WO2015052816A1 - Système d'aide de rééducation et unité de mesure de fonction cérébrale - Google Patents

Système d'aide de rééducation et unité de mesure de fonction cérébrale Download PDF

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Publication number
WO2015052816A1
WO2015052816A1 PCT/JP2013/077664 JP2013077664W WO2015052816A1 WO 2015052816 A1 WO2015052816 A1 WO 2015052816A1 JP 2013077664 W JP2013077664 W JP 2013077664W WO 2015052816 A1 WO2015052816 A1 WO 2015052816A1
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WO
WIPO (PCT)
Prior art keywords
rehabilitation
index
brain function
subject
brain
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Application number
PCT/JP2013/077664
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English (en)
Japanese (ja)
Inventor
石川　亮宏
井上　芳浩
晴英 宇田川
善紀 増田
孝司 網田
俊平 山口
晴雄 宇野
Original Assignee
株式会社島津製作所
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Application filed by 株式会社島津製作所 filed Critical 株式会社島津製作所
Priority to PCT/JP2013/077664 priority Critical patent/WO2015052816A1/fr
Priority to JP2015541385A priority patent/JP6489018B2/ja
Publication of WO2015052816A1 publication Critical patent/WO2015052816A1/fr

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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
    • A61B5/40—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
    • 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
    • A61B5/0075—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence by spectroscopy, i.e. measuring spectra, e.g. Raman spectroscopy, infrared absorption spectroscopy
    • 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
    • A61H1/00—Apparatus for passive exercising; Vibrating apparatus; Chiropractic devices, e.g. body impacting devices, external devices for briefly extending or aligning unbroken bones
    • A61H1/02—Stretching or bending or torsioning apparatus for exercising
    • 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
    • A61H1/00—Apparatus for passive exercising; Vibrating apparatus; Chiropractic devices, e.g. body impacting devices, external devices for briefly extending or aligning unbroken bones
    • A61H1/02—Stretching or bending or torsioning apparatus for exercising
    • A61H1/0274—Stretching or bending or torsioning apparatus for exercising for the upper limbs
    • A61H1/0285—Hand
    • 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
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A61H2201/5023—Interfaces to the user
    • A61H2201/5043—Displays
    • 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
    • A61H2230/00—Measuring physical parameters of the user
    • A61H2230/08—Other bio-electrical signals
    • A61H2230/10—Electroencephalographic signals

Definitions

  • the present invention relates to a rehabilitation support system and a brain function measurement device, and particularly to a rehabilitation support system and a brain function measurement device that support rehabilitation of a subject with a brain function disorder.
  • JP-A-2006-263460 With the configuration that displays the result of exercise recall during rehabilitation as described in JP-A-2006-263460, it is only possible to grasp the success or failure of each rehabilitation exercise, and changes in daily brain function The degree of recovery by rehabilitation cannot be grasped objectively.
  • patients (subjects) themselves and healthcare professionals with limited expertise other than cranial nerve specialists cannot read changes in brain function from the displayed content (measurement data). Have difficulty. Therefore, the above Japanese Patent Application Laid-Open No. 2006-263460 has a problem that it is difficult for those who lack technical knowledge to objectively grasp the degree of recovery of brain function (change in brain function) by rehabilitation. .
  • the present invention has been made to solve the above-described problems, and one object of the present invention is a rehabilitation support system capable of easily and objectively grasping the degree of recovery of brain function by rehabilitation. And a brain function measuring device.
  • a rehabilitation support system is a system that supports rehabilitation of a subject with brain dysfunction, and measures a brain activity of the subject during rehabilitation.
  • a brain function measuring device and a control device that acquires an index indicating the degree of recovery of the brain function of the subject based on the measurement result of the brain activity of the subject in rehabilitation and controls the display of the acquired index on the display device .
  • the rehabilitation of a subject with brain dysfunction in the present invention is cerebral dysfunction classified into mental disorders such as depression and schizophrenia, in addition to brain dysfunction with brain damage such as stroke and cerebral infarction. It is a broad concept including rehabilitation.
  • the index indicating the recovery degree of the brain function of the subject is acquired based on the measurement result of the brain activity of the subject in the rehabilitation, and the acquired index is displayed.
  • a control device that performs control to be displayed on the device
  • an index indicating the degree of recovery of the brain function of the subject can be presented to the user (subject, medical staff, etc.).
  • this index should be used as a measure of rehabilitation such as the daily condition of the subject and the degree of rehabilitation. Can do. And even if the subject (patient) has little change (improvement) in the visible movement such as the movement of the paralyzed part, it can be seen that the index has the effect of rehabilitation, and it can be expected to improve the motivation to rehabilitation, As a result, an improvement in the rehabilitation effect can also be expected.
  • the brain function measuring device is configured to measure the brain activity of the subject during or after the rehabilitation, and the control device regularly An index is acquired and displayed based on the measurement result. If comprised in this way, since the parameter
  • the rehabilitation support system further includes a storage unit that stores the acquired index, and the control device displays the index acquired this time together with the past index stored in the storage unit on the display device. Is configured to do. If comprised in this way, the change of a time-sequential parameter
  • the control device is configured to display the past index stored in the storage unit and the index acquired this time on the display device in a time-series graph format. If comprised in this way, a user can grasp
  • the index indicating the degree of recovery of the brain function of the subject is an index indicating a change in brain function according to the brain function disorder of the subject.
  • subjects with brain dysfunction and movement disorders associated with cerebral dysfunction
  • the rehabilitation is exercise recovery rehabilitation of a partially paralyzed patient associated with a brain disorder
  • the index indicating the degree of recovery of the brain function of the subject is a side index indicating a left-right difference in brain function. If comprised in this way, the recovery
  • the brain function of the action side and the contralateral side becomes dominant by crossover, whereas in the case of hemiplegia, the function that the paralyzed region and the contralateral brain region originally have are
  • the ipsilateral brain function is relatively superior to the healthy subject. Then, this ipsilateral dominant brain activity approaches the brain activity of a normal person with contralateral superiority as the function is restored by rehabilitation. For this reason, it is possible to objectively evaluate the degree of recovery of brain function by rehabilitation by knowing which side of the other side is dominant by the side index.
  • the control device displays numerical data as an index indicating the degree of recovery of the brain function of the subject and a display indicating evaluation of the numerical data on the display device. It is configured. With this configuration, in addition to an index (numerical data) indicating the degree of recovery of the brain function of the subject, a display indicating the evaluation of the numerical data further facilitates the recovery of brain function even for users with limited expertise. The degree can be grasped.
  • the control device displays a sentence that gives up or encourages the subject as a display indicating the evaluation of the numerical data. Is configured to do. If comprised in this way, the motivation to rehabilitation will increase by showing to a test subject the sentence which compliments or encourages a patient (test subject) with a numerical data, As a result, it can anticipate improving the rehabilitation effect more.
  • the brain function measuring device is configured to measure the brain activity of the subject for each daily rehabilitation and control.
  • the apparatus is configured to acquire and display an index based on the measurement result of the brain function measurement apparatus of the day as a result of the daily rehabilitation. If comprised in this way, the user can confirm a parameter
  • a brain function measuring apparatus is a brain function measuring apparatus used for rehabilitation of a subject with a brain dysfunction, and includes a detection terminal unit that detects a signal indicating brain activity of the subject, and a detection terminal A measurement unit that acquires the detection signal of the unit and measures the brain activity of the subject, a display unit, and an index that indicates the degree of recovery of the brain function of the subject based on the measurement result of the brain activity of the subject in the rehabilitation, A control unit that performs control to display the acquired index on the display unit.
  • the index indicating the recovery degree of the brain function of the subject is acquired based on the measurement result of the brain activity of the subject in the rehabilitation, and the acquired index is used.
  • a control unit that performs control to be displayed on the display unit
  • an index indicating the degree of recovery of the brain function of the subject can be presented to the user (such as a subject or a medical worker).
  • the medical staff can use this index as a measure of rehabilitation such as the daily condition of the subject and the degree of rehabilitation.
  • a test subject (patient) understands that there exists a rehabilitation effect with an index, and can expect improvement in motivation to rehabilitation and improvement in rehabilitation effect.
  • the degree of recovery of brain function by rehabilitation can be easily and objectively grasped.
  • the rehabilitation support system 100 is mainly composed of a brain function measuring device 1, a display device 2, a body driving device 3, and a control device 4.
  • the rehabilitation exercise is an exercise for opening and closing the hand with respect to the paralyzed hand, for example, when the paralyzed site is a hand. In this case, even if the subject tries to open and close the hand, the hand cannot be moved due to paralysis.
  • the rehabilitation support system 100 performs brain function measurement during rehabilitation, analyzes the measurement result, and performs motor recall corresponding to the rehabilitation motion of the paralyzed site (rehabilitating motion from the brain by concretely imaging the motion). It is determined whether or not an order can be issued.
  • the rehabilitation support system 100 forcibly moves the paralyzed hand with an external force and actually causes the rehabilitation motion. In rehabilitation, this operation is repeated a predetermined number of times. The rehabilitation is performed continuously over a period of several months, with one set to several sets per day, with the predetermined number of exercise recalls and exercises as one set.
  • the optical probes 5a and 5b and the electrode probe 6 have a function of detecting a signal indicating the brain activity of the subject.
  • the brain function measurement apparatus 1 irradiates measurement light in the wavelength region of near-infrared light from an optical probe 5a for light transmission disposed on the head surface of the subject and reflects the measurement light reflected in the subject's head on the head surface.
  • the intensity (the amount of received light) of the measurement light is acquired by making it incident on the light receiving optical probe 5b disposed above and detecting it. Based on the intensity of the measurement light, it is possible to obtain changes in the amount of hemoglobin (oxygenated hemoglobin, deoxygenated globin and total hemoglobin) associated with brain activity.
  • the side index LI is calculated by the following equation (1).
  • LI (CI) / (C + I) (1)
  • C is the brain activity change (NIRS signal, oxygenated hemoglobin change) of the lesion (paralysis site) and the contralateral motor cortex.
  • I is the brain activity change (NIRS signal, oxygenated hemoglobin change) of the motor area on the same side as the lesion (paralysis site).
  • the brain activity change is a difference (hemoglobin change amount) between detection signals during rest (rest period) during rehabilitation and activity (task period) by motor recall.
  • the motor function of the body is controlled by the opposite motor area by crossover. Therefore, in a healthy person, the brain activity on the movement site (for example, the left hand) and the contralateral side (the motor area on the right side) is dominant. For this reason, for example, when hemiplegia occurs on the left side due to a stroke or the like, the brain function of the paralyzed site (left hand) and the contralateral side (motor field of the right hemisphere) is impaired. In such a case, when the brain function of the subject is measured, the brain on the same side (left side) as the paralyzed site so as to compensate for the function of the brain region (right motor area) opposite to the paralyzed site (left hand).
  • the control device 4 is configured to periodically calculate and display an index (side index LI). Specifically, the control device 4 calculates and displays an index (side index LI) based on the measurement result of the brain function measurement device 1 of the day as a result of the daily rehabilitation. In addition, the control device 4 accumulates and stores the calculated index (side index LI) in the storage unit 42. When displaying the index (side index LI), the control device 4 displays the index (side index LI) calculated this time along with the past index (side index LI) stored in the storage unit 42 in time series. It is configured to display in graph format.
  • step S1 of FIG. 5 a patient (subject) performs a motion recall that opens and closes a paralyzed hand.
  • step S2 brain function measurement (electroencephalogram measurement) by the brain function measuring apparatus 1 is performed. Specifically, the brain function measuring device 1 performs brain function measurement using the electrode probe 6 and outputs the obtained brain function measurement result (electroencephalogram measurement data) to the control device 4.
  • step S3 determines whether there is no motion recall. If it is determined in step S3 that there is no motion recall, the control device 4 proceeds to step S5 and causes the display device 2 to display that the motion recall is not completed. Note that, for example, nothing may be displayed on the display device 2 instead of displaying that the exercise is not recalled.
  • step S8 the control device 4 calculates and displays the index (side index LI). That is, the control device 4 calculates the side index LI by the above formula (1) based on the brain function measurement result (optical measurement data) acquired in step S6.
  • the control device 4 displays the calculated side index LI on the display device 2 in the graph format (graph 51) shown in FIG. 4 together with the past index (side index LI) stored in the storage unit 42. To do.
  • the side index LI for each time may be displayed as a finer time change, for example, the obtained predetermined number of times side An average value of the conversion index LI may be displayed. Further, the control device 4 displays a message indicating the evaluation of the calculated side index LI on the message unit 52.
  • this index (LI) can be used to determine the daily condition of the subject and the degree of rehabilitation. It can be used as a guide for rehabilitation. Furthermore, subjects (patients) are able to understand that the index (LI) is effective for rehabilitation even when there is little change (improvement) in the visible movements such as the movement of the paralyzed part, and the improvement of motivation for rehabilitation is expected. In addition, it can be expected to improve the rehabilitation effect as a result.
  • the past index (LI) stored in the storage unit 42 and the index (LI) acquired this time are displayed in a time-series graph format (graph 51).
  • the control device 4 is configured as described above. Accordingly, since the user can easily grasp the change in the index (LI) from the past to the present at a glance, it is possible to more easily grasp the change in the degree of recovery of brain function due to rehabilitation. Moreover, since the test subject (patient) can recognize the result of the rehabilitation continuously performed over a long period of time by the time-series change of the index (LI), it can be expected to improve the motivation to the rehabilitation.
  • an index (LI) indicating a change in brain function in accordance with the brain function disorder of the subject is used as an index indicating the degree of recovery of the brain function of the subject.
  • unique brain activity ipsilateral dominant brain activity
  • the degree of recovery of brain function can be objectively grasped from the difference from the healthy person index (LI).
  • the main body control unit 115 of the brain function measuring apparatus 101 not only performs the measurement operation control of the brain function measuring apparatus 101 but also executes the same control process as the control apparatus 4 in the first embodiment. It is configured as follows. That is, the main body control unit 115 calculates an index (side index LI) indicating the recovery degree of the brain function of the subject based on the measurement result of the brain activity of the subject in the rehabilitation, and acquires the acquired index (side index LI). Is displayed on the display unit 17. In the second embodiment, the main body control unit 115 also controls the body driving device 3.
  • the main body control unit 115 is an example of the “control unit” in the present invention. Since each process performed by the brain function measuring apparatus 101 (calculation of the localization index LI, the display mode on the display unit 17, the operation process during rehabilitation, and the like) is the same as that in the first embodiment, Description is omitted.
  • the present invention is not limited to this.
  • the body drive device may not be used.
  • the brain function measurement for calculating the lateralization index LI for each movement (motor recall) in the flowchart shown in FIG. 5 (see step S6).
  • the brain function measurement may be performed only at the last one of the predetermined number of exercises.
  • finish of training between step S7 and S8).
  • the lateralization index LI indicates an improvement in brain function
  • a message that gives up or encourages the subject is displayed on the message unit 52.
  • this invention is not limited to this. In the present invention, it is not necessary to display a sentence that compliments or encourages the subject.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Physics & Mathematics (AREA)
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  • Molecular Biology (AREA)
  • General Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
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  • Heart & Thoracic Surgery (AREA)
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  • Spectroscopy & Molecular Physics (AREA)
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  • Physiology (AREA)
  • Rehabilitation Tools (AREA)
  • Measurement And Recording Of Electrical Phenomena And Electrical Characteristics Of The Living Body (AREA)

Abstract

L'invention concerne un système d'aide de rééducation (100), qui comprend : une unité d'affichage (2) ; une unité de mesure de fonction cérébrale (1) pour mesurer l'activité cérébrale d'un sujet pendant une rééducation ; et une unité de commande (4) pour réaliser une commande pour acquérir un indice (LI) représentant le degré de récupération de la fonction cérébrale du sujet, sur la base des résultats de mesure de l'activité cérébrale du sujet pendant la rééducation, et pour afficher l'indice acquis sur l'unité d'affichage.
PCT/JP2013/077664 2013-10-10 2013-10-10 Système d'aide de rééducation et unité de mesure de fonction cérébrale WO2015052816A1 (fr)

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PCT/JP2013/077664 WO2015052816A1 (fr) 2013-10-10 2013-10-10 Système d'aide de rééducation et unité de mesure de fonction cérébrale
JP2015541385A JP6489018B2 (ja) 2013-10-10 2013-10-10 リハビリテーション支援システムおよび脳機能計測装置

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Cited By (3)

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Publication number Priority date Publication date Assignee Title
WO2017213202A1 (fr) * 2016-06-08 2017-12-14 株式会社国際電気通信基礎技術研究所 Système d'instruction de mouvement et procédé d'instruction de mouvement
CN108567412A (zh) * 2017-03-08 2018-09-25 日立数字映像(中国)有限公司 运动障碍评价装置及方法
JP2020151522A (ja) * 2020-06-15 2020-09-24 株式会社ｍｅｄｉＶＲ リハビリテーション支援システム、リハビリテーション支援方法およびリハビリテーション支援プログラム

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JP2011177265A (ja) * 2010-02-26 2011-09-15 Ishida Co Ltd リハビリ支援装置

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WO2017213202A1 (fr) * 2016-06-08 2017-12-14 株式会社国際電気通信基礎技術研究所 Système d'instruction de mouvement et procédé d'instruction de mouvement
CN109310561A (zh) * 2016-06-08 2019-02-05 株式会社国际电气通信基础技术研究所 运动示教系统和运动示教方法
JPWO2017213202A1 (ja) * 2016-06-08 2019-04-11 株式会社国際電気通信基礎技術研究所 運動教示システム及び運動教示方法
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CN109310561B (zh) * 2016-06-08 2021-04-09 株式会社国际电气通信基础技术研究所 运动示教系统和运动示教方法
US11890246B2 (en) 2016-06-08 2024-02-06 Advanced Telecommunications Research Institute International Motion teaching system and motion teaching method
CN108567412A (zh) * 2017-03-08 2018-09-25 日立数字映像(中国)有限公司 运动障碍评价装置及方法
CN108567412B (zh) * 2017-03-08 2022-10-21 麦克赛尔数字映像（中国）有限公司 运动障碍评价装置及方法
JP2020151522A (ja) * 2020-06-15 2020-09-24 株式会社ｍｅｄｉＶＲ リハビリテーション支援システム、リハビリテーション支援方法およびリハビリテーション支援プログラム
JP7179364B2 (ja) 2020-06-15 2022-11-29 株式会社mediVR リハビリテーション支援システム、リハビリテーション支援方法およびリハビリテーション支援プログラム

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