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WO2018180399A1 - Vibration stimulation device - Google Patents

Vibration stimulation device Download PDF

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Publication number
WO2018180399A1
WO2018180399A1 PCT/JP2018/009386 JP2018009386W WO2018180399A1 WO 2018180399 A1 WO2018180399 A1 WO 2018180399A1 JP 2018009386 W JP2018009386 W JP 2018009386W WO 2018180399 A1 WO2018180399 A1 WO 2018180399A1
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Prior art keywords
support member
forearm
vibration
upper arm
user
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PCT/JP2018/009386
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French (fr)
Japanese (ja)
Inventor
研太郎 上杉
優人 本橋
聡史 宮島
貴光 岡山
松井　淳
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帝人ファーマ株式会社
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Publication of WO2018180399A1 publication Critical patent/WO2018180399A1/en

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H1/00—Apparatus for passive exercising; Vibrating apparatus; Chiropractic devices, e.g. body impacting devices, external devices for briefly extending or aligning unbroken bones
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H23/00—Percussion or vibration massage, e.g. using supersonic vibration; Suction-vibration massage; Massage with moving diaphragms
    • A61H23/02—Percussion or vibration massage, e.g. using supersonic vibration; Suction-vibration massage; Massage with moving diaphragms with electric or magnetic drive

Definitions

  • the present invention relates to a vibration stimulation device.
  • Spasticity is defined by Lance et al. As “movement disorders dependent on upper motor neurons that cause an increase in exercise-speed-dependent stretch reflex and accompanied by increased tendon reflexes”. Cerebrovascular disorders such as cerebral infarction and cerebral hemorrhage It is caused by spinal cord injury. When spasticity occurs, muscle tone is remarkably increased, resulting in a decrease in joint range of motion and a decrease in the skill of movement. During rehabilitation such as Activity of Daily Living (ADL) or physical therapy / occupational therapy It becomes an inhibitory factor.
  • ADL Activity of Daily Living
  • ADL Activity of Daily Living
  • physical therapy / occupational therapy It becomes an inhibitory factor.
  • a step is generally taken to relieve muscle tension caused by spasticity as much as possible before rehabilitation.
  • the reduction in the range of motion of the joint caused by the increased muscle tone due to spasticity is improved in the short term, and rehabilitation can be performed more effectively.
  • conditioning alone does not improve the long-term motor function, it is important to perform many rehabilitations such as physical therapy and occupational therapy in order to obtain a long-term improvement effect.
  • thermotherapy and electrical stimulation are performed as others.
  • all methods take time to achieve the effect.
  • the conditioning time performed by the therapist is also considered as a part of rehabilitation, and this time is also calculated as a medical fee (rehabilitation fee for cerebrovascular disease, etc.).
  • this medical treatment fee can be calculated in the medical insurance system (up to 9 units per day)
  • the time required for rehabilitation which is important for long-term improvement effects, is under pressure from conditioning. A sufficient amount is not secured.
  • vibration stimulation therapy has begun to attract attention as one of the conditioning means.
  • This therapy has been reported to have a spasticity-suppressing effect with 5 minutes of treatment, and is useful for reducing conditioning time.
  • vibration stimulation should be performed with the muscles stretched as much as possible in order to attenuate the increase in muscle tone due to the muscle contraction.
  • vibration stimulation can be given to a patient in the supine position in the elbow joint extended state.
  • the positional relationship between the spastic muscles of the forearm and the spastic muscles of the upper arm varies depending on the severity of the patient, the range of motion of the joint, the treatment limb position, and the like.
  • this device by separating the forearm stimulation device and the upper arm stimulation device and changing the positional relationship thereof, it is possible to cope with treatment of patients having various elbow joint movable ranges.
  • the device does not have a means for fixing the angle of the elbow joint, the device cannot maintain the stretched state as much as possible during the treatment, and the treatment effect may be reduced.
  • the vibration stimulating device is provided on at least one of a forearm support member that supports a user's forearm, an upper arm support member that supports the user's upper arm, and each of the forearm support member and the upper arm support member.
  • a vibration stimulating device having a vibrating body and a fixture for fixing a user's treatment part with respect to the vibrating body, the first rotating body having an axis in a short direction of the vibration stimulating device as a rotation axis;
  • a second rotator having a longitudinal axis of the vibration stimulating device as a rotation axis, between the forearm support member and the upper arm support member, wherein the first rotator and the second rotator are at an arbitrary angle.
  • the upper arm support member includes upper arm support member movable means for changing a distance from the rotation axis of the first rotary body, and the upper arm support member movable means arbitrarily connects the rotation axis of the first rotary body and the upper arm support member. It may be possible to fix at a distance of.
  • the vibrator on which the forearm support member is installed may be supported by the forearm vibrator support member, and the forearm vibrator support member may be movable in the longitudinal direction of the vibration stimulation device.
  • a third rotating body including at least one vibrating body and a hand supporting member having at least one fixture for fixing a finger and a palm to the vibrating body, wherein the axis of rotation in the short direction of the vibration stimulating device is a rotation axis; It may be provided between the forearm support member and the hand support member.
  • the forearm support member may include a forearm support member movable portion that is movable in the longitudinal direction of the vibration stimulation device.
  • a device capable of applying a vibration stimulus in a state in which a vibrating body is fixed to the forearm and the upper arm, the first rotating body capable of responding to an angle change of the patient's elbow joint to the elbow joint support portion;
  • the angle of the device can be adjusted arbitrarily according to the positional relationship between the patient's forearm spastic muscles and brachial spastic muscles. It becomes possible to hold the state during the treatment.
  • the vibration stimulating apparatus 1 is a vibration stimulator for a treatment part of a spastic patient as a means to relieve muscle over-tension (spasticity) caused by cerebrovascular disorder such as cerebral infarction or cerebral hemorrhage or spinal cord injury.
  • the vibration stimulation device 1 used to give The vibration stimulation device 1 according to the present embodiment includes a forearm support member 2 for supporting the forearm, an upper arm support member 3 for supporting the upper arm, a forearm vibrating body 4 for applying vibration to the forearm, An upper arm vibrating body 5 for applying vibration to the upper arm, a forearm fixing tool 6 for fixing the user's forearm to the forearm vibrating body, an upper arm fixing tool 7 for fixing the upper arm of the user to the upper arm vibrating body, A first rotating body 8 and a second rotating body 9 are provided.
  • a hand support member 10 for supporting the user's hand, a hand vibrating body 11 for applying vibration to the user's finger, a hand vibrating body 12 for applying vibration to the user's palm, and the hand vibration You may provide the finger fixing tool 13 which fixes a user's finger to a body, and the palm fixing tool 14 which fixes a user's palm to the said palm vibration body.
  • the vibrating body is a vibrating body using, for example, an eccentric motor or a piezoelectric element.
  • the number of forearm vibrators 4 and upper arm vibrators 5 is not limited to one, and may be two or more.
  • the number of finger vibrating bodies 11 and palm vibrating bodies 12 is not limited, and may be two or more, or vibration may be applied to fingers and palms with one vibrating body.
  • One or more forearm fixtures 6, upper arm fixtures 7, finger fixtures 13, and palm fixtures 14 are provided in the vibration stimulation device, and are used to fix each treatment portion to each vibrator. It uses rubber, hook-and-loop fasteners, belts, etc. These can be adjusted according to the size of the user's treatment area.
  • the first rotating body 8 rotates with the axis in the short direction of the apparatus as a rotation axis 15.
  • the first rotating body includes a fixing means 16.
  • the fixing means 16 is, for example, a plunger, and the rotation is fixed by inserting a pin of the plunger into a hole 17 of the first rotating body (not shown).
  • the upper arm support member includes the upper arm support member moving means 18 that slides in the longitudinal direction on the first rotating body, so that the upper arm vibrating body 5 can be adjusted to an arbitrary position in the length direction of the upper arm. is there.
  • the upper arm support member moving means 18 has a fixing means 19, whereby the vibrating body can be fixed at an adjusted position.
  • the upper arm vibrating body 5 is fixed to the upper arm fixture 7.
  • hook and loop fasteners are attached to both ends of the upper arm fixture 7, and by removing both ends of the upper arm fixture 7, it is possible to adjust the position of the upper arm vibrating body 5 in the radial direction.
  • the second rotator 9 rotates with the axis in the short direction of the apparatus as a rotation axis 20.
  • the second rotating body 9 includes a fixing means 21.
  • the fixing means 21 is, for example, a plunger or the like, and the rotation is fixed by inserting a pin of the plunger into a hole 22 of the second rotating body (not shown).
  • the forearm vibrating body 4 is fixed to the forearm vibrating body support member 24.
  • the forearm vibrating body support member 24 can be slid in the longitudinal direction on the forearm support member 2, whereby the forearm vibrating body 4 can be adjusted to an arbitrary position in the length direction of the user's forearm. is there.
  • the forearm vibrator 4 can be fixed to an arbitrary position on the forearm vibrator support member 24 with a hook-and-loop fastener or the like so that the position of the user's forearm in the radial direction can be adjusted. good.
  • the forearm support member 2 has a forearm support member movable portion 25.
  • the forearm support member movable portion 25 can adjust the length of the forearm support member 2 according to the length of the user's forearm by sliding in the longitudinal direction as shown in FIG.
  • the forearm support member movable portion 25 is provided with a fixing means 26.
  • the fixing means 26 is, for example, a plunger.
  • the hand support member 10 has a third rotating body 28 having a rotation axis 27 in the short direction of the apparatus.
  • the third rotating body 28 is provided with a fixing means 29.
  • the fixing means 29 is, for example, a plunger or the like, and the rotation is fixed by inserting a pin of the plunger into a hole 30 of the third rotating body (not shown).
  • each vibrating body 31 (the forearm vibrating body 4, the upper arm vibrating body 5, and the finger vibrating body 11) may be attached on the vibrating body pressing means 32.
  • the vibrating body pressing means 32 is for adjusting the vibration energy applied to the user by pressing the vibrating body against the user's treatment part, and is, for example, an air bag. By supplying air, the air bag expands as shown in FIG. 14, and the vibrating body can be pressed with the intended pressure.
  • FIGS. 13 and 14 A usage example of the vibration stimulation apparatus according to the present embodiment will be described with reference to FIGS.
  • the user's elbow joint is aligned with the rotary shaft 15, and the first rotating body 8 is rotated and fixed in accordance with the maximum elbow extension angle that the user can take.
  • the upper arm support member moving means 18 is moved so that the upper arm vibrating body 5 is in contact with the treatment target muscle, and the upper arm fixture 7 is attached to the upper arm of the user.
  • the forearm support member movable portion 25 is slid, and the length of the forearm support member 2 is adjusted and fixed so as to match the length of the user's forearm. Further, the position of the forearm vibrating body support member 24 is adjusted so that the forearm vibrating body 4 contacts the treatment target muscle of the user's forearm. In this state, the user's wrist joint is aligned with the rotation shaft 27, the forearm is placed on the apparatus, and the forearm is fixed by the forearm fixture 6.
  • the user's palm and fingers are fixed to the apparatus by the finger fixing tool 13 and the palm fixing tool 14, the third rotating body 28 is rotated, and the wrist is bent to the maximum wrist joint movable range that the user can take.
  • the air is supplied to the air bag 34, and vibration is started in a state where the vibrating bodies 4, 5, 11, and 12 are pressed against the user's treatment unit.
  • the user's limb during stimulation may be in the supine position as shown in FIGS. 16 and 17 or may be in the sitting position as shown in FIG.
  • the first rotating body capable of responding to the change in the angle of the user's elbow joint and the second rotating body capable of responding to the change in the extending direction of the user's elbow joint at the elbow joint support portion By effectively adjusting the angle of the device according to the positional relationship between the forearm treatment target muscle and the upper arm treatment target muscle of the user and maintaining the state during treatment, effective vibration against spasticity Stimulation therapy can be provided.

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  • Health & Medical Sciences (AREA)
  • Epidemiology (AREA)
  • Pain & Pain Management (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Rehabilitation Therapy (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Percussion Or Vibration Massage (AREA)

Abstract

Provided is a vibration stimulation device which has: a forearm support member that supports a forearm of a user; an upper arm support member that supports an upper arm of the user; vibrating bodies, at least one of which is installed in each of the forearm support member and the upper arm support member; and a fixture that fixes a portion to be treated of the user with respect to the vibrating bodies. The vibration stimulation device has, between the forearm support member and the upper arm support member, a first rotating body having a transverse axis of the vibration stimulation device as the rotation axis; and a second rotating body having a longitudinal axis of the vibration stimulation device as the rotation axis, wherein the first rotating body and the second rotating body can be fixed at arbitrary angles.

Description

振動刺激装置Vibration stimulator
　本発明は振動刺激装置に関する。 The present invention relates to a vibration stimulation device.
　痙縮とは「上位運動ニューロンの障害により運動速度依存性の伸張反射の亢進を呈し、腱反射の亢進を伴う運動障害」とＬａｎｃｅらによって定義されており、脳梗塞、脳出血などの脳血管障害や脊髄損傷等により生じる。痙縮が生じると、筋緊張が著しく亢進し、その結果、関節可動域の低下や運動の巧緻性の低下等が引き起こされ、Ａｃｔｉｖｉｔｙ　ｏｆ　Ｄａｉｌｙ　Ｌｉｖｉｎｇ（ＡＤＬ）や理学療法・作業療法等のリハビリ実施時の阻害因子になる。 Spasticity is defined by Lance et al. As “movement disorders dependent on upper motor neurons that cause an increase in exercise-speed-dependent stretch reflex and accompanied by increased tendon reflexes”. Cerebrovascular disorders such as cerebral infarction and cerebral hemorrhage It is caused by spinal cord injury. When spasticity occurs, muscle tone is remarkably increased, resulting in a decrease in joint range of motion and a decrease in the skill of movement. During rehabilitation such as Activity of Daily Living (ADL) or physical therapy / occupational therapy It becomes an inhibitory factor.
　そのような背景から、リハビリ実施前には可能な限り痙縮に起因する筋緊張を和らげるステップ（コンディショニング）が一般的にとられている。このようなステップをとることで、痙縮による筋緊張の亢進に起因する関節可動域の低下等が短期的に改善され、リハビリをより効果的に実施することが可能となる。しかし、コンディショニングのみでは長期的な運動機能の改善効果はないため、長期的な改善効果を得るためには理学療法・作業療法等のリハビリを多く実施することが重要である。 From such a background, a step (conditioning) is generally taken to relieve muscle tension caused by spasticity as much as possible before rehabilitation. By taking such steps, the reduction in the range of motion of the joint caused by the increased muscle tone due to spasticity is improved in the short term, and rehabilitation can be performed more effectively. However, since conditioning alone does not improve the long-term motor function, it is important to perform many rehabilitations such as physical therapy and occupational therapy in order to obtain a long-term improvement effect.
　コンディショニングとして最も一般的に実施されている手段はストレッチであり、その他としては温熱療法や電気刺激等が行われている。しかし、どの方法も効果の発現までに時間がかかる。現状では療法士が実施するコンディショニング時間もリハビリの一部として考えられており、この時間も診療報酬（脳血管疾患等リハビリテーション料等）として算定される。しかし、医療保険制度上、本診療報酬が算定できる時間には上限があるため（１日最大９単位）、長期的な改善効果に重要であるリハビリを実施する時間がコンディショニングにより圧迫されてしまい、十分量を確保できていない。また、平成２８年度の診療報酬規程の改定により、回復期リハビリテーション病棟においては、アウトカム評価が導入され、一定水準以上の成果をあげなければ１日６単位を超えるリハビリに関しては出来高算定できない。つまり、より効率的なリハビリが求められるようになっている。このような背景からコンディショニング時間を減らし、リハビリ実施時間を最大限確保することが重要である。 ス ト レ ッ チ Stretching is the most commonly used means for conditioning, and thermotherapy and electrical stimulation are performed as others. However, all methods take time to achieve the effect. Currently, the conditioning time performed by the therapist is also considered as a part of rehabilitation, and this time is also calculated as a medical fee (rehabilitation fee for cerebrovascular disease, etc.). However, because there is an upper limit to the time that this medical treatment fee can be calculated in the medical insurance system (up to 9 units per day), the time required for rehabilitation, which is important for long-term improvement effects, is under pressure from conditioning. A sufficient amount is not secured. In addition, due to the revision of the 2016 medical remuneration regulations, outcome evaluation has been introduced in the convalescent rehabilitation ward, and the volume of rehabilitation exceeding 6 units per day cannot be calculated unless the outcome exceeds a certain level. In other words, more efficient rehabilitation is required. Against this background, it is important to reduce the conditioning time and ensure the maximum rehabilitation time.
　近年、コンディショニング手段の１つとして、振動刺激療法が注目され始めている。当該療法は、５分の治療で痙縮抑制効果が得られると報告されており、コンディショニング時間の削減に有用である。 In recent years, vibration stimulation therapy has begun to attract attention as one of the conditioning means. This therapy has been reported to have a spasticity-suppressing effect with 5 minutes of treatment, and is useful for reducing conditioning time.
　筋に対し振動刺激を与えると、緊張性振動反射（Ｔｏｎｉｃ　Ｖｉｂｒａｔｉｏｎ　Ｒｅｆｌｅｘ：　ＴＶＲ）と呼ばれる反射が起こり、筋が収縮することが知られている。そのため、当該療法においては、この筋収縮による筋緊張の増加を減弱させるために、可能な限り筋を伸張させた状態で振動刺激を実施するのが良いと考えられている。 It is known that when a vibration stimulus is applied to a muscle, a reflex called a tonic vibration reflex (TVR) occurs and the muscle contracts. Therefore, in this therapy, it is considered that vibration stimulation should be performed with the muscles stretched as much as possible in order to attenuate the increase in muscle tone due to the muscle contraction.
　非特許文献１に開示された装置では、肘関節伸展状態で仰臥位の患者に振動刺激を与えることができる。 In the apparatus disclosed in Non-Patent Document 1, vibration stimulation can be given to a patient in the supine position in the elbow joint extended state.
　しかしながら、痙縮患者において、前腕の痙縮筋と上腕の痙縮筋の位置関係はその患者の重症度、関節可動域や治療肢位等によって変わる。当該装置では、前腕刺激用の装置と上腕刺激用の装置を分け、その位置関係を変えることによって、種々の肘関節可動域をもつ患者の治療に対応可能である。しかし、当該装置は、肘関節の角度を固定する手段を有していないため、治療中に可能な限り筋を伸張させた状態を保持できず、治療効果が減弱してしまう可能性がある。 However, in spastic patients, the positional relationship between the spastic muscles of the forearm and the spastic muscles of the upper arm varies depending on the severity of the patient, the range of motion of the joint, the treatment limb position, and the like. In this device, by separating the forearm stimulation device and the upper arm stimulation device and changing the positional relationship thereof, it is possible to cope with treatment of patients having various elbow joint movable ranges. However, since the device does not have a means for fixing the angle of the elbow joint, the device cannot maintain the stretched state as much as possible during the treatment, and the treatment effect may be reduced.
　また、肘関節角度を固定するために、前腕刺激用の装置と上腕刺激用の装置を単純に一体化させるのみでは肘関節の角度の変化と肩関節角度によって決まる肘関節の伸展方向の変化のどちらか一方にしか対応できず、対象患者が制限されてしまう。 In order to fix the elbow joint angle, simply integrating the forearm stimulation device and the upper arm stimulation device will not change the elbow joint angle change and the elbow joint extension direction change determined by the shoulder joint angle. Only one of them can be handled, and the target patient is limited.
　本発明に係る振動刺激装置は、使用者の前腕を支持する前腕支持部材と、使用者の上腕を支持する上腕支持部材と、前記前腕支持部材と前記上腕支持部材にそれぞれ少なくとも１つ設置された振動体および前記振動体に対して使用者の被施療部を固定する固定具を有する振動刺激装置であって、前記振動刺激装置の短手方向の軸を回転軸とする第一回転体と、前記振動刺激装置の長手方向の軸を回転軸とする第二回転体と、を前記前腕支持部材と前記上腕支持部材との間に備え、前記第一回転体と第二回転体は任意の角度で固定可能であるできることを特徴とする振動刺激装置である。
　前記上腕支持部材は前記第一回転体の回転軸との距離を変更する上腕支持部材可動手段を備え、前記上腕支持部材可動手段は前記第一回転体の回転軸と前記上腕支持部材とを任意の距離で固定することが可能であってもよい。
　前記前腕支持部材が設置された前記振動体は前記前腕振動体支持部材に支持され、前記前腕振動体支持部材は前記振動刺激装置の長手方向に可動であってもよい。
　少なくとも１つの振動体および手指と手掌を前記振動体に対し固定する少なくとも１つの固定具を有する手支持部材を備え、前記振動刺激装置の短手方向の軸を回転軸とする第三回転体を前記前腕支持部材と前記手支持部材との間に備えていてもよい。
　前記前腕支持部材は前記振動刺激装置の長手方向に可動である前腕支持部材可動部を備えていてもよい。 The vibration stimulating device according to the present invention is provided on at least one of a forearm support member that supports a user's forearm, an upper arm support member that supports the user's upper arm, and each of the forearm support member and the upper arm support member. A vibration stimulating device having a vibrating body and a fixture for fixing a user's treatment part with respect to the vibrating body, the first rotating body having an axis in a short direction of the vibration stimulating device as a rotation axis; A second rotator having a longitudinal axis of the vibration stimulating device as a rotation axis, between the forearm support member and the upper arm support member, wherein the first rotator and the second rotator are at an arbitrary angle. It is a vibration stimulator characterized by being fixable with.
The upper arm support member includes upper arm support member movable means for changing a distance from the rotation axis of the first rotary body, and the upper arm support member movable means arbitrarily connects the rotation axis of the first rotary body and the upper arm support member. It may be possible to fix at a distance of.
The vibrator on which the forearm support member is installed may be supported by the forearm vibrator support member, and the forearm vibrator support member may be movable in the longitudinal direction of the vibration stimulation device.
A third rotating body including at least one vibrating body and a hand supporting member having at least one fixture for fixing a finger and a palm to the vibrating body, wherein the axis of rotation in the short direction of the vibration stimulating device is a rotation axis; It may be provided between the forearm support member and the hand support member.
The forearm support member may include a forearm support member movable portion that is movable in the longitudinal direction of the vibration stimulation device.
　本発明によれば、前腕と上腕に振動体を固定した状態で振動刺激を加えることができる装置であって、肘関節支持部に患者の肘関節の角度変化に対応可能な第一回転体と患者の肘関節の伸展方向変化に対応可能な第二回転体という２つの回転体を備えることで、患者の前腕痙縮筋と上腕痙縮筋の位置関係に合わせて、装置の角度を任意に調整し、治療中にその状態を保持することが可能となる。 According to the present invention, a device capable of applying a vibration stimulus in a state in which a vibrating body is fixed to the forearm and the upper arm, the first rotating body capable of responding to an angle change of the patient's elbow joint to the elbow joint support portion; By providing two rotating bodies that can respond to changes in the extension direction of the patient's elbow joint, the angle of the device can be adjusted arbitrarily according to the positional relationship between the patient's forearm spastic muscles and brachial spastic muscles. It becomes possible to hold the state during the treatment.
本発明の振動刺激装置の概略図である。It is the schematic of the vibration stimulation apparatus of this invention. 第一回転体の側面図である。It is a side view of a 1st rotary body. 第一回転体の側面図である。It is a side view of a 1st rotary body. 上腕支持部材の位置調整後の第一回転体の側面図である。It is a side view of the 1st rotary body after position adjustment of an upper arm support member. 第二回転体の説明図である。It is explanatory drawing of a 2nd rotary body. 第二回転体の正面図である。It is a front view of a 2nd rotary body. 第二回転体の正面図である。It is a front view of a 2nd rotary body. 前腕振動体支持部材の断面図である。It is sectional drawing of a forearm vibrating body support member. 前腕支持部材可動部の側面図である。It is a side view of a forearm support member movable part. 前腕支持部材可動部の側面図である。It is a side view of a forearm support member movable part. 第三回転体の側面図である。It is a side view of a 3rd rotary body. 第三回転体の側面図である。It is a side view of a 3rd rotary body. 振動体押付手段の正面図である。It is a front view of a vibrating body pressing means. 振動体押付手段の正面図である。It is a front view of a vibrating body pressing means. 本発明の振動刺激装置の開口時の概略図である。It is the schematic at the time of opening of the vibration stimulation apparatus of this invention. 仰臥位における肘関節角度の可動域が広い使用者での振動刺激装置の装着図である。It is a wearing figure of a vibration stimulating device in a user with a wide range of motion of an elbow joint angle in a supine position. 仰臥位における肘関節角度の可動域が狭い使用者での振動刺激装置の装着図である。It is a wearing figure of a vibration stimulating device in a user with a narrow range of motion of an elbow joint angle in a supine position. 座位における振動刺激装置の装着図である。It is a wearing figure of a vibration stimulus device in a sitting position.
　以下、本発明の実施の形態に係る好ましい実施例である振動刺激装置を、添付図面を参照して説明する。 Hereinafter, a vibration stimulation apparatus which is a preferred example according to an embodiment of the present invention will be described with reference to the accompanying drawings.
［装置の説明］
　図１を用いて、本実施の形態に係る振動刺激装置の概略を説明する。本実施の形態に係る振動刺激装置１は、たとえば脳梗塞、脳出血などの脳血管障害や脊髄損傷等により生じた筋の過緊張（痙縮）を和らげる手段として、痙縮患者の被施療部に振動刺激を与えるために用いられる。
　本実施の形態に係る振動刺激装置１は、前腕を支持するための前腕支持部材２と、上腕を支持するための上腕支持部材３と、前腕に振動を付与するための前腕振動体４と、上腕に振動を付与するための上腕振動体５と、前記前腕振動体に使用者の前腕を固定する前腕固定具６と、前記上腕振動体に使用者の上腕を固定する上腕固定具７と、第一回転体８と、第二回転体９とを備える。
　また上記に加え、使用者の手を支持する手支持部材１０と、使用者の手指に振動を付与する手指振動体１１と使用者の手掌に振動を付与する手掌振動体１２と、前記手指振動体に使用者の手指を固定する手指固定具１３と、前記手掌振動体に使用者の手掌を固定する手掌固定具１４を備えても良い。 [Description of device]
The outline of the vibration stimulation apparatus according to the present embodiment will be described with reference to FIG. The vibration stimulating apparatus 1 according to the present embodiment is a vibration stimulator for a treatment part of a spastic patient as a means to relieve muscle over-tension (spasticity) caused by cerebrovascular disorder such as cerebral infarction or cerebral hemorrhage or spinal cord injury. Used to give
The vibration stimulation device 1 according to the present embodiment includes a forearm support member 2 for supporting the forearm, an upper arm support member 3 for supporting the upper arm, a forearm vibrating body 4 for applying vibration to the forearm, An upper arm vibrating body 5 for applying vibration to the upper arm, a forearm fixing tool 6 for fixing the user's forearm to the forearm vibrating body, an upper arm fixing tool 7 for fixing the upper arm of the user to the upper arm vibrating body, A first rotating body 8 and a second rotating body 9 are provided.
In addition to the above, a hand support member 10 for supporting the user's hand, a hand vibrating body 11 for applying vibration to the user's finger, a hand vibrating body 12 for applying vibration to the user's palm, and the hand vibration You may provide the finger fixing tool 13 which fixes a user's finger to a body, and the palm fixing tool 14 which fixes a user's palm to the said palm vibration body.
　本実施の形態において、振動体とは例えば偏心モーターや圧電素子を用いた振動体である。前腕振動体４と上腕振動体５の数は一つに限定されるものではなく、２つ以上であってもよい。また、手指振動体１１と手掌振動体１２の数も限定されるものではなく、２つ以上であってもよいし、一つの振動体で手指および手掌に振動を付与しても良い。 In this embodiment, the vibrating body is a vibrating body using, for example, an eccentric motor or a piezoelectric element. The number of forearm vibrators 4 and upper arm vibrators 5 is not limited to one, and may be two or more. Further, the number of finger vibrating bodies 11 and palm vibrating bodies 12 is not limited, and may be two or more, or vibration may be applied to fingers and palms with one vibrating body.
　前記前腕固定具６、上腕固定具７、手指固定具１３、手掌固定具１４は、当該振動刺激装置に一つまたは複数備えられており、各被施療部を各振動体に固定するためのものであり、ゴムや面ファスナー、ベルト等を使用している。また、これらは使用者の被施療部の大きさに合わせて調節可能になっている。 One or more forearm fixtures 6, upper arm fixtures 7, finger fixtures 13, and palm fixtures 14 are provided in the vibration stimulation device, and are used to fix each treatment portion to each vibrator. It uses rubber, hook-and-loop fasteners, belts, etc. These can be adjusted according to the size of the user's treatment area.
　図２～４に示すように第一回転体８は装置短手方向の軸を回転軸１５として回転する。また、第一回転体は固定手段１６を備えている。前記固定手段１６は例えばプランジャ等であり、図示しないがプランジャのピンが、第一回転体が有する穴１７に挿し込まれることで回転が固定される。
　また、前記上腕支持部材は第一回転体上を長手方向にスライドする上腕支持部材可動手段１８を備えることで、上腕振動体５を上腕の長さ方向の任意の位置に調整することが可能である。前記上腕支持部材可動手段１８は固定手段１９を有しており、これにより振動体を調整した位置に固定することができる。
　さらに、上腕振動体５は上腕固定具７に固定されている。図示しないが上腕固定具７の両端には面ファスナーが取り付けられており、上腕固定具７の両端を取り外すことで、上腕振動体５の上腕の径方向への位置調整を可能にしている。 As shown in FIGS. 2 to 4, the first rotating body 8 rotates with the axis in the short direction of the apparatus as a rotation axis 15. Further, the first rotating body includes a fixing means 16. The fixing means 16 is, for example, a plunger, and the rotation is fixed by inserting a pin of the plunger into a hole 17 of the first rotating body (not shown).
Further, the upper arm support member includes the upper arm support member moving means 18 that slides in the longitudinal direction on the first rotating body, so that the upper arm vibrating body 5 can be adjusted to an arbitrary position in the length direction of the upper arm. is there. The upper arm support member moving means 18 has a fixing means 19, whereby the vibrating body can be fixed at an adjusted position.
Further, the upper arm vibrating body 5 is fixed to the upper arm fixture 7. Although not shown, hook and loop fasteners are attached to both ends of the upper arm fixture 7, and by removing both ends of the upper arm fixture 7, it is possible to adjust the position of the upper arm vibrating body 5 in the radial direction.
　図５～７に示すように、第二回転体９は装置短手方向の軸を回転軸２０として回転する。また、第二回転体９は固定手段２１を備えている。前記固定手段２１は例えばプランジャ等であり、図示しないがプランジャのピンが、第二回転体が有する穴２２に挿し込まれることで回転が固定される。 As shown in FIGS. 5 to 7, the second rotator 9 rotates with the axis in the short direction of the apparatus as a rotation axis 20. Further, the second rotating body 9 includes a fixing means 21. The fixing means 21 is, for example, a plunger or the like, and the rotation is fixed by inserting a pin of the plunger into a hole 22 of the second rotating body (not shown).
　図８に示すように、前腕振動体４は前腕振動体支持部材２４に固定されている。前腕振動体支持部材２４は前腕支持部材２上を長手方向にスライドさせることが可能であり、これにより前腕振動体４を使用者の前腕の長さ方向の任意の位置に調整することが可能である。また図示しないが前腕振動体４を前腕振動体支持部材２４上の任意の位置に面ファスナー等で固定できるようにすることで、使用者の前腕の径方向への位置調整ができるようにしても良い。 As shown in FIG. 8, the forearm vibrating body 4 is fixed to the forearm vibrating body support member 24. The forearm vibrating body support member 24 can be slid in the longitudinal direction on the forearm support member 2, whereby the forearm vibrating body 4 can be adjusted to an arbitrary position in the length direction of the user's forearm. is there. Although not shown, the forearm vibrator 4 can be fixed to an arbitrary position on the forearm vibrator support member 24 with a hook-and-loop fastener or the like so that the position of the user's forearm in the radial direction can be adjusted. good.
　また、図９に示すように前腕支持部材２は前腕支持部材可動部２５を有する。前腕支持部材可動部２５は、図１０に示すように長手方向にスライドさせることで使用者の前腕の長さに合わせて前腕支持部材２の長さを調整することが可能である。さらに前腕支持部材可動部２５には固定手段２６が備えられている。固定手段２６は例えばプランジャ等である。 Further, as shown in FIG. 9, the forearm support member 2 has a forearm support member movable portion 25. The forearm support member movable portion 25 can adjust the length of the forearm support member 2 according to the length of the user's forearm by sliding in the longitudinal direction as shown in FIG. Further, the forearm support member movable portion 25 is provided with a fixing means 26. The fixing means 26 is, for example, a plunger.
　図１１～１２に示すように、前記手支持部材１０は装置の短手方向を回転軸２７とする第三回転体２８を有する。また、第三回転体２８には固定手段２９が備えられている。前記固定手段２９は例えばプランジャ等であり、図示しないがプランジャのピンが、第三回転体が有する穴３０に挿し込まれることで回転が固定される。 As shown in FIGS. 11 to 12, the hand support member 10 has a third rotating body 28 having a rotation axis 27 in the short direction of the apparatus. The third rotating body 28 is provided with a fixing means 29. The fixing means 29 is, for example, a plunger or the like, and the rotation is fixed by inserting a pin of the plunger into a hole 30 of the third rotating body (not shown).
　図１３、１４に示すように、各振動体３１（前腕振動体４、上腕振動体５、手指振動体１１）は振動体押付手段３２上に取り付けられても良い。振動体押付手段３２は使用者の施療部に振動体を押し付けることによって、使用者に付与する振動エネルギーを調整するためのものであり、例えば空気袋等である。送気することで、図１４に示すように空気袋が膨らみ、振動体を意図した圧で押し付けることができる。
［装置の使用例］
　図１５～１８を用いて、本実施の形態に係る振動刺激装置の使用例を説明する。使用者に対し前記振動刺激装置１を装着する際は、まず、図１５に示すように、開口状態である振動刺激装置の第二回転体９を使用者の肘の伸展方向に合うように回転させ、固定する。 As shown in FIGS. 13 and 14, each vibrating body 31 (the forearm vibrating body 4, the upper arm vibrating body 5, and the finger vibrating body 11) may be attached on the vibrating body pressing means 32. The vibrating body pressing means 32 is for adjusting the vibration energy applied to the user by pressing the vibrating body against the user's treatment part, and is, for example, an air bag. By supplying air, the air bag expands as shown in FIG. 14, and the vibrating body can be pressed with the intended pressure.
[Device usage example]
A usage example of the vibration stimulation apparatus according to the present embodiment will be described with reference to FIGS. When mounting the vibration stimulating apparatus 1 on the user, first, as shown in FIG. 15, the second rotating body 9 of the vibration stimulating apparatus in an open state is rotated so as to match the extension direction of the user's elbow. And fix.
　次に、回転軸１５に使用者の肘関節を合わせ、使用者がとれる最大肘伸展角度に合わせて第一回転体８を回転させ、固定する。その後、上腕支持部材可動手段１８を動かし、上腕振動体５が施療対象筋に当接するように配置し、上腕固定具７を使用者の上腕に取り付ける。 Next, the user's elbow joint is aligned with the rotary shaft 15, and the first rotating body 8 is rotated and fixed in accordance with the maximum elbow extension angle that the user can take. Thereafter, the upper arm support member moving means 18 is moved so that the upper arm vibrating body 5 is in contact with the treatment target muscle, and the upper arm fixture 7 is attached to the upper arm of the user.
　次に、前腕支持部材可動部２５をスライドさせ、使用者の前腕の長さに合うように前腕支持部材２の長さを調整し、固定する。さらに、使用者の前腕の施療対象筋に前腕振動体４が当接するように前腕振動体支持部材２４の位置を調整する。その状態において、使用者の手首関節を回転軸２７に合わせて、装置に前腕を配置し、前腕固定具６により前腕を固定する。 Next, the forearm support member movable portion 25 is slid, and the length of the forearm support member 2 is adjusted and fixed so as to match the length of the user's forearm. Further, the position of the forearm vibrating body support member 24 is adjusted so that the forearm vibrating body 4 contacts the treatment target muscle of the user's forearm. In this state, the user's wrist joint is aligned with the rotation shaft 27, the forearm is placed on the apparatus, and the forearm is fixed by the forearm fixture 6.
　次に、使用者の手掌および手指を手指固定具１３、手掌固定具１４により、装置に固定し、第三回転体２８を回転させ、使用者がとれる最大手首関節可動域まで手首を屈曲させる。 Next, the user's palm and fingers are fixed to the apparatus by the finger fixing tool 13 and the palm fixing tool 14, the third rotating body 28 is rotated, and the wrist is bent to the maximum wrist joint movable range that the user can take.
　最後に、空気袋３４に送気し、各振動体４、５、１１、１２を使用者の施療部に押し付けた状態で振動を開始する。刺激に際する使用者の肢位は図１６、１７に示すような仰臥位でも良いし、図１８に示すように座位でも良い。 Finally, the air is supplied to the air bag 34, and vibration is started in a state where the vibrating bodies 4, 5, 11, and 12 are pressed against the user's treatment unit. The user's limb during stimulation may be in the supine position as shown in FIGS. 16 and 17 or may be in the sitting position as shown in FIG.
　本手法によれば、肘関節支持部に使用者の肘関節の角度変化に対応可能な第一回転体と使用者の肘関節の伸展方向変化に対応可能な第二回転体という２つの回転体を備えることにより、使用者の前腕施療対象筋と上腕施療対象筋の位置関係に合わせて、装置の角度を任意に調整し、治療中にその状態を保持することで、痙縮に対する効果的な振動刺激療法を提供することが可能となる。 According to this method, the first rotating body capable of responding to the change in the angle of the user's elbow joint and the second rotating body capable of responding to the change in the extending direction of the user's elbow joint at the elbow joint support portion. By effectively adjusting the angle of the device according to the positional relationship between the forearm treatment target muscle and the upper arm treatment target muscle of the user and maintaining the state during treatment, effective vibration against spasticity Stimulation therapy can be provided.
　１　　振動刺激装置
　２　　前腕支持部材
　３　　上腕支持部材
　４、５、１１、１２、３１　振動体
　６、７、１３、１４　固定具
　８　　第一回転体
　９　　第二回転体
　１０　手支持部材
　１６、１９、２１、２６、２９　固定手段
　１８　上腕支持部材可動手段
　２３　第二回転体支持部材
　２４　前腕振動体支持部材
　２５　前腕支持部材可動部
　２８　第三回転体 DESCRIPTION OF SYMBOLS 1 Vibration stimulator 2 Forearm support member 3 Upper arm support member 4, 5, 11, 12, 31 Vibrator 6, 7, 13, 14 Fixing tool 8 1st rotary body 9 2nd rotary body 10 Hand support member 16, 19, 21, 26, 29 Fixing means 18 Upper arm supporting member moving means 23 Second rotating body supporting member 24 Forearm vibrating body supporting member 25 Forearm supporting member moving part 28 Third rotating body

Claims (5)

  1. 　使用者の前腕を支持する前腕支持部材と、使用者の上腕を支持する上腕支持部材と、前記前腕支持部材と前記上腕支持部材にそれぞれ少なくとも１つ設置された振動体および前記振動体に対して使用者の被施療部を固定する固定具を有する振動刺激装置であって、前記振動刺激装置の短手方向の軸を回転軸とする第一回転体と、前記振動刺激装置の長手方向の軸を回転軸とする第二回転体と、を前記前腕支持部材と前記上腕支持部材との間に備え、前記第一回転体と第二回転体は任意の角度で固定可能である振動刺激装置。 A forearm support member that supports a user's forearm, an upper arm support member that supports a user's upper arm, and at least one for each of the forearm support member and the upper arm support member. A vibration stimulating apparatus having a fixture for fixing a user's treatment part, wherein the first rotating body has a rotational axis as a short axis of the vibration stimulating apparatus, and a longitudinal axis of the vibration stimulating apparatus. A vibration stimulating device comprising: a second rotating body having a rotation axis as a rotation axis between the forearm supporting member and the upper arm supporting member, wherein the first rotating body and the second rotating body can be fixed at an arbitrary angle.
  2. 　前記上腕支持部材は前記第一回転体の回転軸との距離を変更する上腕支持部材可動手段を備え、前記上腕支持部材可動手段は前記第一回転体の回転軸と前記上腕支持部材とを任意の距離で固定することが可能である請求項１に記載の振動刺激装置。 The upper arm support member includes upper arm support member movable means for changing a distance from the rotation axis of the first rotary body, and the upper arm support member movable means arbitrarily connects the rotation axis of the first rotary body and the upper arm support member. The vibration stimulating apparatus according to claim 1, wherein the vibration stimulating apparatus can be fixed at a distance between
  3. 　前記前腕支持部材が設置された前記振動体は前記前腕振動体支持部材に支持され、前記前腕振動体支持部材は前記振動刺激装置の長手方向に可動である請求項１から２のいずれかに記載の振動刺激装置。 3. The vibration body on which the forearm support member is installed is supported by the forearm vibration body support member, and the forearm vibration body support member is movable in a longitudinal direction of the vibration stimulation device. Vibration stimulator.
  4. 　少なくとも１つの振動体および手指と手掌を前記振動体に対し固定する少なくとも１つの固定具を有する手支持部材を備え、前記振動刺激装置の短手方向の軸を回転軸とする第三回転体を前記前腕支持部材と前記手支持部材との間に備える請求項１から３のいずれかに記載の振動刺激装置。 A third rotating body including at least one vibrating body and a hand supporting member having at least one fixture for fixing a finger and a palm to the vibrating body, wherein the axis of rotation in the short direction of the vibration stimulating device is a rotation axis; The vibration stimulation apparatus according to claim 1, which is provided between the forearm support member and the hand support member.
  5. 　前記前腕支持部材は前記振動刺激装置の長手方向に可動である前腕支持部材可動部を備える請求項１から４のいずれかに記載の振動刺激装置。 The vibration stimulation device according to any one of claims 1 to 4, wherein the forearm support member includes a forearm support member movable portion movable in a longitudinal direction of the vibration stimulation device.
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