JPS59160455A - Apparatus for restoring paralyzed upper arm function of heavy limb paralyzed patient by upper motion nerve obstacle - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

[Detailed Description of the Invention] Previously, self-care was completely impossible for patients with severe quadriplegia, and it was extremely difficult to apply existing braces and surgical functional reconstruction methods, and it was difficult to provide complete 24-hour assistance. The invention of this application was made for the purpose of solving the above-mentioned problems.

encephalopathy, mechanical displacement of the jaw, shoulders, neck, and speech, etc.”
Quantitative biological signals are used as a motion command signal source, and signals from sensors attached to the upper limbs and other parts are fed back directly or via a sensory substitution device, integrated and processed, and sent directly or via a telemeter device to the vicinity of the nerves. Provides programmed electrical stimulation output to implanted electrodes.

The purpose of the present invention is to provide a device that executes the patient's intended coordinated movement of the upper limbs using muscle contractions caused by this.

The invention of this application will be described in detail based on examples.

Figure 1 is a block diagram of the entire invention, and claims (1)
- Shows the case where all the devices in (8) are provided.

In other words, as movement commands for paralyzed fingers, elbows, and shoulders, surface electromyograms of the frontalis and masseter muscles of the face (1) of the neck and shoulders (in those with healthy trapezius muscles, shoulders can move backwards and upwards) ] or multi-channel voluntary biosignals such as brain waves are detected by a biosignal detection device 1vc that detects the displacement without malfunctioning even in the presence of various disturbances and noises.

It has the role of providing the multi-dimensional signal processing device 2 with information necessary for controlling the coordinated movements of the upper limbs. As a specific embodiment, for example, an electromyogram is induced using a multipolar surface electrode, and after being amplified using a low noise and high discrimination ratio differential amplification device.

A control signal is obtained by half-wave rectification and taking the time average. Movements of the neck and shoulders are detected by a DC bridge circuit and a high-pass filter, or by an AC bridge circuit, using a DC bridge circuit and a high-pass filter, or an AC bridge circuit to detect changes in electrical resistance caused by the expansion and contraction of the rubber tube for thoracic respiratory pickup or the expansion and contraction of carbon fiber. Namely.

In patients with severe quadriplegia, the movements of the neck and upper parts of the neck are completely normal, and the shoulders can only move backwards and upwards, so these limited remaining functions should be utilized as much as possible. The stimulation waveform generator 3 shown in FIG. It is famous for its multi-channel stimulation pulse train generator that electrically stimulates the system. In a specific embodiment, an analog negative polarity current pulse train or negative polarity voltage pulse train is obtained through a full waveform/A converter and a demultiplexer created by a microcomputer program. A typical waveform has a pulse width Q, l
In order to obtain smooth muscle contraction using a pulse train with a repetition rate of /j-2θl-1g at msec, a method is adopted in which the amplitude of the pulse current or voltage is modulated by a control signal (optional biological signal).

The present invention is based on two biological signal detection apparatuses shown in FIG. Multi-dimensional signal processing device 2. Although it is possible to construct a minimum system using the stimulation waveform generator 3 and the stimulation waveform generator 3, voluntary movements in patients with severe quadriplegia are only possible in part of the shoulders, neck, face, and head.

There is a limit to the amount of information these movements can provide.

VC is insufficient to optimally control coordinated movements of the upper limbs.

In contrast, the majority of these patients.

Many patients do not have any problems with speech generation or hearing, and it is extremely important to use voice, which is a means of transmitting large amounts of high-speed information, in conjunction with voluntary biological signals obtained from the hands, elbows, shoulders, etc. .

The role of the operation of the speech recognition device 4 will be explained using a relatively simple embodiment. First, regarding hand functions, the hand is basically opened and closed using electromyography or mechanical displacement of the shoulders and neck, but the gripping pattern of the hand is selected by voice command depending on the object to be gripped. For example, a typical example of a two-handed grasping motion is the key grip (or f35ide pi'nc).
There is a ``grasp'' (a pattern similar to holding a tip or a stick), and these two movements allow you to perform most of the hand-holding functions. In order to perform a movement with only one voluntary movement (for example, raising and lowering the shoulder), two types of electric stimulation pattern sequences are created and registered, and two types of voices are used to select them using a voice recognition device 4vC. This method allows users to select one motion by registering the motion.Similar voice control can be performed for both the elbow and shoulder.This method is often used repeatedly in daily life. Even in cases where fairly complex three-dimensional control is required, such as the movement of eating, for example, when the trajectory drawn by the upper limbs is approximately constant [It is possible to specify the basic stimulation pattern with a voice command and control it in a limited manner. [Claim 2] Among the patients with quadriplegia who are the subject of the present invention, the degree of paralysis is 1.
There are various individual differences in age, intelligence, etc., and there are also large differences in the voluntary biological signals that can be used. Therefore, if a voluntary biological signal is erroneously generated, or if an ambiguous command causes the device to malfunction, an arm movement that is different from the patient's will may occur. If an unintentional muscle contraction like the one in 2 is detected visually, it is necessary to immediately stop electrical stimulation to the nervous and muscular systems. In such a case i
ce, after the voice recognition device 4 judges a limited simple voice registered in advance, the command device 6 stops one operation and sends it to the stimulation waveform generator 8 without going through the processing of the multi-dimensional signal processing device 2. It can be stopped by applying an interrupt [Claim 3].

Normally, normal people have defensive reactions in their upper extremities to protect themselves from danger. This includes trying to move the danger away from the trunk by extending the upper limbs, and conversely trying to move away from the noxious stimulus to the upper limbs by flexing the upper limbs. The present invention allows the above-mentioned crisis avoidance operation to be performed by voice when a crisis is visually detected.In other words, after the voice recognition device 4 determines a limited simple voice registered in advance, A hazard avoidance command device 6 is provided which instructs a stimulation waveform generator 8 to generate a series of multi-channel stimulation patterns that cause a seed avoidance motion [Claim No. ≠].

Quadriplegic patients do not have upper limb vCU sensitivity, so even if they can move their upper limbs with electrical stimulation,
In order to control it, we must continue to carefully observe it visually. It is not desirable to completely dedicate the visual system, which is the most important information input device for the patient, for this control. This difficulty is solved by providing constant sensory feedback using an advanced sensory substitution device 5. A detailed embodiment of the device is shown in FIG. The input sl'J of this device is the pressure sensor attached to the tip of the finger and the palm of the hand.
, and one finger, elbow.

These are displacement sensors attached to each joint of the shoulder, and their signals are amplified by a transducer amplifier 10, processed by a signal processing device 11, and sent to a piezoelectric element control device 12VC, and after arithmetic processing, a control signal for the piezoelectric element is generated. to occur. The piezoelectric element array 18 is attached to the shoulder or neck where there is no sensory paralysis, and by means of a control voltage sent from the piezoelectric element control device 12, a vibration sensation is applied to the skin l# of the attachment part as a substitute sensation for the upper limbs. Range Item 5].

Stimulation electrodes are implanted subcutaneously to electrically stimulate the nervous and muscular systems. The stimulation electrodes used clinically by the applicants include Teflon-coated stainless steel wires (stranded wires with a diameter of jOμm, total diameter of approximately 0.2 mm).
Although it was ff Mikoil.

For this purpose, it is implanted near the target nerve and the entire stimulation current or stimulation voltage is applied. The contraction force can be changed depending on the stimulation amplitude and frequency. However, when stimulated continuously over a long period of time, the contractile force decreases due to electrochemical or histological changes at the interface between the electrode and living tissue, muscle fatigue, or changes in the distance between the 'it pole and the nerve. There are things to do. On the other hand, a'
1.9 The contractile force of unused muscles may gradually increase through moderate training using electrical stimulation. In order to prevent such local changes from causing large changes in the effect of muscle contraction force, a biological tissue/electrode characteristic correction device 7 is used. Basically, the muscle force and displacement of each joint during stimulation are detected by pressure attached to the upper limb and a displacement transducer, and minute changes such as movement of the stimulation electrode, muscle fatigue, and changes in nerve and muscle thresholds are detected. automatically compensates for changes.

A back signal is sent to the multi-dimensional signal processing device 2 so that the muscle strength caused by stimulation is always kept at a reference value [Claim 6].

Electrodes are implanted under the skin to electrically stimulate the nervous and muscular systems.

Although it is possible to electrically connect this to an external device by wire, there is a risk of infection, so it is desirable to transmit the signal power wirelessly through the skin. Furthermore, the number of stimulating electrodes (channels) increases as more precise control is attempted. In order to prevent coupling and mutual interference between this large number of channels, it is necessary to electrically insulate each channel. The isolation/telemeter device 8 is a device that performs this role, and connects devices inside and outside the skin using radio frequency electromagnetic waves or ultrasonic waves [Claim 7].

The inputs to the voluntary biosignal detection device 1 and voice recognition device 4 shown in FIG. 1 basically enable the quadriplegic patient to grasp objects and eat based on the grasping of the objects according to his or her will. However, when there are multiple objects in front of you, it is recommended to specify the 1% constant object by deriving the potential change of eye movement and processing the signal to determine the eye gaze point, or alternatively, as shown in Figure 2, Figure 3vc, the frontal area The irradiation position of the beam from the light beam irradiation device 14 is detected by the two-dimensional image sensor 15, and the target is designated and
The recognition device 9 performs arithmetic processing.

This object designation/recognition device t 9 vs. causes the upper limb movement control 4' to move the hand closer to the specified object with a simple movement command based on a voluntary biological signal [Claim No. g] section].

Figure 1 shows an example of controlling a paralyzed upper limb using the present invention. This figure shows the stimulation output and grasping force when the electromyogram of the trapezius muscle of the shoulder is used as a hand grasping command signal. The amplitude and frequency of the electromyogram change as the shoulder force increases and decreases, and the amplitude of the stimulation output increases and decreases accordingly, and the grip strength of the hand changes in proportion to the amplitude of the stimulation output. Therefore, it can be seen that by the present invention, paralyzed upper limb function can be easily reconstructed.

[Brief explanation of the drawing]

FIG. 1 shows the overall configuration of the present invention for functionally reconstructing a paralyzed upper limb by functional electrical stimulation. FIG. 2 explains a detailed embodiment of the sensory substitution device. FIG. 8 explains a detailed embodiment of the object designation recognition device using a light beam. Meat Table 1 Continuation of 1 second page 1 ■Applicant Nozomi Hoshimiya, 403-11 Miyanomori Jutaku, 3-10-36 Miyanomori, Chuo-ku, Sapporo Procedural amendment (voluntary) September 22, 1999 Kazuo Wakasugi, Commissioner of the Japan Patent Office /, Indication of the case Showa Jr. Patent Application No. 33;110 2, Title of the Invention Device 3 for reconstructing the paralyzed upper limb function of patients with severe quadriplegia due to upper motor nerve disorder, Relationship with the person making corrections case Patent Applicant's address: 3-7, Arigasaki, Matsumoto City, Hiro No. Hiroshi Agent address (residence) Name:
O9A. B. Subject of amendment: Specification/detailed explanation of the invention and brief explanation of the drawings. This difficulty is solved by providing constant sensory feedback using the advanced sensory substitute device 5. A detailed embodiment of this device is shown in FIG. The input section of this device consists of pressure sensors 16 attached to the tips of the fingers and the palm of the hand. and 2 fingers. These are displacement centers 17 attached to each joint of the elbow and shoulder, and their signals are amplified by the transducer amplifier 10, processed by the signal processing device 11, and sent to the piezoelectric element control device 1.
2, and after arithmetic processing, generates a control signal for the piezoelectric element. The piezoelectric element array 13 is applied to the shoulder or neck without paralysis, and a control voltage sent from the piezoelectric element control device 12 gives a vibration sensation to the skin of the applied part as a substitute sensation for the upper limbs. [Claim 5]. Stimulation electrodes are implanted subcutaneously to electrically stimulate the nervous and muscular systems. The stimulation electrode used clinically by the applicants is a coiled Teflon-coated stainless steel wire (a wire with a diameter of JOμm twisted, total diameter of about 0.2 mm). . - The irradiation position of the beam is detected by the two-dimensional image sensor 15, and the object designation/recognition device 9 performs arithmetic processing. This object designation/recognition device 9 controls the movement of the upper limbs by moving the hand closer to the designated object by a simple movement command based on a voluntary biological signal [claim g]. Figure 2 shows an example of controlling a paralyzed upper limb using the present invention. This figure shows the stimulation output and grasping force when the electromyogram of the trapezius muscle of the shoulder is used as a hand grasping command signal. The amplitude and frequency of the electromyogram change as the shoulder force increases or decreases, and the amplitude of the stimulation output increases or decreases accordingly, and the grip strength of the hand changes in proportion to the amplitude of this stimulation output. Therefore, it can be seen that according to the present invention, paralyzed upper limb function can be easily reconstructed. BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 shows the overall configuration of the present invention for functionally reconstructing a paralyzed upper limb by functional electrical stimulation. FIG. 2 explains a detailed embodiment of the sensory substitution device. FIG. 3 explains a detailed embodiment of the object designation recognition device using a light beam. Figure 1 illustrates the effect of controlling a paralyzed upper limb according to the present invention. Procedure Amendment (Method) % Formula % Indication of Z Case Showa JG Patent Application No. 33110 λ1
Title of the invention Device 3 for reconstructing the paralyzed upper limb function of patients with severe quadriplegia due to upper motor nerve disorder Relationship with the case of the person making the correction Patent applicant address Address: 3-7, Arigasaki, Matsumoto City, Hironohisa, Attorney Name (Name) Date of amendment order May 11, 1955 Subject of amendment
Figure surface °゛77 correction capacity No change in content 口ω4 sweep zero 〇 Separate recitation now - 崴吟畟 Ｇ 郎 fig. 4 car f --- and m- / second

Claims (1)

[Claims] (1) To control the paralyzed upper limb of a severely quadriplegic patient based on the patient's own will (hereinafter abbreviated as voluntary control) 1
Electromyogram of muscles with residual function. A large number of nerves involved in upper limb movement are activated by biological signals such as mechanical displacement of the shoulders and neck, eye movements and accompanying electrical activity, and brain waves (hereinafter referred to as voluntary biological signals), or by a combination of these and sound. -A device that electrically stimulates muscle groups in the required time order and with the required intensity. (2) The above-mentioned patent claim adds a function that registers a series of stimulation patterns of a plurality of nerve and muscle groups to generate upper limb movements that are frequently performed unconsciously in daily life, and can be executed using only a simple audio signal. The device according to scope 1. (8) Commands using voluntary biological signals or voice. Alternatively, the device according to claim 1 has an additional function of stopping unintended muscle contraction due to unnecessary stimulation output in case of malfunction. (4) Claim 1 adds a function to perform an emergency defensive/evasive action when an injury caused by heat or a knife occurs to the upper limb under voluntary control, or when such injury is foreseen. Apparatus described in section. (5) A patient with quadriplegia processes multiple signals obtained from pressure and displacement transducers placed on the fingers, palms, and elbows, and uses a vibration stimulation device placed on areas of normal skin sensation such as the neck and shoulders. The device according to Claim 1 of the Advance Patent Claim which adds a sensory feedback function that produces a vicarious sensation. (6) During long-term use, the characteristics of the interface between the stimulation electrode and the living tissue change, and the Even if you are tired,
2. The device according to claim 1, further comprising a function of adaptively adjusting electrical stimulation conditions so that the effect of muscle contraction force does not change. (7) A function to transmit signals and power for stimulation from outside the body through the skin to each of multiple electrodes implanted in the body to apply electrical stimulation to the nervous and muscular systems;
2. The device according to claim 1, which also has the function of electrically insulating each implanted electrode from the extracorporeal environment. (8) The device according to claim 1, which has a function of specifying a specific object from among a plurality of objects within the visual field and unconsciously moving the palm of the hand to the vicinity of the object.