The present invention relates to a system for assisting rehabilitation which is performed on a hemiplegia patient after, for example, stroke.
In this kind of rehabilitation, a stimulation electrode is placed on the paralyzed limb of the patient. Based on instructions from the brain to try to move the paralyzed limb, the stimulation electrode is energized, and the paralyzed limb is electrically stimulated. This can cause the patient to feel as if the paralyzed limb moves as intended (for example, see Patent Literature 1).
In order to enable an effect of rehabilitation which is performed in a plurality of opportunities, to be properly exerted, and to adequately evaluate the effect, a position where a stimulation electrode is placed on the patient is required to be constant.
Therefore, it is an object of the invention that, in a plurality of opportunities, a position where a stimulation electrode is placed on the patient is made constant irrespective of the practitioner.
In order to attain the object, a first mode which the invention may have is a rehabilitation assistance system comprising:
a stimulation electrode which is to be placed on a part of a body of a patient;
a placement position storing section which stores placement position information indicative of a position where the stimulation electrode is to be placed; and
a guidance information providing section which, based on the placement position information, provides guidance information for guiding the stimulation electrode to the position, to a user.
Based on the guidance information provided by the guidance information providing section, the practitioner (an example of the user) places the stimulation electrode on a predetermined position on the part of the body of the patient. According to the configuration, in a plurality of opportunities, a position where the stimulation electrode is placed on the patient is made constant irrespective of the practitioner. The position is determined as a position where an effect of rehabilitation is properly exerted. Therefore, the effectiveness of rehabilitation which is performed in a plurality of opportunities can be enhanced. Moreover, the placement position of the stimulation electrode is always constant, and therefore the reliability of evaluation of the effect of rehabilitation which is performed in a plurality of opportunities can be enhanced.
The guidance information providing section may optically indicate the guiding information on the part of the body of the patient.
According to the configuration, the practitioner can correctly place the stimulation electrode at a predetermined position while being visually guided by the guidance information which is optically indicated. In a plurality of opportunities, therefore, the position where the stimulation electrode is placed on the patient can be made constant irrespective of the practitioner.
The rehabilitation assistance system may further comprise a display apparatus, and the guidance information providing section may cause the guidance information to be displayed on the display apparatus.
As an example, a case where the guidance information contains an image of the part of the body of the patient, which is acquired in a past will be considered. In this case, the practitioner can correctly place the stimulation electrode at a predetermined position while checking the position where the stimulation electrode was placed in past rehabilitation. In a plurality of opportunities, therefore, the position where the stimulation electrode is placed on the patient can be made constant irrespective of the practitioner.
As another example, a case where the guidance information is a numerical value indicating a distance to the placement position will be considered. In this case, the practitioner can correctly place the stimulation electrode at a predetermined position while checking that the numerical value approaches zero. In a plurality of opportunities, therefore, the position where the stimulation electrode is placed on the patient can be made constant irrespective of the practitioner.
The guidance information may be a sound which changes in accordance with a distance to the placement position.
According to the configuration, the practitioner can correctly place the stimulation electrode at a predetermined position while being acoustically guided by the output sound. In a plurality of opportunities, therefore, the position where the stimulation electrode is placed on the patient can be made constant irrespective of the practitioner.
The rehabilitation assistance system may further comprise:
an image acquiring section which acquires an image of the part of the body of the patient; and
an electrode position information acquiring section which, from the image, acquires electrode position information indicative of a position where the stimulation electrode is placed on the patient.
In this case, the placement position storing section stores the stimulation electrode position information as the placement position information.
According to the configuration, the placement of the stimulation electrode which is determined in rehabilitation performed at a certain timing is stored, and can be used in the next and subsequent rehabilitation processes. In a plurality of opportunities, therefore, the position where the stimulation electrode is placed on the patient can be made constant irrespective of the practitioner.
The rehabilitation assistance system may further comprise
a light emitter which is placed adjacent to the stimulation electrode, and which emits light having a predetermined wavelength.
According to the configuration, the position of the stimulation electrode is detected more easily by an image recognition technique performed by the image acquiring section. Consequently, the position of the stimulation electrode is detected more correctly, and the accuracy of the placement position information which is to be stored in the placement position storing section can be improved. In a plurality of opportunities, therefore, the position where the stimulation electrode is placed on the patient can be made constant irrespective of the practitioner.
The rehabilitation assistance system may further comprise
a normalized scale which is to be placed adjacent to the part of the body of the patient.
According to the configuration, the image acquiring section performs image recognition with respect to the scale, and can correctly specify a position on the part of the body of the patient without using the distance between the image acquiring section and the part of the body of the patient, or the like. Consequently, the position of the stimulation electrode is detected more correctly, and the accuracy of the placement position information which is to be stored in the placement position storing section can be improved. In a plurality of opportunities, therefore, the position where the stimulation electrode is placed on the patient can be made constant irrespective of the practitioner.
The stimulation electrode position information may contain information indicative of a feature point included in the part of the body of the patient.
According to the configuration, even when a scale or the like is not used, the position of the stimulation electrode can be specified by using the feature point on the part of the body of the patient. The feature point itself is not changed over a plurality of processes of rehabilitation, and hence the placement position of the stimulation electrode can be specified with respect to the feature point also in the next and subsequent rehabilitation processes. In a plurality of opportunities, therefore, the position where the stimulation electrode is placed on the patient can be made constant irrespective of the practitioner.
The rehabilitation assistance system may further comprise:
a stimulation applying section which applies electrical stimulation to the part of the body of the patient through the stimulation electrode; and
an evaluating section which evaluates an effect of rehabilitation based on a change of the stimulation electrode position information, which is caused by the electrical stimulation.
According to the configuration, a reaction of the part of the body of the patient to electrical stimulation, i.e., the effect of rehabilitation can be quantitatively evaluated without depending on visual observation by an observer. Electrical stimulation is performed through the stimulation electrode which is correctly placed at the constant position as described above. In a plurality of opportunities, therefore, correctness can be ensured in both an input of stimulation and a reaction to the stimulation.
The rehabilitation assistance system may further comprise
an inertial sensor which is placed adjacent to the stimulation electrode.
In this case, the evaluating section evaluates the effect of rehabilitation based on an output of the inertial sensor.
According to the configuration, it is possible to acquire information of not only displacement of the stimulation electrode, but also the displacement velocity and attitude change of the stimulation electrode. Therefore, the effect of rehabilitation can be evaluated in more detail.
The rehabilitation assistance system may further comprise
at least one of a temperature sensor and a moisture sensor which are placed adjacent to the stimulation electrode.
In this case, the evaluating section evaluates the effect of rehabilitation based on an output of the at least one of the temperature sensor and the moisture sensor.
It is known that the more advancement of recovery of the function of a paralyzed portion, the higher temperature and moisture of the portion are observed. According to the configuration, it is possible to acquire information of the degree of recovery based on not only displacement of the stimulation electrode, but also at least one of the temperature and moisture of a part of the body of the patient. Therefore, the effect of rehabilitation can be evaluated in more detail.
The rehabilitation assistance system may further comprise
a recording section which records the stimulation electrode position information while associating the stimulation electrode position information with at least a timing when the electrode position information is acquired, and patient identification information.
In this case, the evaluating section compares the stimulation electrode position information at a plurality of timings with one another to evaluate the effect of rehabilitation.
According to the configuration, a change of a reaction of the part of the body of the patient to the electrical stimulation, i.e., the progress of rehabilitation can be quantitatively evaluated without depending on visual observation by an observer. Electrical stimulation is performed through the stimulation electrode which is correctly placed at the constant position as described above. In a plurality of opportunities, therefore, correctness can be ensured in both an input of stimulation and a reaction to the stimulation irrespective of the practitioner.
In order to attain the object, a second mode which the invention may have is a rehabilitation assistance system comprising:
a stimulation applying section which applies electrical stimulation to a part of a body of a patient;
an image acquiring section which acquires an image of the part of the body of the patient;
an evaluating section which evaluates a degree of a reaction of the part of the body of the patient to the electrical stimulation, based on the image;
a displaying section which displays the image; and
a display controller which causes a map indicating relationships between a position where the electrical stimulation is applied, and the degree of the reaction, to be displayed on the displaying section.
According to the configuration, irrespective of an evaluator, the placement position of the stimulation electrode can be determined based on a quantitative evaluation. When the stimulation electrode is placed at the placement position which is determined as described above, the position where the stimulation electrode is placed on the patient can be made constant irrespective of the practitioner in a plurality of opportunities.
The stimulation applying section may include a conducting portion which is disposed in a tip end portion of a rod member.
According to the configuration, without conducting a work of attaching/detaching the stimulation electrode to and from a part of the body of the patient, the application of electrical stimulation to a plurality of arbitrary places on the part of the body can be efficiently performed. Therefore, a quantitative evaluation for determining the placement position of the stimulation electrode can be efficiently executed.
The stimulation applying section may include a plurality of conducting portions which are arranged on a sheet member to be attached to the part of the body of the patient.
According to the configuration, when the sheet member is once attached to a part of the body of the patient, the application of electrical stimulation to a plurality of places on the part of the body can be efficiently performed. Particularly, the positional relationships among the plurality of conducting portions are fixed, and hence it is possible to eliminate a situation where the stimulation position is differentiated depending on the practitioner. Therefore, a quantitative evaluation for determining the placement position of the stimulation electrode can be efficiently executed irrespective of the practitioner.
The display controller may cause an image indicating a position of at least one of muscle and nerve which are included in the part of the body of the patient, to be displayed on the displaying section.
According to the configuration, the application position of stimulation performed by the stimulation applying section can be determined by reference to the image. Therefore, application of electrical stimulation to a plurality of places on the part of the body can be efficiently performed.
Hereinafter, embodiments will be described in detail with reference to the accompanying drawings.
As illustrated in
As illustrated in
As illustrated in
According to the configuration, in a plurality of opportunities, positions where the stimulation electrodes 2 are placed on the patient are made constant irrespective of the practitioner. The positions are determined as positions where an effect of rehabilitation is properly exerted. Therefore, the effectiveness of rehabilitation which is performed in a plurality of opportunities can be enhanced. Moreover, the placement positions of the stimulation electrodes 2 are always constant, and therefore the reliability of evaluation of rehabilitation which is performed in a plurality of opportunities can be enhanced.
According to the configuration, the placement positions of the stimulation electrodes 2 are optically indicated on the paralyzed limb 100 by the light beams 51a, and therefore the practitioner can correctly place the stimulation electrodes 2 at the predetermined positions while being guided by the light beams 51a. In a plurality of opportunities, therefore, the positions where the stimulation electrodes 2 are placed on the patient can be made constant irrespective of the practitioner.
According to the configuration, the placement positions of the stimulation electrodes 2 are optically indicated on the paralyzed limb 100 by the images 52a, and therefore the practitioner can correctly place the stimulation electrodes 2 at the predetermined positions while being guided by the images 52a. In a plurality of opportunities, therefore, the positions where the stimulation electrodes 2 are placed on the patient can be made constant irrespective of the practitioner.
As indicated by broken lines in
According to the configuration, the practitioner can correctly place the stimulation electrodes 2 at predetermined positions while checking the positions where the stimulation electrodes 2 was placed in past rehabilitation. In a plurality of opportunities, therefore, the positions where the stimulation electrodes 2 are placed on the patient can be made constant irrespective of the practitioner.
As illustrated in
As illustrated in
According to the configuration, the practitioner can correctly place the stimulation electrode 2 at the predetermined position while checking that the numerical value 63 approaches zero. In a plurality of opportunities, therefore, the position where the stimulation electrode 2 is placed on the patient can be made constant irrespective of the practitioner.
As illustrated in
In the example illustrated in
According to the configuration, the practitioner can correctly place the stimulation electrode 2 at the predetermined position while being guided by the output sound. In a plurality of opportunities, therefore, the positions where the stimulation electrodes 2 are placed on the patient can be made constant irrespective of the practitioner.
Next, a configuration for acquiring the placement position information which is to be stored in the placement position storing section 4 will be described in detail. As indicated by broken lines in
The image acquiring section 7 is configured so as to acquire an image of the paralyzed limb 100 of the patient. In order to know the three-dimensional shape of the paralyzed limb 100 of the patient, preferably, the image acquiring section 7 may be configured so as to be able to acquire depth information. The electrode position information acquiring section 8 is configured so as to acquire electrode position information indicating the position of the stimulation electrode 2 placed on the paralyzed limb 100, through the image acquired by the image acquiring section 7. The placement position storing section 4 is configured so as to be able to store the electrode position information acquired by the electrode position information acquiring section 8, as the above-described placement position information.
According to the configuration, the placement of the stimulation electrode 2 on the paralyzed limb 100 which is determined in rehabilitation performed at a certain timing is stored, and can be used in the next and subsequent rehabilitation processes. In a plurality of opportunities, therefore, the position where the stimulation electrode 2 is placed on the patient can be made constant irrespective of the practitioner. In order to acquire electrode position information through the image recognition technique, preferably, the stimulation electrode 2 may be colored with a color (blue, purple, pink, or the like) which can be clearly distinguished from the skin of the patient.
As indicated by broken lines in
According to the configuration, the position of the stimulation electrode 2 is detected more easily by the image recognition technique performed by the image acquiring section 7. Preferably, the image acquiring section 7 has a high sensitivity to the wavelength of the light which is emitted by the light emitter 9. This enables the position of the stimulation electrode 2 to be detected more correctly, and the accuracy of the placement position information which is to be stored in the placement position storing section 4, to be improved. In a plurality of opportunities, therefore, the position where the stimulation electrode 2 is placed on the patient can be made constant irrespective of the practitioner.
As indicated by broken lines in
According to the configuration, the image acquiring section 7 performs image recognition with respect to the marks of the scale 10, and can correctly specify a position on the paralyzed limb 100 without using the distance between the image acquiring section 7 and the paralyzed limb 100, or the like. Consequently, the position of the stimulation electrode 2 is detected more correctly, and the accuracy of the placement position information which is to be stored in the placement position storing section 4 can be improved. In a plurality of opportunities, therefore, the position where the stimulation electrode 2 is placed on the patient can be made constant irrespective of the practitioner.
The image acquiring section 7 may be configured so as to extract feature points such as a lentigo 100a and a scar 100b on the paralyzed limb 100 of the patient such as illustrated in
According to the configuration, even when the scale 10 or the like is not used, the position of the stimulation electrode 2 can be specified by using the feature point on the part of the body of the patient. The feature point itself is not changed over a plurality of processes of rehabilitation, and hence the placement position of the stimulation electrode 2 can be specified with respect to the feature point also in the next and subsequent rehabilitation processes. In a plurality of opportunities, therefore, the position where the stimulation electrode 2 is placed on the patient can be made constant irrespective of the practitioner.
Next, a configuration for quantitatively evaluating an effect of rehabilitation will be described. As indicated by broken lines in
As illustrated in
The evaluating section 12 is configured so as to evaluate an effect of rehabilitation based on a change of the electrode position information, the change being caused by the electrical stimulation. Specifically, the electrode position information contains the three-dimensional position coordinates of the stimulation electrodes 2, as information, and therefore the direction and degree of the motion which is performed by the paralyzed limb 100 in response to certain electrical stimulation can be quantitatively known based on the displacements of the stimulation electrodes 2.
According to the configuration, a reaction of the paralyzed limb 100 to electrical stimulation, i.e., the effect of rehabilitation can be quantitatively evaluated without depending on visual observation by an observer. Electrical stimulation is performed through the stimulation electrodes 2 which are correctly placed at the constant positions as described above. In a plurality of opportunities, therefore, correctness can be ensured in both an input of stimulation and a reaction to the stimulation.
As indicated by broken lines in
According to the configuration, it is possible to acquire not only information of the displacement of the stimulation electrode 2 in the three-dimensional space, but also that of the displacement velocity and attitude change of the stimulation electrode 2 in the three-dimensional space. Therefore, the effect of rehabilitation can be evaluated in more detail.
As indicated by broken lines in
It is known that, in accordance with the recovery of the function of a paralyzed portion, the temperature and moisture of the portion are raised. According to the above-described configuration, it is possible to acquire information of the degree of recovery based on not only displacement of the stimulation electrode 2 in the three-dimensional space, but also at least one of the temperature and moisture of the paralyzed limb 100. Therefore, the effect of rehabilitation can be evaluated in more detail.
As indicated by broken lines in
Examples of the recording section 15 are a large-capacity storage device (such as a hard disk drive), and a portable storage medium (a disk-type storage medium, a card-type storage medium, a USB memory, or the like). The installation site of the recording section 15 is not particularly limited as far as the section can communicate with the electrode position information acquiring section 8 in a wired or wireless manner. The recording section may constitute a stand-alone system together with the electrode position information acquiring section 8, or be connected with the electrode position information acquiring section 8 via a LAN or a WAN.
As illustrated in
According to the configuration, a change of a reaction of the paralyzed limb 100 to the electrical stimulation, i.e., the progress of rehabilitation can be quantitatively evaluated without depending on visual observation by an observer. Electrical stimulation is performed through the stimulation electrodes 2 which are correctly placed at the constant positions as described above. In a plurality of opportunities, therefore, correctness can be ensured in both an input of stimulation and a reaction to the stimulation.
In the embodiment, the functions of at least the electrode position information acquiring section 8 and the evaluating section 12 are realized from software executed by a cooperation of a processor and memory which are communicably connected to each other. Examples of the processor are a CPU and an MPU. Examples of the memory are a RAM and a ROM. However, the function of at least one of the electrode position information acquiring section 8 and the evaluating section 12 may be realized by hardware such as circuit devices, or a combination of hardware and software.
The stimulation applying section 202 is configured so as to be able to apply electrical stimulation to the paralyzed limb 100 (an example of a part of the body of the patient) of the patient. In response to the electrical stimulation, the paralyzed limb 100 performs a reflex motion. The image acquiring section 203 acquires the manner where the paralyzed limb 100 performs a reflex motion, as image data. The displaying section 204 is configured so as to display the image acquired by the image acquiring section 203.
The evaluating section 205 is configured so as to evaluate the degree of a reaction of the paralyzed limb 100 to the electrical stimulation applied by the stimulation applying section 202, based on the image acquired by the image acquiring section 203. Specifically, the rate of concordance between the image of the paralyzed limb 100 before the application of stimulation, and that of the paralyzed limb 100 reacted to the stimulation is acquired, and it is evaluated that, the lower the rate of concordance, the larger reaction. Alternatively, an adequate marker is attached to the paralyzed limb 100, the amount of displacement of the marker due to the electrical stimulation is image recognized, and the degree of the reaction is evaluated. When electrical stimulation is applied by the stimulation applying section 202 to a plurality of places of the paralyzed limb 100, and the degrees of reactions of the paralyzed limb 100 to the respective stimulation applications are evaluated, thereby obtaining a plurality of sets in which the position where the electrical stimulation is applied is paired with the degree of reaction.
The display controller 206 is configured so as to cause a map 207 indicating relationships between the position where the electrical stimulation is applied by the stimulation applying section 202, and the degree of the reaction of the paralyzed limb 100 which is evaluated by the evaluating section 205, to be displayed on the displaying section 204. In the example illustrated in
The manner of displaying the map 207 is not limited to the example illustrated in
As indicated by broken lines in
Examples of the recording section 208 are a large-capacity storage device (such as a hard disk drive), and a portable storage medium (a disk-type storage medium, a card-type storage medium, a USB memory, or the like). The installation site of the recording section 15 is not particularly limited as far as the section can communicate with the evaluating section 205 in a wired or wireless manner. The recording section may constitute a stand-alone system together with the evaluating section 205, or be connected with the evaluating section 205 via a LAN or a WAN. Alternatively, the recording section 208 may be the placement position storing section 4 which has been described with reference to the first embodiment.
According to the configuration, irrespective of an evaluator, the placement position of the stimulation electrode can be determined based on a quantitative evaluation. When the stimulation electrode is placed at the placement position which is determined as described above, the position where the stimulation electrode is placed on the patient can be made constant irrespective of the practitioner in a plurality of opportunities.
According to the configuration, without conducting a work of attaching/detaching the stimulation electrode to and from the paralyzed limb 100, the application of electrical stimulation to a plurality of arbitrary places on the paralyzed limb 100 can be efficiently performed. Therefore, a quantitative evaluation for determining the placement position of the stimulation electrode can be efficiently executed.
According to the configuration, when the sheet member 202d is once attached to the paralyzed limb 100, the application of electrical stimulation to a plurality of places on the paralyzed limb 100 can be efficiently performed. Particularly, the positional relationships among the plurality of conducting portions 202e are fixed, and hence it is possible to eliminate a situation where the stimulation position is differentiated depending on the practitioner. Therefore, a quantitative evaluation for determining the placement position of the stimulation electrode can be efficiently executed irrespective of the practitioner.
As indicated by the broken lines in
According to the configuration, the application position of stimulation performed by the stimulation applying section 202 can be determined by reference to the image 209. Therefore, application of electrical stimulation to a plurality of places on the paralyzed limb 100 can be efficiently performed.
In the embodiment, the functions of at least the evaluating section 205 and the display controller 206 are realized from software executed by a cooperation of a processor and memory which are communicably connected to each other. Examples of the processor are a CPU and an MPU. Examples of the memory are a RAM and a ROM. However, the function of at least one of the evaluating section 205 and the display controller 206 may be realized by hardware such as circuit devices, or a combination of hardware and software.
The above-described embodiments are examples for facilitating understanding of the invention, and do not limit the invention. The invention may be changed or improved without departing from the spirit of the invention. It is obvious that equivalents are included within the scope of the invention.
The disclosure of Japanese Patent Application No. 2014-115858 filed Jun. 4, 2014 is incorporated in and constituting part of the description of the present application.
Number | Date | Country | Kind |
---|---|---|---|
2014-115858 | Jun 2014 | JP | national |
Filing Document | Filing Date | Country | Kind |
---|---|---|---|
PCT/JP2015/065282 | 5/27/2015 | WO | 00 |