WO2013021492A1 - リハビリ装置 - Google Patents
リハビリ装置 Download PDFInfo
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- WO2013021492A1 WO2013021492A1 PCT/JP2011/068301 JP2011068301W WO2013021492A1 WO 2013021492 A1 WO2013021492 A1 WO 2013021492A1 JP 2011068301 W JP2011068301 W JP 2011068301W WO 2013021492 A1 WO2013021492 A1 WO 2013021492A1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
- A61B5/11—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/0033—Features or image-related aspects of imaging apparatus classified in A61B5/00, e.g. for MRI, optical tomography or impedance tomography apparatus; arrangements of imaging apparatus in a room
- A61B5/004—Features or image-related aspects of imaging apparatus classified in A61B5/00, e.g. for MRI, optical tomography or impedance tomography apparatus; arrangements of imaging apparatus in a room adapted for image acquisition of a particular organ or body part
- A61B5/0042—Features or image-related aspects of imaging apparatus classified in A61B5/00, e.g. for MRI, optical tomography or impedance tomography apparatus; arrangements of imaging apparatus in a room adapted for image acquisition of a particular organ or body part for the brain
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
- A61B5/1455—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue using optical sensors, e.g. spectral photometrical oximeters
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/16—Devices for psychotechnics; Testing reaction times ; Devices for evaluating the psychological state
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/40—Detecting, measuring or recording for evaluating the nervous system
- A61B5/4058—Detecting, measuring or recording for evaluating the nervous system for evaluating the central nervous system
- A61B5/4064—Evaluating the brain
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6801—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be attached to or worn on the body surface
- A61B5/6813—Specially adapted to be attached to a specific body part
- A61B5/6814—Head
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
- G16H20/30—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H40/00—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
- G16H40/60—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices
- G16H40/67—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices for remote operation
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/74—Details of notification to user or communication with user or patient ; user input means
- A61B5/7405—Details of notification to user or communication with user or patient ; user input means using sound
- A61B5/741—Details of notification to user or communication with user or patient ; user input means using sound using synthesised speech
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- A—HUMAN NECESSITIES
- A63—SPORTS; GAMES; AMUSEMENTS
- A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
- A63B22/00—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements
- A63B2022/0094—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements for active rehabilitation, e.g. slow motion devices
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- A—HUMAN NECESSITIES
- A63—SPORTS; GAMES; AMUSEMENTS
- A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
- A63B24/00—Electric or electronic controls for exercising apparatus of preceding groups; Controlling or monitoring of exercises, sportive games, training or athletic performances
- A63B24/0003—Analysing the course of a movement or motion sequences during an exercise or trainings sequence, e.g. swing for golf or tennis
- A63B24/0006—Computerised comparison for qualitative assessment of motion sequences or the course of a movement
- A63B2024/0012—Comparing movements or motion sequences with a registered reference
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- A—HUMAN NECESSITIES
- A63—SPORTS; GAMES; AMUSEMENTS
- A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
- A63B71/00—Games or sports accessories not covered in groups A63B1/00 - A63B69/00
- A63B71/06—Indicating or scoring devices for games or players, or for other sports activities
- A63B71/0619—Displays, user interfaces and indicating devices, specially adapted for sport equipment, e.g. display mounted on treadmills
- A63B71/0622—Visual, audio or audio-visual systems for entertaining, instructing or motivating the user
- A63B2071/0625—Emitting sound, noise or music
- A63B2071/0627—Emitting sound, noise or music when used improperly, e.g. by giving a warning
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- A—HUMAN NECESSITIES
- A63—SPORTS; GAMES; AMUSEMENTS
- A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
- A63B2230/00—Measuring physiological parameters of the user
- A63B2230/08—Measuring physiological parameters of the user other bio-electrical signals
- A63B2230/10—Measuring physiological parameters of the user other bio-electrical signals electroencephalographic signals
- A63B2230/105—Measuring physiological parameters of the user other bio-electrical signals electroencephalographic signals used as a control parameter for the apparatus
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- A—HUMAN NECESSITIES
- A63—SPORTS; GAMES; AMUSEMENTS
- A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
- A63B24/00—Electric or electronic controls for exercising apparatus of preceding groups; Controlling or monitoring of exercises, sportive games, training or athletic performances
- A63B24/0003—Analysing the course of a movement or motion sequences during an exercise or trainings sequence, e.g. swing for golf or tennis
- A63B24/0006—Computerised comparison for qualitative assessment of motion sequences or the course of a movement
Definitions
- the present invention relates to a rehabilitation apparatus, and more particularly to a rehabilitation apparatus for rehabilitation of a patient (subject) whose body part has been paralyzed due to a sequelae of stroke or the like.
- an optical brain functional imaging apparatus that performs noninvasive measurement using light.
- a near-red light having three different wavelengths ⁇ 1 , ⁇ 2 , and ⁇ 3 (for example, 780 nm, 805 nm, and 830 nm) is obtained by a light transmission probe arranged on the scalp surface of the subject.
- the light receiving probe disposed on the scalp surface While irradiating the brain with external light, the light receiving probe disposed on the scalp surface emits near-infrared light intensity (received light amount information) A ( ⁇ 1 ) of each wavelength ⁇ 1 , ⁇ 2 , ⁇ 3 emitted from the brain.
- concentration / optical path length product of total hemoglobin ([oxyHb] + [deoxyHb]) is calculated from the concentration / optical path length product [oxyHb] of oxyhemoglobin and the deoxyhemoglobin concentration / optical path length product [deoxyHb]. Yes.
- a ( ⁇ 1 ) E O ( ⁇ 1 ) ⁇ [oxyHb] + E d ( ⁇ 1 ) ⁇ [deoxyHb] (1)
- a ( ⁇ 2 ) E O ( ⁇ 2 ) ⁇ [oxyHb] + E d ( ⁇ 2 ) ⁇ [deoxyHb] (2)
- a ( ⁇ 3 ) E O ( ⁇ 3 ) ⁇ [oxyHb] + E d ( ⁇ 3 ) ⁇ [deoxyHb] (3)
- E O ( ⁇ m) is an absorbance coefficient of oxyhemoglobin in light having a wavelength ⁇ m
- E d ( ⁇ m) is an absorbance coefficient of deoxyhemoglobin in light having a wavelength ⁇ m.
- FIG. 4A is a cross-sectional view showing a relationship between a pair of light transmitting probe and light receiving probe and a measurement site
- FIG. 4B is a plan view of FIG.
- the light transmitting probe 12 is pressed against the light transmitting point T on the surface of the subject's scalp, and the light receiving probe 13 is pressed against the light receiving point R on the surface of the subject's scalp. Then, light is emitted from the light transmitting probe 12 and light emitted from the scalp surface is incident on the light receiving probe 13.
- the light passing through the banana shape reaches the light receiving point R on the scalp surface.
- the light transmitting point T and the light receiving point R particularly from the midpoint M of the line L connecting the light transmitting point T and the light receiving point R at the shortest distance along the surface of the subject's scalp.
- Received light quantity information A ( ⁇ 1 ), A ( ⁇ 2 ) related to the measurement site S of the subject having a depth L / 2 which is half the distance of the line connecting the shortest distance along the surface of the subject's scalp , A ( ⁇ 3 ) is obtained.
- FIG. 5 is a block diagram showing an example of a schematic configuration of a conventional near-infrared spectrometer. For ease of viewing, several light transmitting optical fibers and several light receiving optical fibers are omitted.
- the near-infrared spectrometer 101 has a rectangular parallelepiped casing 11.
- a light source 2 that emits light
- a light source driving mechanism 4 that drives the light source 2
- a light detector 3 that detects light
- an A / D (A / D converter) 5 and a transmitter
- a light receiving control unit 21, an analysis control unit 122, and a memory 23 are provided.
- a display device 26 having a reference numeral 26a and a keyboard (input device) 27.
- the light source drive mechanism 4 drives the light source 2 by a drive signal input from the light transmission / reception controller 21.
- the light source 2 is, for example, a semiconductor laser LD1, LD2, or LD3 that can emit near-infrared light having three different wavelengths ⁇ 1 , ⁇ 2 , and ⁇ 3 .
- the photodetector 3 transmits and receives light reception signals (light reception amount information) A ( ⁇ 1 ), A ( ⁇ 2 ), and A ( ⁇ 3 ) via A / D 5 by detecting near infrared light respectively.
- a photomultiplier tube For example, a photomultiplier tube.
- the light transmitting optical fiber 14 and the light receiving optical fiber 15 are tubular having a diameter of 2 mm and a length of 2 m to 10 m, can transmit near infrared light in the axial direction, and receive near infrared light incident from one end. Light passes through the inside and exits from the other end, or near-infrared light incident from the other end passes through the inside and exits from one end.
- One light transmission optical fiber 14 has both end portions so that one light transmission probe 12 and one semiconductor laser LD1, LD2, LD3 of the light source 2 are separated by a set length (2 m to 10 m). Connected to.
- One light receiving optical fiber 15 connects one light receiving probe 13 and one photomultiplier tube of the photodetector 3 to both ends so as to be separated by a set length (2 m to 10 m). ing.
- FIG. 2 is a plan view showing an example of a holder 30 into which 64 light transmitting probes and 64 light receiving probes are inserted.
- the light transmitting probes 12 T1 to 12 T64 and the light receiving probes 13 R1 to 13 R64 are arranged so as to alternate between 16 in the vertical direction and 16 in the horizontal direction.
- the probe interval between the light transmitting probe 12 and the light receiving probe 13 becomes constant, and the received light amount information A ( ⁇ 1 ), A ( ⁇ 2 ), A ( ⁇ 3 ) having a specific depth from the scalp surface is obtained.
- a channel with a channel of 30 mm is used.
- the received light amount information A ( ⁇ 1 ), A ( ⁇ 2 ), 15 mm to 20 mm deep from the midpoint of the channel It is believed that A ( ⁇ 3 ) is obtained. That is, the position at a depth of 15 mm to 20 mm from the scalp surface almost corresponds to the brain surface region, and the received light amount information A ( ⁇ 1 ), A ( ⁇ 2 ), A ( ⁇ 3 ) related to the brain activity is obtained.
- the light transmission / reception control unit 21 Based on the control table stored in the memory 23, the light transmission / reception control unit 21 outputs a drive signal for transmitting light to one light transmission probe 12 to the light source drive mechanism 4 at a predetermined time, and A light reception signal (light reception amount information) received by the light reception probe 13 is detected by the photodetector 3.
- a total of 232 (S1 to S232) received light amount information A ( ⁇ 1 ), A ( ⁇ 2 ), and A ( ⁇ 3 ) are collected.
- the analysis control unit 122 uses relational expressions (1), (2), and (3) based on a total of 232 received light amount information A ( ⁇ 1 ), A ( ⁇ 2 ), and A ( ⁇ 3 ).
- a rehabilitation apparatus including a near-infrared spectrometer 101 that can obtain oxyhemoglobin concentration / optical path length product [oxyHb] (brain measurement data) of a patient's brain has been proposed (for example, Patent Documents). 3).
- the rehabilitation device can recall the brain activity corresponding to the exercise content targeted for rehabilitation based on the oxyhemoglobin concentration / optical path length product [oxyHb] etc. Whether or not the patient's brain can recall the brain activity and the degree to which the patient's brain can recall the brain activity are displayed in a graph.
- the brain measurement data may contain artifacts and noise caused by body movements (body movements such as the head and arms that are different from the paralyzed part) that do not correspond to the exercise content targeted for rehabilitation. The result might not be accurate.
- the present invention warns when the subject has caused a body motion that does not correspond to the exercise content to be rehabilitated (a body motion such as a head or an arm that is different from the paralyzed portion). It is an object of the present invention to provide a rehabilitation apparatus that can acquire accurate brain measurement data that does not enter, and can effectively rehabilitate a subject.
- the rehabilitation device of the present invention made to solve the above-described problems is a head mounted part arranged on the surface of the subject's scalp, and controls the head mounted part to obtain brain measurement data related to brain activity. And a determination unit for determining whether the subject's brain can recall brain activity corresponding to the motion content of the paralyzed portion to be rehabilitated based on the brain measurement data.
- a rehabilitation device comprising: a motion sensor attached to a part of the subject's body other than the paralyzed part; and body measurement data relating to body motion of the part of the subject's body from the motion sensor
- the body measurement data acquisition unit that obtains the body movement data detects that there is a body movement that does not correspond to the exercise content to be rehabilitated based on the body measurement data
- the body movement of a part of the subject's body is detected. stop So that and a warning unit for warning so as to.
- the head mounting portion is arranged on the scalp surface of the subject. Further, the motion sensor is attached to a part of the subject's body (for example, the head) different from the paralyzed part (for example, the hand). Then, the subject recalls the motion content (hand motion) of the paralyzed part performed as rehabilitation.
- the brain measurement data acquisition unit obtains brain measurement data related to brain activity from the head-mounted unit, and the body measurement data acquisition unit receives the body part (head) of the subject's body from the motion sensor. Obtain body measurement data about movement.
- the warning unit detects that there is a body movement (movement of the head, not the hand) that does not correspond to the exercise content to be rehabilitated, it stops the movement of a part of the subject's body (head). Warning to let you. As a result, the subject understands that the body part (head) is moving, and can stop the body movement of the body part (head). On the other hand, since the warning unit does not warn when there is no body movement (movement of the head, not the hand) that does not correspond to the exercise content targeted for rehabilitation, the subject does not exercise the exercise content (hand exercise for the rehabilitation target). ) Will continue to be recalled. As described above, according to the rehabilitation apparatus of the present invention, accurate brain measurement data free from artifacts and noise can be acquired, and the subject can perform rehabilitation effectively.
- the exercise content moves a hand that is a paralyzed part of the subject, and the motion sensor may be attached to the head of the subject.
- the head mounting unit is a light transmitting / receiving unit having at least one light transmitting probe disposed on the scalp surface and at least one light receiving probe disposed on the scalp surface.
- the brain measurement data acquisition unit controls the brain measurement by controlling the light transmitting probe to irradiate light on the scalp surface and the light receiving probe to detect light emitted from the scalp surface. Data may be obtained.
- the block diagram which shows the structure of the rehabilitation apparatus which is one Embodiment of this invention.
- the top view which shows an example of the holder in which a light transmission probe and a light reception probe are inserted.
- the block diagram which shows an example of schematic structure of the conventional near-infrared spectrometer.
- FIG. 1 is a block diagram showing a configuration of a rehabilitation apparatus according to an embodiment of the present invention.
- the rehabilitation device 1 has a rectangular parallelepiped housing 11. Inside the housing 11 are a light source 2 that emits light, a light source drive mechanism 4 that drives the light source 2, a light detector 3 that detects light, and A / D (A / D converters) 5 and 42. , A transmission / reception control unit (brain measurement data acquisition unit) 21, an analysis control unit (determination unit) 22, a motion sensor control unit (body measurement data acquisition unit) 31, a warning unit 32, and a memory 23.
- a transmission / reception control unit (brain measurement data acquisition unit) 21, an analysis control unit (determination unit) 22, a motion sensor control unit (body measurement data acquisition unit) 31, a warning unit 32, and a memory 23.
- the rehabilitation device 1 includes a holder 30 as shown in FIG.
- ⁇ in order to determine whether the brain of the patient (subject) can recall the brain activity corresponding to the exercise content to be rehabilitated, three different wavelengths ⁇ are used as brain measurement data. 1, lambda 2, concentration-path length product of oxyhemoglobin measured by near-infrared light lambda 3 [oxyHb], concentration-path length product of deoxyhemoglobin [deoxyHb] and concentration-path length product of total hemoglobin ([ oxyHb] + [deoxyHb]) value is used.
- the patient recalls the action of alternating the hand (part of the body) paralyzed due to sequelae of stroke with goo and par, and the hand paralyzed by recalling it The operation of alternating between Goo and Par is performed.
- determination for determining whether or not the brain measurement data indicating the brain activity corresponding to the exercise content to be rehabilitated recalls the brain activity corresponding to the exercise content to be rehabilitated. It is stored in advance as business data. For example, when the healthy subject performs the exercise contents targeted for rehabilitation, the oxyhemoglobin concentration / optical path length product [oxyHb], deoxyhemoglobin concentration / optical path at each brain coordinate position By measuring the value of long product [deoxyHb] and total hemoglobin and the optical path length product ([oxyHb] + [deoxyHb]), the concentration of oxyhemoglobin at the characteristic brain coordinate position (x, y, z) The optical path length product [oxyHb], deoxyhemoglobin concentration / optical path length product [deoxyHb], and total hemoglobin concentration / optical path length product ([oxyHb] + [deoxyHb]) are stored.
- the brain coordinate position (x 1 , y 1 , z 1 ) when it is determined that the brain coordinate position (x 1 , y 1 , z 1 ) is characteristic, the brain coordinate position Oxyhemoglobin concentration / optical path length product [oxyHb], deoxyhemoglobin concentration / optical path length product [deoxyHb] and total hemoglobin concentration / optical path length product ([oxyHb] + [deoxyHb] in (x 1 , y 1 , z 1 ) ]) Is stored as brain measurement data obtained when the hand is alternately moved to goo and par.
- the brain coordinate position (x, y, z) is a value indicated by a taranic coordinate or an MNI (Emni) coordinate.
- the analysis control unit 22 uses the relational expression (1) (based on a total of 232 received light amount information A ( ⁇ 1 ), A ( ⁇ 2 ), A ( ⁇ 3 ) ( 2) Using (3), from the passing light intensity of each wavelength (oxyhemoglobin absorption wavelength and deoxyhemoglobin absorption wavelength), oxyhemoglobin concentration / optical path length product [oxyHb], deoxyhemoglobin concentration / optical path length product Determine the concentration and path length product ([oxyHb] + [deoxyHb]) of [deoxyHb] and total hemoglobin.
- the analysis control unit 22 performs an action of alternating the hand between goo and par based on the oxyhemoglobin concentration / optical path length product [oxyHb] (brain measurement data) or the like (exercise content to be rehabilitated). It is determined whether or not the patient's brain can recall the brain activity corresponding to.
- the concentration / optical path length product [oxyHb] of oxyhemoglobin the concentration / optical path length product of deoxyhemoglobin [deoxyHb]
- the value of + [deoxyHb]) is compared with the value of the determination data to determine how close the brain measurement data value is to the determination data value.
- the analysis control unit 22 displays an image indicating the determination result on the monitor screen 26a. Thereby, the patient can perform rehabilitation effectively, observing the determination result.
- a part of the patient's body for example, the head
- the paralyzed part for example, the hand
- a motion sensor 41 for attaching to an arm or the like.
- the motion sensor 41 detects the body measurement data B indicating movement, and outputs the body measurement data B to the motion sensor control unit 31 via the A / D 42.
- a 3-axis acceleration sensor, 3-axis Gyro sensor 6-axis motion sensor For example, a 3-axis acceleration sensor, 3-axis Gyro sensor 6-axis motion sensor.
- the motion sensor control unit 31 performs control to acquire the body measurement data B detected by the motion sensor 41 at a predetermined time interval (for example, every 1 second).
- the warning unit 32 detects, based on the body measurement data B, that there is a body motion that does not correspond to the exercise content to be rehabilitated. Control to warn to stop. For example, when the body sensor data B exceeds a threshold value even though the motion sensor 41 is attached to the patient's head and the patient recalls the action of alternating hands with goo and par, the monitor screen 26a is displayed. The image is displayed as “Do not move your head”. On the other hand, when the body measurement data B is equal to or less than the threshold value, no image display indicating a warning is performed on the monitor screen 26a.
- FIG. 3 is a flowchart for explaining an example of the rehabilitation method.
- a doctor or the like places the holder 30 on the surface of the patient's scalp and attaches the motion sensor 41 to the patient's head (part of the body different from the paralyzed portion (hand)).
- the patient is instructed to recall the motion (exercise content to be rehabilitated) of alternating hands with goo and par.
- the light transmission / reception control unit 21 transmits a drive signal for transmitting light to one light transmission probe 12 at a predetermined time based on the control table stored in the memory 23. While outputting to the light source drive mechanism 4, the light receiving signal (brain measurement data) received by the light receiving probe 13 is detected by the photodetector 3.
- the motion sensor control unit 31 acquires the body measurement data B detected by the motion sensor 41.
- the warning unit 32 determines, based on the body measurement data B, whether there is a head movement (body movement not corresponding to the rehabilitation target movement content).
- the analysis control unit 22 determines the oxyhemoglobin concentration / optical path length product [oxyHb] (brain Based on the measurement data, etc., it is determined whether or not the patient's brain can recall the brain activity corresponding to the action of alternating the hand between goo and par (exercise content to be rehabilitated).
- the analysis control unit 22 Does not display an image indicating a warning on the monitor screen 26a, but displays an image indicating that “you are recalling well”.
- the control for analysis is performed in the process of step S108.
- the unit 22 displays an image indicating “not recalled” on the monitor screen 26a.
- step S109 the warning unit 32 determines that the head movement (rehabilitation target). An image indicating a warning is displayed on the monitor screen 26a so as to stop the body movement not corresponding to the exercise content. Then, after performing either the process of step S107, the process of step S108, or the process of step S109, it is determined in the process of step S110 whether or not the patient continues to perform rehabilitation. When it is determined that the patient continues to perform rehabilitation, the process returns to step S102. That is, the processes in steps S102 to S110 are repeated until it is determined that the patient stops rehabilitation. On the other hand, when it is determined that the patient stops rehabilitation, this flowchart is ended.
- ⁇ Other embodiments > (1) In the rehabilitation apparatus 1 described above, the holder 30 having 64 light transmitting probes 12 and 64 light receiving probes 13 is shown. However, different numbers, for example, 9 light transmitting probes and 9 light receiving probes are used. It is good also as a holder which has. (2) In the rehabilitation apparatus 1 described above, the concentration / optical path length product [oxyHb] of oxyhemoglobin and deoxyhemoglobin measured with three different wavelengths ⁇ 1 , ⁇ 2 , and ⁇ 3 as the brain measurement data.
- the rehabilitation apparatus 1 described above the configuration in which one motion sensor 41 is attached to the patient's head has been shown.
- the motion sensor 41 may be attached to the patient's arm. It is good also as a structure attached to a leg
- the rehabilitation apparatus 1 described above when the value of the brain measurement data falls within a predetermined range of the determination data, the patient's brain can recall the brain activity corresponding to the exercise content to be rehabilitated. However, it is also possible to display a graph showing the extent to which the patient's brain can recall brain activity.
- the present invention can be used in a rehabilitation apparatus for rehabilitation of a patient (subject) whose body part has been paralyzed due to sequelae of stroke or the like.
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Abstract
Description
そして、このようにして得られた受光量情報A(λ1)、A(λ2)、A(λ3)から、脳血流中のオキシヘモグロビンの濃度・光路長積[oxyHb]と、デオキシヘモグロビンの濃度・光路長積[deoxyHb]とを求めるために、例えば、Modified Beer Lambert則を用いて関係式(1)(2)(3)に示す連立方程式を作成して、この連立方程式を解いている(例えば、非特許文献1参照)。さらには、オキシヘモグロビンの濃度・光路長積[oxyHb]と、デオキシヘモグロビンの濃度・光路長積[deoxyHb]とから総ヘモグロビンの濃度・光路長積([oxyHb]+[deoxyHb])を算出している。
A(λ1)=EO(λ1)×[oxyHb]+Ed(λ1)×[deoxyHb]・・・(1)
A(λ2)=EO(λ2)×[oxyHb]+Ed(λ2)×[deoxyHb]・・・(2)
A(λ3)=EO(λ3)×[oxyHb]+Ed(λ3)×[deoxyHb]・・・(3)
なお、EO(λm)は、波長λmの光におけるオキシヘモグロビンの吸光度係数であり、Ed(λm)は、波長λmの光におけるデオキシヘモグロビンの吸光度係数である。
送光プローブ12が被検者の頭皮表面の送光点Tに押し当てられるとともに、受光プローブ13が被検者の頭皮表面の受光点Rに押し当てられる。そして、送光プローブ12から光を照射させるとともに、受光プローブ13に頭皮表面から放出される光を入射させる。このとき、光は、頭皮表面の送光点Tから照射された光のうちで、バナナ形状(測定領域)を通過した光が、頭皮表面の受光点Rに到達する。これにより、測定領域の中でも、特に送光点Tと受光点Rとを被検者の頭皮表面に沿って最短距離で結んだ線Lの中点Mから、送光点Tと受光点Rとを被検者の頭皮表面に沿って最短距離で結んだ線の距離の半分の深さL/2である被検者の測定部位Sに関する受光量情報A(λ1)、A(λ2)、A(λ3)が得られるとしている。
図5は、従来の近赤外分光分析計の概略構成の一例を示すブロック図である。なお、見やすくするために、数本の送光用光ファイバや数本の受光用光ファイバ等を省略している。
近赤外分光分析計101は、直方体形状の筐体11を有する。
筐体11の内部には、光を出射する光源2と、光源2を駆動する光源駆動機構4と、光を検出する光検出器3と、A/D(A/Dコンバータ)5と、送受光用制御部21と、解析用制御部122と、メモリ23とを備える。また、筐体11の外部には、64個の送光プローブ12と、64個の受光プローブ13と、64本の送光用光ファイバ14と、64本の受光用光ファイバ15と、モニタ画面26a等を有する表示装置26と、キーボード(入力装置)27とを備える。
光検出器3は、近赤外光をそれぞれ検出することにより、受光信号(受光量情報)A(λ1)、A(λ2)、A(λ3)をA/D5を介して送受光用制御部21に出力する検出器であり、例えば、光電子増倍管等である。
1本の送光用光ファイバ14は、1個の送光用プローブ12と、光源2の1個の半導体レーザLD1、LD2、LD3とを設定長さ(2m~10m)で離れるように両端部に接続している。
1本の受光用光ファイバ15は、1個の受光用プローブ13と、光検出器3の1個の光電子増倍管とを設定長さ(2m~10m)で離れるように両端部に接続している。
送光プローブ12T1~12T64と受光プローブ13R1~13R64とは、縦方向に16個と横方向に16個とに交互となるように配置されることになる。これにより、送光プローブ12と受光プローブ13とのプローブ間隔が一定となり、頭皮表面から特定の深度となる受光量情報A(λ1)、A(λ2)、A(λ3)を得ている。なお、一般的にチャンネルを30mmとしたものが用いられ、チャンネルが30mmである場合には、チャンネルの中点からの深度15mm~20mmの受光量情報A(λ1)、A(λ2)、A(λ3)が得られると考えられている。すなわち、頭皮表面から深度15mm~20mmの位置は脳表部位にほぼ対応し、脳活動に関係した受光量情報A(λ1)、A(λ2)、A(λ3)を得ている。
その結果、図2に示すように平面視すると、合計232個(S1~S232)の受光量情報A(λ1)、A(λ2)、A(λ3)の収集が行なわれる。
そして、解析用制御部122は、合計232個の受光量情報A(λ1)、A(λ2)、A(λ3)に基づいて、関係式(1)(2)(3)を用いて、各波長(オキシヘモグロビンの吸収波長及びデオキシヘモグロビンの吸収波長)の通過光強度から、オキシヘモグロビンの濃度・光路長積[oxyHb]、デオキシヘモグロビンの濃度・光路長積[deoxyHb]及び総ヘモグロビンの濃度・光路長積([oxyHb]+[deoxyHb])を求めている。
これにより、患者がリハビリを行う際に、リハビリ装置がオキシヘモグロビンの濃度・光路長積[oxyHb]等に基づいて、リハビリの対象とする運動内容に対応する脳活動を患者の脳が想起できているか否かを判定することで、患者の脳が脳活動を想起できていることや、患者の脳が脳活動を想起できている程度をグラフで表示することが実行されている。
そこで、本発明は、被検者がリハビリの対象とする運動内容に対応しない体動(麻痺部分とは異なる頭部や腕等の体動)を起こした場合に警告することにより、アーティファクトや雑音が入らない正確な脳測定データを取得することができ、被検者が効果的にリハビリを行うことができるリハビリ装置を提供することを目的とする。
一方、警告部は、リハビリの対象とする運動内容に対応しない体動(手でなく頭の運動)がないときには、警告しないため、被検者は、リハビリの対象とする運動内容(手の運動)を想起し続けることになる。
以上のように、本発明のリハビリ装置によれば、アーティファクトや雑音が入らない正確な脳測定データを取得することができ、被検者は効果的にリハビリを行うことができる。
また、本発明のリハビリ装置は、前記運動内容は、前記被検者の麻痺部分である手を動かすものであり、前記モーションセンサは、前記被検者の頭部に取り付けられるようにしてもよい。
さらに、本発明のリハビリ装置は、前記頭部装着部は、前記頭皮表面に配置される少なくとも一つの送光プローブと、前記頭皮表面に配置される少なくとも一つの受光プローブとを有する送受光部であり、前記脳測定データ取得部は、前記送光プローブが前記頭皮表面に光を照射するとともに、前記受光プローブが前記頭皮表面から放出される光を検出するように制御することで、前記脳測定データを得るようにしてもよい。
リハビリ装置1は、直方体形状の筐体11を有する。筐体11の内部には、光を出射する光源2と、光源2を駆動する光源駆動機構4と、光を検出する光検出器3と、A/D(A/Dコンバータ)5、42と、送受光用制御部(脳測定データ取得部)21と、解析用制御部(判定部)22と、モーションセンサ制御部(体測定データ取得部)31と、警告部32と、メモリ23とを備えるとともに、筐体11の外部には、64個の送光プローブ12と、64個の受光プローブ13と、64本の送光用光ファイバ14と、64本の受光用光ファイバ15と、モーションセンサ41と、モニタ画面26a等を有する表示装置26と、キーボード(入力装置)27とを備える。
また、リハビリ装置1は、図2に示すようなホルダ30を備えている。
例えば、健康な被検者が手をグーとパーとに交互にする動作を行った場合に、脳座標位置(x1、y1、z1)に特徴があると判断したときには、脳座標位置(x1、y1、z1)におけるオキシヘモグロビンの濃度・光路長積[oxyHb]、デオキシヘモグロビンの濃度・光路長積[deoxyHb]及び総ヘモグロビンの濃度・光路長積([oxyHb]+[deoxyHb])の値を、手をグーとパーとに交互にする動作を行うときに得られる脳測定データとして記憶させておく。なお、脳座標位置(x、y、z)は、タライニック座標やMNI(エムニ)座標で示される値である。
例えば、脳座標位置(x、y、z)において、オキシヘモグロビンの濃度・光路長積[oxyHb]、デオキシヘモグロビンの濃度・光路長積[deoxyHb]及び総ヘモグロビンの濃度・光路長積([oxyHb]+[deoxyHb])の値と、判定用データの値とを比較して、脳測定データの値が判定用データの値にどの程度近いかを判定する。このとき、脳測定データの値が判定用データの所定の範囲に入ったときには、手をグーとパーとに交互にする動作(リハビリの対象とする運動内容)に対応する脳活動を患者の脳が想起できているとする。そして、解析用制御部22は、モニタ画面26aに判定結果を示す画像表示を行う。これにより、患者は、判定結果を観察しながら効果的にリハビリを行うことができる。
モーションセンサ制御部31は、患者がリハビリを行う際には、モーションセンサ41で検出された体測定データBを所定の時間間隔(例えば、1秒間隔)で取得していく制御を行う。
まず、ステップS101の処理において、医師等は患者の頭皮表面にホルダ30を配置するとともに、患者の頭部(麻痺部分(手)とは異なる身体の一部)にモーションセンサ41を取り付ける。
次に、ステップS102の処理において、患者に、手をグーとパーとに交互にする動作(リハビリの対象とする運動内容)を想起させるように指示する。
次に、ステップS103の処理を実行すると同時に、ステップS104の処理において、モーションセンサ制御部31は、モーションセンサ41で検出された体測定データBを取得する。
次に、ステップS105の処理において、警告部32は、体測定データBに基づいて、頭の運動(リハビリの対象とする運動内容に対応しない体動)があるか否かを判定する。頭の運動(リハビリの対象とする運動内容に対応しない体動)がないと判定したときには、ステップS106の処理において、解析用制御部22は、オキシヘモグロビンの濃度・光路長積[oxyHb](脳測定データ)等に基づいて、手をグーとパーとに交互にする動作(リハビリの対象とする運動内容)に対応する脳活動を患者の脳が想起できているか否かを判定する。
一方、手をグーとパーとに交互にする動作(リハビリの対象とする運動内容)に対応する脳活動を患者の脳が想起できていないと判定したときには、ステップS108の処理において、解析用制御部22は、モニタ画面26aに「想起できていない」ことを示す画像表示を行う。
そして、ステップS107の処理かステップS108の処理かステップS109の処理かのいずれかの処理を実行した後には、ステップS110の処理において、患者がリハビリを行うことを続けるか否かを判断する。患者がリハビリを行うことを続けると判断したときには、ステップS102の処理に戻る。つまり、患者がリハビリを行うことを止めると判断するまで、ステップS102~ステップS110の処理は繰り返される。
一方、患者がリハビリを行うことを止めると判断したときには、本フローチャートを終了させる。
(1)上述したリハビリ装置1では、64個の送光プローブ12と64個の受光プローブ13とを有するホルダ30を示したが、異なる数、例えば9個の送光プローブと9個の受光プローブとを有するホルダとしてもよい。
(2)上述したリハビリ装置1では、脳測定データとして異なる3種類の波長λ1、λ2、λ3の近赤外光で計測されるオキシヘモグロビンの濃度・光路長積[oxyHb]、デオキシヘモグロビンの濃度・光路長積[deoxyHb]及び総ヘモグロビンの濃度・光路長積([oxyHb]+[deoxyHb])の値を利用する構成を示したが、脳波計(EEG)等により取得された脳測定データを利用する構成としてもよい。
(4)上述したリハビリ装置1では、脳測定データの値が判定用データの所定の範囲に入ったときには、リハビリの対象とする運動内容に対応する脳活動を患者の脳が想起できているとする構成を示したが、患者の脳が脳活動を想起できている程度をグラフで表示する構成としてもよい。
12: 送光プローブ
13: 受光プローブ
21: 送受光部制御部(脳測定データ取得部)
22: 解析用制御部(判定部)
30: ホルダ(頭部装着部)
31: モーションセンサ制御部(体測定データ取得部)
32: 警告部
41: モーションセンサ
T: 送光点
R: 受光点
M: 計測点
Claims (3)
- 被検者の頭皮表面に配置される頭部装着部と、
前記頭部装着部を制御することで、脳活動に関する脳測定データを得る脳測定データ取得部と、
前記脳測定データに基づいて、リハビリの対象とする麻痺部分の運動内容に対応する脳活動を前記被検者の脳が想起できているか否かを判定する判定部と備えるリハビリ装置であって、
前記麻痺部分以外となる前記被検者の身体の一部に取り付けられるモーションセンサと、
前記モーションセンサから前記被検者の身体の一部の体動に関する体測定データを得る体測定データ取得部と、
前記体測定データに基づいて、前記リハビリの対象とする運動内容に対応しない体動があると検知したときには、前記被検者の身体の一部の体動を停止させるように警告する警告部とを備えることを特徴とするリハビリ装置。 - 前記運動内容は、前記被検者の麻痺部分である手を動かすものであり、
前記モーションセンサは、前記被検者の頭部に取り付けられることを特徴とする請求項1に記載のリハビリ装置。 - 前記頭部装着部は、前記頭皮表面に配置される少なくとも一つの送光プローブと、前記頭皮表面に配置される少なくとも一つの受光プローブとを有する送受光部であり、
前記脳測定データ取得部は、前記送光プローブが前記頭皮表面に光を照射するとともに、前記受光プローブが前記頭皮表面から放出される光を検出するように制御することで、前記脳測定データを得ることを特徴とする請求項1又は請求項2に記載のリハビリ装置。
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JP2008245917A (ja) * | 2007-03-30 | 2008-10-16 | Nagaoka Univ Of Technology | 振戦疾患評価装置及び振戦疾患評価方法 |
JP2009285294A (ja) * | 2008-05-30 | 2009-12-10 | Toyota Central R&D Labs Inc | 脳訓練支援装置 |
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JP5573845B2 (ja) * | 2009-12-01 | 2014-08-20 | 株式会社島津製作所 | 光計測システム、それに用いられる携帯型光計測装置及びその使用方法 |
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2011
- 2011-08-10 US US14/131,413 patent/US20140243611A1/en not_active Abandoned
- 2011-08-10 CN CN201180072787.7A patent/CN103732198B/zh not_active Expired - Fee Related
- 2011-08-10 WO PCT/JP2011/068301 patent/WO2013021492A1/ja active Application Filing
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JP2004294593A (ja) * | 2003-03-26 | 2004-10-21 | Hitachi Ltd | 訓練支援装置 |
JP2006263460A (ja) * | 2005-02-25 | 2006-10-05 | Advanced Telecommunication Research Institute International | リハビリテーション支援装置 |
JP2008245917A (ja) * | 2007-03-30 | 2008-10-16 | Nagaoka Univ Of Technology | 振戦疾患評価装置及び振戦疾患評価方法 |
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Cited By (3)
Publication number | Priority date | Publication date | Assignee | Title |
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CN108538383A (zh) * | 2017-03-06 | 2018-09-14 | 顾以群 | 一种用于远程康复系统的康复指导方法及装置 |
JP2021037211A (ja) * | 2019-09-05 | 2021-03-11 | 富士ゼロックス株式会社 | 生体情報測定装置、生体情報測定システム、及び生体情報測定プログラム |
JP7318430B2 (ja) | 2019-09-05 | 2023-08-01 | 富士フイルムビジネスイノベーション株式会社 | 生体情報測定装置、生体情報測定システム、及び生体情報測定プログラム |
Also Published As
Publication number | Publication date |
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CN103732198B (zh) | 2016-03-16 |
US20140243611A1 (en) | 2014-08-28 |
JP5804063B2 (ja) | 2015-11-04 |
JPWO2013021492A1 (ja) | 2015-03-05 |
CN103732198A (zh) | 2014-04-16 |
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