of the lower limb in a position where the antagonist muscles balance each other;
5) lack of information about the resonant states of the muscle.

 The device described in this method is the closest in technical essence to the proposed one, the purpose of which is to increase the efficiency of the recovery process, reduce the time and improve the results of treatment of damage and diseases of the triceps muscle of the leg.

 We propose a device with which it is possible to achieve the following technical result, which consists in obtaining quantitative indicators of the functional state of the triceps muscle. This is achieved by a combination of general qualities: a device for conducting vibrational effects and analyzing the resonant frequency and distinguishing features: a device for functional research additionally includes devices for giving the limbs different angles in the ankle joint with a fixed physiological position in the hip and knee joints, for recording static load on the flexors of the foot and vibration exposure and removal of information about the resonant state directly with the studied range of a limb segment.

 In FIG. 1 shows a block diagram of a vibration stand for studying the condition of the musculoskeletal system. The stand contains a platform on which the vibrator (1) is fixedly mounted, a tire for fixing the limb in its average physiological position (2), located on a metal rigidly fixed couch (3), a support platform (4) and a load cell (5) (for signal measurement on the distal part of the foot.The foot of the subject (6) is installed on the platform and fixed with straps, the platform has a rotary mechanism (7), the axis of rotation of which coincides with the axis of the ankle joint (8) to change the position of the foot. The oscillations are carried out perpendicular to the axis of the Achilles tendon by an electrodynamic vibrator (1) by means of a rod (9) equipped with a vibro-conductor (10). The frequency and amplitude of the forced vibrations are changed by means of a sound generator (11) and a power amplifier (12). ) attached to the Achilles tendon next to the indicator by means of a self-locking tape. The parameters of the oscillatory process, including the resonance state of the muscular-tendon complex, are fixed For preliminary amplification (14) of the signal from the vibration receiver with a vibration meter (15), an oscilloscope (16) and a recorder (17). The general control and automation of vibration tests, statistical analysis, calculation of dissipative characteristics and the decision made on the test results are assigned using standard DACs, ADCs (18) to a computer (19) and an algorithm for extreme amplitude regulation.

 The device is used as follows. The examinee is laid on the couch, the limb is placed on the tire (2) and fixed with straps at the level of the thigh and on the supporting platform for the foot (4). In the projection of the middle third of the Achilles tendon (lower third of the lower leg) with a self-locking tape, a vibration receiver-accelerometer is fixed, next to it with a normalized load on the tendon is a vibroconductor. Research can be carried out with any position of the foot and any static force developed by the flexors of the foot.

We give examples of the use of the proposed device for the diagnosis of functional studies of the triceps muscle of the leg:
1. Patient Sh., 55 years old, 20 years ago was operated on for a subcutaneous rupture of the Achilles tendon of the left leg, a suture was made. On the day of the examination no complaints. The examination revealed flexion-extensor myotendogenic contracture of the ankle joint with a movement amplitude deficit of 15 degrees.

 The patient is laid on the couch (3), the leg is placed on the tire (2) and fixed with straps at the level of the thigh and on the supporting platform for fixing the foot. A piezosensor is fixed in the projection of the middle third of the Achilles tendon with a self-locking tape; next to it, a vibro-conductor is installed on the tendon with a normalized load. A resonance curve was recorded in the position of the foot at an angle of 90 degrees with respect to the lower leg. Then the vibration effect was carried out in the position of passive extension of the foot at an angle of 20 degrees and passive bending at an angle of 40 degrees.

 The studies revealed (Fig. 2) that the amplitude-frequency characteristics (AFC), indicating elasticity and tonus of the triceps muscle of the previously operated limb (Fig. 2b), differ from the healthy one (Fig. 2a). With passive flexion and extension of the foot, the shape of the curves characteristically changes, which is a consequence of the presence of scar tissue in the region of the Achilles tendon and trophic changes in the triceps muscle of the leg.

 2. Patient K., 30 years old. Examined 4 weeks after injury - subcutaneous rupture of the Achilles tendon (Fig. 3A). The examination procedure was similar to that given in 1 clinical example. After the conduction anesthesia of the sciatic nerve was performed (for the operation), the curves changed significantly (Fig. 3b) - the resonance amplitude decreased sharply, which indicates atony of the triceps muscle.

 3. Surveyed M., 35 years old. Almost healthy. The examinee is laid on the couch (3), the leg is placed on the tire (2) and fixed with straps at the level of the thigh and on the supporting platform for fixing the foot. A piezosensor is fixed in the projection of the middle third of the Achilles tendon with a self-locking tape; next to it, a vibro-conductor is installed on the tendon with a normalized load. The resonance curve was recorded in the position of the foot at an angle of 90 degrees with respect to the lower leg and the development of the foot force on the platform with a force of 10 kg (Fig. 4 - 1). Then the vibration effect was carried out in the same position of the foot under pressure of its front section on the platform with a force of 20 kg (Fig. 4 - 2). The frequency response analysis of curves 1 and 2 in FIG. 4 shows that an increase in muscle tone with the development of effort leads to a decrease in amplitude and an increase in resonance frequency.

 Statistical analysis of the data of examination of persons without pathology of the triceps muscle of the tibia showed that the position of the foot significantly affects the frequency at which resonance occurs, and the dissipative properties of the system do not change significantly.

When using the proposed "Device for diagnosing the functional state of the triceps muscle of the leg" the following positive effects are provided:
1. The device provides an assessment of the functional state of the triceps muscle of the leg in dynamics.

 2. The device allows you to evaluate the dynamics of the mechanical characteristics of the Achilles tendon.

 3. The device allows you to take into account the quantitative dynamics of the amplitude-frequency characteristics of various sections of limb segments.

 4. The device allows you to study the resonant state of the tendon and muscle at any position of the foot.

 5. The device allows you to study the resonant state of the muscle under controlled various strength of their contraction.

 6. The use of the proposed device is possible in any conditions of inpatient and outpatient services of practical medicine.

Claims (1)

 A device for diagnosing the functional state of the triceps muscle of the lower leg, comprising a platform with a fixed vibrator connected to the generator, sensors for measuring the signal on the distal foot and lower third of the lower leg, the last of which is connected to a recording device, characterized in that the device is equipped with a reference platform for changing position and fixation of the foot with a rotary mechanism, the axis of which coincides with the axis of the ankle joint and splint for fixing the limb in its average physiological position while the first of the sensors is made dynamometric, and the second in the form of a vibro-accelerometer, mounted on the Achilles tendon next to the vibrator.

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