Upper limb exercise apparatus for breast cancer patients, and exercise method of upper limb exercise apparatus

Abstract

An upper limb exercise apparatus for breast cancer patients, and an exercise method, which apparatus and method effectively solve the problems of upper limb exercise equipment used after a breast cancer surgery having simple functions and failing to fully take into account both the subjective and objective conditions of patients. By means of an electromyographic sensor, a resistive muscle activity of a patient is monitored, and by means of comparing the slope of a subjective resistance curve of the patient and the slope of an overall resistance curve, the variation trend of the resistance level of the patient and the proportion of subjective factors in an overall resistance factor are reflected, such that instinctive responses of the body of the patient and the subjective pain tolerance of the patient can be rationally and fully taken into consideration during exercise. Under safe and tolerable conditions for the patient, exercises with an appropriate intensity and improved human-oriented characteristics can be performed, thereby reducing the reluctance of the patient toward rehabilitation training, and gradually achieving the expected rehabilitation effect.

Description

An upper limb exercise device for breast cancer patients and its exercise method Technical Field

[0001] This invention relates to the field of rehabilitation, specifically to an upper limb exercise device and exercise method for breast cancer patients. Background Technology

[0002] The incision site for breast-conserving surgery in breast cancer patients is usually located on the side of the chest or under the armpit. Axillary lymph node dissection inevitably causes damage to the axillary tissue. After surgery, the upper limb needs to be bound or immobilized for a period of time. In addition, due to the effects of radiotherapy and chemotherapy, lymphedema, tissue adhesion, scar contracture, joint stiffness and other problems are likely to occur. After the upper limb is released from immobilization, arm raising exercises should be performed in time to restore upper limb function. For some patients who have difficulty exercising on their own, equipment-assisted exercises will be chosen.

[0003] The invention patent with application number CN202110546201.1 places the patient's upper arm inside a motion arm plate, and drives the motion arm plate to rotate through a crank and gear mechanism, thereby achieving passive lifting of the patient's upper limb. Current arm-raising exercise devices are very similar to this patent, and both simply perform arm-raising rehabilitation exercises through mechanical lifting.

[0004] To ensure that the exercise does not cause secondary injury to the patient, the exercise device is equipped with sensors such as pressure sensors, electromyography sensors, and spasticity sensors to detect the patient's muscle tension and control the exercise intensity. For example, the invention patent application number: 201710997117.5 uses a spasticity sensor to monitor the spasticity of the patient's limbs so that the exercise can be stopped when the patient's muscles spasm. Such devices use various sensors to comprehensively detect the objective tension of the patient's limbs under passive traction, that is, the passive tension of the muscles.

[0005] However, none of the aforementioned devices take the patient's subjective will into account when controlling exercise behavior. During exercise, even within a safe intensity, patients may instinctively resist due to pain. If rehabilitation equipment does not consider the patient's different rehabilitation stages and individual pain tolerance and resistance, treating the patient as a machine and passively exercising them only within so-called "safe" limits, it will exacerbate the patient's pain and resistance to rehabilitation exercise. Conversely, excessive concern for the patient's pain will delay the rehabilitation cycle and may even prevent the patient from achieving rehabilitation expectations. Effectively distinguishing subjective factors from resistance factors is the foundation of humane exercise.

[0006] In addition, unlike mechanical equipment, the human body does not have a fixed strength limit. The safety strength set based on various sensors is sometimes not entirely reliable. The body's defensive or resistant instinctive response to injury is a more effective signal for preventing injury. Therefore, from a safety perspective, it is also very beneficial to take the patient's subjective wishes into consideration.

[0007] The purpose of this invention is to design a scheme that incorporates the patient's subjective will as one of the control factors and rationally analyzes the weight of subjective factors in the resistance factors of exercise, so as to achieve the goal of neither excessively forcing the patient's subjective will to exercise by objective factors, nor excessively indulging the patient's subjective will to slack off in exercise. Summary of the Invention

[0008] This invention provides an upper limb exercise device and exercise method for breast cancer patients, aiming to solve the problem that postoperative upper limb exercise devices for breast cancer patients are simple in function and cannot fully consider the subjective and objective conditions of patients.

[0009] The technical solution is as follows:

[0010] An upper limb exercise device for breast cancer patients includes an execution system and a control system. The execution system is used for passive exercise of the patient's upper limbs, and the control system is used to control the actions of the execution system.

[0011] The actuator includes a base and a lead screw. The lead screw is vertically arranged and its lower end is rotatably mounted on the base. The lower end of the lead screw is equipped with a drive motor that drives the lead screw to rotate. The lead screw is equipped with a climbing unit, which includes a nut and a sliding sleeve. The nut is threaded into the lead screw, and the sliding sleeve is loosely fitted on the lead screw and located above the nut. Two horizontal handles are mounted on the side wall of the sliding sleeve, and the two handles are symmetrical from left to right.

[0012] The control system includes a pressure sensor, an electromyography (EMG) sensor, a dual-channel oscilloscope, and a PLC controller. The pressure sensor monitors the pressure between the nut and the sliding sleeve, and the EMG sensor monitors the EMG signal when the patient's biceps brachii contracts. Both the pressure sensor and the EMG sensor are connected to the signal input terminal of the dual-channel oscilloscope. The dual-channel oscilloscope is connected to the PLC controller, and the PLC controller controls the speed and start / stop of the drive motor based on the output results of the dual-channel oscilloscope.

[0013] The nut has several vertical plungers evenly distributed around its upper circumference, and the sliding sleeve has several vertical plunger cavities evenly distributed around its lower circumference. Each plunger is inserted into a plunger cavity and slides and seals with the plunger cavity. The sliding sleeve has an annular hydraulic cavity, and the upper ends of all the plunger cavities are connected to the hydraulic cavity, which is filled with hydraulic oil.

[0014] The pressure sensor is located inside the hydraulic chamber.

[0015] The lead screw is coaxially provided with a protective cylinder. The lower end of the protective cylinder contacts the base, and the upper end of the lead screw passes through the protective cylinder. A limiting nut is provided at the upper end of the lead screw above the protective cylinder. Two axial vertical grooves are opened on the side wall of the protective cylinder, and two handles extend out from the two vertical grooves respectively.

[0016] The handle is equipped with a roller located in a vertical groove.

[0017] A method for upper limb exercise in breast cancer patients includes passively raising the upper limb using the aforementioned exercise device, with the specific steps as follows:

[0018] Step 1: Set the maximum extreme value F of the pressure sensor through the PLC controller. When the pressure sensor reading reaches 80% of the extreme value F, reduce the speed of the drive motor. When the extreme value F is reached, brake the drive motor.

[0019] Step 2: Attach the electromyography (EMG) sensor to the patient's biceps brachii on the affected side, and connect both the EMG sensor and the pressure sensor to a dual-channel oscilloscope.

[0020] Step 3: The patient faces the exercise device in a sitting or standing position, and holds the handles on the left and right sides with both hands respectively.

[0021] Step four: After the patient is ready, start the drive motor. The drive motor drives the lead screw to rotate, and the lead screw drives the climbing unit to rise through the nut, so that the patient's upper limb is gradually raised.

[0022] Step 5: During the ascent of the climbing unit, the dual-channel oscilloscope receives and compares the signal waveforms of the pressure sensor and electromyography sensor in real time, and transmits the comparison results to the PLC controller.

[0023] Step six: Based on the waveform comparison results, the PLC controller controls the speed, start / stop, and direction of the drive motor.

[0024] If the slope of the waveform of the electromyography sensor suddenly increases during exercise, with an increase of more than 30%, the system will brake suddenly and reverse the drive motor.

[0025] This invention utilizes the different force exertion points when patients subconsciously resist arm-raising movements. By monitoring the patient's muscle resistance through electromyography (EMG) sensors, and comparing the slope of the patient's subjective resistance curve with the slope of the total resistance curve, it reflects the changing trend of the patient's resistance level and the weight of subjective factors in the total resistance factors. This allows for reasonable and sufficient consideration of the patient's instinctive reactions and subjective pain tolerance during exercise, enabling more humane and reasonably intense exercise that is safe and tolerable for the patient. This minimizes the patient's resistance to rehabilitation exercises and gradually achieves the expected rehabilitation.

[0026] In addition, by monitoring the patient's instinctive limb resistance response in the event of a sudden situation that could cause harm through a sudden increase in the slope of the electromyographic sensor waveform, the device can be braked in time to protect the patient, which is more reliable than setting a fixed safety threshold. Attached Figure Description

[0027] Figure 1 is a front view of the present invention.

[0028] Figure 2 is a front sectional view of the present invention.

[0029] Figure 3 is a perspective view of the present invention.

[0030] Figure 4 is a 3D view of the climbing unit.

[0031] Figure 5 is a cross-sectional view of the climbing unit.

[0032] Figure 6 is a cross-sectional view of the sliding sleeve.

[0033] Figure 7 shows the waveforms of the pressure sensor and electromyography sensor during normal exercise.

[0034] Figure 8 shows the waveforms of the pressure sensor and electromyography sensor when the patient resists pain. Detailed Implementation

[0035] Referring to the accompanying drawings, an upper limb exercise device for breast cancer patients includes an execution system and a control system. The execution system is used for passive exercise of the patient's upper limbs, and the control system is used to control the actions of the execution system.

[0036] The execution system includes a base 1 and a lead screw 2. The lead screw 2 is vertically arranged and its lower end is rotatably mounted on the base 1. The lower end of the lead screw 2 is equipped with a drive motor 3 that drives the lead screw 2 to rotate. The lead screw 2 is equipped with a climbing unit, which includes a nut 4 and a sliding sleeve 5. The nut 4 is threadedly engaged with the lead screw 2, and the sliding sleeve 5 is loosely fitted on the lead screw 2 and located above the nut 4. When the lead screw 2 rotates, the nut 4 rises along the lead screw 2, thereby pushing the sliding sleeve 5 to rise. Two horizontal handles 6 are mounted on the side wall of the sliding sleeve 5. The two handles 6 are symmetrical from left to right. When the patient holds the two handles 6 with both hands, the climbing unit rises and raises the patient's upper limbs.

[0037] The control system includes a pressure sensor 7, an electromyography (EMG) sensor 8, a dual-channel oscilloscope 9, and a PLC controller 10. The pressure sensor 7 monitors the pressure between the nut 4 and the sliding sleeve 5. The EMG sensor 8 monitors the EMG signal when the patient's biceps brachii contracts. Both the pressure sensor 7 and the EMG sensor 8 are connected to the signal input terminal of the dual-channel oscilloscope 9. The dual-channel oscilloscope 9 is connected to the PLC controller 10. The PLC controller 10 controls the speed and start / stop of the drive motor 3 according to the output results of the dual-channel oscilloscope 9.

[0038] Pressure sensor 7 monitors the pressure between nut 4 and sliding sleeve 5, which is the resistance when the climbing unit passively lifts the patient's upper limb. The resistance includes the patient's subconscious resistance due to pain and the objective traction resistance caused by tissue adhesion, scar contracture, joint stiffness, etc. Electromyography (EMG) sensor 8 is fixed to the biceps brachii muscle of the patient's upper arm and monitors the EMG signal when the patient's upper arm muscles contract. When the patient resists the arm-lifting movement, due to pain in the armpit, the main manifestation is the subconscious contraction of the biceps brachii muscle to pull down the forearm. Therefore, the monitoring value of EMG sensor 8 reflects the degree of resistance of the patient. Pressure sensor 7 and EMG sensor 8 input the monitoring results into dual-channel oscilloscope 9 in the form of electrical signals. Dual-channel oscilloscope 9 analyzes and compares the signal waveforms of the two to analyze the degree of resistance of the patient and sends the analysis results to PLC controller 10. PLC controller 10 controls the speed and start / stop of the motor according to the received analysis results.

[0039] The nut 4 has several vertically oriented plungers 11 evenly distributed around its upper circumference, and the sliding sleeve 5 has several vertically oriented plunger cavities 12 evenly distributed around its lower circumference. Each plunger 11 is inserted into a corresponding plunger cavity 12 and slides and seals with the plunger cavity 12. The sliding sleeve 5 has an annular hydraulic cavity 13, and the upper ends of all plunger cavities 12 are connected to the hydraulic cavity 13, which is filled with hydraulic oil. The nut 4 pushes the sliding sleeve 5 axially through the plungers 11, and the hydraulic cavity 13 connects all plunger cavities 12, thus ensuring that all plungers 11 are subjected to the same force, thereby ensuring that the sliding sleeve 5 is balanced and will not be tilted or jammed. When the nut 4 descends, the sliding sleeve 5 also descends synchronously under the negative pressure in the hydraulic cavity 13.

[0040] The hydraulic chamber 13 is directly machined in an open manner on the top of the sliding sleeve 5, and then the upper end is closed with an end cap.

[0041] The pressure sensor 7 is installed in the hydraulic chamber 13 to monitor the climbing resistance of the climbing unit by monitoring the liquid pressure in the hydraulic chamber 13.

[0042] The lead screw 2 is coaxially provided with a protective cylinder 14. The lower end of the protective cylinder 14 contacts the base 1, and the upper end of the lead screw 2 extends out of the protective cylinder 14. A limiting nut 15 is provided on the upper end of the lead screw 2 above the protective cylinder 14 to limit the protective cylinder 14. The protective cylinder 14 is designed to prevent the patient from touching the rotating lead screw 2. Two axial vertical grooves 16 are opened on the side wall of the protective cylinder 14. Two handles 6 extend out from the two vertical grooves 16 respectively, without affecting the up and down movement of the two handles 6.

[0043] The handle 6 is equipped with a roller 17, which is located in the vertical groove 16. The roller 17 cooperates with the vertical groove 16 to ensure that the handle 6 moves smoothly along the vertical groove 16.

[0044] A method for upper limb exercise in breast cancer patients includes passively raising the upper limb using the aforementioned exercise device, with the specific steps as follows:

[0045] Step 1: Set the maximum extreme value F of pressure sensor 7 through PLC controller 10. When the reading of pressure sensor 7 reaches 80% of the extreme value F, reduce the speed of drive motor 3. When the extreme value F is reached, brake drive motor 3. The extreme value F is set to limit the maximum lifting force of the climbing device on the patient's upper limbs to avoid excessive lifting force that could cause secondary injury to the patient. The specific value of F is set by medical staff according to the patient's rehabilitation process.

[0046] Step 2: Attach the electromyography (EMG) sensor 8 to the patient's biceps brachii on the affected side, and connect both the EMG sensor 8 and the pressure sensor 7 to the dual-channel oscilloscope 9. The EMG sensor 8 monitors the EMG signal when the patient's biceps brachii contracts, and the pressure sensor 7 monitors the pressure in the hydraulic chamber 13 during the climbing process of the climbing unit. Both sensors transmit the monitoring results to the dual-channel oscilloscope 9 in real time in the form of electrical signals.

[0047] Step 3: The patient faces the exercise device in a sitting or standing position, and holds the handles 6 on the left and right sides with both hands respectively. The handles 6 of the exercise device are roughly at the height of the patient's chest. If the patient has too much difficulty raising their arms, the height of the handles 6 can be appropriately lowered. The patient should not be too far away from the exercise device, and their arms should be slightly bent to avoid the patient's upper body needing to lean forward significantly when raising their arms.

[0048] Step four: After the patient is ready, start the drive motor 3. The drive motor 3 drives the lead screw 2 to rotate. The lead screw 2 drives the climbing unit to rise through the nut 4, so that the patient's upper limb is gradually raised.

[0049] Step 5: During the ascent of the climbing unit, the dual-channel oscilloscope 9 receives and compares the signal waveforms of the pressure sensor 7 and the electromyography sensor 8 in real time, and transmits the comparison results to the PLC controller 10.

[0050] Specifically, the dual-channel oscilloscope 9 monitors the slope K of the two sets of signal waveforms in real time, and obtains the angle θ between the tangent direction of the two sets of signal waveforms and the horizontal axis according to the arctangent function θ=arctanK. Then, it compares the angle θ between the two sets of signals. The conversion between slope and angle can be performed by an oscilloscope that supports function functions, a PLC that supports function functions, or an external computer software, depending on the selection of equipment and its functional support.

[0051] Step six: Based on the waveform comparison results, the PLC controller 10 controls the speed, start / stop, and direction of the drive motor 3.

[0052] Specifically, when the patient's resistance is not significant, the waveform of the electromyography sensor 8 tends to be stable, while the waveform of the pressure sensor 7 rises relatively evenly as the climbing unit ascends and the resistance to the patient's upper limb increases, as shown in Figure 7. At this time, the waveform angle θ1 of the electromyography sensor 8 and the waveform angle θ2 of the pressure sensor 7 are significantly different, indicating that the patient does not experience a significant increase in pain as the upper limb is raised. At this time, the drive motor 3 can rotate rapidly, and the climbing unit drives the upper limb to rise at a uniform speed. At this time, the climbing speed of the climbing unit does not exceed 50 cm / min.

[0053] If the patient experiences significant pain and subconsciously resists, the waveform of the electromyography (EMG) sensor 8 will rise significantly, as shown in Figure 8. If the waveform angle θ1 of the EMG sensor 8 reaches 60% of the waveform angle θ2 of the pressure sensor 7, it indicates that the waveform change trend of the pressure sensor 7 is highly similar to that of the EMG sensor 8. In other words, at this time, the patient's pain intensifies significantly as the upper limb is raised. At this point, the speed of the drive motor 3 needs to be reduced, and the climbing speed of the climbing unit should not exceed 30 cm / min. When the waveform angle θ1 of the EMG sensor 8 reaches 60% of the waveform angle θ2 of the pressure sensor 7... If the angle θ2 is 75%, the drive motor 3 needs to be temporarily braked to keep the patient at that elevation level. If the patient's pain is relieved and resistance weakens, and the waveform angle of the electromyography sensor 8 begins to decrease, it indicates that the patient can accept further elevation of the upper limb. At this time, the drive motor 3 is rotated slowly to try to continue to raise the upper limb slightly. The climbing speed of the climbing unit should not exceed 15cm / min. If the patient's pain is not relieved or resistance is not weakened, or even if the waveform angle of the electromyography sensor 8 continues to increase, it indicates that the patient is less likely to accept further elevation of the upper limb. In this case, the drive motor 3 is reversed, and the climbing unit begins to descend to allow the patient to rest.

[0054] During exercise, if the waveform slope of the electromyography sensor 8 suddenly increases by more than 30%, it indicates that the patient is experiencing sudden pain. In this case, the system will brake and reverse the drive motor 3. This mechanism is designed to protect the patient in case of an emergency.

[0055] This invention utilizes the different force exertion positions when patients subconsciously resist arm-raising movements. By monitoring the patient's muscle resistance through electromyography sensor 8, it can reasonably and fully consider the patient's instinctive reactions and subjective pain tolerance during exercise. Under safe and tolerable conditions, it can conduct exercises of reasonable intensity, minimize the patient's resistance to rehabilitation exercises, and gradually achieve the expected rehabilitation.

Claims

1. An upper limb exercise device for breast cancer patients, comprising an execution system and a control system, wherein the execution system is used for passive exercise of the patient's upper limbs, and the control system is used to control the actions of the execution system; characterized in that The execution system includes a base (1) and a lead screw (2). The lead screw (2) is vertically arranged and its lower end is rotatably mounted on the base (1). The lower end of the lead screw (2) is equipped with a drive motor (3) that drives the lead screw (2) to rotate. The lead screw (2) is equipped with a climbing unit, which includes a nut (4) and a sliding sleeve (5). The nut (4) is threadedly engaged with the lead screw (2), and the sliding sleeve (5) is loosely fitted on the lead screw (2) and located above the nut (4). Two horizontal handles (6) are mounted on the side wall of the sliding sleeve (5), and the two handles (6) are symmetrical from left to right. The control system includes a pressure sensor (7), an electromyography sensor (8), a dual-channel oscilloscope (9), and a PLC controller (10). The pressure sensor (7) monitors the pressure between the nut (4) and the sliding sleeve (5). The electromyography sensor (8) monitors the electromyography signal when the patient's biceps brachii contracts. Both the pressure sensor (7) and the electromyography sensor (8) are connected to the signal input terminal of the dual-channel oscilloscope (9). The dual-channel oscilloscope (9) is connected to the PLC controller (10). The PLC controller (10) controls the speed and start / stop of the drive motor (3) according to the output result of the dual-channel oscilloscope (9).

2. The breast cancer patient upper limb exercise device according to claim 1, characterized in that, The nut (4) has several vertical plungers (11) evenly distributed around its upper circumference, and the sliding sleeve (5) has several vertical plunger cavities (12) evenly distributed around its lower circumference. The plungers (11) are inserted into the plunger cavities (12) one by one and slide and seal with the plunger cavities (12). The sliding sleeve (5) has an annular hydraulic cavity (13). The upper ends of all the plunger cavities (12) are connected to the hydraulic cavity (13), and the hydraulic cavity (13) is filled with hydraulic oil.

3. The breast cancer patient upper limb exercise device according to claim 2, characterized in that, The pressure sensor (7) is located inside the hydraulic chamber (13).

4. The breast cancer patient upper limb exercise device according to claim 1, characterized in that, The lead screw (2) is coaxially provided with a protective cylinder (14), the lower end of the protective cylinder (14) is in contact with the base (1), the upper end of the lead screw (2) passes through the protective cylinder (14), and the upper end of the lead screw (2) is provided with a limiting nut (15) located above the protective cylinder (14); two axial vertical grooves (16) are opened on the side wall of the protective cylinder (14), and two handles (6) extend out from the two vertical grooves (16) respectively.

5. The breast cancer patient upper limb exercise device according to claim 4, characterized in that, The handle (6) is equipped with a roller (17) located in the vertical groove (16).

6. A method for exercising the upper limbs of breast cancer patients, comprising passively raising the upper limbs using an exercise device, wherein the exercise device is any one of the upper limb exercise devices for breast cancer patients as described in claims 1-5, and the specific steps are as follows: Step 1: Set the maximum extreme value F of the pressure sensor (7) through the PLC controller (10). When the reading of the pressure sensor (7) reaches 80% of the extreme value F, reduce the speed of the drive motor (3). When the extreme value F is reached, brake the drive motor (3). Step 2: Attach the electromyography sensor (8) to the biceps brachii on the affected side of the patient, and connect both the electromyography sensor (8) and the pressure sensor (7) to the dual-channel oscilloscope (9); Step 3: The patient faces the exercise device in a sitting or standing position, and holds the handles on the left and right sides with both hands respectively (6). Step 4: After the patient is ready, start the drive motor (3). The drive motor (3) drives the lead screw (2) to rotate. The lead screw (2) drives the climbing unit to rise through the nut (4), so that the patient's upper limbs are gradually raised. Step 5: During the ascent of the climbing unit, the dual-channel oscilloscope (9) receives and compares the signal waveforms of the pressure sensor (7) and the electromyography sensor (8) in real time, and transmits the comparison results to the PLC controller (10). Step six: The PLC controller (10) controls the speed, start / stop and direction of the drive motor (3) according to the waveform comparison results.

7. The breast cancer patient upper extremity exercise method according to claim 6, wherein, If the waveform slope of the electromyography sensor (8) suddenly increases during exercise, and the increase exceeds 30%, then the emergency brake is applied and the drive motor (3) is reversed.

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