CN103735270B - Following through leading network pilot feedback rehabilitation training system of upper limb development of potential training - Google Patents
Following through leading network pilot feedback rehabilitation training system of upper limb development of potential training Download PDFInfo
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Abstract
What upper limb development of potential was trained follows through leading network pilot feedback rehabilitation training system, belong to upper extremity function rehabilitation equipment field, it is characterized in that, that a kind of traditional Chinese medical science guiding art is conducted in conjunction with meridians, carry out nervus centralis development of potential, the computer man-machine dialog mode system of upper extremity exercise reconstruction, setting agonist signal curve simulation absolute altitude, the signal sequence grown from weak to strong is formed by motor program, under the Six Steps Chinese medicine meridian guiding training guidance of sound with image, dredging the meridian, QI and blood regulating, the state of saving up strength to start out before making it in development of potential.Computer calculates Angle of Elbow Joint under limbs different motion position of normal person and patient and the bioelectric current curve post discrepancy in elevation automatically, and what enable to shoot the arrow at the target carries out the training such as motor program reconstruction, thus improves the effect for the treatment of.
Description
Technical field
The invention belongs to and follow through leading network pilot feedback rehabilitation training system technical field.
Background technology
Central nervous system (Centralnervoussystem, CNS) plasticity mainly passes through functional training, excavate the normal cell around damage zone in CNS system, substitute damage zone cell by the mode of function integrity, recover the motor function of limbs.Relatively thick, simple limb action, the negligible amounts of required motor neuron, on the contrary meticulousr, action is more complicated, the quantity of arranging the motor neuron needed for this motion is then more, thus the recovery of stroke hemiplegin patient upper extremity function comparatively lower limb recover slow.Neural instruction and guide upper limb development of potential training; the upper extremity exercise function of old hemiplegic patient can be improved preferably; upper limb development of potential training under Six Steps traditional Chinese medical science guiding art guides; system excavates neural potential by building safe " crisis state ", improves the motor function in all joints of stroke hemiplegin patient's upper limb.The equipment that existing training patient upper limb uses, the passive exercise mainly with upper limb is main, lacks the active exercise of patient, therefore effectively can not develop brain potential.Therefore, the upper limb trainer material of hemiplegic patient's application, in fact can not make the exploitation CNS potential that patient is real.Up to the present, there is not yet the report with similar upper limb development of potential exercise equipment training patient upper extremity function both at home and abroad.
Summary of the invention:
Object of the present invention, is that network pilot feedback rehabilitation training system led by the network that follows providing a kind of upper limb development of potential.
Feature of the present invention, then a kind of " people-machine " dialog mode, under remedial gymnast instructs based on Six Steps traditional Chinese medical science guidance method, by the active exercise of patient's upper limb carry out the exploitation of Ipsilateral potential function of sport, follow through leading network pilot feedback rehabilitation training instrument.This instrument for training trains screen, sensor and upper extremity exercise development of potential exercise equipment to form by computer, dual image display type, wherein:
Computer:
Be provided with: CCD photographic head, export the input port of the articular dyskinesia image of the suffered training of the ill upper limb of patient.
The electrode that the ill upper limb suffered training joint of patient connects exports, and reflects the bioelectric current input port of ill upper limb by training articular dyskinesia.
Also be provided with:
Sound with image dubs explanation module: the module of relation between meridians conducting system and extremity motor function, is called for short human potential and develops promotion module.
Upper limb healing treatment module: contain: the waveform of all joints bioelectric current of being trained during human upper limb proper motion and elevation ruler thereof, and grow from weak to strong according to joint motions, be organized into successively and indicate correspondence position by the training bioelectric current amplitude in joint and the sequence of meansigma methods, and during human upper limb proper motion, by the flexion angle under the training moving image in joint and joint motions to diverse location, wherein at least comprise: close to 0 °, 90 °, 180 ° three critical angle, 0 ° of <90 ° of <180 °.
Music background selects module: under remedial gymnast instructs, by patient from main separation.
Memory module: store patient personal information, and rehabilitation training project, title, degree and the progress of carrying out in the past.
Image driver module: on described dual image display type training screen, showing normal person respectively when carrying out upper limb flexing, unbending movement, being furnished with the bioelectric current waveform of absolute altitude, and the joint at corresponding upper extremity exercise position stretch angle in the wrong.
Control module: be a Vista software administration platform, according to " people---machine " conversational mode, make patient under remedial gymnast instructs, carry out the rehabilitation training of all joint parts of ipsilateral upper limb, step is as follows:
Step (1): remedial gymnast inputs personal patient information, and described historical data of in the past carrying out rehabilitation project,
Step (2): remedial gymnast judges whether patient has contraindication, if do not have, then input signal (1).Otherwise input signal " 0 ", deconditioning,
Step (3): remedial gymnast judges the fitness of patient to training.If patient has carried out standing bed training, and have 90 ° of positions and stand 30 minutes, blood pressure, breathing, pulse vital sign still belong to when recording normally, then patient can adaptive training, input signal " 1 ", otherwise input signal " 0 " deconditioning,
Step (4): system initialization.At the juxtra-articular of patient's ill upper limb, bioelectrode is installed, and the bioelectric current under kinestate is inputted described computer, or CCD photographic head, be arranged on described upper extremity exercise development of potential exercise equipment, can photograph on the position of the ill upper limb of patient by training joint motions image.Remedial gymnast is according to exercise prescription, and described upper extremity exercise development of potential training devices hangs setting, and weight is equivalent to the sandbag of loss of weight amount,
Step (5): remedial gymnast starts described computer, transfer described human potential and develop promotion module, and on described dual image display type training screen, the movement relation image between the meridians conducting system of display sound with image and extremity motor function, development of potential consciousness is set up for patient
Step (6): patient dresses suspender belt, suffer from hands and wear hand expansion board, trunk is push up position, both legs are kneeled on the foam-rubber cushion of base, its position, with the vertical line that patient's both hands can be made just to be positioned at support frame top middle portion loss of weight pulley, is connected the hook of suspender belt with loss of weight position
Step (7): click step successively and train:
Step (7.1): prop up training.Patient, in elbow joint is in flexing position, slowly props up, until when elbow joint stretches ° position, angle >=90 in the wrong only, now:
If the elbow joint motion obstacle image of the ill upper limb of patient of CCD photographic head input, then by described image driver module, described dual image is presented on training screen, the motive position of the ill upper limb elbow joint of display patient, along with the motion of elbow joint, the motive position of the ill upper limb of display patient in real time, until when remedial gymnast applies the resistance of motion, till when the ipsilateral upper limb of patient reaches limit of sports record, go to step 7.2
If via the bioelectric current waveform that the bioelectrode that the ill upper limb of patient connects exports, then by described image display motion module, on described dual image display type training screen, demonstrate the ill upper limb of patient and be in the different bioelectric current waveform stretched under elbow angle at elbow joint, go to step 7.2
Step (7.2): support falls training: from the elbow joint of patient's upper limb, be in and stretch position and start, slowly support falls, until when elbow joint is in flexing position only, repeated execution of steps 7.1,
Step (7.3): computer by normal person and patient on upper extremity exercise image not coordination show real-time angular difference or the bioelectric current real-time difference on absolute altitude of stretching elbow angle, be input in corresponding training effect's data set respectively,
Described computer according to the following steps, calculates patient's ipsilateral upper limb and normal person's homonymy upper limb elbow joint, is in the angle of the real-time elbow joint angle under different motion position.
1st step: computer control CCD photographic head, absorbs the elbow joint motion sequence of patient's ipsilateral upper limb and the normal person's homonymy upper limb started from same motion starting point with identical frequency acquisition, till arriving exercise end separately,
2nd step: on two images of same sampling instant, use Canny edge-finding software, detect the point that in upper extremity exercise image and background image juncture area, pixel is undergone mutation respectively, obtain two sections of different upper limb inner profile curves, cover part elbow, all elbow joint and part upper arm
3rd step: get a bit at arm segment and each of elbows, go in the same direction to shoulder elbow joint direction, obtain the point that Curvature varying is maximum, be the flex point on inner profile curve.Again dorsad oppositely going of elbow joint direction, find Curvature varying to start constant point, as the outer point of contact of inner profile curve, obtain the flex point of two different motion images and outer point of contact,
4th step: along respective two articles of outer point of contacts of two different motion images, make the outer tangent line of respective inner profile curve, the angle of two described outer tangent lines, be two described inner profile curves angle separately,
5th step: often opening on moving image, takes up an official post in any tangent line and gets a bit, make vertical line to another tangent line, make the intersection point of the starting point of intersection point, vertical line and two tangent lines form a right angled triangle, obtain the value of two tangent line angles,
6th step: obtain on normal person's moving image, on the angle of inner profile curve and movement of patient image, the difference of the angle of described inner profile curve, is effect data,
7th step: obtain on every two different motion images, the difference of two inner outline angles, composition effect data group stores,
Step (7.4): computer judges whether to reach each training 20-30 minute, train the time requirement of 2 times every day, and be for 60 times the setting value of a course for the treatment of, if do not reach, repeat step (7.1)-step (7.3), until meet training time and the course for the treatment of of setting, go to step (8); Directly go to step (8) if reached,
Step (8): remedial gymnast, in step (7.4), sends interrupt instruction after last rehabilitation training, according to the result that step (7.3) obtains, determines next step rehabilitation goal, performs off-line rehabilitation training,
Step (9): repeated execution of steps (7)-step (8), until patients ' recovery.
The invention solves the problem of the upper extremity exercise development of potential training of the still unsolved computer-aided control of earlier application patent.
Attached with illustrating:
Fig. 1. upper extremity exercise development of potential training devices structure chart;
Fig. 2. system block diagram of the present invention;
Fig. 3. program flow chart of the present invention;
Fig. 4. the calculating schematic diagram of inner profile curve angle α.
A. inner outline;
61.62. outer tangent line;
7. flex point;
81.82. point of contact.
Detailed description of the invention:
Upper extremity exercise development of potential exercise equipment, is the active exercise formula exercise equipment of stroke hemiplegin patient upper extremity function rehabilitation, comprises: pulley loss of weight parts 1, frame support member 2, suspender belt fixed part 3, loss of weight parts 4 and base member 5, wherein:
Base member 5 is double-layer frames of a tube bending, and upper strata framework is provided with the place mat part that the both legs when trunk is push up position are squatted,
Support frame parts 2 is one and described base member 5, wide and be vertically fixed on the length direction of the framework left and right sides, described base member 5 upper strata, in " door " font by first, second two-layer framework 21, the double-layer frame of 22 compositions, be connected with many ribs at two " door " font tops of described double-layer frame
Pulley loss of weight parts 1 are respectively by a support bar by two, be welded on described frame support member (2) first or/and the top middle portion of second layer framework 21,22 and side, the first pulley 11, second pulley 12 on totally two ribs, and embed groove that described pulley 11,12 circumferencial direction opens, the steel wire rope wrapped in plastic tube forms jointly.
Suspender belt fixed part 3 is a kind of vest type device for fastening suspenders, is worn on the chest of patient, and top is linked up with the steel cord ends on described first pulley 11 and is connected.
Loss of weight parts 4 are sandbags, link up be connected with the steel cord ends of described second pulley 12 side.
Rehabilitation training is carried out in patient's upper limb of the present invention active exercise, the brain potential of patient can be developed veritably, be conducive to the recovery of non-damaging cells in central nervous system, and impel the normal cell around damage zone to play a role the function of alternative damaging cells, improve training effectiveness and effect.
Training step is as follows:
1. prepare before training: if patient has carried out standing bed training, and there are 90 ° of positions stand 30 minutes, when the vital signs such as blood pressure, breathing, pulse still record normally, this training can be carried out.Dress suspender belt, suffer from hands and wear hand expansion board, trunk is push up position, and both legs are kneeled on the foam rubber cushion of base, and its position can make patient's both hands, is just positioned on the vertical of support frame top middle portion loss of weight pulley, with shoulder with wide.The hook of suspender belt with pulley loss of weight system is connected.Therapist is positioned at the suffering limb side of patient, and hang the sandbag of required loss of weight amount according to exercise prescription, remedial gymnast also can hold handle, passes through the amount of the size adjustment loss of weight of auxiliary dynamics according to the practical situation of patient.
2, train: comprise and prop up and support two kinds and train.
Prop up training: patient is in elbow joint flexing position, and note body centre being shifted to paralysis side.Instruct the dark air-breathing of patient and slowly breathe out, darker air-breathing of concentrating one's energy is held the breath, be primarily focused on the triceps brachii of paralysis side, while slowly propping up, know from experience the sensation that triceps brachii shrinks.Patient suitably assisted by remedial gymnast when can not oneself prop up, when stretching elbow angle more than 90 °, remedial gymnast according to circumstances suitably reduces auxiliary dynamics, and builds critical atmosphere by speeches such as " prop up otherwise fallen; adhere to otherwise touched ", encourages patient to do the best and oneself props up.When Ipsilateral elbow joint be positioned at stretch 0-5 ° time, encourage patient to adhere to 6 seconds.
Support falls to training: bilateral elbow joint is in and stretches a 0-5 °, center of gravity is shifted to paralysis side upper limb, guide the dark air-breathing of patient's row, slow expiration adjustment, the suction time of exhaling is 1/2 than probably, and the capable support of Mental imagery elbow joint falls to moving, and assembles whole body energy in brain, speech guides the support of patient's upper limb to fall, and holds the breath and knows from experience the sensation of triceps brachii contraction.According to circumstances can carry out suitable auxiliary elbow joint to stretch or increase resistance suitable above Ipsilateral, and with " refuel, prop up; otherwise to have fallen, adhere to, prop up; otherwise touched " etc. speech build crisis atmosphere, when Ipsilateral elbow joint is positioned at 90 °, flexing position, encourage patient to adhere to 6 seconds.
3. each 20 minutes of training time, be for 30 times a course for the treatment of, after a course for the treatment of terminates, re-start assessment, determine the treatment whether carrying out next course for the treatment of.
Indication: this device be applicable to central nervous system unify stable disease after osteoarticular injury acute stage and chronic phase hemiplegia, cerebral palsy, the patient such as cerebral palsy of children, not exclusively paraplegia, peripheral nerve injury and articular muscle dysfunction the training of upper extremity exercise functional rehabilitation, be still applicable to the patient that can not improve upper extremity function through the treatment of Traditional Rehabilitation method further.
Contraindication: 1. cardiovascular stress response ability, has severe cardiac, lung, liver and renal insufficiency, and serious infections, fracture, dyscrasia etc. can not carry out rehabilitation training persons; 2. the fixing rear unstable person of elbow fracture; 3. ipsilateral upper limb shoulder joint, elbow joint, wrist fracture do not heal.
Points for attention: incremental series training need be carried out, and should be noted protection, prevent elbow joint, carpal joint from damaging.
Claims (1)
1. what upper extremity exercise development of potential was trained follows through leading network pilot feedback rehabilitation training system, it is characterized in that, a kind of " people-machine " dialog mode, under remedial gymnast instructs based on Six Steps traditional Chinese medical science guidance method, to be carried out the exploitation of Ipsilateral potential function of sport by the active exercise of patient's upper limb follow through leading network pilot feedback rehabilitation training instrument, screen, sensor and upper extremity exercise development of potential exercise equipment is trained to form by computer, dual image display type, wherein:
Computer:
Be provided with: the ill upper limb of patient that CCD photographic head exports is subject to the input port of training articular dyskinesia image,
The electrode of the connection at the ill upper limb elbow joint place of patient exports, and reflects the dyskinetic by training joint bioelectric current input port of ill upper limb,
Also be provided with:
The module of dubbing the relation between explanation meridians conducting system and extremity motor function of sound with image, is called for short human potential and develops promotion module,
Upper limb healing treatment module: the waveform containing all joints bioelectric current of being trained during human upper limb proper motion and elevation ruler thereof, and grow from weak to strong according to joint motions, be organized into successively and indicate correspondence position by the training bioelectric current amplitude in joint and the sequence of meansigma methods, and during human upper limb proper motion, by the flexion angle under the training moving image in joint and joint motions to diverse location, wherein at least comprise: close to 0 °, 90 °, 180 ° three critical angle, 0 ° of <90 ° of <180 °
Music background selects module: under remedial gymnast instructs, by patient from main separation,
Memory module: store patient personal information, and rehabilitation training project, title, degree and the progress of carrying out in the past,
Image driver module: on described dual image display type training screen, showing normal person respectively when carrying out upper limb flexing, unbending movement, being furnished with the bioelectric current waveform of absolute altitude, and the joint at corresponding upper extremity exercise position stretch angle in the wrong,
Control module: be a Vista software administration platform, according to " people-machine " conversational mode, make patient under remedial gymnast instructs, carry out the rehabilitation training of all joint parts of ipsilateral upper limb, step is as follows:
Step (1): remedial gymnast inputs personal patient information, and carried out the historical data of rehabilitation training project in the past,
Step (2): remedial gymnast judges whether patient has contraindication, if do not have, then input signal " 1 ", otherwise input signal " 0 ", deconditioning,
Step (3): remedial gymnast judges the fitness of patient to training; If patient has carried out standing bed training, and have 90 ° of positions and stand 30 minutes, blood pressure, breathing, pulse vital sign still belong to when recording normally, then patient can adaptive training, input signal " 1 ", otherwise input signal " 0 " deconditioning,
Step (4): system initialization; At the juxtra-articular of patient's ill upper limb, bioelectrode is installed, and the bioelectric current under kinestate is inputted described computer, or CCD photographic head, be arranged on described upper extremity exercise development of potential exercise equipment, can photograph on the position of the ill upper limb of patient by training joint motions image; Remedial gymnast, according to exercise prescription, described upper extremity exercise development of potential exercise equipment hangs the sandbag that setting weight is equivalent to loss of weight amount,
Step (5): remedial gymnast starts described computer, transfer described human potential and develop promotion module, and on described dual image display type training screen, the movement relation image between the meridians conducting system of display sound with image and extremity motor function, development of potential consciousness is set up for patient
Step (6): patient dresses suspender belt, suffer from hands and wear hand expansion board, trunk is push up position, and both legs are kneeled on the foam-rubber cushion of base, its position, with the vertical line that patient's both hands can be made just to be positioned at support frame top middle portion loss of weight pulley, is connected the hook of suspender belt with loss of weight position;
Step (7): train according to the following steps successively:
Step (7.1): prop up training; Patient, in elbow joint is in flexing position, slowly props up, until when elbow joint stretches ° position, angle >=90 in the wrong only, now:
If the elbow joint motion obstacle image of the ill upper limb of patient of CCD photographic head input, then by described image driver module, will on described dual image display training screen, the motive position of the ill upper limb elbow joint of display patient, along with the motion of elbow joint, the motive position of the ill upper limb of display patient in real time, until when remedial gymnast applies the resistance of motion, till when the ipsilateral upper limb of patient reaches limit of sports record, go to step (7.2)
If via the bioelectric current waveform that the bioelectrode that the ill upper limb of patient connects exports, then by described image driver module, on described dual image display type training screen, demonstrate the ill upper limb of patient and be in the different bioelectric current waveform stretched under elbow angle at elbow joint, go to step (7.2)
Step (7.2): support falls training: from the elbow joint of patient's upper limb, be in and stretch position and start, slowly support falls, until when elbow joint is in flexing position only, repeated execution of steps (7.1),
Step (7.3): computer by normal person and patient on upper extremity exercise image not coordination show real-time angular difference or the bioelectric current real-time difference on absolute altitude of stretching elbow angle, be input in corresponding training effect's data set respectively,
Described computer according to the following steps, calculates patient's ipsilateral upper limb and normal person's homonymy upper limb elbow joint, is in the angle of the real-time elbow joint angle under different motion position,
1st step: computer control CCD photographic head, absorbs the elbow joint motion sequence of patient's ipsilateral upper limb and the normal person's homonymy upper limb started from same motion starting point with identical frequency acquisition, till arriving exercise end separately,
2nd step: on two images of same sampling instant, use Canny edge-finding software, detect the point that in upper extremity exercise image and background image juncture area, pixel is undergone mutation respectively, obtain two sections of different upper limb inner profile curves, cover part elbow, all elbow joint and part upper arm
3rd step: get a bit at arm segment and each of elbows, go in the same direction to shoulder elbow joint direction, obtain the point that Curvature varying is maximum, be the flex point on inner profile curve; Again dorsad oppositely going of elbow joint direction, find Curvature varying to start constant point, as the outer point of contact of inner profile curve, obtain the flex point of two different motion images and outer point of contact,
4th step: along respective two articles of outer point of contacts of two different motion images, make the outer tangent line of respective inner profile curve, the angle of two described outer tangent lines, be two described inner profile curves angle separately,
5th step: often opening on moving image, takes up an official post in any tangent line and gets a bit, make vertical line to another tangent line; Make the intersection point of the starting point of intersection point, vertical line and two tangent lines form a right angled triangle, obtain the value of two tangent line angles,
6th step: obtain on normal person's moving image, on the angle of inner profile curve and movement of patient image, the difference of the angle of described inner profile curve, is effect data,
7th step: obtain on every two different motion images, the difference of two inner outline angles, composition effect data group stores,
Step (7.4): computer judges whether to reach and is trained for 20-30 minute at every turn, train the time requirement of 2 times every day, it is for 60 times the setting value of a course for the treatment of, if do not reach, repeat step (7.1)-step (7.3), until meet training time and the course for the treatment of of setting, go to step (8); Directly go to step (8) if reached,
Step (8): remedial gymnast, in step (7.4), sends interrupt instruction after last rehabilitation training, according to the result that step (7.3) obtains, determines next step rehabilitation goal, performs off-line rehabilitation training;
Step (9): repeated execution of steps (7)-step (8), until patients ' recovery.
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