JP6512704B2 - Hemiplegia motor function recovery training device and program - Google Patents

Description

  The present invention relates to a hemiplegia motor function recovery training apparatus and program.

Patients suffering from cerebrovascular disease often have hemiplegia in the lower and upper limbs as a sequelae. Rehabilitation using the plasticity of the brain is effective for such hemiplegia, and it is possible to restore part of the motor function. Brain plasticity is the replacement of function in the damaged part of the brain by another part.
Heretofore, as rehabilitation using such brain plasticity, a method called forcible repeated therapy has been used. This forced repeated therapy induces the extension reflex of the paralyzed area by the forged technique, and sends the voluntary command from the brain to the paralyzed site at the moment of enhancing the excitement of the motor area, thereby the patient's intended voluntary movement Training that causes Repeating this training rebuilds and strengthens the neural circuit between the brain and muscles. Such a prompting procedure requires accuracy because it is necessary to cause voluntary exercise in the target muscle.
Conventionally, trained occupational therapists have conducted such rehabilitation, but in order to obtain sufficient rehabilitation effects, it is necessary to perform the procedure for a long time and for a long time, so the burden of the occupational therapists etc. Becomes large.

  Therefore, a training device capable of performing treatment training on a hemiplegia site has been developed (for example, Patent Document 1). In addition, in order to more accurately reproduce the facilitative procedure performed by the occupational therapist or the like, a training device capable of performing treatment training for rotating the joint has also been developed (for example, Patent Document 2).

JP 2002-119555 A Japanese Patent Publication 2009-536535

However, the technology disclosed in Patent Document 1 mentioned above only performs passive exercise, and the patient does not exercise voluntarily, so from the viewpoint of functional recovery, the rehabilitation effect is weak. Met.
In addition, since the technology disclosed in Patent Document 2 described above can rotate joints, it is possible to more accurately reproduce the facilitation procedure performed by an occupational therapist or the like. The configuration is complicated and unsuitable for use at home. If it can not be used at home, it may be difficult to perform rehabilitation over a long period of time, and it may be difficult to obtain sufficient rehabilitation effect.

  This invention is made in view of the said situation, and an object of this invention is to provide the hemiplegia motor function recovery training apparatus and program which can perform effective rehabilitation by more simple structure.

A hemiplegia motor function recovery training device according to a first aspect of the present invention is a hemiplegia for performing a flexion-extension movement of a joint connected by a biarticular muscle among joints constituting a lower limb or an upper limb of a hemiplegia patient. A motor function recovery training device,
A first training which is passive training which extends a first joint located proximal to the trunk among the joints connected by the biarticular muscles and flexes a second joint located distal to the trunk; A bending and stretching mechanism for repeatedly performing a second training, which is training of a voluntary movement for bending the first joint and extending the second joint,
The bending and stretching mechanism is a resistance-associated type that applies resistance to a force to bend the first joint and applies an assist force in a direction equal to the direction of force to bend the first joint when performing the second training. The cooperative control is performed, and the resistance-associated cooperative control is stopped when the first training is performed.

In this case, the bending and stretching mechanism
A device body installed horizontally,
A pedestal provided on the device body and in which the patient's lower or upper limbs are disposed so as to contact the sole or palm;
A first position corresponding to a state in which the first joint of a patient whose leg or upper limb is disposed on the base is bent and the second joint is extended; And a pedestal driving unit configured to linearly reciprocate between a second position corresponding to a state in which the second joint is bent while the second joint extends.
When performing the second training to move the pedestal from the second position to the first position, the pedestal driving unit applies resistance to the force to move the pedestal and moves the pedestal. Performing said resistance-associated cooperative control that applies an assist force in a direction equal to the direction, and moving said pedestal from said first position to said second position, when performing said first training, said resistance-associated cooperative control To stop,
You may do it.

Further, when moving the base from the first position to the second position, the base driving unit moves the base from the first position to a predetermined range at a first speed, and when the base driving unit exceeds the predetermined range. Move at a second speed faster than the first speed,
You may do it.

The base further includes a force sensor provided on the pedestal and detecting a motion signal of the patient as a force signal.
The assist force applied to the pedestal drive unit by the resistance-associated cooperative control is set according to a force signal detected by the force sensor.
You may do it.

A program according to a second aspect of the present invention is connected by the two joint muscles in order to perform bending and extension exercises of joints connected by the two joint muscles among the joints constituting the lower limbs or the upper limbs of a hemiplegia patient The first training, which is passive training for extending a first joint located proximal to the trunk of the joints and bending a second joint located distal to the trunk, bending the first joint and the first training A computer for controlling a hemiplegic motor function recovery training apparatus comprising a bending and stretching mechanism for repetitively performing a second training which is training of a voluntary movement for extending a second joint,
At the time of execution of the second training, the resistance accompanying type that applies resistance to the bending force of the first joint and applies an assisting force in the same direction as the direction of the bending force of the first joint to the bending and stretching mechanism. An execution unit that executes cooperative control,
A stop unit that causes the bending and stretching mechanism to stop the resistance-associated cooperative control at the time of execution of the first training;
Act as

  According to the present invention, in the first training, by stretching the first joint and bending the second joint, it is possible to effectively induce the stretching reflex of the biarticular muscle. In addition, muscle tension by stretching reflex can be effectively maintained since the second training in which the resistance and assist force are applied is started in a state in which the muscle is tensioned through the first training. For this reason, effective rehabilitation can be performed with a simpler configuration.

It is a perspective view showing a schematic structure of a hemiplegia motor function recovery training device concerning an embodiment of this invention. It is a perspective view which shows the schematic structure of the apparatus frame of the hemiplegia motor function recovery training apparatus of FIG. It is a perspective view which shows the external appearance of the drive mechanism of the hemiplegia motor function recovery training apparatus of FIG. It is sectional drawing which shows the cross-section of the drive mechanism of the hemiplegia motor function recovery training apparatus of FIG. It is a top view which shows the structure of a strain gauge. It is a block diagram showing the system configuration of a hemiplegia motor function recovery training device. It is a figure which shows the use condition of a hemiplegia motor function recovery training apparatus. It is a flow chart explaining a flow of functional recovery training by a hemiplegia motor functional recovery training device. It is a figure showing the range of motion of a knee joint. It is a figure which shows the movement of a hemiplegia motor function recovery training apparatus and a user at the time of function recovery training. It is a figure which shows an example of transition of the target speed of a drive mechanism, the real speed of a drive mechanism, and the force measured with the strain gauge. It is a figure which shows an example of speed of a drive mechanism, and transition of surface myoelectric potential. The figure which shows an example of transition of the surface myoelectric potential in the case where function recovery training is performed in the state which turned off the power supply of the hemiplegia motor function recovery training apparatus, and the value of M and C is changed and function recovery training is performed. It is. It is a figure which shows the model of a muscle fiber and a muscle spindle.

An embodiment of the present invention will be described below with reference to FIGS.
A schematic configuration of the hemiplegia motor function recovery training apparatus 100 is shown in FIG. As shown in FIG. 1, the hemiplegia motor function recovery training device 100 includes a device frame 10 and a drive mechanism 20 incorporated in the device frame 10. A pedestal 70 for fixing the user's foot is fixed to the upper portion of the drive mechanism 20. Although not particularly shown in FIG. 1, the hemiplegia motor function recovery training apparatus 100 is a so-called personal computer (hereinafter referred to as a personal computer including a central processing unit, a random access memory, a read only memory, etc.). , “PC”) 40, and transmits various detection values to the PC 40. The PC 40 executes various controls of the hemiplegia motor function recovery training apparatus 100 based on various detected values and a program described below.

  A schematic configuration of the device frame 10 is shown in FIG. As shown in FIG. 2, on the bottom surface of the device frame 10, a pair of support rails 11 and a rack 12 having teeth on the top surface are provided to extend substantially the entire length of the device frame 10 along the longitudinal direction. There is.

  A schematic appearance of the drive mechanism 20 is shown in FIG. As shown in FIG. 3, the drive mechanism 20 is provided with a leg 23 slidably fixed to the support rail 11 and a servomotor 21 as a drive member. A pinion 22 engaged with the rack 12 via a pulley transmission mechanism 29 is rotatably fixed to the servo motor 21. When the drive mechanism 20 reciprocates the support rail 11, the rotational force of the servomotor 21 is transmitted to the pinion 22 via the pulley transmission mechanism 29, and the drive mechanism 20 extends the support rail 11 via the pinion 22 and the rack 12. Reciprocate in the direction.

  4 is a cross-sectional view of the cross section of the drive mechanism 20 taken along line A-A of FIG. 3 as viewed in the direction of arrow B shown in FIG. As shown in FIG. 4, in the drive mechanism 20, a base 28, a fixed shaft 25 whose lower end is fixed to the base 28, a pair of strain gauges 24 whose one end is fixed to the fixed shaft 25, a longitudinal direction of the base 28 A pair of auxiliary rails 27 provided in a direction extending along the movable portion 26 and a movable portion 26 slidably attached to the auxiliary rails 27 are provided.

  The upper end of the movable portion 26 is fixed to the pedestal 70, and the auxiliary rail 27 reciprocates by following the movement of the pedestal 70. The strain gauge 24 is a high sensitivity sensing mechanism capable of detecting even a weak force of a hemiplegic patient by converting strain into voltage, one end being fixed to the fixed shaft 25 as described above, and the other end Is fixed to the movable portion 26. When the pedestal 70 moves relative to the base 28, the movable portion 26 moves the auxiliary rail 27 following the pedestal 70. When the movable portion 26 moves the auxiliary rail 27 in this manner, the strain gauge 24 expands and contracts following the movement of the movable portion 26.

  As shown in FIG. 5A, the strain gauge 24 includes a detection unit 24a. As described above, when the pedestal 70 moves relative to the base 28, the detection portion 24a of the strain gauge 24 expands and contracts from the state of FIG. 5A to the state of FIG. 5B. Then, an electrical signal corresponding to the stress generated in the detection unit 24a is output from the detection unit 24a to the PC 40 as a stress signal.

  The system configuration of the hemiplegia motor function recovery training apparatus 100 is shown in FIG. As shown in FIG. 6, the hemiplegia motor function recovery training apparatus 100 includes the servomotor 21 and the strain gauge 24 described above, a PC 40 that executes various processes, and an operational amplifier 46 that amplifies a stress signal output from the strain gauge 24. And a motor driver 45 that controls power supply to the servomotor 21 based on a signal output from the PC 40, and an encoder 44 that detects a rotation angle of the servomotor 21 and outputs a detection signal to the PC 40. The PC 40 calculates the pulses output from the CNT module 41 that counts pulses output for each rotation angle of the servo motor 21 through the encoder 44, the DA module 42 that transmits the power supply signal to the servo motor 21 to the motor driver 45, and the strain gauge 24 An AD module 43 that receives the stress signal amplified by the amplifier 46 is provided.

  FIG. 7 shows the state of use of the hemiplegia motor function recovery training apparatus 100 having such a configuration. As shown in FIG. 7, a hemiplegic patient (hereinafter, “user 1”) faces the hemiplegic motor function recovery training device 100 and holds a sitting position using a chair or the like. Then, the paralyzed foot (hereinafter, "paralyzed limb") is fixed to the pedestal 70 so that the back of the foot is in contact. In the present embodiment, functional recovery training is described in which the stretch reflex of knee joint flexion is induced by stretching biceps femoris muscle and gastrocnemius muscle that are bi-articular muscles.

  A flowchart for explaining the flow of the function recovery training using the hemiplegia motor function recovery training apparatus 100 is shown in FIG.

  As shown in FIG. 8, when this process is started, first, initial conditions are set (step S100). For example, the height of a chair for holding the sitting position by the user 1, the length of the foot of the user 1, and the like are set. Next, the origin of the strain gauge 24 is set (step S101). Since the strain gauge 24 is a high sensitivity sensing mechanism that can detect even weak force of hemiplegic patients, the output value is affected by various factors such as unintended foot swing of the user 1 and floor vibration. It will change. In order to suppress such an unnecessary change, the user 1 sets the origin in a state where the foot is fixed to the pedestal 70 at step S101.

  Thereafter, training is started (step S102). When the training is started, first passive training is performed to move the drive mechanism 20 at a predetermined first speed to a predetermined value (step S103), and then at a second speed higher than the first speed. The second passive training to move the drive mechanism 20 is executed (step S104).

The first passive training (step S103) and the second passive training (step S104) will be described.
As shown in FIG. 9, when the angle of the knee joint when the knee is extended to the maximum is set to 0 °, the knee joint can generally bend to a position of 130 °. As described above, since the user 1 fixes the paralyzed limb to the pedestal 70 so that the back of the foot contacts, when the drive mechanism 20 moves the support rail 11, the knee joint and the foot are moved together with the movement of the drive mechanism 20. The angles of the joints change.
The movements of the user 1 and the drive mechanism 20 at the time of function recovery training using such a hemiplegia motor function recovery training apparatus 100 will be described with reference to FIGS. 10 (a) to 10 (d). When the drive mechanism 20 moves from the position shown in FIG. 10 (a) to the position shown in FIG. 10 (c), the knee joint extends and the ankle joint bends as the drive mechanism 20 moves. In the state shown in FIG. 10 (c), the knee joint is extended and the ankle joint is expressed as being flexed, and in the state shown in FIG. 10 (a), the knee joint is bent and Ankle joints are described as being stretched. On the other hand, when the drive mechanism 20 moves from the position shown in FIG. 10 (c) to the position shown in FIG. 10 (a), the knee joint of the user 1 bends as the drive mechanism 20 moves. Ankle joints extend. In this embodiment, when the knee joint of the user 1 is flexed and the ankle joint is in an extended state, the position taken by the drive mechanism 20 is taken as a flexed position (position A shown in FIG. 10), and the knee joint is extended. The position taken by the drive mechanism 20 when the ankle joint is in a bent state is taken as an extended position (position B shown in FIG. 10). In addition, the correspondence of the position of the drive mechanism 20 and the angle of the knee joint of the user 1 is set at the time of setting of initial conditions in step S100.

In the first passive training (step S103), as shown in FIG. 10A, with the drive mechanism 20 in the bending position directed to the extension position, a position closer to the bending position by a predetermined distance C than the extension position , Acceleration position) at a first speed. At the same time as the knee joint of the user 1 is extended at the first speed by such first passive training, the ankle joint of the user 1 is also flexed at the first speed. When the drive mechanism 20 reaches the acceleration position, the process shifts to the second passive training (step S104), and the drive mechanism 20 moves to the extended position at a second speed higher than the first speed (FIG. 10 (b)). Thereby, at the same time as the knee joint of the user 1 is extended at the second speed, the ankle joint of the user 1 is flexed at the second speed.
The first passive training (step S103) and the second passive training (step S104) described above are both passive training performed using only the driving force of the drive mechanism 20.

  After the knee joint is completely extended and the second passive training (step S104) is completed, the user 1 starts a voluntary exercise to bend the knee joint. On the other hand, the hemiplegia motor function recovery training apparatus 100 determines whether or not 200 milliseconds have elapsed after such second training (step S104) is completed (step S105). If it is determined that 200 milliseconds have elapsed (step S105; YES), RACC, that is, resistance-associated cooperative control is executed.

  Next, this resistance-associated cooperative control will be described. The resistance-associated cooperative control is an assist that assists the movement of the paralyzed limb in a direction equal to the direction of the force of the user 1 who tries to move the drive mechanism 20 based on the stress signal output from the strain gauge 24. It is control which applies resistance to the force of the user 1 who tries to move the drive mechanism 20 while applying force. That is, the user 1 moves the drive mechanism 20 in the position of FIG. 10C to the position of FIG. 10D to bend the knee joint after the second training (step S104) is finished. Apply power to The drive mechanism 20 assists the movement in this direction and applies resistance.

Specifically, a target velocity of the drive mechanism 20 is set based on a stress signal output from the strain gauge 24, and control for moving the drive mechanism 20 according to the target velocity is shown. First, the impedance equation in the drive mechanism 20 with respect to the force F is expressed as the following equation 1.

In order to convert into the relational expression of velocity, if the equation 1 is discretized and K = 0 is given, the following equation 2 is obtained.

By moving the drive mechanism 20 in accordance with the target speed calculated using the equation 2, an assist force can be applied to the movement of the user 1.
The ratio of M and C can be obtained, for example, by substituting “0” for the force F _{n of the} paralyzed limb and “0” for the target angular velocity. The impedance characteristic can be adjusted by adjusting the ratio of M and C.

And resistance can be added by setting a time delay between the setting time of P _n and the measurement time of F _n . The magnitude of this time delay may be set based on the magnitude of the stress signal output from the strain gauge 24 or may be set in advance to a predetermined time.

このように、仮想力を加えると、歪みゲージ２４の出力のみに基づいて目標速度を設定する場合よりも、より適切に目標速度を設定することができる。すなわち、麻痺肢の力Ｆ_ｎが大きくなり駆動機構２０が加速される場合には、目標速度をより好適に増大させることができるため、使用者１は先に押されたような加速感をより好適に感じることができる。一方、麻痺肢の力Ｆ_ｎが小さくなり、駆動機構２０が減速される場合には、目標速度を移動方向と反対方向に遅らせることができるため、より好適に減速感を感じることができる。以上のように、仮想力Ｆ_ｃを加えると、運動意図の方向と同じ方向に麻痺肢が押されていると感じることができるようになる。 In addition, an imaginary force F _c shown in the following equation 3 can be added to the force F _{n of the} paralyzed limb shown in the equation 2.

Thus, when the virtual force is applied, the target velocity can be set more appropriately than when the target velocity is set based only on the output of the strain gauge 24. That is, when the force F _{n of the} paralyzed limb is increased and the drive mechanism 20 is accelerated, the target speed can be more suitably increased. I can feel suitable. On the other hand, when the force F _{n of the} paralyzed limb becomes small and the drive mechanism 20 is decelerated, the target velocity can be delayed in the direction opposite to the moving direction, so that the feeling of deceleration can be felt more suitably. As described above, when the virtual force F _c is applied, it becomes possible to feel that the paralyzed limb is pressed in the same direction as the direction of exercise intention.

  With such RACC, the user 1 resists his own force to move the drive mechanism 20 when performing voluntary exercise training to bend the knee joint as shown in FIG. 10 (d). While obtaining the force, it is possible to obtain an assist force for moving the drive mechanism 20 in the same direction as the intended direction.

  In the first passive training (step S103) and the second passive training (step S104) described above, stretching reflex can be induced to tension the muscles. Furthermore, in a state in which the muscles are tensioned through the first passive training (step S103) and the second passive training (step S104), it is possible to execute the voluntary exercise to which the resistance and assist force are added (step S106). , Muscle tone by stretching reflex is effectively maintained. For this reason, rehabilitation can be performed effectively.

  By the way, after the passive training by the first passive training (step S103) and the second passive training (step S104) is completed, the extension of the user 1 is performed until transition to the voluntary exercise by the RACC (step S106). There is a time lag (about 200 milliseconds) for the movement due to reflection to occur. Therefore, in the present embodiment, when it is determined that 200 milliseconds have not elapsed after the second training (step S104) is ended (step S105; NO), the process waits for 200 milliseconds to elapse. Thus, by waiting for 200 milliseconds to elapse, the operation of the hemiplegia motor function recovery training apparatus 100 can be synchronized with the voluntary movement or rhythm of the user 1, so that the training effect can be improved. become.

  When the RACC (step S106) ends, it is then determined whether the number of times of training exceeds a predetermined number (step S107). The number of times of training indicates the number of times of performance restoration training consisting of the first passive training (step S103), the second passive training (step S104) and the RACC (step S106). The above-mentioned functional recovery training can not achieve a sufficient effect by one operation alone, and can be repeated to rebuild and strengthen the neural circuit between the brain and the muscle. Therefore, in order to perform rehabilitation of the paralyzed limb effectively, it is necessary to repeat the functional recovery training described above a predetermined number of times. Therefore, when it is determined that the number of times of training does not exceed the predetermined number (step S107; NO), the process returns to the first passive training (step S103), and the series of training is performed again. On the other hand, when it is determined that the number of times of training has exceeded the predetermined number of times (step S107: YES), the present training is ended.

FIG. 11 shows changes in the moving speed (left axis) of the drive mechanism 20 and the force (right axis) detected by the strain gauge 24 when the above-described function recovery training is performed. The target velocity of the drive mechanism 20 is indicated by a broken line, the actual velocity of the drive mechanism 20 is indicated by a solid line, and the force detected by the strain gauge 24 is indicated by an alternate long and short dash line.
As shown in FIG. 11, when the control is started, the drive mechanism 20 actually moves to the first speed in period A, and then to the second speed higher than the first speed in period B. Moved. After that, in period C, it moved at a speed corresponding to the force detected by the strain gauge 24. That is, in the period C, the drive mechanism 20 can be moved based on the voluntary movement of the user 1.

  Next, a surface electrode was attached to the semitendinoid muscle which is a knee joint flexion muscle, function recovery training was performed using the hemiplegia motor function recovery training apparatus 100, and transition of the surface myoelectric potential was measured. The results are shown in FIG. The transition of the surface myoelectric potential (right axis) is indicated by a solid line, and the transition of the actual velocity (left axis) of the drive mechanism 20 is indicated by a broken line. As shown by P1 and P2 in FIG. 12, the myoelectric potential was rising immediately after the second passive training (step S104) was completed. From this, it was shown that the training using the hemiplegia motor function recovery training apparatus 100 effectively induced the extension reflex of the knee flexor muscle.

Next, it was verified whether the assist power was applied to the paralyzed limb appropriately by RACC. Specifically, the following conditions 1 to 3 are set, function recovery training is performed using the hemiplegia motor function recovery training apparatus 100, and the surface of the semitendinoid muscle as in the measurement shown in FIG. The transition of myoelectric potential was measured.
Condition 1. The function recovery training is performed with the power of the hemiplegia motor function recovery training apparatus 100 turned off.
Condition 2. The function recovery training is performed with the values of M and C shown in Equation 1 set to appropriate values.
Condition 3. The function recovery training is performed in a state in which the values of M and C shown in the equation 1 are set to values (inappropriate values) larger than the values set in the condition 2.
The results are shown in FIG. The transition of the surface myoelectric potential under the condition 1 is indicated by an alternate long and short dash line, the transition of the surface myoelectric potential under the condition 2 is indicated by a solid line, and the transition of the surface myoelectric potential under the condition 3 is indicated by a broken line.

As shown in FIG. 13, the maximum value of the surface myoelectric potential under the condition 1 was 0.08 mV, and the maximum value of the surface myoelectric potential under the condition 3 was 0.12 mV. This is because in the case of Condition 3, the virtual mass and the virtual viscosity increase, so that a larger load is applied than during normal bending, and a large force is required for the knee flexing movement. In addition, the maximum value of the surface myoelectric potential under the condition 2 was about 0.04 mV. Thus, the maximum value of the surface myoelectric potential under the condition 2 was less than 1/2 of the maximum value of the surface myoelectric potential under the condition 1.
From the above, it is shown that the drive mechanism 20 can be moved with a small force by appropriately setting the values of M and C. Therefore, even in the case of a hemiplegic patient who can exert only a weak force, the RACC can move the drive mechanism 20 and can perform voluntary exercise training using the hemiplegia motor function recovery training apparatus 100. Indicated.

  As described above in detail, according to this embodiment, the knee joint extension and the ankle joint flexion are simultaneously performed in the first passive training (step S103) and the second passive training (step S104). Stretch reflexes of biceps femoris and gastrocnemius can be effectively induced. In addition, in the facilitation technique performed by occupational therapists and the like, stretching reflex of gastrocnemius muscle is induced by rotating the ankle joint, but in the present embodiment, stretching of the knee joint and bending of the ankle joint are simultaneously performed. The same effect as rotating the ankle joint can be obtained. Therefore, effective rehabilitation can be performed with a simple configuration.

  In addition, after the knee joint is extended to an angle close to 0 ° by the first passive training (step S103) and the second passive training (step S104), the knee joint is rapidly extended to 0 ° at a high speed. The Rukoto. Such movement can cause the muscle spindle to stretch rapidly, effectively increasing muscle tone, and thus more effectively inducing the stretch reflex.

  A schematic view of muscle fibers 51 and muscle spindles 52 is shown in FIG. As shown in FIG. 14, the muscle fibers 51 and the muscle spindles 52 are coupled in parallel. When the muscle fiber 51 is stretched, the muscle spindle 52 is also stretched simultaneously, and the muscle spindle 52 generates a pulse 53 according to the length of extension and the rate of extension. Specifically, when the muscle fiber 51 is stretched, the pulse 53 of the interval as shown in FIG. 14 (a) is generated, and when the muscle fiber 51 is moved quickly, the pulse 53 is shown in FIG. 14 (b). Generate pulses 53 of intervals as shown. For this reason, when the muscle fiber 51 is rapidly stretched, as shown in FIG. 14 (c), both the pulse 53 shown in FIG. 14 (a) and the pulse 53 shown in FIG. 14 (b) are combined. Will occur in the That is, a larger action potential is generated. In this embodiment, after extending the knee joint at the first speed, in order to extend at the second speed higher than the first speed, that is, when the knee joint is at an angle close to 0 °, the knee joint is sharply The muscle spindle 52 can generate a large action potential. That is, it becomes possible to induce the elongating reflex more effectively.

  In addition, in order to execute resistance-associated cooperative control based on the stress signal output from the strain gauge 24, the user's paralyzed limb has an appropriate amount of resistance and assist force for inducing the stretch reflex. Can be added.

  In the above embodiment, the foot is placed on the pedestal 70, and by performing bi-articular muscle biceps femoris muscle and gastrocnemius muscle, training for extending and reflecting the knee joint flexion is performed. Is not limited to this. For example, functional recovery training may be performed to bring the palm into contact with the pedestal 70 and extend the biceps, which is a biarticular muscle.

  In addition, although the said embodiment demonstrated the hemiplegia motor function recovery training apparatus 100 provided with the drive mechanism 20 which carries out the slide movement of the support rail 11, this invention is not limited to this. For example, a motor may be provided which is attached to the knee joint and the ankle joint and capable of bending and extending each joint.

  The present invention is capable of various embodiments and modifications without departing from the broad spirit and scope of the present invention. In addition, the embodiment described above is for explaining the present invention, and does not limit the scope of the present invention. That is, the scope of the present invention is indicated not by the embodiments but by the claims. And, various modifications applied within the scope of the claims and the meaning of the invention are considered to be within the scope of the present invention.

Reference Signs List 1 user, 10 apparatus frame, 11 support rails, 12 racks, 20 drive mechanisms, 21 servomotors, 22 pinions, 23 legs, 24 strain gauges, 24a detection units, 25 fixed shafts, 26 movable units, 27 auxiliary rails, 28 base, 29 pulley transmission mechanism, 40 PC, 41 CNT module, 42 DA module, 43 AD module, 44 encoder, 45 motor driver, 46 operational amplifier, 51 muscle fibers, 52 muscle spindles, 53 pulses, 70 pedestals, 100 pieces Paralysis motor function recovery training device

Claims (5)

A hemiplegic motor function recovery training device for performing bending and extension movements of a joint connected by two joint muscles among joints constituting a lower limb or an upper limb of a hemiplegia patient,
A first training which is passive training which extends a first joint located proximal to the trunk among the joints connected by the biarticular muscles and flexes a second joint located distal to the trunk; A bending and stretching mechanism for repeatedly performing a second training, which is training of a voluntary movement for bending the first joint and extending the second joint,
The bending and stretching mechanism is a resistance-associated type that applies resistance to a force to bend the first joint and applies an assist force in a direction equal to the direction of force to bend the first joint when performing the second training. Perform cooperative control, and stop the resistance-associated cooperative control at the time of execution of the first training;
A hemiplegia motor function recovery training device characterized in that. The bending and stretching mechanism
A device body installed horizontally,
A pedestal provided on the device body and in which the patient's lower or upper limbs are disposed so as to contact the sole or palm;
A first position corresponding to a state in which the first joint of a patient whose leg or upper limb is disposed on the base is bent and the second joint is extended; And a pedestal driving unit configured to linearly reciprocate between a second position corresponding to a state in which the second joint is bent while the second joint extends.
When performing the second training to move the pedestal from the second position to the first position, the pedestal driving unit applies resistance to the force to move the pedestal and moves the pedestal. Performing said resistance-associated cooperative control that applies an assist force in a direction equal to the direction, and moving said pedestal from said first position to said second position, when performing said first training, said resistance-associated cooperative control To stop,
The hemiplegia motor function recovery training device according to claim 1 characterized by things. When moving the pedestal from the first position to the second position, the pedestal driving unit moves the pedestal from the first position to a predetermined range at a first speed, and when the pedestal driving unit exceeds the predetermined range Move at a second speed faster than the speed,
The hemiplegia motor function recovery training apparatus according to claim 2, The pedestal includes a force sensor provided on the pedestal and detecting a motion signal of the patient as a force signal.
The assist force applied to the pedestal drive unit by the resistance-associated cooperative control is set according to a force signal detected by the force sensor.
The hemiplegia motor function recovery training apparatus according to claim 2 or 3, characterized in that: Of the joints constituting the lower or upper limbs of a hemiplegia patient, the joint connected by the biarticular muscles is located proximal to the trunk of the joints connected by the biarticular muscles, in order to perform bending and extension movements of the joints connected by the biarticular muscles First training, which is passive training for extending one joint and bending a second joint located at the distal end of the trunk, and training of voluntary movement for bending the first joint and extending the second joint A computer for controlling a hemiplegic motor function recovery training apparatus comprising a bending and stretching mechanism for repeating the second training;
At the time of execution of the second training, the resistance accompanying type that applies resistance to the bending force of the first joint and applies an assisting force in the same direction as the direction of the bending force of the first joint to the bending and stretching mechanism. An execution unit that executes cooperative control,
A stop unit that causes the bending and stretching mechanism to stop the resistance-associated cooperative control at the time of execution of the first training;
A program that acts as

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