US20210045962A1 - Equipment to elicit frissons or aesthetic chills, through the multisensorial and multimodal stimulation; with the objective of relieving chronic pains and the method to use it - Google Patents

Equipment to elicit frissons or aesthetic chills, through the multisensorial and multimodal stimulation; with the objective of relieving chronic pains and the method to use it Download PDF

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US20210045962A1
US20210045962A1 US16/613,165 US201916613165A US2021045962A1 US 20210045962 A1 US20210045962 A1 US 20210045962A1 US 201916613165 A US201916613165 A US 201916613165A US 2021045962 A1 US2021045962 A1 US 2021045962A1
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Jorge Serani Mostazal
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
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    • A61H23/00—Percussion or vibration massage, e.g. using supersonic vibration; Suction-vibration massage; Massage with moving diaphragms
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    • A61H2201/102—Characteristics of apparatus not provided for in the preceding codes with further special therapeutic means, e.g. electrotherapy, magneto therapy or radiation therapy, chromo therapy, infrared or ultraviolet therapy with aromatherapy
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Definitions

  • This invention provides the equipment and how to use it, for the self-care of patients with chronic pain, by inducing and/or intensifying and/or maintaining their own frissons, by means of multisensory and multimodal stimulations.
  • This invention provides the equipment and how to use it, for the self-care of patients with chronic pain, by inducing and/or intensifying and/or maintaining their own frissons, by means of multisensory and multimodal stimulations.
  • Among the individual and social benefits provided by this invention is to improve the individual's, family and work life of patients by decreasing the cost of medical treatments, without producing habituation and reducing adverse side effects.
  • the ultimate goal of this invention is to make patients with chronic pain reassure that they are able to regain the ability to have it under control, since ignorance about what is happening to them and feelings of helplessness exacerbate anxiety and fear. Holden R and Holden J. (2013).
  • chronic pain The standard definition of chronic pain given by the International Association for the Study of Pain is one that persists beyond normal pain for a tissue over time. In an arbitrary way a chronic pain has been defined as that which lasts more than 12 weeks after a continuous acute pain. At a medical level the difference between acute and chronic pain, is that in which acute pain the goal of the treatment pointed to the causes of it, while in chronic pain the goal is to direct attention to its effects in order to maximize the functionality and the patient's quality of life.
  • chronic pain is a common, complex and challenging condition, where to deal with it with good results requires understanding the biological, social, physical and psychological context of the individual.
  • Simons L. et al (2014) argue that chronic pain involves complex brain circuits that include sensory, emotional, cognitive and interoceptive processing, which in rigour is a another pathology, since it causes changes in the nervous system that aggravate it (comorbidity)
  • pain is a sensory and emotional experience that can vary widely among people, and even in the individual, depending on the context and meaning of the pain and the psychological state of the person.
  • Cognitive and emotional factors such as anxiety and fear, have an important influence on the perception of pain.
  • the pain that affects patients with chronic pain can be classified as:
  • cabeza crónicos fibromialgia y lumbalgia crónica Seizure drugs Relieve pain caused by damage Neuropathic pain, chronic to nerve fibers headaches, fibromyalgia and chronic low back pain Opioids Activate neurotransmitters, Acute pain such as post-operative endorphins, which reduce pain or bone fractures. and increase well-being.
  • neurostimulation therapies include invasive and non-invasive methods.
  • electromagnetic energy is applied to specific anatomical targets to elicit the neurostimulation of the network of neural circuits.
  • Authors Edwards C. et al (2017) made a literature review in which they present three devices of this type of apparatus; of deep stimulation of the brain, of motor cortex stimulation and of vagus nerve stimulation.
  • All these implantable systems include three primary components: the electrode, the extension and the pulse generator.
  • the electrode is implanted in the target area, the extension subcutaneously connects the electrode to the pulse generator, which also provides the electrical energy (batteries) to the device.
  • the pulses interfere and block the electrical signals that cause the pain, an effect that is based on the Gate Control Theory; of the authors Melzack R and Wall P. (1965).
  • multisensory stimulation refers to the conbination of information from different sensory modalities (the five classic ones: vision, hearing, touch, taste and smell), as well as some less obvious ones such as proprioeption, the kinesthetic, pain and vestibular sense, which gives rise to the changes associated with the perception and reception of those stimuli.
  • Multimodal perception deals with how at some point of perceptual processing, in which sensations are selected, organized and interpreted, in it information coming from various sensory modalities is integrated. According to Follman R. et al (2016), the information captured by the senses is first integrated separately and then combined in various multimodal convergence zones, including the cortical and subcortical regions and also in the multimodal association zones.
  • music therapy consists of using music in a therapeutic way, aimed at improving the functional physical, psychological, cognitive and/or social aspects of patients. Furthermore, music therapy interventions can be designed to promote well-being, manage stress, relieve pain, express feelings, improve communication and promote physical rehabilitation. It is said that music is not only heard but felt in the body, which suggests that there are other senses involved in the experience, in addition to hearing, as well as proprioception, the vestibular system and/or cutaneous touch.
  • Huang J. et al (2013) did an experiment to demonstrate that the stimuli of the skin afferents that innervate the skin and the deep tissues of the body, contribute to the perception of the metric.
  • the participants had to discriminate between 2 sequences, one of 2 pulses (like the marches) and another of 3 (waltz).
  • the stimuli were presented to them in three different ways: 1) unimodal (hearing and touch separately), 2) Different combinations of bimodal inputs that were distributed between the auditory and tactile channels and 3) Simultaneous bimodal inputs in which the two channels contained passwords metric congruent or incongruent.
  • Huang et al demonstrated first that the metric is well perceived, from 70 to 85%, when the tactile or auditory keys were presented separately since in the bimodal inputs the tactile and auditory keys were integrated to produce percepts (products of artistic excellence) metric coherent In addition, a high performance was observed, 70 and 90%, when all the important notes of the metric were assigned to a single channel and reduced to 60% when half of the notes were assigned to the remaining one. By simultaneously presenting the notes in both channels, congruent keys improved recognition by up to almost 90%.
  • Garza-Villaroel et al concluded that music decreased self-reported pain, anxiety and symptoms of depression, in conditions of chronic pain. They also observed that self-selected music had a greater analgesic effect than that offered by researchers. This would be the most complete Bibliographical review and meta-analysis, regarding the relationship chronic pain music, made up to that date
  • the CN 202822492U utility model discloses a multifunctional therapeutic electromusical stimulation device that combines acupuncture, moxibustion technology (heating body points) and music therapy technology.
  • the multifunctional therapeutic apparatus comprises an output circuit, a storage unit, an audio decoder unit, a signal processing unit, a main control unit, an A/D conversion unit, an audio amplification unit and a volume and power regulation unit and where the output circuit is connected to a therapeutic electrode that is applied to the body through pulses.
  • the storage unit stores music files that are used according to a therapeutic prescription.
  • Jusin P. et al (2008) did a study to investigate emotional reactions in daily life, with and without music. To avoid the use of self-reports, participants were given notebooks that issued random warnings during the day, with each warning they had to report their situation and their emotional state. When comparing the emotional states reported by the participants with or without daily music, the results revealed that their emotional states were more positive with the presentation of music. The authors conclude that music induces emotions and that it can be done on a daily basis.
  • Zentner M. and Grandjean D. and Scherer K. (2008) conducted several experiments using self-reports to examine the emotions most commonly experienced by the public during various musical events.
  • 2002 attendants to different types of concerts were recruited to answer a questionnaire indicating which affective state, from a list of 65 possible ones, was the one they had perceived most frequently in the events.
  • the affective state they had experienced most frequently was relaxation (44.6%), happiness (41.5%) and joy (39%), respectively.
  • the last ones were anger (with 2.4%), depression (2.7%) and distress (3.4%).
  • Zetner el al concluded that the excitation effect of music can be differentiated empirically in many subunits (they determined 40 affective states), which grouped into 9 emotions: delight, nostagia, transcend, peace, tenderness, energy, joy, tension and sadness and in 3 big factors, sublime, vitality and upset. In summary, it is concluded that positive emotions are the most frequently experienced in musical events.
  • Sena K. (2013) conducted a systematic review on emotional regulation (ER), which is an internal process in which the person maintains a comfortable state of excitement, while regulating one or more aspects of the emotion.
  • ER emotional regulation
  • the objectives of the literature review were to explore and synthesize, what is known about how music and musical experiences impact on the neural structures related to ER. In addition to considering the implications of these findings to structure the presentation of stimuli that facilitate ER; In short, find the way to use music to enhance emotional regulation.
  • Sena The results obtained by Sena indicate that there are certain musical characteristics and experiences that cause patterns of desired and unwanted neuronal activation related to ER.
  • the desired activation patterns occur when listening to favorite and familiar music and also when singing and in the musicians when improvising. Unwanted activation patterns arise when complex, dissonant and unexpected musical events occur.
  • a determining feature of emotions is the duration of the experience, which has been defined as the amount of time that elapses between the beginning and end of an emotional episode.
  • the beginning and end of an emotional episode can be identified relatively easily, since unlike the state of mind that is less specific, less intense, more durable and less given to be activated by a given stimulus, emotions begin with an external and internal event. It has been observed that the duration of emotions is highly variable, where there are some that last a couple of seconds and others that last for hours or more. While sadness tends to last a long time, shame, disgust and fear tend to last a short time
  • Verduyn et al (2012) affirm that a characteristic of emotions is their intensity and that during an emotional episode the intensity varies, giving rise to a profile of intensity over time which can have different forms and where the variability of the intensity profile of the emotion can be described by three functional characteristics; the inclination at the beginning of the emotion (slope), the asymmetries in the profile and the number of maxima.
  • slope the inclination at the beginning of the emotion
  • maxima the asymmetries in the profile
  • Frissons known as aesthetic musical chills are a psychophysiological response to a gratifying auditory and/or visual stimulus that induces a pleasant affective state or otherwise said of a positive valence.
  • the frisson are characterized by the chills that cause, in some cases by piloerection and pupil dilation and are studied by psychology and neuroscience. However unlike the chills in the frissons there are trembles and great emotional intensity.
  • the frisson implies a pleasant but variable sensation, since it affects different parts of the body, depending on the person and the circumstances of the induction and that comprises sensorial, affective biological, and psychological components similar to those of a sexual orgasm.
  • audiovisual stimuli caused by rhythmic lights and sound stimuli, are a way of externally influencing the brain and an effective method to diminish the stress, anxiety and the perception of pain. It has been shown that the distraction caused by audiovisual stimuli diminishes pain as a result of distracting the attention from it.
  • the authors did a controlled trial in which the participants were divided into 2 groups, one of them was a video presented with landscapes, but in silence and the second one with a blank screen.
  • the pain was caused by the modified tourniquet technique, the pain threshold was defined at the time the patient reported the start of the pain and the level of tolerance was defined as the moment the person reported unbearable pain. With the results obtained in the experiment, the authors concluded that visual stimuli considerably increased pain threshold and pain tolerance.
  • ATA American Massage Therapy Association
  • massage is “a soft manipulation of soft tissues including taking them, causing movements and/or applying pressure”
  • another definition of massage is that it is “a systematic tactile form and a kinesthetic stimulation”.
  • moderate massage is one of the most effective known of alternative therapies.
  • the mechanism most commonly used to explain the therapeutic effects of massage to reduce pain is the aforementioned Theory of the Gate, which considers that pain stimulates the nerve fibers shorter, less myelinated (A ⁇ ) and slower to bring the stimuli to the brain, in comparison with the pressure signals that are conveyed by myelinated fibers, long (A ⁇ and A ⁇ ) and fast, which block the arrival of the former.
  • the vibratory massages are groups of techniques that consist of rhythmic manipulations of the soft tissues. These rhythmic manipulations have a unique oscillation pattern that depends on the type of vibration applied and of the “seal” of the vibration (light and/or caressing, slow and/or heavy or rough). Vibrations that differ in frequency, amplitude, pressure and area of exposure cause resonances or repercussions, undulations and rebounds within the body.
  • a multifunctional vibrant physiotherapy equipment which includes the body of the physiotherapy equipment, wherein the body of the physiotherapy equipment passes through a hinge connection, and which is equipped with a slot for massaging the feet.
  • Vibration is a mechanical stimulus characterized by an oscillatory wave.
  • the biomechanical factors that determine its efficiency are frequency, amplitude, acceleration and duration.
  • a dumbbell is described with a tubular bar, inside which there is a vibrating device, which is characterized by having two electric motors, one at each end of the dumbbell, which are connected to each other by means of an axis that rotates.
  • U.S. Pat. No. 5,327,886 is disclosed a device for electronic massage that has the function of a pad and includes an eccentric wheel driven by a motor that turns and produces vibration and a thermoelectric module that produces cold or heat for the pad, as appropriate.
  • the device also has a fan to dissipate excessive heat and can be used only as a cold compress or as a compress and massager.
  • Boehme R. et al (2018) did a study to differentiate tactile stimuli (including massages and caresses), made by oneself from those of third parties, since the mechanism that causes this distinction is currently unknown.
  • fMRI functional magnetic resonance Imaging
  • these researchers concluded that touching oneself causes a broad deactivation in the brain, which clearly differentiates it from affective contact made by third parties. This difference was significant and was manifested early in the sensory processes by the amplitude of the spots in the right anterior cerebral cortex (less clear when touching Itself). At the behavioral level, sensory attenuation produces a higher perceptual threshold in these circumstances, that is, the stimuli themselves are perceived less.
  • cold therapy or cryotherapy is the treatment for pain that uses the method of locally cooling the irritated nerve and is used for rehabilitation with a mild cold (inflammation, edema and others) or to destroy with intense cold tissues malignant or not.
  • Cryotherapy includes many specific techniques; ice bags, frozen gels, Ice massages, immersion in ice coolants (eg N2) and others.
  • the spine composed of cartilage and bones, is simplified as a homogeneous cylinder, the spinal cord as a whole in which the gray matter is not distinguished from the white and the rest of the torso is modeled as muscle tissue.
  • the model assumes all the thermal properties as homogeneous and isotropic and the Pennes heat transfer bio equation is used.
  • U.S. Pat. No. 6,023,932 A1 shows a portable device for the local transfer of cold in humans and animals when they require it to relieve pain or inflammation of both muscles and joints.
  • the device comprises a thermoelectric unit having a cold side and a hot side, a DC power source connected to the thermoelectric unit, a heat sink that is associated with the hot side of the thermoelectric unit, a fan to reduce the heat of the heatsink and a band or the like to fix the device to the person.
  • the system can cool the nerves of the body up to about 15° C., which decreases nerve impulses.
  • the system has cold elements that can be Peltier cells or a catheter through which cold or hot water is passed through. The hot portion of the Peltier cells can be cooled by a coolant that absorbs the heat and then dissipates it.
  • essential oils are natural compounds, complex and with different components, mainly terpenes, and there are different ways to extract them from different plants, including water or steam distillation, extraction with solvents, with pressure or with fluids.
  • supercritical Essential oils have been attributed different beneficial properties, which according to the author has been scientifically proven. More than 40 plant derivatives have been Identified for medicinal or therapeutic use, where lavender, eucalyptus and chamomile are the most used.
  • perceptual learning has three characteristics; it is a lasting learning, it is perceptual (the way the brain senses sensations) and it is a product of practice (experience).
  • perception adapts to tasks and the environment are the following: differentiation, unification, attentional weighting and impression of stimulus.
  • objects and events in real lie comprise multiple sensory attributes, which are processed in different independent modes.
  • this sensory information to give shape to a unique perceptible object is not yet clear.
  • Combining information about a common source with different characteristics, through the senses can improve discrimination and reaction to various objects.
  • a second powerful tool to unify stimuli is the spatial one, since there are multiple cases in which a sensory modality dominates the percept of an object or multisensory event.
  • a classic example is the ventriloquistic effect, where the percept of an auditory stimulus is “captured” by the spatial location of a visual stimulus.
  • Chronic pain has a physical, emotional and cognitive dimension in the individual and the frissons are positively related to all of them with the aim of alleviating the chronic pain of patients.
  • the purpose of this invention is to induce frissons through multisensory and multimodal stimulation, wherein the stimuli that elicit them are related to the senses of hearing, vision, touch, and smell. To achieve this objective, it is important that the various stimuli act synchronously around the music, since the latter has proven to be the most efficient way to elicit them.
  • a secondary objective of the present invention is to intensify and keep the previously induced frissons in time in order to maximize the pain relief in the patient.
  • the equipment for the treatment of chronic pain of this invention which can be operated by the patient himself or initially with the help of an assistant, comprises a computer with a music and a video player and a computer system that mainly controls the hydraulic circuit with a cooler and an actuator, illumination and a diffuser, and to enhance their effects, recourse to perceptual learning.
  • a computer with a music and a video player
  • a computer system that mainly controls the hydraulic circuit with a cooler and an actuator, illumination and a diffuser, and to enhance their effects, recourse to perceptual learning.
  • music and visual stimuli can produce intense emotions and frissons, as well as improvements in physical condition, a decrease in stress and anxiety, depression reduction, improvements in mood and cognitive functions, and a decrease in chronic pain. Notwithstanding the above, not all musical and visual stimuli are appropriate to elicit frissons and decreases in pain. Next, different aspects of the patient, the stimuli and the way to present them are analyzed.
  • Emotions whose understanding and effects are fundamental in this invention are defined as a complex state of feelings that result in physical and physiological changes that influence on thoughts and behavior: emotionality is associated with different psychological constructs including temperament, personality, mood and motivation.
  • emotionality is associated with different psychological constructs including temperament, personality, mood and motivation.
  • the generation of an emotion in the subcortical regions of the brain activates the hypothalamus, the Autonomic Nervous System (ANS) and the release of adrenaline and cortisol.
  • the activation of the ANS includes the sympathetic nervous system, which prepares the warming and strength reactions (fight-flight) and the parasympathetic one that acts during the digestion and the rest, both systems predominate according to the context.
  • the sympathetic causes, through hormones, the alteration of different tissues and organs, including cardiac and respiratory activity, as well as blood pressure.
  • the heart rate (HR) and respiratory rate (RF) increase in response to the exciting music (stress) and decrease with the relaxing music.
  • the FC and the FR increase. In addition both of them tend to increase with the music, when compared with silence and FC decreases with the unpleasant music and increases with the pleasant one.
  • feelings are moods that are produced by causes that impress you, and these can be cheerful and happy or painful and sad. The feeling arises as a result of an emotion that allows the subject to be aware of his mood.
  • states of mood do not have a clear event that causes them, or if it had occurred, it is not clearly Identifiable by those who experience it.
  • AE are diffused and longer lasting affective states that do not have an specific orientation towards a certain stimulus”; Fridja N. (1999).
  • Anxiety There are studies that show that anxiety levels can predict the severity and behavior of patients with chronic and acute pain. As well as that the techniques of reducing anxiety and the use of anxiolytic drugs reduce the pain derived from medical procedures.
  • Cognition Cognitive changes that occur during fear increase the perception of the threat, increase attention, which then increases the catastrophic assessment of pain, avoidance and the level of disability.
  • Depression It has been observed the existence of a considerable overlap between pain and depression which induces changes in the patient's neuroplasticity and brain neurobiological mechanisms. Such changes are fundamental to facilitate the occurrence and development of chronic pain and chronic pain induced by depression.
  • Gender Identity It has been suggested that if the information conveyed by a music has gender identity, related to a specific sex, the perception of the listeners would be slightly different. However there are opinions that music would not be related to gender characteristics, but would be attributed by listeners. Sergeant D. (2016).
  • Rhythm and Tempo The rhythm is the harmonious combination of sounds, voices or words, which include pauses, silences and cuts and the tempo corresponds to the speed with which a piece of music is played.
  • the tempo determines the music causes happiness or sadness; a high tempo would be fun or expressive and a low one relaxing or boring. It has been observed that the tempo is the musical characteristic most related to the affective states. As for the effect of the rhythm, it would go in the same sense as the tempo. Fernandez-Sotos et al (2016).
  • the musical genre is a category that brings together musical compositions that share different criteria of affinity, such as its function, its instrumentation, its rhythm, its cultural characteristics and others. It has been observed that emotions, especially those related to valence, would be different depending on the musical genre. As an example, the opera involves music and singing as well as a large audiovisual framework from the orchestra and set design. Rodica F. et al (2011).
  • Kort Y. et al (2006) performed an experiment in which the participants, after having done a stressful task, watched a film of nature, either on a small or a large screen, while evaluating their physiological parameters. The results indicated that the larger size of the screen and therefore the higher the degree of immersion in the film facilitated post-stress recovery in terms of physiological measurements.
  • Diette G. et al (2003) did a study, presenting visual and auditory stimuli, to determine which visual distractors and sounds would reduce pain and anxiety in post-surgery patients, for which they presented murals with natural views, during and after of the procedure. They also received audio, before, during and after the surgery, at the same time as the intensity of the pain and the level of anxiety were evaluated. The results indicate an efficient response of distraction therapy with natural views and sounds to decrease pain.
  • the tactile stimuli are presented by means of a closed hydraulic circuit with 3 pumps, one of them peristaltic 2 diaphragm, in addition to flexible tubes to drive the fluid, connections, an actuator, a cooler with Peltier plates, a sensor of temperature and a thermostat.
  • This equipment allows to massage with light strokes and caresses, apply cold and vibrations, joint or combined, on the skin surface and the muscles of the upper part of the spine, of the patients.
  • the skin is innervated by skin receptors that belong to the somatosensory system, which make up the sense of touch and capture different specific stimuli that provide information to the Central Nervous System (CNS): mechanoreceptors, thermoreceptors (temperature) and nociceptors (pain).
  • mechanoreceptors provide information about touch, pressure, vibration and skin tension and according to their function are classified in the corpuscles of Meissner, Pacinianos and Ruffini and Merkel discs.
  • tactile CT nerve fibers that have a low threshold, are not myelinated and have a low speed of signal conduction.
  • vibro-tactile perception depends mainly on the mechanoreceptors of rapid adaptation (Pacini and Meissnner corpuscles) and slow (Merkel discs). From the mechanical point of view, the sinusoidal wave has different characteristics (amplitude and firing frequency) that generate different vibrotactile perceptions.
  • the vibration threshold is defined as the lowest oscillatory displacement capable of being detected and there are significant differences in the thresholds depending on the frequency, the magnitude, the contact area and the location of the vibrotactile stimulation.
  • the vibratory sensitivity in the corporal periphery has different characteristics depending on the body region that receives the stimulus, among them the existence of glabrous skin areas and the different receptors and afferent fibers that innervate them.
  • the average density of the hair follicles in the forehead is significantly higher than in other areas of the body (292 hair follicles/cm2) compared to the back (29 follicles/cm2). Seah S. and Griffin M.
  • thermosensation Is regulated by receptors that transduce, encode and transmit thermal Information.
  • Park B. and Kim S. (2013) state that there are two types of thermosensitive fibers, some that respond to heat and others to cold.
  • Cold receptors which perceive changes in skin temperature from 1° C., ranging from 15 to 30° C., are classified Into 2 groups, the superficial and the deep, of which 60% It's located in the periphery of the body. These receptors can transmit information through small fibers that are mielinizated at a speed that goes from 5 to 15 m/s and also through C fibers.
  • the cold stimulus is applied by means of a low flow T ° that recirculates inside a tube of cross section of the hydraulic circuit and that Is applied on the skin and the muscles that cover the upper part of the patient's spine and in where the tube that touches the skin runs parallel to said column.
  • the turbulence of the flow is mainly due to the work of the peristaltic pump and the passage of the flow through the actuator.
  • the cold is obtained from a Peltier plate cooler. In this respect it's necessary to model the behavior of the turbulent flow caused by the peristaltic pump and by the actuator, however it is important to note that there are few analytical studies that treat them (if they exist are for steel tubes and hoses), as well as the transfer of heat between the fluid and the body tissues. Here are some models that explain these phenomena:
  • Turbulent flows have the following properties: Irregularity, three-dimensionality, diffusivity, dissipation and a high Reynolds number.
  • the Reynolds-Navier-Stokes equations can be obtained in three dimensions, according to Reynolds. (1895), which represents a system of 5 variables to be determined, but with 7 independent unknown identities. Although this is the most complete turbulence model, a general solution for this type of equations is not available and simpler models such as k- ⁇ (k-epsilon) or k- ⁇ (k-omega) are used. They are deduced from the LES (Large Eddy simulation) model, but they have restrictions.
  • Model k- ⁇ (k-epsilon) of Hanjalic K and Launder B. (1972), is the most used model in computational fluid dynamics. It is a model of 2 transport equations to represent the turbulent properties of a flow. The first variable of this model is the turbulent kinetic energy (K), this variable determines the turbulent intensity, while the second variable represents the turbulent dissipation (Epsilon). This model is appropriate for totally turbulent flows and the equations are:
  • the turbulent flow that causes the vibration and stimulation of the skin and the muscles that cover the spine is caused by the narrowing of the flow by the actuator or by the peristaltic pump.
  • the pumping of a peristaltic pump is a function of four parameters: the radius ⁇ , the number of waves a, the number of Reynolds Re and the time of flow (without dimension) y .
  • the Reynolds number There are different definitions for the Reynolds number, however in a papr done by Cheng X. et al (2017) they use the following equation:
  • v is the average velocity of the fluid.
  • the Reynolds number for pump speeds of 100 rad/min, at a flow velocity of 1.69 m/s was 2678.22 and from that pump speed they were Increasing from 10 to 10 radians/min until reaching a maximum of 190 radians, with a flow velocity of 3.17 m/s and a Reynolds number of 5014.69.
  • the Reynolds number was greater than 4000, considered as turbulent (since Re ⁇ 2300 is a laminar flow, with 2300 ⁇ Re ⁇ 4000 is a transient flow and greater than 4000 turbulent).
  • the greater the number of Reynolds the greater the fluid turbulence and the greater greater the vibration of the tubes and the tappings that stimulate the cutaneous surface covering the patient's spine.
  • An Important element to be determined in this invention is the heat transfer between the cutaneous, muscular and bony tissues, from the upper part of the spine and the cold and turbulent fluid (Reynolds N), contained in a tube parallel to the first ones and whose characteristics are to be straight, of circular cross section, of smooth inner surface and that transport an Incompressible fluid.
  • the Ditus-Boelter correlation is the most recent way, and the most generally used for fluids with Prandtl number in the range of 0.7 to 100 and in tubes with L/D>60, where L is the length and D the diameter of the tube.
  • This correlation is simple to apply but is not accurate when the temperature differences between fluids (cold, heat) are very high and the Internal surfaces of the tube aren't smooth.
  • the Nusselt No (Nu) is the ratio of heat transmission by convection and conduction, in a delimited flow.
  • the Prandtl No. can be represented as the relationship between the kinematic viscosity and the thermal diffusivity of a fluid ⁇ (v/ ⁇ ).
  • the Ditus-Boelter correlation should be used in flows with a Reynolds number not higher than 10,000 but in practice it is used with values lower than that.
  • a second source of turbulences within the hydraulic circuit of the present invention are those coming from a hydraulic actuator, which causes vibrations in the walls of the tubes of the first, which are transmitted to the skin and muscles that cover the upper part of the spine.
  • the hydraulic actuator consists of a cylinder that moves longitudinally and in both directions, on a pair of pistons that are fixed and are hollow; water circulates inside of them, and that end in ringed nozzles that point in an opposite way, towards both directions of the cylinder, discharging into the tubes of the circuit and where the actuator is fed alternately by water driven by each one of the two ways solenoid valves, two steps, located on the sides of the cylinder and whose openes is controlled by a computer system.
  • Ci (gas) H ⁇ Ci (liquido),
  • H I the component of Henrys law for H and Ci (gas) and Ci (liquid) are the concentrations of the component of the fragrance I in the gas and in the liquid phase in (gr/L).
  • the literature shows that the olfactory perception of a mixture of fragrances can be calculated from a combination of variables, the concentrations of odorants in a gas, its chemical structure, the odor threshold and the neuronal signals in the transduction.
  • This model simplifies the analysis to predict a) the Intensity of the smell and b) the character of a mixture of fragrances and the concentration of the vapors in It, using a psychophysical model known as the Law of Steven's Psychophysics, which relates the magnitude of the sensation and Intensity of a stimulus and the Strongest Component Model.
  • the intensity of the smell perceived in a mixture of fragrances was calculated from the concentrations used in the Stevens Law.
  • the model is derived from sensory experiments related to the relationship between the magnitude of the applied stimulus and the perceived sensations and contemplates non-linear relationships between both and for the related to smell can be expressed assuming that the perceived sensation ( ⁇ ) is proportional to the magnitude of the stimulus (Ci gas) raised to an exponent ni:
  • Ci gas is the concentration of the odorant in the gas phase
  • ODTi is the threshold for the concentration of odor in the air (units of mass or moles per volume) and the parameter ni is defined as the exponent of the Law of Stevens for each odorant in particular
  • FIG. 1 shows a patient in a therapy session to alleviate chronic pain by inducing, intensifying and maintaining their own frissons, by presenting multisensory and multimodal stimuli.
  • FIG. 2 shows the way to place the hydraulic circuit in the back of the patient in order to apply the tactile stimuli, vibrotactiles and cold, on the surface of the skin and muscles that cover the upper part of the spine.
  • FIG. 3 shows a diffuser of essential oils, which has 2 circular containers, one for each oil, embedded in a textile fiber, together with a resistance, all inside a box with a straight parallelepiped shape and two holes in its upper face.
  • FIG. 4 shows the hydraulic circuit that allows to apply the tactile, vibro-tactile and cold stimuli and whose operation is controlled through a computer system through a PC and that comprises 3 hydraulic pumps, hoses and connections, 1 actuator, 1 cooler, 1 T ° sensor, 1 thermostat, one 3-way valve and 2 positions and another two 2 two-way and two positions all normally closed.
  • FIG. 5 shows an actuator that allows to apply tactile stimuli, caresses, on the cutaneous surface covering the upper part of the patient's spine, which is complemented by two, 2-way valves and 2 positions; one on each side of the actuator.
  • the objective of this invention is to provide the equipment and the method to use it for the self-care of patients with chronic pain through frisson induction by means of actuators, including a hydraulic circuit with an actuator.
  • actuators including a hydraulic circuit with an actuator.
  • Special mention within the stimuli used in this invention is occupied by music, since it has been shown to be the most efficient way of presenting sensory stimuli to elicit frissons and for this reason some of the tactile and visual stimuli have been synchronized with the music (multimodal stimulation).
  • FIGS. 1A and 18 show how to use the hydraulic circuit ( 400 ), in shoulder strap, with the head in ( 421 ) and the flexible tube ( 405 ), surrounding the patient's back and allowing to elicit the stimuli and vibrotactiles of this invention.
  • the flexible tube FIG. 1B is attached to the skin by means of double suction cups ( 101 ), loose to maintain the vibration of the tube.
  • the container on the patient's back ( 102 ) of FIG. 1B comprises part of the hydraulic circuit: the hydraulic pump, a 3-way valve, a temperature sensor and a cooler.
  • the actuator ( 500 ) is located skimming the skin covering the upper part of the spine.
  • FIG. 2 shows the necessary hardware to elicit the necessary audiovisual stimuli to enhance the cold and vibrotactile stimuli caused by the hydraulic circuit described above.
  • Hardware elements could be important to use virtual reality (VR) technology, but not having it, does not prevent the patient from experiencing the benefits of this invention.
  • VR virtual reality
  • VR virtual reality technology
  • VT virtual reality technology
  • VT is the simulation of an imaginary environment in 3 dimensions that provides visual interactive experiences in real time, sounds, tactile sensations and other forms of feedback and is the technology necessary to implement VR.
  • budgetary, technical or other constraints make it advisable to use this technology according to the preferences of the patients.
  • Virtual reality systems can be classified into 3 types; a) non-immersive, b) semi-immersive and c) totally immersive.
  • the non-immersive approach offers a virtual world, through a simple window on the desktop of the PC, on a high-resolution monitor.
  • the non-immersive devices are lower cost and quickly accepted by users and can be improved with future investments.
  • the monitor ( 211 ) should have a curved screen (not excluding), since it provides a visual experience with less distortion, more natural and that causes less eye fatigue in long sessions, than those of flat screen and with wide viewing angles. It should have a large screen (not excluding) and high resolution (not excluding), so that it is easier to work with graphics, video and multimedia.
  • Audio system Unless you want to have a good sound, without using VR headsets, a good audio system ( 202 ) is required, which makes the therapies more immersive. A surround sound, greater clarity and deeper bass are the benefits of a good speaker system. For this purpose we must consider the cost, the frequency response, the power, the impedance, the sensitivity, the performance, the distortion and the directionality.
  • the software comprises four subcomponents: 3D modeling, 3D graphics software, software to edit digital sounds and virtual simulation softwares:
  • the IDE Integrated Development Environment
  • the IDE is the official iOS application that allows you to program and download the program to our cards.
  • the diffuser and the hydraulic circuit work alone or in parallel and can be synchronized or not with the audio and video of the computer.
  • the microcontroller can be powered through the USB connection or with an external power supply in the present case with a power source.
  • the musical and visual stimuli that most effectively awaken emotions are pieces of classical music, melancholic music and videos of landscapes and natural life ( 201 ) and ( 212 ), respectively.
  • Multimedia is a technology that allows to integrate text, number, graphics, still or moving images, animation, sounds and videos and also allows navigation along different documents. It refers to any object or system that uses multiple means of physical or digital expression to present or communicate information.
  • the multimedia presentations can be viewed or heard on a stage, transmitted or played locally by means of a multimedia player, as understood by this invention.
  • a transmission can be live or recorded and with analog or digital technology and the digital can be downloaded or transmitted in streaming.
  • Windows Media Player (latest version 12), which is available for Windows 7, 8 and 10.
  • Windows Media components can be downloaded so that QuickTime can play Windows Media files.
  • free VLC Media Player which is a free and open source multimedia player, multiplatform and a framework that plays most multimedia files, as well as DVD, Audio CD, VCD and various transmission protocols.
  • the odorants of this invention are presented through an essential oil diffuser ( 301 ) which is connected to a power source ( 302 ).
  • the diffuser comprises a box with two holes which comprises two containers ( 303 ) and ( 304 ) among which are 2 resistors ( 305 ) and ( 306 ), in oil soaked in a cotton ( 307 ) and ( 308 ). The oil is released through the holes in the box when the resistance is heated, a process that is controlled from the PC through the Computational System.
  • a Wemos D1 mini card is used, which is responsible for activating/deactivating it, either individually (one container) or in parallel (both containers.) This is done from the PC by means of a relay module. With two channels ( 309 ) to allow the passage of the 24 V of a strip that in turn comes from the power source.
  • an hydraulic circuit is used, closed and parallel, ( 400 ) that allows to massage with strokes and caresses and also apply cold and vibrations, to the cutaneous surface of the upper part of the patients' spine.
  • the vibrations are caused by the turbulent flow generated by the peristaltic pump and the actuator, and transmitted to the tubes.
  • the circuit comprises 3 pumps, one peristaltic ( 402 ) moved by a stepper motor (DC, 24 V and 0.6 A) and 2 microdiaphragm pumps ( 403 ) and ( 404 ), (DC 12V and 1.5 A), flexible tubes ( 405 ), Y connections, a cooler with Peltier plates ( 406 ), a thermostat ( 407 ) and a temperature sensor ( 408 ), a micro mini three-way valve, two positions ( 401 ), normally closed (DC 12V and 185 mA), and an hydraulic actuator ( 500 ), which has two 2-way valves, 2 positions, normally closed, at both sides of it ( 413 ) and ( 414 ).
  • the hydraulic circuit comprises two parallel hydraulic half-circuits ( 409 ) and ( 410 ), functionally separated by the normally closed three-way solenoid valve ( 401 ) and wherein the operation of the first half-circuit ( 410 ) is controlled by a chicken Nano microcontroller (A0), loaded with a program.
  • the microcontroller simultaneously controls the activation of the two microdiaphragm solenoid pumps ( 403 ) and ( 404 ) and the opening of the three-way valve ( 401 ), through a 5V relay module and three channels, through a USB cable Android from the PC.
  • the operation of the first hydraulic half circuit ( 410 ) comprises the micro mini three-way solenoid valve, normally closed ( 401 ), which upon opening allows the flow to simultaneously go to the two microdiaphragm pumps ( 403 ) and ( 404 ), located in parallel and fed through two independent tubes ( 415 ) and ( 416 ), respectively, and which are born from one in common ( 414 ), coming from the cooler through the 3-way valve.
  • the discharge of the fluid is done by two independent tubes ( 417 ) and ( 418 ) that are then joined together with a third one ( 419 ) that connects with the discharge tube of the peristaltic pump ( 420 ) and wherein the fluid that both microdiaphragm pumps drives through the tube ( 419 ), towards the cooler ( 406 ), is done to the rhythm of the music of the computer's multimedia player.
  • the Peltier plate cooler with fans for each of them and water blocks, has a temperature sensor at its inlet, the readings of which can be seen on the PC screen. It also has an STC-1000 Digital Thermostat that is powered by the 220V of the home electric network and that is regulated independently. As programmed in the thermostat, the set of 3 Peltier cells and their respective fans will be activated/deactivated. The set of Peltier cells and fans are powered from a power supply o 12V and 40 A.
  • this semicircuit is given by a sound sensor, capable of detecting an audible signal and converting it into a voltage signal, which is read by the analog input of the microcontroller.
  • the program musical_source_code or loaded in the microcontroller performs an analysis of these signals by separating the high and low frequencies to activate the microdiaphragm pumps (outputs D12 and D13).
  • the microdiaphragm pumps are controlled through an Android USB cable and a three-channel relay module (one for the valve) from the PC.
  • FIG. 2 ( 210 ) to accompany the sounds (outputs D12, D13, D4 and D9, D10 and D11).
  • the activation signals of the pumps are received by the L298 driver, which is responsible for activating and deactivating the pumps, giving them power from the 12 V power source.
  • the hydraulic semicircuit and LED lighting ( 210 ) works with any 2 instruments that have different sound frequencies (e.g. drum and flute).
  • the hydraulic circuit of this Invention is similar to the hydraulic circuit of a musical water source.
  • the second of the semicircuitos has two modes of work, in the first ( 409 ) the flow has a unidirectional sense and in the second works alternately bidirectional ( 409 ) and ( 409 A), due to the movement of advance and retraction of the engine step by step of the peristaltic pump, within a limited range, given by the lengths of its cylinder and plungers.
  • this working mode of the second hydraulic semicircuit ( 409 ) is given by the Wemos D1 mini Card, mentioned above, which is responsible for controlling both the activation/deactivation of the peristaltic pump ( 402 ), as well as the speed of rotation of the same, the execution times of the same, the cycle restart times and the option to select random movements, speeds and times.
  • This is done from the PC through an Android USB connection to the Wemos D1 mini card.
  • the card sends the necessary pulses directly to the DAT Input of the driver (Kamoer).
  • the activation/deactivation is also carried out by means of a one-channel relay, which controls the opening of the solenoid valve towards the peristaltic pump.
  • the activation/deactivation is carried out by means of a relay, to allow the passage of the 24 V necessary for the supply of the driver (Kamoer) of the peristaltic pump.
  • the 24 V comes from the power source 24V, 10 A, which shares the voltage with the diffuser system by means of a power strip.
  • One of the protoboard of the driver allows to have more feeds of 5 v and their respective earths (GND) to power the relay modules and share the GND lands with the driver (Kamoer) and the Wemos D1 mini card of the control of diffusers.
  • the 2nd mode of the 2nd semicircuit ( 409 ) is intended to make a slight caress on the skin covering the upper part of the spine and is achieved through the work of an actuator ( 500 ), the 3-way solenoid valve and two positions ( 401 ) the two 2-way valves and 2 positions ( 413 ) and ( 414 ) and the stepper motor work of the peristaltic pump ( 402 ).
  • stepper motor which operates bi-directionally at a predetermined distance
  • Wemos D1 mini Card which is responsible for controlling the peristaltic pump ( 402 ) and simultaneously activating/deactivating the mini micro three-way solenoid valve and the two 2 ways solenoid valves, using a 5V and 4-channel relay module, via an Android USB cable from the PC.
  • the hydraulic actuator FIG. 5 , ( 500 ) consists of a cylinder ( 501 ) partially lined in a fabric with hairs ( 502 ), which starting from a central position ( 603 ) and with an inner ring at the center ( 506 ), moves longitudinally and alternately in both directions and in the same distance ( 504 ) or ( 505 ), on a pair of plungers that are fixed and hollow, water circulates inside them (507) and ( 608 ), and ending in nozzles rings that point in opposite way ( 609 ) and ( 610 ), to both directions of the cylinder and discharging into the tubes of the hydraulic circuit ( 611 ) and ( 612 ) and wherein the actuator is alternately fed by water driven by the two solenoid valves, 2 ways and two positions ( 413 ) and ( 414 ), located on both of the cylinder.
  • each of the plungers On the outside of each of the plungers and at the same distance from its narrow ends are located two rings ( 515 ) and 516 ) that can stop the advance of the cylinder towards both sides and where each of both pistons have at their distal ends two inner rings ( 517 ) and ( 618 ) and grooves on the outside to screw two tube connectors ( 519 ) and ( 520 ) that catch a mesh ( 521 ) and ( 522 ).
  • the inner rings as well as the mesh are intended to generate turbulent flows and the distance traveled by the actuator in either direction must be equal to the angular distance that the motor travels step by step in the corresponding displacements.
  • the cycle is initiated when the 3-way solenoid valve ( 401 ) opens, the peristaltic pump ( 402 ) is activated, one of the two-way valves is opened ( 413 ) or ( 414 ) and drives the fluid to any of the nozzles ( 509 ) or ( 510 ), while it flows to the second nozzle, dragging the inner ring of the cylinder ( 506 ) to the fluid passage.
  • the cycle is repeated in the opposite direction with the advance/return of the stepper motor of the peristaltic pump and the alternating opening of the 2-way solenoid valves ( 413 ) and ( 414 ).

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US16/613,165 2019-07-02 2019-07-02 Equipment to elicit frissons or aesthetic chills, through the multisensorial and multimodal stimulation; with the objective of relieving chronic pains and the method to use it Abandoned US20210045962A1 (en)

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