CN107041748A - One kind is used for backbone reduction system electrocardio and triggers Magnetotherapeutic apparatus - Google Patents

Abstract

An electrocardiographic trigger circuit used in a spinal rehabilitation device, which treats the slight muscle contracture and muscle tension caused by modern people's bad living habits and diseases. Muscle tension mostly occurs on the attached or associated muscle groups on both sides of the spine, which will lead to fatigue, overload and even deformation of the spine over time. In the field of spinal rehabilitation, it has been proved to be an effective treatment method to relieve muscle tension by applying mechanical and electric fields while implementing spinal traction and fixation. The invention provides multiple treatment means and effectively combines electric and magnetic treatments. It can effectively improve various muscle health indicators through the induced discharge of the nerve ganglia related to muscle tension in the human body; at the same time, it can make adaptive adjustments in real time in combination with myoelectric detection to obtain better therapeutic effects. Introducing an electrocardiographic trigger circuit in the above magnetic stimulation process can effectively reduce the phenomenon of mutual interference of different bioelectrics.

Description

An electrocardiographic trigger magnetic therapy device for spinal rehabilitation system

technical field

The present application relates to the field of spinal rehabilitation, in particular to a spinal and muscle rehabilitation device.

Background technique

Modern people have a certain part of the body in a fixed posture for a long time due to sitting work, bad living habits, disease or some reason, and the muscles are in a state of continuous contraction under low load for a long time. This results in a loss of water in the matrix of fibrous tissues such as ligaments, weakened viscoelastic properties, and reduced interfiber lubrication. At the same time, the distance between fibers is shortened and the contact period is prolonged, which may lead to the formation of chemical transverse bonds between fibers, which leads to the occurrence of adhesion between fibers. In this group of people, chronic inflammation of muscle tissue often leads to new fibers. These new fibers are arranged in disorder and form adhesions with the original fibers again, further limiting the sliding between fibers. Over time, this "vicious circle" will cause slight muscle contractures, causing muscle tension. The lifestyle of modern people determines that such muscle tension mostly occurs on the attachment of the spine or related large and small muscle groups, which will lead to spinal fatigue, overload and even irreversible damage over time.

In the field of spinal rehabilitation, the implementation of spinal traction and fixation while relieving muscle tension by applying mechanical and electric fields has been proven to be an effective treatment. However, this process will inevitably cause unnecessary damage to the spine, and even cause spinal cord injury (SCI), and medical workers are often reluctant to adopt active treatment options in order to avoid the damage. At the same time, accidental massage injuries often occur during non-spinal injury massage. Therefore, it is necessary to provide effective real-time electrophysiological monitoring means when it comes to spinal treatment. How to combine electrophysiological detection with various spinal rehabilitation methods is a promising direction in this field. It is also the focus of research in this field to obtain effective and representative data from many electrophysiological indicators and use them to guide subsequent spinal rehabilitation.

Neuroelectrophysiological examination is a technology that measures, records and analyzes the bioelectricity generated by the peripheral nerves of the organism and the electrical characteristics of the organism based on the principles of neuroanatomy and relying on various forms of energy stimulation. Evoked potentials (EPs) refer to giving specific stimuli (sound, light or somatosensory stimuli) to the nervous system (from receptors to cerebral cortex), or to make the brain process information about stimuli (positive or negative). The system and the corresponding parts of the brain produce bioelectrical responses that can be detected and have a relatively fixed time interval (time-locked relationship) and a specific phase with the stimulus. It reflects the integrity of the structure and function of cells and molecular systems of synaptic transmission and axonal conduction, and is an effective functional indicator.

Electromyography (EMG) is a bioelectrical signal generated with muscle movement. When a person's limbs move, the neurons in the cerebral cortex that control the motor area are excited and generate electrical pulses of a certain frequency. The electrical pulses are accurately transmitted to specific muscle fibers through the nervous system. When these electrical pulses reach the nerve-muscle synapse , the end plate potential is generated in the muscle fiber, and its depolarization will generate a series of action potentials in the muscle fiber, causing muscle contraction, and making the limb complete the action set by the brain. Surface EMG is a comprehensive physiological electrical phenomenon generated by muscle activities in various parts of limb movement. The analysis and research of surface EMG can find the corresponding relationship between it and the physiological state of muscles and limb movement patterns. It can be widely used in clinical medicine and sports medicine. , medical rehabilitation and many other fields. In human skeletal muscle, it has been widely recognized that there is a myofascial trigger point (MTrP) in the muscle tension zone. Spontaneous electrical activity can be recorded in the MTrP area of the muscle tension band, and further, muscle tension will also be expressed and detected in the form of myoelectricity. To put it simply, the muscle expresses its physiological state through the electrophysiological signal (in the present invention, the statement of the physiological state of the muscle tension is emphasized); conversely, the muscle tension can be properly adjusted by means of an external field affecting the myoelectricity.

In the prior art, there are methods and devices for improving muscle tension by electrically stimulating the patient and receiving the patient's myoelectricity/biofeedback signal. However, these devices use simple electrode stimulation, the frequency is roughly between 5 Hz and 100 Hz, and the electrical signal includes a simple waveform. The stimulating effect on the human body is single, and it is easy to cause peripheral nerve fatigue and generate a large amount of unnecessary electrode heat. Insertion of electrodes or patch electrodes may cause keratinopathy and unnecessary damage. Patients will have unnecessary imagination about the intuitive and visible electrode stimulation, and this psychology will also lead to the deterioration of the treatment effect. The bottom line is that peripheral nerves may respond well to short-term stimuli, but long-term treatment can lead to nerve fatigue and diminished effectiveness. The reason is that during the evolution process, the human nerves have an adaptation process to the harmful stress reflex produced by external stimuli. However, the body's own neurons, including ganglia, are not prone to such fatigue, or their fatigue tolerance period is longer.

A ganglion is a nodular structure formed by the collection of neuron cell bodies with the same function outside the central nervous system. Its surface is covered by a membrane of connective tissue, which contains blood vessels, nerves, and fat cells. The capsule is connected with the outer membrane and perineurium of the peripheral nerve, and penetrates deep into the ganglion to form a reticular scaffold in the ganglion. The fibers sent by the nerve cells in the ganglion are distributed to the relevant parts of the body, called postganglionic fibers. According to the difference in physiology and shape, the ganglion can be divided into two types: spinal ganglion (sensory ganglion) and autonomic ganglion. Cerebrospinal ganglia are functionally sensory neurons and morphologically pseudounipolar or bipolar neurons. Vegetative ganglia include sympathetic and parasympathetic ganglia. The sympathetic ganglia are located on either side of the spine. Parasympathetic ganglia are located near or within the walls of the organs they innervate. Within the ganglion, the axons of the preganglionic neurons form synapses with the postganglionic neurons. Ganglia are connected to the brain and spinal cord by nerve fibers.

The inventor found through physiological tests in the laboratory that the bioelectricity generated by the human body is imprecise and controllable in amplitude and frequency by stimulating the nervous system including the ganglion, and the bioelectricity helps to promote nerve-controlled muscles, Rhythmic relaxation and contraction of connective tissue and blood circulation of peripheral capillaries. At the same time, the stimulation of ganglia will also lead to the effect of ascending nerve fibers on the brain. In practice, it can relieve the tension and anxiety of patients, and has a certain therapeutic effect on muscle tension caused by nerves. However, in the process of magnetic stimulation, mutual interference with ECG signals will inevitably occur. While shielding, the above-mentioned interference can also be improved by using ECG to trigger the magnetic stimulation circuit. This is also a technology that is difficult for those skilled in the art to solve urgently. question. At the same time, how to accurately locate the stimulation position simply, quickly and non-invasively is a difficult problem that those skilled in the art cannot overcome. In the past, physical therapy practitioners often used experience and patient feedback to perform positioning, which was inaccurate and could cause accidental damage; of course, some people also proposed to measure by adding electrodes, but the laboratory environment is very different from clinical practice, and the cost of detection remains high. At the same time, the requirements for the operator are very high.

Contents of the invention

The invention provides a rehabilitation system for patients with spinal injuries, spinal fatigue and related muscle tension relief and treatment. It overcomes the shortcomings of the previous restoration devices that can only target a single spinal problem, integrates multiple treatment methods, and realizes intelligent treatment under the monitoring of preset detection programs. At the same time, considering the multiple pathogenic mechanisms that may exist in the same appearance of the user, the detection and judgment logic combined with multiple detection means enables the device to make appropriate physical therapy according to the specific situation of the user. In order to achieve effective and safe spinal adjustment and rehabilitation, unnecessary secondary injuries or delays can be avoided.

The rehabilitation device mentioned in the present invention includes a myoelectric detection module 1 , a magnetic therapy module 2 , a support module 3 , a control module 4 , a display module 5 , and an electrocardiogram module 6 .

The invention relates to the fields of electrophysiology and electromagnetic medicine. The amplitude and frequency spectrum of the well-known electromyography (EMG) signal has its own characteristics: the surface EMG signal measured from the human body surface is usually very weak, and the amplitude generally does not exceed 5mV; the frequency is also relatively low, and the spectrum range is generally 0.02-1000Hz , the spectrum energy is mainly concentrated between 0.25 and 350Hz. There is a good linear relationship between the degree of muscle relaxation and tension and the magnitude of the generated surface electromyographic voltage. The root mean square method is used to measure the amplitude of EMG voltage, which can not only reflect the change characteristics of EMG signal amplitude in the time dimension, but also depend on the internal relationship between muscle loading factors and the physiological and biochemical processes of the muscle itself. Therefore, the Time-domain analysis indicators are often used to reflect the state of muscle activity in real time and without damage, and have good real-time performance. At the same time, the impedance of the muscle parts of the human body can effectively express the degree of relaxation of the human body. Generally speaking, the more relaxed the human body, the smaller the impedance. Therefore, the above-mentioned methods can be used in combination to obtain the degree of human muscle tension in real time and accurately, and grade it.

The obtained muscle tension may contain a variety of information, such as bone damage caused by spinal strain and hyperplasia, lactic acid metabolism disorders and pain caused by muscle spasm, and muscle tension caused by external force or psychology, etc. If the different causes of muscle tension cannot be effectively distinguished, targeted treatment cannot be effectively carried out. The present invention obtains the real-time myoelectricity and impedance signals of the human body by setting a myoelectric signal collector in a specific area of the body surface, and at the same time realizes the identification of the abnormal inducement of the above-mentioned myoelectric signal through the preset program in the gated logic circuit that can be programmed in real time And classification, and according to different judgment results to carry out the combination of different treatment methods.

First, transcranial magnetic stimulation (TMS) is implemented on the user, and the selected stimulation area is located in the epidural, and is detected by the magnetic field-evoked potential. A simple magnetic stimulator consists of a DC power supply, a charging circuit, an energy storage element, a discharge switch, a charge and discharge control circuit, and a coil. Various transcranial magnetic stimulation instruments and control devices including software well known to those skilled in the art are all incorporated into the present invention by reference, for example, the DTMS transcranial magnetic stimulation circuit device described in US2008200749A or the commercialized American Medtronic Mag Pro type magnetic stimulator.

The excitation generated by the application of magnetic stimulation to the motor area of the cortex depolarizes the anterior horn cells of the spinal cord or the motor fibers of the peripheral nerves through the descending conduction pathway, and the potential changes recorded in the corresponding muscles, nerves, and spinal cord are the motor evoked potential detection stimulation. According to different stimulation modes, SRPs can be divided into sensory evoked potential (somatosensory evoked potential, SEP) and motor evoked potential (motion evoked potential, MEP). SEP mainly reflects the functional status of the dorsal ascending sensory pathway of the spinal cord, while the MEP of transcranial stimulation reflects the integrity of the descending motor conduction pathway of the ventral spinal cord. Using MEP is helpful to detect whether the spine has substantial damage, especially for potential damage that does not show obvious physical impairment, and has a good flaw detection effect. MEP can be divided into spinal cord motor evoked potential (SCMEP), nerve motor evoked potential (MEP-N) and muscle motor evoked potential (MMEP), which can be used to detect nerve damage in different parts of the human body. The research of Maerten, Dvorak et al. pointed out that in spondylosis and intervertebral disc herniation, the sensitivity of MEP is 84%, which is significantly higher than the 36% of SEP, and the sensitivity of MEP to cervical spinal canal stenosis is slightly higher than that of lumbar spinal canal stenosis. It is presumed that the small size of the cervical spinal canal makes it easier to compress the spinal cord after stenosis. Machida reported that the sensitivity of transcranial MEP to patients with traumatic spinal cord injury was 85%. In order to reach the stimulation site through the skull and scalp, the peak value of the magnetic field should not be less than 1 Tesla (T) through the selection of coil turns and current value, and should generally be between 1-2T. A flat plate circular coil (which has a larger stimulation range and is more suitable for peripheral nerves) is set on the top of the user's skull in a tangential relationship with it. It can be an iron core coil or a combined coil. The diameter of the coil is between 12-20 cm. The distance from the top of the user's head is less than 3.5 cm. Because it is only used for physiological detection, the action time is short, and natural cooling or air cooling can be used. Fast-frequency TMS is realized at a depth of 1-3 cm in the user's skull through the coil, that is, the frequency of the time-varying magnetic field generated by the variable current is greater than 1 Hz. The detection of transcranial magnetic stimulation MEP signals can be realized by using a common motor potential detector, and the spinal cord conduction pathway can be detected by analyzing conventional indicators such as its conduction time and signal size. In this case, mechanical massage of the affected area or related parts should be strictly prohibited to avoid secondary damage to the spine in subsequent massage steps.

Second, MEP can also be used to detect peripheral nerve conduction pathways. The MEP acquisition method of the peripheral nerve is similar to the existing SEP technology. The anode of the patch guide electrode is set on the target muscle belly to be tested, and the cathode is set on the tendon segment of the nerve descending to ensure that the distance between the electrodes is more than 35mm. If necessary, subcutaneous microneedle electrodes can be used instead to improve the signal pickup effect and avoid noise interference. At the same time, according to the patient's main statement, the MEP signal can be picked up in a specific limb nerve pathway or ganglion, and then focus on the myoelectric waves transmitted through a specific spinal segment, and can qualitatively measure the damage of a specific nerve pathway. The selection of the target muscles can be based on the conventional selection criteria for transcranial magnetic stimulation signal detection in the field. In principle, the main muscles of the limbs far away from the trunk are preferred, and are not limited thereto.

In the waveform signal obtained by MEP detection, the first single-phase positive wave that arrives quickly is called a direct wave (D wave), because it is not transmitted through the synapse, so it is also called a direct wave; There is a group of positive waves (I waves), which are caused by the indirect excitation of pyramidal cells by contact fibers, which are called indirect waves. The MEP waveform elicited by electrical stimulation indicates that the spinal cord conduction tract is functioning normally, and the disappearance of the waveform indicates that the conduction function is blocked, that is, the judging principle of "all or nothing" or an 80% decrease in amplitude, and its monitoring sensitivity can reach 100%. If there is D wave conduction block, it will be classified by the gate control circuit, and mechanical massage is prohibited to prevent treatment injuries. While the D wave conduction is normal, but the I wave latency is prolonged (the judgment standard is approximately 2.5-5 times the normal time) indicates that there is inflammatory injury, such as demyelinating symptoms caused by overwork. Clinical experiments have shown that when the patient is awake without anesthesia, more than two consecutive transcranial magnetic stimulation can effectively simulate the normal evoked signal. Moderate mechanical massage supplemented by magnetic field-induced myoelectric stimulation helps activate neurons and conduction pathways.

Finally, the myoelectricity detection module also includes a pick-up device for myoelectricity (such as surface electromyography signal), which is used to detect the electrical conduction ability of nerves. After the MEP test is completed and it is judged that the patient does not have spinal cord, nerve injury and other diseases that are not suitable for mechanical massage, the myoelectric pickup device detects the myoelectric signal of the specific massage part of the patient in real time. When muscle pain, spasm or simple fatigue occurs, the conduction speed of peripheral nerve fibers at the problem point (including pain point, spasm point, and fatigue area, etc., the same below) slows down and blood circulation is not smooth, which is also in line with general knowledge. It can be obtained and further distinguished through the detection of electromyographic signals.

Recent kinematic studies have shown that the more slow-twitch fibers in human skeletal muscle and the larger the area percentage, the slower the MPF decline slope in the frequency domain analysis index of EMG signals. Furthermore, pain, especially chronic long-term pain, can lead to an increase in the proportion and volume of local muscle fast-twitch fibers, while slow-twitch fibers are correspondingly weakened, resulting in a significantly increased slope of MPF decline. For example, it is clinically found that pathological inflammation or non-pathological spasm of the teres minor muscle can lead to an increase in the spontaneous discharge frequency of the dorsal root ganglia of the spinal cord, which may result in corresponding lateral root pain and radial pain in the upper limbs. Problems—there will be high-frequency electrical signals in the relevant nerve tissues around the pain site, which is manifested by a sharp drop in the median frequency, that is, a significant increase in the median frequency slope (MPs). The inventor believes that the high-frequency rapid discontinuity phenomenon in the conduction process of nerve fibers is an adaptive phenomenon of the body under incomplete blockade. The high-frequency discontinuity of the electrical signal at the problem point makes the charge of the cells around the organ tissue change rapidly between increase and decrease. This high-frequency flash is not only a physiological indicator, but also a stimulation and treatment method.

In the muscle soreness caused by exercise fatigue, the synchronization of motor unit excitation is strengthened to maintain muscle tension during fatigue; as well as the blood flow obstruction caused by increased intramuscular pressure and excessive sarcolemmal excitation caused by lactic acid accumulation, resulting in Decreased muscle fiber conduction velocity, which can be used as a dominant indicator in post-exercise fatigue. Through massage and physical therapy, the EMG amplitude can be slowly increased, and the median power frequency (MPF) of the EMG signal can also be increased at the same time. It can also be understood as the rest of the fast muscle fibers, the recovery of lactic acid metabolism and the blood circulation of problem points. normal.

The sampling frequency of the electrodes for detecting pain signals is 300Hz-500Hz, preferably 450Hz; the sampling frequency of the electrodes for detecting fatigue signals is 8-300Hz, preferably 20-100Hz, more preferably 50Hz. The common mode rejection ratio is greater than 120dB, and the sensitivity is 1μV. The pick-up electrode uses an active surface electrode to measure the electrical activity on the muscle surface, and the diameter of the conductive area is between 6-12mm. The electrode is made of graphite electrode or titanium electrode to prevent accidents in the magnetic field.

Before placing the electrodes, use skin temperature-changing paint to smear the patient's self-reported affected area and extend it to the side of the spine. The skin temperature-changing paint can effectively mark the temperature difference on the body surface, and form a clear image on the position and surrounding areas that affect blood circulation such as muscle tension and spasm, as well as on the healthy side Compared. The skin temperature color-changing paint uses a binary mixture of palmityl alcohol and myristyl alcohol as a solvent, and adjusts the ratio of the two and the processing technology to make the color change range between approximately 30-44 degrees Celsius, and further at 33 degrees Celsius. Between -40 degrees Celsius. Mark the above-mentioned low temperature points that are significantly lower than those on the healthy side and surrounding areas.

Each group of three electrodes is set around the marked point as the center, the active and measuring electrode lines are parallel to the main muscle fiber direction at the marked point, the long axis of the electrode itself is in the same direction as the muscle fiber, and the distance is 2-2.5cm, and it should be avoided as far as possible. On the tendon, a neutral electrode was placed at an electrically neutral position near the above-mentioned marked point. The healthy side is selected symmetrically, and a set of electrodes is also set.

After the myoelectric signal pick-up device is connected with an on-site myoelectric signal processing device, which realizes filtering and amplifying for logical judgment, if the signal obtained in the low-frequency sampling sequence enters the fatigue signal judgment process; if the signal obtained in the high-frequency sampling sequence Then enter the pain signal judgment process. In the above-mentioned EMG signal judgment process, fast Fourier transform is implemented to obtain its MPF value for frequency domain analysis. In the process of frequency domain analysis, the Matalab analyzer is used to monitor whether the MPF value meets the preset indicators. For example, if there is a rapid drop or even a flash (like a cliff-like drop), it indicates that it enters the mitigation mode 2-1, otherwise it enters the relaxation mode 2-2; The self-adaptive neural network learning mode can also be used to make judgments, combined with laboratory data to obtain the EMG distribution map on both sides of the normal spine, and to set the body area EMG weighting coefficient table for different height, age, weight and body fat parameters. Judgment is made after the EMG data/healthy side data exceed the weighting coefficient.

During the above signal pickup process, the working procedure of the control module is carried out according to the following logic: detect the MEP signal generated by the transcranial magnetic stimulation in the target muscle, and judge whether there is damage to the nerve descending conduction link, specifically whether the D wave is detected correctly ; If there is a link conduction obstacle, any form of mechanical massage is strictly prohibited; if the MEP signal is normal, it will enter the real-time surface electromyography monitoring process, which mainly depends on whether the MPF value in the monitoring signal drops rapidly or even flashes off. This massage mode can also further combine MPs signals and monitor the latency of EMG signals.

In relief mode 2-1, apply a static magnetic field with a size of 0.6-0.9T, set in the up and down (or left and right) direction of the massage table; apply ultrasound at the indicated position of the skin temperature and trace the side of the spine, and the ultrasound convergence depth is 0.8-2.5cm, The frequency is 0.2-1.0MHz, the power is 1mW/cm ² ; the ultrasonic transducer used is close to the skin, the effective area of the transducer probe is 10mm×8mm, and the longitudinal direction is perpendicular to the human spine. Ultrasound forms a converging point with an area of 1 square centimeter in the subcutaneous tissue corresponding to the approximate ganglion, where the charged particles in the cell wall and cytoplasm of the nerve tissue vibrate, and depolarize the cell membrane according to the Hall effect. The action potential will be transmitted to the corresponding skeletal muscle, causing a slight twitch or tremor. This action potential is sent out by the patient's own nerve node, which is highly simulated and adaptable, and the magnitude of the induced action potential is nonlinearly related to the ultrasound frequency. At the same time, the magnitude of the aforementioned ultrasonic frequency is adaptively changed with the electromyographic signal obtained by the aforementioned picking electrodes, and this feedback mode reduces the MPF drop value of the electromyographic signal. Because of the "on or nothing" characteristic of the depolarization of multiple nerve cell membranes, the above-mentioned nonlinear increase of the evoked potential can be observed clinically, that is, it may appear to change linearly without following the adjustment of the ultrasound frequency. The adjustment of the ultrasonic frequency by the control module is carried out in units of 0.1 KHz, and the adjusted ultrasonic frequency is maintained for at least one cycle each time, and the above-mentioned MPF value is detected at intervals of cycles.

In relaxation mode 2-2, a static magnetic field (to avoid the effect on the user's head) is applied, the size is 2.5T, and it can be set up and down (or left and right) on the massage table; then select the one with the most obvious temperature change according to the above skin temperature indication. The position is taken as the center of the gradient magnetic field action zone, and the gradient magnetic field is applied with a size of 100mT and a switching rate of 10-15mT/m.s (y circle). Under its action, the above-mentioned action zone, including nerves and muscle receptors, produces bioelectric effects, resulting in irregular muscle abdominal jitters that are difficult to detect with the naked eye, which is helpful for blood circulation and lactic acid metabolism. Generate more or less heat. The heat generated will cause the temperature change of the part where the skin thermochromic paint is applied, and after reaching the threshold value of the phase change material contained therein, it will cause the phase change material to absorb heat and liquefy, thereby avoiding thermal damage to the skin. At the same time, the operator can monitor the skin temperature through the color of the skin temperature-changing paint. During the stop period of the gradient magnetic field and when the EMG acquisition module starts the working cycle, the above-mentioned phase change material will also function to prevent the temperature of the coated part from being too low, and to prevent the muscle tension caused by the change of heat and cold in the skin and muscles from causing EMG signals. error.

The analysis results of a large sample of electrocardiograms of patients with different types of cervical spondylosis show that cervical spondylosis and abnormal electrocardiograms have a greater correlation and even identity, so it is also called cervical heart syndrome. The bioelectricity generated during the magnetic field stimulation of the peripheral nerve will inevitably partially overlap or even conflict with the ECG signal. Clinical data show that this situation is especially obvious in patients with cervical spondylosis, and the error interval of the therapeutic effect of ultrasonic magnetic field will increase significantly. If real-time ECG detection can be further added to the working process of the above-mentioned magnetic therapy module, it will provide a better timing indication for the ultrasonic magnetic therapy cut-in.

Holden's research in 2004 showed that the blood vessel wall will generate a potential difference on the body surface in the static magnetic field, and the induced electric field may affect the propagation of the cardiac action potential (The sensitivity of the heart to staticmagnetic fields【J].Progress in Biophysics & Molecular Biology, 2005, 87(2-3): 289_320.). Specifically, for the commonly used three-lead, five-lead, and twelve-lead ECG test results, the influence of static magnetic field induced potential is mainly reflected in T wave deformation or delay. Static magnetic field therapy, for example, in the relief mode 2-1 of the present invention, because the magnetic field strength is not enough to have a significant impact on ECG, but through detection and comparison of experimental results, it can still be seen that similar adverse potential differences interfere with the therapeutic effect. In order to avoid interference, reliable grounding, filters and metal covers can be added to the ECG. Furthermore, the ECG signal can be used to trigger the ultrasound in the S-wave triggering mode 2-1 through the circuit.

However, in the process of magnetic field variation in relaxation mode 2-2, the detection of ECG signals is often severely distorted, so how to achieve a better timing of magnetic therapy cut-in will be a further technical problem to be solved. The data obtained in the experiment of "Influence of Abdominal Breathing on Heart Rate" conducted by Hebei Normal University shows that subjectively controlling the rhythm of abdominal breathing helps to control the heart rate at a relatively low and stable level. Similarly, related research by Xi'an Jiaotong University also shows that heart rate and respiration can interact, and the coupling relationship will not be repeated here. In the present invention, a lower heart rate is obviously beneficial for avoiding interference to peripheral nerve bioelectricity; at the same time, there will be a relatively obvious relaxation stage for the respiratory muscles in the end-expiration period of abdominal breathing, which can be achieved through the user's conscious Extend to 6-8 seconds. At this time, controlling the switching rate of the gradient magnetic field in the 2-2 massage mode to the peak value will achieve better results. Therefore, the present invention is further equipped with a breathing indicating device, which can adopt any prior art acousto-optic and other prompting means, such as a buzzer or LED flashing lights. It is used to indicate the frequency of abdominal breathing for the user. At the same time, after the user enters a stable breathing state, it cooperates with the change of the gradient magnetic field to keep the magnetic field switching frequency in sync with the exhalation phase of abdominal breathing. Clinical experiments have shown that most adults can maintain a breathing rate of 5-7 times per minute when performing abdominal breathing with the breathing indicator device, and at the same time, the heart rate will drop to a lower heart rate level within its normal range. At this time, the effect of combined magnetic field therapy is significantly improved, and the measured MPF value can be relatively increased by 1%-10% when the treatment time is equal.

Furthermore, in the working process of the above-mentioned rehabilitation system, the effect of drug-assisted treatment is added, which is realized by the drug therapy module, and the purpose is to promote blood flow at local locations and improve the effect of relieving muscle tension. The medicine is added or subtracted by using bone-reinforcing and blood-activating prescriptions well known to those skilled in the art. After steaming and purification, the active ingredients are further ground and mixed into the aforementioned skin temperature-changing paint and applied to the parts receiving magnetic therapy. In the process of magnetic stimulation, the above-mentioned medicine penetrates into the skin after being heated to realize the medicine effect.

detailed description

The spine rehabilitation system includes a physiotherapy platform 31 for carrying a user, and the platform is provided with an opening corresponding to the head and face of a person so as to facilitate the user to breathe in a prone position. The stand is made of non-metallic material to avoid affecting the effect of electromagnetic therapy, and there are four support columns with rollers underneath. A ring-shaped fence 32 is arranged around the platform 31, and movable railings are provided on the fence corresponding to the user's feet, and the overall fence is in the shape of a mouth that can be opened and closed at one end. A support arm 321 is provided at the position corresponding to the head of the user on the fence 32 , and more than one support arm 322 is provided on the side of the fence corresponding to the torso of the user. The support arm can rotate at multiple angles, bend and slide on the fence to adapt to different positions. The material of the support arm is non-metal, and a fixing seat 323 is provided at the end thereof. An ultrasonic probe, an infrared probe, a gradient magnetic field coil, etc. are detachably connected to the fixing seat of the support arm. A static magnetic field generator 324 is provided on the left side of the fence, which realizes providing a static magnetic field for the user's torso on the stand 31 . The size is specifically 0.6-0.9T, realized by a steady and controllable current, and various common technologies in this field can be used. A magnetic shielding plate 325 is provided at the fence corresponding to the position of the user's head, which is made of a ferromagnetic material with high magnetic permeability, such as silicon steel, and can be slid and adjusted along the fence, with a thickness between 1-5mm. After sliding to an appropriate position, the foldable cover can be folded to cover the user's head to effectively prevent the user's head from receiving unnecessary magnetic field stimulation.

A flat circular or figure-eight coil 21 is detachably fixed on the fixing base of the above-mentioned support arm 321 , which can be a core coil or a combined coil. The diameter of the coil is between 9-20cm, preferably 12-15cm, and the peak value of the generated magnetic field is not less than 1T. During the transcranial magnetic stimulation process, the distance between the center of the coil and the top of the user's head is less than 3.5 cm by adjusting the support arm. The frequency of the magnetic field generated by the time-varying current should be greater than 1 Hz, and the coil wire is connected to the control device through the fixing seat on the support arm 321 . During the transcranial magnetic stimulation stage, an anode electrode 11 is set on the belly of the target muscle of the user's back or upper limb, and a cathode electrode 12 is set on the tendon of the descending nerve. The electrode adopts graphite electrode, and the distance between the two is more than 35mm. The signals collected by the above two electrodes are transmitted to the control device, and analyzed after filtering, shaping and amplifying: when the first received single-phase normal-phase D wave is blocked, the control device will give an alarm prompt to remind the operator that the user cannot Perform any form of mechanical massage and stop further transcranial magnetic stimulation; when the D wave is normal and the subsequent group of positive phase I waves has a delay greater than 2.5 times the normal duration, the transcranial magnetic stimulation is normally performed for one cycle or The detection of the I wave latency becomes shorter and stops. A cycle can be input by the control device, generally between 120s-600s.

The selection of the above-mentioned target muscles can be based on the user's self-report, or can be carried out after observation with skin temperature-changing paint. The specific method is: select palmitic alcohol, myristyl alcohol, leuco agent and color developer as raw materials, wherein the leuco agent can choose thermosensitive dye crystal violet lactone CVL, the color developer can choose diphenol propane BPA, two alcohols It exists as a solvent and a proportioning substance. The solvent and solute are poured into a vessel heated by a water bath and stirred for one hour sufficient to obtain the complex. Its color-changing performance depends on the mass ratio of the four substances. When the mass ratio of CVL: BPA: myristyl alcohol: palmityl alcohol is 1:3.3:41:22, the melting point of the compound is the lowest, and it is between 33-40 degrees Celsius Has good discoloration properties. Evenly mix the above-mentioned compound with common phase change materials. The phase change materials can be selected from paraffin wax, etc., and the phase change temperature is about 40 degrees through simple proportioning and processing. The mixed phase change material and the above-mentioned compound are coated on the affected part and the corresponding position on the healthy side as described by the user. After standing for 3 minutes, observe whether there is obvious skin temperature discoloration, and mark the position that is obviously different from the surrounding skin or from the healthy side.

The surface electromyography signal pick-up electrodes are set around the marking point as the center, and a group of three electrodes 13 wherein the neutral electrode is placed at the electrical neutral position closest to the marking point, and the active measuring electrode ensures that its connection line is parallel to the main point at the marking point. The direction of the muscle fiber, the long axis of the electrode itself is in the same direction as the muscle fiber, and the distance between the two electrodes is 2-2.5cm. At this time, it should be avoided to be placed on the tendon. A group of electrodes 14 is also placed symmetrically on the healthy side. The sampling frequency of the electrodes for detecting pain signals is 300Hz-500Hz, preferably 450Hz; the sampling frequency of the electrodes for detecting fatigue signals is 8-300Hz, preferably 20-100Hz, more preferably 50Hz. The common mode rejection ratio is greater than 120dB, and the sensitivity is 1μV. The pick-up electrode uses an active surface electrode to measure the electrical activity on the muscle surface, and the diameter of the conductive area is between 6-12mm. The electrodes are graphite electrodes or titanium electrodes.

The wires drawn from the two groups of electrodes are respectively filtered and amplified to realize fast Fourier transform to obtain their MPF values. Thereafter, the two groups of data enter the logic judgment unit 41 of the control device respectively. The affected-side signal obtained in the high-frequency sampling sequence enters the pain signal judgment process, while the affected-side signal obtained in the low-frequency sampling sequence enters the low-frequency judgment process. In each judging process, the Matalab analyzer 42 of the control device carries out frequency domain analysis to it, and first judges whether the MPF value obtained in the high-frequency sampling sequence has a rapid decline or a flash phenomenon, and the judging standard is to measure the corresponding median frequency Whether the slope (MPs) is significantly increased, the normal range of the slope value should be preset with reference to the user's age, body fat, weight, and the corresponding signal of the healthy side, or it can be obtained through adaptive learning of the user's multiple experiments. Generally, if the MPs value is greater than or equal to 60%, it can be considered that the user's affected muscles need to be relieved by physiotherapy, and enter the process 2-1. If the MPF value obtained in the high-frequency sampling sequence does not show the above-mentioned rapid decline, the analyzer 42 further analyzes the MPF value obtained by the low-frequency sampling of the affected area, and also performs analysis and comparison according to the above-mentioned steps. At this time, the MPs value is greater than 45% and combined with the latency time of the collected electromyographic signal, it can be judged that the user needs to relax with physical therapy, and enter process 2-2.

In mode 2-1, the control device activates the static magnetic field generator 324 to apply a static magnetic field, and a static magnetic field with a size of 0.6-0.9T is applied to the user's torso, especially the spine; an ultrasonic wave is set at a point 5-10 cm above the spine. Action area: Ultrasound is applied through the ultrasonic probe, the ultrasonic convergence depth is 0.8-2.5cm, the frequency is 0.3-1.0MHz, and the power is 1mW/cm ² ; the transducer of the ultrasonic probe used is close to the skin, and the effective area of the transducer is 10mm×8mm , the longitudinal direction is perpendicular to the direction of the human spine. Ultrasound forms a converging point with an area of 1 square centimeter in the subcutaneous tissue corresponding to the approximate ganglion, where the charged particles in the cell wall and cytoplasm of the nerve tissue will vibrate, and depolarize the cell membrane according to the Hall effect. The action potential will be transmitted to the corresponding skeletal muscle, causing a slight twitch or tremor. Meanwhile, the aforementioned. The magnitude of the ultrasonic frequency is adaptively changed with the electromyographic signal obtained by the aforementioned pick-up electrodes, and this feedback mode reduces the MPF drop value of the electromyographic signal or in other words makes the MPs value "increase". The control device stops the magnetic field function every working cycle, and enters the time sequence of surface electromyography signal acquisition. After working mode 2-1, enter the high-frequency sampling sequence, and repeat the above steps again for the picked-up skin surface EMG signal. Until the measured MPF or MPs value reaches the preset standard.

In mode 2-2, apply a static magnetic field (to avoid the effect on the user's head), the size is 2.5T, which can be set in the left and right directions of the massage bed; then select the position with the most obvious temperature change according to the above skin temperature indication as the gradient magnetic field effect In the center of the belt, a gradient field is applied with a magnitude of 100 mT and a switching rate of 10-15 mT/m.s (y circle). The gradient coils are arranged on one of the aforementioned support arms.

Under the action of the gradient magnetic field, the tissue in the above-mentioned action zone, including nerves and muscle receptors, undergoes a bioelectric effect, thereby achieving muscle belly shaking in an irregular form that is difficult to detect with the naked eye. Clinical experiments have shown that in addition to promoting blood circulation and lactic acid metabolism, it also helps the fatigue recovery of the corresponding neural pathways, and at the same time generates more or less heat according to the switching rate of the gradient magnetic field. The heat generated will cause the temperature change of the part where the skin thermochromic paint is applied, and after reaching the threshold value of the phase change material contained therein, it will cause the phase change material to absorb heat and liquefy, thereby avoiding thermal damage to the skin. At the same time, the operator can monitor the skin temperature through the color of the skin temperature-changing paint. During the stop period of the gradient magnetic field, when the myoelectric acquisition module starts to work, the above-mentioned phase change material will also undergo a phase change to release heat to avoid the temperature of the coated part from being too low, and to prevent muscle tension caused by changes in cold and heat in the skin and muscles. EMG signal error. The magnitude of the switching rate of the gradient magnetic field is adaptively changed with the electromyographic signal obtained by the aforementioned pick-up electrodes, and this feedback method reduces the MPF drop value of the electromyographic signal or in other words makes the MPs value "increase". The control device stops the magnetic field function every working cycle, and enters the time sequence of surface electromyography signal acquisition. The difference is that after the working mode 2-2, it enters the low-frequency sampling sequence, and the picked-up signal repeats the above steps again until the MPF or MPs value reaches the preset standard.

Wherein the gradient magnetic field coil is provided with an 8-shaped coil on the aforementioned support arm fixing base, the upper half of the coil is fixed on the fixing base, and the lower half of the coil is arranged under the aforementioned stand. The upper and lower coils are relatively formed, and the entire coil can move back and forth following the support arm to adapt to changes in different positions.

Further, an infrared skin temperature monitoring probe can be added to prevent burns. The infrared thermometer can be realized by adopting common techniques in the art, and its monitoring range is between 30-45 degrees Celsius. Its detection head is installed on the aforementioned support arm fixing seat, and is electrically connected with the control device. By presetting the early warning temperature in the control device, such as 41 degrees Celsius (the specific selection of phase change materials needs to be considered here), the temperature early warning for the monitoring area is realized to prevent burns or accidents.

Further, in order to avoid the interaction between the electric potential field generated by the static magnetic field on the vessel wall and the electrocardiographic action potential in mode 2-1, an electrocardiographic detector 61 may be introduced. It uses common three-lead, five-lead or twelve-lead methods to detect the user's ECG. In order to avoid interference, the electrocardiogram detector 61 is protected by means of reliable grounding, filters and outer metal jackets. A detection trigger circuit can also be used to realize the start of the ECG S wave triggering the ultrasound. That is, corresponding circuits are added on the ECG detector: the ECG signal detection circuit 62 realizes the amplification of the ECG signal, and the signal frequency band is at 1-2KHz, and the amplification factor can be adjusted; the S wave detection circuit 63 is composed of a follower, a QRS filter , rectifying circuit, peak hold device and comparator. The electrocardiogram output signal is converted into a voltage signal and then input to the monostable trigger to detect the S wave and obtain the S wave synchronous pulse signal. The driving circuit is triggered on the rising edge of the S wave, and the start of the ultrasonic signal is realized. Based on the trigger circuit, the R-wave action of the cardiac action potential is avoided, thereby reducing the mutual influence between the two. Further, the trigger circuit is not directly connected to the start circuit but is connected to the start circuit through the control module. At this time, after the rising edge trigger signal is obtained, the control module temporarily stores the signal, and starts the ultrasonic signal after receiving the next trigger signal; the above temporary storage behavior can effectively reduce the refractory period response of peripheral nerves and increase the effective duration of treatment. According to the actual effect, it can also be further set to temporarily store two or more trigger signals before waiting for an opportunity to drive the ultrasonic circuit to work.

Further in order to achieve better timing of magnetic therapy cut-in in mode 2-2. Add a buzzer or similar warning means at the fence near the user's head. The buzzer is electrically connected to the control device and managed by it, and is used to guide the user to perform abdominal breathing. At the same time, after the user enters a stable breathing state, it cooperates with the change of the gradient magnetic field to make the switching frequency of the magnetic field coincide with the frequency of abdominal breathing. gas phases are kept in sync. Specifically, the buzzer sounds to remind the user to inhale, and the control device controls the switching rate of the gradient magnetic field coil to be at least 80% of its peak value during the 3s-6s of the buzzer sounding. Clinical experiments have shown that most adults can maintain a breathing rate of 5-7 times per minute when performing abdominal breathing with the breathing indicator device, and at the same time, the heart rate will drop to a lower heart rate level within its normal range. At this time, the effect of combined magnetic field therapy is significantly improved, and the measured MPF value can be relatively increased by 1%-10% when the treatment time is equal.

Furthermore, in the working process of the above-mentioned rehabilitation system, the effect of drug-assisted treatment is added, which is realized by the drug therapy module, and the purpose is to promote blood flow at local locations and improve the effect of relieving muscle tension. The medicine is added or subtracted by using bone-reinforcing and blood-activating prescriptions well known to those skilled in the art. After steaming and purification, the active ingredients are further ground and mixed into the aforementioned skin temperature-changing paint and applied to the parts receiving magnetic therapy. In the process of magnetic stimulation, the above-mentioned medicine penetrates into the skin after being heated to realize the medicine effect. The specific drug components are as follows (mass ratio): Epimedium 5, Rhizoma Drynaria 21, Achyranthes bidentata 6, safflower 1, Fangfeng 9, musk 1, mountain lacquer 2, dried blood 11, psoralen 3, amber 4, Chuanxiong 10, Notopterygium 2. The medicinal ingredient can also be applied to the affected area separately after the skin temperature-changing paint is removed, and at this time, the temperature monitoring is completely completed by the aforementioned infrared probe. A hydrogel dressing can also be added during use; the above-mentioned drug coating is evenly coated in the medical sterile transparent hydrogel dressing layer; the dressing layer is cut into a specific shape and laid on the main muscle groups on both sides of the spine, such as the vertical spine Muscles, multifidus, etc., are not limited to specific magnetic therapy locations; at the same time, the mechanical stretching effect of the corresponding muscle groups needs to be matched after coating, which is realized by adding mechanical stretching rods for the upper limbs; the stretching rods are set on the massage platform for use side of the user's head, the height is slightly higher than the back of the prone user; the pulling direction is parallel to the platform, and the force direction is away from the human body so as to realize the pulling of the user's upper limbs; the pulling is controlled by the control module, and the frequency is Between 5-15 minutes. Further, stretching can be coordinated with abdominal breathing rate. Specifically, the buzzer sounds to remind the user to stretch after breathing, and relax after stretching lasts for 4-8 seconds; the user takes the disappearance of the pulling force as an exhalation instruction.

The aforementioned control device can be realized by using common single-chip microcomputer, field programmable gate control circuit or microcomputer in the field, and using a small keyboard or a conventional keyboard as an input device.

The above-mentioned embodiments are only used for explaining the technical solution of the present invention, and should not be understood as limiting its protection scope. Any improvement or modification made by those skilled in the art on the basis of the present invention without departing from the concept of the present invention will not depart from the protection scope of the present invention.

Claims (3)

1. a kind of electrocardio for backbone reduction system triggers Magnetotherapeutic apparatus,

The backbone reduction system includes：

Checking with EMG method module 1, magnetic field module 2, massage module 3, control module 4, display module 5 and electrocardio module 6 etc.；Wherein The checking with EMG method module detects human body surface myoelectric in real time, and is classified according to myoelectricity level and feature, the classification knot Muscle tonue and the caused muscle of spasm and external force or psychology are tight caused by fruit can lack of proper care to user's bone injury, lactic acid metabolism Etc. make a distinction；The classification results that the control module is sent according to checking with EMG method module enter default alleviation massage mode 2- 1 or relaxing massage pattern 2-2；

User's electrocardio is detected using modes such as three common leads, five leads or 12 leads using electrocardioscanner 61；Adopt Electrocardioscanner 61 is protected with modes such as reliable ground, wave filter and outer cover metal-coatings and touched simultaneously using detection Power Generation Road come realize electrocardio S ripples triggering ultrasound startup；

It is characterized in that：Related circuit is set up on electrocardioscanner；ECG signal sampling circuit 62 is realized to electrocardiosignal Amplification, signal band 1KHz-2KHz, multiplication factor is adjustable；S ripples detecting circuit 63 by follower, QRS wave filters, whole wave circuit, Peak-holding circuit and comparator are constituted；Electrocardiogram output signal is input to monostable flipflop after being converted to the whole ripple of voltage signal In detect S ripples, and obtain S ripple synchronization pulses；Drive circuit is triggered in the rising edge of S ripples, is realized for ultrasound letter Number startup；Evade out the R crest value effects of heart action potential based on the triggers circuit, reduce both influence each other.

2. electrocardio according to claim 1 triggers Magnetotherapeutic apparatus, wherein the triggers circuit passes through control module and ultrasound Start-up circuit is connected；After rising edge trigger signal is obtained, control module keeps in the signal, when obtaining next trigger signal Just start ultrasonic signal afterwards；Platform above-below direction applies magnetostatic field, size 0.6- where patient in above-mentioned alleviation pattern 2-1 0.9T；Backbone side is traced back perpendicular to instruction point application ultrasound in discoloration skin thermo-paint indicating positions, and ultrasound converges depth 0.8- 1.5cm, frequency 0.2-1MHz, power 1mW/cm²；Transducer probe effective area 10mm × 8mm, is close to skin, and convergent point exists The convergence region of corresponding about 1 square centimeter of neurode formation under skin；The convergence region causes thin in corresponding nerve fiber After birth depolarization, the action potential of generation causes it to dominate skeletal muscle generation slight jitter；In ultrasonication interlude, Foregoing checking with EMG method module continues to be picked up myoelectricity near mark point；By the feedback signal to above-mentioned supersonic frequency size Adaptivity adjustment is made, adjustment direction was the MPF values of myoelectricity relative to electromyographic signal detection module in a upper work period There is rise trend in obtained record value.

3. electrocardio triggers this material device according to claim 2, wherein setting up a buzzer close to user's head position Or similar warning means indicate user's control breathing；Coordinate the change of gradient magnetic after user enters steady breathing state Change, make magnetic field switching frequency synchronous with the expiration phase holding of abdominal respiration；Specifically buzzer, which sounds, points out user to inhale Gas, control device controls the switching rate of gradient magnetic field coil to be at least held in its peak value between buzzer sounds 3s-6s On 80%.