RU2698587C2 - Complex for treating locomotor diseases - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medical equipment, namely to complexes for treating locomotor disorders in children. Complex comprises diagnostic unit (1) and therapeutic unit (2). Diagnostic unit comprises frequency generator (3) with pitch of 1 Hz, computer (7), a resonance state detector and a resonance state recording system. Therapeutic unit comprises musical centre (9) and apparatus for vibration exposure on the patient. Program is installed in diagnostic unit in computer and performs spectrum analysis. Monitoring of resonance frequency, at which the analysed bone segment resonates with the generated frequency, is performed by means of a program. Resonance state detector is vibration sensor (4). Resonance state recording system comprises signal amplifier (5) and digital card (6) connected to the vibration sensor and a computer. Therapeutic unit additionally consists of a generator of mechanical vibrations (10), a device for applying resonant frequency on mechanical vibrations (11), simulators for action on lumbosacral region (13), femoral (14) and calcaneal bones (15). Devices for applying resonance frequency on mechanical vibrations are connected with vibroacoustic transducers (12) of simulators by signal transmission channels. Training apparatus are equipped with vibroacoustic transducers. Mechanical vibration generator is configured to provide vibrations with frequency corresponding to the audio frequency contained in the musical fragment. Vibroacoustic transducers are configured to produce a resonant frequency for a defective bone.

EFFECT: providing a complex of equipment for vibration resonance therapy of the locomotor system of a child for higher clinical effectiveness by reducing the length of vibration exposure and enlarging the scope of application.

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Description

The invention relates to medicine, namely to neuropathology, more specifically to devices for non-drug rehabilitation of children with disorders of the musculoskeletal system (OA) and the consequences of damage to the central and peripheral nervous systems (cerebral palsy, prenatal and postpartum lesions of the central and peripheral nervous system, residual effects of encephalitis, meningoencephalitis, peripheral paralysis, paresis, etc.).

Currently, for the treatment of certain diseases of the musculoskeletal system of children, a large number of different methods of exposure (massage, acupuncture, etc.), complexes of dynamic exercises and simulators are offered. (Semenova K.A. Cerebral Palsy. M: Medicine, 1981, p. 38-101; RU 2070816, 1994; RU 2000089, 1991;). However, these methods are characterized by relatively low efficiency and relatively long rehabilitation period.

One of the promising areas of treatment in recent years has been the use for these purposes of vibration exposure to the patient's body as part of monotherapy, and as an element of complex therapy.

So, it is proposed for the treatment of scoliotic disease of the spine (RU 2104684, 1998) to carry out vibration action on the spine with a frequency of 10-50 Hz, an amplitude of 1-5 mm in combination with isometric tension and muscle relaxation for 5-10 seconds. The duration of the treatment session is 2-3 hours. Vibration is combined with manual therapy, therapeutic massage, electromyostimulation, thermomagnetotherapy, X-ray therapy, diet therapy, psychotherapy and medical lifestyle correction. The course of treatment is several months for 15-20 sessions per month.

A known method of treating scoliosis in children (RU 2241505, 2004) using a vibration stimulus against the background of exposure to the spinal region of biological feedback and infrared laser radiation. Vibration exposure is carried out at a frequency of 10 Hz along the spinal roots along the entire length of the spine for 3 minutes per segment of the spine. The procedures are carried out daily for 1.5 hours, the course of treatment is 15 days.

The disadvantage of the above devices is the limited scope, in particular, the lack of impact on bone growth rate, as well as a minor healing effect of vibration procedures on the patient, which requires a complex effect of various procedures.

Vibromassage of the germinal zones of shortened limb segments for 3-5 minutes at a frequency of 25 Hz is used to lengthen the child's limbs against a therapeutic dosed walk and massage of a shortened limb (RU 2158122, 2000).

This technology allows to achieve limb lengthening by only 2 mm, that is, it is not very efficient.

Along with using therapeutic effects as an element in complex procedures, vibration is widely used in various simulators designed to train muscles and treat individual pathologies. In particular, there are a large number of various simulators for the treatment of diseases of the spine and lumbosacral region.

So, it is known (RU 2408354, 2010) a simulator based on a vibroplatform performing a three-dimensional motion cycle. In this case, the patient performs exercises that have a reflexive force or relaxing effect on the skeletal muscles. The oscillation frequency of the platform is 25-50 Hz. The duration of one session is 10-15 minutes. The disadvantage of these simulators is the practical inapplicability for the treatment of sick young children.

A known simulator (RU 4464, 1991), containing a vibration device associated with a table mounted with the ability to move relative to the support racks and having a means of fixing a person. In this case, the person is placed on the table upside down and held in this position by means of a fixation tool connected to his legs. The main disadvantage of the simulator is its low efficiency for the treatment of children with lesions of the musculoskeletal system, in particular, due to the lack of choice of the optimal mode for vibrational effects on the spine. In addition, such vibration devices affect limited areas of the human body without taking into account the nature of the load distribution. At the same time, simulators aimed at normalizing the shape and size of a number of bones, in particular, the child’s calcaneus, are practically absent.

Numerous simulators affecting the foot, as a rule, are aimed at normalizing the internal organs of a person through acupuncture points. So, it is proposed (RU 2337663, 2008; RU 59974, 2006) to use a massage mat having massage protrusions and irregularities located on the surface, for example, porous pebbles mixed with elements of permanent magnets, nodules, etc.

However, these simulators are not suitable for children with underdeveloped calcaneus and practically do not affect its development.

Of the other simulators, the Lotos orthopedic simulator (RU 2307640, 2007), previously developed by the patent holder, should be noted, in which the base is equipped with a vertical support, a seat, a set table and tubes for fixing the knees, and the legs are fixed by the installed fixing module in the form of a half cylinder, which consists from a vertical stop made in the form of a half cylinder and a horizontal stop equipped with devices for mounting it on the base. The disadvantage of the device is the need to place the child in the simulator for at least 2-3 hours a day, which is quite difficult for a sick child, as well as the lack of effectiveness of this effect.

A common disadvantage of the known simulators is that they do not take into account the specific state of the bones of a particular child, which does not allow for effective treatment using vibration.

The closest in technical essence and the achieved effect to the claimed invention is the previously developed by the author and successfully implemented in the Regional charity fund "Rehabilitation of the child. Center G.N. Romanov" audio-resonance technology for the treatment of diseases of the ODA (RU 2367381, 2009). The technology was based on the fact that collagen cells of bone tissue are filled with calcium hydroxyphosphate (hydroxyappatite), which has the qualities of a piezoelectric effect and pyroelectric effect (Mechanisms of bone tissue regeneration. Sat. M .: Medicine, 1972, p. 40.). In the course of the research, equipment was developed and a methodology for interpreting the obtained results was created to determine the vibration frequency that is optimal for affecting a specific femur of a particular child in order to create resonance in piezoelectric bone crystals, and a complex of equipment was designed that allows acting on this femur during treating a child.

The developed complex consisted of a diagnostic unit and a treatment unit. The diagnostic unit included a frequency generator with a step of 1 Hz, associated speakers with the same dynamic level equal to 6 decibels, a pickup installed at a distance of 1 cm from the measured area and connected to a computer for real-time recording, an oscilloscope and a spectrum analyzer, allowing to display changes in amplitude fluctuations transmitted directly from the pickup, as well as a temperature sensor located as close as possible to the skin surface of a fragment of the studied bone, a change in temperature which indicates the occurrence of resonance and allows you to fix the resonant frequency.

The treatment unit includes a music center that selects musical fragments containing the set frequency, sound-reproducing equipment, through the speakers of which, located as close as possible to the patient’s femur, which is affected, musical fragments with microfiched frequency that cause resonance in the bone defective limb.

This technology allowed for the growth of the femur up to 2 mm per week and allowed to extend the leg to 2-3 cm.

The disadvantage of the technology and the equipment used was the duration of the daily session for at least 3 hours for 20-30 days, which caused difficulties when working with the child. In addition, as the experiments showed, the effectiveness of the therapeutic effect required expanding the spectrum of the effect of vibration on other fragments of the OAA, in particular, on the pelvic zone and calcaneus, the underdevelopment of which made it difficult for the child to move even with normalization of his thigh bones. However, the transfer of the above technology to other defective bones did not allow for a sufficiently clear fixation of the resonance frequency, in particular due to masking of the signal surrounding the soft tissue of the bone, and thereby to carry out an effective effect on the bone tissue.

The technical task of the claimed invention was the creation of an improved complex used for vibroresonant therapy of an OA for a child's equipment in order to increase the effectiveness of treatment, in particular, by reducing the time of vibration exposure and expanding its scope.

The technical result was achieved as a result of the creation of a complex of equipment, which includes diagnostic and treatment units, in which, in addition to a frequency generator with a step of 1 Hz, in the diagnostic unit, a resonance state registration sensor and a resonance state registration system, including a computer in which a program that analyzes the spectrum, with the help of which the resonance frequency is monitored, and a seismic sensor is used as a sensor for recording the resonance state, as In the system for registering a resonant state, the unit contains a signal amplifier and a digital card, and a treatment unit containing a digital music station and vibration exposure equipment, which further comprises a mechanical vibration generator, a device for applying a resonant frequency to mechanical vibrations associated with vibroacoustic transducers of simulators, and simulators for impact on the sacrospinal-sacral zone, femurs and calcaneus, equipped with vibroacoustic transform firs capable of producing a resonant frequency for a given defective bone. The monitoring algorithm is given in Appendix 1.

Using a digital musical station as a musical center allows you to precisely observe harmonic relationships for a given sound frequency, or “masked” into a piece of music that is comfortable for listening with an unsaturated density of the sound palette.

It is possible to use, along with the seismic sensor, additionally as a thermal sensor of an infrared thermometer, but it has a control (optional) character.

A feature of the claimed complex is the possibility of influencing the bone tissue of a patient’s limbs with a combination of a mechanical carrier frequency with a resonant frequency mixed in a musical fragment. In this case, VLPs are used that can affect the body with a frequency significantly higher than that used when using analogues. In this case, various simulators are used, capable of transmitting a resonating signal to the bone of a particular patient.

The general scheme of the complex is shown in FIG. 1, where the following notation is used: diagnostic unit 1; treatment unit 2; low frequency generator (LFO) 3; seismic sensor 4; signal amplifier 5; sound card 6; computer 7; infrared thermometer 8; digital music station (CMS) 9; mechanical frequency generator (GMC) 10; frequency overlay device 11; vibroacoustic transducer 12; a simulator for acting on the lumbosacral zone 13, a simulator for acting on the femur 14 and a simulator for acting on the calcaneus 15. In FIG. 2 shows a General view of the simulator 13, where the following notation is used: wooden vibration platform 16; support 17; VAP 12; VAP mount 18.

A general view of the simulator for influencing the femur 14, which received the code name "Lotus-M", is shown in FIG. 3. The simulator is an angular orthopedic seat, consisting of side supports 19 and the base 20; vertical support 21, retainers of the body 22, seat 23; a module for fixing the legs 24, a vertical stop 25, a horizontal stop 26, self-supporting tubes 27; stage 28 and vibroacoustic transducer 12.

A drawing of a simulator for acting on the calcaneus 15 is shown in FIG. 4, where the following designations are used: foot area 29; vibroacoustic transducer 12; surface 30; stand 31; support 32; holder for VAP 33; patient seat 34.

The complex consists of the following parts: diagnostic unit 1 and treatment unit 2. Diagnostic unit 1 is designed to establish the resonant frequency of a particular bone of a given patient. It includes an LFO 3 with a step of 1 Hz with speakers, a miniature vibration transducer (vibration sensor) 4 connected to an amplifier 5, which is connected via a sound card 6 to a computer 7, where a program is installed that performs spectrum analysis, which is used to monitor resonance frequencies. Diagnostic unit 1 may also include an infrared thermometer 8.

Treatment block 2 is designed to generate a therapeutic vibrational signal and its therapeutic effect on a patient placed in an appropriate simulator. The treatment unit 2 includes a CMS 9 connected to a computer 7, a HMC 10, and the CMS 9 and a HMC 10 are connected by signal transmission channels to a frequency superimposing device 11, which in turn is connected to a VAP 12 simulators 13-15 using signal transmission channels or other known methods (for example, floppy disks or flash cards with recording information, etc.).

As a simulator 13, acting on the lumbosacral zone of the spine, a vibroplatform 16 made of wood mounted on legs 17 is used, and the vibroacoustic transducer 12 is placed under the center of the platform 16 using the VAP 18 mount.

As a simulator acting on the femur of the patient 14, a modification of the Lotus simulator is used by placing in the simulator at least one vibroacoustic transducer 12 in the simulator of the patient’s hips, producing acoustic vibrations with frequencies that create resonance in the patient’s femur to which it adjoins . (The resonant frequencies for each specific bone are usually different). The simulator is an angular orthopedic seat, consisting of side supports 19 and the base 20; vertical support 21, retainers of the body 22, seat 23; a module for fixing the legs 24, a vertical stop 25, a horizontal stop 26, insert tubes 27; table 28 and vibroacoustic transducer 12. Installation of one or two VAPs 12 on the simulator is determined by the indications for this patient.

The simulator for acting on the calcaneus bones 15 is made in the form of a footrest 29, consisting of two surfaces 30 interconnected by struts 31 mounted on supports 32, and under the upper surface a vibroacoustic transducer 12 is installed using the device 33, producing acoustic vibrations with a frequency , creating a resonance in his calcaneal bones of this patient. The simulator, as a rule, is supplemented with a seat for the patient 34. The upper cover of the stand, as a rule, is made transparent, which makes it possible to better fix the position of the child's legs relative to the vibro-acoustic transducer 12.

The complex works as follows. The patient is placed on the couch and installed on his body in the corresponding zone (lumbosacral zone, thigh, heel) of the patient's vibration sensor 4 connected to amplifier 5. The signal from amplifier 5 goes to the sound card 6, which digitizes the signal and sends it to the computer 7, where the program performing the spectrum analysis is installed, with the help of which the resonance frequency is monitored. Next, using a low-frequency generator 3 generate a signal that is reproduced through the speakers. A change is made to the LFO 3 frequencies in increments of 1 Hz, until the level on the spectrum analyzer in computer 7 reaches a peak value, which indicates that the studied area of the bone has entered resonance with the generated frequency. To control measurements, temperature changes in the area of the test bone are additionally monitored using an infrared thermometer 8, and the frequency at which a temperature increase is observed (pyroeffect) is recorded as the resonance frequency. Based on the selected resonant frequency, a sound fragment is created in the CMS 10, in which the found resonant frequency is “masked” into a musical fragment and then superimposed on the basic mechanical vibrations of the HMC 9 using device 11. The signal then goes to the VAP 12 simulators for affecting bone tissue. During this exposure, it becomes possible to actively influence the quality indicators of the dynamic electrical potentials of bone tissue, which are considered as mechanoelectric transducers that are directly or indirectly involved in the processes of physiological and reparative regeneration.

Simulators work as follows.

During the treatment session, on the impact on the spinal column, the child is seated on a vibrating platform 16 in a Turkish position with a straight back resting on the ischial tubercles, in the center of the vibrating platform with maximum proximity to VAP 12. VAP 12 is vibrated with the found frequency. Session time 20-30 minutes. The frequency of the procedure is 5 times a week. The treatment in 44 children in 2016 showed that when using this simulator, the patient’s treatment time is reduced by 15-20% compared to children who have not previously been given this procedure

The method of using the simulator "Lotus-M" 14 is as follows. The patient is placed in the simulator with his back to the vertical support 21 in the “sitting in Turkish” position so that his pelvis is close to the support and the ischial tubercles are placed on the seat 23. The patient's body is fixed in the chest area on the support 21 with the help of fixation straps 22 Then, the legs of the patient are moved apart to the desired angle using the vertical stop 25 of the module 24, which is then fixed motionless on the base 20. Then, insertion tubes 27 are placed on the patient’s lap, onto which the table 28 is then installed with additional fastening one if necessary on the side supports 19. Then include one or both of the VAP 12 (according to the patient's testimony).

In total, 315 children with various diseases of the ODA were treated using the Lotus-M simulator. As studies have shown, with its use, the growth of tubular bones per week on average was 2 mm. At the same time, the time spent in the simulator decreased from a few hours to 20-60 minutes.

During the treatment session, to normalize the size and shape of the calcaneus, the child sits in the chair 33, placing the heel (s) in the center of the upper surface of the stand 29 at the maximum proximity to VAP 12, adjusting the position using the transparency of the upper surface 30. VAP 12 is vibrated with found frequency. Session time 20-30 minutes. The frequency of the procedure is 5 times a week.

The treatment carried out in 2016 of 94 children showed that in 6-8 weeks the calcaneus increases to a value characteristic of a given age of the child, which indicates the stimulating effect of this simulator on calcaneus growth

The treatment was carried out against the background of traditional methods of rehabilitation of children with disabilities ODA used in the Regional Charitable Fund "Rehabilitation of the child. Center G.N. Romanova. "

Bone growth was monitored periodically, usually weekly. In this case, the resonance frequency was specified in connection with a change in the length and size of the bone of the treated limb.

Depending on the characteristics of the child’s disease, the complex can be applied both sequentially when using all simulators, and when using one or two of them.

Industrial applicability of the method is illustrated by the following examples.

Example 1. Patient Matvey A., 2.5 years. Diagnosis: cerebral palsy, spastic-hyperkinetic syndrome. To stimulate an increase in the volume of the vertebrae in the lumbosacral spine, the method of inducing resonance in the vertebrae at the level of L1-S5 was used. To increase the growth rate of the calcaneus, the method of inducing resonance in the right and left calcaneus was used. To correct the length of the left femur, the method of inducing resonance in the left femur was used. The impact was carried out using a vibroacoustic transducer. The exposure time averaged 20 minutes per day for each exposure zone. Measurements were taken 1 time in 3 weeks.

The results of measuring the resonant frequency are given in table. one.

The results of measuring the length of the lumbosacral spine, thighs on the right and left, the sum of the distance from the calcaneal tuber to the supporting surface (height), the length of the vector running through the middle of the calcaneus and connecting the front and rear edges of the calcaneal supporting surface (length) and the length of the vector running through the middle of the calcaneus and connecting the inner and outer edges of the calcaneus (width) to the right and left are given in table. 2

Example 2. Patient Artem E., 12 years old. Diagnosis: cerebral palsy spastic-hyperkinetic form. To correct the length of the right femur, the method of inducing resonance in the right femur was used. Measurements were taken once every 2 weeks. The impact was carried out using a vibroacoustic transducer on the simulator "Lotus-M". The exposure time averaged 30 minutes per day. The results of measuring the length of the thigh on the right and left, as well as the resonant frequency are given in table. 3

Example 3. Patient Kirill F., 5 years old. Diagnosis: cerebral palsy left-sided hemiparesis. To correct the length of the left femur, the method of inducing resonance in the left femur was used. Measurements were taken 1 time in 10 days. The impact was carried out using a vibroacoustic transducer "Lotus-M". The exposure time averaged 20 minutes per day. The results of measuring the length of the thigh on the right and left, as well as the resonant frequency are given in table. four

Example 4. Patient Uma S., 9 years old. Diagnosis: Scoliotic disturbance of posture, right-side asymmetry, flat feet.

To correct the length of the right femur, the method of inducing resonance in the right femur was used. Measurements were carried out once a week. The impact was carried out using a vibroacoustic transducer simulator "Lotus-M". The exposure time averaged 20 minutes per day. The results of measuring the length of the thigh on the right and left, as well as the resonant frequency are given in table. five

Example 6. Patient Dasha B., 7 years old. Diagnosis: cerebral palsy spastic tetraparesis. Symptomatic epilepsy. To increase the growth rate of the calcaneus, the method of inducing resonance in the right and left calcaneus was used. The impact was carried out using a vibroacoustic transducer of the heel simulator. The exposure time averaged 30 minutes per day for each calcaneus. The results of measuring the sum of the distance from the calcaneal tuber to the supporting surface (height), the length of the vector running through the middle of the calcaneus and connecting the front and back edges of the supporting surface of the calcaneus (length) and the length of the vector running through the middle of the calcaneus and connecting the inner and outer edges heel bones (width) on the right and left, as well as the resonant frequency are given in table. 7

Example 7. Patient Artyom A., 2.5 years. Diagnosis: Congenital malformation of the central nervous system. Meningomyeloradiculocele of the thoracolumbar spine. Condition after surgical treatment. To stimulate an increase in the volume of the vertebrae in the lumbosacral spine, the method of inducing resonance in the vertebrae at the level of L1-S5 was used. Measurements were carried out once a month. The impact was carried out using a vibroacoustic transducer simulator. The exposure time averaged 30 minutes per day. The results of measuring the resonant frequency are given in table. eight.

In total, according to the claimed method, in 2013-2016. 315 children with various ODA diseases were treated. As studies have shown, when using the claimed method, bone growth per week on average was 2 mm, and the total bone growth during treatment was 15-20 mm.

Claims (5)

1. A complex for the treatment of disorders of the musculoskeletal system in children, including a diagnostic unit containing a frequency generator with a step of 1 Hz, a computer, a resonance state registration sensor, a system for recording a resonant state, and a treatment unit containing a music center and vibration equipment impact on the patient, characterized in that the diagnostic unit in the computer has a program that performs spectrum analysis, with which the resonance frequency is monitored, at which sleduemy bone portion comes into resonance with the generated frequency, as a sensor registering the resonance state is used in vibration sensor, the system comprises a registration resonance state signal amplifier and a digital map associated with a vibration sensor and a computer, and the treatment unit additionally consists of a generator of mechanical vibrations, a device for applying a resonant frequency to mechanical vibrations associated with vibroacoustic transducers of simulators by signal transmission channels, as well as simulators for influencing the lumbosacral zone, femurs and calcaneus equipped with vibroacoustic transducers, a generator mechanical vibrations is configured to provide vibrations with a frequency corresponding to the frequency contained in a musical fragment AUC, vibroacoustic transducers are arranged to produce a resonant frequency for a given defective bone. 2. The complex according to claim 1, characterized in that as a simulator for impact on the lumbosacral zone, a vibroplatform made of wood is used, mounted on supports, in which the vibroacoustic transducer is located under the center of the platform. 3. The complex according to claim 1, characterized in that an orthopedic simulator is used as a simulator for acting on the femur, including a base with a fixing module for the legs, a vertical support connected to the base, a seat, a table and insert tubes for knees, and at least one vibroacoustic transducer is installed under the table at the level of the hips. 4. The complex according to p. 1, characterized in that as a simulator for acting on the calcaneus, a simulator is used, made in the form of a footrest, consisting of two surfaces interconnected by uprights, and a vibroacoustic transducer producing acoustic fluctuations with a frequency that creates a resonance in the calcaneus of the patient.

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