JP6308400B2 - Hemiplegic thumb function recovery training device - Google Patents

Description

When one of the left and right half is paralyzed, it is called hemiplegia.
The present invention relates to a hemiplegic thumb function recovery training device for training a hemiplegic finger and promoting recovery, which is for a hemiplegic patient.

Hemiplegia often remains after a stroke. This hemiplegia can be partially restored by rehabilitation. This rehabilitation is performed by skilled doctors and therapists, but since the training takes a long time and a long period of time, the physical burden on the doctors and therapists is great.
For the purpose of eliminating this burden, conventionally, a training apparatus has been proposed (see, for example, Patent Document 1).

  In the training apparatus shown in Patent Document 1, a hemiplegic hand is put into a glove. Restrain the wrist with a belt. In this state, the retaining clasp is moved. Then, the glove is “gripped” and the finger is bent. Recovery training is carried out by repeating gripping and opening.

  In the training apparatus shown in Patent Document 1, it is necessary to prepare gloves for the left hand and for the right hand. It is not easy for not only patients but also doctors and caregivers to put gloves on paralyzed hands. In addition, care must be taken not to make mistakes in the left and right gloves, which is a burden not only for patients but also for doctors and caregivers.

  In this type of training, it is important to stimulate and strengthen the functions remaining in the body. In the training apparatus shown in Patent Document 1, since the hand is mechanically spread and repeatedly gripped, the training progresses apparently even in a state where the patient has withdrawn from the hand (a state of weakness). However, the training effect cannot be obtained in a state where power is exhausted. There is a need for a training device that can restore function more reliably.

  The present inventors have proposed a training apparatus that can solve a considerable problem of the training apparatus disclosed in Patent Document 1 (see, for example, Patent Document 2).

  The training apparatus shown in Patent Document 2 includes a slope portion that supports a patient's arm, a hand platform that supports the patient's hand, a bracket that extends upward from the front portion of the hand platform, And a finger bending mechanism that is attached and pushes down the index finger.

The finger bending mechanism applies an external force downward to the index finger when the index finger is bent, and does not apply an external force to the index finger when the index finger extends. Since the extension of the index finger is a self-extending operation, the patient can be encouraged to self-extend and the effect of recovery training can be enhanced.
The training device shown in Patent Literature 2 can solve many of the problems of the training device shown in Patent Literature 1 in that gloves are not required and self-extension is promoted.

However, the training device shown in Patent Document 2 is effective for four fingers of the five fingers except the thumb, but is not suitable for the thumb.
For other fingers, bending and stretching exercises are sufficient, but for the thumbs, the bending and stretching motions (also referred to as bending and stretching training) that flexes and stretches the thumbs almost parallel to the palm, and this bending and stretching motion and approximately 90 ° motion. It is necessary to carry out the movement of moving the thumb and finger to the palm in different directions (referred to as palmar adduction / abduction movement).
Since the training apparatus shown in Patent Document 2 performs only bending and stretching of the finger, it is not suitable for training of the thumb.

A device obtained by further improving the training device shown in Patent Literature 2 is shown in Patent Literature 3. However, even the training device shown in Patent Document 3 is insufficient for thumb training.
Therefore, there is a demand for a training apparatus that is suitable for the thumb and has a great training effect that cannot be obtained from Patent Documents 1-3.

JP 2006-87705 A JP 2011-56079 A JP 2012-50728 A

  An object of the present invention is to provide a training apparatus that is suitable for a thumb and has a large training effect.

The invention according to claim 1 is a hemiplegic thumb that performs two types of recovery training, bending-extension training and palmar adduction / abduction training, with the thumb of a patient with paralysis of a thumb of one hand as a training target Noh recovery training device,
A first hand support for supporting the hand with the palm facing down;
A second hand support that is arranged below the first hand support and supports the hand with the thumb facing up and the palm vertically oriented;
A first arm extending horizontally from a first swivel shaft arranged vertically;
A first servo motor for horizontally turning the first arm;
A first torque measuring mechanism for detecting torque applied to the first arm;
A second arm extending horizontally to form a V-shape with the first arm from a second axis of rotation arranged parallel to the first axis of rotation;
A second servo motor for horizontally turning the second arm;
A second torque measuring mechanism for detecting torque applied to the second arm;
A slider attached to the first arm movably along the axis of the first arm and attached to the second arm movably along the axis of the second arm;
A spindle extending vertically from the slider;
A first finger-hanging member on which a thumb of a hand that is rotatably supported around the vertical axis and is placed on the first hand support base is fitted to the support shaft;
A first tapping member for tapping the vicinity of the first joint of the thumb to be fitted to the first finger hanging member;
A third torque measurement mechanism that detects a reaction torque applied to the first tapping member from the thumb,
A second finger hanging member on which a thumb of a hand placed on the second hand support is fitted to the support shaft so as to be rotatable around a vertical axis at a position below the first finger hanging member;
A second tapping member for tapping the vicinity of the thumb ball of the thumb to be fitted to the second finger hanging member;
A fourth torque measurement mechanism for detecting a reaction force torque applied to the second tapping member from the thumb,
Based on the torque information from the first and third torque measuring mechanisms, the first finger hooking portion is moved in the direction in which the thumb finger is bent, and is bent and extended so as to extend while applying a resistance force according to the reaction torque. subjecting controlling real, confers resistance to the second finger placing portion the thumb is corresponding to the reaction torque to move in the direction of rolling the palm side on the basis of the torque information from the second-fourth torque measuring mechanism consisting of that control section to implement the volar abduction motion control while.

  In the invention according to claim 2, preferably, the first hand support base, the second hand support base, the first arm, the second arm, the slider, the support shaft, the first finger hook portion, and the first finger support portion. The two-finger holding portion is collectively stored in the housing.

  In the invention according to claim 3, preferably, the casing includes a floor, a pair of walls extending upward from both ends of the floor, and a ceiling extending between the upper ends of the walls, The casing is open at the front and rear, and the first tapping member and the second tapping member are attached to the casing so as to be movable at least in parallel with the wall.

  In the invention according to claim 4, preferably, the first finger-holding portion has a U-shaped cross section in which the first hand support base side is open, and the second finger hook portion is on the second hand support base side. It has an open U-shaped cross section.

  In the invention which concerns on Claim 5, Preferably, the said 1st hand support stand and the said 2nd hand support stand are open | released upwards.

  In the invention which concerns on Claim 6, Preferably, the said ceiling is comprised with the material which can be seen through.

  In the invention which concerns on Claim 7, Preferably, at least one of the said 1st tapping member and the said 2nd tapping member can adjust an attachment angle by an angle adjustment mechanism.

  According to the first aspect of the present invention, by placing a hand on the first hand support base and fitting the thumb of this hand into the first finger-hanging portion, bending and stretching training can be performed on the thumb. Further, by placing a hand on the second hand support base and fitting the thumb of this hand into the second finger-hanging portion, palm side adduction / abduction training can be performed on the thumb. Therefore, comprehensive training of the thumb can be performed.

In addition, according to the first aspect, the thumb can be extended or abducted on the palm side while the resistance is applied by the control unit. Thereby, the stimulus of the stretch reflex is maintained, and the automatic motion is effectively performed. This automatic movement is essential for rehabilitation using the plasticity of the brain.
Therefore, the present invention provides a training apparatus that is suitable for the thumb and has a great training effect.

In the invention which concerns on Claim 2, the main component is collectively accommodated in the housing | casing. Since the housing serves as a protective cover, there is no worry that the patient, doctor, or caregiver touches the main components, and it is safe.
Moreover, since the main components are collectively stored in the housing, the training apparatus can be easily transported and moved.

In the invention which concerns on Claim 3, front and back are open | released, and a 1st tapping member and a 2nd tapping member can move in parallel with a wall.
By inserting one hand on the left and right from the front of the housing and the other hand on the left and right from the rear of the housing, training can be performed on the left and right hands with a single training device.

In the invention which concerns on Claim 4, the 1st, 2nd finger-hanging part is exhibiting the U-shaped cross section by which the 1st, 2nd hand support stand side was open | released.
Patients are said to have greater emotional undulations than healthy individuals. During training, it is often driven by the urge to remove the finger from the training device.
According to the present invention, since the U-shaped cross section is exhibited, the thumb can be easily removed from the first or second finger-hanging portion, giving a sense of security to the patient. Furthermore, it has the convenience that it can be removed immediately by fixing with a hook-and-loop fastener.

In the invention which concerns on Claim 5, upper direction is open | released by the 1st hand support stand and the 2nd hand support stand.
As described above, it is said that a patient has a greater emotional undulation than a healthy person. During training, there is often a drive to remove hands from the training device. However, in the training device of Patent Document 1, the wrist cannot be removed because the wrist is restrained by the band. As a result, there is a concern that the patient is stressed and the patient becomes unwilling to train, and there is a possibility that the function recovery training may be hindered.
In this regard, in the present invention, the hand can be removed from the first and second hand supports by raising the hand up. Therefore, a sense of security can be given to the patient.
Furthermore, from the clinical experiment result of the training device of Patent Document 3, it was found that a paralyzed patient takes time to wear a finger on the finger-hanging part due to reasons such as the shoulder becoming tense. Even in a paralyzed patient, the hand support can be moved by a slider in order to wear it without stress.

In the invention which concerns on Claim 6, the ceiling is comprised with the material which can be seen through.
The patient can see the state of the hands and thumbs through the transparent ceiling, and can give the patient a sense of security. Furthermore, from the result of the clinical experiment of Patent Document 3, since the patient can see the finger himself / herself, there is an advantage that it is possible to grasp the movement state of the thumb and to facilitate the training.

  According to the invention which concerns on Claim 7, at least one of a 1st tapping member and a 2nd tapping member can be further easily adjusted to the angle suitable for training by an angle adjustment function.

It is a front view of the hemiplegia thumb function recovery training apparatus concerning the present invention. FIG. 2 is a sectional view taken along line 2-2 of FIG. FIG. 3 is a sectional view taken along line 3-3 in FIG. 1. It is a principle diagram of a first tapping mechanism. It is an effect | action figure of a 1st tapping member. It is a principle diagram of a second tapping mechanism. It is a perspective view of a 2nd hand support stand. It is an effect | action figure of a 2nd tapping member. It is a disassembled perspective view of a thumb movement mechanism. It is an effect | action figure of a thumb movement mechanism. It is a principle diagram of a 1st torque measurement mechanism. It is a figure explaining bending motion during bending-extension type training. It is a figure explaining extension exercise | movement during a bending type | formula training. It is a figure explaining palm side adduction / abduction training. It is a figure explaining the pattern change of a 1st hand support stand. It is a figure explaining the pattern change of a 2nd hand support stand.

  Embodiments of the present invention will be described below with reference to the accompanying drawings.

  As shown in FIG. 1, a hemiplegic thumb function recovery training apparatus (hereinafter abbreviated as “training apparatus”) 10 includes a casing 15 including a floor 11, left and right walls 12 and 13, and a ceiling 14, and left and right A first hand support base 18 supported by the first horizontal bar 16 and the second horizontal bar 17 passed to the walls 12, 13, a first finger-holding member 19 disposed in the vicinity of the first hand support base 18, and The first tapping member 21, the first tapping mechanism 40 that moves the first tapping member 21, the second hand support 23 supported by the floor 11, and the second hand support 23 are disposed in the vicinity. The second finger hanging member 24 and the second tapping member 25, the second tapping mechanism 50 for moving the second tapping member 25, the thumb moving mechanism 70 for moving the first and second finger hanging members 21, 24, and the control unit 27.

(A) to (D) described around the control unit 27 indicate connection of signal lines. Thus, torque information is input to the control unit 27 from a plurality of torque measurement mechanisms. The control unit 27 comprehensively controls the plurality of servo motors 46, 57, 74 and 79.
The first tapping mechanism 40 and the second tapping mechanism 50 cause a stretched reflection and play a role of promoting an automatic movement, and can be a complicated mechanism as shown in the drawings. The left and right rails 61 are provided with stoppers 61a and 61b at both ends.

  A bracket 26 is provided at a corner portion between the floor 11 and the right wall 13, and a first turning shaft 71 is spanned between the bracket 26 and the ceiling 14. A second swivel shaft 76 is disposed behind the first swivel shaft 71, and the second swivel shaft 76 is also spanned between the bracket 26 and the ceiling 14. A first servo motor 74 is attached to the inner surface of the right wall 13. A second servo motor 79 is disposed behind the first servo motor 74 in the drawing, and the second servo motor 79 is also attached to the inner surface of the wall 13.

As shown in FIG. 2, a slider 28 with a lock is attached to the first horizontal bar 16 and the second horizontal bar 17 set at a higher position than the first horizontal bar 16 so as to be movable in the front and back direction of the drawing. A rail 29 is laid on the slider 28, and a first hand support 18 with a lock is attached to the rail 29. The rail 29 includes stoppers 29a and 29b at both ends.
The elbow is lowered and the wrist is bent downward, and the hand is placed on the first hand support base 17. Since the first hand support 17 is inclined, the thumb can bend and stretch in the direction of the front and back of the drawing at a position lower than the other fingers.
In addition, in FIG. 1, the first hand support 18 can be moved left and right and up and down in the drawing for initial alignment.

  As shown in FIG. 3, longitudinal positioning members 31, 31 are attached to the wall 12, and a large number of holes 32 are provided at equal pitches in these positioning members 31, 31. By appropriately selecting the holes 32, the height positions of the first horizontal bar 16 and the second horizontal bar 17 can be changed. This change in the height position is necessary when the pattern is changed in order to perform the bending exercise of the left hand and the right hand.

The configuration of an example of the first tapping member 21 shown in FIG. 1 and the first tapping mechanism 40 that moves the first tapping member 21 will be described in detail with reference to FIG.
As shown in FIG. 4, the first tapping mechanism 40 includes a first elevating plate 41 that is attached to the ceiling 14 so as to be elevable, a first elevating screw 42 that elevates the first elevating plate 41, and a first A slider 43 with a lock that is attached to the elevating plate 41 so as to be movable in the left-right direction of the drawing, a first horizontal screw 44 that moves the slider 43 laterally, and a rail that is laid on the slider 43 and extends in the front-back direction of the drawing 45, a first tapping servo motor 46 attached to the rail 45 so as to be movable and lockable in the front and back direction of the drawing, an L-shaped arm 47 driven by the first tapping servo motor 46, and the L-shaped arm 47 The first tapping member 21 provided at the distal end of the L-shaped arm 47 and the third torque measuring mechanism 48 provided at the base of the L-shaped arm 47 are provided.

The first tapping member 21 is preferably a rubber roller or a soft resin roller. The first tapping member 21 can move within a certain range from top to bottom, left and right, and front and rear in the drawing.
In the first tapping mechanism 40, the configuration for moving the first tapping member 21 three-dimensionally is not limited to this example, and can be changed as appropriate.
As shown in FIG. 5, the first joint 68 a of the thumb 68 is tapped with the first tapping member 21.

The configuration of an example of the second tapping member 25 shown in FIG. 1 and the second tapping mechanism 50 that moves the second tapping member 25 will be described in detail with reference to FIG.
As shown in FIG. 6A, the second tapping mechanism 50 includes a second lifting plate 51 that is attached to the floor 11 so as to be lifted and lowered, and a second lifting screw 52 that lifts and lowers the second lifting plate 51. The slider 53 is attached to the second elevating plate 51 so as to be movable in the left-right direction of the drawing, the second horizontal screw 54 for moving the slider 53 laterally, and is laid on the slider 53 and extends in the front-back direction of the drawing. The rail 55, a bracket 56 attached to the rail 55 so as to be movable in the front and back direction of the drawing, a second tapping servo motor 57 attached to the bracket 56, and the second tapping servo motor 57 are driven. The L-shaped arm 58, the second tapping member 25 provided at the tip of the L-shaped arm 58, and the fourth torque measuring mechanism 59 provided at the base of the L-shaped arm 58 It is equipped with a.

Preferably, an angle adjustment mechanism 100 as illustrated in FIG. 6B is provided under the bracket 56. The angle adjustment mechanism 100 includes a support base 101 and a rotating member 103 attached to the support base 101 via a screw 102 so as to be rotatable in the horizontal direction of the drawing. A bracket 56 is attached to the rotating member 103. Since the rotating member 103 rotates about the screw 102, the angle of the L-shaped arm 58 can be freely adjusted.
Note that the angle adjustment mechanism 100 may be added to the first tapping mechanism 40 shown in FIG. Therefore, it is recommended that the angle adjustment mechanism 100 be provided on both or one of the first tapping mechanism 40 and the second tapping mechanism 50.

  In FIG. 1, left and right rails 61 are laid on the floor 11, and a front and rear rail 63 is provided on a slider 62 with a lock that moves along the left and right rails 61. A second hand support with a lock is provided on the front and rear rail 63. 23 is attached to be movable back and forth.

  As shown in FIG. 7, the second hand support base 23 includes a floor portion 64, a left wall portion 65, and a right wall portion 66, and the front and rear and the top are opened. Further, the right wall portion 66 is notched so that the thumb 68 of the hand 67 shown by an imaginary line can protrude, and as a result, has a slope 69, 69. By the left and right rails 61 and 61 and the front and rear rail 63, the second hand support base 23 can be moved back and forth and right and left. Stoppers 61 a, 61 a are provided at the ends of the left and right rails 61, 61, and stoppers 63 a are provided at the ends of the front and rear rails 63.

  When the hand 67 is placed on the second hand support base 23, the thumb ball 68 b of the thumb 68 can be tapped with the second tapping member 25 as shown in FIG. 8.

That is, as shown in FIG. 1, the first hand support 18 is disposed above, and the second hand support 23 is disposed below the first hand support 18. From the arm and hand structure, the hand is extended forward from the lowered elbow to the second hand support 23. The hand is extended to the first hand support base 18 shown in FIG. 2 with the wrist bent.
The wrist angle can be freely adjusted. The training effect increases when the wrist is bent.

In FIG. 1, the first hand support base 18 is arranged on the upper side and the second hand support base 23 is arranged on the lower side, so that the patient can naturally hold his / her hand without changing the height of the chair. Alternatively, it can be placed on the second hand support 23.
This is the reason why the above-described first hand support 18 is placed on the top and the second hand support 23 is placed on the bottom.
As a result of arranging the first hand support base 18 and the second hand support base 23 in the vertical direction, the width (left-right width) dimension of the housing 15 can be reduced, and the apparatus can be made compact.

Next, the configuration of the thumb moving mechanism 70 that is the most important mechanism will be described.
As shown in FIG. 9, the thumb moving mechanism 70 horizontally moves the first arm 72 via a first arm 72 that extends horizontally from a first turning shaft 71 that is arranged vertically and a first timing belt 73. A first servo motor 74 that pivots in the first direction, a first torque measuring mechanism 75 that detects torque applied to the first arm 72 (details will be described later), and a second pivot that is arranged in parallel with the first pivot 71. A second arm 77 extending horizontally so as to form a V-shape from 76 to the first arm 72; a second servo motor 79 for horizontally turning the second arm 77 via a second timing belt 78; A second torque measuring mechanism 81 for detecting torque applied to the two arms 77; and a second torque measuring mechanism 81 which is attached to the first arm 72 so as to be movable in the axial direction of the first arm 72 and is movable in the axial direction of the second arm 77. 2 er A slider 82 and 83 mounted to 77, and a U Jimesu member 84 which is attached to the slider 82, a support shaft 85 and 86 extending vertically from the the U Jimesu member 84, a. The support shafts 85 and 86 may be a single vertical axis.

The first finger hanging member 19 is attached to the support shaft 85 so as to be rotatable around the vertical axis, and the second finger hanging member 24 is attached to the support shaft 86 so as to be rotatable around the vertical axis. The first and second finger-hanging members 19 and 24 have U-shaped cross sections or U-shaped cross sections with open side surfaces, and hook-and-loop fasteners 87 and 87 are attached to the bottoms.
In this example, a U-shaped male member 88 is attached to the second arm 77, and the U-shaped male member 88 is fitted to the U-shaped female member 84 via support shafts 85 and 86.
Preferably, stopper pieces 89 and 89 for preventing the sliders 82 and 83 from coming off are attached to the tips of the first and second arms 72 and 77, respectively.

  In the training apparatus 10 of the present invention, the flexion / extension training for the thumb of the left hand, the palmar adduction / abduction training for the thumb of the left hand, the flexion / extension training of the thumb of the right hand, and the palmar adduction / extraction of the thumb of the right hand Four types of training consisting of rolling training can be implemented, and the first servo motor 74 and the second servo motor 79 are the main driving sources for this implementation. That is, since the main drive is performed by only the two motors 74 and 79, the training apparatus 10 can be reduced in size and weight.

The operation of the thumb moving mechanism 70 will be described with reference to FIG.
In FIG. 10, the first servo motor 74 rotates the first arm 72 as shown by the arrow (1). At this time, the 2nd servomotor 79 is made into a non-rotating state, and the 2nd arm 77 is made still. Then, the support shaft 85 moves as shown by the arrow (2) by the action of the couple (torque).

  Further, the second servo motor 79 rotates the second arm 77 as shown by the arrow (3). At this time, the 1st servomotor 74 is made into a non-rotating state, and the 1st arm 72 is made still. Then, the support shaft 85 moves as shown by the arrow (4) by the action of the couple.

That is, by comprehensively controlling the output torques of the first servo motor 74 and the second servo motor 79, the support shaft 85 can be moved to an arbitrary position on the plane of FIG.
In addition, the magnitude of the force acting on the support shaft 85 can be controlled by mutually controlling the output torques of the first servo motor 74 and the second servo motor 79.

Next, the configuration and operation of the first torque measurement mechanism 75 will be described on behalf of the first to fourth torque measurement mechanisms 75, 81, 48, and 59.
As shown in FIG. 11, the first torque measuring mechanism 75 includes a pin 91 extending in parallel to the first turning shaft 71 from the first arm 72, and one end fitted to the pin 91 and parallel to the first arm 72. A rod-shaped member 92 fixed to the first pivot shaft 71 in such a manner, a constricted portion 93 provided in the middle of the rod-shaped member 92, a strain cage 94 attached to the constricted portion 93, and the strain cage And a torque conversion unit 95 that converts the distortion information obtained in 94 into torque.

Although detailed structural calculation is omitted, the principle of torque measurement can be explained as follows.
When the first turning shaft 71 is rotated by the torque Tm, the torque Tm is divided into the torque Ta and the torque Ts, and then merges into the torque (Tm).
Since the cross-sectional area and material of the first arm 72 are known, the rigidity of the first arm 72 is known. Similarly, since the dimensions, cross-sectional area, and material of the rod-shaped member 92 and the constricted portion 93 are known, the rigidity of the rod-shaped member 92 is known.

  Torque Ta is measured by the strain cage 94. Since the mutual ratio between the rigidity of the first arm 72 and the rigidity of the rod-shaped member 92 is known, the torque Ta and the torque Tm can be estimated structurally from the torque Ta.

Since the constricted portion 93 is more easily bent than other portions, it is greatly deformed by the torque Ts. As a result, the torque measurement accuracy of the strain gauge 94 is greatly increased.
The strain gauge 94 may be directly attached to the first arm 72 without the rod-shaped member 92 and the pin 91. However, since the first arm 72 is a strength member, the constricted portion 93 cannot be provided, and the generated deformation becomes slight, and the torque measurement accuracy decreases.
According to the present invention, the first arm 72 is not damaged, and the constricted portion 93 is provided in the attached bar-shaped member 92. Therefore, the soundness of the first arm 72 can be maintained although the configuration is somewhat complicated.
Furthermore, it is advantageous in that both rigidity and sensitivity can be achieved.

  Since the second to fourth torque measuring mechanisms 81, 48 and 59 have the same principle as the first torque measuring mechanism 75, the description thereof is omitted.

  The operation of the training apparatus 10 described above will be described next. When it is necessary to distinguish left and right in the hand 67, L and R are added as in the left hand 67L and the right hand 67R.

As shown in FIG. 12A, the left hand 67 </ b> L is placed on the first hand support base 18. At this time, a hook-and-loop fastener 96 is attached to the thumb 68. Then, by moving the first hand support base 18 upward and right, the thumb 68 is brought close to the first finger hooking member 19 and the surface fasteners 87 and 96 are bonded together.
Since the first finger hanging member 19 is rotatably attached to the support shaft 85, it follows the direction of the thumb 68. That is, no excessive force is applied to the thumb 68.

Next, in FIG. 12B, the support shaft 85 is moved forward (moved to the upper left in the drawing). The thumb 68 is bent as shown by the arrow (5) so that the thumb 68 is under the other finger.
Next, as shown in FIG. 12C, the first joint 68 a (including the vicinity) is tapped with the first tapping member 21. This tapping causes stretch reflection and promotes automatic extension of the thumb 68.

  Preferably, as shown in FIG. 12C, an electrode 106 for applying electrical stimulation, a vibrator 107 for applying vibration stimulation, and an indicator lamp 108 are attached to the forearm portion 105. In addition, a speaker 109 is arranged around the patient. The indicator lamp 108 is preferably a small and lightweight LED (light emitting diode). The indicator lamp 108 is wound around the forearm 105 with a belt 111. The indicator lamp 108 may be placed in a visible place such as the side of the speaker 109 without being wrapped around the forearm portion 105.

  From just before tapping the first joint 68a with the first tapping member 21, until the automatic extension is completed, the vibrator 107 is operated to apply an auxiliary stimulus serving as a vibration stimulus. On the other hand, the electrode 106 is actuated throughout the exercise to apply a supplementary stimulus that is an electrical stimulus.

  At the same time, the indicator lamp 108 blinks and the speaker 109 is played. Then, the patient recognizes that automatic extension is imminent. That is, the patient concentrates on training with visual and auditory stimuli. The patient's motor cortex can be effectively reconstructed. When the indicator lamp 108 is wrapped around the forearm portion 105, both the thumb and the indicator lamp 108 enter the patient's field of view, and both the thumb and the flashing light can be seen simultaneously, and training can be further promoted.

Preferably, it is recommended to provide an extended reflection time lag between the time when the bending of the arrow (5) shown in FIG. 12 (b) ends and the time when the tapping starts shown in FIG. 12 (c). Is done.
When the dynamic flexion movement is changed to the automatic extension movement, it takes time until the movement due to the stretch reflex of the patient occurs. A so-called time lag occurs. Therefore, a short stretch reflection time lag is provided in the device control before the other dynamic bending motion is finished and the automatic stretching motion is started. Thereby, the operation | movement of a training apparatus can synchronize well with a patient's automatic motion and rhythm, and a training effect can be improved. The extended reflection time lag varies depending on the patient, but is set in the range of 0.05 to 0.10 seconds.

As shown in FIG. 13A, the L-shaped member 47 is pushed by the thumb 68 and the reaction torque is detected by the third torque measuring mechanism 48. Torque obtained by adding resistance torque to the reaction torque is generated by the first servo motor 74 and the second servo motor 79 shown in FIG.
Then, as shown in FIG. 13B, the thumb 68 extends as indicated by an arrow (6) while receiving resistance. During this time, since the first tapping member 21 continuously detects the reaction force torque, a resistance adjusted according to the increase or decrease of the reaction force torque is applied.

  Next, the left hand 67L is placed on the second hand support base 23 as shown in FIG. At this time, the hook-and-loop fastener 96 is affixed to the thumb 68 as well. Then, by moving the second hand support base 23 upward and to the right, the thumb 68 is brought close to the second finger hanging member 24 and the surface fasteners 87 and 96 are bonded together. Since the second finger hanging member 24 is rotatably attached to the support shaft 86, it follows the direction of the thumb 68. That is, no excessive force is applied to the thumb 68.

Next, in FIG. 14B, the support shaft 86 is advanced. As indicated by the arrow (7), the thumb 68 is inwardly added to the palm.
Next, as shown in FIG. 14 (c), the thumb ball 68 b (including the vicinity) is tapped with the second tapping member 25. This tapping causes stretch reflection and promotes automatic abduction of the thumb 68.

  Preferably, as shown in FIG. 14C, an electrode 106 for applying electrical stimulation, a vibrator 107 for applying vibration stimulation, and an indicator lamp 108 are attached to the forearm portion 105. In addition, a speaker 109 is arranged around the patient. Further, instead of the tapping stimulus of the second tapping member 21, it is possible to attach the vibrator 107 that gives the vibration stimulus to the thumb ball 68b.

  From just before tapping the thumb ball 68b with the second tapping member 21, the vibrator 107 is operated to apply an auxiliary stimulus serving as a vibration stimulus until automatic abduction is completed. On the other hand, the electrode 106 is actuated throughout the exercise to apply a supplementary stimulus that is an electrical stimulus.

  At the same time, the indicator lamp 108 blinks and the speaker 109 is played. Then, the patient recognizes that automatic abduction is imminent. That is, the patient concentrates on training with visual and auditory stimuli. The patient's motor cortex can be effectively reconstructed. When the indicator lamp 108 is wrapped around the forearm portion 105, both the thumb and the indicator lamp 108 enter the patient's field of view, and both the thumb and the flashing light can be seen simultaneously, and training can be further promoted.

Preferably, an extended reflection time lag is provided between the time when the palm side inversion of the arrow (7) shown in FIG. 14 (b) ends and the time when the tapping starts shown in FIG. 14 (c). It is recommended.
When changing from the other dynamic rotational motion to the automatic rotational motion, it takes time until the motion due to the stretch reflex of the patient occurs. A so-called time lag occurs. Therefore, a short stretch reflection time lag is provided in the device control before the other dynamic rotational motion ends and before the automatic rotational motion starts. Thereby, the operation | movement of a training apparatus can synchronize well with a patient's automatic motion and rhythm, and a training effect can be improved. The extended reflection time lag varies depending on the patient, but is set in the range of 0.05 to 0.10 seconds.

The reaction torque is detected by the fourth torque measuring mechanism (FIG. 6, reference numeral 59) in the same manner as described with reference to FIG. Torque obtained by adding resistance torque to the reaction torque is generated by the first servo motor 74 and the second servo motor 79 shown in FIG.
Then, as shown in FIG. 14 (c), the thumb 68 is abducted as shown by the arrow (8) while receiving resistance. During this time, since the second tapping member 25 continuously detects the reaction force torque, a resistance adjusted according to the increase or decrease of the reaction force torque is applied.

As described above, the flexion and extension training and the palmar adduction / abduction training were performed on the thumb 68 of the left hand 67L.
That is, recovery training was performed by inserting the left hand into the housing 15 from the front of FIG.
Since the back of the housing 15 is open, bending and stretching training and palm side adduction / abduction training can be performed by inserting the right hand from the back of the housing 15. This will be described below.

FIG. 15A is a view equivalent to FIG. 12A, and a bending / extension exercise for the thumb 68 of the left hand 67L was performed.
At this time, FIG. 15B is a view equivalent to FIG. 2, in which the first horizontal bar 16 is low and the second horizontal bar 17 is high. For the right hand 67R, the first horizontal bar 16 is set higher and the second horizontal bar 17 is set lower as shown in FIG.

  In addition, as shown in FIG. 15D, the first tapping member 21 is moved to the vicinity of the second horizontal bar 17. Thus, bending / extension training for the thumb 68 of the right hand 67R can be performed.

FIG. 16A is a diagram equivalent to FIG. 14A, and palm side adduction / abduction training for the thumb 68 of the left hand 67L was performed.
As shown in FIG. 16B, the second tapping member 25 is moved. Thus, palm side adduction / abduction training can be performed for the thumb 68 of the right hand 67R.

  In FIG. 1, it is desirable that the ceiling 14 is made of a transparent plate such as an acrylic resin. This is because the patient can see the state of the hand 67 and the thumb 68 through the transparent ceiling 14 and can give the patient a sense of security.

  Preferably, a CCD camera is mounted on the wall 13 of the housing 15 or in the vicinity thereof. It is preferable to photograph the hand 67 and the thumb 68 with a CCD camera and place the monitor at a position where the patient can observe. This is because the patient can observe the state of training. In this case, the ceiling 14 may be opaque.

  The present invention is suitable for an apparatus for training a thumb of a paralyzed patient.

  DESCRIPTION OF SYMBOLS 10 ... Hemiplegia finger ability recovery training apparatus, 11 ... Floor of casing, 12, 13 ... Wall, 14 ... Ceiling, 15 ... Housing, 18 ... First hand support base, 19 ... First finger rest, 21 ... First DESCRIPTION OF SYMBOLS 1 tapping member, 23 ... 2nd hand support stand, 24 ... 2nd finger hook member, 25 ... 2nd tapping member, 27 ... Control part, 48 ... 3rd torque measurement mechanism, 59 ... 4th torque measurement mechanism, 67 ... hand , 67L ... Left hand, 67R ... Right hand, 68 ... Thumb, 68a ... First joint of thumb, 68b ... Thumb ball, 70 ... Thumb movement mechanism, 71 ... First pivot, 72 ... First arm, 74 ... First servo Motor, 75 ... first torque measuring mechanism, 76 ... second turning shaft, 77 ... second arm, 79 ... second servo motor, 81 ... second torque measuring mechanism, 82, 83 ... slider, 85, 86 ... support shaft , 100 ... Angle adjustment mechanism.

Claims (7)

A hemiplegic thumb ability recovery training device for training the thumb of a patient with paralysis of a thumb of one hand and performing two types of recovery training, flexion and extension training and palmar adduction / abduction training,
A first hand support for supporting the hand with the palm facing down;
A second hand support that is arranged below the first hand support and supports the hand with the thumb facing up and the palm vertically oriented;
A first arm extending horizontally from a first swivel shaft arranged vertically;
A first servo motor for horizontally turning the first arm;
A first torque measuring mechanism for detecting torque applied to the first arm;
A second arm extending horizontally to form a V-shape with the first arm from a second axis of rotation arranged parallel to the first axis of rotation;
A second servo motor for horizontally turning the second arm;
A second torque measuring mechanism for detecting torque applied to the second arm;
A slider attached to the first arm movably along the axis of the first arm and attached to the second arm movably along the axis of the second arm;
A spindle extending vertically from the slider;
A first finger-hanging member on which a thumb of a hand that is rotatably supported around the vertical axis and is placed on the first hand support base is fitted to the support shaft;
A first tapping member for tapping the vicinity of the first joint of the thumb to be fitted to the first finger hanging member;
A third torque measurement mechanism that detects a reaction torque applied to the first tapping member from the thumb,
A second finger hanging member on which a thumb of a hand placed on the second hand support is fitted to the support shaft so as to be rotatable around a vertical axis at a position below the first finger hanging member;
A second tapping member tapping the thumb ball near beside fitted the thumb on the second finger placing member,
A fourth torque measurement mechanism for detecting a reaction force torque applied to the second tapping member from the thumb,
Based on the torque information from the first and third torque measuring mechanisms, the first finger hooking portion is moved in the direction in which the thumb finger is bent, and is bent and extended so as to extend while applying a resistance force according to the reaction torque. subjecting controlling real, confers resistance to the second finger placing portion the thumb is corresponding to the reaction torque to move in the direction of rolling the palm side on the basis of the torque information from the second-fourth torque measuring mechanism and that control section to implement the volar abduction motion control while,
A hemiplegic thumb ability recovery training device consisting of.
  The first hand support, the second hand support, the first arm, the second arm, the slider, the support shaft, the first finger rest, and the second finger rest are collectively stored in a housing. The hemiplegic thumb ability recovery training apparatus according to claim 1. The housing includes a floor, a pair of walls extending upward from both ends of the floor, and a ceiling extending between the upper ends of the walls,
The housing is open at the front and back,
The hemiplegia thumb ability recovery training apparatus according to claim 2, wherein the first tapping member and the second tapping member are attached to the housing so as to be movable in parallel to at least the wall.   The first finger-hanging portion has a U-shaped cross section with the first hand support base side open, and the second finger-holding portion has a U-shaped cross section with the second hand support base side open. Item 1. The hemiplegic thumb ability recovery training device according to Item 1.   The hemiplegia thumb ability recovery training apparatus according to claim 1, wherein the first hand support base and the second hand support base are open at the top.   The hemiplegic thumb ability recovery training apparatus according to claim 3, wherein the ceiling is made of a material that can be seen through.   The hemiplegia thumb ability recovery training apparatus according to claim 4, wherein an attachment angle of at least one of the first tapping member and the second tapping member can be adjusted by an angle adjusting mechanism.

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