RU2523346C2 - Device for assessing functional state of locomotor system - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medical equipment. A device for assessing the functional state of the locomotor system comprises a recorder for locomotor parameters. The recorder comprises weight sensors and a foot base plate supported by bearing elements with a sole imaging sensor placed under the plate and connected to a computer. The base plate is made of an optically transparent material, while the bearing elements are configured in the form of stands provided with weight sensors. Data outputs of the weight sensors are connected to the computer recording and displaying a sole image and centre-of-pressure position on each sole and the common centre-of-pressure of the soles in the same coordinate.

EFFECT: using the invention enables enhancing the device, reducing time costs for the examination, providing the higher accuracy of localising centres of pressure in relation to the soles by enabling the strategic combination of the computed plantography and stabilometric findings.

5 cl, 5 dwg

Description

The invention relates to medicine, namely to instrumental orthopedic diagnostics, is intended to obtain both plantographic and stabilographic data on the functional state of the musculoskeletal system of the patient’s musculoskeletal system and can be used for mass screening examinations of the population.

A device for performing stabilometry [1] is known, comprising a support platform mounted on the base using elastic elements with strain gauges fixed to them, a signal processing circuit, and a device that records the movement of a common pressure center (OCD). The elastic elements are made in the form of beams of rectangular cross section with blind and through holes and disk-like thickenings at the ends. The stabilizer allows you to register the movement of the patient’s common center of pressure (OCD) in a standing position and during movement, as well as the acceleration of the common center of pressure (OCD) in two directions. The stabilizer allows for functional diagnostics and to assess the damage to the musculoskeletal system, to determine the effectiveness of therapeutic measures. However, the stabilograph does not allow us to judge the exact position of the OCD relative to the position of the feet, since the examination does not record the position of the feet on the supporting platform. To place the feet on the platform, there is a marking on which the patient must place the feet, however, the accuracy of the feet is only visually controlled, which leads to inaccurate measurements.

A device for determining the functional state of the musculoskeletal system in the form of a computer planograph containing a stand for the patient being examined with a supporting surface for receiving an image of the test foot and a computer for processing the received image, characterized in that the stand for the patient being examined is hollow, the supporting surface of the stand includes an optically transparent area for the test foot, and a lodgement for a digital camera is made at the base of the stand, located so that the projection of the center of the camera lens is located in the geometric center of the optically transparent portion of the supporting surface [2].

The disadvantage of the above device is the inability to simultaneously examine two feet. To obtain an image of the other foot of the patient, turn 180 ° and repeat the study.

A known method for diagnosing the condition of the departments of the foot using a device made on the basis of a flatbed scanner. The method is carried out by recording the imprints of the plantar surface of the feet and subsequent image processing by the graphic-calculating method using a computer program that includes determining the state of the front, middle and rear sections of the foot. A distinctive feature of the method is that the patient stands with one foot on a flatbed scanner placed on the surface of the load receiving platform of electronic tensometric scales for static weighing, and with the other foot on a support platform located on the sides of the scanner and scales, and depending on the specified load on the foot, equal to 20, 50 and 80% of body weight, scan the plantar surface of the foot and simultaneously measure the height of its arch using a device for measuring the height of the foot [3].

The disadvantage of this device is that it does not allow you to examine the feet at the same time, but allows you to explore only in two stages: first, the patient sets the left foot on the scanner, the right on the support, then the right on the scanner, and the left on the support.

Closest to the proposed is the selected device as the closest analogue for assessing the functional state of the musculoskeletal system in the form of a planograph, containing a frame, a support plate for the feet made of frosted organic glass, characterized in that on one base there are scales connected to the frame by rotating mechanisms, a flatbed scanner is installed under the base plate of the device, and a table for the scanner, which has a lifting and lowering mechanism based on rotating eccentrics, is installed n on horizontal guides. [4]

A significant disadvantage of this device is the use of a matte base plate and the need for wetting the feet before examination to facilitate the processing of images of plantograms.

In addition, the use of two scales allows you to only visually control the load on the left and right feet when scanning the feet and does not allow you to determine the position of the pressure center, i.e. conduct stabilographic studies, and therefore, combine plantography and stabilometry data.

Moreover, such a device does not allow examining the feet at the same time, but only in two stages: first, the imprint of one leg is scanned, and then the scanner is moved under the other leg.

The invention is aimed at solving the problem of expanding the functionality of a device for assessing the condition of the musculoskeletal system (OAE), reducing time spent on research, improving the accuracy of determining the position of pressure centers relative to the position of the feet by providing the ability to quickly integrate the results of computer plantography and stabilometry.

The essence of the invention lies in the fact that in the device for determining the functional state of the musculoskeletal system, containing at least one recorder parameters of the musculoskeletal system, including weight sensors and supported by the supporting elements of the support plate for the feet with a fingerprint image sensor installed under the plate the sole surface of the feet connected to the computer, it is proposed to make the support plate of an optically transparent material, and the support elements to be made in the form toek provided with weight sensors, the weight sensor information outputs connected with a computer adapted to register and display simultaneously on a single system image imprint of the plantar surface of the foot and the coordinate position data of the center of pressure on each of the feet, and total pressure center stop.

The support elements in the form of racks can be equipped with means for adjusting the height, and the support plate is equipped with means for controlling the horizontal position.

Strain gages can be used as weight sensors. As an image sensor, a means from a number of can be used: a video camera, a camera or a scanner. The device may contain two recorders interconnected by means of position fixation, mainly in the form of a plate.

In the inventive device, the implementation of the base plate of an optically transparent material eliminates the need for wetting the feet before the examination, which simplifies and speeds up the examination process with high accuracy. The implementation of the supporting elements in the form of racks equipped with weight sensors, the information outputs of which are connected to a computer equipped with a module for comparing data on the position of the pressure center on each of the feet and the common center of the pressure of the feet with data on the load distribution within the feet, allows you to expand the functionality of the device to assess the condition of the musculoskeletal system (OAA) and reduce the time and material costs of determining the functional state of the OAA of the patient by simultaneously checking denominations of plantography and stabilometry, as well as to increase the accuracy of determining the position of the center of pressure in relation to the position of the feet and to provide the possibility of operational integration of the results of computer plantography and stabilometry.

The presence of means for adjusting the height and means of controlling the horizontal position of the base plate also improves the accuracy of determining the position of the center of pressure with respect to the position of the feet.

The ability to use load cells as sensors, and as an image sensor, means from a number: a video camera, camera or scanner, expands the functionality of the device.

The possibility of using two recorders in the device, interconnected by means of a position fixation tool, mainly in the form of a plate, makes it possible to accurately determine the position of the pressure center of each leg separately, i.e. conduct bilateral research and integrate plantography and stabilometry data. In addition, such a device allows you to explore the feet at the same time, while there is no need to move the scanner.

The figure 1 shows a General view in isometric of the proposed device for determining the functional state of the patient's ODE in the use of one registrar. The figure 2 shows a General view in isometric of the proposed device for determining the functional state of the patient's ODE in the use of two registrars. The figure 3 shows a block diagram of the connection of information sensors of the recorder to a personal computer. The figure 4 shows the results of the examination of the patient D., and the figure 5 shows the results of the examination of the patient P. in the option of using two registrars.

The figure 1 shows a variant of the device for determining the functional state of the ODE with one recorder 1, which contains a support plate 2 made of optically transparent material, for example, impact-resistant glass, with four support posts 3, which are equipped with height adjustment mechanisms, made, for example, in the form of adjusting screws 4. Under the base plate 1 is an image sensor, made in this case in the form of a flatbed scanner 5, the output of which is connected via a common bus to computer 7 directly governmental or through microcontroller (not shown in the figures). Weight sensors, made, for example, in the form of load cells 6, can be located both on the outer surface of each of the racks 3, and in the inner part of the racks 3. The information outputs of the load cells 6 and scanner 5 are connected via a common bus and a standard interface to a personal computer 7 directly or through a microcontroller (not shown in the figures). This option can be used when bilateral research is not required and it is enough to know the location of the common bcc pressure center. The use case of two recorders 1, shown in figure 2, is used for bilateral studies when it is necessary to know the location of the center of pressure of each leg separately. This option is preferred because it allows you to obtain information about the position of the center of pressure for the left and right legs separately, as well as to obtain a more accurate distribution of weight between both legs. In this case, to fix the relative position of the registrars 1, fixing means in the form of a fixing plate 8. A fixing plate 8 has four holes for accommodating adjacent adjacent posts 3 of the recorders 1.

The proposed device in the use of two registrars works as follows. Previously, one of the registrars 1, for example, used to examine the patient's left leg, is mounted on a stable floor. Racks 3, adjacent to the recorder 1, designed for the right leg, are installed in the holes of the fixing plate 8. Using the adjusting screws 4, adjust the height of the racks 3 and achieve a horizontal position of the support plate 2, for example, using a level (not shown in the figures). Next, a second recorder 1, designed for the right foot, is installed on the floor, so that the posts 3 adjacent to the posts of the first recorder 1 fall into the other two holes of the fixing plate 8. Using the adjusting screws 4, the support plate 2 of the second recorder 1 for the right foot is set horizontally.

During the examination, the patient stands barefoot on the support plate 2 of the registrar 1, placing his feet on different support plates 2 of the two registrars 1, and assumes the usual vertical position with the distribution of weight on both legs. According to the data coming from the load cells 6 through the microcontroller (not shown in the figures) to the information input of the computer 7, where the percentage distribution of the weight under the left and right legs is determined using the appropriate control program module, this information is continuously displayed on the computer screen 7 and the operator conducting examination, provides operational control of the uniformity of the patient’s weight distribution between the left and right feet. If necessary, the patient’s posture is adjusted to equalize the load on the feet. After that, the image of the feet is recorded using a flatbed scanner 5. The scan data is transmitted to a computer 7, where using the appropriate software module based on digital image processing using the image segmentation algorithm, the feet receive both the external contour of the foot and the border of the contact area of the foot (actually plantogram) by highlighting the difference in brightness of the contour at the border of the image of the foot and filling homogeneous areas within the foot. Upon completion of the scan, stop images are displayed on the computer screen 7 simultaneously with the image of the trajectory of the center of pressure attributable to the left and right legs separately and the common center of pressure of the OCD. This allows you to control the correct position of the feet on the support plates 2 and, if necessary, correct their position and re-scan the feet. After successful completion of the scan, the registration of stabilometric data from sensors 6 is started for a specified time interval (usually 30 seconds). When using one recorder 1, stabilometry is performed according to the classical scheme with the registration of the DLC. In the case of using two registrars 1, bilateral stabilometry is performed with registration of CD for each leg separately and calculation of the OCD. The computer 7 is configured to register and simultaneously display in one coordinate system the image of the footprint of the plantar surface of the feet and data on the position of the center of pressure on each of the feet and the common center of pressure of the feet with the formation of the reporting document.

Example 1. Patient D., aged 16, has a radiological diagnosis of idiopathic right-sided thoracic scoliosis of the fourth degree (Cobb angle 63 °) with left-sided structural anti-distortion in the upper thoracic region (45 °) and with left-sided structural anti-distortion in the lumbar region (Cobb angle 41 °). It also has survey data on a computer optical topograph TODP, according to which the balance of the body is slightly disturbed in the frontal plane with the torso axis tilted to the right by 0.98 ° and severely disturbed in the sagittal plane with the torso inclined anteriorly by 6.7 °, and is also severely disturbed in the horizontal plane with twisting the shoulder girdle relative to the pelvis counterclockwise by 8.6 °.

In order to clarify the diagnosis, an examination was performed on two stabiloplantographs. The protocol for examining patient D. is shown in Fig. 4 and includes images of the plantar surface of the left and right feet with statokinesiograms superimposed on them describing the deviation of CD for each foot, as well as the statokinesiogram of OCD (between the feet near the ordinate axis). In the upper left corner are the stabilometric parameters and the weight per left foot, and in the upper right there are the same parameters for the right foot. These parameters include: X, Y is the average value of the coordinates of the CD, weight is the average weight falling on the corresponding leg, Vx, Vy is the average value of the speed of movement of the CD in the transverse and longitudinal directions, and V is the average value of the total speed of movement of the CD. At the bottom of the survey protocol, the same parameters for DLC are given. Stabilometric data indicate that in patient D., the right foot is overloaded (53.11% of the total weight) and performs the supporting function, while the left foot performs (to a greater extent) the balancing function (for the left foot Vy = 6.26 mm / s, and for the right foot - Vy = 5.13 mm / s); also the CD at the right foot is moved anteriorly, and at the left foot - posterior to the OCD (the angle of rotation of the line connecting the CDs was 5.5 °), which is consistent with the presence of a rough turn of the shoulder girdle relative to the pelvis according to topographic data; OCD is located from the line connecting the external contour of the heels at a distance of 43.7% of the length of the feet, i.e. shifted anteriorly (normal position 38-39%), which is consistent with the presence of a strong torso anteriorly according to topographic data.

Example 2. Patient P., 12 years old without structural scoliosis, has examination data on a TODP computer optical topograph, according to which the torso balance is disturbed in the frontal plane with the torso axis inclined to the left by 2.37 ° and in the sagittal plane with the torso inclined anteriorly by 1.58 °, and also in the horizontal plane with the twisting of the shoulder girdle relative to the pelvis counterclockwise by 2.9 °. In order to test the method of stabilization, he was examined on two stabilography and the protocol of his examination is shown in figure 5. Stabilometric data indicate that in patient P., the right foot is overloaded (52.5% of the total weight) and performs the supporting function, while the left foot performs (to a greater extent) the balancing function (for the left foot Vy = 3.88 mm / s, and for the right foot - Vy = 2.82 mm / s); also, the center of the right foot is slightly moved anteriorly, and the left foot is posterior to the center of the center (the angle of rotation of the line connecting the central center was only 0.96 °), which is consistent with the presence of a small turn of the shoulder girdle about the pelvis counterclockwise according to topographic data; OCD is located from the line connecting the external contour of the heels at a distance of 41.0% of the length of the feet, i.e. shifted anteriorly (normal position 38-39%), which is consistent with the presence of topographic data less pronounced torso anteriorly than patient D.

The above examples indicate that the combination of two examination methods in one device: plantography and stabilometry makes it possible to register and display the trajectory of the CD movement for the feet and the exact position of the feet in a single coordinate system in one image, which opens up new, not existing, earlier possibilities in the study of functional conditions of the musculoskeletal system. In particular, it became possible to investigate how the position of the CD on the foot (according to stabilography) correlates with the load distribution within the foot (according to plantography). Comparison of the Position of the CD with the load distribution provides an increase in the accuracy of diagnosis of the state of the ODE.

Thus, the inventive device allows not only to expand the functionality and reduce the time and material costs for determining the functional state of the patient’s ODE by simultaneously conducting plantography and stabilometry, but also allows to increase the accuracy of determining the position of the pressure center in relation to the position of the feet and to provide the possibility of operational integration of the results computer plantography and stabilometry.

Information sources

1. STABILOGRAPH. Veshutkin V.D., Danilov V.I., Efimov A.P., Smirnov G.V. Patent for invention RU 2063168, published on July 10, 1996.

2. Computer plantograph. Solomin V.Yu., Solomin Vit.Yu., Fedotov V.K., Ignatiev Yu.T. Utility Model Patent RU 54751, published July 27, 2006

3. A method for determining the spring function of the foot using an increasing load. Gavrikov K.V., Perepelkin A.I., Mandrikov V.B., Vorobev A.A., Klauchek S.V. Patent for invention RU 2358650, published on June 20, 2009

4. Device for plantography. Russian S.V., Lvov S.E., Koryshkov N.A., Kuraev A.V. Utility Model Patent RU 12341, published January 10, 2000

Claims (5)

1. A device for determining the functional state of the musculoskeletal system, comprising at least one recorder of the parameters of the musculoskeletal system, including weight sensors and a support plate for the feet supported by supporting elements with an image sensor for imprinting the plantar surface of the feet connected under the plate connected to computer different the fact that the support plate is made of optically transparent material, and the support elements are made in the form of racks equipped with weight sensors, while the information outputs of the weight sensors are connected to a computer configured to register and simultaneously display in one coordinate system the image of the imprint of the plantar surface of the feet and data on the position of the center of pressure on each of the feet and the common center of pressure of the feet. 2. The device for determining the functional state of the musculoskeletal system according to claim 1, characterized in that the supporting elements in the form of racks are equipped with a means for adjusting the height, and the support plate is equipped with a means for controlling the horizontal position. 3. A device for determining the functional state of the musculoskeletal system according to claim 1, characterized in that strain sensors are used as weight sensors. 4. A device for determining the functional state of the musculoskeletal system according to claim 1, characterized in that the image sensor uses a means from a number: a video camera, a camera or a scanner. 5. A device for determining the functional state of the musculoskeletal system according to any one of claims 1 to 4, characterized in that it comprises two recorders interconnected by means of position fixation, mainly in the form of a plate.

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