Summary of the invention
Subject to be solved by the invention
Problem of the present invention is that providing the concentrated force that can promote patient and more reliably realizing the instruction of functional rehabilitationPractice device and training method.
Means for solving the problems
The present invention staff's discovery can implement the training device and the training that promote treatment repeatedly to solve the above subjectMethod is effective.
Promote treatment to refer to that curer (doctor and teacher of the recuperating etc.) operates finger or the trick of the paralysis of patient repeatedly, uses needleSpine swashs necessary neural circuit, induces the movement as target.Be rebuild by the way that the movement is repeated by persistence,Strengthen necessary neural circuit and promote paralysis recovery new method of rehabilitation.
Promote to refer to that wanting mobile position application stimulation to patient carrys out assist exercise so that patient is easy to intendThe method for the movement done.
Unilateral side paralysis patient is difficult to make to benumb limbs movement by the will (instruction from brain) of itself.But pass throughStimulation is applied to paralysis limbs, can cause to uphold and reflect, so that nerve cell is excited, is made to benumb limb according to the instruction from brainBody is mobile.Therefore, it is stimulated to apply to neural circuit relevant to movement as a purpose, rapidly stretches the muscle of target, muscular tone causes to uphold after increasing at once to reflect, and orders the contraction of the muscle, thus induces the movement as target.
Also, there is paralysis side and non-paralysis side in usually unilateral paralysis patient.Firstly, feeling good and can be just variousOften carry out the training that arbitrarily paleocinetic non-paralysis side is trained device.Moreover, understanding patient, grasping training deviceTrained " knack ".Then, the training of device is trained in paralysis side.That is, using " knack " grasped in non-paralysis side,The training of device is also trained to paralysis side.
In principle, left brain control right side, right brain control left side, but exist in brain related to the motor function of the left and right sides" common portion ".If having grasped the association of the movement with training device in training by the training of the non-paralysis side of training deviceIt reconciles and moves knack etc., then improved for the effect and efficiency of the training for the training device for benumbing side.
In order to induce the target action of forearm, it is necessary to cause to uphold by the stimulation of needle point and reflect.In the instruction of patent document 1Practice in device, the extension of needle point can not simply be caused to be reflected.
On the other hand, in the present invention, reflection is upheld so as to cause random autokinetic movement in order to induce, addition mentions patientThe stimulation mechanism of high concentrated force is effective.
Invention according to claim 1 provides paralysis functional recovery training device, the paralysis functional recovery training devicePassive movement component is included, moves it passively the paralysis part applied force of patient from outside；Random autokinetic movementComponent allows the patient to firmly make the fiber crops with the will of itself and the paralysis part to the patient applies resistanceThe componental movement of numbness；And stimulation prompt component, the stimulation for transmitting firmly opportunity is applied to patient.
In the invention of claim 2, preferably, passive movement and arbitrarily autonomous can be implemented by same moving linkMovement, the passive movement be the paralysis part applied force from outside to patient and move it passively, the random autokinetic movementIt is to allow the patient to exert oneself to make the part of the paralysis with the will of itself and the paralysis part to patient applies resistanceMovement.
In the invention of claim 3, preferably, the stimulation applied to patient is acted in passive movement componentIn the process with the movement of passive movement component after any one opportunity among the two be applied to the stimulation of patient.
In the invention of claim 4, preferably, about the stimulation applied to patient, visual stimulus is applied to patient, is listenedFeel the stimulation of at least one of stimulation and haptic stimulus.
In the invention of claim 5, preferably, visual stimulus is using luminous.
In the invention of claim 6, preferably, auditory stimulation uses voice.
In the invention of claim 7, preferably, haptic stimulus uses mechanical oscillation.
In the invention of claim 8, preferably, it is configured to, moving link uses the bar operated for patient, and bar is keptFor that can be rotated centered on the axis vertical with length axis, in the case where rotating in a first direction, fiber crops of the bar to patientNumbness part applied force and make its carry out passive movement, in a second direction that is opposite the first direction rotate in the case where, the barIt is set to carry out random autokinetic movement and the paralysis part to patient applies resistance.
In the invention of claim 9, preferably, above-mentioned bar is rotated in the first rotational direction with the first angular speed,Then it is rotated with second angular speed bigger than the first angular speed, is then revolved in a second rotational direction in the first rotational directionTurn, also, starts the stimulation for stimulating component to patient in the first angular speed region.
In the invention of claim 10, preferably, before bar rotates in a second direction terminate to patient apply withThe relevant stimulation of a side in vision and the sense of hearing.
In the invention of claim 11, preferably, the end with the rotation of bar in a first direction simultaneously terminates to troublePerson applies stimulation relevant to the side in vision and the sense of hearing.
In the invention of claim 12, preferably, in the rotation of bar in a second direction terminate to patient apply withThe relevant stimulation of tactile.
Invention according to claim 13 is paralysis functional recovery training method, it includes: from outside to the paralysis of patientPart applied force and the passive movement for moving it passively；It is allowed the patient to and the paralysis part to patient applies resistanceEnough will with itself exert oneself to make the random autokinetic movement of the componental movement of the paralysis；And patient is applied and is used for transmittingThe process of the stimulation on power opportunity.
In the invention of claim 14, preferably, in paralysis functional recovery training, in the process for carrying out passive movementAny one opportunity after neutralization passive movement in the two, which applies patient, to stimulate.
In the invention of claim 15, preferably, in paralysis functional recovery training, stimulation is visual stimulus, the sense of hearingAt least one of stimulation and haptic stimulus.
In the invention of claim 16, preferably, in paralysis functional recovery training, patient is applied by light and is piercedSwash.
In the invention of claim 17, preferably, in paralysis functional recovery training, patient is applied by voice and is piercedSwash.
In the invention of claim 18, preferably, in paralysis functional recovery training, patient is applied by vibration and is piercedSwash.
Invention effect
In the invention of claim 1, in the training of functional rehabilitation for realizing unilateral paralysis patient, it is used for due to havingTo patient apply stimulation stimulation prompt component, therefore have can easily make patient understand carry out arbitrarily it is paleocinetic whenEffect as machine.
In the invention of claim 2, since passive movement and arbitrarily autonomous fortune can be implemented by same moving linkIt is dynamic, therefore there is the simple structure of training device and alleviate effect as the burden to patient.
In the invention of claim 3, since the stimulation to patient is during passive movement or passive movement knotPatient is applied after beam, therefore there is following such effect: can be before carrying out random autokinetic movement to patient'sFinger or forearm apply the stimulation sharply accelerated, promote to uphold reflection, it is contemplated that effective training.
In the invention of claim 4, since stimulation prompt component applies visual stimulus or auditory stimulation or touching to patientFeel any one of stimulation or be combined with a variety of stimulations, therefore has and can select suitably to stimulate structure according to trained situationEffect as part.
In the invention of claim 5, due to visual stimulus be based on luminous stimulation, have can be illustrated and letterJust effect as the stimulation to patient is carried out.
In the invention of claim 6, since auditory stimulation is voice-based stimulation, there is following such effectFruit: patient it will be appreciated that stimulation meaning, so as to more swimmingly be transferred to random autokinetic movement.
In the invention of claim 7, since haptic stimulus is the stimulation based on vibration, having be can reduce to troubleEffect as the burden of the training of person.
In the invention of claim 8, due to moving link be for patient operation bar, bar be maintained as can with lengthIt is rotated centered on the vertical axis of degree axis, which is configured to, in the case where rotating in a first direction, to the paralysis part of patientApplied force and make its carry out passive movement, in a second direction that is opposite the first direction rotate in the case where, by patientParalysis part apply resistance and its made to carry out random autokinetic movement, therefore the construction with training device is easy and can subtractThe effect of the burden of light patient.
In the invention of claim 9, due to starting the stimulation for stimulating component to patient in the first angular speed region, becauseThis has the effect of that patient can rich in ampleness identify the opportunity shifted to random autokinetic movement.
In the invention of claim 10, due to terminating to apply and regard to patient before bar rotates in a second directionFeel stimulation relevant with the side in the sense of hearing, therefore can reliably identify the opportunity shifted to random autokinetic movement with patientEffect.
In the invention of claim 11, since the end of the rotation with bar in a first direction simultaneously terminates to patientApply the imparting of relevant to the side in vision and sense of hearing stimulation, thus have patient can more reliably identify to arbitrarily oneselfThe effect on the opportunity of main motion transfer.
In the invention of claim 12, due to during bar rotates in a second direction terminate to patient apply withThe relevant stimulation of tactile, therefore having can be such that patient is identified after abundant confirmation stimulation relevant to tactile to arbitrarily autonomous fortuneThe effect on the opportunity that turn is moved.
In the invention of claim 13, pierced due to applying in the training of functional rehabilitation for realizing paralysis patient to patientSwash, therefore having can easily make patient understand effect as the opportunity of exerting oneself.
In the invention of claim 14, due to during carrying out passive movement or after passive movement to patientApply stimulation, therefore with following such effect: can be before carrying out random autokinetic movement to the finger of patient or precedingArm applies the stimulation sharply accelerated, promotes to uphold reflection, so as to expect effective training.
In the invention of claim 15, due to assigning appointing in visual stimulus or auditory stimulation or haptic stimulus to patientOne kind of anticipating is combined with a variety of stimulations, therefore has and can be selected as the type suitably stimulated according to trained situationEffect.
In the invention of claim 16, since the stimulation to patient is that had based on luminous stimulation to patientThe stimulation effect that can be illustrated and easily carry out.
In the invention of claim 17, since the stimulation to patient is voice-based stimulation, have it is following thisThe effect of sample: patient can more swimmingly shift to random autokinetic movement it will be appreciated that the meaning stimulated.
In the invention of claim 18, the stimulation to patient is the stimulation based on vibration, therefore has and can reduce troubleEffect as the burden of the training of person.
[embodiment]
As shown in Figure 1, paralysis functional recovery training device 10 consists of the following parts: mobile station 12, with castor (ten thousandTo wheel) 11；Forearm mounting table 13 is set to one end in the mobile station 12；Device pedestal 14 is set to mobile station 12On；Half cylinder body 15 is supported in the device pedestal 14 in a manner of it can rotate around trunnion axis, and upper surface is opened wide；As the bar 16 of moving link, it is set in the half cylinder body 15；Wrist supports portion 17 is set in half cylinder body 15；Drive shaft 18, one end and half cylinder body 15 link, and extend along trunnion axis；It is pivotally supported platform 19,19, they are set to deviceOn pedestal 14, drive shaft 18 is rotatably supported；Servo motor 21 is set on device pedestal 14, to drive shaft 18It is driven；Encoder 23 is set to the servo motor 21, measures the rotation angle of motor drive shaft 22；Control unit 24, carry out withUnder a series of controls: obtain rotary angle information from the encoder 23, repeatedly rotate forward the direction to the left and right of half cylinder body 15,Stop, reversion, stopping, in rotating forward, in order to cause the extension of muscle to be reflected simultaneously by the anxiety for realizing the muscle of functional rehabilitationIt is excited to make nerve cell, and controls application muscle with the first angular speed and than the second angular speed of the first angular speed high speedThe speed of stimulation for the lasting stimulation for carrying out muscle and maintain muscular tone in reversion and apply resistance；And torqueConversion portion 25, torque that operation applies bar 16 are simultaneously sent to control unit 24.
In addition, a part of castor 11 is also possible to common wheel (non-Universal wheel).Also, it also can be omitted castor11.In this case, mobile station 12 is estrade.
If it is estrade, then estrade can be substituted with desk appropriate or desk, therefore whether be configured at mobile station 12It is arbitrary under device pedestal 14.
But since servo motor 21 and encoder 23 are heavier, in terms of the burden for mitigating people, recommend as this realityApplying example like that keeps device pedestal 14 integrated with mobile station 12.
Also, as long as a part of 15 cylinder of half cylinder body is cut out, and notch rate is not limited to 50%.Moreover, partly cuttingCylinder 15 is in principle using half cyclotomy cylinder but it is also possible to be polygon cylinder.
Torque detection means 60 are provided between half cylinder body 15 and drive shaft 18.The torque detection means are described below60 structurally and functionally.
As shown in Fig. 2, mobile station 12 is made of main part 27 and secondary platform part 29, the main part 27 is by four pillars26 bearings, which extends from the main part 27 and front end is supported by a pillar 28.The pair platform part 29 is thinIt is long, there is space 31,32 in its left and right, allow the patient at least one party entered in space 31 and space 32.It can pass throughThe lightweight of mobile station 12 is constituted and realized inside by light gauge steel (specifically, aluminium frame) comprising pillar 26,28.
The top of bar 16 is provided with the light-emitting component 71,71 as visual stimulus mechanism, which is thornSwash a mode of prompt component.The light-emitting component 71,71 is flashed under the control of control unit 24.Control unit 25 justFace (closest to the face of patient) is provided with the loudspeaker 72 as auditory stimulation mechanism, which is stimulation prompt structureOne mode of part.
Other structures element continues to use the label of Fig. 1, and omits the description.
As shown in figure 3, the upper surface of half cylinder body 15 opens wide.
As shown in figure 4, half cylinder body 15 is by the first cam follower 31 and the bearing of the second cam follower 32 for around dampeningFlat axis rotates freely.
Moreover, as shown in figure 5, half cylinder body 15 is by third cam follower 33, the 4th cam follower 34 and the 5thThe bearing of cam follower 35 is to rotate freely around horizontal axis.
In addition, the 4th cam follower 34 in center can be dismantled.Also, cam follower 31~35 is by fulcrum, peaceThe assembling part that needle bearing loaded on the axis and the roller for surrounding the needle bearing are constituted, but as long as being so-called free roll(rotating freely roller), construction is arbitrary.
As shown in fig. 6, drive shaft 18 links via the motor drive shaft 22 of shaft coupling 36 and servo motor 21.In the drive shaft 18On in front end be fixed with the bar-like member 38 of the band plate-like extended upwards, be formed with than the bar-like member 38 by front end sideSquare shaft portion 39 is being formed with external thread part 41 by front end side than party axle portion 39.
It is fixed with plectane 42 in one end of half cylinder body 15, is provided with square hole 43 on the plectane 42.Square shaft portion 39 is embedded inIn the square hole 43.Then, as shown in figure 3, being equipped with nut 44 at external thread part 41.Pass through the above content, half cylinder body 15Link with drive shaft 18, completes the positioning in the axial direction of half cylinder body 15.That is, without having to worry about half cylinder body 15 in rotationAxis moves up.
It is rotatably supported as shown in fig. 6, drive shaft 18 is pivotally supported platform 19,19 by a pair.This be pivotally supported platform 19 withIt is pivotally supported between platform 19, key 45 is fixed in drive shaft 18.Also, it is being pivotally supported platform 19 and is being pivotally supported between platform 19, backstopBlock 46 is fixed on device pedestal 14.
As shown in fig. 7, stop block 46 has stop surface 47,48 on an upper, which is configured at drive shaftUnder 18.Key 45 is located at the top of drive shaft 18 in a neutral state.Drive shaft 18 can respectively rotate to the left and right from neutral position90 °, 18 maximum of drive shaft can rotate 180 °.That is, key 45 is moved to position shown in imaginary line.Even key shown in imaginary lineAt 45, also there is the gap α of 1.5mm or so with stop surface 47.Therefore, usual key 45 is not abutted with stop surface 47.About backstopFace 48 is also same.
When the failure etc. because of control system causes the rotation amount of drive shaft 18 to change, key 45 and stop surface 47 and stop surfaceA side in 48 abuts, and drive shaft 18 does not further rotate.It as a result is to be rotated without having to worry about half cylinder body (in Fig. 3, label 15)More than predetermined angular.That is, although the control of rotation amount is carried out by encoder in the present invention, in order to guard against the failure of encoderDeng provided with mechanical stop part, to improve safety.
As shown in figure 8, wrist supports portion 17 is supported by the bracket 49 for the U-shaped opened above and via screw 52,52Bending part 53,54 in the left and right of the wall portion 51, the 51 and clamping wrist of the bracket 49 is constituted.It can be hooked by fingerStick 5 rotates screw 52.
As shown in figure 9, in the state that wrist 56 is clamped across the bending part 53,54 that bolster 57,57 is controlled intoRow training, but since the top of bracket 49 and the bending part 53,54 of left and right is open, it can be as sky as long as patient is readyWhite arrow extracts wrist 56 upwards like that.That is, with rich in open sense, correspondingly, constriction and restraint feeling very little can be implemented morePreferred training.
As shown in Figure 10, patient for example needs to implement to train to left hand, and wrist 56 is placed in wrist supports portion 17, willForethiga 58 is placed in forearm mounting table 13.
It will be from making the wrist 56 of left hand be known as " inward turning fortune to the center rotating of body as arrow (1) when patient viewIt is dynamic ", " outward turning campaign " will be known as outside rotation as arrow (2).
It will be known as " random autokinetic movement " towards the movement that arrow (1) or arrow (2) rotate by the will of itself, will beLarger cause the random autokinetic movement and is known as " passive movement " from externally applied force with the movement rotated towards another party.
For example, can be caused to the direction of arrow (2) " arbitrarily certainly by carrying out " passive movement " to the direction of arrow (1)Main motion ".
Since drawing is many and diverse, wrist is not recorded in Figure 11 (a), but Figure 11 (a) is in neutral condition, from the shapeState starts to train.
As shown in Figure 11 (b), passive movement is carried out by servo motor 21.
Specifically, as shown in figure 12, firstly, carrying out passive movement with the first angular speed, brish acceleration is then carried out,Passive movement is carried out with the second angular speed again.For example, the first angular speed is 2.5 radian per seconds, the second angular speed be 11.0 radians/Second.That is, the second angular speed is made to be about 2 times~5 times of the first angular speed.
Brish acceleration is set as the maximum acceleration that servo motor 21 can export.For example, from 0.01 secondOne angular speed is transferred to the second angular speed.Angular acceleration is about 1000 radian per second of (11.0-2.5)/0.01=at this time2。
That is, improving the muscular tone for realizing functional rehabilitation as follows: having been carried out centainly with the first angular speedAfter rotation, rapidly rotated with brish acceleration and the second angular speed.In this way, having motivated extension to reflect by muscular tone.
It is reflected by the extension, promotes the contraction of muscle, as shown in Figure 11 (c), carried out arbitrarily with the will of patientAutokinetic movement.But in order to carry out the stimulation of muscle persistently using servo motor 21 to maintain muscular tone, make servo motor 21Generate lighter resistance.
To generate lighter resistance by servo motor 21, need to know turn that patient generates in the rotation of activeSquare.That is, increasing resistance (moment of resistance) if torque is big, reducing resistance if torque is small, so that patient will not be becomeBurden.
In the present invention, there are torque detection means for the purpose.
In addition, being able to detect shaft torque and strain gauge is pasted onto drive shaft 18.But in the outer of drive shaft 18When diameter is smaller, the torsional capacity (in Figure 14, reference numeral θ a) of axis is smaller, and therefore, it is difficult to be measured and evaluated error is larger.
In the present invention, the good torque detection means of measurement accuracy are used as following.
As shown in figure 13, torque detection means 60 consist of the following parts: pin 61, in a manner of extending to drawing frontIt is erected at the peripheral part of plectane 42；Bar-like member 38, one end is chimeric with the pin 61 and extends to the rotation center of plectane 42；ContractingNeck 62 is set to the midway of the bar-like member 38；Strain gauge 63 is pasted on the necking part 62；And torque conversion portion25, strain information acquired by the strain gauge 63 is scaled torque.
One end of bar-like member 38 is chimeric with pin 61 via the long hole 64 extended on the length direction of bar-like member 38, makesBar-like member 38 must be allowed relative to the movement of pin 61.Also, the other end of bar-like member 38 is clipped in drive shaft by flange 65,66In 18 other square shaft portion 67.
Bar-like member 38 can also be pole, square rod other than band plate, and shape is arbitrary, still, if it is band plate,Then the width at both ends is larger, therefore one end easily can be installed on plectane 42 using the width and can easily will be anotherOne end is installed on drive shaft 18.
Next the effect of the torque detection means 60 of such structure is described.
As shown in Figure 14 (a), by random autokinetic movement, torque Tm is applied to plectane 42 via bar 16.Torque Tm was bothIt is directly passed to drive shaft 18 and is also indirectly transferred to drive shaft 18 via bar-like member 38.If the torque directly transmitted is Ta,If the torque transmitted indirectly is Ts, then Tm=Ta+Ts.Strain gauge 63 is only arranged at bar-like member 38.
As shown in Figure 14 (b), by torque Ts, bar-like member 38 is with necking part 62 is inflection point and is bent into く shape.TurnSquare Ts is bigger, is bent bigger.Using the systematicness, can on structural mechanics calculating torque Ts.
Here, if 18 length is L1 from inflection point to drive shaft, if 61 length is L2 from inflection point to pin, if necking downThe length in portion 62 is Lx, if the width of necking part 62 is b.Although not recording in figure, the thickness (drawing of necking part 62 is setFront and back sides direction size) it is h.Also, the longitudinal modulus of elasticity (Young's modulus) of necking part 62 is set as E.
As shown in Figure 14 (c), when torque Ta acts on drive shaft 18, drive shaft 18 is slightly reversed.Torque Ta is bigger, figureIn angle, θ a it is bigger.Using the systematicness, also can on structural mechanics calculating torque Ta.
Here, if the length of drive shaft 18 is LL, if diameter is R.Also, the transverse modulus of elasticity of drive shaft 18 is set as G.
Although detailed description is omitted, torque Ta is the function of Ts as shown below.
[mathematical expression 1]
Tm=Ta+Ts
Torque Ts can be found out using strain gauge 63, therefore, using torque conversion portion 25, according to what is obtained by strain gauge 63Strain information finds out torque Tm.Accordingly with torque Tm, the moment of resistance is generated by servo motor 21.The resistance is described belowThe detailed content of square.
In random autokinetic movement, when applying the resistance of size appropriate, the forearm of patient is persistently stimulated and maintainsMuscular tone can more greatly rotate.
In addition, the width b of necking part 64 is smaller, and bar-like member 38 is more significantly bent, in necking part in Figure 14 (b)Biggish strain is generated at 64.Due to being pasted with strain gauge 63 on such necking part 64, precisely finds out and turnSquare Tm.That is, precision when directly strain gauge can be pasted in drive shaft 18 shown in Figure 14 (c) with being apparently higher than is to torqueIt is detected.
Next, the acquiring method to the moment of resistance is illustrated.
When in the current angle for setting servo motor as θ, imaginary inertia be I, imaginary viscosity is C, imaginary elasticity is K, needleFormula of impedance to the torque Tm detected is following formula.
[mathematical expression 2]
Assuming that K=0, carries out discretization and transplants.
Rotation speed (angular speed)
Δ t: sampling time
Tn: the moment of resistance
When at the uniform velocity, the size of resistance is determined by adjusting C value.It, can be by adjusting K1, K2 in acceleration/decelerationTo determine the moment of resistance.In particular, in the case where the delay of time to be reduced, as long as being set in a manner of close to K2=0 after determining CDetermine I value.
By the above content, moment of resistance Tn is set to value appropriate.
Next, being illustrated to the effect of visual stimulus mechanism and auditory stimulation mechanism.
During exercise in machine stimulation, it is important that patient (unilateral side paralysis patient) transmitting be added random active movement whenMachine is to cause random autokinetic movement.If cannot achieve the purpose, it can not just become effective stimulation.Therefore, in order to cause to haveThe random autokinetic movement of effect, needs to study beginning/stopping opportunity of visual stimulus mechanism and auditory stimulation mechanism.It is pierced about visionOn the beginning/stopping opportunity for swashing mechanism and auditory stimulation mechanism, need to consider item below.
In order to implement more effective training, need to carry out random autokinetic movement while carrying out and upholding reflection.
It starts to work from two stimulation mechanisms, patient is changed to according to vision/Auditory Perception according to from the random of brainIt instructs and all spends the time until being moved.
Improve the concentrated force of patient.
As a result, if starting to stimulate when carrying out random autokinetic movement or passively the second angular speed moves, patient fromStimulation mechanism perceptible stimulus and so that muscular work is spent the time, the extension of patient reflection terminates, can not rhythm it is goodGround is synchronously carried out rotary motion, and training effect is lower.Therefore, from random autokinetic movement or passively, the movement of the second angular speed is openedBeginning stimulate just too late.
Based on the cognition, using the midway of passively the first angular speed as stimulation at the beginning of machine.By fast from first jiaoThe midway of degree starts to stimulate, and can carry out arbitrarily autonomous fortune according to the random instruction from brain while uphold reflectionIt is dynamic.
Also, the end opportunity by the end of passively the second angular speed as stimulation.As stimulation mechanism, it is expected that making to suffer fromThe concentrated force of person improves/continues.By shortening stimulation time, the concentrated force of patient can be made to improve/continue.Recognized based on aboveKnow, provides control shown in figure 15.
The longitudinal axis of Figure 15 is rotation angle, different from angular speed dimension shown in Figure 12.
Passive movement is implemented with the first angular speed and the second angular speed.Since the first angular speed is low speed, with slopeSmall straight line indicates, since the first angular speed is high speed, is indicated, is had a common boundary for brish acceleration with the big straight line of slope.
In the present invention, in the midway in the first angular speed region, preferably at the point Ps in latter stage, start to shine (or hairSound).That is, light-emitting component 71,71 shown in Fig. 2 starts to shine and make a sound from loudspeaker 72 in the latter stage of rotating forward.Due toBar 16 is hold, therefore visual confirmation shines patient at once.Also, since loudspeaker 72 is placed near patient, patientSound is heard at once.In this way, patient is made to concentrate one's energy.It as a result is to uphold reflection sufficiently to improve.(or sounding) is shone at second jiaoTerminate at speed finish time Pf.It shines (or sounding) time for example, about 0.2 second, it is extremely short.
In addition, being had studied when the second angular speed region or random autokinetic movement start (when reversion starts) in Figure 15The case where applying stimulation, but there is delay, it upholds reflection and does not improve sufficiently.Therefore, when as in the present invention in first jiao of speedRegion is spent, when preferably the latter stage in the first angular speed region starts to apply stimulation, eliminates delay, reflection is upheld and sufficiently improves.
Above can be illustrated to arrange for the following contents.
In Figure 11, the arrow (1) of Figure 11 (b) shows passive movement, and the arrow (2) of Figure 11 (c) shows autonomous movementI.e. random autokinetic movement.Patient can implement passive movement and random autokinetic movement by same moving link (bar 16).?The light-emitting component 71 as stimulation prompt component is provided on bar 16, to understand the opportunity of exerting oneself.
That is, device shown in Figure 11 includes the servo motor 21 as passive movement component, from outside to the fiber crops of patientNumbness part applied force moves it passively；As the servo motor 21 of random autokinetic movement component, pass through the fiber crops to patientNumbness part is applied resistance and allows the patient to be exerted oneself with the will of itself so that the componental movement benumbed；And it is mentioned as stimulationThe light-emitting component 41 for showing component applies the stimulation for transmitting firmly opportunity to patient.
Next, being illustrated to the vibratory stimulation mechanism of a mode as stimulation prompt component.
In vibratory stimulation, it is important that for patient the induction of training goal muscle/amplification uphold reflection, cause its withMeaning autokinetic movement.But if vibratory stimulation is added when passive movement starts, outside training goal muscle is expected in advanceContraction, with passive direction fight, thus can not cause sufficient passive movement and based on it extension reflect.Also, ifVibratory stimulation is added when the movement of active starts, then upholds and reflects via the logical Induced by Stimulation of rush, therefore vibratory stimulationEffect reduces.
If cannot achieve the amplification/induction for upholding reflection, effective stimulation can not be become.Therefore, it is necessary to induceThe effective opportunity for upholding reflection starts/terminate vibratory stimulation.About beginning/end opportunity of vibratory stimulation, need to consider withUnder item.
If starting to stimulate in passively the second angular speed by vibratory stimulation mechanism, until patient perceivable's vibration is simultaneouslyPromote to need the time until upholding reflection.
If it is after inducing extension reflection, then it can be improved random autokinetic movement sensitivity and make random autokinetic movementContinue.
That is, if starting vibratory stimulation in passive second angular speed, until physical perception vibrates and upholds muscle insteadThe time is spent until penetrating, training effect is lower.Therefore, it is known that start vibratory stimulation in passive second angular speed with regard to too late.
Based on the cognition, it is set as the vibratory stimulation since the midway in the first angular speed region of passive movement.With Figure 16 andFigure 17 is illustrated its specific example.
As shown in figure 16, vibratory stimulation mechanism is by the wiring 73 that extends from control unit 24 and the front end for being set to the wiring 73And the vibration pad 74,75 with oscillator is constituted.
It is pasted with vibration pad 74,75 respectively in the inner side and outer side of forethiga 58.Before a stimulation rotation of vibration pad 74Tetres (Yen returns interior muscle), utilizes another vibration pad 75 stimulation supinator (returning outer muscle).
As long as oscillator converts rotational motion into the vibrating motor of vibration, the piezoelectric ceramics for generating strain because of electric energy etc.The mechanical energy of electric energy or compressed air is converted to the part of vibration, no matter what type is ok.
As shown in figure 17, vibration is started in the midway (in this example embodiment at the time of than intermediate forward) of the first angular speed's.The also sustained vibration in brish acceleration, the second angular speed, delay terminates to vibrate in the midway of reversion.
It is different from light and sound, have the effect of promoting to uphold reflection as vibration.In addition, compared with light and sound, vibrationThe influence for bringing patient is more stable.That is, by applying vibratory stimulation until reversion midway, promotees in which can not increase the burden of patientIt is reflected into upholding.Vibration duration in one circulation is, for example, about 0.8 second.
In addition, the light-emitting component 71 as visual stimulus mechanism in stimulation time other than continuously lighting, can also be withIt is to be lighted with the interval that the short time flashes repeatedly.
Also, light-emitting component is also possible to the illuminator being made of the arrow mark of the expression direction of motion or character.At thisIn the case where the illuminator of sample, patient can more swimmingly be transferred to random autokinetic movement it will be appreciated that the meaning stimulated.
Loudspeaker 72 as auditory stimulation mechanism can be buzzer or bell.But if it is considered that generate melodious soundSound then preferably generates the loudspeaker of synthesized voice.
Also, sounding is also possible to the recording of the sound of people or simulates the voice that the sound of people is synthesized.In this wayVoice in the case where, patient it will be appreciated that stimulation meaning, so as to more swimmingly be transferred to random autokinetic movement.
In the above-described embodiment, it is carried out to by the unilateral paralysis forearm functional recovery training of object of unilateral paralysis patientExplanation, but the present invention is not limited to unilateral side to benumb patient, can also apply to ataxia patient certainly.Also, above-mentionedIn embodiment, the paralysis functional recovery training device that the type of the bar of rotation is held to unilateral paralysis patient is illustrated, butThe a part that can also apply to the other kinds of body for for example making patient moves back and forth such paralysis function constructedDevice can be resumed training.
Industrial availability
The present invention is suitble to following training: the left half body of training or the forethiga of right paraplegic patient are to promote to restore.
Label declaration
10: paralysis functional recovery training device；16: the bar as moving link；21: as passive movement component and arbitrarilyThe servo motor of autokinetic movement component；71: as the light-emitting component of visual stimulus mechanism, which is stimulation promptOne mode of component；72: as the loudspeaker of auditory stimulation mechanism, which is one of stimulation prompt componentMode；74,75: as the vibration pad of vibratory stimulation mechanism, which is a mode of stimulation prompt component.