RU227165U1 - ELECTROMYOSTIMULATOR - Google Patents

Abstract

The utility model relates to the field of medical technology, namely to means for the rehabilitation treatment of sedentary patients with diseases of the musculoskeletal, nervous and vascular systems, and can be used for the rehabilitation of sedentary patients using the method of electromyostimulation in order to intensify blood supply and lymphatic drainage in the peripheral vessels of the extremities with simultaneous control of blood supply and pulse amplitude in the problem area. The electromyostimulator is a housing with an indication window and connectors for connecting electrodes, which houses a programmable controller, a power supply, a visual control and manual control unit with a touch LCD display, a stimulation pulse generation unit connected to the controller output, as well as a rheographic registration unit. signal, the output of which is connected to the controller input. The technical result provided by the claimed utility model is to expand the functionality and scope of application of the electromyostimulator for controlled restoration of blood supply in the problem area, preferably in the limb, without negative side effects due to the presence of feedback on the characteristics of the pulse wave, which provides the ability to select the optimal mode of stimulating effects.

Description

The utility model relates to the field of medical technology, namely to means for the rehabilitation treatment of sedentary patients with various diseases of the musculoskeletal, nervous and vascular systems and can be used for the rehabilitation of sedentary patients using the method of electromyostimulation in order to intensify blood supply and lymphatic drainage in the peripheral vessels of the extremities with simultaneous control of blood supply to tissues and pulse wave characteristics in the problem area.

Electromyostimulation is a physiotherapeutic method of rehabilitation treatment based on electrical stimulation of muscle and nervous tissue. It is carried out by transmitting current with certain characteristics from the myostimulator to a certain area of the body through electrodes applied to the skin. When exposed to electric current on muscles and nerves, their bioactivity increases and oxygen utilization accelerates; blood supply and lymphatic drainage are activated, parallel to passive muscle contraction, expansion of peripheral vessels occurs, which leads to activation of blood flow.

Currently, there are various options for electromyostimulators, both commercially produced, for example, “Anzas”, “Miorhythm”. A typical example is an electrical neuromyostimulator according to utility model patent No. RU 32697, 09/27/2003, containing a galvanic isolation unit, a control unit, a digital-to-analog converter, an analog-to-digital converter, a protection unit, electrodes, while it additionally contains a high-speed control and monitoring unit, an amplifier power and a unit for fixing the output voltage and load current, while the control unit is connected to a high-speed control and monitoring unit, the output of which is connected to the power amplifier through a digital-to-analog converter, and the input is connected to the output of an analog-to-digital converter, the first input of the block for fixing the output voltage and current load is connected to the first output of the power amplifier, the second input is connected to the second output of the power amplifier through electrodes, and the output of the unit for fixing the output voltage and load current is connected to the input of the analog-to-digital converter.

The disadvantage of this technical solution is the lack of built-in means of monitoring the patient’s condition directly during the treatment procedure. When carrying out the procedure in a hospital, the result of treatment is determined “after the fact” by ultrasound Dopplerography or rheography using stationary medical equipment, but if the myostimulation procedure is carried out by the patient independently at home, the only criterion for its success or failure is the patient’s subjective feelings.

There are also known design options for electromyostimulators containing means for monitoring certain physiological characteristics of the patient, usually heart rate, electrical and locomotor muscle activity, such as, for example, a wireless electrical neurostimulator, characterized by the fact that it contains podometric and goniometric sensors connected to the controller, and electrodes, connected to a unit for switching electrodes and synchronizing the processes of stimulation and recording ECG and EMG, connected to a unit for generating stimulation pulses and a unit for recording EMG and ECG signals, while the switching and synchronization unit, the unit for generating stimulation pulses and the unit for recording EMG and ECG signals are connected to the controller , including a signal processing module for locomotor sensors and a signal processing module for EMG and ECG signals, as well as a radio modem, an input unit and an information output unit connected to the controller (RF utility model patent No. 170403 dated 10/14/2016).

The disadvantage of this technical solution is the limited set of controlled parameters (muscle activity and heart rate are monitored), which does not allow a sufficiently complete assessment of the patient’s condition.

The closest to the claimed technical solution is a wireless electrical neurostimulator (US patent No. 2016151626, 06/02/2016), including a current source configured to generate one or more electrical stimuli based on one or more selected parameters associated with one or more electrical stimuli, as well as a block for recording electromyographic signals (EMG), configured to process the received EMG signal.

The disadvantage of this technical solution is the lack of means for controlling hemodynamics in the problem area, as a result of which stimulation of blood supply is an uncontrollable side effect. Meanwhile, insufficient blood supply to body tissues during the rehabilitation procedure reduces its effectiveness, and excessive stimulation of blood flow in peripheral vessels in some vascular disorders can have undesirable consequences, including blood clot rupture with subsequent thromboembolism.

The technical problem to be solved by the claimed utility model is the development of an electromyostimulator that allows monitoring during the electromyostimulation procedure one of the most important parameters of the cardiovascular system - the intensity of blood flow in the problem area of the body, due to the fact that this function is absent in known devices.

The technical result provided by the claimed utility model is to expand the functionality of the electromyostimulation device, specifically to realize the possibility of its use for controlled restoration of blood supply in a problem area, preferably in a limb, without negative side effects due to the presence of feedback on characteristics (amplitude and duration) pulse wave, which provides the ability to select the optimal mode of stimulating effects.

The declared technical result is achieved due to the fact that the design of the electromyostimulator, containing a stimulation pulse generation unit, a power supply and a programmable control controller, additionally includes a rheographic signal recording unit with electrodes connected to it, while the output of the rheographic signal recording unit is connected to the analog input of the controller , and the input of the stimulation pulse generation block is connected to the analog output of the controller. The device also includes a battery control unit, a visual control unit and a manual control unit connected to the controller.

The operating principle of the rheographic signal recording unit is to isolate and record fluctuations in the impedance of body tissues, which are a consequence of the passage of a pulse wave through the vessels and capillaries. An indicator of the intensity of blood flow is the rheographic index, defined as the relative amplitude of the pulse wave. This block consists of a probe pulse generator with electrodes connected to it, applied to the patient’s body, a differential signal extraction unit, and an operational amplifier with a low-pass filter.

Based on data continuously received from the rheographic signal recording unit about changes in impedance corresponding to changes in blood supply to body tissues, the programmable controller, acting according to an algorithm stored in permanent memory, determines the result of the procedure’s impact on the patient’s vascular system, and in accordance with this regulates the degree of stimulating effect ( amplitude and frequency of stimulating impulses).

In fig. 1 presented:

1 - programmable controller;

2 - block for generating stimulation pulses;

3 - electrical stimulation electrodes;

4 - rheographic signal registration block;

5 - electrodes for monitoring the rheographic signal;

6 - touch display;

7 - battery control unit.

The block diagram of the proposed device is shown in Fig. 1.

The device is made in a single housing and contains a stimulation pulse generation unit 2, to the output of which electrical stimulation electrodes 3 are connected by wires; programmable controller 1, the analog output of which is connected to the input of the stimulation pulse generating unit 2; electrodes for monitoring the rheographic signal 5, connected by wires to the input of the rheographic signal recording unit 4, the output of which is connected to the analog input of the control controller. In the window of the housing cover there is a touch display 6 connected to the controller via the SPI bus, which serves to control the electromyostimulation process and, if necessary, manually control its parameters. The device is powered by a battery and includes a battery control unit 7 connected to the analog input of controller 1.

The device works as follows.

1. After applying the electrical stimulation electrodes 3 and the rheographic signal control electrodes 5, the power of the device is turned on, the control controller 1 is initialized, begins receiving data from the rheographic unit 4 and calculates the amplitude of the pulse wave. If the obtained result does not fit into the permissible range specified by the program, the controller generates a warning message on display 6 and stops executing the program.

2. Controller 1 generates a series of control pulses at the input of the stimulation pulse generation unit 2, in accordance with which the stimulation pulse generation unit outputs current pulses to the electrodes 3. If, due to the high contact resistance of the electrodes with the skin, the current amplitude does not reach the specified values, block 2 generates an error signal sent to the interrupt input of the controller, which in response generates a warning message on display 6 and stops execution of the program.

3. If the amplitude of the pulse wave and the amplitude of the current pulses are within the acceptable range, the further operating mode of the device is determined by the rehabilitation procedure program stored in the permanent memory of the controller, which connects the intensity of the impact (amplitude and frequency of the stimulating pulses) with the continuously controlled amplitude and duration of the pulse wave in the problem area and heart rate. The program is developed by the attending physiotherapist individually for each patient or selected using the touch display 6 from a set of pre-developed standard programs.

Application example

Testing of the performance of the proposed device was carried out on a prototype made using the Atmega328 microcontroller, MCP601 operational amplifiers in the signal generation, detection and filtering units, a 3.5'' touch LCD display in the visual control and manual control unit and a miniature pulse transformer at the output of the generation unit stimulating impulses.

The electromyostimulation procedure was used, in particular, during the rehabilitation of a patient after hip replacement surgery in order to relieve pain, muscle spasms, and restore blood circulation in the ligaments and muscles of the hip joint. Electrical stimulation electrodes were placed on the anterior and posterior surfaces of the thigh muscles that support the hip joint. Rheographic electrodes were placed on the back of the thigh at a distance of 15-25 cm, also using conductive gel. The duration of the procedure is 10-20 minutes, the amplitude of the stimulating current pulses was automatically adjusted within the range of 2-10 mA. Continuous monitoring of pulse wave parameters with a rheographic sensor allows you to adjust in real time the optimal amplitude of current pulses and the duration of exposure in accordance with the program embedded in the controller.

In fig. Figure 2 shows rheographic curves before (1) and during (2) the electromyostimulation procedure. The procedure is carried out until the increase in the relative amplitude of the pulse wave Am (rheographic index) reaches a programmatic value (usually from 20% to 30%).

In fig. Figure 3 illustrates the process of operation of the device according to one of the possible algorithms during the myostimulation procedure: increasing the amplitude of current pulses until the rheographic index reaches a value 20-30% higher than the initial one, and then, if the index remains at the achieved level, reducing the amplitude to 0. The result of the procedure is ultimately an improvement in blood supply to the tissues of the problem area to a given level.

Claims (1)

An electromyostimulator, including a control programmable controller, a power supply, a visual control and manual control unit, a stimulation pulse generation unit, the output of which is connected to the electrical stimulation electrodes, and the input is connected to the output of the controller, rheographic electrodes and a rheographic signal recording unit, the input of which is connected to the rheographic electrodes , and the output is connected to the input of the controller, characterized in that the rheographic signal recording unit consists of a probe pulse generator to which rheographic electrodes are connected, a differential signal extraction unit and an operational amplifier with a low-pass filter, and a control programmable controller based on continuously received data from the unit recording a rheographic signal of data on impedance changes is configured to adjust the amplitude and frequency of stimulation pulses.

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