Manual muscle strength testing device

Abstract

The purpose of the present invention is: to provide a manual muscle strength testing device with which it is possible, by using an inertial sensor and a load exercise measurement device of simple configuration, to capture very small muscle contractions of the fingers while suppressing the compensatory effects of surrounding muscles; and to make it possible to evaluate the state or the degree of recovery of the median, ulnar, and radial nerves by measuring only a load exercise of the index finger.　A manual muscle strength testing device according to the present invention has, inter alia: a finger insertion part 30, comprising an other finger fixation part 28 having a space that is shaped so as to prevent movement, in any direction, of a middle, a ring, or little finger inserted thereinto, and an index finger insertion part 29 having a space that is shaped such that an inserted index finger is able to move towards the pad side or the thumb side, or the fingernail side or the thumb side; a ring 15 that can be fitted onto the fingertip of the index finger; a pressure sensor 32 capable of measuring the size of a load acting on the fingertip and a 3-axis acceleration sensor 11 capable of measuring the movement of the fingertip, fixed to the ring 15; and a load elastic body 31 that applies an adjustable load to the fingertip on which the ring 15 is worn.

Description

Manual muscle testing device

[0001] The present invention relates to a manual muscle testing device that can evaluate the condition and degree of recovery of the median nerve, ulnar nerve, and radial nerve.

[0002] In recent years, with the emergence of therapeutic drugs for various central and peripheral nerve disorders and advances in regenerative medicine, neurological disorders are rapidly evolving from an era of "incurable" to an era of "selecting the appropriate treatment for the pathology." However, because the recovery of damaged nerve fibers is extremely slow, it is important to evaluate the minute nerve recovery that occurs with treatment. Currently, there are two main methods of neurological assessment used in clinical settings: a grip strength test (hereafter referred to as "grip strength test") and manual muscle testing (hereafter referred to as "MMT"). The former method, grip strength testing, involves measuring and recording the patient's grip strength daily to visualize changes in grip strength and evaluate the patient's neurological condition and recovery. The latter method, MMT, involves a physician touching the affected area of ​​the patient's body and assessing their motor status under skeletal load to measure the degree of neurological damage. The degree of neuropathy is then subjectively assessed by the doctor into the following six levels (MMT 0-5). ・0 (Zero): When the patient tries to move the muscles, they do not move at all and no force is applied. ・1 (Trace): When force is applied, muscle contraction occurs (muscle contraction), but the joint cannot be moved. ・2 (Poor): When gravity is removed (when moving roughly horizontally to the ground), enough force is applied to move the joint. ・3 (Fair): When gravity is removed (when moving roughly perpendicular to the ground), enough force is applied to move the joint. ・4 (Good): When a certain amount of resistance is applied, the joint can be moved firmly. ・5 (Normal): When considerable resistance is applied, the muscle strength is sufficient to move the joint to the end.

[0003] However, both grip strength testing and MMT nerve assessment methods have their own problems, as well as common problems. First, grip strength testing has problems such as "grip dynamometers are designed for healthy individuals and cannot measure a patient's slight grip strength." Second, the values ​​obtained by grip dynamometers are expressed as the sum of the strength of multiple muscles innervated by the median and ulnar nerves, making it impossible to evaluate the strength of each nerve individually (median, ulnar, radial nerve). For example, if the median nerve is normal but only the ulnar nerve is impaired, the grip dynamometer will mainly measure the strength of the muscles innervated by the normal median nerve, making it impossible to evaluate the condition or recovery of the muscles innervated by the ulnar nerve. Second, MMT has problems such as "measurements are based on subjective classification of the degree of nerve damage, dependent on the physician's skill level, so the measurement results are not quantitative or objective" and "damaged nerve fibers recover very slowly, making it difficult to evaluate the degree of minute nerve recovery on a six-point scale." As a result, even though the nerves are in the process of recovery, it is not possible to properly evaluate the actual improvement in symptoms and report it to the patient using objective indicators, which has led to the problem of treatment being discontinued.In addition, a problem common to both is that "because both the grip strength test and MMT measure maximum muscle strength, they are not suitable for clinical settings where emphasis is placed on the condition of each nerve and the evaluation of recovery."

[0004] Patent Document 1 (JP 2014-8324 A) describes a measuring device (10) for evaluating the maximum muscle strength of a finger alone, which includes a fixing base (12) for fixing the arm (2) to reduce the influence of the arm's strength, and a sensor unit (11) for inserting the finger alone to measure muscle strength, and a thumb and finger evaluation system (see particularly paragraph

[0009] and Figures 1 and 4). Furthermore, Patent Document 2 (JP 2016-83004 A) describes a health monitoring system including a motion detection device (1) that detects the movement of a user's fingers and transmits measurement data, and a management device (2) that receives and accumulates the measurement data from the motion detection device (1), analyzes the finger movement based on the measurement data, and monitors the user's health condition (see particularly paragraph

[0016] and Figure 1). The motion detection device (1) includes a plurality of motion detection sensors (3) and a communication device (4) connected to the motion detection sensors (3) and communicating with the management device (2). The document describes that the output sensor (3) has a base part (5), a pair of arm parts (6), an acceleration sensor (7) that detects the acceleration of the fingers, and a tactile sensor (8) that detects the pressure when the fingers touch an object, and that the motion detection sensor (3) is attached to at least three fingers (thumb, little finger, index finger, or middle finger), and that detection of the movement of the thumb and index finger or middle finger is used to determine whether there is a disorder of the median nerve, detection of the movement of the little finger is used to determine whether there is a disorder of the ulnar nerve, and detection of the movement of the thumb and index finger is used to determine whether there is a disorder of the radial nerve (see, in particular, paragraphs 0017, 0027 and Figures 2 to 4).

[0005] JP 2014-008324 A (Patent No. 5958962 A) JP 2016-083004 A (Patent No. 6546733 A)

[0006] However, as described in paragraph 0012, the thumb and finger evaluation system described in Patent Document 1 contributes to the evaluation of muscle strength and motor coordination of the thumb and fingers and to rehabilitation. However, similar to the problems with grip strength tests, it is not possible to evaluate the muscle strength of each nerve (median, ulnar, radial nerve), and like grip strength tests and MMT, it measures maximum muscle strength, making it unsuitable for clinical settings where emphasis is placed on the condition of each nerve and recovery evaluation. Furthermore, as described in paragraph 0027, the health monitoring system described in Patent Document 2 is used to determine disorders of the median nerve, ulnar nerve, and radial nerve. However, the motion detection device (1) comprises a plurality of motion detection sensors (3), a management device (2), and a communication device (4). The motion detection sensor (3) has a base portion (5), a pair of arm portions (6), an acceleration sensor (7), and a tactile sensor (8). The motion detection sensor (3) must be attached to at least three fingers (thumb, little finger, index finger, or middle finger), resulting in a complex and expensive system configuration. Furthermore, since each finger is constantly monitored while being able to move freely, there is a problem that the system is easily affected by the force of the arm or other fingers.

[0007] In order to solve all at once the problems of the grip strength test and MMT actually used in clinical settings as well as the problems of Patent Documents 1 and 2, the first object of this invention is to provide a manual muscle strength testing device that can capture minute muscle contractions of the fingers while suppressing the compensatory action of the surrounding muscles, by using a simply configured load exercise measuring device and a small, lightweight inertial sensor, and the second object of this invention is to make it possible to evaluate the state and degree of recovery of the median nerve, ulnar nerve, and radial nerve by measuring only the load exercise of the index finger using this manual muscle strength testing device.

[0008] The manual muscle strength testing device of the invention according to claim 1 is characterized by comprising: an other finger fixing unit capable of fixing the middle finger, ring finger, and little finger of a subject; an inertial sensor that can be attached to the fingertip of the subject's index finger and that can measure the movement of the fingertip and record or transmit measurement data; and a load applying unit that applies a load to the fingertip to which the inertial sensor is attached.

[0009] The invention according to claim 2 is the manual muscle strength testing device according to claim 1, wherein the load applying unit is any one of an elastic body fixed to the pad side of the fingertip and contracting when subjected to a force in a direction in which the fingertip moves toward the pad side, an elastic body fixed to the nail side of the fingertip and expanding when subjected to a force in a direction in which the fingertip moves away from the nail side, an elastic body fixed to the thumb side of the fingertip and contracting when subjected to a force in a direction in which the fingertip moves toward the thumb, an elastic body fixed to the other finger fixing unit side of the fingertip and expanding when subjected to a force in a direction in which the fingertip moves away from the other finger fixing unit, an elastic body fixed to the nail side of the fingertip and contracting when subjected to a force in a direction in which the fingertip moves toward the nail, and an elastic body fixed to the pad side of the fingertip and expanding when subjected to a force in a direction in which the fingertip moves away from the pad side.

[0010] The invention of claim 3 is characterized in that, in the manual muscle strength testing device of claim 1 or 2, it comprises a pressure sensor that can be attached to the fingertip and that can measure the magnitude of the load applied to any one of the pad side, thumb side, and nail side of the fingertip and record or transmit the load measurement data, the inertial sensor and the pressure sensor are fixed to a ring that can be attached to the fingertip, the pressure sensor is fixed to all or any one of the pad side, thumb side, and nail side of the fingertip outside the annular part of the ring, and the load application unit applies a load to the pressure sensor that is fixed to any one of the pad side, thumb side, and nail side of the fingertip.

[0011] According to the manual muscle strength testing device of the invention as set forth in claim 1, it is possible to provide a manual muscle strength testing device that can capture minute muscle contractions in the subject's fingers while suppressing compensatory actions of the surrounding muscles, by using a load exercise measuring device with a simple configuration and a small, lightweight inertial sensor.

[0012] According to the manual muscle strength testing device of the invention according to claim 2, in addition to the effects of the invention according to claim 1, the load applying section is any one of an elastic body that is fixed to the pad side of the fingertip and contracts when subjected to a force in a direction in which the fingertip moves toward the pad side, an elastic body that is fixed to the nail side of the fingertip and expands when subjected to a force in a direction in which the fingertip moves away from the nail side, an elastic body that is fixed to the thumb side of the fingertip and contracts when subjected to a force in a direction in which the fingertip moves toward the thumb, an elastic body that is fixed to the other finger fixing section side of the fingertip and expands when subjected to a force in a direction in which the fingertip moves away from the other finger fixing section, an elastic body that is fixed to the nail side of the fingertip and contracts when subjected to a force in a direction in which the fingertip moves toward the nail, and an elastic body that is fixed to the pad side of the fingertip and expands when subjected to a force in a direction in which the fingertip moves away from the pad side. Therefore, a substantially constant load can be applied to the fingertip when the fingertip moves toward the pad side, the thumb side, or the nail side.

[0013] According to the manual muscle strength testing device of the invention of claim 3, in addition to the effects of the invention of claim 1 or 2, it is provided with a pressure sensor that can be attached to a fingertip and can measure the magnitude of the load applied to any one of the pad side, thumb side, and nail side of the fingertip and record or transmit the load measurement data, the inertial sensor and the pressure sensor are fixed to a ring that can be attached to the fingertip, the pressure sensor is fixed to all or any one of the pad side, thumb side, and nail side of the fingertip on the outside of the ring part of the ring, and the load application part applies a load to the pressure sensor fixed to any one of the pad side, thumb side, and nail side of the fingertip, so that it is possible to measure the magnitude of the load applied to the fingertip when the index finger is moved.

[0014] 1 is a perspective view and a side view showing a manual muscle testing device according to Example 1 and a first usage example. FIG. 2 is a perspective view of a main body of the manual muscle testing device according to Example 1. FIG. 3 is a perspective view of a ring, a finger pressing unit, an other finger pressing unit, and a finger cot used in Example 1. FIG. 4 is a perspective view and a side view showing a manual muscle testing device according to Example 1 and a second usage example. FIG. 5 is a perspective view and a side view showing a manual muscle testing device according to Example 1 and a third usage example. FIG. 6 is a diagram showing the relationship between the displacement amount and amplitude δ based on the output of an acceleration sensor. FIG. 7 is a graph showing the δa value of the median nerve obtained by the first usage example. FIG. 8 is a graph showing the δa value of the ulnar nerve obtained by the second usage example. FIG. 9 is a graph showing the δa value of the radial nerve obtained by the third usage example. FIG. 10 is a perspective view showing the structure of a manual muscle testing device according to Example 2. FIG. 11 is a diagram showing a state in which a ring is worn on an index finger in Example 2, and the ring itself. FIG. 12 is a diagram showing first to third usage examples of the manual muscle testing device according to Example 2. 10 is a perspective view showing the structure of a finger insertion section in the manual muscle testing device according to Example 3. FIG. 11 is a diagram showing first to sixth usage examples of the manual muscle testing device according to Example 3.

[0015] Hereinafter, embodiments of the present invention will be described with reference to examples.

[0016] FIG. 1 is a perspective view and a side view showing a manual muscle testing device according to Example 1 and a first example of use, and FIG. 2 is a perspective view of the main body of the manual muscle testing device according to Example 1. As shown in FIGS. 1( a), 1(b), and 2, the manual muscle testing device according to Example 1 includes the following components (A) to (I): (A) a palm rest 1 consisting of a rectangular plate-like body on which a subject's entire palm P can be placed. The plate-like body constituting the palm rest 1 has a plurality of holes 2 formed in a matrix, with two holes 2 near the center of the long side connected by a slit 3. Furthermore, pins 4 are fixed to each of the seven holes 2 in the center, arranged in two rows. The heads of the pins 4 protrude from the underside of the plate-like body. (B) a rectangular side wall 5 extending downward from one side of the palm rest 1. The side wall 5 has an opening 6 in its center, and legs 7 extending from the underside of the palm rest 1 on both the left and right inner sides. In addition, a leg 7 extends from the underside of another corner of the palm rest 1, and these three legs 7 support the palm rest 1 and the side wall 5. Although three legs 7 are provided to improve workability on the underside of the palm rest 1, thin legs may be extended from the underside of corners where no legs 7 are provided to increase stability. Conversely, the legs 7 on the inside of the side wall 5 may not be provided. Furthermore, instead of providing legs 7, a rectangular parallelepiped auxiliary member of approximately the same height as the side wall 5 may be placed opposite the side wall 5, and the palm rest 1 may be placed on the auxiliary member. (C) Restraint 8 for fixing the palm P to the upper surface of the palm rest 1. The restraint 8 has a buckle 10 at one end of a flat belt 9, and the other end of the flat belt 9 can be passed through the buckle 10 and folded back to adjust its length. That is, the other end of the flat belt 9 is passed through the slit 3 on the front side of Figure 1, and then passed from the bottom side through the slit 3 on the back side of Figure 1, and then set in the buckle 10 over the palm P of the subject as shown in Figure 1(a), and the length of the flat belt 9 is adjusted to fix the palm P on the upper surface of the palm rest section 1. (D) Triaxial acceleration sensor 11 that measures fingertip movement and transmits measurement data. The triaxial acceleration sensor 11 is attached to at least one fingertip (the index finger in Figure 1(a)) on the palm P of the subject, measures the movement of the attached fingertip, and transmits measurement data.The measurement data transmitted from the triaxial acceleration sensor 11 is received, processed, and analyzed by an analysis unit (not shown), allowing the amplitude δ of the acceleration data in the fingertip's moving direction to be measured. Alternatively, the measurement data may be recorded in memory along with the measurement time instead of being transmitted from the triaxial acceleration sensor 11, and the memory may be connected to the analysis unit and retrieved after the measurement is completed. (E) A load application unit 12 that applies an adjustable load to the fingertip whose movement is being measured. The load application unit 12 is composed of a cable tie 13 set in a hole 19 of a ring 15 (described later), two rubber bands 14, and pins 4 (with heads onto which the ends of the rubber bands 14 can be hooked) fixed to the two rows of seven holes 2 described in (A) above.

[0017] 3(a) to 3(d) are perspective views of the ring 15, finger pressing unit 20, other finger pressing unit 23, and finger cot 26 used in Example 1, and each component will be described below. (F) Ring 15 for fastening the triaxial acceleration sensor 11 to the subject's fingertip. As shown in FIG. 3(a), the ring 15 comprises a ring-shaped portion 16 into which the subject's fingertip (the index finger in FIG. 1(a)) can be inserted, a sensor fixing portion 18 provided in a position opposite the slit 17 in the ring-shaped portion 16, and through-holes 19 provided on both sides of the sensor fixing portion 18. When performing measurements, a cable tie 13 is set in the through-holes 19. The annular portion 16 has a slit 17 and is elastic, so that even if the finger diameter varies by a few millimeters, the fingertip can fit into the annular portion 16. However, since finger diameters vary greatly from person to person, and rings 15 may be worn on fingertips other than the index finger, it is better to prepare multiple types of rings 15 with different diameters of the annular portion 16. It is also better to make the diameter of the annular portion 16 smaller at the tip and larger at the rear. (G) Finger pressing portion 20, which presses the finger whose movement is to be measured toward the palm rest portion 1. The finger pressing unit 20 presses the finger (index finger in FIG. 1( a)) whose movement is to be measured against the palm rest 1 between the second and third joints of the finger on which the triaxial acceleration sensor 11 is attached, while the subject's palm P is fixed to the top surface of the palm rest 1 with the palm facing up or down. As shown in FIG. 3( b), the finger pressing unit 20 consists of a U-shaped portion 21 with a height sufficient to allow its lower end to contact the top surface of the palm rest 1 when placed over the second and third joints of the finger to be measured and pressed against it, and a flat finger pressing portion 22 located above the U-shaped portion 21. Similar to the ring 15, it is recommended to prepare multiple finger pressing units 20 with different U-shaped portions 21 of different widths and heights. (H) Other finger pressing unit 23 presses the finger adjacent to the finger whose movement is to be measured against the palm rest 1.The other finger pressing unit 23 is used to press the finger adjacent to the finger whose movement is to be measured (the middle finger in FIG. 1A) toward the palm rest 1 while the subject's palm P is facing upward and fixed to the top surface of the palm rest 1. As shown in FIG. 3C, it consists of a semicircular ring portion 24 with a height such that its lower end contacts the top surface of the palm rest 1 when placed over the finger to be pressed, and a flat portion 25 for pressing the other finger located in the center of the upper side of the semicircular ring portion 24. It is recommended that the other finger pressing unit 23 also be prepared in multiple types with different widths and heights of the semicircular ring portion 24, similar to the ring 15 and finger pressing unit 20. (I) A finger cot 26 is worn on the subject's fingertip to stabilize the position of the ring 15. The fingerstall 26 is fitted onto the tip of the finger whose movement is to be measured (the index finger in FIG. 1(a)) to stabilize the position of the ring 15 and improve the fit of the ring 15. As shown in FIG. 3(d), it is made of an elastic material such as rubber, molded into a dome shape with a closed tip and numerous protrusions 27 on its surface. As with the ring 15, it is advisable to prepare multiple types of fingerstalls 26 with different diameters and sizes, and it is also advisable to provide ventilation holes on the side to prevent the ring from getting stuffy.

[0018] In a first use example, the manual muscle testing device described above is used. As shown in FIG. 1, the subject's palm P is fixed upward on the top surface of the palm support section 1. The subject is instructed to bend the index finger at the second joint, move the fingertip upward, and then return it to its original position while measuring the fingertip movement. This allows the condition of the flexor digitorum superficialis muscle to be determined. The measured values ​​can then be analyzed to evaluate the condition and degree of recovery of the median nerve. The measurement procedure in the first use example will now be described in detail.

[0019] (Step A1) The fingerstall 26 is placed on the tip of the subject's index finger. (Step A2) A ring 15 is selected that fits the size of the fingertip on which the fingerstall 26 is placed, and the triaxial acceleration sensor 11 is fixed to the sensor fixing portion 18 of the ring 15 using double-sided tape or adhesive. Note that if a ring 15 is selected that already has the triaxial acceleration sensor 11 fixed to the sensor fixing portion 18, the process of fixing the triaxial acceleration sensor 11 is not necessary. (Step A3) The subject's index finger, which is wearing the fingerstall 26, is inserted into the ring portion 16 of the ring 15 to which the triaxial acceleration sensor 11 is fixed, and the ring portion 16 is brought into close contact between the first joint and the fingertip, and the ring portion 16 is fixed so that the top surface of the triaxial acceleration sensor 11 and the pad side of the fingertip are facing the same direction. (Step A4) Once the 3-axis acceleration sensor 11 has been secured in place, the subject's palm P is placed facing upward on the top surface of the palm rest 1, the other end of the flat belt 9 is passed through one of the slits 3, and then through the other slit 3 from the underside of the palm rest 1, and then set into the buckle 10 above the center of the subject's palm P, and the length of the flat belt 9 is adjusted to secure the palm P to the top surface of the palm rest 1. Note that instead of using the restraint 8 to secure the palm P to the top surface of the palm rest 1, the examiner's hand H may be used to press the back of the subject's hand against the palm rest 1 and secure it there.

[0020] (Step A5) One end of one rubber band 14 is hooked to each of the cable ties 13 set on both sides of the ring 15, and the other end of one rubber band 14 is hooked through the hole 2 in the palm rest portion 1 to one of the pins 4 in one row (the second one from the arm side in Figure 1(b)), and the other end of the other rubber band 14 is similarly hooked through the hole 2 in the palm rest portion 1 to a pin 4 in the corresponding position in the other row. The state in which two rubber bands 14 are not hooked on pins 4 will be called load 0, the state in which the other ends of two rubber bands 14 are hooked on pins 4 located at the position corresponding to their most compressed state (hereinafter referred to as the "shortest position") will be called load 1, the state in which the other ends of two rubber bands 14 are hooked on pins 4 located one arm away from the shortest position will be called load 2, the state in which the other ends of two rubber bands 14 are hooked on pins 4 located two arms away from the shortest position will be called load 3, and the state in which the other ends of two rubber bands 14 are hooked on pins 4 located three arms away from the shortest position will be called load 4. (Step A6) Place the finger pressing unit 20 over the area between the second and third joints of the index finger and press it toward the palm rest 1, and place the other finger pressing unit 23 over the middle finger and press it toward the palm rest 1. The pressing method can be selected from the following methods: pressing with the examiner's hand, placing a weight on the finger pressing flat portion 22 and the other finger pressing flat portion 25, or fixing the finger pressing portion 20 and the other finger pressing flat portion 25 to the upper surface of the palm rest portion 1 using an elastic material such as a rubber band or a member that fits into the hole 2. (Step A7) The triaxial acceleration sensor 11 is activated, and the examinee is instructed to bend the second joint of the index finger over three seconds, hold it at the maximum range of motion for three seconds, and then return it to its original position over three seconds. These instructions are repeated five times to measure the fingertip movement, and the triaxial acceleration sensor 11 is stopped after the measurement is completed.

[0021] FIG. 4 is a perspective view and a side view showing the manual muscle testing device according to Example 1 and a second usage example. In the second usage example, the manual muscle testing device according to Example 1 is used. As shown in FIG. 4 , the subject's palm P is held sideways, with the middle finger, ring finger, and little finger fixed on the upper surface of the palm rest 1. The subject is instructed to open the entire index finger relative to the middle finger, move the fingertip upward, and then return it to its original position while measuring the movement of the fingertip. The condition of the dorsal interosseous muscle can then be determined by analyzing the measured values. The condition and degree of recovery of the ulnar nerve can then be evaluated. Next, the measurement procedure in the second usage example will be described in detail.

[0022] (Step B1) A ring 15 that fits the size of the subject's index finger is selected, and the triaxial acceleration sensor 11 is fixed to the sensor fixing portion 18 using double-sided tape or adhesive. Note that if a ring 15 with the triaxial acceleration sensor 11 already fixed to the sensor fixing portion 18 is selected, the process of fixing the triaxial acceleration sensor 11 is not necessary. Alternatively, as in Step A1 above, a fingerstall 26 may be attached to the tip of the subject's index finger. In this case, a ring 15 that fits the size of the fingertip on which the fingerstall 26 is attached is selected. (Step B2) The subject's index finger is inserted into the annular portion 16 of the ring 15 with the triaxial acceleration sensor 11 fixed, and the annular portion 16 is brought into close contact between the first joint and the fingertip. The ring is fixed so that the top surface of the triaxial acceleration sensor 11 and the thumb side of the fingertip face the same direction. (Step B3) Once the 3-axis acceleration sensor 11 has been secured, the subject's palm P is placed sideways on the top surface of the palm rest 1, and the middle, ring, and little fingers are secured to the top surface of the palm rest 1. The middle, ring, and little fingers may be secured by the tester's hand H as shown in Figure 4(a), or by providing slits similar to slit 3 at appropriate positions on the palm rest 1, and using the restraint 8 as in step A4 above, passing the other end of the flat belt 9 through the two slits, and then setting it on the buckle 10 near the ring finger of the subject's palm P, and adjusting the length of the flat belt 9.

[0023] (Step B4) One end of one rubber band 14 is hooked to each of the cable ties 13 set on both sides of the ring 15, and the other end of one rubber band 14 is hooked through the hole 2 in the palm rest 1 to one of the pins 4 in one row (the second pin from the fingertip in Figure 4(b) ). The other end of the other rubber band 14 is also hooked through the hole 2 in the palm rest 1 to a pin 4 in the corresponding position in the other row. Note that the definitions of loads 0 to 3 are the same as those described in Step A5 above. (Step B5) After the two rubber bands 14 are hooked onto the pins 4, the triaxial acceleration sensor 11 is activated, and the subject is instructed to open the entire index finger relative to the middle finger over three seconds, hold it at the maximum range of motion for three seconds, and then return it to its original position over three seconds. These instructions are repeated five times to measure the fingertip movement, and the triaxial acceleration sensor 11 is stopped after the measurement is completed.

[0024] FIG. 5 is a perspective view and a side view showing the manual muscle testing device according to Example 1 and a third use example. In the third use example, the manual muscle testing device according to Example 1 is used. As shown in FIG. 5 , the palm P of the subject is fixed to the upper surface of the palm rest 1 with the second joint of the index finger facing downward and slightly extending forward from the side wall 5. The subject is instructed to bend the index finger at the second joint 90 degrees, then extend the fingertip, and then return it to its original position while measuring the fingertip movement. The condition of the extensor digitorum communis muscle can be determined by analyzing the measured values. The condition and degree of recovery of the radial nerve can then be evaluated. Next, the measurement procedure in the third use example will be described in detail.

[0025] (Procedure C1) Select a ring 15 that fits the size of the subject's index finger, and secure the triaxial acceleration sensor 11 to its sensor mount 18 using double-sided tape or adhesive. Note that if a ring 15 with the triaxial acceleration sensor 11 already attached to the sensor mount 18 is selected, the process of attaching the triaxial acceleration sensor 11 is unnecessary. Alternatively, as in Procedure A1, a finger cot 26 may be attached to the tip of the subject's index finger. In this case, select a ring 15 that fits the size of the fingertip to which the finger cot 26 is attached. (Procedure C2) Insert the subject's index finger into the annular portion 16 of the ring 15 with the triaxial acceleration sensor 11 attached, press the annular portion 16 tightly between the first joint and the fingertip, and secure the ring 15 so that the top surface of the triaxial acceleration sensor 11 faces the nail side of the fingertip. (Procedure C3) Once the triaxial acceleration sensor 11 is attached, place the subject's palm P facing downward on the top surface of the palm rest 1 and secure it to the top surface of the palm rest 1. The palm P may be fixed by the examiner's hand as in step B3 above, or a slit similar to slit 3 may be provided at an appropriate position on the palm rest 1, and the other end of the flat belt 9 may be passed through the two slits using the restraint 8 as in step A4 above, and then the flat belt 9 may be set in the buckle 10 near the third joint of the examinee's middle finger, and the length of the flat belt 9 may be adjusted.

[0026] (Step C4) One end of one rubber band 14 is hooked to each of the cable ties 13 set on both sides of the ring 15, and the other end of one rubber band 14 is hooked to one of the pins 4 in one row (the fourth pin from the fingertip side in FIG. 5B ) through the opening 6 in the side wall 5, and the other end of the other rubber band 14 is also hooked to a pin 4 at a corresponding position in the other row through the opening 6 in the side wall 5. The definitions of loads 0 to 3 are the same as those explained in Step A5 above. After the rubber band 14 is hooked to the pin 4, the finger pressing unit 20 may be placed between the second and third joints of the index finger and pressed against the palm rest 1, as in Step A6 above. (Step C5) After the two rubber bands 14 are attached to the pins 4, the triaxial acceleration sensor 11 is activated and the subject is instructed to extend the index finger from a 90-degree bent position at the second joint over three seconds, hold the finger at its maximum range of motion for three seconds, and then return it to its original position over three seconds. These instructions are repeated five times to measure the fingertip movement, and the triaxial acceleration sensor 11 is stopped after the measurement is completed.

[0027] 6 is a diagram showing the relationship between the displacement and amplitude δ based on the output of the acceleration sensor 11. As described above, steps A1 to A7 of the first usage example allow measurement of fingertip movement when the subject's palm P is facing upward and fixed to the upper surface of the palm rest 1, and the index finger is bent and extended at the second joint. Steps B1 to B6 of the second usage example allow measurement of fingertip movement when the subject's palm P is turned sideways and the middle finger, ring finger, and little finger are fixed to the upper surface of the palm rest 1, and the index finger is opened and closed relative to the middle finger. Steps C1 to C6 of the third usage example allow measurement of fingertip movement when the subject's palm P is facing downward and fixed to the upper surface of the palm rest 1, and the index finger is bent 90 degrees at the second joint and then extended and extended. Analysis of these measurements allows evaluation of the condition and degree of recovery of the median nerve, ulnar nerve, and radial nerve. Although the amplitudes are different in each of the first to third use examples, if the fingertip movement is graphed based on the measurement data transmitted from the acceleration sensor 11, with the horizontal axis as the time axis and the vertical axis as the displacement in the Y-axis direction, the graph will have the shape shown in Figure 6. Therefore, in the analysis based on the measurement data obtained in the first to third use examples, the position before the fingertip movement is set as the initial value y ０, the fingertip is moved and held at the maximum range of motion for 3 seconds as the holding value y, and the initial value y ０ and the difference between the retention value y (y ０ The amplitude δ was measured by calculating the amplitude δ − y, and the average value δa of the amplitude δ for a total of five measurements was calculated to evaluate the condition and degree of recovery of the median nerve, ulnar nerve, and radial nerve.

[0028] Figure 7 is a graph showing the δa values ​​of the median nerve obtained by the first use example. Figure 7(a) plots the variance of δa at load 0 and δa at loads 1 to 4 for each subject, with the horizontal axis representing δa without load and the vertical axis representing δa with load. Note that subjects plotted with circles are those previously evaluated by a doctor as MMT5 (Normal), subjects plotted with squares are those previously evaluated as MMT4 (Good), and subjects plotted with triangles are those previously evaluated as MMT3 (Fair). Figure 7(b) is a graph comparing the progress of the approximation line for δa at loads 0 to 4 for each group of subjects previously evaluated by a doctor as MMT3 to 5. From these graphs, it can be seen that the MMT5 subject group often had δa exceeding 1 at all loads of 0 to 4, and is plotted in the upper right region of Figure 7(a). The MMT4 subject group had δa values ​​close to 1 at loads of 0 to 4, but Figure 7(a) shows that there was variation between subjects close to MMT5 and subjects close to MMT3. The MMT3 subject (one) was able to move his fingertip to some extent at load 1, indicating that he was in a state with the same characteristics as the MMT3 criterion (a state in which enough force can be applied to move a joint even against gravity). Considering the above findings, when the variance of δa at load 0 and δa at loads 1 to 4 is plotted on the graph of Figure 7(a), if it is plotted in the upper right region, it is likely to belong to the MMT5 group, if it is plotted between the upper right region and the lower left region, it is likely to belong to the MMT4 group, and if it is plotted in the lower left region, it is likely to belong to the MMT3 group. Furthermore, the MMT4 group has a large variance that makes it difficult even for doctors to distinguish between them. However, by plotting the variance of δa at load 0 and δa at loads 1 to 4 on the graph in Figure 7(a), it is possible to determine whether the condition is closer to the MMT5 group or the MMT3 group, which may enable a more detailed evaluation than the conventional 6-point evaluation.

[0029] Figure 8 is a graph showing the δa values ​​of the ulnar nerve obtained by the second use example. Figure 8(a) plots the variance of δa at load 0 and δa at loads 1 to 3 for each subject, with the horizontal axis representing δa without load and the vertical axis representing δa with load. Note that, like Figure 7(a), the circle, square, and triangle plots represent subjects previously evaluated by a doctor as MMT5, MMT4, and MMT3, respectively. Figure 8(b) is a graph comparing the progression of the approximation line for δa at loads 0 to 3 for each group of subjects previously evaluated by a doctor as MMT3 to 5. These graphs show that the MMT5 subject group often had δa exceeding 0.7 at loads 0 to 3, and are plotted in the upper right region of Figure 8(a). The MMT4 subject group often had δa within the range of 0.4 to 0.6 at loads 0 to 3, but Figure 8(a) shows a wide variation from subjects close to MMT5 to subjects close to MMT3. One MMT3 subject was able to move his fingertips to some extent at load 1, demonstrating the same characteristics as the MMT3 criterion (a state in which enough force is applied to move the joint even against gravity). Considering the above findings, when the variances of δa at load 0 and δa at loads 1 to 3 are plotted on the graph in Figure 8(a), those plotted in the upper right region are likely to belong to the MMT5 group, those plotted between the upper right region and the lower left region are likely to belong to the MMT4 group, and those plotted in the lower left region are likely to belong to the MMT3 group. It is also clear that the δa values ​​decrease with increasing load in the MMT4 and MMT3 subject groups. Furthermore, the MMT4 group has large variations, as in Figure 7, making it difficult even for doctors to distinguish between them. However, by plotting the variance of δa at load 0 and δa at loads 1 to 3 on the graph in Figure 8(a), it is possible to determine whether the condition is closer to the MMT5 group or the MMT3 group, which may enable more detailed evaluation than the conventional 6-point evaluation.

[0030] Figure 9 is a graph showing the radial nerve δa values ​​obtained by the third use example. Figure 9(a) plots the variance of δa at load 0 and δa at loads 1 to 2 for each subject, with the horizontal axis representing δa without load and the vertical axis representing δa with load. Note that, like Figure 7(a), the circle, square, and triangle plots represent subjects previously evaluated by a doctor as MMT5, MMT4, and MMT3, respectively. Figure 9(b) is a graph comparing the progression of the approximation line for δa at loads 0 to 2 for each group of subjects previously evaluated by a doctor as MMT3 to 5. From these graphs, it can be seen that for the MMT5 subject group, δa often had a value of around 1.2 at all loads of 0 to 1, and δa often had a value of around 1 at load 2, and are plotted in the upper right region of Figure 9(a). For the MMT4 and MMT3 subject groups, δa was around 1 at load 0, but at loads 1 to 2, δa often dropped sharply to around 0.4 to 0.1. Figure 9(a) shows that δa when under load is lower than for the MMT5 subject, and that for the MMT3 subject group, δa at loads 0 to 2 was lower than the δa of the MMT4 subject group. Considering the above findings, when the variance of δa at load 0 and δa at loads 1 to 3 is plotted on the graph in Figure 9(a), it can be said that if it is plotted in the upper right region, it is likely to belong to the MMT5 group, if it is plotted in the region from the lower center to the lower right, it is likely to belong to the MMT4 group, and if it is plotted in the lower left region, it is likely to belong to the MMT3 group. Furthermore, when evaluating the degree of recovery of the radial nerve using the third use example, it is thought that the δa value should be obtained by applying a smaller load, and it can be seen that the method of applying the load is important.

[0031] Fig. 10 is a perspective view showing the structure of a manual muscle testing apparatus according to Example 2, Fig. 11 is a diagram showing a state in which a ring is worn on an index finger in Example 2 and the ring itself, and Fig. 12 is a diagram showing first to third usage examples of the manual muscle testing apparatus according to Example 2. As shown in Figs. 10 to 12, the manual muscle testing apparatus according to Example 2 comprises the following components (J) to (N). Note that some components are common to Example 1, and therefore the same numbers are used for the common components, and the explanations may be simplified.

[0032] (J) A finger insertion section 30 includes an other-finger fixing section 28, which allows the subject's middle finger, ring finger, and little finger to be inserted and has a space shaped so that the inserted middle finger, ring finger, and little finger cannot move in either direction, and an index finger insertion section 29, which allows the subject's index finger to be inserted and has a space shaped so that the inserted index finger can move toward the ventral side or the thumb side, or toward the nail or the thumb side. The other-finger fixing section 28 is rectangular and cylindrical, allowing the middle finger, ring finger, and little finger to be inserted from both sides, while the index finger insertion section 29 is cylindrical with an L-shaped cross section, allowing the index finger to be inserted from both sides. Since finger sizes vary from person to person, multiple finger insertion sections 30 with different lengths and heights for the other-finger fixing section 28 are prepared, taking into consideration the width and thickness of the middle finger, ring finger, and little finger when aligned. (K) A removable load elastic body 31 that can be inserted and fixed to the protruding portion of the index finger insertion section 29. The load elastic body 31 corresponds to the load application section 12 (particularly the two rubber bands 14) in Example 1, and by using elastic bodies of various softness (sponge in Figure 10), for example, it is possible to apply an adjustable load to the fingertip. Also, in Figure 10, the cross section of the protruding part of the index finger insertion section 29 is arched, so the load elastic body 31 is also semi-cylindrical, but the cross section of the protruding part of the index finger insertion section 29 may also be U-shaped, in which case the load elastic body 31 will be prismatic.

[0033] (L) A triaxial acceleration sensor 11 that measures fingertip movement and transmits measurement data. For details of the triaxial acceleration sensor 11, see (D) in Example 1. (M) A pressure sensor 32 that measures the magnitude of the load applied to the fingertip and transmits the measurement data. In FIG. 11(C), the pressure sensor 32 is fixed to the pad side of the subject's index finger. Therefore, when the tip of the index finger is moved toward the pad side inside the index finger insertion section 29, as shown in FIG. 12(A), the pressure sensor 32 receives a repulsive force from the load elastic body 31. Therefore, by receiving, processing, and analyzing the pressure measurement data measured by the pressure sensor 32 in an analysis unit (not shown), the magnitude of the pressure applied to the pad side of the fingertip can be confirmed. In Example 2, in order to transmit the acceleration measurement data and pressure measurement data measured by the triaxial acceleration sensor 11 and the pressure sensor 32, a data transmission means 33 is attached to the subject's wrist, as shown in FIG. 11(A), and the triaxial acceleration sensor 11, the pressure sensor 32, and the data transmission means 33 are connected by a signal transmission line 34. (N) A ring 35 for fixing the 3-axis acceleration sensor 11 and the pressure sensor 32 to the fingertip. As shown in Fig. 11(B) , the ring 35, like the ring 15 described in (F) of Example 1, has an annular portion that can be inserted into the tip of the subject's index finger, an upper surface side sensor fixing portion 36 provided in a position opposite the slit in the annular portion, a lower surface side sensor fixing portion 37 fixed to one side of the slit in the annular portion (the left side of the figure), and a side surface side sensor fixing portion 38 fixed to one side of the annular portion (the right side of the figure). In the first and third use examples described below, the triaxial acceleration sensor 11 is fixed to one of the upper sensor fixing portion 36 and the lower sensor fixing portion 37, and the pressure sensor 32 is fixed to the other, to measure the movement of the fingertip and the pressure applied to the pad side of the fingertip in the first use example and the nail side of the fingertip in the third use example. In the second use example described below, the triaxial acceleration sensor 11 is fixed to one of the upper sensor fixing portion 36 and the lower sensor fixing portion 37, and the pressure sensor 32 is fixed to the side sensor fixing portion 38, to measure the movement of the fingertip and the pressure applied to the thumb. Note that in order to stabilize the position of the ring 35, a fingerstall 26 described in (I) of Example 1 and shown in FIG. 3(d) may be used.

[0034] FIG. 12A shows a first example of use of the manual muscle testing device according to Example 2. In this first example of use, a load elastic body 31 of appropriate softness is inserted and fixed into the protruding portion of the index finger insertion section 29. Then, with the subject's palm P facing upward, the middle finger, ring finger, and little finger are inserted into the other finger fixing section 28, and the index finger is inserted into the index finger insertion section 29. The subject is then instructed to bend the index finger at the second joint and move the fingertip upward (in the direction of the arrow), and then return it to its original position while measuring the movement of the fingertip and the pressure applied to the ventral side of the fingertip. The condition of the flexor digitorum superficialis can be determined by analyzing these measurements. Furthermore, the condition and degree of recovery of the median nerve can be evaluated in the same manner as in Example 1. Regarding the procedures corresponding to measurement procedures A1 to A4 in the first use example of Example 1, in the case of the first use example of Example 2, the procedure can be completed simply by wearing the ring 35 to which the triaxial acceleration sensor 11 and the pressure sensor 32 are fixed on the index finger of the subject, inserting the middle finger, ring finger, and little finger into the other finger fixing portion 28, and inserting the index finger into the index finger inserting portion 29, which is simpler than Example 1. Furthermore, regarding the procedure corresponding to measurement procedure A5 in the first use example of Example 1, in the case of the first use example of Example 2, a state in which the load elastic body 31 is not inserted is load 0, a state in which the softest load elastic body 31 is inserted and fixed is load 1, a state in which the second softest load elastic body 31 is inserted and fixed is load 2, a state in which the third softest load elastic body 31 is inserted and fixed is load 3, and a state in which the fourth softest (hardest) load elastic body 31 is inserted and fixed is load 4. Furthermore, with regard to the procedures corresponding to measurement procedures A6 and A7 in the first use example of Example 1, in the case of the first use example of Example 2, procedure A6 can be omitted, and the subject is instructed to start the triaxial acceleration sensor 11 and pressure sensor 32, bend the second joint of the index finger over three seconds, hold it at the maximum range of motion for three seconds, and return it to its original position over three seconds. These instructions are repeated five times to measure the movement of the fingertip, and the pressure on the pad side of the fingertip is measured. After the measurement is completed, the triaxial acceleration sensor 11 and pressure sensor 32 are stopped, which is almost the same as procedure A7 in Example 1.

[0035] 12(B) is a diagram showing a second example of use of the manual muscle testing device according to Example 2. In this second example of use, a load-applying elastic body 31 of appropriate softness is inserted and fixed into the protruding portion of the index finger insertion section 29. Then, with the subject's palm P turned sideways, the middle finger, ring finger, and little finger are inserted into the other finger fixing section 28, and the index finger is inserted into the index finger insertion section 29. The subject is then instructed to open the entire index finger relative to the middle finger, move the fingertip upward (in the direction of the arrow), and then return it to its original position. The movement of the fingertip and the pressure applied to the thumb side of the fingertip are measured, thereby determining the condition of the dorsal interosseous muscle. Furthermore, by analyzing these measurements, the condition and degree of recovery of the ulnar nerve can be evaluated in the same manner as in Example 1. Regarding the procedures corresponding to measurement procedures B1 to B3 in the second use example of Example 1, in the case of the second use example of Example 2, the procedure can be completed simply by wearing the ring 35 to which the triaxial acceleration sensor 11 and the pressure sensor 32 are fixed on the index finger of the subject, inserting the middle finger, ring finger, and little finger into the other finger fixing portion 28, and inserting the index finger into the index finger inserting portion 29, which is simpler than Example 1. Furthermore, regarding the procedure corresponding to measurement procedure B4 in the second use example of Example 1, in the case of the second use example of Example 2, as in the case of the first use example of Example 2, the state in which the load elastic body 31 is not inserted is load 0, the state in which the softest load elastic body 31 is inserted and fixed is load 1, the state in which the second softest load elastic body 31 is inserted and fixed is load 2, the state in which the third softest load elastic body 31 is inserted and fixed is load 3, and the state in which the fourth softest (hardest) load elastic body 31 is inserted and fixed is load 4. Furthermore, with regard to the procedure corresponding to measurement procedure B5 in the second use example of Example 1, in the case of the second use example of Example 2, the triaxial acceleration sensor 11 and pressure sensor 32 are activated, and the subject is instructed to open the entire index finger toward the middle finger over three seconds, hold it at the maximum range of motion for three seconds, and return it to its original position over three seconds. These instructions are repeated five times to measure the movement of the fingertip, and the pressure on the thumb side of the fingertip is measured. After the measurement is completed, the triaxial acceleration sensor 11 and pressure sensor 32 are stopped, which is almost the same as procedure B5 in Example 1.

[0036] 12(C) is a diagram showing a third example of use of the manual muscle testing device according to Example 2. In this third example of use of Example 2, a loading elastic body 31 of appropriate softness is inserted and fixed into the protruding portion of the index finger insertion section 29. Then, with the subject's palm P facing downward, the middle finger, ring finger, and little finger are inserted into the other finger fixing section 28, and the index finger is inserted into the index finger insertion section 29. The subject is then instructed to bend the index finger 90 degrees at the second joint, extend the fingertip in the direction of the arrow, and then return it to its original position. The fingertip movement and the pressure on the nail side of the fingertip are measured, thereby determining the condition of the extensor digitorum communis muscle. Furthermore, by analyzing these measurements, the condition and degree of recovery of the radial nerve can be evaluated in the same manner as in Example 1. Regarding the procedures corresponding to the measurement procedures C1 to C3 in the third use example of Example 1, in the case of the third use example of Example 2, the procedure can be completed simply by wearing the ring 35 to which the triaxial acceleration sensor 11 and the pressure sensor 32 are fixed on the index finger of the subject, inserting the middle finger, ring finger, and little finger into the other finger fixing portion 28, and inserting the index finger into the index finger inserting portion 29, which is simpler than Example 1. Furthermore, regarding the procedure corresponding to the measurement procedure C4 in the third use example of Example 1, in the third use example of Example 2, as in the first use example of Example 2, the state in which the load elastic body 31 is not inserted is load 0, the state in which the softest load elastic body 31 is inserted and fixed is load 1, the state in which the second softest load elastic body 31 is inserted and fixed is load 2, the state in which the third softest load elastic body 31 is inserted and fixed is load 3, and the state in which the fourth softest (hardest) load elastic body 31 is inserted and fixed is load 4. Furthermore, with regard to the procedure corresponding to measurement procedure C5 in the third use example of Example 1, in the case of the third use example of Example 2, the three-axis acceleration sensor 11 and pressure sensor 32 are activated, and the subject is instructed to extend the index finger from a position where it is bent 90 degrees at the second joint over three seconds, hold the index finger at the maximum range of motion for three seconds, and return it to its original position over three seconds.These instructions are repeated five times to measure the movement of the fingertip, and the three-axis acceleration sensor 11 and pressure sensor 32 are stopped after the measurement is completed, which is almost the same as procedure C5 in Example 1.

[0037] Fig. 13 is a perspective view showing the structure of a manual muscle testing apparatus according to Example 3, and Fig. 14 is a diagram showing first to sixth usage examples of the manual muscle testing apparatus according to Example 3. As shown in Figs. 13 and 14, the manual muscle testing apparatus according to Example 3 includes the following components (O) to (S). Note that some components are common to Examples 1 and 2, and therefore the same numbers are used for the common components and their explanations may be simplified. Furthermore, the three-axis acceleration sensor 11, pressure sensor 32, and ring 35 for fixing these shown in Fig. 11 are the same as those used in Example 2, and therefore their explanations will be omitted (see (L) to (N) of Example 2).

[0038] (O) A finger insertion section 40 including an other-finger fixing section 28 into which the subject's middle finger, ring finger, and little finger can be inserted, having a space shaped to prevent the inserted middle finger, ring finger, and little finger from moving in any direction, and an index finger insertion section 39 into which the subject's index finger can be inserted, having a space shaped to allow the inserted index finger to move toward the ventral side, thumb side, or nail side. The other-finger fixing section 28 has the same configuration as in Example 2, and the index finger insertion section 39 has a T-shaped cylindrical cross section that allows the index finger to be inserted from both sides, as shown in FIG. 13(A). Since finger sizes vary among individuals, multiple finger insertion sections 40 with different lengths and heights of the other-finger fixing section 28 are prepared, similar to the finger insertion section 30 in Example 2. (P) A detachable loading elastic body 31 that can be inserted and fixed to the protruding portion of the index finger insertion section 39, excluding the portion adjacent to the other-finger fixing section 28. For details, see (K) in Example 2. FIG. 13B shows the state in which the load elastic body 31 is inserted and fixed to all protruding portions. (Q) A load ring elastic body 41, one end of which can be fixed to the end of the protruding portion of the index finger insertion portion 39 except for the portion adjacent to the other finger fixing portion 28, and the other end of which can be hooked and fixed to the pressure sensor 32. FIG. 13C shows the overall shape and fixed state of the load ring elastic body 41. (R) A bag-shaped other finger fixing portion 42 into which the subject's middle finger, ring finger, and little finger can be inserted, having a space shaped so that the inserted middle finger, ring finger, and little finger cannot move in either direction (see FIG. 14E). (S) A load strap-like elastic body 43, one end of which can be fixed to the outside of the little finger insertion portion of the bag-shaped other finger fixing portion 42, and the other end of which can be hooked and fixed to the pressure sensor 32 (see FIG. 14E).

[0039] 14A is a diagram showing a first example of use of the manual muscle testing device according to Example 3. In the first example of use of Example 3, a loading elastic body 31 of appropriate softness is inserted and fixed into the protruding portion of the index finger insertion section 39, and then the subject's palm P is turned upward, and the middle finger, ring finger, and little finger are inserted into the other finger fixing section 28, and the index finger is inserted into the index finger insertion section 39. The subsequent movement of the index finger, determination of the state of the flexor digitorum superficialis muscle, evaluation of the state and degree of recovery of the median nerve by analysis of the measured values, and correspondence and comparison with the measurement procedures A1 to A7 in the first example of use of Example 1 are all exactly the same as those in the first example of use of Example 2.

[0040] 14(B) is a diagram showing a second use example of the manual muscle testing device according to Example 3. In the second use example of Example 3, a loading elastic body 31 of appropriate softness is inserted and fixed into the protruding portion of the index finger insertion section 39, and then, with the subject's palm P turned sideways, the middle finger, ring finger, and little finger are inserted into the other finger fixing section 28, and the index finger is inserted into the index finger insertion section 39. The subsequent movement of the index finger, determination of the state of the dorsal interosseous muscle, evaluation of the state and degree of recovery of the ulnar nerve by analysis of the measured values, and correspondence and comparison with measurement procedures B1 to B5 in the second use example of Example 1 are all exactly the same as those in the second use example of Example 2.

[0041] 14(C) is a diagram showing a third use example of the manual muscle testing device according to Example 3. In this third use example of Example 3, a loading elastic body 31 of appropriate softness is inserted and fixed into the protruding portion of the index finger insertion section 39, and then, with the subject's palm P facing downward, the middle finger, ring finger, and little finger are inserted into the other finger fixing section 28 and the index finger into the index finger insertion section 39. The subsequent movement of the index finger, the determination of the state of the extensor digitorum communis muscle, the evaluation of the state and degree of recovery of the radial nerve through analysis of the measured values, and the correspondence and comparison with the measurement procedures C1 to C5 in the third use example of Example 1 are all the same as those in the third use example of Example 2.

[0042] 14(D) is a diagram showing a fourth use example of the manual muscle testing device according to Example 3. The fourth use example of Example 3 is common to the first use examples of the manual muscle testing device according to Examples 2 and 3 in that it allows for the state of the flexor digitorum superficialis to be determined and the state and degree of recovery of the median nerve to be evaluated by analyzing measured values. In both first use examples, a load elastic body 31 of appropriate softness is inserted and fixed to the protruding portion of the index finger insertion section 29 or 39, and then the subject's fingers other than the thumb are inserted into the finger insertion section 30 or 40, and the index finger is moved while the load elastic body 31 is contracted to measure the movement of the fingertip. In contrast, in the fourth use example of Example 3, one end of a load ring-shaped elastic body 41 is fixed to the end of the protruding portion of the index finger insertion section 39, and the other end is hooked onto the pressure sensor 32. Then, the subject's fingers other than the thumb are inserted into the finger insertion section 40, and the index finger is moved while the load ring-shaped elastic body 41 is stretched to measure the movement of the fingertip. Furthermore, the manner in which the index finger is moved after a finger other than the thumb is inserted into the finger insertion portion 40, the state of the flexor digitorum superficialis muscle is determined, the state of the median nerve and the degree of recovery are evaluated by analyzing the measured values, and the correspondence and comparison with the measurement procedures A1 to A7 in the first use example of the first embodiment are almost the same as those in the first use example of the second embodiment. However, with regard to the procedure corresponding to procedure A5, in the fourth use example of the third embodiment, the state in which the other end of the ring-shaped elastic body 41 for load application is not hooked on the pressure sensor 32 is the load of 0, the softest state. Load 1 is when one end of the heavy load ring-shaped elastic body 41 is fixed and the other end is hooked to the pressure sensor 32, load 2 is when one end of the second softest load ring-shaped elastic body 41 is fixed and the other end is hooked to the pressure sensor 32, load 3 is when one end of the third softest load ring-shaped elastic body 41 is fixed and the other end is hooked to the pressure sensor 32, and load 4 is when one end of the fourth softest (hardest) load ring-shaped elastic body 41 is fixed and the other end is hooked to the pressure sensor 32.

[0043] 14(E) is a diagram showing a fifth use example of the manual muscle testing device according to Example 3. The fifth use example of Example 3 is similar to the second use examples of the manual muscle testing device according to Examples 2 and 3 in that it allows for the state of the dorsal interosseous muscle to be determined and the state and degree of recovery of the ulnar nerve to be evaluated by analyzing measured values. In both second use examples, a load elastic body 31 of appropriate softness is inserted and fixed to the protruding portion of the index finger insertion section 29 or 39, and the subject's fingers other than the thumb are inserted into the finger insertion section 30 or 40. The index finger is moved while the load elastic body 31 is contracted to measure the movement of the fingertip. In contrast, in the fifth use example of Example 3, the subject's middle finger, ring finger, and little finger are inserted into the bag-shaped other finger fixing section 42 to which one end of a load strap-like elastic body 43 is fixed. The other end of the load strap-like elastic body 43 is hooked onto the pressure sensor 32, and the index finger is moved while the load strap-like elastic body 43 is stretched to measure the movement of the fingertip. Furthermore, the manner of movement of the index finger, determination of the state of the dorsal interosseous muscle, evaluation of the state and degree of recovery of the ulnar nerve by analysis of the measured values, and the correspondence and comparison with measurement procedures B1 to B5 in the second use example of Example 1 are almost the same as those in the second use example of Example 2, but with regard to the procedure corresponding to procedure B4, in the case of the fifth use example of Example 3, the state in which the other end of the load strap-like elastic body 43 is not hooked onto the pressure sensor 32 is load 0, the state in which the other end of the softest load strap-like elastic body 43 is hooked onto the pressure sensor 32 is load 1, the state in which the other end of the second softest load strap-like elastic body 43 is hooked onto the pressure sensor 32 is load 2, the state in which the other end of the third softest load strap-like elastic body 43 is hooked onto the pressure sensor 32 is load 3, and the state in which the other end of the fourth softest (hardest) load strap-like elastic body 43 is hooked onto the pressure sensor 32 is load 4.

[0044] 14(F) is a diagram showing a sixth use example of the manual muscle testing device according to Example 3. The sixth use example of Example 3 is common to the third use examples of the manual muscle testing device according to Examples 2 and 3 in that it allows for the state of the extensor digitorum communis muscle to be determined and the state and degree of recovery of the radial nerve to be evaluated by analyzing measured values. In both third use examples, a load elastic body 31 of appropriate softness is inserted and fixed to the protruding portion of the index finger insertion section 29 or 39, and then the subject's fingers other than the thumb are inserted into the finger insertion section 30 or 40, and the index finger is moved while the load elastic body 31 is contracted to measure the movement of the fingertip. In contrast, in the sixth use example of Example 3, one end of a load ring-shaped elastic body 41 is fixed to the end of the protruding portion of the index finger insertion section 39, and the other end is hooked onto the pressure sensor 32. Then, the subject's fingers other than the thumb are inserted into the finger insertion section 40, and the index finger is moved while the load ring-shaped elastic body 41 is stretched to measure the movement of the fingertip. Furthermore, the manner in which the index finger is moved after a finger other than the thumb is inserted into the finger insertion portion 40, the state of the extensor digitorum communis muscle is determined, the state of the radial nerve and the degree of recovery are evaluated by analyzing the measured values, and the correspondence and comparison with the measurement procedures C1 to C5 in the third use example of the first embodiment are almost the same as those in the third use example of the second embodiment. However, with regard to the procedure corresponding to procedure C4, in the case of the sixth use example of the third embodiment, the state in which the other end of the load-applying annular elastic body 41 is not hooked on the pressure sensor 32 is the load of 0, the softest state. Load 1 is when one end of the heavy load ring-shaped elastic body 41 is fixed and the other end is hooked to the pressure sensor 32, load 2 is when one end of the second softest load ring-shaped elastic body 41 is fixed and the other end is hooked to the pressure sensor 32, load 3 is when one end of the third softest load ring-shaped elastic body 41 is fixed and the other end is hooked to the pressure sensor 32, and load 4 is when one end of the fourth softest (hardest) load ring-shaped elastic body 41 is fixed and the other end is hooked to the pressure sensor 32.

[0045] (Variations of Examples 1 to 3) Variations of the manual muscle strength testing device according to Examples 1 to 3 are listed below. (1) The side wall 5 in Example 1 had one opening 6 in the center. However, similar to the palm rest 1, multiple holes through which rubber bands can be passed may be provided, so that the ends of the rubber bands 14 can be hooked onto the heads of the pins 4 protruding from the underside of the plate-like body constituting the palm rest 1. (2) The restraining unit 8 in Example 1 had a buckle 10 at one end of the flat belt 9. However, it may be an elastic belt or a palm pressure unit of various sizes that can be detachably attached to the upper surface of the palm rest 1. (3) Although a three-axis acceleration sensor 11 was used in Example 1, a one-axis acceleration sensor or a two-axis acceleration sensor may be used to measure the amount of displacement in one axis direction of fingertip movement (for example, the amount of displacement in the Y-axis direction as shown in FIG. 6 ). A two-axis acceleration sensor may also be used to measure the amount of displacement in two axes direction of fingertip movement. Furthermore, tilt sensors and gyro sensors may also be used, and in the claims, these are collectively referred to as "inertial sensors."

[0046] (4) In Example 1, the load-applying portion 12 was composed of the cable tie 13, two rubber bands 14, and pins 4 fixed to the two rows of seven holes 2. However, the load-applying portion 12 may be composed of an adjustable load-applying mechanism, such as an elastic member or a solenoid, that is installed on the palm rest portion 1 or the side wall portion 5 and applies an adjustable load to one of the fingertip, the triaxial acceleration sensor 11, and the ring 15 whose movement is to be measured. Furthermore, the adjustable load-applying mechanism may be formed by attaching and detaching weights of different weights to the triaxial acceleration sensor 11 or the ring 15. When such an adjustable load-applying mechanism is used as the load-applying portion, the holes 2 in the palm rest portion 1 or the openings 6 in the side wall portion 5 may not be necessary. (5) In Example 1, the triaxial acceleration sensor 11 was fixed to the sensor fixing portion 18 of the ring 15 with double-sided tape or adhesive. However, usability would be improved if the sensor fixing portion 18 were configured to allow the triaxial acceleration sensor 11 to be attached and detached. (6) In the first to third usage examples of Examples 1 to 3 and the fourth to sixth usage examples of Example 3, the states of the flexor digitorum superficialis, dorsal interosseus, and extensor digitorum communis were assessed to evaluate the state and degree of recovery of the median nerve, ulnar nerve, and radial nerve, respectively. However, the state of the median nerve may be assessed to evaluate the state of the opponens pollicis (muscle that presses the thumb and index finger together) or the abductor pollicis brevis (muscle that spreads the thumb apart), the state of the ulnar nerve may be assessed to evaluate the state of the opponens digiti minimi (muscle that presses the thumb and little finger together) or the flexor digitorum profundus (muscle that bends the little finger and ring finger), and the state of the radial nerve may be assessed to evaluate the state of the wrist extensor (muscle that lifts the entire back of the hand).

[0047] (7) In Example 2, the positions at which the three-axis acceleration sensor 11 and the pressure sensor 32 were fixed in the first and third use examples were different from the positions at which the three-axis acceleration sensor 11 and the pressure sensor 32 were fixed in the second use example. However, by providing an acceleration sensor fixing portion opposite the side sensor fixing portion 38 of the ring 35, and fixing the three-axis acceleration sensor 11 to the acceleration sensor fixing portion in either use example and fixing the pressure sensor 32 to all of the upper sensor fixing portion 36, the lower sensor fixing portion 37, and the side sensor fixing portion 38, measurements in the first to third use examples can be performed while the ring 35 is initially worn on the fingertip. Furthermore, in Example 3, once the ring 35 is attached to the fingertip, all of the measurements in the first to sixth use examples can be performed. In particular, in the first to third use examples, as shown in Figures 14(A) to 14(C), the relationship between the subject's palm P and the finger insertion section 40 is the same, with only the orientation of the palm P and the direction in which the index finger is moved being different. After the subject's fingers other than the thumb are inserted into the finger insertion section 40, the tests in the first to third use examples can be performed consecutively, significantly shortening the test time. (8) In Examples 2 and 3, the pressure sensor 32 was fixed to the ring 35 to measure the magnitude of the load applied to the fingertip. However, if the magnitude of the load applied to the fingertip from the load elastic body 31, the load ring-shaped elastic body 41, and the load strap-shaped elastic body 43 is measured in advance and the magnitude is determined based on the softness of the elastic body, the pressure sensor 32 may not be provided.

[0048] DESCRIPTION OF SYMBOLS 1 Palm restraint section 2 Hole 3 Slit 4 Pin 5 Side wall section 6 Opening 7 Leg section 8 Restraint section 9 Flat belt 10 Buckle 11 3-axis acceleration sensor 12 Load application section 13 Rubber band attachment section 14 Rubber band 15 Ring 16 Ring section 17 Slit 18 Sensor fixing section 19 Through hole 20 Finger pressing section 21 U-shaped section 22 Flat section for finger pressing 23 Other finger pressing section 24 Semicircular ring section 25 Flat section for other finger pressing 26 Finger cot 27 Protrusion 28 Other finger fixing section 29 Index finger insertion section 30 Finger insertion section 31 Load elastic body 32 Pressure sensor 33 Data transmission means 34 Signal transmission line 35 Ring 36 Upper surface sensor fixing section 37 Lower surface sensor fixing portion 38 Side surface sensor fixing portion 39 Index finger insertion portion 40 Finger insertion portion 41 Ring-shaped elastic body for load 42 Bag-shaped portion for fixing other fingers 43 Strap-shaped elastic body for load H Hand of person being inspected P Palm δ Amplitude δa Average value of amplitude δ

Claims

1. A finger fixing portion capable of fixing the subject's middle finger, ring finger, and little finger; an inertial sensor that can be attached to the tip of the subject's index finger and that can measure the movement of the fingertip and record or transmit the movement measurement data; a load applying unit that applies a load to the fingertip on which the inertial sensor is attached, The load applying portion is any one of an elastic body fixed to the pad side of the fingertip and contracting when it receives a force in a direction in which the fingertip moves toward the pad side, an elastic body fixed to the nail side of the fingertip and expanding when it receives a force in a direction in which the fingertip moves away from the nail side, an elastic body fixed to the thumb side of the fingertip and contracting when it receives a force in a direction in which the fingertip moves toward the thumb side, an elastic body fixed to the other finger fixing portion side of the fingertip and expanding when it receives a force in a direction in which the fingertip moves away from the other finger fixing portion, an elastic body fixed to the nail side of the fingertip and contracting when it receives a force in a direction in which the fingertip moves toward the nail side, and an elastic body fixed to the pad side of the fingertip and expanding when it receives a force in a direction in which the fingertip moves away from the pad side. A manual muscle strength testing device characterized by:

2. a pressure sensor that can be attached to the fingertip and can measure the magnitude of a load applied to any one of the pad side, thumb side, and nail side of the fingertip and record or transmit load measurement data; the inertial sensor and the pressure sensor are fixed to a ring that can be worn on the fingertip, The pressure sensor is fixed to one or all of the pad side, thumb side, and nail side of the fingertip on the outside of the annular portion of the ring, The load applying unit applies a load to a pressure sensor fixed to any one of the pad side, thumb side, and nail side of the fingertip.

2. The manual muscle strength testing apparatus according to claim 1 .

3. (delete)