Patent Application
20160074271
1. Field
The disclosure relates to a device for training a limb of a patient who needs to recover a motor function.
2. Description of the Related Art
JP2006-346108A discloses a training device including two switches to be pushed by an upper limb of a patient. JP2012-061101A discloses a training device including an attachment attached to an upper limb of a patient and four wires for suspending the attachment.
A training device according to the disclosure is for training a limb and includes a target part to be touched with the limb and a force generator that generates a lifting force acting upward on the limb by electricity in a manner allowing the limb to move upward and downward.
A preferable embodiment according to the disclosure will be described in detail referring to the attached drawings. In the description, the same component or the component having the same function is denoted with the same reference sign and repeated description thereof will be omitted.
As illustrated in
The work platform 2 is placed on the floor. A chair 11 (see
The upper portion 2a of the work platform 2 is at a height where the chest of a patient sitting on the chair 11 comes. The upper portion 2a is provided with a top plate 21, a first support plate 22, a second support plate 23, and a chest stopper 24. The top plate 21 is horizontally positioned in the middle in the right and left direction of the work platform 2 and close to the rear edge of the work platform 2.
The first support plate 22 is positioned adjacent the rear side of the top plate 21 to protrude from the rear edge of the work platform 2 in a tongue-shape. A first switch 25 to be manipulated by an upper limb of a patient is provided on the first support plate 22. That is, the training device 1 includes the first switch 25. The first switch 25 has a dome-shaped push button 25a. By pushing the push button 25a, the first switch 25 is switched on or off The push button 25a is a first target part T1 to be touched by a patient with an upper limb.
As illustrated in
The second support plate 23 is attached to the upward/downward slider 21d, protrudes rearward, and faces the top plate 21. A second switch 26 to be manipulated by an upper limb of a patient is provided on the second support plate 23. That is, the training device 1 includes the second switch 26. The second switch 26 has a dome-shaped push button 26a. By pushing down the push button 26a, the second switch 26 is switched on or off. The push button 26a is a second target part T2 to be touched by a patient with an upper limb. The second switch 26 is positioned in the forward side of the first switch 25 and higher than the first switch 25.
A tilt portion 23a which become lower toward the rearward side is provided on the rear portion of the second support plate 23. The tilt portion 23a allows a patient to push the push button 26a of the second switch 26 with an upper limb with little chance of interference between the upper limb and the rear portion of the second support plate 23. A vertical wall 23b is vertically provided on the forward portion of the second support plate 23. The vertical wall 23b prevents an upper limb of a patient from moving excessively forward to fall off from the second support plate 23.
Positions of the second support plate 23 and the second switch 26 can be adjusted along the forward and rearward direction by changing the position of the forward/rearward slider 21c. That is, the forward/rearward slider 21c constitutes an adjustor Al for adjusting the position of the second switch 26 along the forward and rearward direction. Heights of the second support plate 23 and the second switch 26 can be adjusted by changing the position of the upward/downward slider 21d. That is, the upward/downward slider 21d constitutes an adjustor A2 for adjusting the height of the second switch 26. The training device 1 includes adjustors A1 and A2 to adjust the position of the second switch 26 along the forward and rearward direction and the upward and downward direction.
A bellows cover 27 is provided over the guide 21a in a region in the rearward side of the forward/rearward slider 21c. The rear end of the cover 27 is fixed to the rear end of the guide 21a, and the front end of the cover 27 is fixed to the forward/rearward slider 21c. The cover 27 extends and contracts along with the change in the position of the forward/rearward slider 21c. The cover 27 prevents an upper limb of a patient from touching the guide 21a.
An anti-drop stopper 28 that generates a counter force against the descending of the second switch 26 while adjusting the height is provided on the upper end of the strut 21b. The anti-drop stopper 28 includes a winding up shaft 28a protruding forward from the strut 21b and a sheet spring 28b wound around the winding up shaft 28a. An end of the sheet spring 28b is fixed to the upward/downward slider 21d. The sheet spring 28b is fed out from the winding up shaft 28a along with the downward movement of the upward/downward slider 21d, generating a counter force against the descending of the upward/downward slider 21d. In this manner, the weight of the second switch 26 and its support members (the second support plate 23 and the upward/downward slider 21d) is reduced, which makes it easy to adjust the height of the second switch 26.
The chest stopper 24 includes a chest stopping frame 24a provided along the rim of the first support plate 22 and a cushion 24b covering the chest stopping frame 24a. Both the ends of the chest stopping frame 24a are fixed to the upper portion 2a of the work platform 2. The chest stopper 24 restricts the movement of the chest of a patient toward the switches 25 and 26. When manipulating the switches 25 and 26, the movement of the chest toward the switches 25 and 26 is restricted, so that an upper limb has to be moved further. With the restriction on the movement of the chest, a larger amount of exercise is required of an upper limb.
As illustrated in
As illustrated in
The wire guide 32 includes a frame body 36A, two connecting frames 36B, two top plates 37A and 37B, and two pulleys 38A and 38B. The frame body 36A is configured with, for example, a rectangular aluminum frame. The frame body 36A is horizontally positioned above the work platform 2 with the long sides along the forward and rearward direction. The connecting frames 36B are, for example, vertically extending aluminum frames disposed side by side along the right and left direction. The connecting frames 36B connect the front edge of the frame body 36A and the front edge of the work platform 2.
The top plates 37A and 37B are each provided over the upper portion of the frame body 36A. The top plate 37A is positioned close to the rear edge of the frame body 36A, and the top plate 37B is positioned close to the front edge of the frame body 36A. The pulley 38A is attached to the middle of the bottom of the top plate 37A and higher than the sling 30. The position where the pulley 38A is attached to the top plate 37A can be adjusted along the forward and rearward direction. That is, the force generator 3 includes an adjustor A3 for adjusting the position of the pulley 38A along the forward and rearward direction. The pulley 38B is attached to the middle of the bottom of the top plate 37B.
The wire 31 pulled upward from the sling 30 runs about the pulley 38A to be directed forward and runs about the pulley 38B to be directed downward. The front end of the wire 31 running about the pulley 38B to be directed downward is connected to the motor 33.
The motor 33 is positioned near the bottom ends of the connecting frames 36B to be fixed in the work platform 2. As illustrated in
The torque of the motor 33 is controlled by the controller 6. As described above, since there is little change in winding radius of the wire 31 and mutual rubbing of the wire 31 is prevented, the ratio of the torque applied to the reel 34 to a tensional force applied to the wire 31 is approximately constant. Therefore, the tensional force applied to the wire 31 is controlled by controlling the torque of the motor 33. The motor 33, with its torque controlled, applies a tensional force to the wire 31 in a manner allowing the sling 30 to move upward and downward.
The tensional force applied to the wire 31 by the motor 33 serves as a lifting force acting upward on an upper limb of a patient to which the sling 30 is attached. That is, the force generator 3 generates a lifting force acting upward on an upper limb of a patient in a manner allowing the upper limb of the patient to move upward and downward. Hereinafter in the description, a load-relieving force is generated by the force generator 3 as a specific example of the lifting force against the weight of an upper limb. The load-relieving force is a force that reduces the muscle power required to support the weight of an upper limb. The load-relieving force is no greater than the weight of the upper limb.
As illustrated in
The vibratory stimulator 5 includes, for example, a vibrating body 50 embedded with a vibration motor and a power feeding cable 51 connected to the vibrating body 50. By using an adhesive tape or the like, the vibrating body 50 is stuck on a portion of an upper limb of a patient where the motion during the training is related to. The vibratory stimulator 5 is supplied with power via the power feeding cable 51 and gives a vibratory stimulus from the vibrating body 50 to an upper limb of a patient. A connector 52 is provided on the end opposite the vibrating body 50 of the power feeding cable 51.
The number of the electrical stimulator 4 and the number of the vibratory stimulator 5 are not limited. Each number may be one or more.
The controller 6 includes a main body 60, a terminal 61, and a monitor 62 and controls the motor 33, the electrical stimulator 4, and the vibratory stimulator 5. The main body 60 is embedded with a controlling computer and a servo controller and disposed in the left portion of the work platform 2. A plurality of connectors 63A connected to the controlling computer is provided on the upper portion of the rear face (the face close to a patient) of the main body 60. A connector 42 of the electrical stimulator 4 or a connector 52 of the vibratory stimulator 5 is connected to the connector 63A. In this manner, the electrical stimulator 4 and the vibratory stimulator 5 are connected to the controlling computer in the main body 60. The switches 25 and 26 and the monitor 62 are also connected to the controlling computer in the main body 60 via cables (not shown). A motor 33 is connected to the servo controller via a cable (not shown). As a hardware configuration, the main body 60 comprises, for example, a circuitry including a processor and a memory. The memory stores a program for configuring each function. The processor configures each function by executing the program stored in the memory. The hardware configuration of the main body 60 is not necessarily limited to one configuring each function by executing the program. For example, the main body 60 may configure each function by a specific logic circuit or ASIC (Application Specific Integrated Circuit) made by integrating the specific logic circuit.
The terminal 61 is a connector unit including a plurality of connectors 63B. The connector 63B is same as the connector 63A. The connector 63B is provided on the rear face (the face close to a patient) of the terminal 61. The terminal 61 is fixed to the right portion of the work platform. That is, when viewed from a patient, the switches 25 and 26 are provided between the main body 60 and the terminal 61.
The connectors 63B are connected to the controlling computer in the main body 60 via cables (not shown) and arrayed in parallel to the connector 63A of the main body 60 with regard to the controlling computer. Thus, in a similar manner as the connection to the connector 63A, the electrical stimulator 4 and the vibratory stimulator 5 can be connected to the controlling computer by connecting the connector 42 and the connector 52 to the connector 63B. In this manner, the electrical stimulator 4 and the vibratory stimulator 5 can selectively be connected to either right or left side to the switches 25 and 26 according to whether training is performed for the right upper limb or the left upper limb.
The monitor 62 is, for example, a liquid crystal display fixed to a connecting frame 36B in a manner facing a patient. The monitor 62 may be a touch panel that can be used as an input device to the controlling computer.
The controller 6 serves as a motor controlling device MC of the force generator 3. That is, the force generator 3 includes the motor controlling device MC, and the motor 33 and the motor controlling device MC constitute a servo mechanism. The controller 6 as the motor controlling device MC controls the torque of the motor 33. The target torque is determined by multiplying the target tensional force of the wire 31 by the winding radius of the wire 31. The target tensional force of the wire 31 can previously be determined through an input device, such as a keyboard (not shown).
The controller 6 supplies power via the power feeding cables 41 and 51 to drive the electrical stimulator 4 and the vibratory stimulator S. The power supplied to the electrical stimulator 4 can previously be set using an input device, such as a key board (not shown). The timing of supplying power to the vibratory stimulator 5 can also be set using the input device, such as a key board (not shown).
As an example of a setting of the timing of driving the vibratory stimulator 5, the vibratory stimulator 5 may be driven in response to the on and off of the switches 25 and 26. In such a setting, the vibratory stimulator 5 gives a vibratory stimulus to an upper limb in response to the on and off of the switches 25 and 26. For example, the timing may be set such that the driving starts when one of the switches 25 and 26 is pushed and the driving stops when the other one of the switches 25 and 26 is pushed. The setting of the timing may be such that a plurality of vibratory stimulators 5 can be driven at different timings. The setting of the timing may be such that the vibratory stimulator 5 can continuously be driven during the training or the vibratory stimulator 5 cannot be driven throughout the training.
The setting of the timing of driving the electrical stimulator 4 as well as the setting of the timing of driving the vibratory stimulator 5 may be allowed. As an example of a setting of the timing of driving the electrical stimulator 4, the electrical stimulator 4 may be driven in response to the on and off of the switches 25 and 26. In such a setting, the electrical stimulator 54 gives an electrical stimulus to an upper limb in response to the on and off of the switches 25 and 26. For example, the timing may be set such that the driving starts when one of the switches 25 and 26 is pushed and the driving stops when the other one of the switches 25 and 26 is pushed. The timing may be set such that the electrical stimulator 4 can continuously be driven during the training or the electrical stimulator 4 cannot be driven throughout the training.
The controller 6 presents various kinds of information related to the training on the monitor 62. The information to be presented includes, for example, the numbers of the on and off of the switches 25 and 26, a time interval between the on and off of the switches 25 and 26, and a target tensional force of the wire 31.
The procedure of training using the training device 1 will now be described. A patient P first sits on the chair 11 in the rearward side of the work platform 2 as illustrated in
The load-relieving force generated by the force generator 3 is adjusted according to the weight of an upper limb of the patient P. That is, the motor 33 determines the target tensional force to be applied to the wire 31.
The current value to be supplied from the controller 6 to the electrical stimulator 4 is set. The current value is set such that the joint of the upper limb does not move by an electrical stimulus. Then, the timing to supply power from the controller 6 to the vibratory stimulator 5 is set. The preparation for training is now complete. The sequential order of attaching the sling 30, sticking the electrodes 40A and 40B, sticking the vibrating body 50, and conducting various settings is not limited to the order described above.
Now, the patient P performs a repetitive motion, namely, alternately pushing the switches 25 and 26, to train the upper limb of the patient P. That is, the patient P performs a repetitive motion of alternately touching the target parts T1 and T2. A set of the training finishes when the number of the repetitive motions reaches a target number. A set of the training may be finished when a previously determined time has elapsed.
During the repetitive motion, the force generator 3 generates a lifting force acting upward on the upper limb in a manner allowing the upper limb to move upward and downward. Thus the weight of the upper limb is continuously reduced during the repetitive motion. The force generator 3 is required to generate only a lifting force, so that the configuration of the force generator 3 can be simplified. For example, a group of the sling 30, the wire 31, the motor 33, and the motor controlling device MC constitutes the force generator 3 as described above. Since the motion required of the upper limb is only a simple motion of touching the target parts T1 and T2, the easiness of training can drastically be improved by continuously reducing the weight with the force generator 3. Since the force generator 3 does not force the upper limb to move, the patient P extends and flexes the upper limb by his or her own strength. So that the training is highly effective for recovering the motor function of the upper limb. Thus, an effective training can be performed with a simple configuration.
The force generator 3 generates a lifting force by electrical power, so that the lifting force can be controlled in a desired manner by controlling the supply power. The lifting force can precisely be varied considering the state of the upper limb so that the repetitive motion is performed further smoothly. For example, the controller 6 as the motor controlling device MC may increase the lifting force when the sling 30 is accelerating in a direction toward the pulley 38A, and decrease the lifting force when the sling 30 is accelerating in a direction remote from the pulley 38A. That is, when the motor 33 is accelerating in the direction to wind up the wire 31, the lifting force may be set larger than when the motor 33 is still, and when the motor 33 is accelerating in the direction to feed out the wire 31, the lifting force may be set smaller than when the motor 33 is still.
An example of the controlling procedure of changing the lifting force according to the rotation of the motor 33 in such a manner is illustrated in
The muscle power of the upper limb is estimated based on, for example, the angular velocity and the angular acceleration of the motor 33, the inertia of the motor 33, the weight of the upper limb, the viscosity coefficient of the motor 33, the frictional resistance in the motor 33, the viscosity coefficient of the reel 34 and the wire 31, and the radius of the reel 34 (S03). The estimated muscle power is multiplied by a predetermined ratio to calculate an assist force (S04). The predetermined ratio is, for example, 0 to 80%. It may be configured that the predetermined ratio is set through the input device, such as a keyboard.
When the motor 33 is accelerating in the direction to wind up the wire 31, it can be estimated that the muscle power for raising the upper limb is being generated. Therefore, the assist force for raising the upper limb (an upper limb raising-assist force) is calculated. When the motor 33 is accelerating in the direction to feed out the wire 31, it can be estimated that the muscle power for lowering the upper limb is being generated. Therefore, the assist force for lowering the upper limb (an upper limb lowering-assist force) is calculated.
Then the assist force is added to or subtracted from the load-relieving force (S05). Specifically, when the motor 33 is accelerating in the direction to wind up the wire 31, the upper limb raising-assist force is added to the load-relieving force. When the motor 33 is accelerating in the direction to feed out the wire 31, the upper limb lowering-assist force is subtracted from the load-relieving force. A torque that generates the force calculated by adding the assist force to or subtracting the assist force from the load-relieving force is calculated (S06). The motor 33 is controlled to generate the calculated target torque (S07).
By repeating the procedure illustrated in
In this manner, the upward and downward movement of the upper limb can be assisted corresponding to the intension of the patient, so that the repetitive motion can be performed more smoothly. Since the assist force is calculated according to the estimated muscle power of the upper limb, the upper limb is assisted to move upward and downward with a force commensurate with the muscle power of the upper limb. The muscle power of the upper limb is estimated based on the rotational state of the motor 33 detected by the rotational angle sensor 35 without using a force sensor. Controlling the torque through the procedure illustrated in
The controller 6 as the motor controlling device MC may change the load-relieving force according to the position of the sling 30. For example, the load-relieving force may be changed according to the height of the sling 30.
For example, the load-relieving force illustrated in
It may be configured to input a parameter for identifying the correlation between the height of the sling 30 and the load-relieving force through an input device, such as a keyboard. For example, it may be configured to receive an input of the load-relieving forces R1, R2, and R3 in the dead zones B1, B2, and B3 and the widths W1, W2, and W3 of the dead zones B1, B2, and B3 illustrated in
As described above, by changing the load-relieving force, the load-relieving force can be adjusted according to the behavior of the upper limb, so that the load on the upper limb during the training can be optimized.
The force generator 3 generates a lifting force only by the tensional force applied to the single wire 31 in a manner allowing the sling 30 to move upward and downward. Since this configuration hardly restricts the position of the upper limb, the motion is performed further by the strength of the patient P.
The training device 1 includes the switches 25 and 26 of which state changes between the on and off by pushing the target parts T1 and T2. The state of the training can properly be checked by detecting a patient touching the target parts T1 and T2.
During the repetitive motion, the electrical stimulator 4 gives an electrical stimulus to the upper limb of the patient P. Stimulating the muscle of the patient P in this manner can further improve the easiness of training. Since a current value given to the electrical stimulator 4 is set so as not to generate a motion of a joint, the upper limb is not forced to move. Thus the effect of facilitating the motion by the strength of the patient P is not deteriorated.
During the repetitive motion, the vibratory stimulator 5 gives a vibratory stimulus to the upper limb of the patient P. A vibratory stimulus effectively gives effect on deep sensitivity of a muscle of the patient P and stimulates a nerve pathway from the cerebrum to the muscle. Thus the motor function can be recovered effectively. In particular, when the vibratory stimulator 5 is driven in response to the manipulation of the switches 25 and 26, the stimulation to a nerve pathway is repeated corresponding to the repetitive motion of the upper limb. This further effectively facilitates the recovery of the motor function.
As described above, the training device 1 includes the adjustors A1 and A2 for adjusting the position of the second switch 26. With the adjustor A2, the relative position along the upward and downward direction of the second switch 26 to the first switch 25 can be adjusted. So that the height difference between the first switch 25 and the second switch 26 can be adjusted considering the degree of paralysis or the degree of recovery of motor function of the patient P. For example, if the degree of paralysis is low, the height difference between the first switch 25 and the second switch 26 may be increased to raise the load of the training. As the motor function recovers by repeating the training, the height difference between the first switch 25 and the second switch 26 may be increased to raise the load of the training.
Furthermore, with the adjustor A1, the relative position along the forward and rearward direction of the second switch 26 to the first switch 25 can be adjusted. Considering the degree of paralysis or the degree of recovery of motor function of the patient P, the distance along the forward and rearward direction between the first switch 25 and the second switch 26 can be adjusted. For example, if the degree of paralysis is low, the distance along the forward and rearward direction between the first switch 25 and the second switch 26 may be lengthened to increase the moving distance of the upper limb. As the motor function recovers by repeating the training, the distance along the forward and rearward direction between the first switch 25 and the second switch 26 may be lengthened to increase the moving distance of the upper limb.
The easiness of training can be controlled by adjusting the position of the second switch 26 using the adjustors A1 and A2, so that a further effective training can be performed. The adjustors A1 and A2 may be configured to adjust the position of the first switch 25 instead of the second switch 26 or configured to adjust both the positions of the first switch 25 and the second switch 26.
The training device 1 includes an adjustor A3 for adjusting the position of the pulley 38A along the forward and rearward direction. With this mechanism, the position of the sling 30 suspended from the pulley 38A can be adjusted considering the positions of the first switch 25 and the second switch 26 so that the repetitive motion can be performed more smoothly.
A tensional force applied to the wire 31, that is, a lifting force generated by the force generator 3 may be adjusted according to the degree of paralysis or the degree of recovery of motor function of the patient P. For example, if the degree of paralysis is low, the lifting force may be reduced to raise the load of the training. As the recovery of motor function progresses, the lifting force may be reduced to raise the load of training.
The controller 6 as the motor controlling device MC may change the lifting force according to the on and off of the switches 25 and 26. During the repetitive motion of alternately pushing the switches 25 and 26, the upper limb is raised after pushing the switch 25 and lowered after pushing the switch 26. For example, the lifting force after pushing the switch 25 and the lifting force after pushing the switch 26 may be set different from each other, so that different lifting forces can be applied during raising and lowering of the upper limb. Specifically, a method may be employed such that different adjustment ratios to be multiplied by the load-relieving force to calculate the lifting force are set for the calculation after pushing the switch 25 and after pushing the switch 26. For example, when the adjustment ratio for the calculation after pushing the switch 25 is set larger than the adjustment ratio for the calculation after pushing the switch 26, a greater lifting force is applied when the upper limb is raised. It may be configured to receive an input to set the adjustment ratio. By changing the lifting force according to the on and off of the switches 25 and 26, the lifting force can be adjusted corresponding to the motion of the upper limb without, for example, estimation of the muscle power of the upper limb,
The lifting force may be changed according to the on and off of the switches 25 and 26 and to the position of the sling 30. Specifically, such method may be as follows. When the position of the sling 30 is higher than a predetermined height (hereinafter referred to as “reference height during raising”) during a period from when the switch 25 is pushed until when the switch 26 is pushed, the lifting force is calculated by multiplying the load-relieving force by the adjustment ratio for raising the upper limb. When the position of the sling 30 is lower than a predetermined height (hereinafter referred to as “reference height during lowering”) during a period from when the switch 26 is pushed until when the switch 25 is pushed, the lifting force is calculated by multiplying the load-relieving force by the adjustment ratio for lowering the upper limb. It may be configured to receive inputs to set the reference height during raising and the reference height during lowering. By changing the lifting force according to the on and off of the switches 25 and 26 and to the position of the sling 30, the lifting force corresponding to the motion of the upper limb can further be optimized.
The controller 6 may store training data. The training data includes a cycle period of the repetitive motion and a target tensional force applied to the wire 31. Such training data may be analyzed afterward to check the degree of recovery of motor function. For example, the progress of recovery of motor function can be checked from the decrease in a cycle period of the repetitive motion.
The scope of the present invention is not particularly limited to the embodiment described above. Various modifications can be made without departing from the scope and spirit of the invention. For example, the switches 25 and 26, the electrical stimulator 4, and the vibratory stimulator 5 are not necessarily included in the training device. The number of target parts to be touched by an upper limb of a patient is not limited to two. The number of target part or target parts may be one, or three or more. The present invention can also be applied to the training of a lower limb of a patient. That is, the present invention can be applied to the training of limbs including an upper limb and a lower limb.
Indeed, the novel devices and methods described herein may be embodied in a variety of other forms; furthermore, various omissions, substitutions and changes in the form of the devices and methods described herein may be made without departing from the spirit of the inventions. The accompanying claims and their equivalents are intended to cover such forms or modification as would fall within the scope and spirit of the inventions.
Certain aspects, advantages, and novel features of the embodiment have been described herein. It is to be understood that not necessarily all such advantages may be achieved in accordance with any particular embodiment of the invention. Thus, the invention may be embodied or carried out in a mariner that achieves or optimizes one advantage or group of advantages as taught herein without necessarily achieving other advantages as may be taught or suggested herein.
| Number | Date | Country | Kind |
|---|---|---|---|
| 2013-110273 | May 2013 | JP | national |
This application is a continuation application of PCT Application No. PCT/JP2014/063300, filed May 20, 2014, the entire contents of which are incorporated herein by reference.
| Number | Date | Country | |
|---|---|---|---|
| Parent | PCT/JP2014/063300 | May 2014 | US |
| Child | 14946785 | US |
