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WO2014208772A1 - Dispositif de support d'entraînement à la marche, système de support d'entraînement à la marche, procédé de support d'entraînement à la marche, et programme - Google Patents

Dispositif de support d'entraînement à la marche, système de support d'entraînement à la marche, procédé de support d'entraînement à la marche, et programme Download PDF

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Publication number
WO2014208772A1
WO2014208772A1 PCT/JP2014/067461 JP2014067461W WO2014208772A1 WO 2014208772 A1 WO2014208772 A1 WO 2014208772A1 JP 2014067461 W JP2014067461 W JP 2014067461W WO 2014208772 A1 WO2014208772 A1 WO 2014208772A1
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WO
WIPO (PCT)
Prior art keywords
walking
training
walking training
present
predetermined
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/JP2014/067461
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English (en)
Japanese (ja)
Inventor
田中　英一郎
雄大 鈴木
弓削　類
裕美 河原
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Shibaura Institute of Technology
Space Bio Laboratories Co Ltd
Original Assignee
Shibaura Institute of Technology
Space Bio Laboratories Co Ltd
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Publication date
Application filed by Shibaura Institute of Technology, Space Bio Laboratories Co Ltd filed Critical Shibaura Institute of Technology
Publication of WO2014208772A1 publication Critical patent/WO2014208772A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices ; Anti-rape devices
    • A61F5/01—Orthopaedic devices, e.g. long-term immobilising or pressure directing devices for treating broken or deformed bones such as splints, casts or braces
    • A61F5/0102—Orthopaedic devices, e.g. long-term immobilising or pressure directing devices for treating broken or deformed bones such as splints, casts or braces specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations
    • 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
    • A61H1/02—Stretching or bending or torsioning apparatus for exercising
    • A61H1/0237—Stretching or bending or torsioning apparatus for exercising for the lower limbs
    • A61H1/024—Knee
    • 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
    • A61H1/02—Stretching or bending or torsioning apparatus for exercising
    • A61H1/0237—Stretching or bending or torsioning apparatus for exercising for the lower limbs
    • A61H1/0244—Hip
    • 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
    • A61H1/02—Stretching or bending or torsioning apparatus for exercising
    • A61H1/0237—Stretching or bending or torsioning apparatus for exercising for the lower limbs
    • A61H1/0255—Both knee and hip of a patient, e.g. in supine or sitting position, the feet being moved together in a plane substantially parallel to the body-symmetrical plane
    • 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
    • A61H1/02—Stretching or bending or torsioning apparatus for exercising
    • A61H1/0237—Stretching or bending or torsioning apparatus for exercising for the lower limbs
    • A61H1/0266—Foot
    • 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
    • A61H3/00—Appliances for aiding patients or disabled persons to walk about
    • 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
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/12—Driving means
    • A61H2201/1207—Driving means with electric or magnetic drive
    • A61H2201/1215—Rotary drive
    • 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
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/16—Physical interface with patient
    • A61H2201/1602—Physical interface with patient kind of interface, e.g. head rest, knee support or lumbar support
    • A61H2201/1628—Pelvis
    • A61H2201/163—Pelvis holding means therefor
    • 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
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/16—Physical interface with patient
    • A61H2201/1602—Physical interface with patient kind of interface, e.g. head rest, knee support or lumbar support
    • A61H2201/164—Feet or leg, e.g. pedal
    • A61H2201/1642—Holding means therefor
    • 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
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/16—Physical interface with patient
    • A61H2201/1602—Physical interface with patient kind of interface, e.g. head rest, knee support or lumbar support
    • A61H2201/165—Wearable interfaces
    • 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
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A61H2201/5007—Control means thereof computer controlled
    • 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
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A61H2201/5007—Control means thereof computer controlled
    • A61H2201/501—Control means thereof computer controlled connected to external computer devices or networks
    • 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
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A61H2201/5023—Interfaces to the user
    • A61H2201/5043—Displays
    • A61H2201/5046—Touch screens
    • 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
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A61H2201/5058—Sensors or detectors
    • A61H2201/5071—Pressure sensors
    • 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
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A61H2201/5058—Sensors or detectors
    • A61H2201/5084—Acceleration sensors
    • 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
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A61H2201/5097—Control means thereof wireless

Definitions

  • the present invention relates to a walking training support device, a walking training support system, a walking training support method, and a program, and more specifically, a walking training support device that supports walking training using a walking support device that performs an assisting operation for walking motion.
  • the present invention relates to a walking training support system, a walking training support method, and a program.
  • walking training for paralyzed patients is performed by lifting and moving the legs so that the legs of the patient can move in the same way as walking by a physical therapist, occupational therapist, doctor, or the like.
  • the work is often performed using a plurality of human hands, which is very troublesome, and the current situation is that manpower is not sufficient even for hemiplegic patients who are said to be 1.3 million people a year in Japan.
  • the target recovery level cannot always be reached.
  • Patent Document 1 discloses a walking that detects the movement of the wearer from the myoelectricity of the wearer and assists the movement of the wearer's hip joint and knee joint.
  • An auxiliary device is disclosed.
  • Patent Documents 2 to 3 by the present inventors disclose a walking assist device that assists the movement of the lower limb portion of the wearer by lifting the lower limb portion of the wearer from the sole of the wearer. ing.
  • Patent Document 4 power from a motor as a power source is transmitted to the knee joint and ankle joint by a flexible shaft to assist the movement of the wearer's lower limb, and the wearer's
  • a walking assistance device that brings a more natural walking motion to the wearer by controlling the rotation angle and torque of the motor based on the movement of the lower limb portion.
  • JP 2006-204426 A Japanese Patent No. 4635135 JP 2008-220635 A JP 2009-213671 A
  • Patent Documents 1 to 4 described above can greatly reduce the labor of a physical therapist and the like. Because you have to rely on sensory things such as physical therapists, occupational therapists, doctors, etc., and are reproducible and difficult to judge objectively without variation, it is necessary to accurately determine the level of exercise. However, there is a problem that it is not always possible to perform effective walking training.
  • the present invention has been made to solve the above-described problems, and an object thereof is to provide a walking training support device, a walking training support system, a walking training support method, and a program capable of performing more effective walking training.
  • the walking training support device of the present invention is a walking in which an assisting operation for a walking motion by the trainer is performed according to a preset parameter in a state worn by a trainer who performs walking training.
  • Detection means for detecting a predetermined physical quantity indicating a walking state when walking training is performed by the trainee using an auxiliary device, and exercise of the trainer based on the physical quantity detected by the detection means
  • Determination means for determining a level
  • execution means for executing a process predetermined to support the walking training according to the exercise level determined by the determination means.
  • the walking assisting device that performs the assisting operation with respect to the walking motion by the trainer according to the preset parameter in a state where the trainer who performs the walking training wears the detecting means. Is used to detect a predetermined physical quantity indicating a walking state when walking training is performed by the trainee.
  • the exercise level of the trainee is determined by the determination unit based on the physical quantity detected by the detection unit, and according to the exercise level determined by the determination unit by the execution unit, A process predetermined to assist the walking training is executed.
  • the walking assist device that performs the assisting operation for the walking motion by the trainer according to the preset parameter in a state where the trainer who performs the walking training is worn.
  • a predetermined physical quantity indicating a walking state when the trainee performs walking training is detected, and based on the detected physical quantity, the exercise level of the trainee is determined, and the determined exercise level is obtained. Accordingly, since the predetermined processing is executed as support for the walking training, the exercise level of the trainee can be accurately determined, so that more effective walking training can be performed.
  • the physical quantity may be a physical quantity indicating followability to the auxiliary motion of walking training by the trainee.
  • the exercise level can be determined more accurately, and as a result, more effective walking training can be performed.
  • the execution unit may execute a process of setting the parameter to the walking assistance device according to the exercise level determined by the determination unit as the predetermined process. .
  • the setting of a walking assistance apparatus can be performed more simply.
  • the execution unit sets a parameter to be set in the walking assist device.
  • the execution means may execute a process of presenting a training method according to the exercise level determined by the determination means as the predetermined process.
  • the execution means may execute a process of creating a training menu according to the exercise level determined by the determination means as the predetermined process.
  • the execution unit selectively selects any one from a plurality of predetermined types of walking assistance devices according to the exercise level determined by the determination unit. You may perform the process shown to. Thereby, walking training can be performed more effectively.
  • the plurality of types of walking assist devices may assist at least one of a knee joint and an ankle joint and a combination of different combinations.
  • the training regarding the lower limbs in general can be performed comprehensively and effectively.
  • the exercise level may be a paralysis level of the trainee.
  • the effective walking training according to the trainee's paralysis level can be performed.
  • the walking training support system of the present invention includes the walking training support apparatus of the present invention and the walking assist device in which the parameters are set by the walking training support apparatus. .
  • the walking training support device of the present invention since the walking training support device of the present invention is provided, the exercise level of the trainee can be accurately determined in the same manner as the walking training support device. More effective walking training can be performed.
  • the walking training support method of the present invention performs the assisting operation for the walking motion by the trainer according to the preset parameter in a state worn by the trainer who performs the walking training.
  • a detecting step for detecting a predetermined physical quantity indicating a walking state when the training is performed by the trainer using the walking assist device, and the trainer based on the physical quantity detected by the detecting step.
  • a determination step for determining the exercise level, and an execution step for executing a process predetermined as supporting the walking training according to the exercise level determined in the determination step.
  • the walking training support method of the present invention since it operates in the same manner as the walking training support device of the present invention, the result of being able to accurately determine the exercise level of the trainer, as with the walking training support device. Can perform more effective walking training.
  • the program of the present invention performs an auxiliary operation for the walking motion by the trainer according to a preset parameter in a state where the computer is worn by a trainer who performs walking training.
  • a detecting means for detecting a predetermined physical quantity indicating a walking state when walking training is performed by the trainer using the walking assist device, and the trainer based on the physical quantity detected by the detecting means.
  • a determination means for determining the exercise level, and an execution means for executing a predetermined process for supporting the walking training according to the exercise level determined by the determination means. is there.
  • the computer can be caused to act in the same manner as the walking training support apparatus of the present invention, so that the exercise level of the trainee is accurately determined in the same manner as the walking training support apparatus. As a result, more effective walking training can be performed.
  • the walking by the trainee using the walking assist device in which the assisting operation for the walking motion by the trainer is performed according to a preset parameter in a state worn by the trainer performing the walking training.
  • a predetermined physical quantity indicating a walking state when training is performed is detected, the exercise level of the trainer is determined based on the detected physical quantity, and the walking training is supported according to the determined exercise level. Since the predetermined process is executed, it is possible to accurately determine the exercise level of the trainee. As a result, an effect that more effective walking training can be performed is obtained.
  • FIG. 1 It is a side view which shows the structure of an example of the close contact type walking aid apparatus which concerns on embodiment. It is a block diagram which shows the principal part structure of the electric system of the walking assistance apparatus shown in FIG. It is a figure used for description of control of the non-restraining type walking auxiliary device concerning an embodiment, and is a side view showing an example of a link mechanism which modeled a leg. It is a figure with which it uses for description of control of the non-restraining type walking assistance device which concerns on embodiment, and is a side view which shows an example of the reference point on a sole support plate.
  • a walking training support system 10 includes a walking training support device 20 that plays a central role in the system 10 and walking assistance that a trainer wears when performing walking training.
  • Device 30 the walking training support device 20 that plays a central role in the system 10 and walking assistance that a trainer wears when performing walking training.
  • the walking assist device 30 has a range in which the motor function is lost (unilateral (hemiplegia), bilateral (paraplegia)), and the level of paralysis of the trainee (hereinafter referred to as “paralysis level”). .)
  • a non-restraining type walking assist device 30A (see also FIG. 3), which will be described later, is a contact type.
  • the walking assist device 30B (see also FIG. 5) capable of assisting the knee joint and the ankle joint, and the walking assist device 30C (see also FIG. 8) capable of assisting only the ankle joint in a close contact type.
  • Three types are prepared in advance. In the following, when the walking assistance devices 30A to 30C are described without being particularly distinguished, they are referred to as “walking assistance device 30”.
  • the walking training support device 20 and the walking assistance device 30 according to the present embodiment have a function of mutually transmitting and receiving various information such as control information and actual measurement information described later. .
  • the walking training support system 10 according to the present embodiment a case where communication between the walking training support device 20 and the walking assistance device 30 is performed by wireless communication will be described. It is good also as a form performed by.
  • a walking training support device 20 is connected to a system bus BUS, and a CPU (Central Processing Unit) 20A that controls the operation of the entire walking training support device 20 is provided. Is provided.
  • a CPU Central Processing Unit
  • a RAM Random Access Memory
  • ROM Read Only Memory
  • a secondary storage unit here, a hard disk device
  • the system bus BUS is connected to a display 20F used for displaying various information and a wireless communication unit 20H that controls a wireless communication operation between external devices such as the walking assist device 30. Yes.
  • the CPU 20A can access the RAM 20B, the ROM 20C, and the secondary storage unit 20D, obtain various input information via the keyboard 20E, and display various information on the display 20F. Further, the CPU 20A can exchange various information with an external device via the wireless communication unit 20H.
  • the walk training assistance apparatus 20 which concerns on this Embodiment is provided with other input devices, such as a mouse
  • the walking assist device 30A includes a lower body mounting part 50A, an upper body support part 50B, and a control unit C1 (see also FIG. 4) described later.
  • the lower body mounting portion 50A is mounted on the lower body including the thigh, and includes a drive motor 52A that controls the angle of the knee joint of the wearer's right foot and a drive that controls the angle of the foot joint of the wearer's right foot.
  • a motor 52B, a drive motor 52C that controls the angle of the knee joint of the left leg of the wearer, and a drive motor 52D that controls the angle of the ankle joint of the left leg of the wearer are provided.
  • stepping motors are applied as the drive motors 52A to 52D, but the present invention is not limited to this.
  • the lower body wearing part 50A is connected to the center link 54, the center link 54, and the lower right body thigh drive mechanism and the left lower body thigh drive mechanism that drive the knee joint of the wearer, and the lower right body thigh.
  • the lower right body lower leg thigh drive mechanism that is connected to the wearer's right ankle joint and the lower left body lower leg thigh drive mechanism that is connected to the left lower body thigh drive mechanism and that drives the wearer's left ankle joint.
  • a mechanism a mechanism.
  • the lower right half thigh drive mechanism includes a timing belt 56, a main gear 58, a fixed link 60, a rotation link 62, a parallel link 64, a right thigh attachment link 66, a right knee joint link 68, have.
  • the timing belt 56 transmits the rotation of the drive motor 52A to the main gear 58.
  • the main gear 58 meshes with the timing belt 56 and rotates.
  • the fixed link 60 is connected to the center link 54 at its center, and the rotation shaft of the main gear 58 is fixed at its front end.
  • the rotation link 62 has the rotation axis of the main gear 58 as the axis center of the upper rotation axis of the main gear 58 and the connection portion with the front end of the fixed link 70 as the axis center of the lower rotation axis of the main gear 58. It is fixed and rotates with the main gear 58.
  • the parallel link 64 is fixed to itself with the shaft provided at the rear end of the fixed link 60 as the upper rotating shaft and the connecting portion with the central portion of the fixed link 70 as the axial center of the lower rotating shaft.
  • the shape of the link 60, the rotation link 62, and the fixed link 70 is rotated while maintaining a parallelogram shape.
  • the right thigh attachment link 66 is connected to the center link 54 by an omnidirectional joint, and is connected to the left end of the right knee joint link 68 by an omnidirectional joint.
  • the right knee joint link 68 is connected to the rear end portion of the fixed link 70 at the right end portion of the right knee joint link 68. They are connected by a joint.
  • the timing belt 56 is driven and the main gear 58 rotates.
  • the rotation link 62 rotates.
  • each link moves while maintaining the parallelogram shape of the fixed link 60, the rotary link 62, the fixed link 70, and the parallel link 64.
  • the fixed link 70 moves, the right knee joint link 68 also moves together.
  • the right thigh attachment link 66 rotates about the connection portion with the center link 54.
  • the rotation link 62, the parallel link 64, and the right thigh attachment link 66 always move while maintaining substantially parallel.
  • the right lower leg drive mechanism includes a timing belt 74, a main gear 76, a fixed link 70, a rotation link 78, a parallel link 80, a right lower leg attachment link 72, and a right foot support plate 82. And comprising.
  • the timing belt 74 transmits the rotation of the drive motor 52B to the main gear 76.
  • the main gear 76 meshes with the timing belt 74 and rotates.
  • the fixed link 70 has the lower rotation shaft of the rotation link 62 and the upper rotation shaft of the parallel link 80 at its front end, and the upper rotation of the lower rotation shaft and the rotation link 78 of the parallel link 64 at its center. It has a shaft and is connected to the right knee joint link 68 at its rear end. Further, the upper rotation shaft of the rotation link 78 located at the center of the fixed link 70 is connected to the rotation shaft of the main gear 76, and the rotation link 78 can rotate around the rotation shaft as the main gear 76 rotates. It is.
  • the rotation link 78 is connected to the rear end of the right side of the right foot support plate 82 by an omnidirectional joint, and is rotatable around the omnidirectional joint.
  • the parallel link 80 is connected to the center end portion of the right side of the right foot sole support plate 82 by an omnidirectional joint, and can rotate around the omnidirectional joint.
  • the right lower leg attachment link 72 is connected to the left end of the right knee joint link 68 at its upper end and the rear left end of the right foot support plate 82 at its lower end by an omnidirectional joint. Has been.
  • the timing belt 74 is driven and the main gear 76 rotates.
  • the rotation link 78 rotates.
  • each link and the right foot support plate 82 move while maintaining the parallelogram shape of the rotation link 78, the right foot support plate 82, the fixed link 70, and the parallel link 80.
  • the right lower leg attachment link 72 rotates around the connection with the right knee joint link 68.
  • the rotary link 78, the parallel link 80, and the right lower leg attachment link 72 always move while maintaining substantially parallel.
  • the configuration and driving mode of the left lower body thigh drive mechanism are substantially the same as those of the right lower body thigh driving mechanism described above, and the configuration and driving mode of the left lower body thigh driving mechanism are described above. Since it is almost the same as the thigh drive mechanism, description thereof is omitted here.
  • the upper body support part 50B supports the upper body including the upper waist and includes a back carrier right face plate 84, a back child left face plate 86, a back carrier back face plate 88, and an upper body link 90 that fixes each face plate of the back carrier. Composed.
  • the back carrier back plate 88 is fixed on its back surface by an elastic link portion and a metal screw.
  • the lower body mounting portion 50A and the upper body support portion 50B described above are elastically connected by an elastic link 92 that can be elastically deformed in the front-rear and left-right directions.
  • the elastic link 92 is fixed by a metal screw or the like at the center of the center link 54, and is fixed by a metal screw or the like on the back surface of the backpack back plate 88.
  • the acceleration sensor S1 corresponds to the position corresponding to the lower back portion of the back plate 88
  • the acceleration sensor S2 corresponds to the ankle portion of the left foot support plate 83 at a position corresponding to the foot joint portion of the right foot support plate 82.
  • An acceleration sensor S3 is provided at each position.
  • a six-axis acceleration sensor is used as the acceleration sensors S1 to S3, but the present invention is not limited to this.
  • the pressure sensor S4 is provided in the foot region of the right foot support plate 82, and the pressure sensor S5 is provided in the heel region. Further, a pressure sensitive sensor S6 is provided in the foot tip region of the left sole support plate 83, and a pressure sensitive sensor S7 is provided in the heel region.
  • a pressure sensitive sensor S4 to S7 a thin pressure sensor in which a pressure sensitive conductive rubber (PCR Technical) having a thickness of 0.5 [mm] is sandwiched between copper foil seals. Needless to say, this is not a limitation.
  • the wearer When wearing the walking assist device 30A, the wearer puts both feet on the right foot support plate 82 and the left foot support plate 83, and puts both lower leg portions on the right lower leg attachment link 72 and the left lower leg attachment link 73, respectively.
  • the back of the knee is attached to the right knee joint link 68 and the left knee joint link 69, and both thighs are attached to the right thigh attachment link 66 and the left thigh attachment link 67, respectively.
  • the walking assist device 30A includes a control unit C1 including a wireless communication unit 98 and a control unit 99.
  • the wireless communication unit 98 performs wireless communication with the wireless communication unit 20H of the walking training support apparatus 20.
  • the control unit 99 controls the overall operation of the walking assist device 30A, and includes a CPU and various storage units such as a RAM and a ROM.
  • acceleration sensors S1 to S3, pressure sensors S4 to S7, and drive motors 52A to 52D are electrically connected to control unit 99.
  • the operation of the drive motors 52A to 52D is controlled based on the measurement values obtained by the acceleration sensors S1 to S3 and the pressure sensitive sensors S4 to S7.
  • FIG. 5 the configuration of the close contact type walking assist device 30B according to the present embodiment will be described.
  • FIG. 5 only the walking assist device corresponding to the right foot of the wearer is shown, but actually, a walking assist device corresponding to the left and right feet of the wearer is prepared.
  • the walking assist device 30B includes a motor that generates power for assisting the movement of the knee joint of the wearer with respect to one foot of the wearer, that is, the knee joint motor 35.
  • the motor for generating power for assisting the movement of the wearer's ankle joint, that is, the ankle motor 36 is provided.
  • the knee joint motor 35 and the ankle motor 36 are fixedly installed on the back surface of the wearer with a belt or the like, but the present invention is not limited to this.
  • signals for driving the knee joint motor 35 and the foot joint motor 36 are transmitted by a connection cable that connects the control unit 31 (see also FIG. 7) described later and these motors.
  • a DC servo motor is applied as the knee joint motor 35 and the ankle motor 36, but other motors such as a stepping motor and a geared motor may be applied. Needless to say.
  • drive control of each motor of the knee joint motor 35 and the ankle joint motor 36 is basically performed by receiving control of its own rotation angle and rotation angular velocity. Therefore, the signal for controlling the driving of each motor needs to have information on the rotation angle and the rotation angular velocity.
  • the rotation shafts of the knee joint motor 35 and the ankle motor 36 protrude from the motor body, and the rotation shaft of the knee joint motor 35 is the rotation of the motor-side encoder 37.
  • the rotation shaft of the foot joint motor 36 is connected to the rotation shaft of the motor-side encoder 38.
  • the motor-side encoders 37 and 38 detect the rotation angle and the rotation direction of the rotation shafts of the knee joint motor 35 and the ankle motor 36 as the rotation angle.
  • the walking assist device 30B is connected to the rotation shaft of the knee joint motor 35 and transmits the power for assisting the movement of the wearer's knee joint to one foot of the wearer.
  • Two flexible shafts are provided: a flexible shaft 39 and an ankle joint flexible shaft 40 that is connected to the rotation shaft of the ankle motor 36 and transmits power for assisting the movement of the wearer's ankle joint.
  • a flexible shaft an inner shaft formed by winding a plurality of layers of metal wires around a single metal wire so that the metal wires of each layer spiral in opposite directions, such as a rigid wire And the like which are passed through an outer tube made of vinyl chloride or the like covered on the outer surface.
  • the flexible shafts 39 and 40 have their upper ends connected to the rotation shafts of the motors 35 and 36, and rotate with the rotation of the rotation shafts of the motors.
  • the flexible shaft may twist due to the drag from the object. End up. That is, when the other end portion of the flexible shaft is fixed to an object, even if rotation is applied from the one end portion, the rotation angles generated at both end portions are different. Therefore, in such a case, when a desired rotation angle is given to the end portion on which the object is fixed, it is necessary to apply an extra force, that is, torque, from the end portion on the rotating side.
  • ⁇ 1 is a rotation angle generated on the side to which rotation is applied among the ends of the flexible shaft
  • ⁇ 2 is a rotation angle generated on the side fixed to the object among the ends of the flexible shaft
  • k is a torsion spring constant. It is.
  • This torsion spring constant k takes a different value depending on the flexible shaft used.
  • the walking assist device 30B includes a knee joint operation assisting portion 41 that is connected to the lower end of the knee joint flexible shaft 39 and is disposed at the knee joint portion of the wearer, and an ankle joint flexible shaft.
  • 40 has an ankle joint movement assisting portion 42 which is connected to the lower end of 40 and is arranged at the wearer's ankle joint portion.
  • the walking assist device 30B according to the present embodiment includes thigh fixing links 43 to 45 that fix the wearer's thigh and the knee joint operation assisting portion 41.
  • the walking assist device 30B according to the present embodiment includes crus fixing links 46 to 48 that connect the knee joint motion assisting portion 41 and the ankle joint motion assisting portion.
  • the crus fixing links 46 to 48 are fixed to the rotation shaft of the knee joint operation assisting portion 41 and are driven in the front-rear direction by the rotation of the fixed shaft.
  • the walking assist device 30B includes an ankle joint movement assisting portion 42 that is connected to the lower end of the ankle joint flexible shaft 40 and is disposed at the lower ends of the crus fixing links 46 to 48,
  • a sole support plate 49 is provided to support the sole portion of the wearer.
  • the sole support plate 49 is fixed to the rotation shaft of the ankle joint operation assisting portion 42 and can be rotated about the fixed shaft by the rotation of the fixed shaft.
  • the walking assist device 30B includes a knee joint encoder 33 disposed at a connection portion between the lower end of the knee joint flexible shaft 39 and the knee joint operation assisting portion 41, and the lower end of the ankle joint flexible shaft 40.
  • An ankle joint encoder 34 disposed at a connection portion with the ankle joint motion assisting portion 42.
  • the said connection part and the rotating shaft of each joint encoder 33 and 34 are connected, The rotation angle and rotation direction of the said connection part are detected as a drive angle.
  • the walking assist device 30B follows according to the walking state of the wearer, as shown in FIG. 6 as an example, the pressure at two locations under the thumb ball and the heel can be measured.
  • the pressure sensor S8 and the pressure sensor S9 are embedded in the insole of the foot corresponding to the right foot, and the pressure sensor S10 and the pressure sensor S11 are embedded in the insole of the foot corresponding to the left foot.
  • the pressure sensitive sensors S8 to S11 a thin pressure sensor in which a pressure sensitive conductive rubber (made by PCR Technical) having a thickness of 0.5 [mm] is sandwiched between copper foil seals. Needless to say, this is not a limitation. The same applies to the measurement position and the number of measurement points.
  • the walking assist device 30B includes a control unit C2 including a wireless communication unit 29 and a control unit 31.
  • the wireless communication unit 29 performs wireless communication with the wireless communication unit 20H of the walking training support device 20.
  • the control unit 31 controls the operation of the entire walking assist device 30B, and includes a CPU and various storage units such as a RAM and a ROM.
  • the pressure-sensitive sensors S8 to S11 are electrically connected to the control unit 31, and each of the pair of joint encoders 33 and 34, the motor-side encoders 37 and 38, The knee joint motor 35 and the foot joint motor 36 are electrically connected, and the control unit 31 includes pressure sensors S8 to S11, joint encoders 33 and 34, and motor-side encoders 37 and 38. Based on the measured value, the operation of each joint motor 35, 36 is controlled.
  • the structure of the close contact type walking assistance device 30C according to the present embodiment will be described.
  • the walking assistance device 30C according to the present embodiment has substantially the same configuration as the above-described walking assistance device 30B, and therefore, the same reference numerals as those in FIG. Therefore, the description is omitted.
  • the walking assist device 30C according to the present embodiment includes a knee assist motor 35, a motor-side encoder 37, a knee joint flexible shaft 39, and the like related to the knee assist device 30B.
  • a fixed band 32 is provided. That is, the walking assist device 30B according to the present embodiment is configured to assist the wearer's knee joint and ankle joint, whereas the walking assist device 30C according to the present embodiment is only an ankle joint. It is supposed to assist.
  • the walking assist device 30C includes a control unit C2 having the same configuration as the walking assist device 30B.
  • pressure-sensitive sensors S8 to S11 are connected to the control unit 31 of the control unit C2, and a pair of joint encoders 34, a motor-side encoder 38, and an ankle joint motor, respectively.
  • 36 is electrically connected, and the control unit 31 operates each joint motor 36 based on the measurement values obtained by the pressure sensors S8 to S11, each joint encoder 34, and each motor side encoder 38. Control.
  • the walking assistance device 30A is configured so that the right foot support plate 82 and the left foot support plate 83 are positioned so as to follow the trajectory generated from the joint angle of the healthy person walking and the length of the wearer's foot. It is possible to perform toe trajectory tracking control for controlling the period and phase. Hereinafter, the foot tip trajectory tracking control will be described.
  • the wearer's foot is modeled as a link mechanism as shown in FIG.
  • the trajectory of the thumb ball and the eyelid is calculated by forward kinematics using each joint angle change data during walking of the healthy person and the length between each joint of the wearer measured in advance.
  • the joint angle change data during the walking of the healthy person is described in the literature “Yoshihiro Ehara, Sumiko Yamamoto, Introduction to Body Dynamics and Analysis of Walking (2002), pp.
  • a target trajectory of points is generated as shown in FIG. 12 as an example, and a plurality of basic points (20 points in the present embodiment) are determined on the trajectory in one cycle, and linear interpolation is performed.
  • the control interval at this time updates the target value every 1 [msec].
  • the stride length of the target trajectory is expanded or contracted according to the wearer's experience and walking environment.
  • the stride when wearing the walking assist device 30A is measured as needed, and the walking cycle preset at the time of the above-mentioned maximum stride (in this embodiment, the walking cycle of a healthy person is set to 1).
  • the walking assist device 30A operates slowly because the stride is small at the start and end of walking, but the walking assist device 30A operates faster as the step starts and the stride increases. Then, control is performed so that the walking cycle becomes smaller. Note that 1.08 [s / step] calculated based on the above-mentioned document 1 can be applied as the walking cycle of the healthy person.
  • the pressure sensors S4 to S7 are attached to the right foot sole support plate so that two locations under the thumb ball and the heel can be measured to follow the walking state of the wearer.
  • the walking phase of the wearer is determined from the combination of output voltages of the pressure sensors. In particular, carefully determine the transition to the swing phase, not only determine that the heel of the foot you want to shift to the swing leg, but also switch the target value after confirming the center of gravity shift to the one leg standing, Consider safety.
  • the walking assist device 30A can perform joint torque control in addition to the above-described foot tip trajectory tracking control.
  • the acceleration sensor S1 is applied to the waist part and the joint part of both ankles of the walking assist device 30A.
  • the acceleration obtained by each of the acceleration sensors S1 to S3 is set so as to follow the torque of each joint calculated in advance. Use it to control the movement of each joint.
  • a device using the above-described template of foot acceleration is employed as the joint torque control, but is not limited thereto.
  • each joint may be controlled by a dynamic equation using acceleration measurement data obtained in real time by the acceleration sensors S1 to S3.
  • the foot trajectory tracking control when a certain walking speed comes out, it is more flexible than the foot trajectory tracking control and operates at that timing.
  • Teaching can be performed to the wearer, which is effective.
  • the control using the measurement data of real-time acceleration as described above is performed, the muscular power assistance (power assist) of the movement that the wearer wants to walk is performed. )It can be performed.
  • control using the foot acceleration template and the control using real-time acceleration measurement data may be applied in combination.
  • the walking assist device 30A can selectively execute any one of the foot tip trajectory tracking control and the joint torque control.
  • the greatest feature of the walking assist device 30B according to the present embodiment is that load torque can be measured using a flexible shaft.
  • hybrid control is performed to control both the tip position of the ankle joint, the angle of the knee joint, and the torque of each joint.
  • torque control it is possible to assist when it is necessary to exert a force even when the target angle is reached such as when one leg is standing.
  • a current value proportional to the deviation from the target angle corresponding to the walking phase is determined. Further, the angle difference is calculated from the angles of the motor-side encoders 37 and 38 and the joint encoders 33 and 34, the load torque applied to each joint is calculated by multiplying the torsional rigidity of the flexible shaft, and the target torque corresponding to the walking phase is calculated. The current value proportional to the deviation is determined.
  • the two target values are angles and torques necessary for a healthy person to walk, and the current value is determined by adjusting this ratio, and the motors 35 and 36 are driven.
  • walking assist device 30B lays an insole with pressure sensitive sensors S8 to S11 embedded on the thumb ball and the heel portion on the sole, as an example. As shown in FIG. 13, the walking phase is determined from the change in voltage obtained by each pressure sensor. As a result, it is possible to cope with a wearer who has a weak muscle strength and is difficult to obtain an electromyogram.
  • the walking assist device 30B according to the present embodiment is configured such that the specific gravity between the angle control and the torque control can be set by setting the ratio in the hybrid control. That is, in the hybrid control according to the present embodiment, [7: 3] and [8: 2] can be set as [angle control: torque control]. In the hybrid control according to the present embodiment, [10: 0] can be set as [angle control: torque control], but in this case, only angle control is performed. In the hybrid control according to the present embodiment, the above-described walking cycle can be set, and the hybrid control is performed so as to follow a preset walking cycle.
  • control method of the walking assist device 30C according to the present embodiment is substantially the same as the control method of the walking assist device 30B, but the walking assist device 30B controls both the knee joint and the ankle joint.
  • the walking assist device 30C is different only in that control is performed only on the ankle joint.
  • any of the foot tip trajectory tracking control, joint torque control, and hybrid control is realized by PID control for each motor.
  • FIG. 14 shows a functional block diagram showing a functional configuration of the walking training support system 10 according to the present embodiment.
  • the walking training support system 10 according to the present embodiment includes a detection unit 20A1, a determination unit 20A2, and an execution unit 20A3.
  • the detection unit 20A1 uses a walking assist device 30 in a state worn by a trainee (patient) and uses a predetermined physical quantity indicating a walking state when walking training is performed by the trainer. To detect.
  • a physical quantity a physical quantity indicating followability to the assisting operation by the walking assist device 30 of the walking training by the trainee is applied, but the present invention is not limited thereto.
  • a physical quantity indicating another walking state such as information indicating the amount of movement of the walking assist device 30 during walking training by a trainee may be applied.
  • the determination unit 20A2 determines the trainee's paralysis level based on the physical quantity detected by the detection unit 20A1, and the execution unit 20A3 according to the present embodiment is determined by the determination unit 20A2. In accordance with the determined level, a process predetermined to support walking training is executed.
  • execution part 20A3 which concerns on this Embodiment performs the process which sets to the walking assistance apparatus 30 of the various parameters according to the level determined by determination part 20A2 as said predetermined process.
  • the execution unit 20A3 according to the present embodiment, as the predetermined process, sets a parameter to be set in the walking assist device 30 when the level determined by the determination unit 20A2 reaches a predetermined target level. A process of changing to a predetermined type of parameter according to the target level is executed.
  • the execution unit 20A3 executes a process of presenting a training method according to the level determined by the determination unit 20A2 on the display 20F as the predetermined process. Further, the execution unit 20A3 according to the present embodiment executes a process of creating a training menu according to the level determined by the determination unit 20A2 and storing it in the secondary storage unit 20D as the predetermined process. . Furthermore, the execution unit 20A3 according to the present embodiment performs a plurality of types (three types in the present embodiment) determined in advance according to the level determined by the determination unit 20A2 as the predetermined process. A process of selectively presenting any one from the walking assist device 30 on the display 20F is executed.
  • FIG. 15 schematically shows main storage contents of the secondary storage unit 20D provided in the walking training support apparatus 20 according to the present embodiment.
  • the secondary storage unit 20D is provided with a database area DB for storing various databases and a program area PG for storing various application programs.
  • the database area DB includes a training menu basic information database DB1 and a patient information database DB2.
  • FIG. 16 shows an example of changes in muscle tonus associated with the transition of each stage in the Brunstrom stage.
  • the training menu basic information database DB1 is a database prepared for performing walking training corresponding to each paralysis level. As schematically illustrated in FIG. , Period allocation, and training program information are stored.
  • the training program includes information on auxiliary device type, equipment used, program, and upper training frequency.
  • the said stage is information which shows each stage in the Brunsstrom stage mentioned above
  • the said period allocation is information which shows the ratio of the period allocation between each stage at the time of implementing walking training.
  • FIG. 17 it is shown that the allocation of the periods of stage 1, stage 2, stage 3, stage 4, stage 5, and stage 6 is 3: 2: 2: 2: 2: 2. Yes.
  • the auxiliary device type is information indicating the type of the walking assist device 30 used for the patient of the paralysis level included in the corresponding stage, and corresponds to the above-described walking assist device 30A in the present embodiment.
  • Three types of walking assist devices 30 of “non-restraint type”, “close contact type (knee joint + ankle joint)” corresponding to walking assist device 30B, and “close contact type (ankle joint)” corresponding to walking assist device 30C are applied. Has been.
  • the said instrument used is information which shows the instrument used with respect to the patient of the paralysis level contained in the corresponding stage, and in this Embodiment, two types of instruments, "three-dimensional harness” and “parallel bar", are included. Has been applied.
  • the program is information indicating a control method applied in the walking assisting device 30 worn by the patient of the paralysis level included in the corresponding stage, and parameters applied in the control.
  • the control The above-described three types of control methods, “foot tip tracking control”, “joint torque control”, and “hybrid control”, are applied, and the above parameters are “leg weight compensation” and “walking”. Two types of “period” are applied.
  • the leg weight compensation is information indicating the degree of weight relief from the leg of the patient of the paralysis level included in the corresponding stage, and the PID when each motor is PID controlled in the walking assist device 30. This can be realized by adjusting the control amount in (proportional control).
  • the upper limit of the training frequency is information indicating the upper limit of the frequency when the patient at the corresponding stage performs walking training using the corresponding assisting device type walking assist device 30.
  • the upper limit of the training frequency is 1
  • the information includes information indicating how many days of walking training can be performed in a week, and information indicating the upper limit value of the walking training time per day.
  • each information of patient ID (Identification), training start date, target training period, paralysis level, and training menu is stored. It is configured to be stored.
  • the patient ID is information individually assigned to all patients in the walking training support system 10 in order to identify the corresponding patient.
  • the training start date is information indicating the date on which the corresponding patient started training
  • the target training period is a target reported by the corresponding patient or proposed by a physical therapist or the like. This is information indicating the training period.
  • the paralysis level is information indicating the paralysis level of the corresponding patient.
  • two types of information “initial” that is the level at the start of training and “current” that is the latest level. Consists of.
  • the training menu is information indicating a corresponding patient-specific training menu created in a walking training support program (see also FIG. 20) described later.
  • the training start date of a patient who is given “10001” as the patient ID is May 10, 2013, the target training period of the patient is 12 weeks, and the training start time of the patient This shows that the paralysis level is stage 1, the current paralysis level is stage 3, and the training menu A is created and registered as a training menu.
  • FIG. 19 schematically shows a configuration example of the training menu according to the present embodiment.
  • the training menu according to the present embodiment has no “period allocation” and “elapsed week” compared to the information (see also FIG. 17) of the training menu basic information database DB1 described above.
  • "And” implementation date “are different only in that they are included.
  • the elapsed week is information indicating the week that has elapsed from the training start date when the target training period of the corresponding patient is allocated to each stage by the period allocation in the training menu basic information database DB1.
  • the implementation date is information indicating the actual calendar period of the corresponding elapsed week.
  • training corresponding to the first half of the stage 4 that is, contact type (knee joint + ankle joint) ) Is used to perform 20% leg weight compensation and to perform hybrid control with the walking cycle set to any one of 1 to 1.5.
  • the walk training assistance process by each component (detection part 20A1, determination part 20A2, execution part 20A3) of the walk training assistance apparatus 20 comprised as mentioned above uses a computer by running a program. It may be realized by a software configuration. In this case, the program according to the present embodiment is included in the program. However, it is not limited to realization by software configuration, and it goes without saying that it may be realized by hardware configuration or a combination of hardware configuration and software configuration.
  • the walking training support apparatus 20 realizes the walking training support processing by the above-described components by executing the program.
  • a form in which the program is installed in the walking training support device 20 in advance a form provided in a state stored in a computer-readable recording medium, a form distributed via wired or wireless communication means Etc. may be applied.
  • the operation of the walking training support system 10 will be described.
  • a case where the training menu basic information database DB1 has already been constructed in order to avoid complications will be described.
  • a case will be described in which walking training is performed by two persons, a patient and an assistant such as a physical therapist.
  • FIG. 20 is a flowchart showing the flow of the walking training support program executed by the CPU 20A of the walking training support device 20 when an instruction to execute the walking training support processing is input via the keyboard 20E or the like.
  • the program is stored in advance in the program area PG of the secondary storage unit 20D.
  • step 100 of the figure the display 20F is controlled to display an initial screen having a predetermined format, and in the next step 102, input of predetermined information is waited.
  • FIG. 21 shows an example of the display state of the initial screen.
  • the area A1 that is specified when the current walking exercise is the first (first) exercise and the case that the second and subsequent exercises are specified.
  • an area A3 for inputting a patient's paralysis level and an area A4 for inputting a target training period when the current walking training is the first training are displayed.
  • a region A5 for inputting the patient ID of the patient when the current walking training is the second or later training is displayed.
  • the operator points the area A1 using a mouse or the like when this time is the first walking training. specify.
  • the operator inputs the paralysis level of the patient at this time in the area A3 and the target training period in the area A4 using the keyboard 20E, a mouse, etc., respectively, and then near the lower end of the initial screen. Pointing to the displayed end button.
  • the operator designates the area A2 and inputs the patient ID given to the patient in the area A5, and then designates the end button.
  • step 102 is affirmative and the process proceeds to step 104.
  • step 104 it is determined whether or not this time is the first walking training based on the input information on the initial screen. If the determination is affirmative, the process proceeds to step 106 and is input on the initial screen. After all the information of the stage corresponding to the paralysis level is read from the training menu basic information database DB1, the process proceeds to step 110.
  • step 104 the current walking training is regarded as the second and subsequent training, and the process proceeds to step 108, where all the IDs corresponding to the patient IDs input on the initial screen are displayed. Information is read from the patient information database DB2, and then the process proceeds to step 110.
  • step 110 the display 20F is controlled so as to display an information presentation screen having a predetermined format based on the information read out by the processing of step 106 or step 108. Wait for input of information.
  • FIG. 22 shows an example of the display state of the information presentation screen.
  • the paralysis level of the patient is displayed, and the type of walking assist device 30 to be used (in the example shown in FIG. ), Information to be used ('3D harness' in the example shown in the figure), and the implementation time ('within 3 hours' in the example shown in the figure), which is the upper limit of the walking training time Is displayed together with a message prompting to perform walking training.
  • the type of walking assist device 30 to be used in the example shown in FIG.
  • Information to be used '3D harness' in the example shown in the figure
  • the implementation time 'within 3 hours' in the example shown in the figure
  • step 110 when the process of this step 110 is performed after passing through the process of said step 106, while displaying the paralysis level of the said information presentation screen applying the paralysis level input by the operator on the said initial screen,
  • the information on the type, equipment, and execution time of the walking assistance device 30 to be used are “auxiliary device type”, “use equipment”, and “training frequency” read from the training menu basic information database DB1 by the processing of step 106 above.
  • Each information of the upper limit time of the daily training in “Upper limit” is applied and displayed.
  • the paralysis level of the information presentation screen is “paralysis level” in the information read from the patient information database DB2 by the process of step 108.
  • “Current” information is applied and displayed, and the information on the type, equipment, and execution time of the walking assistance device 30 to be used is “auxiliary device type” in the training menu in the information read from the patient information database DB2. ”,“ Usage tool ”, and“ Upper training frequency upper limit ”, each information of upper limit time of daily training is applied and displayed.
  • step 112 is affirmative and the process proceeds to step 114.
  • step 114 information on the program included in the information read out by the processing in step 106 or step 108 (in this embodiment, the control method, the ratio of angle control and torque control when the control method is hybrid control, leg, Each part weight compensation value and each information on the walking cycle (hereinafter referred to as “control information”) are transmitted to the device to be used via the wireless communication unit 20H.
  • control information each information on the walking cycle
  • the control unit of the device to be used stores the received control information in the storage unit provided in itself.
  • the walking cycle in the control information according to the present embodiment has a width such as “2 to 3 times” or “1.5 to 2 times” as shown in FIG. 17 as an example.
  • the maximum value of the width is applied in the first half of the walking training period of the corresponding stage, and the minimum value of the width is applied in the second half of the period. Or the like can be applied.
  • the walking cycle corresponding to the stage 6 is information indicating that the walking cycle is adjusted according to the situation. Can be applied.
  • control target device starts control according to the control information received from the walking training support device 20, and when performing the control, information indicating the target value of the parameter to be controlled (hereinafter, referred to as the control target).
  • target information information indicating the target value of the parameter to be controlled
  • actual measurement information information detected by various sensors
  • the device to be used is the walking assist device 30A and the toe trajectory tracking control is performed
  • information indicating the target trajectory is set as the target information
  • the acceleration sensors S1 to S3 and the pressure sensors S4 to S7 are used. Is transmitted to the walking training support device 20 as the actual measurement information.
  • the target device is the walking assist device 30A and performs joint torque control
  • the information indicating the target foot acceleration is the target information
  • the information indicating the output values from the acceleration sensors S1 to S3 is the above information. It transmits to the walking training assistance apparatus 20 as measurement information.
  • the target device is the walking assist device 30B
  • the information indicating the target angle and the target torque is set as the target information
  • the output values from the joint encoders 33 and 34 are transmitted as the measured information to the walking training support device 20.
  • the device to be used is the walking assist device 30C
  • the information indicating the target angle and the target torque is set as the target information
  • the output value from the joint encoder 34 is transmitted as the measured information to the walking training support device 20.
  • the target information and the actual measurement information transmitted from the use target device are received and stored in a predetermined area of the secondary storage unit 20D in association with the time information indicating the time at that time.
  • the device to be used transmits end information indicating the end of the walking training to the walking training support device 20 via the wireless communication unit.
  • step 120 it is determined whether or not the end information has been received. If a negative determination is made, the process returns to the above step 118, while the process proceeds to step 122 when an affirmative determination is made.
  • the target information and the actual measurement information received from the use target device are sequentially stored in the predetermined area of the secondary storage unit 20D in time series.
  • step 122 the target information and the actual measurement information stored by the above processing are read from the secondary storage unit 20D, and based on the read target information and actual measurement information, the gait training operation by the patient is performed by the target device.
  • a value indicating the followability with respect to the auxiliary motion (hereinafter referred to as “followability information”) is derived as follows.
  • a value indicated by the actual measurement information is converted into a value indicating a physical quantity similar to the value indicated by the target information.
  • shift amount of the value obtained by this and the value shown by target information is calculated as said follow-up information.
  • next step 124 based on the followability information obtained by the above process, it is determined as to which stage the patient's paralysis level is.
  • the value indicated by the followability information obtained by the process of step 122 is within a predetermined range, the value is read by the paralysis level input on the initial screen or the process of step 108. It is determined that the paralysis level (hereinafter referred to as “applied paralysis level”) is the patient's paralysis level. On the other hand, if the value indicated by the follow-up information exceeds the upper limit of the above range, it is determined that the paralysis level that is one step lower than the applied paralysis level is the patient's paralysis level. Furthermore, when the value indicated by the follow-up information is below the lower limit of the range, it is determined that the paralysis level that is one step higher than the applied paralysis level is the patient's paralysis level.
  • the range is a range in which the patient's paralysis level can be regarded as the applied paralysis level, for each stage of the paralysis level.
  • a range obtained in advance by an experiment using an actual device to be used, a computer simulation based on a design specification of the device to be used, or the like can be applied.
  • the timing for newly creating or updating patient information is determined in advance from the timing when this time is the first gait training and the time when it was last updated (or newly created).
  • the timing at which the period (one week in the present embodiment) has passed and the paralysis level determined by the processing of step 124 (hereinafter referred to as “determination paralysis level”) are registered in the patient information database DB2.
  • determination paralysis level the paralysis level determined by the processing of step 124
  • the present invention is not limited to this. For example, in addition to these timings, a timing in which a predetermined period has elapsed since the most recent change in the paralysis level may be applied.
  • step 1228 patient information is newly created or updated as shown below.
  • the actual calendar period corresponding to the determined elapsed week is specified, and the determined elapsed week and the determined calendar period are combined with the information excluding the period allocation read from the training menu basic information database DB1.
  • Create a training menu is an example when a training menu is created for the first time after starting training.
  • a patient ID that is not registered in the patient information database DB2 is newly generated, along with the generated patient ID and the generated training menu,
  • the date of this day, the target training period input on the initial screen, the paralysis level input on the initial screen, and the judgment paralysis level are expressed as “training start date”, “target training period”, “paralysis level” ( Initially) and “paralysis level” (current) are newly registered in the patient information database DB2, respectively.
  • the “paralysis level” (current) and the training menu corresponding to the patient ID input on the initial screen in the patient information database DB2 are determined as the determination paralysis.
  • the patient information database DB2 is updated by replacing the level and the created training menu respectively.
  • the process proceeds to step 130, and after executing the process of displaying the training menu obtained by the above process together with the patient ID on the display 20F, the walking training support program is terminated. .
  • the patient and the assistant can grasp the current paralysis level and patient ID of the patient, and at the next and subsequent walking training. The schedule can be grasped.
  • the trainee who performs walking training wears the trainer according to the preset parameters (control information parameters in the present embodiment).
  • a walking assist device that performs an assisting operation for walking motion
  • a predetermined physical quantity (following information in this embodiment) indicating a walking state when walking training is performed by the trainee is detected.
  • the exerciser's exercise level (in this embodiment, paralysis level) is determined, and predetermined processing is performed to support the walking exercise according to the determined exercise level.
  • the exercise level of the trainee can be determined accurately, and as a result, more effective walking training can be performed.
  • the physical quantity is a physical quantity indicating the followability to the auxiliary motion of the walking training by the trainee, and as a result, the exercise level can be determined more accurately, resulting in a more effective result. Training.
  • the predetermined process a process for setting the parameter according to the determined exercise level in the walking assist device is executed. Therefore, the parameter setting is performed manually. Compared with the case where it carries out via, the setting of a walking assistance apparatus can be performed more simply.
  • a parameter to be set in the walking assist device is predetermined according to the target level. Since the process of changing to a different type of parameter (in this embodiment, the process of changing the control information when the paralysis level is improved) is performed, the walking assistance device regardless of the exercise level of the trainee Compared with the case where the type of parameter to be set is fixed, walking training can be performed more effectively.
  • a process of presenting a training method according to the determined exercise level (in this embodiment, a training method indicated by information displayed on the information presentation screen)
  • the trainer can grasp his / her own training method.
  • the labor by the physical therapist can be reduced more and walking training can be performed more effectively.
  • a process for creating a training menu corresponding to the determined exercise level is executed, so that the trainer grasps the schedule of the subsequent walking training.
  • a plurality of predetermined walking assistance devices in this embodiment, three types of walking assistance devices 30A to 30C) according to the determined exercise level. Since the process which selectively presents any one is performed from the walking assistance apparatus), walking training can be performed more effectively.
  • the plurality of types of walking assist devices assist at least one of the knee joint and the ankle joint and different combinations of joints. Can be done automatically.
  • the exercise level is the level of the trainee's paralysis
  • effective walking training can be performed according to the level of the trainee's paralysis.
  • walking training is performed for a paralyzed patient.
  • the present invention is not limited to this, and for example, walking training may be performed for elderly people. .
  • an evaluation method predetermined for the elderly is applied.
  • the ratio of the latter value to the former value may be applied as a physical quantity indicating the followability of the present invention.
  • NIHSS National Institute of Health Stroke scale
  • MAS Motor Assessment Scale
  • Motricity Index Modified Ashworth scale
  • FMA Fugl-Meyer assessment
  • SIAS Stroke Impairment Assessment Set
  • JSS Stroke Severity Scale
  • An evaluation method such as NIH stroke scale, Functional Independence measure (FIM), Barthel index, Ueda 12-step hemiplegia function test may be applied.
  • walking training is performed by two patients and an assistant has been described, but the present invention is not limited to this.
  • walking training is performed only by the patient. It is good also as a form which performs.
  • each stage of the Brunstrom stage is applied as each stage of the paralysis level
  • the present invention is not limited to this, for example, each stage of the Brunstrom stage. It is good also as a form which further divides
  • the said embodiment demonstrated the case where the walking training assistance apparatus 20 comprised as a separate body from the walking assistance apparatus 30 was applied as a walking training assistance apparatus of this invention, this invention is limited to this.
  • the walking training support device of the present invention may be configured integrally with the walking assistance device 30.
  • the present invention is not limited to this, and the initial paralysis level of the patient is automatically set. It is good also as a form which specifies.
  • a sensor capable of detecting a motion such as a six-axis acceleration sensor is provided on the waist, sole or the like of the walking assist device 30 and the output value of the sensor is measured with the walking assist device 30 attached. It is good also as a form which acquires continuously by series and specifies the paralysis level from the change of the said output value.
  • the configuration of the walking training support system 10 described in the above embodiment is an example, and unnecessary components may be deleted without departing from the gist of the present invention. Needless to say, new components can be added.
  • walking training support system 20 walking training support device 20A CPU (detection means, determination means, execution means) 20D secondary storage unit 20F display 30, 30A to 30C walking assist device 31 control unit 33, 34 joint encoder 35 knee joint motor 36 ankle motor 37, 38 motor side encoder 52A to 52D drive motor 99 control unit C1, C2 control unit S1 to S3 Acceleration sensor S4 to S11 Pressure sensor DB1 Training menu basic information database DB2 Patient information database

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  • Health & Medical Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Rehabilitation Therapy (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Pain & Pain Management (AREA)
  • Epidemiology (AREA)
  • Nursing (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Rehabilitation Tools (AREA)
  • Manipulator (AREA)
  • Prostheses (AREA)

Abstract

　La présente invention concerne un dispositif de support d'entraînement à la marche, un système de support d'entraînement à la marche, un procédé de support d'entraînement à la marche, et un programme, qui peuvent permettre un entraînement à la marche plus efficace. En utilisant un dispositif d'aide à la marche (30) qui est porté par un individu s'entraînant à la marche et réalise des mouvements auxiliaires relativement aux mouvements de marche de l'individu s'entraînant en fonction de paramètres prédéfinis (informations de commande), un dispositif de support d'entraînement à la marche (20) exécute un traitement prédéfini, une quantité physique prédéfinie (informations de suivi) qui indique le statut de marche lorsque l'individu s'entraîne à la marche étant détectée, le niveau de mouvement (niveau de paralysie) de l'individu s'entraînant est déterminé sur la base de la quantité physique détectée, et l'entraînement à la marche est supporté en fonction du niveau de mouvement prédéterminé.
PCT/JP2014/067461 2013-06-28 2014-06-30 Dispositif de support d'entraînement à la marche, système de support d'entraînement à la marche, procédé de support d'entraînement à la marche, et programme Ceased WO2014208772A1 (fr)

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WO2025181373A1 (fr) * 2024-02-28 2025-09-04 Centre National De La Recherche Scientifique Actionneur articulaire physiologique

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