WO2015186587A1 - リハビリテーション支援システム - Google Patents
リハビリテーション支援システム Download PDFInfo
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- WO2015186587A1 WO2015186587A1 PCT/JP2015/065282 JP2015065282W WO2015186587A1 WO 2015186587 A1 WO2015186587 A1 WO 2015186587A1 JP 2015065282 W JP2015065282 W JP 2015065282W WO 2015186587 A1 WO2015186587 A1 WO 2015186587A1
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- patient
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- stimulation electrode
- stimulation
- support system
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- 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
-
- 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
- A61N1/0456—Specially adapted for transcutaneous electrical nerve stimulation [TENS]
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/48—Other medical applications
- A61B5/4848—Monitoring or testing the effects of treatment, e.g. of medication
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/70—Means for positioning the patient in relation to the detecting, measuring or recording means
-
- 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
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- 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
-
- 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
- A61N1/36031—Control systems using physiological parameters for adjustment
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
- A61N5/06—Radiation therapy using light
- A61N5/0613—Apparatus adapted for a specific treatment
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
- A61N5/06—Radiation therapy using light
- A61N5/0613—Apparatus adapted for a specific treatment
- A61N5/0622—Optical stimulation for exciting neural tissue
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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
- G16H10/00—ICT specially adapted for the handling or processing of patient-related medical or healthcare data
- G16H10/60—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for patient-specific data, e.g. for electronic patient records
Definitions
- the present invention relates to a system for supporting rehabilitation performed for a hemiplegic patient due to, for example, a stroke.
- stimulation electrodes are placed on the patient's paralyzed limbs.
- the stimulation electrode is energized based on a command from the brain to move the paralyzed limb, and electrical stimulation to the paralyzed limb is performed.
- the patient can feel as if the paralyzed limb has moved as intended (see, for example, Patent Document 1).
- an object of the present invention is to make the position where the stimulation electrode is arranged on the patient constant over a plurality of occasions regardless of the practitioner.
- a first aspect that the present invention can take is a rehabilitation support system, A stimulation electrode placed on a part of the patient's body; An arrangement position storage unit storing arrangement position information indicating a position where the stimulation electrode is arranged; A guidance information providing unit that provides guidance information for guiding the stimulation electrode to the position based on the arrangement position information; It has.
- the practitioner places the stimulation electrode at a predetermined position on a part of the patient's body based on the guidance information provided by the guidance information providing unit.
- the position where the stimulation electrode is arranged on the patient can be made constant over a plurality of occasions regardless of the practitioner. Since such a position is determined as a position where the rehabilitation effect is appropriately exhibited, the effectiveness of the rehabilitation performed over a plurality of occasions can be enhanced.
- the arrangement position of the stimulation electrode is always constant, it is possible to improve the reliability of evaluation with respect to the effect of rehabilitation performed over a plurality of occasions.
- the guidance information providing unit may be configured to optically show the guidance information on a part of the patient's body.
- the practitioner can accurately arrange the stimulation electrode at a predetermined position while being visually guided by the optically indicated guidance information. Therefore, regardless of the practitioner, the position where the stimulation electrode is arranged on the patient can be made constant over a plurality of occasions.
- the rehabilitation support system may include a display device, and the guidance information providing unit may display the guidance information on the display device.
- the practitioner confirms the position of the stimulation electrode disposed in the rehabilitation performed in the past,
- the stimulation electrode can be accurately placed at a predetermined position. Therefore, regardless of the practitioner, the position where the stimulation electrode is arranged on the patient can be made constant over a plurality of occasions.
- the practitioner can accurately arrange the stimulation electrode at a predetermined position while confirming that the numerical value approaches zero. Therefore, regardless of the practitioner, the position where the stimulation electrode is arranged on the patient can be made constant over a plurality of occasions.
- the guidance information may be configured to be a sound that changes according to the distance to the arrangement position.
- the practitioner can accurately arrange the stimulation electrode at a predetermined position while being audibly guided by the output sound. Therefore, regardless of the practitioner, the position where the stimulation electrode is arranged on the patient can be made constant over a plurality of occasions.
- the rehabilitation support system is: An image acquisition unit for acquiring an image of a part of the patient's body; Through the image, an electrode position information acquisition unit that acquires electrode position information indicating the position of the stimulation electrode disposed on the patient; It can be set as the structure provided with.
- the arrangement position storage unit stores the stimulation electrode position information as the arrangement position information.
- the arrangement of the stimulation electrodes determined in the rehabilitation performed at a certain time can be stored and used in the next and subsequent rehabilitation. Therefore, regardless of the practitioner, the position where the stimulation electrode is arranged on the patient can be made constant over a plurality of occasions.
- the rehabilitation support system is: It can be set as the structure provided with the light emission part which is arrange
- the position of the stimulation electrode can be detected more accurately, and the accuracy of the arrangement position information stored in the arrangement position storage unit can be improved. Therefore, regardless of the practitioner, the position where the stimulation electrode is arranged on the patient can be made constant over a plurality of occasions.
- the rehabilitation support system is: It may be configured with a normalized scale that is placed adjacent to a portion of the patient's body.
- the image acquisition unit performs image recognition based on the scale, and the position on the part of the patient's body regardless of the distance between the image acquisition unit and the part of the patient's body, or the like. Can be accurately identified.
- the position of the stimulation electrode can be detected more accurately, and the accuracy of the arrangement position information stored in the arrangement position storage unit can be improved. Therefore, regardless of the practitioner, the position where the stimulation electrode is arranged on the patient can be made constant over a plurality of occasions.
- the stimulation electrode position information may include information indicating feature points included in a part of the patient's body.
- the position of the stimulation electrode can be specified using the feature points in a part of the patient's body without using a scale or the like. Since the feature point itself does not change over a plurality of rehabilitations, the placement position of the stimulation electrode can be specified based on the feature point in the next and subsequent rehabilitations. Therefore, regardless of the practitioner, the position where the stimulation electrode is arranged on the patient can be made constant over a plurality of occasions.
- the rehabilitation support system is: A stimulation applying unit that applies electrical stimulation to a part of the patient's body through the stimulation electrode; Based on the change of the stimulation electrode position information due to the electrical stimulation, an evaluation unit that evaluates the effect of rehabilitation; It can be set as the structure provided with.
- the response of a part of the patient's body to electrical stimulation that is, the effect of rehabilitation can be quantitatively evaluated without being observed by the observer.
- Electrical stimulation is performed through stimulation electrodes that are accurately placed at fixed positions as described above. Therefore, it is possible to ensure the accuracy of both the stimulus input and the response to the stimulus over a plurality of occasions regardless of the practitioner.
- the rehabilitation support system is: It can be set as the structure provided with the inertial sensor arrange
- the evaluation unit evaluates the effect of rehabilitation based on the output of the inertial sensor.
- the rehabilitation support system is: It may be configured to include at least one of a temperature sensor and a humidity sensor disposed adjacent to the stimulation electrode.
- the evaluation unit evaluates the effect of rehabilitation based on the output of the at least one of the temperature sensor and the humidity sensor.
- the rehabilitation support system is:
- the stimulation electrode position information may be configured to include a recording unit that records at least a point in time when the electrode position information is acquired and patient identification information.
- the evaluation unit evaluates the effect of rehabilitation by comparing the stimulation electrode position information for a plurality of time points.
- a second aspect of the present invention is a rehabilitation support system,
- a stimulation application unit that applies electrical stimulation to a part of the patient's body;
- An image acquisition unit for acquiring an image of a part of the patient's body;
- An evaluation unit that evaluates the magnitude of a response of a part of the patient's body by the electrical stimulation based on the image;
- a display unit for displaying the image;
- a display control unit that causes the display unit to display a map representing a relationship between the position where the electrical stimulation is applied and the magnitude of the reaction; It has.
- the arrangement position of the stimulation electrode can be determined based on quantitative evaluation regardless of the evaluator. If the stimulation electrode is arranged at the arrangement position determined in this way, the position where the stimulation electrode is arranged on the patient can be made constant over a plurality of occasions regardless of the practitioner.
- the stimulation applying unit may include a conductive unit provided at the tip of the rod.
- the stimulation applying unit may include a plurality of conductive units arranged on a sheet body attached to a part of the patient's body.
- the display control unit may be configured to display an image indicating a position of at least one of a muscle and a nerve included in a part of the patient's body on the display unit.
- the stimulation application position by the stimulation application unit can be determined with reference to the image. Therefore, it is possible to efficiently apply electrical stimulation to a plurality of locations in a part of the patient's body.
- FIG. 1 is a functional block diagram showing a rehabilitation support system 1 (hereinafter abbreviated as support system 1) according to the first embodiment.
- the support system 1 according to the present embodiment is configured to support rehabilitation performed for a hemiplegic patient due to a stroke, for example.
- the support system 1 includes at least one stimulation electrode 2.
- the stimulation electrode 2 is configured to be disposed on the patient's paralyzed limb 100 (an example of a part of the body).
- the stimulation electrode 2 is used to promote recovery of the brain and nerves by repeatedly operating the paralyzed limb 100 through energization stimulation.
- the stimulation electrode 2 is connected to an electrical stimulation device (not shown) through the cord 3.
- the electrical stimulation device is configured to detect a command from the brain of a patient who intends to move the paralyzed limb 100 or a command from the support system 1 and to energize the stimulation electrode 2 based on the command.
- the paralyzed limb 100 moves as shown by a two-dot chain line in FIG. As a result, the patient can feel as if the paralyzed limb has moved as intended. Such repeated stimulation is known to promote functional recovery of the paralyzed limb.
- the support system 1 includes an arrangement position storage unit 4.
- the arrangement position storage unit 4 stores arrangement position information indicating the position where the stimulation electrode 2 is arranged.
- the arrangement position information can be, for example, three-dimensional coordinates in a space including the paralyzed limb 100. In this case, the position where the stimulation electrode 2 is arranged can be specified by specific three-dimensional coordinates.
- Examples of the arrangement position storage unit 4 include a memory element, a large-capacity storage device (such as a hard disk), and a portable storage medium (such as a disk-type storage medium, a card-type storage medium, and a USB memory).
- the support system includes a guidance information providing unit 5.
- the guidance information providing unit 5 provides the practitioner (an example of a user) with guidance information for guiding the stimulation electrode 2 to the position indicated by the arrangement position information based on the arrangement position information stored in the arrangement position storage unit 4. Is configured to do.
- the practitioner places the stimulation electrode 2 at a predetermined position on the paralyzed limb 100 based on the guidance information provided by the guidance information providing unit 5.
- the position where the stimulation electrode 2 is arranged on the patient can be made constant over a plurality of occasions regardless of the practitioner. Since such a position is determined as a position where the rehabilitation effect is appropriately exhibited, the effectiveness of the rehabilitation performed over a plurality of occasions can be enhanced. Moreover, since the arrangement position of the stimulation electrode 2 is always constant, it is possible to improve the reliability of the evaluation for the effect of rehabilitation performed over a plurality of occasions.
- the pointer 51 includes a light source capable of emitting a light beam 51a.
- the type of the light source is not limited as long as it can emit a light beam having a certain degree of directivity.
- the pointer 51 emits a light beam 51 a (an example of guidance information) that points to a point on the paralyzed limb 100 corresponding to the three-dimensional coordinates stored in the arrangement position storage unit 4.
- the point indicated by the light beam 51a is a position where the stimulation electrode 2 specified by the three-dimensional coordinates is arranged. The practitioner places the stimulation electrode 2 at the position indicated by the light beam 51a.
- the practitioner since the arrangement position of the stimulation electrode 2 is optically indicated on the paralyzed limb 100 by the light beam 51a, the practitioner guides the stimulation electrode 2 to a predetermined position while being guided by the light beam 51a. Can be placed accurately. Therefore, regardless of the practitioner, the position where the stimulation electrode 2 is arranged on the patient can be made constant over a plurality of occasions.
- FIG. 3B shows a projector 52 as an example of the guidance information providing unit 5.
- the projector 52 is configured to be able to project an image 52 a corresponding to the stimulation electrode 2.
- the projector 52 projects an image 52 a (an example of guidance information) on a point on the paralyzed limb 100 corresponding to the three-dimensional coordinates stored in the arrangement position storage unit 4.
- the point on which the image 52a is projected is a position where the stimulation electrode 2 specified by the three-dimensional coordinates is arranged.
- the practitioner since the arrangement position of the stimulation electrode 2 is optically shown on the paralyzed limb 100 by the image 52a, the practitioner guides the stimulation electrode 2 to a predetermined position while being guided by the image 52a. Can be placed accurately. Therefore, regardless of the practitioner, the position where the stimulation electrode 2 is arranged on the patient can be made constant over a plurality of occasions.
- the support system 1 may be configured to include a display device 6 as indicated by a broken line in FIG.
- Examples of the display device 6 include a stationary display device (such as a display and a monitor) and a portable display terminal (such as a smartphone, a tablet terminal, and a head-mounted display).
- the display device 6 is communicably connected to the guidance information providing unit 5.
- the guidance information providing unit 5 displays the guidance information on the display device 6.
- FIG. 4A shows an example in which an image 61 is displayed on the display device 6 as guidance information.
- the image 61 includes the paralyzed limb 100 of the patient on which the stimulation electrode 2 is disposed in the rehabilitation performed in the past.
- Examples of the image 61 include an image captured by an appropriate imaging unit and a computer graphics image modeled based on the captured image.
- the practitioner can accurately place the stimulation electrode 2 at a predetermined position while confirming the position of the stimulation electrode 2 that has been disposed in the past rehabilitation. Therefore, regardless of the practitioner, the position where the stimulation electrode 2 is arranged on the patient can be made constant over a plurality of occasions.
- an image 62 obtained by imaging the current patient's paralyzed limb 100 may be displayed on the display device 6.
- the guidance information providing unit 5 displays the image 61 on the display device 6 so as to be aligned with or superimposed on the image 62.
- the arrangement accuracy of the stimulation electrode 2 is further improved.
- the matching rate between the image 61 and the image 62 may be detected, and an indicator corresponding to the matching rate may be displayed on the display device 6. According to such a configuration, not only the placement accuracy of the stimulation electrode 2 is further improved, but also the misplacement of the patient and the electrode placement site can be prevented.
- a numerical value 63 indicating the distance to the position where the stimulation electrode 2 is arranged may be displayed on the display device 6 as the guidance information.
- the guidance information providing unit 5 includes the three-dimensional coordinates (position where the stimulation electrode 2 is arranged) indicated by the arrangement position information stored in the arrangement position storage unit 4 and the three-dimensional coordinates indicating the current position of the stimulation electrode 2. And the result is displayed on the display device 6.
- the current position of the stimulation electrode 2 can be detected through appropriate imaging means and sensors.
- the stimulation electrode 2 is arranged at a predetermined position, the difference between the three-dimensional coordinates indicated by the arrangement position information and the three-dimensional coordinates indicating the current position is zero.
- the practitioner can recognize that the stimulation electrode 2 is disposed at a predetermined position with the fact that the numerical value 63 displayed on the display device 6 is zero.
- the practitioner can accurately arrange the stimulation electrode 2 at a predetermined position while confirming that the numerical value 63 approaches zero. Therefore, regardless of the practitioner, the position where the stimulation electrode 2 is arranged on the patient can be made constant over a plurality of occasions.
- the display device 6 that displays a numerical value 63 indicating the distance to the position where the stimulation electrode 2 is arranged may be provided in a part of the stimulation electrode 2. According to such a configuration, the practitioner can determine the arrangement of the stimulation electrode 2 while confirming the numerical value 63 displayed on the display device 6 provided on the stimulation electrode 2. Therefore, regardless of the practitioner, the position where the stimulation electrode 2 is arranged on the patient can be made constant over a plurality of occasions.
- FIG. 6 shows an example in which a sound that changes in accordance with the distance to the position where the stimulation electrode 2 is arranged is used as the guidance information.
- the guidance information providing unit 5 includes the three-dimensional coordinates (position where the stimulation electrode 2 is arranged) indicated by the arrangement position information stored in the arrangement position storage unit 4 and the three-dimensional coordinates indicating the current position of the stimulation electrode 2.
- the sound corresponding to the difference value is output.
- the current position of the stimulation electrode 2 can be detected through appropriate imaging means and sensors.
- the first sound is output when the stimulation electrode 2 is at a position away from the predetermined arrangement position
- the second sound is output when the stimulation electrode 2 is arranged at the predetermined position.
- An example of the difference between the first sound and the second sound is the volume of the sound.
- the sound output increases as the stimulation electrode 2 approaches a predetermined arrangement position.
- Another example of the difference between the first sound and the second sound is the sound frequency (high or low).
- the sound (frequency) output increases as the stimulation electrode 2 approaches a predetermined arrangement position.
- Another example of the difference between the first sound and the second sound is the pitch of the sound that is repeatedly output. For example, the pitch of the sound repeatedly output becomes shorter as the stimulation electrode 2 approaches a predetermined arrangement position.
- the first sound may be silence and the second sound may be a predetermined sound.
- the predetermined sound is output only when the stimulation electrode 2 is disposed at a predetermined position. Note that the magnitude of the sound, the level of the sound (frequency), and the length of the pitch may be opposite to the example shown here.
- the practitioner can accurately place the stimulation electrode 2 at a predetermined position while being guided by the output sound. Therefore, regardless of the practitioner, the position where the stimulation electrode 2 is arranged on the patient can be made constant over a plurality of occasions.
- the support system 1 may include an image acquisition unit 7 and an electrode position information acquisition unit 8.
- the image acquisition unit 7 is configured to acquire an image of the paralyzed limb 100 of the patient.
- the image acquisition unit 7 is preferably configured to acquire depth information so that the shape of the paralyzed limb 100 of the patient can be grasped three-dimensionally.
- the electrode position information acquisition unit 8 is configured to acquire electrode position information indicating the position of the stimulation electrode 2 disposed on the paralyzed limb 100 through the image acquired by the image acquisition unit 7.
- the arrangement position storage unit 4 is configured to store the electrode position information acquired by the electrode position information acquisition unit 8 as the arrangement position information.
- the arrangement of the stimulation electrode 2 on the paralyzed limb 100 determined in the rehabilitation performed at a certain time can be stored and used in the next and subsequent rehabilitation. Therefore, regardless of the practitioner, the position where the stimulation electrode 2 is arranged on the patient can be made constant over a plurality of occasions.
- the stimulation electrode 2 is colored with a color (blue, purple, pink, etc.) that can be clearly distinguished from the patient's skin.
- the support system 1 may be configured to include a light emitting unit 9.
- the light emitting unit 9 is arranged adjacent to the stimulation electrode 2 and configured to emit light having a predetermined wavelength. “Light of a predetermined wavelength” means not only visible light but also infrared light.
- the light emitting unit 9 may be provided as a part of the stimulation electrode 2.
- the image acquisition unit 7 preferably has high sensitivity to the wavelength of light emitted from the light emitting unit 9. Thereby, the position of the stimulation electrode 2 can be detected more accurately, and the accuracy of the arrangement position information stored in the arrangement position storage unit 4 can be improved. Therefore, regardless of the practitioner, the position where the stimulation electrode 2 is arranged on the patient can be made constant over a plurality of occasions.
- the support system 1 may be configured to include a scale 10.
- the scale 10 is positioned adjacent to the patient's paralyzed limb 100 and has a normalized scale, as shown in FIG.
- “normalized” means that one unit on the scale (here, one scale) is associated with another unit such as 1 cm or 1 inch.
- a size-normalized object may be placed adjacent to the patient's paralyzed limb 100.
- the image acquisition unit 7 performs image recognition based on the scale of the scale 10, and the position on the paralyzed limb 100 is determined regardless of the distance between the image acquisition unit 7 and the paralyzed limb 100. It can be accurately identified. Thereby, the position of the stimulation electrode 2 can be detected more accurately, and the accuracy of the arrangement position information stored in the arrangement position storage unit 4 can be improved. Therefore, regardless of the practitioner, the position where the stimulation electrode 2 is arranged on the patient can be made constant over a plurality of occasions.
- the image acquisition unit 7 can be configured to extract feature points such as a mole 100a and a scar 100b on the patient's paralyzed limb 100 as shown in FIG.
- the electrode position information acquisition unit 8 may include information indicating the feature point in the electrode position information.
- the position of the stimulation electrode 2 can be specified based on the direction and distance with respect to the mole 100a.
- the position of the blood vessel in the paralyzed limb 100 may be extracted as a feature point.
- the position of the stimulation electrode 2 can be specified using the feature points in a part of the patient's body without using the scale 10 or the like. Since the feature point itself does not change over a plurality of rehabilitations, the arrangement position of the stimulation electrode 2 can be specified based on the feature point in the next and subsequent rehabilitations. Therefore, regardless of the practitioner, the position where the stimulation electrode 2 is arranged on the patient can be made constant over a plurality of occasions.
- the support system 1 may include a stimulus application unit 11 and an evaluation unit 12.
- the stimulation application unit 11 is configured to apply electrical stimulation to the patient's paralyzed limb 100 through the stimulation electrode 2. Due to the electrical stimulation, the paralyzed limb 100 performs reflex movement.
- the image acquisition unit 7 acquires a state in which the paralyzed limb 100 performs a reflex motion as image data.
- the electrode position information acquisition unit 8 acquires electrode position information of the stimulation electrode 2 before and after electrical stimulation based on the image acquired by the image acquisition unit 7.
- the evaluation unit 12 is configured to evaluate the effect of rehabilitation based on changes in electrode position information due to electrical stimulation. Specifically, since the electrode position information includes position coordinates of the stimulation electrode 2 in the three-dimensional space as information, the stimulation electrode 2 indicates in which direction and how much the paralyzed limb 100 has moved in response to a certain electrical stimulation. Can be quantitatively grasped based on the displacement of.
- the response of the paralyzed limb 100 to electrical stimulation that is, the effect of rehabilitation can be quantitatively evaluated without being visually observed by the observer.
- Electrical stimulation is performed through the stimulation electrode 2 that is accurately placed at a fixed position as described above. Therefore, it is possible to ensure the accuracy of both the stimulus input and the response to the stimulus over a plurality of occasions regardless of the practitioner.
- the support system 1 may be configured to include an inertial sensor 13.
- the inertial sensor 13 is disposed adjacent to the stimulation electrode 2.
- the inertial sensor 13 may be provided as a part of the stimulation electrode 2.
- the inertial sensor 13 is configured to output a signal corresponding to the displacement (speed, acceleration, posture change) of the stimulation electrode 2 due to electrical stimulation.
- the evaluation unit 12 is configured to evaluate the effect of rehabilitation based on the output of the inertial sensor 13 in addition to the change in electrode position information due to electrical stimulation.
- the support system 1 may be configured to include a temperature / humidity sensor 14.
- the temperature / humidity sensor 14 is disposed adjacent to the stimulation electrode 2.
- the temperature / humidity sensor 14 may be provided as a part of the stimulation electrode 2.
- the temperature / humidity sensor 14 is configured to output a signal corresponding to at least one of temperature and humidity at a location where the temperature / humidity sensor 14 is disposed.
- the evaluation unit 12 performs rehabilitation based on the output from the temperature / humidity sensor 14 in addition to or in place of the change in the electrode position information due to the electrical stimulation. It is configured to evaluate the effects of.
- the support system 1 may be configured to include a recording unit 15.
- the recording unit 15 is configured to record the electrode position information acquired by the electrode position information acquisition unit 8 in association with at least the time when the electrode position information is acquired and the patient specifying information (name, patient number, etc.). Yes. Examples of other information recorded in the recording unit 15 include disease names, treatment conditions, treatment details, and the like.
- Examples of the recording unit 15 include a large-capacity storage device (such as a hard disk) and a portable storage medium (such as a disk-type storage medium, a card-type storage medium, and a USB memory).
- the recording unit 15 may be installed at any location as long as the recording unit 15 can communicate with the electrode position information acquisition unit 8 in a wired or wireless manner.
- the electrode position information acquisition unit 8 and a stand-alone system may be configured, or may be connected to the electrode position information acquisition unit 8 via a LAN or a WAN.
- the evaluation unit 12 is configured to evaluate the effect of rehabilitation by comparing electrode position information for a plurality of time points.
- the electrode position information for a plurality of time points is referred to what is recorded in the recording unit 15.
- the progress of the rehabilitation is quantified by comparing the response in the previous rehabilitation with the response in the current rehabilitation. Can be evaluated.
- the progress of the rehabilitation can be quantitatively determined by recording images at a plurality of time points acquired by the image acquisition unit 7 under the same imaging condition in the recording unit 15 and evaluating the correlation rate of the plurality of images. Can be evaluated.
- the evaluation of the correlation rate of the image is not limited to the evaluation of a predetermined state of the paralyzed limb 100 (for example, the end point of the operation), and is an aspect of evaluating the operation trajectory and speed based on the acquired image. Also good.
- the change in the response of the paralyzed limb 100 to the electrical stimulation that is, the progress of rehabilitation can be quantitatively evaluated without visual observation by the observer.
- Electrical stimulation is performed through the stimulation electrode 2 that is accurately placed at a fixed position as described above. Therefore, it is possible to ensure the accuracy of both the stimulus input and the response to the stimulus over a plurality of occasions regardless of the practitioner.
- At least the functions of the electrode position information acquisition unit 8 and the evaluation unit 12 are realized by software executed by cooperation of a processor and a memory that are connected to be communicable.
- the processor include a CPU and an MPU.
- the memory include RAM and ROM.
- at least one of the functions of the electrode position information acquisition unit 8 and the evaluation unit 12 can be realized by hardware such as a circuit element or a combination of hardware and software.
- FIG. 9 is a functional block diagram showing a rehabilitation support system 201 (hereinafter abbreviated as support system 201) according to the second embodiment.
- the support system 201 according to the present embodiment is configured to support an operation of determining an appropriate arrangement position of the stimulation electrode.
- the support system 201 includes a stimulus application unit 202, an image acquisition unit 203, a display unit 204, an evaluation unit 205, and a display control unit 206.
- the stimulation application unit 202 is configured to apply electrical stimulation to the patient's paralyzed limb 100 (an example of a part of the patient's body). Due to the electrical stimulation, the paralyzed limb 100 performs reflex movement.
- the image acquisition unit 203 is configured to acquire, as image data, a state in which the paralyzed limb 100 performs a reflex motion.
- the display unit 204 is configured to display the image acquired by the image acquisition unit 203.
- the evaluation unit 205 is configured to evaluate the magnitude of the reaction of the paralyzed limb 100 to the electrical stimulation applied by the stimulation applying unit 202 based on the image acquired by the image acquisition unit 203. Specifically, the coincidence rate between the image of the paralyzed limb 100 before applying the stimulus and the image of the paralyzed limb 100 that has reacted to the stimulus is acquired, and the lower the coincidence rate, the higher the response is evaluated. Alternatively, the magnitude of the reaction may be evaluated by attaching an appropriate marker to the paralyzed limb 100 and recognizing an image of the amount of marker displacement caused by electrical stimulation.
- the display control unit 206 causes the display unit 204 to display a map 207 that represents the relationship between the position where the electrical stimulation is applied by the stimulation application unit 202 and the magnitude of the reaction of the paralyzed limb 100 evaluated by the evaluation unit 205. It is configured. In the example shown in FIG. 9, the electrical stimulus application location where a greater response is obtained is superimposed on the image acquired by the image acquisition unit 203 on the display unit 204.
- the map 207 suggests a position where the stimulation electrode should be arranged in the rehabilitation. The practitioner determines the placement position of the stimulation electrode based on the map 207.
- the display mode of the map 207 is not limited to the example shown in FIG.
- contour lines corresponding to the magnitude of the reaction may be superimposed on the image acquired by the image acquisition unit 203.
- the map displayed on the display unit 204 does not need to be superimposed on the image acquired by the image acquisition unit 203.
- the map may be provided as a computer graphics image generated by modeling based on the image of the paralyzed limb 100 acquired by the image acquisition unit 203.
- the support system 201 may be configured to include a recording unit 208.
- the recording unit 208 is configured to record the evaluation result by the evaluation unit 205 in association with at least the time when the evaluation is performed and patient identification information (name, patient number, etc.). Examples of other information recorded in the recording unit 208 include a disease name, treatment condition, treatment content, and the like.
- Examples of the recording unit 208 include a large-capacity storage device (such as a hard disk) and a portable storage medium (such as a disk-type storage medium, a card-type storage medium, and a USB memory).
- the recording unit 15 may be installed anywhere as long as it can communicate with the evaluation unit 205 by wire or wireless.
- a stand-alone system may be configured with the evaluation unit 205, or may be connected to the evaluation unit 205 via a LAN or WAN.
- the recording unit 208 may be the arrangement position storage unit 4 described with reference to the first embodiment.
- the arrangement position of the stimulation electrode can be determined based on the quantitative evaluation regardless of the evaluator. If the stimulation electrode is arranged at the arrangement position determined in this way, the position where the stimulation electrode is arranged on the patient can be made constant over a plurality of occasions regardless of the practitioner.
- FIG. 10A shows an example of the stimulus application unit 202.
- a conductive portion 202b is provided at the tip of a rod 202a. Electrical stimulation is applied to the paralyzed limb 100 from the conductive portion 202b in accordance with a signal input through the signal line 202c.
- FIG. 10B shows another example of the stimulus applying unit 202.
- the stimulation applying unit 202 according to this example includes a sheet body 202d to be attached to the paralyzed limb 100.
- a plurality of conductive portions 202e are arranged on the sheet body 202d.
- electrical stimulation is sequentially applied from each conductive portion 202e to the paralyzed limb 100.
- the display control unit 206 can be configured to cause the display unit 204 to display an image 209 indicating at least one of muscles and nerves included in the paralyzed limb 100.
- the image 209 is a computer graphics image created in advance based on anatomical knowledge.
- the stimulus application position by the stimulus application unit 202 can be determined with reference to the image 209. Therefore, the application of electrical stimulation to a plurality of locations in the paralyzed limb 100 can be performed efficiently.
- At least the functions of the evaluation unit 205 and the display control unit 206 are realized by software executed by the cooperation of a processor and a memory that are communicably connected.
- the processor include a CPU and an MPU.
- the memory include RAM and ROM.
- at least one function of the evaluation unit 205 and the display control unit 206 can be realized by hardware such as a circuit element or a combination of hardware and software.
Abstract
Description
患者の身体の一部に配置される刺激電極と、
前記刺激電極が配置される位置を示す配置位置情報を記憶している配置位置記憶部と、
前記配置位置情報に基づいて、前記位置へ前記刺激電極を誘導する誘導情報をユーザに提供する誘導情報提供部と、
を備えている。
前記患者の身体の一部の画像を取得する画像取得部と、
前記画像を通じて、前記患者に配置された前記刺激電極の位置を示す電極位置情報を取得する電極位置情報取得部と、
を備えている構成とされうる。
この場合、前記配置位置記憶部は、前記刺激電極位置情報を前記配置位置情報として記憶する。
前記刺激電極に隣接して配置され、所定の波長を有する光を出射する発光部
を備えている構成とされうる。
前記患者の身体の一部に隣接して配置される正規化されたスケール
を備えている構成とされうる。
前記刺激電極を通じて前記患者の身体の一部に電気刺激を印加する刺激印加部と、
前記電気刺激による前記刺激電極位置情報の変化に基づいて、リハビリテーションの効果を評価する評価部と、
を備えている構成とされうる。
前記刺激電極に隣接して配置された慣性センサ
を備えている構成とされうる。
この場合、前記評価部は、前記慣性センサの出力に基づいて、リハビリテーションの効果を評価する。
前記刺激電極に隣接して配置された温度センサと湿度センサの少なくとも一方
を備える構成とされうる。
この場合、前記評価部は、前記温度センサと前記湿度センサの前記少なくとも一方の出力に基づいて、リハビリテーションの効果を評価する。
前記刺激電極位置情報を、少なくとも当該電極位置情報が取得された時点および患者特定情報と関連付けて記録する記録部
を備えている構成とされうる。
この場合、前記評価部は、複数の時点についての前記刺激電極位置情報を比較してリハビリテーションの効果を評価する。
患者の身体の一部に電気刺激を印加する刺激印加部と、
前記患者の身体の一部の画像を取得する画像取得部と、
前記画像に基づいて、前記電気刺激による前記患者の身体の一部の反応の大きさを評価する評価部と、
前記画像を表示する表示部と、
前記電気刺激を印加した位置と前記反応の大きさの関係を表すマップを、前記表示部に表示させる表示制御部と、
を備えている。
Claims (18)
- 患者の身体の一部に配置される刺激電極と、
前記刺激電極が配置される位置を示す配置位置情報を記憶している配置位置記憶部と、
前記配置位置情報に基づいて、前記位置へ前記刺激電極を誘導する誘導情報をユーザに提供する誘導情報提供部と、
を備えている、
リハビリテーション支援システム。 - 前記誘導情報提供部は、前記患者の身体の一部に前記誘導情報を光学的に示す、
請求項1に記載のリハビリテーション支援システム。 - 表示装置を備えており、
前記誘導情報提供部は、前記誘導情報を前記表示装置に表示する、
請求項1または2に記載のリハビリテーション支援システム。 - 前記誘導情報は、過去に取得された前記患者の身体の一部の画像を含んでいる、
請求項3に記載のリハビリテーション支援システム。 - 前記誘導情報は、前記配置位置までの距離を示す数値である、
請求項3に記載のリハビリテーション支援システム。 - 前記誘導情報は、前記配置位置までの距離に応じて変化する音である、
請求項1に記載のリハビリテーション支援システム。 - 前記患者の身体の一部の画像を取得する画像取得部と、
前記画像を通じて、前記患者に配置された前記刺激電極の位置を示す電極位置情報を取得する電極位置情報取得部と、
を備えており、
前記配置位置記憶部は、前記刺激電極位置情報を前記配置位置情報として記憶する、
請求項1から6のいずれか一項に記載のリハビリテーション支援システム。 - 前記刺激電極に隣接して配置され、所定の波長を有する光を出射する発光部を備えている、
請求項7に記載のリハビリテーション支援システム。 - 前記患者の身体の一部に隣接して配置される正規化されたスケールを備えている、
請求項7または8に記載のリハビリテーション支援システム。 - 前記刺激電極位置情報は、前記患者の身体の一部に含まれる特徴点を示す情報を含んでいる、
請求項7から9のいずれか一項に記載のリハビリテーション支援システム。 - 前記刺激電極を通じて前記患者の身体の一部に電気刺激を印加する刺激印加部と、
前記電気刺激による前記刺激電極位置情報の変化に基づいて、リハビリテーションの効果を評価する評価部と、
を備えている、
請求項7から10のいずれか一項に記載のリハビリテーション支援システム。 - 前記刺激電極に隣接して配置された慣性センサを備えており、
前記評価部は、前記慣性センサの出力に基づいて、リハビリテーションの効果を評価する、
請求項11に記載のリハビリテーション支援システム。 - 前記刺激電極に隣接して配置された温度センサと湿度センサの少なくとも一方を備え、
前記評価部は、前記温度センサと前記湿度センサの前記少なくとも一方の出力に基づいて、リハビリテーションの効果を評価する、
請求項11または12に記載のリハビリテーション支援システム。 - 前記刺激電極位置情報を、少なくとも当該電極位置情報が取得された時点および患者特定情報と関連付けて記録する記録部を備えており、
前記評価部は、複数の時点についての前記刺激電極位置情報を比較してリハビリテーションの効果を評価する、
請求項11から13のいずれか一項に記載のリハビリテーション支援システム。 - 患者の身体の一部に電気刺激を印加する刺激印加部と、
前記患者の身体の一部の画像を取得する画像取得部と、
前記画像に基づいて、前記電気刺激による前記患者の身体の一部の反応の大きさを評価する評価部と、
前記画像を表示する表示部と、
前記電気刺激を印加した位置と前記反応の大きさの関係を表すマップを、前記表示部に表示させる表示制御部と、
を備えている、
リハビリテーション支援システム。 - 前記刺激印加部は、棒体の先端部に設けられた導電部を備えている、
請求項15に記載のリハビリテーション支援システム。 - 前記刺激印加部は、前記患者の身体の一部に装着されるシート体上に配列された複数の導電部を備えている、
請求項15に記載のリハビリテーション支援システム。 - 前記表示制御部は、前記患者の身体の一部に含まれる筋肉と神経の少なくとも一方の位置を示す画像を前記表示部に表示させる、
請求項15から17のいずれか一項に記載のリハビリテーション支援システム。
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