KR101991435B1 - Rehabilitation equipment combining joint exercise therapy and functional electrical stimulation - Google Patents

Abstract

The present invention relates to a rehabilitation therapy device combining joint exercise therapy and functional electrical stimulation, which rehabilitate joints of hemiplegic patients due to brain injury or stroke, and can increase an effect of rehabilitation by active muscular contraction by combining a physical structure of the joint through the rotation principle of a hinge and precise control of a drive unit with the functional electrical stimulation which gives movement to the human nerve by giving electrical stimulation from the outside.

Description

BACKGROUND OF THE INVENTION 1. Field of the Invention [0001] The present invention relates to a rehabilitation therapy apparatus and a functional electrical stimulation therapy,

The present invention relates to a rehabilitation treatment apparatus, and more particularly, to a rehabilitation treatment apparatus that rehabilitates joints of a patient suffering from hemiplegia due to brain injury or stroke, wherein the physiological rehabilitation structure of the joints, The present invention relates to a rehabilitation treatment apparatus that combines articulation therapy and functional electrical stimulation that can enhance the effect of rehabilitation exercise by inducing active muscle contraction by combining functional electrical stimulation that gives stimulation and movement.

Symptoms of sudden loss of consciousness or paralysis of one limb and paralysis are often suddenly associated with blood vessels in the brain, so medical terms such as cerebrovascular disease or stroke do.

The term stroke refers to the following phenomenon: "Suddenly, the cerebral blood vessels are blown up or blocked due to any cause, and the blood circulation to the brain is not made, or the brain is damaged due to the direct brain damage. Headache, and the like "refers to the state of sudden occurrence of cerebrovascular disease (cerebrovascular accident) (cerebrovascular accident, Brain stroke) is also used as the term.

These strokes are known to be the most common cause of adult death in our country, and once it is fatal, it causes severe physical disabilities such as hemiplegia or speech disorders.

Ultimately, hemiplegia can occur due to movement disorders and sensory deficits associated with paralysis caused by central nervous system injury such as stroke, traumatic brain injury, or cerebral palsy, postural imbalance, lack of physical self-awareness, It is one of the exercise paralysis that can not be used to generate a proper size of force at a necessary moment.

In this case, only medication and surgical treatment will cause permanent and fatal injury to the body. Therefore, rehabilitation should be performed within 3 to 6 months after the occurrence of hemiplegia, Continuous motion induction requires transitional effects.

In order to treat these hemiplegic patients, the neurological developmental therapy approach is used to make posture adjustments and movements through the therapist and one-to-one exercise therapy, and to control pain by using electrotherapy and muscle strength training using exercise equipment, , Balance training, etc., need to be treated through the patient's own exercise.

However, due to the lack of human resources of the therapist, the cost of one-to-one treatment through the therapist is rather high, and the treatment using the rehabilitation treatment apparatus is performed in many parts. Due to the characteristics of the rehabilitation treatment apparatus currently developed, It is not possible to apply the electric stimulation and the rehabilitation effect is greatly reduced.

Patent Registration No. 10-1093954 (December 24, 2011)

SUMMARY OF THE INVENTION The present invention has been made in order to solve the above-mentioned problems, and an object of the present invention is to provide a hinge reel, The present invention provides a rehabilitation treatment device that combines articulation therapy and functional electrical stimulation, which improves the effect of rehabilitation exercise by inducing active muscle contraction by applying a functional electrical stimulation (FES) that stimulates and moves.

According to another aspect of the present invention, there is provided a method of operating a patient, comprising: a first cradle for receiving a lower part of a patient's joint; a second cradle connected to the first cradle by a hinge, And an electrode unit formed on the second holder and contacting the skin of the patient, the rehabilitation apparatus comprising: a support member provided between the support member and the first holder to rotate the first holder through a driving unit; An operation detecting unit for collecting motion information including a rotation angle and a velocity of the first cradle; A stimulus applying unit for applying an electric stimulus through the electrode unit and controlling the intensity and time of the stimulation, and electric stimulation information applied to the electrode unit at a specified angle of the first cradle in conjunction with the reciprocating rotation of the first cradle And a controller configured to control the stimulation applying unit based on the control signal. .

In this case, the driving means includes an airbag 20 provided between the support and the first cradle to rotate the first cradle in accordance with the inflow and outflow of air and equipped with an air inlet hose, And a pressure sensor for measuring an internal pressure of the airbag, wherein the setting unit sets electrical stimulation information applied to the electrode unit at a specified angle and pressure of the first cradle, So that the stimulus applying unit can be controlled.

A first storage unit for storing motion information of the motion sensing unit according to electric stimuli applied according to each training mode, a storage unit for storing the motion information of the motion sensing unit according to the training mode, A feedback unit for providing a selected training mode to the control unit; As shown in FIG.

In addition, the first cradle further includes a handle capable of being gripped by a hand and capable of measuring a grip force, and the feedback unit includes a second collecting unit for monitoring the grip force collected through the handle in response to the training mode, And the analysis unit may reflect the grip strength measurement result of the second collection unit when the training mode is selected.

In addition, the handle portion may be configured to be bent in correspondence with the ratchet movement of the hand and the joint of the hand, and includes a calculating portion for calculating the dimensions of the hand and the arm of the patient contacting the second cradle, And a guide unit for guiding an attachment position of the electrode in accordance with the calculation result of the calculation unit; As shown in FIG.

The present invention can significantly improve the effect of rehabilitation training by adding electrical stimulation to CPM, which is a passive exercise device for improving upper and lower limb function of hemiplegic patients, to induce active and functional movement.

Physiologically similar muscle mobilization and contraction can be achieved through patterns of frequency domain to stimulate excitable tissues of nerves and muscles, and functional wrist rehabilitation is possible with emphasis on strengthening muscles to help relieve stiffness.

1 is a first side view according to an embodiment of the present invention,
2 is a second side view according to one embodiment of the present invention,
3 is a block diagram showing a configuration and a connection relationship according to an embodiment of the present invention;
4 is a side view according to the second embodiment of the present invention,
5 is a partial perspective view showing a hand and a second restraint according to the second embodiment of the present invention,
6 is a block diagram showing a configuration and a connection relationship according to the second embodiment of the present invention.

Hereinafter, the structure of the rehabilitation treatment device combining the joint exercise therapy and the functional electrical stimulation according to the present invention will be described in detail with reference to the accompanying drawings.

The present invention basically comprises a combination of FES (Functional Electrical Stimulation) based on various types of CPM (Continuous Passive Motion) for joint motion therapy, So that the rehabilitation treatment can be performed.

FIG. 1 is a first side view according to an embodiment of the present invention, FIG. 2 is a second side view according to an embodiment of the present invention, FIG. 3 is a block diagram showing a configuration and a connection relationship according to an embodiment of the present invention, Of the wrist joints.

1 is a perspective view of a patient's upper part of the wrist joint connected to the first cradle 10 by a hinge 12 and a first cradle 10 for holding a hand 30, A supporting member 13 provided at a lower portion of the second mounting table 11 and a second mounting table 11 provided between the supporting member 13 and the first mounting table 10, A plurality of air bags 20 having respective air inflow hoses 21 and an air hose 41 connected to the air inflow hose 21 rotate And a control unit 40 connected to the air inlet hose 21 and having an air pump 41 for introducing or discharging air into or from the air bag 20.

A plurality of fastening members for restricting the movement of the arms 31 on the upper portion of the second cradle 11 so as to maintain the training effect by preventing the arm 31 from moving during rehabilitation of the patient's hand 30, 14 may be installed.

The CPM is an example of a CPM, and may be formed not only for the wrist joint but also for the exercise treatment of the knee joint or the ankle joint of the lower limbs. The lower part of the joint is centered on the first joint member 10, (Not shown).

The first cradle 10 and the second cradle 11 are hinged to each other to perform reciprocal rotation corresponding to the movement of the joints. In this figure, the airbag 20 and the air pump A pneumatic system using a motor 41 and a power transmission system using a motor and a reduction gear can be applied.

Referring to FIG. 2, the rehabilitation treatment apparatus of the present invention operates the air pump 41 provided in the control unit 40 so that air is drawn into and sucked into the air bag 20, 30).

In the accompanying drawings, the airbags 20 are all shown in an inflated state, but air can be partially injected in consideration of the state of the patient's hand 30. That is, when it is desired to reduce the movement of the hand 30, the hand 30 may be inflated by crossing the airbag 20 one by one. If the hand 30 is not in good condition, And the rehabilitation treatment can be performed by inflating only one or two of them.

In the embodiment of the present invention for the FES based on the CPM, the control unit 40 is provided with the air pump 41 and the air pump 41 in addition to the configuration of the electrode unit 50, the motion sensing unit 16 and the feedback unit 60 The structure of the stimulus applying section 42 and the setting section 43 is added.

The electrode unit 50 is formed on the second holder 11 and contacts the patient's skin. The electrode unit 50 contacts the body of the user such as an electrotherapy apparatus and outputs an electric stimulation signal. In other words, it is made of a flexible material and is coated with an adhesive material containing a conductive material on the lower side, and can be temporarily attached to the skin of the user, and the electric power of the anode (+) and the cathode (- The skin and muscles of the body are subjected to electrical stimulation.

At this time, the electrode unit 50 may be integrally formed with the second cradle 11, but may be connected to the second cradle 11 through a power supply cable having a sufficient length to freely change the attachment position.

The motion sensing unit 16 is configured to collect motion information including a rotation angle and a velocity of the first cradle 10, and can be configured using a gyro sensor. That is, in the above-mentioned CPM, the movement of the wrist joint is transmitted to the control unit through the gyro sensor attached to the first cradle 10.

The stimulus applying unit 42 provided in the control unit 40 is a circuit and an element that can apply electric stimulation through the electrode unit and can control the intensity and time of the stimulation. And the output intensity can be amplified and controlled by using a transducer.

The setting unit 43 is connected to the electrode unit 50 at a specified angle of the first cradle 10 in conjunction with the reciprocating rotation of the first cradle 10 by driving the air pump 41 And controls the stimulus applying unit 42 by setting the electric stimulation information.

The pressure sensor 44 measures the internal pressure of the airbag 20 when the pneumatic CPM is implemented as in the embodiment of the present invention. By setting the electric stimulation information applied to the electrode unit 50 at the specified angle and pressure and controlling the stimulus applying unit 42, electric stimulation can be performed with a more accurate movement of the joint.

The CPM and FES characteristics of wrist rehabilitation are as follows: First, the normal wrist joint can be in the range of 160 degrees from the bending 85 degrees to the extension 75 degrees. As the wrist is bent, , And the maximum gripping force is generated at an extension angle of 30 degrees.

In this case, the limitation of upper limb movements in patients with hemiplegia is caused by excessive rigidity shrinkage and shortening of the wrist bending muscles and limitation of the range of motion of the wrist joint, resulting in excessive bending of the wrist. , It is very important to ensure the ideal posture of the wrist and the operating range of the fingertip.

In order to secure the range of motion of the wrist joint, the CPM is used to maintain the joint spacing and the direction of movement through the manual therapy of the physical therapist. This is a passive method and the transition effect is insufficient without the patient's active muscle contraction effort.

Therefore, it is ideal to maintain physiological muscle contraction for the nerve root and to maintain and secure the range of motion. The electrical stimulation parameters that induce the physiological muscle contraction are the modulation of the natural shrinkage pattern induction through duration and amplitude modulation while focusing on frequencies below 50 Hz that can induce the strong axis in the range of 1 ~ 1000 Hz .

In addition, the trigger point for starting the muscle contraction is operated by a gyro sensor and a pressure sensor at a functional wrist posture of 0 to 20 degrees (since an ideal wrist span of 30 degrees may be difficult if the patient is rigid according to the patient) . The angle between the thumb and the second fingers can be adjusted by inducing a C bar type opening to take a functional posture and adjusting the angle and order of the fingers of the fingers according to the angle of the wrist.

Next, as a method for reducing the bending stiffness of the wrist in a hemiplegic patient, there are a method of strengthening the muscles of the wrist extensor and the wrist extensor of the wrist, and a method of inducing muscle fatigue of the wrist bend muscle There are ways.

It is possible to use muscle stimulation for the wrist extensor recommended as an efficient method, but it can be used as exercise. However, it can be used without restriction to time, place, and equipment through electric stimulation. It can also be used as an assist or resistance exercise.

The electric stimulation parameters for strengthening muscle strength are focused on frequencies above 50Hz which cause strong axis in the range of 1 ~ 1000Hz and induce natural shrinkage through duration and amplitude modulation, Use a frequency mode that minimizes fatigue by adjusting the intermittent rate.

At this time, it is also important to set the ratio to reduce the feeling of interruption time by inducing natural muscle contraction with less discomfort by increasing / decreasing the whole cycle, and also considering the pumping stimulus variable for promoting blood circulation promoting muscle contraction activity.

The feedback unit 60, which is a means for finding and presenting an optimal training mode tailored to the individual, in addition to the training mode selected from the user in a preset state and stored in the experimental method, (61), a first collecting unit (62), and an analyzing unit (63).

The storage unit 61 stores the frequency, the pulse width, and the current of the electrical stimulation according to the training mode created so as to be presented to the user as a memory and selected.

The first collecting unit 62 is configured to store motion information of the motion sensing unit 16 according to electric stimuli applied according to each training mode. The first collecting unit 62 collects the wrist motion of the user during rehabilitation training, Storage is done to confirm the change.

The analysis unit 63 analyzes the motion information stored in the first storage unit to select a training mode having improved motion characteristics. The motion analyzing unit 63 determines a motion characteristic based on the movement speed and angle of the comparison wrist, And the selected training mode is provided to the control unit so that the rehabilitation training can be performed in the most effective mode in the future.

FIG. 4 is a side view according to the second embodiment of the present invention, FIG. 5 is a partial perspective view showing the hand and the second restraint according to the second embodiment of the present invention, FIG. 6 is a block diagram to be

As mentioned above, since the degree of bending of the normal wrist joint is closely related to the gripping force of the object, that is, the grip strength, the first holder 10 in the second embodiment of the present invention is formed in a shape that can be gripped by the hand The grip portion 15 is configured to be able to bend in response to the movement of the ratchet of the hand and the joint of the hand. At this time, the handle 15 may be provided with a joint corresponding to the finger joint and an elastic body capable of restoring the bent state. In addition, the handle 15 may be wrapped around the handle 15 by hand, It can also be composed of material.

In accordance with the second embodiment of the present invention, in addition to the above-described first embodiment, it is possible to select a training mode having high efficiency in response to the addition of the grip portion 15 and reflecting the grip force collected in real time during training. A configuration capable of guiding the sub-installation position is added. Hereinafter, in order to prevent the gist of the present invention from being blurred in the description of the second embodiment of the present invention, a duplicate description of the same configuration as that described above will be omitted.

As the grip force measurement becomes possible through the grip 15, the feedback unit 60 has a function similar to the function of the first collecting unit 62, and the grip unit 15 The analysis unit 63 is configured to reflect the grip force measurement result of the second collecting unit 64 when the training mode is selected.

That is, the analyzing unit 63 selects the training mode capable of generating a good gripping force in the optimal training mode by comparing the grip strength measured in real time as well as the wrist movement according to the training mode. A training mode may be selected based on the weight of the training mode.

Also, in consideration of the fact that the size of the arm, which is the rehabilitation region, varies for each user, the present invention 2 includes a scan unit 70 for calculating the arm size of the user and guiding the attachment position of the electrode unit for effective FES As described above, as shown in FIG. 5 (a), the electrode at a selected position may be operated in a state where a plurality of electrodes are integrally formed, or the electrode unit may be formed by a detachable attachment method as shown in FIG. 5 (b).

For this purpose, the scanning unit 70 includes a calculator 71 for calculating the dimensions of the hands and arms of the patient in contact with the second holder 11. It is preferable that a plurality of sensing units capable of sensing the contact of the user's arm are installed on the second cradle as shown in the accompanying drawings and the size of the arm is calculated through the number or position of the sensing unit Method can be used.

Correspondingly, the scan unit 70 includes a guide unit 72 connected to the setting unit 43 and guiding the attachment position of the electrode by reflecting the calculation result of the calculation unit 71. In order to do this, it is necessary to basically store basic information about the position of the electrode, in addition to the information on the position of the muscle corresponding to the size of the arm. In correspondence with this basic information, It is possible to guide the accurate mounting position of the electrode unit 50 in conjunction with the LED lamp of the display unit or the display unit provided separately.

It is to be understood that the invention is not limited to the disclosed embodiment, but is capable of many modifications and variations within the scope of the appended claims. It is self-evident.

10: First Stand 11: Second Stand
12: Hinge 13: Support
14: Fixing member 15: Handle portion
16: motion detection unit 20: air bag
21: inlet hose 30: hand
31: arm 40:
41: air pump 42: stimulus applying section
43: setting section 44: pressure sensor
50: electrode part 60: feedback part
61: storage unit 62: first collecting unit
63: Analysis section 64: Second collection section
70: Scanning section 71:
72:

Claims (5)

A second cradle 11 connected to the first cradle 10 and the hinge 12 to receive the upper side of the joint of the patient and a second cradle 10 connected to the second cradle 10, (10) provided between the support (13) and the first cradle (10) to rotate the first cradle (10) by driving means ,
An electrode unit 50 formed on the second holder 11 and contacting the patient's skin;
An operation detecting unit (16) for collecting motion information including a rotation angle and a velocity of the first cradle (10);
A stimulation applying unit 42 for applying an electric stimulus through the electrode unit 50 and controlling the intensity and time of the stimulation and a magnetic pole applying unit 42 for applying a magnetic field to the first holder 10 in cooperation with the reciprocating rotation of the first holder 10 And a setting unit (43) for setting the electric stimulation information to be applied to the electrode unit (50) at a specified angle and controlling the stimulus applying unit (42);
A storage unit 61 for storing the frequency, pulse width, and current of the electric stimulation according to the training mode, and a first collecting unit 61 for storing the motion information of the motion sensing unit 16 according to the electric stimulus applied in accordance with each training mode. (60) for providing the selected training mode to the control unit (40), and an analyzing unit (63) for analyzing the stored motion information to select a training mode with improved motion characteristics. Wherein the joint motion therapy is combined with functional electrical stimulation.
The method according to claim 1,
The driving means is provided between the supporting member 13 and the first mounting base 10 to rotate the first mounting base 10 in accordance with the inflow and outflow of air and to connect the airbag 20 with the air inlet hose 21, An air pump 41 connected to the air inlet hose 21 to introduce or discharge air into or from the airbag 20 and a pressure sensor 44 for measuring the internal pressure of the airbag 20,
Wherein the setting unit (43) controls the stimulation applying unit (42) by setting electric stimulation information applied to the electrode unit (50) at a specified angle and pressure of the first cradle (10) Rehabilitation therapy devices that combine exercise therapy with functional electrical stimulation.
delete The method according to claim 1,
The first cradle (10) further comprises a handle (15) capable of being gripped by a hand and capable of measuring grip force,
The feedback unit 60 further includes a second collecting unit 64 for monitoring the grip force collected through the handle 15 in response to the training mode, And the result of measuring the grip force of the second collecting part (64) is reflected. The rehabilitation treatment device combining the joint exercise therapy and the functional electric stimulation.
The method of claim 4, wherein
The handle 15 is configured to be able to bend in response to the ratchet movement of the hand and the joint of the hand,
A calculator 71 for calculating the dimensions of a hand and an arm of the patient in contact with the second cradle 11; A scanning unit 70 having a guide unit 72 for guiding an attachment position; Further comprising a joint motion therapy and a functional electrical stimulation.

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