Classifications

• • A—HUMAN NECESSITIES
  • A41—WEARING APPAREL
  • A41D—OUTERWEAR; PROTECTIVE GARMENTS; ACCESSORIES
  • A41D1/00—Garments
  • A41D1/002—Garments adapted to accommodate electronic equipment
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
  • A61N1/00—Electrotherapy; Circuits therefor
  • A61N1/02—Details
  • A61N1/04—Electrodes
  • A61N1/0404—Electrodes for external use
  • A61N1/0472—Structure-related aspects
  • A61N1/0484—Garment electrodes worn by the patient
• • 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
  • A61H23/00—Percussion or vibration massage, e.g. using supersonic vibration; Suction-vibration massage; Massage with moving diaphragms
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
  • A61N1/00—Electrotherapy; Circuits therefor
  • A61N1/02—Details
  • A61N1/04—Electrodes
  • A61N1/0404—Electrodes for external use
  • A61N1/0408—Use-related aspects
  • A61N1/0452—Specially adapted for transcutaneous muscle stimulation [TMS]
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
  • A61N1/00—Electrotherapy; Circuits therefor
  • A61N1/18—Applying electric currents by contact electrodes
  • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
  • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
  • A61N1/36003—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation of motor muscles, e.g. for walking assistance
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
  • A61N1/00—Electrotherapy; Circuits therefor
  • A61N1/18—Applying electric currents by contact electrodes
  • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
  • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
  • A61N1/36014—External stimulators, e.g. with patch electrodes
  • A61N1/36021—External stimulators, e.g. with patch electrodes for treatment of pain
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
  • A61N1/00—Electrotherapy; Circuits therefor
  • A61N1/18—Applying electric currents by contact electrodes
  • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
  • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
  • A61N1/36014—External stimulators, e.g. with patch electrodes
  • A61N1/3603—Control systems

Definitions

• the present invention relates to a medical therapy arrangement according to the preamble of the independent claim.
• the present invention relates in general to muscle relaxation, and more particular to muscle relaxation for spastic muscles in patients having injuries to the central nervous system (CNS) at least by using muscle stimulation.
• CNS central nervous system
• musculoskeletal pain is a common related complaint. Pain originating from dysfunction in the musculoskeletal system is in most cases caused by muscle spasms due to muscular imbalance. If the pain is not treated properly, patients risk developing chronic pain syndromes, conditions that are difficult to cure.
• EMS Electrical muscle stimulation
• electromyostimulation is a commonly known method for increasing muscle mass in specific areas, by providing an electric current into the muscle causing contraction, which gradually leads to increased mass in the treated muscle.
• Trancutaneous Electrical Nerve Stimulation (TENS) is closely related to EMS, but instead of stimulating muscles to contract, electric stimulation is used to indirectly treat pain, by distracting the brain through the stimulation of other body parts.
• TENS Trancutaneous Electrical Nerve Stimulation
• US-4,580,572 a garment for electrical monitoring of sites or electrical stimulation, such as EMS is disclosed.
• the parameters of the EMS current signal may be chosen which resemble the physiology of the body.
• the signals in the nervous system may be compared to current impulses (stimuli) to the synapses. When a certain amount of stimuli has occurred, signal substances are excreted.
• a phasic EMS-stimulus is given with a frequency ranging between 2 and 50 Hz, and having a duration between 5 to 300 microseconds.
• Muscle relaxation in spastic muscles gives the possibility to induce controlled functional muscle contraction in chosen relaxed muscles.
• the frequency needed to induce muscle contraction is higher than the frequency used for optimal antagonist muscle relaxation (20Hz/30 ⁇ ).
• Stimulation frequencies for functional muscle contraction are ranging from 25 to 50 Hz and the duration needed is between 50-300 ⁇ .
• the pulsed EMS current signal is controlled by at least the following parameters; pulse frequency, pulse duration, pulse strength.
• the pulse duration of the current signal is selected such that it resembles the pulse duration of nervous signals. For example, a pulse duration of approximately 5 to 60 microseconds, such as 30 ⁇ , has been found to be suitable. However, even shorter pulse duration could be advantageous. Too long pulse duration of the EMS current signal does not correspond to the neurophysiologic parameters of the body.
• the professional skills of a neuromuscular system specialist is required for calibrating the system before use, such that the correct agonist muscles are provided with EMS electrodes and joints corresponding thereto are provided with vibrator devices. Every chosen muscle stimulation is paired with an anatomically relevant joint stimulation in order to strengthen the desired relaxation effect. Furthermore, the parameters of the pulsed EMS current signal need to be selected, which parameters may differ between patients.
• WO- 2011/067327 relates to a system and garment for muscle relaxation of a spastic muscle, and is assigned to the applicant of the present application.
• the system is adapted to cause muscle relaxation by reducing muscular spasticity through stimulation of joints and muscles.
• the system consists of a garment with electrodes, a hardware unit and software controlling the stimulation.
• WO-03/006106 relates to a method and apparatus for electrical stimulation to selected tissues via an array of electrodes positioned on and/or in the body. Each electrode may be connected either as anode, cathode or neither to provide discrimination between stimulated and non-stimulated regions of tissues of the body.
• WO-2011/079866 relates to an apparatus for external activation of paralyzed body parts by stimulation of peripheral nerves.
• US-2011/0152968 relates to an orthosis for a gait modulation system, and finally, US- 7072721, that relates to an electrode vest for electrical stimulation of the abdomen and back
• US- 7072721 that relates to an electrode vest for electrical stimulation of the abdomen and back
• electrode patches provided with an adhesive for attaching the electrodes to the patient's skin. These electrode patches are disposable, and it is often very time-consuming to attach the electrodes and to connect the electrical cables to each of the electrode patches.
• the object of the present invention is to achieve an improved stimulation therapy arrangement, which is more user-friendly and less time-consuming to use, than the presently used adhesive electrodes.
• an electrical stimulation therapy preferably must be applied at least 30 minutes in order to give prolonged effect
• one further and important aspect of the stimulation therapy arrangement is that it is comfortable and easy to use for the wearer.
• One great advantage of the arrangement according to the present invention is that it is easy to use. This is, among other things, related to that the control unit that includes the pulse generating circuitry, is easily attached to the garment by some few manual steps by attaching the connection board to a connection unit which is integrated into the garment.
• the garment is elastic and is intended to be tightly worn by the patient.
• the garment is ready for use in a user- friendly way for external electrical stimulation therapy of muscles.
• Electrodes e.g. silicone-electrodes, are arranged at the inner surface of the garment, the surface facing the patient's skin and in contact to the patient's skin.
• the electrical connections connecting the electrodes to connection units are flexible and elastic.
• the garment is made from materials chosen such that the garment may be washed in conventional laundry machines.
• the garment includes electrical connections adapted to connect the electrodes to one or several connection units, which do not influence the overall flexibility/elasticity of the garment. This is achieved, according to one embodiment, by integrating, e.g. by weaving silver threads into elastic bands or ribbons or into a piece of elastic.
• an insulated conductor is integrated (e.g. weaved) into a piece of elastic.
• connection units are integrated into the garment, they have e.g. a flat extension, and they are flexible.
• they are made from a rubber material and are provided with a magnetic material.
• each connection element of the connection unit is provided with a magnet beneath the rubber material and arranged such that a connection pad may be attached at the upper surface and held in place by the magnet.
• the connection pad is naturally also provided with a magnetic material enabling the attachment.
• connection pads are arranged at a flexible flat board having the magnetic material arranged at predefined positions in order to exactly connect each of the connection pads to a mating connection element of the connection unit.
• the connection board and the connection unit are held together by the magnetic forces created by the magnetic material at the respective parts.
• both the connection unit(s) at the garment and the connection board(s) are made of a flexible material, which is an important aspect making the garment more comfortable to wear.
• the control unit is adapted to control connection of each of the electrodes to be in the state of acting as anode, cathode, or being disconnected.
• the control unit enables a very flexible control of the application of the stimulation pulses and by using short simulation pulse durations very complex stimulation programs may be used in that many muscles and muscle groups may be covered during the therpy.
• the control unit preferably applies a so-called open-loop control, i.e. no feedback is used to control the applied current/voltage.
• open-loop control i.e. no feedback is used to control the applied current/voltage.
• the amount of energy supplied to the patient via the electrodes is much lower than the energy levels used for by devices for pain relief.
• One risk, or drawback, with such devices is that the applied energy might stimulate the muscle to contract.
• the level of the stimulation energy used in connection with the present invention is much lower than used for example in the device described in WO-03/006106.
• Figure 1 is a schematic block diagram illustrating the medical therapy arrangement according to the present invention.
• Figure 2 is a schematic cross-sectional view of a part of the connector board and connector unit according to an embodiment of the present invention.
• Figure 3 is a schematic block diagram illustrating another embodiment of the medical therapy arrangement according to the present invention.
• the present invention relates to a medical therapy arrangement 2, for applying electrical stimulation to a human or animal subject, comprising a garment 4 adapted to be tightly arranged at said subject, and provided with a plurality of electrodes 6 at the inner surface which are adapted to be in electrical contact to the skin of the subject.
• the arrangement further comprises a control unit 8 which is adapted to provide each electrode 6 to work as one or many of anode, cathode or being disconnected, in accordance with a predetermined therapy stimulation program.
• connection unit 10 which comprises a predetermined number of connection elements 12 being respectively electrically connected to the electrodes 6 via separate connection lines 14, which are flexible and elastic.
• connection board 16 is provided which comprises a predetermined number of connection pads 18 being electrically connected to the control unit 8.
• connection unit 10 is an integrated part of the garment 4 and preferably arranged such that the connection elements 12 are accessible to establish electrical connections to the connection pads 18 of said connection board 16.
• connection board 16 is detachably attachable to the connection unit 10 by a fastening means 20, such that the connection unit 10 and the connection board 16, when attached to each other, are positioned in relation to each other in order to electrically connect the connection pads 18 to mating connection elements 12.
• the fastening means 20 is adapted to detachably attach the connection board 16 to the connection unit 10 by magnetic forces.
• Figure 2 is a schematic cross-sectional view of a part of the connector board 16 and the connector unit 10.
• the magnetic forces are created by magnetic material, in the figure indicated as separate magnets, arranged at predefined positions of the connection board 16 and the connection unit 10, respectively.
• the magnets are arranged behind each of the pads 18 and elements 12 in order to secure the electrical connection.
• the magnets may be arranged e.g. behind every second pad and element or at positions close to the pads and elements.
• connection board 16 and connection unit 10 ensure that these are correctly positioned in relation to each other.
• one or many protuberances and mating indentations may be arranged at the connection board and connection unit, respectively.
• the fastening means 20 comprises mechanical means which is adapted to detachably attach the connection board to the connection unit.
• These mechanical means may e.g. comprise one or many Velcro straps arranged to provide for the necessary pressure between the connection board and connection unit in order to establish electrical connection between the pads and elements.
• the mechanical means may also be embodied by some kind of snap connection.
• connection unit 10 has an essentially planar extension and is made from a flexible material, e.g. a flexible rubber material.
• connection board 16 has an essentially planar extension and is made from a flexible material, e.g. a flexible rubber material.
• connection unit 10 is made from a flexible material, in order to make the garment comfortable to wear, but it is also possible, within the scope of the present invention, that the connection board 16 and/or the connection unit 10 is made from a rigid material.
• connection unit is made from a flexible material but the connection board is made from a more rigid material, e.g. from a suitable plastic material.
• connection board 16 and the connection unit 10 have essentially the same size.
• shape is approximately rectangular having a length in the interval of 8-12 cm, a width of 1.5-3 cm and a thickness of 0.25-1.5 cm.
• connection lines 14, that connect each electrode 6 to a respective connection element 12, are flexible and elastic such the wearer of the garment may move unimpededly.
• the connection line 14 is included into a piece of elastic into which an electrical conductor is integrated. This is achieved e.g. by weaving conducting threads, e.g. made from silver, into the piece of elastic.
• the connection line 14 is an insulated conductor being directly integrated, e.g. by weaving, into the material of the garment.
• the control unit 8 is preferably a separate unit in relation to the connection board 16, and that the connection pads 18 are connected to the control unit 8 via an electrical cable 22.
• the control unit 8 comprises a stimulation pulse generator, an energy source, a storage means, an input/output unit and a coupling unit.
• the energy source typically being a battery, e.g. a rechargeable battery, is adapted to energize the circuitry of the control unit, e.g. the stimulation pulse generator.
• the predetermined therapy stimulation program is stored in the storage means and specific instructions related to the specific patient to be treated is input by the physician via the interface.
• the input/output unit may include one or many buttons and a display, e.g. a touchscreen.
• control unit is preferably attached to the garment wearer by some kind of strap in a position where it is easily accessed but not prevents movements.
• control unit instead is an integral part of the connection board, and then the connecting electrical cable is obviated.
• the control unit is preferably adapted to apply an open-loop control when controlling the application of stimulation pulses. I.e. no feed-back is used which is advantageous in order to avoid that higher stimulation current is applied in the situation where an electrode loses, or has less, contact to the skin.
• the garment is preferably made from a predetermined number of interconnectable parts. The reason is that the garment then is easier to put on. Each part is then provided with a connection unit that in turn is connected to the electrodes.
• a part of the body has to be subjected to stimulation, e.g. an arm or a leg.
• a garment is used that is adapted to enclose that part.
• the entire body has to be enclosed by the garment in order to gain full effect of the therapy.
• the garment comprises a synthetic fiber made from a polyurethane-polyurea copolymer, e.g. spandex or elastene.
• the garment comprises five major textile and support materials. Elastic spandex for areas covering muscles and, embedded in this spandex, muscle electrodes for skin contact; firm elastic spandex textile in joint areas to induce joint stability and specific skin contact of embedded muscle and vibration (if included) electrodes; and Velcro to interlock the garment parts and also induce joint stability and electrode skin contact. Zippers are placed in the different garment parts to enable simple dressing and use of the garment. Padding and other supportive materials are placed between the textile layers to enhance stability and electrode skin contact.
• each garment may be tailor made for each patient. Hence, each patient may be individually measured. Based on the calibration made by the specialist, the therapist chooses which muscles to stimulate and therefore induce muscle relaxation of corresponding spastic muscles.
• the tailor made garment is produced and the control unit is programmed with the necessary parameters such as to perform a vibrator (if included) and EMS stimulation in the prescribed manner.
• the electrodes are arranged at the inner surface of the garment and must therefore be flexible to adapt to the skin surface.
• the electrodes are silicone-electrodes.
• the number of electrodes is naturally dependent upon the therapy to be applied, but preferably at least ten electrodes are included, often much more.
• control unit comprises a sensing unit adapted to receive electrical signals, e.g. EMG- signals, sensed by one or many of said electrodes. The received signals may then be analyzed and used to improve the therapy.
• sensed electrical signals are used to decide which therapy to be used and then apply that therapy in accordance with an open-loop controlled stimulation therapy.
• the arrangement also provides for combined electrical and vibration therapy. This embodiment is schematically illustrated in figure 3. The same references used in figure 1 and 2 apply here as well.
• a plurality of vibration units 7 are arranged at the garment, e.g. at the inner surface of the garment, and wherein each vibration unit being connected to the connection unit via a flexible and elastic vibration unit connection line 15.
• the vibration units may also be arranged at the outer surface of the garment and apply the vibrations through the garment material.
• vibration units may be used, e.g. based upon piezo-technology, a so- called DC-motor, or a solenoid based unit.
• the relation between the number of electrical stimulation electrodes and vibration units is 2: 1. However, even fewer vibration units may be used.

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• Health & Medical Sciences (AREA)
• Life Sciences & Earth Sciences (AREA)
• General Health & Medical Sciences (AREA)
• Veterinary Medicine (AREA)
• Public Health (AREA)
• Animal Behavior & Ethology (AREA)
• Engineering & Computer Science (AREA)
• Radiology & Medical Imaging (AREA)
• Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
• Biomedical Technology (AREA)
• Heart & Thoracic Surgery (AREA)
• Biophysics (AREA)
• Pain & Pain Management (AREA)
• Physical Education & Sports Medicine (AREA)
• Epidemiology (AREA)
• Rehabilitation Therapy (AREA)
• Textile Engineering (AREA)
• Electrotherapy Devices (AREA)
• Neurology (AREA)

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Related Child Applications (2)

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Cited By (4)

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Citations (4)

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• 2012
  • 2012-06-26 SE SE1250685A patent/SE1250685A1/sv not_active Application Discontinuation
• 2013
  • 2013-06-17 JP JP2015520117A patent/JP2015521521A/ja active Pending
  • 2013-06-17 EP EP13734525.2A patent/EP2863983B8/en active Active
  • 2013-06-17 US US14/410,965 patent/US10279164B2/en active Active
  • 2013-06-17 EP EP21166903.1A patent/EP3878506B1/en active Active
  • 2013-06-17 WO PCT/SE2013/050700 patent/WO2014003633A1/en not_active Ceased

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