JP2012029787A - Thrombosis preventing device - Google Patents

Thrombosis preventing device Download PDF

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JP2012029787A
JP2012029787A JP2010170680A JP2010170680A JP2012029787A JP 2012029787 A JP2012029787 A JP 2012029787A JP 2010170680 A JP2010170680 A JP 2010170680A JP 2010170680 A JP2010170680 A JP 2010170680A JP 2012029787 A JP2012029787 A JP 2012029787A
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support plate
thrombosis
foot
motor
swing
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JP5598756B2 (en
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Kazuo Ishii
和男 石井
Ali Forough Nassiraei Amir
アリ フォロー ナシライ アミル
Takashi Sonoda
隆 園田
Yuya Nishida
祐也 西田
Koji Okamoto
好司 岡本
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Kyushu Institute of Technology NUC
University of Occupational and Environmental Health Japan
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Kyushu Institute of Technology NUC
University of Occupational and Environmental Health Japan
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Abstract

PROBLEM TO BE SOLVED: To provide a thrombosis preventing device which is configured to be smaller and easily mounted, and assists the lower limb motion of a passenger sitting on a seat in an airplane of a long distance route or the like or a patient under surgery or after surgery, and in which the pump function by a self physiological muscle is used, and the blood flow of a deep part vein is made to increase, and the thrombus is prevented.SOLUTION: The thrombosis preventing device includes: a body 1 which has a body support section 2; an oscillating body 4 which is rotatably supported by a rotary shaft 3 to the body support section 2 and is equipped with a sole support plate 6; and a rocking mechanism 5 which is prepared at the body 1, and in which the one end thereof is connected with the oscillating body 4, and which makes the sole support plate 6 rock. When the toe is laid on the sole support plate 6, the oscillating body 4 is made to rock, thereby the dorsiflexion and extension motion can be carried out centering the ankle of a foot joint.

Description

本発明は、下肢運動を補助して、静脈の血流を増加させ、血栓を予防することができる血栓症予防装置に関する。   The present invention relates to a thrombosis-preventing device capable of assisting lower limb movement, increasing venous blood flow, and preventing thrombus.

一般の方でも耳にする機会の増えたエコノミークラス・シンドローム/深部静脈血栓症(DVT)という病気は、長距離路線の飛行機内で長時間動かないでいると血液の循環が悪くなり、下肢で血液が凝固し、凝固した血栓が肺に飛んで肺梗塞を発症し、意識を失ったり、最悪の場合は死亡する病であり、誰にも起こりうる病態である。大学病院などの医療現場では、外科、整形外科、泌尿器科、産婦人科、救急領域など様々な診療科で手術中、手術後にこのような病態を経験する。血栓症は欧米で多くみられる疾患であったが、現在、日本は近来稀に見る高齢化社会に突入しており、さらに食の欧米化により日本においても血管障害、血栓症の発症頻度が増加してきている。米国でのDVT発生は年間200万人、肺血栓塞栓症は年間60万人、その内10%が死亡との報告がなされているように、周術期の危険な疾患である。   Economy class syndrome / deep venous thrombosis (DVT), which has increased the chances of being heard even by the general public, has a poor blood circulation when it is not moving for a long time on an airplane on a long-haul route. Blood clots, clots that clot fly to the lungs and develop pulmonary infarction, which is a disease that can cause loss of consciousness or death in the worst case. In medical settings such as university hospitals, patients experience such pathological conditions during and after surgery in various departments such as surgery, orthopedics, urology, obstetrics and gynecology, and emergency areas. Although thrombosis is a common disease in the West, Japan is now entering an aging society that is rarely seen in the world, and the incidence of vascular disorders and thrombosis is increasing in Japan due to the westernization of food. Have been doing. DVT in the United States is a perioperative dangerous disease, as 2 million people are diagnosed annually and pulmonary thromboembolism is reported to be 600,000 people a year, 10% of which are reported dead.

血栓症の予防のために、弾性ストッキングを用いて下肢の浅在静脈の血管床面積を減少させ、相対的に深部静脈の血流量をあげるといった方法が行われている。また、下肢に巻いたカフに空気を送り込み、膨らませることにより下肢や足底の圧迫を行い、血流を改善させて静脈還流量を増加させる方法もとられている。   In order to prevent thrombosis, a method of reducing the blood vessel bed area of the superficial vein of the lower limb using an elastic stocking and relatively increasing the blood flow volume of the deep vein has been performed. In addition, there is a method in which air is sent to a cuff wound around a lower limb and inflated to compress the lower limb and the sole of the foot to improve blood flow and increase venous return.

図6は、下肢に巻いたカフに空気を送り込み、膨らませることのできる従来公知の空気圧マッサージ器具を例示する図である(特許文献1参照)。例示の空気圧マッサージ器具は、全体が長靴形状に形成され、左右夫々の脚に装着する一対のカフを有している。カフは、足先から足踵を経て脛及びふくらはぎを包囲すると共に、足首の曲がり具合に対応して途中で折曲した形状を有し、ブーツを履くように装着するようにしたものである。ファスナーを引き下げることによって脚挿入口を開放することができ、また、ファスナーを引き上げることによって脛及びふくらはぎを脚挿入口で包囲する。   FIG. 6 is a diagram exemplifying a conventionally known pneumatic massage device that can send air into a cuff wound around a lower limb and inflate it (see Patent Document 1). The illustrated pneumatic massage device is formed in the shape of a boot and has a pair of cuffs attached to the left and right legs. The cuff surrounds the shin and calf through the toes from the toes, and has a shape that is bent in the middle corresponding to the bending state of the ankle, and is worn so as to wear boots. The leg insertion opening can be opened by pulling down the fastener, and the shin and calf are surrounded by the leg insertion opening by pulling up the fastener.

夫々のカフには2個ずつエアー注入口が取り付けられている。カフを両脚に装着した後、各エアー注入口にホース(図示省略)を接続する。このホースは、エアーポンプ(図示省略)に接続されている。このエアーポンプによって、各カフの内部に空気を導入したり排出を行うことによって、空気の減圧と加圧との繰り返しにより脚のマッサージを行うことができる。   Two air inlets are attached to each cuff. After attaching the cuff to both legs, a hose (not shown) is connected to each air inlet. This hose is connected to an air pump (not shown). By introducing and discharging air into each cuff with this air pump, the legs can be massaged by repeating the decompression and pressurization of the air.

しかし、このような空気圧マッサージ器具は、エアーポンプや制御装置などを内蔵したマッサージ器本体や電源コード、及びカフとマッサージ器本体の間を連結する空気の配管チューブ類などを必要とするために、構成が複雑となる。さらには、外部からの圧迫によるマッサージでは、下肢の浮腫の存在や装着の具合により、深部静脈の血流が十分得られないことがある。   However, since such a pneumatic massage device requires a massage device body and a power cord with a built-in air pump, a control device, etc., and an air piping tube connecting the cuff and the massage device body, etc. The configuration becomes complicated. Furthermore, in the case of massage by external compression, the blood flow in the deep veins may not be sufficiently obtained due to the presence of edema of the lower limbs or the wearing condition.

また、このような空気(流体)圧マッサージを、手術台上の患者に適用する場合、その複雑な構成が、手術者である医者やそのスタッフの作業を阻害する恐れが生じる。このような問題を解決するために、特許文献2は、流体圧マッサージ器を手術台に装着する技術を開示する。   In addition, when such an air (fluid) pressure massage is applied to a patient on an operating table, the complicated configuration may hinder the operation of a doctor who is an operator or the staff. In order to solve such a problem, Patent Document 2 discloses a technique of mounting a fluid pressure massager on an operating table.

しかし、特許文献2に開示の技術は、手術台に装着することはできるものの、依然として、特許文献1が必要としたような複雑な構成を有している。さらに、このような空気圧マッサージ器具は、より一般的に、例えば、長距離路線の飛行機内等の座席に対して適用することは困難である。   However, although the technique disclosed in Patent Document 2 can be mounted on an operating table, it still has a complicated configuration as required by Patent Document 1. Further, such a pneumatic massage device is more generally difficult to apply to a seat such as an airplane on a long-haul route.

特開2003−79688号公報JP 2003-79688 A 特許第4414178号公報Japanese Patent No. 4414178

本発明は、より小型で容易に装着可能な構成にして、上述したエコノミークラス・シンドローム或いは深部静脈血栓症(DVT)を含む静脈血栓症に対して、長距離路線の飛行機内等の座席に座っている乗客とか、手術中或いは手術後の患者の下肢運動を補助して、生理的な自己の筋肉によるポンプ機能を用いて、深部静脈の血流を増加させ、血栓を予防することができる血栓症予防装置を提供することを目的としている。   The present invention is configured in a more compact and easy-to-wear configuration to sit on a seat in an airplane or the like on a long-haul route against venous thrombosis including the above-mentioned economy class syndrome or deep vein thrombosis (DVT). A thrombus that can help prevent thrombus by increasing the blood flow of deep veins by using the pump function by physiological self-muscles, assisting the lower limb movement of the patient during or after surgery It aims to provide a disease prevention device.

本発明の血栓症予防装置は、本体支持部を有する本体部と、本体支持部に対して回転可能に回転軸により支持され、かつ足裏支持板を備えた揺動体と、本体部に備えられ、かつ一端が揺動体又は回転軸に連結されて、揺動体に備えた足裏支持板を揺動させる揺動機構と、を備える。足裏支持板上に足先を載置した際には、揺動体を揺動させることにより、足関節を背屈及び伸展運動させることができる。ここで言う足関節を背屈するとは、足首の踝付近を中心に足裏のつま先側が人体の頭側に回転することを意味する。また、足関節を伸展するとは、足首の踝付近を中心に足裏のつま先側が人体の頭と反対側に回転することを意味する。   The thrombosis prevention device of the present invention is provided in a main body having a main body support, a swinging body that is supported by a rotation shaft so as to be rotatable with respect to the main body support, and includes a sole support plate. And a swinging mechanism having one end connected to the swinging body or the rotating shaft and swinging the sole support plate provided in the swinging body. When the tip of the foot is placed on the sole support plate, the ankle joint can be dorsiflexed and extended by swinging the swinging body. The dorsiflexion of the ankle mentioned here means that the toe side of the sole rotates to the head side of the human body around the vicinity of the heel of the ankle. Also, extending the ankle joint means that the toe side of the sole rotates to the side opposite to the head of the human body around the vicinity of the heel of the ankle.

揺動機構は、それを駆動するモータと、該モータを制御する制御装置を備える。揺動機構は、モータの回転運動を伝えるクランク駆動用雄ねじと、該クランク駆動用雄ねじの回転により左右に動かされるクランク駆動体と、該クランク駆動体の左右の動きを揺動体に伝達するクランクシャフトを備える。或いは、揺動機構は、モータの回転運動を回転軸に伝達して、回転軸を回転させることにより揺動体を揺動させるよう構成することができる。   The swing mechanism includes a motor that drives the swing mechanism and a control device that controls the motor. The swing mechanism includes a crank drive male screw that transmits the rotational motion of the motor, a crank drive body that is moved left and right by the rotation of the crank drive male screw, and a crankshaft that transmits the left and right movements of the crank drive body to the swing body. Is provided. Alternatively, the rocking mechanism can be configured to rock the rocking body by transmitting the rotational motion of the motor to the rotating shaft and rotating the rotating shaft.

足裏支持板は、様々な足のサイズに対応させるため、及び、血栓症予防装置の回転軸と人の足を回転する回転軸である足踝付近との位置の違いから回転によって足裏支持板と足裏の位置ずれが生じることによる足に対するストレスを解消するための二つの対策のために、スライダ機構を介して取り付けられる。この足裏支持板には、その上に載置した足先を固定可能の足先ホルダーを装着する。血栓症予防装置は、本体部に連結部を介して、下腿固定部が一体に連結される。   The foot support plate supports the foot by rotating to accommodate various foot sizes and due to the difference in position between the rotation axis of the thrombosis prevention device and the vicinity of the footpad, which is the rotation axis that rotates the human foot. It is attached via a slider mechanism for two measures for relieving stress on the foot due to displacement between the plate and the sole. The foot support plate is provided with a foot holder that can fix the foot placed on the foot support plate. In the thrombosis prevention device, the crus fixing part is integrally connected to the main body part via the connection part.

本発明による血栓症予防装置によって、下肢の深部静脈である膝窩静脈の血流速度の増加が確認された。これは、足関節を背屈すると下腿の腓腹筋やヒラメ筋が収縮し、この中を走行するいわゆる深部静脈が筋繊維で圧縮され、中の血液がポンプ機能で心臓方向へ流出したことによる。本発明により、術後における血栓症の発生予防の効果が高くなる。病院の規模に応じて数台〜数十台を導入し、手術後2〜7日(あるいは離床するまで)使用するようにすることができる。また、長時間運航される飛行機座席に対して導入することができる。   With the thrombosis prevention device according to the present invention, an increase in blood flow velocity in the popliteal vein, which is a deep vein in the lower limb, was confirmed. This is because when the ankle joint is dorsiflexed, the gastrocnemius and soleus muscles of the lower leg contract, the so-called deep veins that run through them are compressed by muscle fibers, and the blood inside flows out toward the heart by the pump function. According to the present invention, the effect of preventing the occurrence of thrombosis after surgery is enhanced. Depending on the scale of the hospital, several to several tens of vehicles can be introduced and used for 2 to 7 days (or until getting out of bed) after the operation. In addition, it can be introduced for airplane seats operated for a long time.

(A)は、本発明に基づき構成した血栓症予防装置を例示する斜視図であり、(B)は、(A)とは同一の血栓症予防装置を、脚を載置した状態で、異なる方向から見た斜視図である。(A) is a perspective view which illustrates the thrombosis prevention apparatus comprised based on this invention, (B) differs in the state which mounted the leg the same thrombosis prevention apparatus as (A). It is the perspective view seen from the direction. 血栓症予防装置の使用状態を説明する図であり、図中の(a)は、足関節を伸展させた状態を、(b)は、その途中段階の足関節の状態を、そして、(c)は、足関節を背屈させた状態をそれぞれ例示している。It is a figure explaining the use condition of the thrombosis prevention apparatus, (a) in the figure shows the state where the ankle joint is extended, (b) shows the state of the ankle joint in the middle stage, and (c ) Each illustrates a state where the ankle joint is bent back. (A)は、図1(B)に示す上面カバー10及び裏板11と一方の側板12を取り除いて、本体部1内部を例示する図であり、(B)は側面断面図である。(A) is the figure which remove | eliminated the upper surface cover 10, the back plate 11, and one side plate 12 which are shown to FIG. 1 (B), and illustrates the inside of the main-body part 1, (B) is side sectional drawing. (A)は、図1に例示した血栓症予防装置を用いてドップラー式血流測定器で測定した膝窩静脈の血流速度を表すグラフであり、(B)は、時間の経過につれて変化する装置への指令角度を表すグラフであり、(C)は、足関節を背屈及び伸展運動するときの1サイクル分を分割し、屈曲運動時間をa秒、運動一時停止時間をb秒、伸展運動時間をc秒、1サイクル最後の停止時間をd秒とした場合の装置使用例毎の秒数を例示する表である。(A) is a graph showing the blood flow velocity of the popliteal vein measured with a Doppler blood flow meter using the thrombosis prevention device illustrated in FIG. 1, and (B) changes with the passage of time. (C) is a graph showing the command angle to the device, and (C) divides one cycle when the ankle joint is dorsiflexed and extended, the flexion movement time is a second, the exercise pause time is b seconds, and the extension It is a table | surface which illustrates the number of seconds for every example of apparatus use when exercise | movement time is set to c second and the stop time of the last cycle is set to d second. 比較のために従来の空気圧装置を用いて測定した膝窩静脈の血流速度を表すグラフである。It is a graph showing the blood flow velocity of the popliteal vein measured using the conventional pneumatic apparatus for the comparison. 下肢に巻いたカフに空気を送り込み、膨らませることのできる従来公知の空気圧マッサージ器具を例示する図である。It is a figure which illustrates the conventionally well-known pneumatic massage instrument which can send air into the cuff wound around the lower limbs and can inflate.

以下、例示に基づき本発明を説明する。図1(A)は、本発明に基づき構成した血栓症予防装置を例示する斜視図であり、(B)は、(A)とは同一の血栓症予防装置を、脚を載置した状態で、異なる方向から見た斜視図である。本発明の血栓症予防装置は、足踝付近を回転軸として足関節を背屈及び伸展運動させる装置であり、図示の本体部1がこれに相当する。この本体部1に備えた揺動機構5は、モータの回転運動から足裏支持板6(シューズ装着部)を回転(揺動)運動させる。下腿を固定しなくても足関節の背屈及び伸展で充分な深部静脈の血流が得られるが、スペースに余裕があるときは、この本体部1に連結部15を介して下腿固定部16を一体に連結しても良い。下腿固定部16は、下腿をクッション18の上に載せた状態で、下腿ホルダー17により固定する。下腿ホルダー17の材質は特に限定するものではないが、例えば化繊の布でよく、構成は一対の帯状の布の片方を下腿固定部16の台座部に固定し、帯状の布のもう一方に面ファスナー(例えば、株式会社クラレ製のマジックテープ(登録商標))を装着することでよく、面ファスナーの代わりにボタン等で固定する構成でもよい。   Hereinafter, the present invention will be described based on examples. FIG. 1A is a perspective view illustrating a thrombosis-preventing device configured according to the present invention, and FIG. 1B is the same thrombosis-preventing device as in FIG. It is the perspective view seen from a different direction. The thrombosis-preventing device of the present invention is a device that causes the ankle joint to bend and extend with the vicinity of the toe as a rotation axis, and the illustrated main body 1 corresponds to this. The swing mechanism 5 provided in the main body 1 rotates (swings) the foot support plate 6 (shoe mounting portion) from the rotational motion of the motor. Even if the lower leg is not fixed, sufficient deep vein blood flow can be obtained by dorsiflexion and extension of the ankle joint. However, when there is enough space, the lower leg fixing part 16 is connected to the main body part 1 via the connecting part 15. May be connected together. The crus fixing part 16 is fixed by the crus holder 17 in a state where the crus are placed on the cushion 18. The material of the lower leg holder 17 is not particularly limited. For example, a synthetic fiber cloth may be used, and one of the pair of belt-like cloths is fixed to the pedestal part of the lower leg fixing part 16 and the other side of the belt-like cloth is faced. A fastener (for example, Kuraray Co., Ltd. Velcro (registered trademark)) may be attached, and a configuration may be adopted in which a button or the like is used instead of a hook-and-loop fastener.

揺動体4は、その下部両側に本体支持部2を配置し、かつ、本体支持部2に対して回転可能に回転軸3により支持する。例示の揺動体4は、揺動機構5の一端が連結される裏板11と、その裏板11の両側に固定されて、回転軸3が貫通する側板12と、裏板11に対向するようにおもて側に配置された足裏支持板6とから構成されている。足裏支持板6は、様々な足のサイズに対応させるため、及び、血栓症予防装置の回転軸と人の足を回転する回転軸である踝付近との位置の違いから回転によって足裏支持板と足裏の位置ずれが生じることによる足に対するストレスを解消するための二つの対策のために、スライダ機構を介して裏板11に取り付けられている。スライダ機構は、図3(A)を参照して後述するように、縦スライダ21と横スライダ22から構成される。この揺動体4を揺動させることにより、足裏支持板6上に載置した足首の踝付近を中心に足関節を背屈及び伸展運動させることができる。   The oscillating body 4 is provided with the main body support portions 2 on both sides of the lower portion thereof, and is supported by the rotary shaft 3 so as to be rotatable with respect to the main body support portions 2. The illustrated oscillating body 4 is opposed to the back plate 11, the back plate 11 to which one end of the swing mechanism 5 is coupled, the side plate 12 that is fixed to both sides of the back plate 11 and through which the rotary shaft 3 passes. It is comprised from the sole support plate 6 arrange | positioned at the front side. The sole support plate 6 supports the sole by rotation in order to correspond to various foot sizes and from the difference in position between the rotation axis of the thrombosis prevention device and the vicinity of the heel, which is the rotation axis that rotates the human foot. It is attached to the back plate 11 via a slider mechanism for two measures for relieving stress on the foot due to displacement between the plate and the sole. The slider mechanism includes a vertical slider 21 and a horizontal slider 22 as described later with reference to FIG. By oscillating the oscillating body 4, the ankle joint can be dorsiflexed and extended around the vicinity of the heel of the ankle placed on the sole support plate 6.

足裏支持板6上には、シューズを履いた状態で、或いはシューズを脱いだ状態で、足裏を載せて、足の長さの違いによって縦スライダ21を上下に移動して、足踵受19に足踵がしっかり着くようにした状態で、足先ホルダー14により足先を固定する。足裏支持板6に装着される足先ホルダー14の材質及び構成は、足裏支持板6に足先を固定できるものであれば良く、例えば、上述した下腿ホルダー17と同様なもので良い。以上の説明のように、縦スライダ21の一つの機能として様々な足のサイズに対応させる機能を有する。   On the sole support plate 6, with the shoes on or with the shoes removed, the soles are placed, and the vertical slider 21 is moved up and down depending on the length of the foot to receive the footpad. With the footpad firmly attached to 19, the toe is fixed by the toe holder 14. The material and configuration of the foot holder 14 to be attached to the foot support plate 6 may be any material as long as the foot tip can be fixed to the foot support plate 6. For example, the material may be the same as the above-described crus holder 17. As described above, one function of the vertical slider 21 has a function corresponding to various foot sizes.

次に、回転(揺動)における機能について説明する。揺動体4の回転軸3と足の回転軸である踝付近とは個人差があって一致させることは元々困難であって、それらの位置は通常違っている。このため、足先ホルダー14を足裏支持板6に固定している位置と足先ホルダー14が足を固定している位置が、例えば数10度回転揺動して、図3(B)の図の状態よりも右に(時計方向に)回転すれば、足先ホルダー14を足裏支持板6に固定している位置は上側に移動し、足先ホルダー14が足を固定している位置は下側に移動するので、そのままだと足の甲を圧迫することになる。そのときに足裏支持板6を縦スライダ21により上下動をフリーにすることで、この足の甲の圧迫を防止する働きが機能する。   Next, functions in rotation (swing) will be described. The rotating shaft 3 of the rocking body 4 and the vicinity of the heel, which is the rotating shaft of the foot, are inherently difficult to match and their positions are usually different. Therefore, the position at which the foot tip holder 14 is fixed to the sole support plate 6 and the position at which the foot tip holder 14 fixes the foot rotate, for example, several tens of degrees to swing, as shown in FIG. If it rotates to the right (clockwise) from the state shown in the figure, the position where the foot holder 14 is fixed to the sole support plate 6 moves upward, and the position where the foot holder 14 fixes the foot. Will move down, so if you keep it, it will press the instep. At that time, by making the sole support plate 6 free to move up and down by the vertical slider 21, the function of preventing the compression of the instep of the foot functions.

さらに、足踵の位置は足の回転軸である踝付近より下にあるので、特に大きな足の人の場合は、図3(B)の図の状態よりも右に回転すれば、被験者の足踵側が回転軸3側に回転移動する方向の力が働くが、足裏支持板6の下方部分に遮られることにより、足を湾曲しようとする力が働き、足を圧迫することになる。そのときに足裏支持板6を支える揺動体4を、図3(B)で言えば、ほぼ左右動をフリーにすることで、この足の圧迫を防止する働きが機能する。   Further, since the position of the toes is below the vicinity of the toe, which is the rotation axis of the feet, in the case of a person with a particularly large foot, if the subject rotates to the right from the state shown in FIG. A force in the direction in which the heel side rotates toward the rotary shaft 3 works, but when the lower part of the sole support plate 6 is blocked, a force to bend the foot works and presses the foot. In this case, the swinging body 4 that supports the sole support plate 6 can be operated in a manner that prevents the foot from being compressed by making the left-right movement almost free in FIG. 3B.

足裏支持板6は平面構造として、足関節を背屈動作させるようにする。足裏を載せて足先を固定した状態で、揺動機構5を動作させることにより、足首の踝付近を中心に足関節を背屈及び伸展することができる。これによって、下腿部の筋肉を伸縮させることにより、深部静脈の血流量の増加を図ることができた。   The sole support plate 6 has a planar structure so that the ankle joint is dorsiflexed. The ankle joint can be dorsiflexed and extended around the vicinity of the heel of the ankle by operating the swing mechanism 5 with the soles fixed and the toes fixed. As a result, it was possible to increase the blood flow volume of the deep vein by expanding and contracting the muscles of the lower leg.

図2は、血栓症予防装置の使用状態を説明する図であり、図中の(a)は、足関節を伸展させた状態を、(b)は、その途中段階の足関節の状態を、そして、(c)は、足関節を背屈させた状態をそれぞれ例示している。この装置は、踝付近を軸として足関節を背屈及び伸展動作させ、ふくらはぎの筋ポンプを活用することにより血流を促進させる。例えば、術後48時間以内の抗凝固剤を適用できない場面での適用を想定すると、姿勢としてはフラットに仰臥した状態で適用することが望ましい。短周期で背屈と伸展を繰り返す。静脈血流は背屈動作で発生し、3〜4秒間持続することが確認された。背屈角度〜伸展角度は、70°〜105°が望ましい。伸展状態から背屈状態までの時間は2秒〜10秒が望ましい。この範囲で、充分な血流を得ることができた。この足裏面の曲げ角度、速度は任意に設定できるようにする。詳しくは後述する。   FIG. 2 is a diagram for explaining a use state of the thrombosis prevention device, in which (a) is a state in which the ankle joint is extended, (b) is a state of the ankle joint in the middle stage, And (c) has illustrated the state which bent the ankle joint, respectively. In this device, the ankle joint is dorsiflexed and extended with the vicinity of the heel as an axis, and blood flow is promoted by utilizing a calf muscle pump. For example, assuming application in a scene where an anticoagulant within 48 hours after surgery cannot be applied, it is desirable to apply the posture while lying on a flat surface. Repeated dorsiflexion and extension in a short cycle. It was confirmed that venous blood flow was generated by dorsiflexion and lasted for 3-4 seconds. The dorsiflexion angle to the extension angle is preferably 70 ° to 105 °. The time from the extended state to the dorsiflexion state is preferably 2 to 10 seconds. Sufficient blood flow could be obtained within this range. The bending angle and speed of the sole of the foot can be set arbitrarily. Details will be described later.

なお、自発で足関節を背屈した場合と、装置により他動で足関節を背屈させた場合を対比すると、他動で背屈させたほうが、血流効果が3秒程度と長く持続することが確認できた。また、各動作間にインターバルを設けて、一定周期で運転と休憩を繰り返しても良い。   In addition, comparing the case where the ankle joint is dorsiflexed spontaneously and the case where the ankle joint is dorsiflexed by other movements by the device, the blood flow effect lasts about 3 seconds longer when the dorsiflexion is caused by other movements. I was able to confirm. Moreover, an interval may be provided between each operation | movement, and a driving | operation and a break may be repeated with a fixed period.

次に、図3により揺動機構の詳細について説明する。図3(A)は、図1(B)に示す上面カバー10及び裏板11と一方の側板12を取り除いて、本体部1内部を例示する図であり、(B)は側面断面図である。揺動機構5は、それを駆動するモータ24と、モータ制御装置とを備え、かつ、クランクシャフト23の一端が揺動体4に連結され、もう一端がクランク駆動体27に連結されている。このクランク駆動体27を貫通してクランク駆動用雄ねじ28が配設されている。そして、クランク駆動用雄ねじ28が貫通するクランク駆動体27の内部は、ボールねじ構成に形成することが望ましい。さらにクランク駆動用雄ねじ28はモータ24の回転運動を伝えられる構成にしている。   Next, details of the swing mechanism will be described with reference to FIG. 3A is a view illustrating the inside of the main body 1 with the top cover 10 and the back plate 11 and one side plate 12 shown in FIG. 1B removed, and FIG. 3B is a side sectional view. . The swing mechanism 5 includes a motor 24 for driving the swing mechanism 5 and a motor control device, and one end of the crankshaft 23 is connected to the swing body 4 and the other end is connected to the crank drive body 27. A crank driving male screw 28 is disposed through the crank driving body 27. The inside of the crank drive body 27 through which the crank drive male screw 28 penetrates is preferably formed in a ball screw configuration. Further, the crank driving male screw 28 is configured to transmit the rotational movement of the motor 24.

次に図3(B)により揺動機構の動きを説明する。モータ24によりクランク駆動用雄ねじ28に回転運動を伝え、このクランク駆動用雄ねじ28の回転によりクランク駆動体27を左右に動かす。クランク駆動体27はクランクシャフト23に左右の動きを伝達する。次に、図3(B)で言えばクランクシャフト23が揺動体4を斜め右上側に押すことで、回転軸3を介して揺動体4は右回転し、逆に斜め左下側に引くことにより回転軸3を介して揺動体4は左回転する。   Next, the movement of the swing mechanism will be described with reference to FIG. The motor 24 transmits a rotational motion to the crank driving male screw 28, and the crank driving body 27 is moved left and right by the rotation of the crank driving male screw 28. The crank driver 27 transmits left and right movements to the crankshaft 23. Next, in FIG. 3B, when the crankshaft 23 pushes the rocking body 4 diagonally to the upper right, the rocking body 4 rotates to the right via the rotating shaft 3 and is pulled diagonally to the lower left. The rocking body 4 rotates counterclockwise via the rotating shaft 3.

以上のように、クランク駆動による揺動機構の例を述べたが、例えば、モータの回転を減速する歯車又はパルスモータ等を用いて、回転軸3部分に歯車やベルト等により直接動力を伝えて回転(揺動)することもできる。さらには、モータを用いること無く、例えば,空気圧式のアクチュエータのような他の駆動源を用いることもできる。   As described above, the example of the swing mechanism by the crank drive has been described. For example, by using a gear or a pulse motor that decelerates the rotation of the motor, the power is directly transmitted to the rotary shaft 3 portion by a gear or a belt. It can also be rotated (oscillated). Furthermore, other drive sources such as a pneumatic actuator can be used without using a motor.

クランクシャフト23内には、スプリングが内蔵されており、被験者の足関節に無理な力が加わらないように、足関節の硬さの個人差を吸収する。また、装置の回転軸3と被験者の足関節の回転軸は同一でないので、この回転軸の違いを吸収するため、足裏の設置面にスライダ機構13を備えている。このスライダ機構13は、図示のように、足先の長さ方向に調整可能の縦スライダ21と、それと直角方向の奥行き方向に調整可能の横スライダ22を有している。モータ制御装置は、モータ24を制御することにより、足裏面の曲げ角度、速度を任意に設定可能にする。このために、モータ24の回転速度及び回転数を検知するエンコーダ25、踝部分の角度検知をするポテンショメータ26、過電流の防止のためのカレントセンサ(図示省略)等を備えている。   A spring is built in the crankshaft 23 to absorb individual differences in the hardness of the ankle joint so that excessive force is not applied to the subject's ankle joint. Further, since the rotation axis 3 of the apparatus and the rotation axis of the subject's ankle joint are not the same, a slider mechanism 13 is provided on the installation surface of the sole to absorb the difference between the rotation axes. As shown in the figure, the slider mechanism 13 has a vertical slider 21 that can be adjusted in the length direction of the foot and a horizontal slider 22 that can be adjusted in the depth direction perpendicular thereto. The motor control device can arbitrarily set the bending angle and speed of the sole surface by controlling the motor 24. For this purpose, an encoder 25 for detecting the rotation speed and the number of rotations of the motor 24, a potentiometer 26 for detecting the angle of the collar portion, a current sensor (not shown) for preventing overcurrent, and the like are provided.

図4(A)は、図1に例示した血栓症予防装置を用いて測定した血流速度を表すグラフであり、(B)は、時間の経過につれて変化する装置への指令角度を表すグラフであり、(C)は、足関節を背屈及び伸展運動するときの1サイクル分を分割し屈曲運動時間をa秒、運動一時停止時間をb秒、伸展運動時間をc秒、1サイクル最後の停止時間をd秒とした場合の装置使用例毎の秒数を例示する表である。また、図5は、比較のために従来の空気圧装置(Kendall社のSCD EXPRESS)を用いて測定した深部静脈の血流速度を表すグラフである。図4(A)及び図5において、横軸は時間[sec]を、また、縦軸は血流速度[cm/s]を表している。いずれのグラフにおいても、正方向と負方向の二つの血流速度が記録されているが、横軸基準ラインより下側の負方向の波形が膝窩静脈の血流速度を表している。なお、本測定はドップラー式血流測定器によるものであり、横軸基準ラインより上側の正方向の波形は、本発明とは関係がないので説明を省略する。グラフ中の装置稼働期間中の血流速度を見れば、本発明装置は、シンプルな構成にも拘わらず、既存の装置(図5)と同等以上の血流速度が得られていることが分かる。なお、血流速度は個人差が大きく、センサの取り付け角度によっても速度が変わるため、基準波形が必要となる。自発的に足関節を背屈及び伸展運動した時の膝窩静脈の血流速度を基準波形とした。   4A is a graph showing the blood flow velocity measured using the thrombosis prevention device illustrated in FIG. 1, and FIG. 4B is a graph showing the command angle to the device that changes over time. Yes, (C) divides one cycle of the ankle joint during dorsiflexion and extension movement, bending movement time is a second, movement pause time is b seconds, extension movement time is c seconds, It is a table | surface which illustrates the number of seconds for every example of apparatus use when a stop time is d second. FIG. 5 is a graph showing the blood flow velocity of a deep vein measured using a conventional pneumatic device (Kendall SCD EXPRESS) for comparison. 4A and 5, the horizontal axis represents time [sec], and the vertical axis represents blood flow velocity [cm / s]. In both graphs, two blood flow velocities in the positive direction and the negative direction are recorded, but the waveform in the negative direction below the horizontal axis reference line represents the blood flow velocity in the popliteal vein. In addition, this measurement is based on a Doppler blood flow measuring instrument, and the waveform in the positive direction above the horizontal axis reference line is not related to the present invention, and thus the description thereof is omitted. Looking at the blood flow velocity during the operation period of the device in the graph, it can be seen that the device of the present invention has a blood flow velocity equal to or higher than that of the existing device (FIG. 5) despite the simple configuration. . In addition, since a blood flow velocity has a large individual difference and the velocity changes depending on the mounting angle of the sensor, a reference waveform is required. The blood flow velocity of the popliteal vein when the ankle joint was voluntarily dorsiflexed and extended was used as a reference waveform.

図4(A)と、(B)を比較しながら説明すると、この例では、装置への回転指令が出る部分である屈曲運動時間aの立ち上がり部の時刻から少し遅れて、(A)に示すように、静脈血流速度が立ち上がり、運動一時停止時間bになっても静脈血流速度は0にはならず、立ち上がりから3秒程度経過して0になっていることが分る。また伸展運動時間cにおいては、静脈血流速度は0のままであり、伸展運動は静脈血流速度の増加には寄与しないことが分る。   4A is compared with FIG. 4B. In this example, the example shown in FIG. 4A is slightly delayed from the time of the rising portion of the bending motion time a, which is a portion where a rotation command to the apparatus is output. Thus, it can be seen that even when the venous blood flow velocity rises and the exercise pause time b is reached, the venous blood flow velocity does not become zero, and has become zero after about 3 seconds from the rise. In addition, during the stretching exercise time c, the venous blood flow velocity remains 0, and it can be seen that the stretching exercise does not contribute to the increase in the venous blood flow velocity.

1 本体部
2 本体支持部
3 回転軸
4 揺動体
5 揺動機構
6 足裏支持板
10 上面カバー
11 裏板
12 側板
13 スライダ機構
15 連結部
16 下腿固定部
17 下腿ホルダー
18 クッション
19 踵受
21 縦スライダ
22 横スライダ
23 クランクシャフト
24 モータ
25 エンコーダ
26 ポテンショメータ
27 クランク駆動体
28 クランク駆動用雄ねじ
DESCRIPTION OF SYMBOLS 1 Main-body part 2 Main-body support part 3 Rotating shaft 4 Oscillator 5 Oscillator mechanism 6 Foot support board 10 Upper surface cover 11 Back board 12 Side board 13 Slider mechanism 15 Connection part 16 Lower leg fixing part 17 Lower leg holder 18 Cushion 19 heel support 21 Vertical Slider 22 Horizontal slider 23 Crankshaft 24 Motor 25 Encoder 26 Potentiometer 27 Crank driver 28 Crank drive male screw

Claims (7)

本体支持部を有する本体部と、
前記本体支持部に対して回転可能に回転軸により支持され、かつ足裏支持板を備えた揺動体と、
前記本体部に備えられ、かつ一端が前記揺動体又は前記回転軸に連結されて、前記揺動体に備えた前記足裏支持板を揺動させる揺動機構と、を備え、
前記足裏支持板上に足先を載置した際には、前記揺動体を揺動させることにより、足首の踝付近を中心に足関節を背屈及び伸展運動させる構成にした血栓症予防装置。
A body portion having a body support portion;
An oscillating body that is supported by a rotation shaft so as to be rotatable with respect to the main body support portion and includes a sole support plate;
A swing mechanism provided on the main body and having one end coupled to the swing body or the rotary shaft and swinging the sole support plate provided on the swing body;
A thrombosis-preventing device configured to cause the ankle joint to bend and extend around the vicinity of the heel of the ankle by swinging the swinging body when the foot tip is placed on the sole support plate. .
前記揺動機構は、それを駆動するモータと、該モータを制御する制御装置を備えた請求項1に記載の血栓症予防装置。 The thrombosis prevention device according to claim 1, wherein the swing mechanism includes a motor that drives the swing mechanism and a control device that controls the motor. 前記揺動機構は、前記モータの回転運動を伝えるクランク駆動用雄ねじと、該クランク駆動用雄ねじの回転により左右に動かされるクランク駆動体と、該クランク駆動体の左右の動きを前記揺動体に伝達するクランクシャフトを備えた請求項2に記載の血栓症予防装置。 The swing mechanism transmits a crank drive male screw that transmits the rotational motion of the motor, a crank drive body that is moved to the left and right by rotation of the crank drive male screw, and a left and right movement of the crank drive body to the swing body. The thrombosis-preventing device according to claim 2, further comprising a crankshaft. 前記揺動機構は、前記モータの回転運動を前記回転軸に伝達して、回転軸を回転させることにより前記揺動体を揺動させるよう構成した請求項2に記載の血栓症予防装置。 The thrombosis prevention device according to claim 2, wherein the rocking mechanism is configured to rock the rocking body by transmitting the rotation motion of the motor to the rotation shaft and rotating the rotation shaft. 前記足裏支持板は、スライダ機構を介して前記揺動体に取り付けられている請求項1に記載の血栓症予防装置。 The thrombosis prevention device according to claim 1, wherein the foot support plate is attached to the swinging body via a slider mechanism. 前記足裏支持板には、その上に載置した足先を固定可能の足先ホルダーを装着した請求項1に記載の血栓症予防装置。 The thrombosis prevention device according to claim 1, wherein the foot support plate is provided with a foot tip holder capable of fixing a foot tip placed thereon. 前記本体部に連結部を介して下腿固定部を一体に連結した請求項1に記載の血栓症予防装置。
The thrombosis prevention device according to claim 1, wherein a crus fixing part is integrally connected to the main body part via a connection part.
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