This application is a national phase filing of PCT/JP2018/032373, filed on Aug. 31, 2018, which claims priority to Japanese Patent Application No. 2017-167540, filed on Aug. 31, 2017, the entire disclosures each of which are incorporated herein by reference.
The present disclosure relates to a hemiplegic forearm function recovery training device and method.
Occurrence of stroke may result in paralysis on either the left or right side of a body. The paralysis occurring on either the left or right side is called hemiplegia. A function lost due to the hemiplegia can be partially recovered by rehabilitation. This rehabilitation is performed manually by a skilled physician or therapist. However, training takes time over a long period of time, which imposes a great physical burden on the physician or therapist. To avoid the burden, various training devices are proposed (see, for example, Patent Literatures 1 to 3).
Patent Literature 1: Unexamined Japanese Patent Application Kokai Publication No. 2012-061101
Patent Literature 2: International Publication No. WO2014/092076
Patent Literature 3: Unexamined Japanese Patent Application Kokai Publication No. 2016-101497
In the training devices described in the aforementioned Patent Literatures 1 to 3, a forearm is to be mounted on the device. However, the shapes or conditions of the forearms depend on patients, and in some cases, forearm muscular atrophy may make straight stretching of the wrist difficult. Thus mounting of the forearm on the device is hard work and takes time, and thus there are growing concerns about a decrease in training efficiency.
In view of the above circumstances, an objective of the present disclosure is to provide hemiplegic forearm function recovery training device and method capable of achieving efficient training.
To achieve the above objective, a hemiplegic forearm function recovery training device according to a first aspect of the present disclosure is a hemiplegic forearm function recovery training device for promoting recovery for a hemiplegic patient by training a paralyzed forearm of the patient. The device includes a forearm mounting part on which the forearm is to be mounted. The forearm mounting part includes a mounting body including a forearm fixing portion for fixing the forearm and a gripping mechanism capable of being gripped by a hand of the forearm fixed by the forearm fixing portion, an inner frame portion capable of being fitted to the mounting body and rotatable around the forearm, an outer frame portion to guide the inner frame portion in a rotation direction thereof, and a control part to perform a series of controls that repeatedly causes normal rotation, stop, reverse rotation, and stop of the inner frame portion while acquiring rotation angle information of the inner frame portion. In the normal rotation, the control part controls angular velocity or acceleration of the inner frame portion to stimulate a training target muscle of the forearm. In the reverse rotation, the control part provides resistance to the inner frame portion to sustain stimulation to the training target muscle to maintain muscle tone.
In this case, the gripping mechanism may include a grip that is a rod-like member extending in one direction to be capable of being gripped by the hand of the forearm, and a cross section of the grip that is orthogonal to a longitudinal direction of the grip has an elliptic or oval shape. The gripping mechanism may further include one of the following mechanisms: a first adjustment mechanism to adjust a rotation position of the grip around an axis of rotation extending in the longitudinal direction, a second adjustment mechanism to adjust offset of the grip with respect to the central axis that is a center of rotation of the inner frame portion, and a third adjustment mechanism to adjust a position of the grip relating to a direction of the central axis that is the center of rotation of the inner frame portion.
The forearm fixing portion may include a base portion to be fitted to the inner frame portion, a pair of pad portions to hold the forearm therebetween from opposite sides, and ratchet mechanisms attached to the base portion to enable the corresponding pad portions to be pushed against the forearm and enable the pushing against the forearm to be released with a one-touch manipulation.
The ratchet mechanisms may each include a slider slidable with respect to the base portion and provided with the pad portion at a tip of the slider, and the slider may be graduated.
The inner frame portion or the forearm mounting part may be provided with an elbow mount for placement of an elbow of the forearm.
The device may further include an arm part provided at a distal end with a first joint for coupling to the forearm fixing portion and at a proximal end with a second joint for coupling to a mount attached to a base. The first joint and the second joint may allow the position of the forearm fixing portion to be adjusted in 5 degrees of freedom.
The mount may include a vice mechanism attachable to a plate-like member.
A hemiplegic forearm function recovery training method according to a second aspect of the present disclosure is a hemiplegic forearm function recovery training method for promoting recovery for a hemiplegic patient by training a paralyzed forearm of the patient. The method includes mounting the forearm on a mounting body including a forearm fixing portion for fixing the forearm and a gripping mechanism capable of being gripped by a hand of the forearm fixed by the forearm fixing portion, inserting the mounting body into an inner frame portion rotatable around the forearm; and performing a series of controls that repeatedly causes normal rotation, stop, reverse rotation, and stop of the inner frame portion while acquiring rotation angle information of the inner frame portion. In the normal rotation, angular velocity or acceleration of the inner frame portion is controlled to stimulate a training target muscle of the forearm. In the reverse rotation, resistance is provided to the inner frame portion to sustain stimulation to the training target muscle to maintain muscle tone.
According to the present disclosure, the forearm mounting part to which the forearm is mounted has separate components that are the rotary inner frame portion and the mounting body to which the forearm is mounted, and thereby only insertion of the mounting body in the inner frame portion after mounting of the forearm to the mounting body enables the forearm to be easily mounted in the device. As a result, training can be effectively performed.
Embodiments of the present disclosure are described in detail hereinafter with reference to the drawings.
As illustrated in
A proximal end of the arm part 3 is attached to the mount 4. The forearm mounting part 2 is attached to a distal end of the arm part 3. The arm part 3 is rotatable with respect to the mount 4, and the forearm mounting part 2 is rotatable with respect to the arm part 3. Thus the hemiplegic forearm function recovery training device 1 enables the forearm mounting part 2 to be positioned in a place where the forearm S can be easily moved, with the mount 4 attached to the desk 5. The forearm mounting part 2 is positioned at such a place and the forearm S is mounted.
A configuration of the forearm mounting part 2 is first described. The forearm mounting part 2 includes an outer frame portion 2A, an inner frame portion 2B, and a control part 2C, as illustrated in
A housing 2Aa of the outer frame portion 2A is illustrated in
The rotation guide 2Ab of the outer frame portion 2A is provided with bearings 2Ac as illustrated in
The inner frame portion 2B rotates along the rotation guide 2Ab. The inner frame portion 2B is provided with a pulley 2Bb around which a timing belt 2Ca of a control part 2C described later is wound. Grooves that engage with the timing belt 2Ca are formed in the outer circumference of the pulley 2Bb. The timing belt 2Ca engages with these grooves and the pulley 2Bb and the timing belt 2Ca rotate without slipping.
The control part 2C includes the timing belt 2Ca, a pulley 2Cb, and a rotation drive 2Cc, as illustrated in
The rotation drive 2Cc is attached to the outer frame portion 2A and has a motor and an encoder. As the motor of the rotation drive 2Cc rotates, the pulley 2Cb rotates, which via the timing belt 2Ca, causes the pulley 2Cb, that is, the inner frame portion 2B, to rotate with respect to the outer frame portion 2A. The encoder of the rotation drive 2Cc detects a rotation angle of the axis of rotation of the rotation drive 2Cc. Conversely, rotation of the inner frame portion 2B can cause the pulley 2Cb to rotate via the timing belt 2Ca.
The control part 2C controls rotation of the inner frame portion 2B. Specifically, the control part 2C performs a series of controls that repeatedly causes, by the motor, normal rotation, stop, reverse rotation, and stop of the inner frame portion 2B while acquiring, by the encoder, rotation angle information of the inner frame portion 2B. In the normal rotation, the control part 2C controls angular velocity or acceleration of the inner frame portion 2B to stimulate a training target muscle of the forearm that induces muscle tone and stress reflex upon the muscle tone. In the reverse rotation, the control part provides resistance to the inner frame portion 2B to sustain stimulation to the training target muscle to maintain the muscle tone.
As illustrated in
The base portion 21 is fitted into the inner frame portion 2B as illustrated in
The forearm fixing portion 22 fixes the forearm S as illustrated in
As illustrated in
The unlock 22Bbd is provided on a top of the locking frame 22Bba. A pad portion 22A side of the protrusion 22Bbb is orthogonal to a direction of movement of the slider 22Ba, and the other side opposite to the pad portion 22A side thereof inclines with respect to the direction of movement of the slider 22Ba. Thus, as illustrated in
The locking frame 22Bba is supported by the spring 22Bbc and vertically displaceable in the internal space of the case 22Bb. Thus, as illustrated in
In this way, the forearm fixing portion 22 can easily sandwich the forearm between the paired pad portions 22A by the ratchet mechanisms 22B.
The slider 22Ba is provided with marks 22Bab. As illustrated in
The gripping mechanism 23 is positioned to be grippable by a hand of the forearm S, with the forearm S fixed to the forearm fixing portion 22. As illustrated in
The grip portion 23A is a rod-like member extending in one direction to be capable of being gripped by the hand located at a front-end of the forearm S. The cross section of the grip portion 23A that is orthogonal to the longitudinal direction has an elliptic or oval shape. The first adjustment mechanism 23B adjusts a rotation position of the grip portion 23A around an axis of rotation (rotation direction indicated by arrows α) extending in the longitudinal direction, as illustrated in
The second adjustment mechanism 23C adjusts offset of the grip portion 23A with respect to the central axis that is a center of rotation of the inner frame portion 2B. Specifically, the second adjustment mechanism 23C is a plate-like member that is rotatable around the rotation central axis 23E, and adjusts offset of the grip portion 23A by rotation (rotation in a direction indicated by arrows β) of the plate-like member. The second adjustment mechanism 23C can fix a position of the grip portion 23A in a direction indicated by arrows β. This second adjustment mechanism 23C can position the grip portion 23A to be able to be easily gripped in accordance with an angle of the wrist of the forearm S.
The third adjustment mechanism 23D adjusts a position of the grip portion 23A relating to a direction of the central axis (direction indicated by arrows γ) that is the center of rotation of the inner frame portion 2B. Specifically, movement of the rotation central axis 23E in the direction indicated by arrows γ adjusts movement of the grip portion 23A. The third adjustment mechanism 23D can fix a position of the grip portion 23A in the direction indicated by arrows γ. This third adjustment mechanism 23D can position the grip portion 23A to be able to be easily gripped in accordance with a length (distance) of the forearm S.
This gripping mechanism 23 can adjust the orientation and the position of the grip portion 23A to be easily gripped by the hand. The hemiplegic forearm function recovery training device 1 according to the present embodiment is described as including the first adjustment mechanism 23B, the second adjustment mechanism 23C, and the third adjustment mechanism 23D, but may include any one of those adjustment mechanisms.
As illustrated in
Next, a configuration of the arm part 3 is described. As illustrated in
The arm part 3 includes an end cover 3B, a spherical portion 3C, and a mount 3D at a portion of the arm part 3 that is coupled to the forearm mounting part 2. The end cover 3B, the spherical portion 3C, and the mount 3D constitute a first joint that connects the arm part 3 to the forearm fixing portion 22.
The end cover 3B is attached to the arm body 3A, and the spherical portion 3C is rotatably sandwiched between the arm body 3A and the end cover 3B. The spherical portion 3C is integral with the mount 3D, and the forearm mounting part 2 is coupled with the mount 3D. Thus the spherical portion 3C enables the forearm mounting part 2 to rotate in 3 degrees of freedom with respect to the arm part 3, as illustrated in
The arm part 3 includes a rotary portion 3E and a rotary portion 3F at a portion of the arm part 3 that is coupled to the mount 4, as illustrated in
In this way, the first joint and the second joint of the arm part 3 allow the position of the forearm fixing portion 22 to be adjusted in 5 degrees of freedom.
Next, a configuration of the mount 4 is described. The mount 4 is a vice mechanism that can attach the proximal end portion (second joint) of the arm part 3 to a plate-like member (base) such as a desk 5. As illustrated in
The arm part 3 is mounted on the housing 4A and the housing 4A is disposed on the desk 5 that is an attachment target. The lower plate 4B is disposed under the desk 5 that is the attachment target. The lower plate 4B has the pad portion 4C that abuts against the rear side of the plate of the desk 5. As illustrated in
Next, an operation of the hemiplegic forearm function recovery training device 1 is described.
As illustrated in
Then the arm part 3 is moved to position the forearm mounting part 2 in an appropriate position (Step S2; positioning step). Specifically, after rotating the rotary portions 3E and 3F and determining a direction of extension of the arm part 3, the spherical portion 3C is rotated and an attitude of the forearm mounting part 2 is changed to position the forearm mounting part 2 in a position where the inserted forearm S can be easily moved.
Next, the forearm S is mounted on the mounting body 20 (Step S3; mounting step). First, the forearm S is placed on the base portion, with the grip portion 23A gripped by the hand. In a case in which gripping of the grip portion 23A is hard, the orientation and position of the grip portion 23A can be adjusted by the first adjustment mechanism 23B, the second adjustment mechanism 23C, and the third adjustment mechanism 23D.
Then the forearm S is fixed to the mounting body 20 using the forearm fixing portion 22. Specifically the sliders 22Ba of the pair of ratchet mechanisms 22B are slid in a direction of the forearm S to press the pad portion 22A against the forearm S. In this case, the forearm S is desirably placed at the center of the mounting body 20.
Next, the mounting body 20 is inserted in the inner frame portion 2B of the forearm mounting part 2 (Step S4; insertion step). Specifically, the mounting body 20 is inserted in the forearm mounting part 2 in such a way that the protrusion 21Bc of the mounting body 20 abuts the protrusion 2Bc of the inner frame portion 2B.
Next is the training of the forearm S (Step S5; control step). Specifically, the control part 2C performs a series of controls that repeatedly causes, by driving of the motor, normal rotation, stop, reverse rotation, and stop of the inner frame portion 2B while acquiring, by the encoder of the control part 2C, rotation angle information. In the normal rotation, the control part 2C controls angular velocity or acceleration of the inner frame portion 2B to stimulate a training target muscle of the forearm S that induces muscle tone and stress reflex upon the muscle tone. In the reverse rotation, the control part provides resistance to the inner frame portion 2B to sustain stimulation to the muscle to maintain the muscle tone.
This provides the forearm S, for example, with a passive excise of pronation (or supination) by sudden acceleration or with a voluntary active excise of supination (or pronation). Here, a facilitating stimulus by sudden acceleration in a pronation (or supination) direction is provided before voluntary supination (or pronation). The facilitating stimulus by sudden acceleration prompts stretch reflex, and effective training can be expected.
As described above, according to the present embodiment, the forearm mounting part 2 to which the forearm S is mounted has separate components that are the rotary inner frame portion 2B and the mounting body 20 to which the forearm S is mounted, and thereby only insertion of the mounting body 20 in the inner frame portion 2B after mounting of the forearm S to the mounting body 20 enables the forearm S to be easily mounted in the device. As a result, training can be effectively performed.
Furthermore, according to the present embodiment, the orientation and position of the grip portion 23A can be adjusted in accordance with states of bending and extending of a wrist, which provides easy gripping of the grip portion 23A by the hand. This can achieve efficient training.
Furthermore, according to the present embodiment, the forearm S is fixed to the mounting body 20 by the ratchet mechanism 22B, which facilitates fixing of the forearm S. This can achieve prompt fixing of the forearm S compared with fixing of the forearm S by screws without the ratchet mechanism 22B, and can release the fixing with a one-touch manipulation.
Furthermore, according to the present embodiment, the arm part 3 enables the forearm mounting part 2 to be positioned in a position where training is easily performed (where pronation and supination excises of the forearm are easily performed), which can maximize training effects.
Furthermore, according to the present embodiment, the mount 4 enables the hemiplegic forearm function recovery training device 1 to be installed at various places, which can enhance versatility. A power supply box and a control unit can be contained in a dedicated stand on which the mount is fixed, and an auxiliary stimulation device such as vibration/electrical stimulus can be further contained. Since such a dedicated stand may have a height lower than that of a common desk, the stand itself can be placed under the desk.
As illustrated in
By contrast, as illustrated in
In addition, as illustrated in
The foregoing describes some example embodiments for explanatory purposes. Although the foregoing discussion has presented specific embodiments, persons skilled in the art will recognize that changes may be made in form and detail without departing from the broader spirit and scope of the invention. Accordingly, the specification and drawings are to be regarded in an illustrative rather than a restrictive sense. This detailed description, therefore, is not to be taken in a limiting sense, and the scope of the invention is defined only by the included claims, along with the full range of equivalents to which such claims are entitled.
This application claims the benefit of Japanese patent Application No. 2017-167540, filed on Aug. 31, 2017, the entire disclosure of which is incorporated by reference herein.
The present disclosure can be applicable to promote recovery for a hemiplegic patient by training a paralyzed forearm of the patient.
Number | Date | Country | Kind |
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JP2017-167540 | Aug 2017 | JP | national |
Filing Document | Filing Date | Country | Kind |
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PCT/JP2018/032373 | 8/31/2018 | WO |
Publishing Document | Publishing Date | Country | Kind |
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WO2019/045051 | 3/7/2019 | WO | A |
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