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Development of an electrically driven elbow orthosis for patients with severe weakness of elbow flexors

为肘部屈肌严重无力的患者开发电动肘部矫形器

基本信息

批准号：
13671517
负责人：
TANI Toshikazu
金额：
$ 2.24万
依托单位：
Kochi Medical School
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2001
资助国家：
日本
起止时间：
2001 至 2002
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-13671517/
关键词：
Shoulder girdle weakness Elbow joint Biceps muscle Electromyogram Electrically driven orthosis Rehabilitation

项目摘要

A prominent weakness of shoulder abduction characterizes some cases of cervical spondylosis as an easily recognizable disability. In such patients, the motor deficits also involve external rotators of the shoulder and, to a lesser degree, elbow flexors, usually without a clear sensory loss. This condition called 'cervical spondylotic amyotrophy', 'the dissociated motor loss', or 'the shoulder girdle disc', probably results from segmental cord or root involvement. More recent designation, 'postoperative C-5 radiculopathy', implies a relatively frequent appearance of this syndrome as a neurologic complication of a decompressive cervical spine surgery. As a result of poor recovery of the elbow flexors after severe axon loss, the patients have difficulty in feeding oneself and doing up buttons despite fine finger movement preserved. To provide elbow flexion in such patients, we developed an electrically driven orthosis. We attached a motor (DME44SA-12V, Japan Servo Corp, Japan) with a decelerator (CDF-11-30-2A-R, Harmonic Drive Corp) to the standard elbow orthosis. The electromyographic discharge that was picked up with a pair of surface electrodes placed on the biceps muscle activated the motor. The printed circuit plate was developed so that the motor output can be controlled by the magnitude of the electromyographic discharge of the biceps muscle. Artifacts resulting from 60 Hz interference caused by the electrostatic or electromagnetic fields of nearby electrical appliances were controlled by specifying high- and low-frequency filters. The electric noise occurring when the switch closes and opens and was minimized by shielding the entire circuit.

肩关节外展是颈椎病的一个突出的弱点，它是一种容易辨认的残疾。在这类患者中，运动障碍还包括肩部外旋肌和肘关节屈肌，但程度较轻，通常没有明显的感觉丧失。这种情况称为“颈椎病肌萎缩症”、“游离性运动丧失”或“肩带椎间盘”，可能是由节段性脊髓或根受累引起的。最近的名称为“术后C-5神经根病”，意味着该综合征作为颈椎减压手术的神经系统并发症出现的频率相对较高。由于严重的轴突丧失后肘关节屈曲肌恢复不良，患者在进食和扣钮扣方面存在困难，尽管保留了良好的手指运动。为了使此类患者肘关节能够屈曲，我们开发了一种电动矫形器。我们将电机（DME44SA-12V, Japan Servo Corp, Japan）和减速机（CDF-11-30-2A-R, Harmonic Drive Corp）连接到标准肘关节矫形器上。放置在二头肌上的一对表面电极捕捉到的肌电图放电激活了马达。印制电路板的发展，使电机输出可以由肌二头肌的肌电图放电的大小控制。由附近电器的静电或电磁场引起的60赫兹干扰产生的伪影通过指定高频和低频滤波器来控制。当开关闭合和打开时产生的电噪声，并通过屏蔽整个电路而最小化。