JPH0428601Y2 - - Google Patents

Description

[Detailed Description of the Invention] [Industrial Application Field] The present invention relates to a stimulation state notification device for a stimulation device for activating the paralyzed part of a patient with motor paralysis.

[Conventional technology]

Traditionally, electromyography, electroencephalography, jaw,
Mechanical displacement of the shoulders, neck, etc. and voluntary biological signals such as voice are used as movement command signal sources, and signals from detection means (sensors) attached to each of the above parts are used as functional electrical stimulation (hereinafter referred to as "Functional electrical stimulation").
(denoted as FES) using a computer to apply electrical stimulation programmed by the above-mentioned FES computer to the electrode implanted near the nerve or muscle,
Japanese Patent Laid-Open Publication No. 2003-1993 developed a stimulator that caused the patient to perform the intended limb movements using the muscle contractions caused by this.
It is disclosed in Publication No. 59-160455. Like this
The FES computer-based stimulator can activate not only the limbs but also the motor functions of the respiratory muscles, trunk muscles, genitourinary organs, etc., and is especially effective for muscle atrophy, muscle shortening, and muscle contraction caused by motor paralysis caused by strokes, spinal cord injuries, etc. It has remarkable therapeutic effects on joint contractures, bone atrophy, muscle spasticity, and circulatory disorders.In particular, the above publication describes the use of pressure and displacement sensors attached to the fingers, elbows, etc. of quadriplegic patients.
A sensory feedback function is also disclosed in which vicarious sensations are generated by a sensory stimulation device placed in areas of normal sensation such as the neck and shoulders. Various types of such stimulation devices 16 have been proposed; for example, Japanese Patent Laid-Open No. 61
217174 and the above-mentioned Japanese Unexamined Patent Publication No. 59-160455, a conventional example as shown in FIG. 4 is disclosed. In Fig. 4, 1a, 1b...1n detect the remaining voice, joint, muscle displacement, respiratory biopotential (electroencephalogram, electromyogram, bioaction potential), and various other biosignals obtained from the living body of a patient with motor paralysis. These sensors are detection means, and the detection signals from these detection means 1a to 1n are passed through a multiplexer 2, amplified by an amplifier 3a and an analog-to-digital conversion circuit 3b, which constitute a signal processing means 3, and then digitized for control. It is supplied to the FES computer 4 as a signal. The FES computer 4 stores stimulation data for each control signal in a storage means 5 within the FES computer 4, and recognizes various control signals inputted by the signal processing means 3 and stores them in the storage means 5. Select stimulus data. The stimulation data to be stored in the storage means 5 is created for each paralyzed patient by a large-sized stimulation pattern data generation computer 17 in the stimulation pattern data generation device 19. That is, ROM
The stimulation data written in the ROM by the writer 18 is inserted into the storage means 5 of the FES computer 4. FES computer 4 mentioned above
Based on the stimulation data selected in , a stimulation pulse train is supplied to an output processing means 6 composed of a digital-to-analog conversion circuit 6a and an isolator 6b that prevents power supply current from flowing into the living body, and is passed through a demultiplexer 7 to paralyze the living body. Patient 8's paralyzed hand 8a,
A plurality of electrode groups 11a, 11b...11m are embedded in the elbow 8b, upper arm 8c, etc., and are composed of coils (wires with a diameter of 50 μm twisted to a diameter of about 0.2 mm) coated with tetrafluoroethylene resin. Stimulation is used to activate the paralyzed areas.

Furthermore, a technology has been demonstrated that attempts to more smoothly control the paralyzed movement functions operated by stimulation data through the central nervous system by feeding back vicarious sensations to the remaining functions of the paralyzed patient.
An example of its configuration is shown as a skin substitute device that performs sensory feedback. That is, pressure sensor wires or displacement sensors 12a, 12b, 12c, 12d are connected to the hand 8a, elbow 8b, upper arm 8c, etc. of the paralyzed patient 8.
..., etc., to detect pressure changes and displacements when the paralyzed hand 3a, elbow 3b, upper arm 3c, etc. are operated by the stimulation pulse train, and after amplifying this detection output with the amplifier circuit 13, the signal processing circuit 14 and then supplied to the piezoelectric element control circuit 15a, the paralyzed patient 8
A piezoelectric element array 15 provided at a non-paralyzed region such as the neck of the patient is driven. The paralyzed patient 8 receives pressure stimulation sent from the piezoelectric element array 15 to the central nervous system, and operates, for example, the sensors of the joint and muscle displacement detection means 1b with a predetermined strength.

[Problem that the invention attempts to solve]

According to the above-mentioned conventional configuration, the paralyzed patient 8 uses the stimulation pulse train to control the remaining functions, that is, the hand 8
Even if there is no sensation, such as when gripping the tip 9 with a, it is possible to feed back such vicarious sensation to the residual function and proportionally control the paralyzed area, but pressure or displacement sensors 12a, 12
b, 12c, 12d, and 12e, and it is also necessary to attach the piezoelectric element array 15, etc., which has the disadvantage of increasing the physiological burden on the paralyzed patient.

The present invention was developed in view of the above-mentioned drawbacks, and its purpose is to facilitate stimulation proportional control without placing any burden on paralyzed patients.

[Means for solving problems]

As an example of the present invention is shown in Fig. 1, the remaining functional movements of a paralyzed patient are detected and a control signal digitized by an analog-to-digital conversion circuit 3b is supplied to a functional electrical stimulation computer 4. The control signal outputs the stimulation data stored in the storage means 5 in the functional electrical stimulation computer 4 to the stimulator 16 for stimulating the plurality of electrodes 11a to 11m implanted in the paralyzed patient to activate the paralytic function. When the control signal is within the upper and lower limits of the dynamic range of the analog-to-digital conversion circuit 3b, the notification means 2 is used so that the magnitude of the control signal can be determined.
3, and when the control signal exceeds the upper limit of the dynamic range of the analog-to-digital converter circuit 3b or is below the lower limit, an alarm signal is output to the notification means 23.

[Effect]

In the stimulation state notification device 16 of the present invention, the magnitude and upper and lower limit values of the control signal for controlling the stimulation pulse train supplied to the paralyzed region of the patient are notified by the notification means 23 such as display means or sound emitting means. It can be used as a vicarious sensation for the patient 8.

〔Example〕

Hereinafter, one embodiment of the stimulation state notification device of the present invention will be described with reference to FIGS. 1 to 3.

In FIG. 1 of this example, parts corresponding to those in FIG. 4 are designated by the same reference numerals. Detection signals detected by microphones or sensors such as voice detection means 1a, joint and muscle displacement detection means 1b...biopotential detection means 1n are supplied to the input terminal of a multiplexer 2, and one of these detection signals is selected. , and is outputted to the output terminal and supplied to the amplifier circuit 3a and A/D 3b. The amplifier circuit 3a and A/D 3b are included in the signal processing means 3, and the detection signal is amplified and converted into a digital signal as a control signal. This control signal is supplied to the FES computer 4, a storage means 5 comprised of ROM, RAM, etc. in the FES computer 4, an audio circuit 21 to be described later, and a display circuit 22.
The storage means 5 in the FES computer 4 stores operation programs and stimulation data. For example, when trying to make the patient 8 perform a grasping motion of grasping the tip 9 with the paralyzed hand 8a of the patient 8, the stimulation data is obtained by measuring the nerve and muscle thresholds or the maximum stimulation intensity for electrical stimulation, and A/A/
Depending on the magnitude of the control signal from the D3b, the FES computer 4 selects predetermined stimulation data from these and supplies it to the digital-to-analog conversion circuit (D/A) 6a of the output processing means 6 to convert the stimulation data into analog data. As a stimulus pulse train of signals, isolator 6b
The demultiplexer 7 supplies multiple stimulation pulses (channels 1 to m) to the electrodes 11a, 11b...11m implanted in the hand 8a of the patient 8, stimulating nerves, muscles, etc., and numbing the paralyzed area. Use it to grasp the tip 9. An acoustic circuit 21 and a display circuit 22 to which control signals are supplied from the A/D 3b mentioned above.
are detailed below. The output end of the display circuit 22 is connected to the display means 24 in the notification means 23. As the display means 24, LED, LCD, FL (fluorescent display tube), CRT, meter, etc. can be selected.
The output end of the acoustic circuit 21 is connected to a sound emitting means 25 such as a speaker, a bell, a buzzer, etc. in the notifying means 23. The digital control signal output from the A/D 3b is sampled every several tens of milliseconds within the FES computer 4, and changes in the voltage value of the control signal input are detected as shown in the first step _ST1 in FIG. Next, the FES computer 4 uses this detected value as A/D3b.
In the second step _ST2 , it is determined whether or not the dynamic range is within the upper or lower limit of the dynamic range, and if it is within the upper and lower limits, the FES computer 4 uses a predetermined algorithm to If the voltage of the detected value is low, the sound and display level will be reduced.
3rd step ST ₃ for control data that increases the sound or display level if the voltage of the detected value is high
Convert with . This data is supplied from the FES computer 4 to the audio circuit 21 and the display circuit 22 as an analog control signal via the D/A 26, ₂₇ (fourth step ST4). For example, a bar graph 24a or the like is displayed. In this case, as shown in Figure 3A, multiple LEDs may be arranged vertically or horizontally, and the LEDs may be turned on sequentially (indicated by black circles) as the display level increases; various display methods are possible. It will be done. In addition, as shown in FIG. 3B, the speaker of the sound emitting means 25 emits a sound (continuous or intermittent sound) whose volume (or pitch) is gradually increased from the lower limit value to the upper limit value (increasingly in the case of the pitch). By making the sound, the paralyzed patient 8 can recognize through the senses of the eyes or ears how tightly he is gripping the tip 9 even though he cannot feel the skin gripping the tip 9, and the paralyzed patient 8 can use his remaining functions to recognize how strongly he is grasping the tip 9. For example, joint or muscle displacement detection means 1b
You can control the movement of.

Furthermore, if the FES computer 4 determines in the second step _ST2 that the magnitude of the control signal exceeds the upper limit value or is less than the lower limit value of the dynamic range of the A/D 3b, the control signal is shown in the fifth step _ST5 . As
The FES computer 4 outputs caution display control data, and the control signals converted into analogs by the D/A 26 and 27 are sent to the acoustic circuit 21 and the display circuit 2.
2. In this case, the alarm sound emitted from the sound emitting means 25 such as a speaker through the acoustic circuit 21 is an intermittent or continuous sound different from the sound quality within the upper and lower limits. This sound is emitted when the control voltage value is A/
The sound will continue until it enters the upper and lower limits of the dynamic range of D and returns to the controllable range in which the stimulation data output can change according to the control signal. Further, when an abnormality exceeding the upper and lower limits is displayed on the display means 24 through the display circuit 22, the display may be dimmed or an abnormality indicator light provided elsewhere may be turned on.

In this way, if an abnormal condition is notified through the notification means 23, the paralyzed patient 8 will be able to understand how strongly he/she is grasping the tip 9 during the grasping motion of the tip 9, even if the paralyzed patient 8 has no sensation on the skin, and will be able to grasp the tip 9 firmly. This will prevent you from damaging the tip by grasping it.

Note that the present invention is not limited to the embodiments described above, and various modifications can be made without departing from the gist of the invention.

[Effect of idea]

Since the present invention is constructed as described above, it is possible to provide biological feedback without adding many pressure sensors, displacement sensors, or piezoelectric element arrays to the living body, and its practical effects are great.

[Brief explanation of the drawing]

Fig. 1 is a system diagram showing one embodiment of the stimulation state notification device of the present invention, Fig. 2 is a flowchart showing an example of the operation of Fig. 1, Fig. 3 is an explanatory diagram of the notification state, and Fig. 4 is a conventional one. FIG. 2 is a system diagram of a stimulator. 1a is a voice detection means, 1b is a joint and muscle displacement detection means, 1n is a biopotential detection means, 2 is a multiplexer, 3b is an A/D, 4 is an FES computer,
5 is a storage means, 6a, 26, 27 are D/A, 21
is an acoustic circuit, 22 is a display circuit, 23 is a notification means,
24 is a display means, and 25 is a sound emitting means.

Claims (1)

[Claims for Utility Model Registration] Detecting the remaining functional movements of a paralyzed patient and supplying a control signal digitized by an analog-to-digital conversion circuit to a functional electrical stimulation computer. In a stimulator for outputting stimulation data stored in a storage means in a paralytic patient to stimulate a plurality of electrodes implanted in a paralytic patient to activate a paralytic function, the control signal is transmitted to the analog-to-digital conversion circuit. Within the upper and lower limits of the dynamic range, the control signal is output to the notification means so that the size of the control signal can be determined, and if the control signal exceeds the upper limit of the dynamic range of the analog-to-digital conversion circuit or is below the lower limit. 1. A stimulation state notification device which outputs an alarm signal to the notification means when .