RU2786989C1 - Method for training and quantifying finger motility and the functional state of the brain for controlling the coordinated movement of the fingers and a device for its implementation - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: group of inventions relates to the fields of medicine and developmental pedagogy, in particular to neurology and psychiatry, and can be used to restore motility in patients who have suffered an ischemic stroke or have coarse-motor disorders associated with brain and spinal cord injuries and other neurological pathologies of the upper extremities, as well as to prevent the appearance and slow down the development of dementia in the elderly and compensation for developmental delays in children. A device for implementing the method is proposed, and the method includes stages in which the fingers press the buttons of the console with the backlight on until it is turned off, and in each training cycle the right hand or the left hand or both hands are used simultaneously, and the number of buttons turned on in the range from one to five for each of the hands, the frequency and number of re-closures, the amount of the required force of pressing the button with a finger to turn off its backlight is assigned by setting the corresponding values of the listed parameters of the training cycle in the application program on a control-analyzing device electrically connected to the push-button console and implementing a multiply repeating random algorithm for turning on the backlight of the buttons, the assessment of finger motility and the functional state of the brain by controlling the coordinated movement of the fingers is carried out by a control-analyzing device based on the statistical characteristics of the arrays of time intervals between turning the buttons on and off with each finger according to the results of a separate training cycle and in dynamics according to the cumulative information stored in it about all personal training sessions, moreover, in order to expand the informative assessment of the functional state of the brain, training cycles are carried out using only the left eye or only the right eye, or both eyes at the same time.

EFFECT: group of inventions provides a reliable statistical assessment of finger motility and the functional state of the brain by controlling the coordinated movement of the fingers and make it possible to track the effectiveness of training and the dynamics of changes in important functional indicators of the human brain.

2 cl, 1 dwg

Description

The invention relates to the fields of medicine and developmental pedagogy, in particular, to neurology and psychiatry, and can be used to restore motor functions in patients who have had an ischemic stroke or have severe motor disorders associated with brain and spinal cord injuries and other neurological pathologies of the upper limbs , as well as to prevent the onset and slow down the development of dementia in the elderly and to compensate for developmental delays in children.

Human hands are closely connected with the brain. The connection of hands with the structure of the brain has long been known. About a third of the signals received by the cerebral cortex come from the fingers or are sent by them, as well as by the palms, up to 30% of the energy is spent by the brain on controlling the movement of the fingers. It has been proven that the thoughts and eyes of a child move at the same speed as the fingers, so systematic exercises to train the movements of the fingers are a powerful means of increasing the efficiency of the brain. The level of development of speech in children is always in direct proportion to the degree of development of fine movements of the fingers.

The Japanese doctor Yoshiya Hasegawa has researched and successfully uses in the practice of communicating with numerous elderly patients certain regular finger exercises to prevent and even treat senile dementia (Yoshiya Hasegawa. How to pump your brain with a light movement of your fingers. A unique Japanese method of training thinking, memory, attention, logic to prevent brain aging - Moscow: Eksmo, 2019. - 160 p.). As a result of human evolution, the commands coming to the hands from the brain became more and more complex, which, in turn, contributed to the incredibly complex adaptation of the fingers, which influenced the further development and complication of the brain. There is an interaction between our fingers and the brain. Today we can say that these processes went in parallel, mirroring each other. A special role is played by the human thumb, which has no analogues in the animal world. Keeping the activity of the thumb, we keep the activity of the brain almost at the same level as in youth. On the pads of the fingers are nerve endings associated with certain areas in both hemispheres of the brain. The more active the movements of the fingers of the hand, the more the brain is involved in capturing signals from their tips. The brain is recharged and its work improves

The right hand is mainly associated with the left hemisphere of the brain, which is responsible for abstract-logical thinking, oral speech, and digital information processing. The work of the left hemisphere forms a personality, in the left hemisphere there is a selection of information that accompanies a person in his life.

The left hand controls the right hemisphere of the brain, which expresses emotions, forms creative impulses, love and feelings, is engaged in intuitive, aesthetic, artistic activities, and is in charge of concrete-figurative thinking. The right hemisphere carries out the summation of intuitive experience.

The brain manages the human biosystem as an integral entity, functionally without separating the mental or physiological components of the body. And hands, palms and fingers help in this control and stimulate the brain, both physiologically and mentally. Therefore, part of the medical and psychological tasks relating to the entire human body can be solved using fine motor skills of the fingers. Among these tasks are improving the child's memory, attention, speech, spatial representations, reducing fatigue, increasing the ability to voluntary control, improving handwriting, increasing efficiency, activating intellectual and cognitive processes, expanding the reserve capabilities of the child's brain functioning. The active use of fine motor skills of the fingers has a certain potential in the rehabilitation of adults after injuries and strokes, for the prevention and slowing down of the development of senile dementia.

For this, weaving, stringing beads and rings, assembling mosaics, paper cutting are currently used, the movements of the first three fingers, which are usually active in everyday life, are used. The thumb, index and middle fingers, as well as the part of the palm adjacent to them and the motor field corresponding to them, are designated as the social zone of the hand. The last two fingers - the ring and little fingers - are outside the social zone and are usually passive in everyday activities, so many exercises do not involve them, although ignoring the ring finger and little finger in exercises reduces the effectiveness of training by a third.

To obtain the maximum effect, exercises should include isolated movements of each of the fingers, combinations of various group movements of the fingers, the need to apply dosed efforts when performing exercises using various communication channels between the brain and fingers with the possibility of obtaining statistical values of the selected criteria for assessing the functional state of a particular person.

It is known that repetitive active purposeful movements, and especially of the fingers, significantly contribute to the restoration of motor functions. In patients who have had a stroke, in addition to physical therapy, this approach has been implemented over the past 10 years in such methods as training in virtual reality, when patients learn movements based on feedback, and training in conditions where movements are facilitated by a robot (Chernikova L. A. Brain plasticity and modern rehabilitation technologies, Annals of Clinical and Experimental Neurology, 2007, 1(2):40-47). This makes it possible to actively include biocontrol in motor rehabilitation programs, organized by electromyogram and aimed at developing accurate finger movements in patients with mild and moderate paresis and impaired fine motor skills of the hand, but does not provide full-fledged rehabilitation in patients with gross motor disorders.

A well-known analogue of the claimed invention is an experimental study of fine motor skills of the hands using a digital graphics tablet (K.G. SELIVANOV. Experimental study of fine motor skills of the hands using a digital graphics tablet. - ISSN 2079-0023. Vyunik NTU "KhSh", 2012. No. 18 ( 991), pp. 137-143). The essence of the method is to study the individual characteristics of the fine motor skills of the hands of the subjects using the developed software tool when performing a series of sequential tests in the form of drawing linear lines on a digital graphics tablet with a wireless pen. The course of correction of fine motor skills of the hand includes tactile interaction of the patient with the touch panel of a digital graphics tablet through the patient's consistent performance of exercises aimed at developing hand motor skills and motivation for active purposeful activity. To do this, the patient touches the surface of the tablet panel with a finger at a given point and continues to move his finger along a given trajectory so that the color of the points of the trajectory line changes to a given one as the finger moves, indicating a positive exercise. The sequence of exercises - from simple movements to complex ones. When performing the exercise, the movements of the patient's hands on the panel can repeat the movements of the toothbrush in the oral cavity. The duration of the course is determined by the overall severity of the patient's condition and can be at least 22-30 days with a session time of 10-30 minutes. Classes are held 5 days a week. EFFECT: method provides effective rehabilitation of patients of this group with the formation of the required motor action as an exemplary (reference) during training of muscle groups involved in the implementation of complex movements that provide self-care for the patient. The possibilities of this method are limited by the lack of an objective numerical assessment of the functioning of the fingers when performing the proposed tasks.

Very similar to the described method, the invention according to patent RU 2616338 "Method for rehabilitation correction of fine motor skills of the hand" (IPC A61N 1/00/, A61M 21/02, priority dated 2015.12.14, published 2017.04.14), including a course of tactile interaction of the patient with the sensory panel of a digital graphics tablet. The aim of the invention is to train the patient, allowing him to serve himself without outside help, for example, when brushing his teeth. The disadvantage of the invention is the limited list of tasks to be solved.

Also known is the rehabilitation complex ArmeoSpring (Armeo Spring) (site on the Internet - http://mstvlespb.ru/armeospring), which offers an effective and modern rehabilitation program for the motor functions of the upper limbs for patients with strokes. Neurological research confirms that neuroplasticity provides compensation and the ability to restore lost limb function through intense, repetitive and task-oriented movements. The Armeo therapy concept increases the effectiveness of the rehabilitation program through functional, intense and targeted exercises. Patients, even with a significant loss of motor functions, can exercise in the presence of a general practitioner or instructor. Thus, motivation is stimulated and the patient's potential for recovery is increased.

The disadvantages of the known technical solution is the complexity of the equipment for the procedures and the need for the presence of an attendant.

A well-known analogue is the invention "Device for the development of motor skills of the fingers" "by patent RU 2290090 (MPK A61N 1/00, priority dated 2004.07.15, published 2006.12.27), including a spring mechanism in the housing for dosing loads on the fingers during their training. Its disadvantage is the lack of biofeedback for assessing the effectiveness and correction of training.

An analogue is also the invention "Method for rehabilitation assessment of the function of fine motor skills of the hand" according to patent RU 2712019 (IPC А61В 5/00, priority dated 2019.03.22, published 2020.01.24), based on the use of a tablet computer to test the patient's motor activity before and after conducting a course of treatment and including performing movements of bringing and spreading the fingers of the paretic hand with measuring the distance between the fingers applied to the surface of the touch panel of the tablet computer. The main disadvantage of the invention is that only the first and second fingers of the paretic hand are involved in training and evaluation, which significantly reduces the effectiveness of training and evaluation of hand motility function.

The closest technical solution to the claimed is the invention "Device for the restoration and development of the functions of the hands" according to patent RU 2617199 (IPC А61Н 1/00, А63В 23/16, priority dated 2014.04.09, published 2017.04.21), containing a hand trainer, a control object interacting with a hand trainer, strain gauges, a block for collecting and preprocessing information, a personal computer for collecting, processing and storing information, devices for visual and auditory communication and an adjustable means for accommodating a user, on which a hand trainer is fixed on at least one side . The distinguishing feature of the invention is the use of leaf springs with replaceable elements with different degrees of roughness and density at the free ends of the hand trainer to stimulate tactile receptors, and puppets of various designs as an object of control. The complexity of the device makes it almost impossible to use it for mass individual training. An additional disadvantage is the lack of a mechanism for a quantitative objective assessment of fine motor skills of the fingers and the related work of the brain.

The purpose of the claimed invention is to provide the possibility of mass, affordable and cheap training of fine motor skills of the fingers with the involvement of the corresponding structures of the brain and a constant objective quantitative assessment of the effectiveness of training and the functional state of a person. The goal in the proposed method of training and quantitative assessment of the motor skills of the fingers and the functional state of the brain to control the coordinated movement of the fingers and the device for its implementation, in contrast to the known analogues and prototype, is achieved by an objective numerical assessment of the dynamics of changes in the physiological parameters of fine motor skills of the fingers and of the functional state of the areas of the brain interconnected with the fingers based on the results of the technical and functional-methodological implementation of the complex of the following interconnected therapeutic and educational actions:

1. The specified number of stochastic inclusions (highlighting) by the application program of the control-analyzing device for one, two, three, four or five buttons of the consoles of the left or right hand or both hands together;

2. Fixing the switching off of the illuminated buttons and the time intervals between turning the buttons on and off with each finger involved;

3. Saving in the database of the program of time intervals of the reaction to turning off the backlight of the buttons in each cycle and for each finger;

4. Statistical processing of the received information arrays to estimate the reaction time of each finger when randomly illuminated buttons are turned off with the calculation of the mathematical expectation, plotting the change in these parameters over time, the deviations of these parameters in each training session from their average accumulated values;

5. Measuring the force of pressing a button with a finger or setting the necessary force to turn off the backlight from two or three possible values by adjusting the springs in the buttons;

6. Checking the influence of the visual channels on fine motor skills using a bandage or spectacle frame with drop-down blinds to close the right or left eye.

In FIG. 1 shows a diagram of a device according to the claimed invention. The control-analyzing device 1 with the application program is electrically connected by interface (wires) 2 with illuminated double buttons 3 of the console 4.1 for the left hand and the console 4.2 for the right hand through a detachable connection. In FIG. 1 the button console 4.1 is shown folded, and the button console 4.2 is conventionally shown adjusted to the size of a particular palm and fingers. Each double button corresponds to one specific finger. Adjusting the push-button consoles 4.1 and 4.2 to the sizes of the palms and fingers of the trainees is ensured by the movable fastening of the levers 5 in the base 6 with the function of bringing them together, spreading them apart and fixing them in a certain position like fingers, and the illuminated paired buttons 3 can move along the levers 5 and be attached in the right place. Goggles 7 with drop-down opaque shields 8 are used to close the left or right eye in separate workouts.

The device implements a method including the following operations:

- adjustment of the push-button consoles 4.1 and 4.2 to the sizes of the palms and fingers by spreading the levers 5 to the sides relative to the bases 6 and moving along them and fixing the illuminated paired buttons 3 in a convenient place;

- connection by interface 2 of the control-analytical device 1 with paired buttons 3 through the connectors on the push-button consoles 4.1 and 4.2;

- placement of a training person at a table in convenient accessibility from push-button consoles 4.1 and 4.2;

- calling the application program on the control-analyzing device 1 and setting the parameters of the next training cycle - the number of repetitions of the illumination of the buttons 3 of the consoles 4.1 and 4.2, the hand involved in the training - left, right or both at the same time, the number of simultaneously illuminated buttons - one, two, three, four or five, the force required to turn off the illuminated buttons, the time intervals for changing the backlight; the force required to turn off the backlight of the button is set by the corresponding pre-compression of the spring; instead of springs regulating the force of turning off the backlight, strain gauges can be used;

- when launched, the application program generates, using a random number generator, a stochastic process of backlighting buttons 3 on consoles 4.1 and 4.2 according to the specified parameters of the next training cycle;

- when the trainee presses the illuminated buttons 3 with the required force, the program fixes and archives the time intervals from the moment the backlight is turned on to the moment the backlight is turned off for each button 3;

- if it is necessary to check the influence of visual information channels on fine motor skills, the left or right eye is closed with a lowering shield 8 of the spectacle frame 7;

- at the end of the training cycle, in the database of the application program, based on the accumulated measurements of the reactions of each finger to turn off the illuminated buttons, statistical estimates of the functioning of each finger of the left and right hands in this cycle and the accumulated assessment for all previous cycles for a particular person are calculated. The following will be used as such accumulated statistical estimates:

- the mathematical expectation of the reaction time of each finger when the corresponding illuminated buttons are turned off;

- graphs of changes in mathematical expectations over time;

- reaction deviations in each training from the average accumulated values;

- similar statistical estimates of the efforts of pressing each finger on the buttons when they are turned off.

The proposed method and device for its implementation make it possible, through targeted training of the fingers, to stimulate intellectual development and fight its delay in children, delay the onset of senile dementia in the elderly and slow its progression, and perform physiotherapeutic procedures with patients who have had a stroke or brain injury.

The practical feasibility of the invention is not in doubt, since it relies on the prior art, the use of components proven in other applications (illuminated buttons and gadgets - specialized processors, programmers, smartphones, personal computers) and the performance of such applied computer programs.

Claims (2)

1. A method for training and quantifying the motor skills of the fingers and the functional state of the brain to control the coordinated movement of the fingers, in which the fingers press the buttons of the console with the backlight turned on until it is turned off, and in each training cycle the right hand or the left hand is involved, or both hands at the same time, and the number of buttons to be turned on in the range from one to five for each of the hands, the frequency and number of repeated activations, the amount of effort required to press the button with your finger to turn off its backlight are assigned by setting the corresponding values of the listed parameters of the training cycle in the application program on the control an analyzing device electrically connected to the button console and implementing a repeatedly repeated random algorithm for turning on the backlight of the buttons, assessing the motor skills of the fingers and the functional state of the brain to control the coordinated movement of the fingers, control analysis is carried out by the statistical characteristics of the arrays of time intervals between turning the buttons on and off with each finger following the results of a separate training cycle and in dynamics according to the aggregate information stored in it about all the personal trainings carried out, and in order to expand the information content of the assessment of the functional state of the brain, training cycles are carried out using only left eye or right eye only, or both eyes at the same time. 2. A device for implementing the method according to claim 1, including a spectacle frame with drop-down shields for closing according to the training plan for the left or right eye and electrically connected to the control-analyzing device through connectors on the push-button consoles, double individually illuminated and corresponding to their fingers buttons on the movable levers consoles for the left and right hands with the function of turning off the backlight when the fingers are pressed on the buttons with a given force, and the consoles are made customizable to the size of the palms and fingers of the trainees, and the paired buttons are equipped with a device for regulating or measuring the force to turn off the backlight of the buttons with the fingers, the control-analyzing device has a loaded application program with the function of setting in the training cycle the conditions for training the fingers of only the left or only the right, or both hands at the same time, the number of simultaneously illuminated buttons in the training cycle in the range from one to five for each hand, the number repetitions of tasks in a cycle, the frequency of turning on the backlight of the buttons, the implementation of the stochastic process of backlighting the console buttons, fixing the time intervals for turning off the backlight of each button from the moment it was turned on, archiving, statistical processing of the array of fixed delays for turning off the backlit buttons with each finger and saving personal information about all training cycles, and a personal computer is preferably used as a control-analyzing device.

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