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    • 专利摘要:
    METHOD FOR PROVIDING A MUSCULAR ELECTRIC STIMULUS SIGNAL TO THE BODY TISSUE THAT HAS CONTACT WITH THE MUSCULAR TISSUE, EQUIPMENT FOR ELECTRIC MUSCULAR TISSUE EQUIPMENT, USE OF EQUIPMENT, COMPUTER PROGRAM PRODUCT, DATA CARRIER AND COMPUTER PRODUCTThe invention relates to a method and equipment for electrical stimulation of muscle tissue. The electrodes (12) of an electrode array (13) are activated according to a sequence of activation patterns, each pattern defining a subset of electrodes (12) to be activated, each subset consisting of at least one electrode (12) , by providing a muscle electrical stimulus signal to the muscle tissue through the subset of electrodes (12). Alternatively, with said electrode activation (12), a response signal associated with the respective activation pattern is received from a sensor (30; 12). Optionally, at least one electrode (12) is then selected for stimulation, corresponding to a location determined to be suitable for stimulation, and the muscle tissue is stimulated. The process can be repeated in order to track the appropriate location for stimulation in a dynamic situation. Optionally, body part orientation is estimated from the measured response signals.
    公开号:BR112012010384A2
    申请号:R112012010384-9
    申请日:2010-10-29
    公开日:2020-07-14
    发明作者:Alexander F. Kolen；Agathe Puszka
    申请人:Koninklijke Philips Electronics N.V；
    IPC主号:
    专利说明:

    METHOD FOR PROVIDING AN ELECTRIC STIMULATION SIGN
    MUSCULAR TO THE BODY TISSUE THAT HAS CONTACT WITH THE MUSCULAR TISSUE, EQUIPMENT FOR ELECTRIC STIMULATION OF THE MUSCULAR TISSUE, USE OF AN EQUIPMENT, PRODUCT OF COMPUTER PROGRAM, DATA CARRIER AND COMPUTER The invention refers to the field of muscular electrical stimulus. More specifically, the invention relates to a method for providing an electrical muscle stimulus signal to the body tissue that has contact with the muscle tissue, and to an equipment for electrical muscle tissue stimulus.
    BACKGROUND OF THE INVENTION The electrical stimulus or functional electrical stimulation (FES) of muscles is a well-known application, for example, in the areas of stroke rehabilitation, spinal cord injury rehabilitation, incontinence treatment and treatment of sport reinforcement. From WO 2007/017778 A2, an equipment for electrical stimulation of muscle tissue is known, which has an electrode system with an electrode array. The equipment has an electrode selector to select one or more stimulating electrode pads. In one example, after the electrode system is positioned on a user's skin, the impedance between each of the electrode pads and the skin is measured, and based on the measured impedance, one or more stimulus electrode pads are selected. In another example, stimulus electrode paddles can be selected based on the area in which the muscle has the lowest activity. The equipment can be used to stimulate muscle tissue by providing an electrical signal, so that muscle tissue contracts and relax alternately. Before stimulating muscle tissue, a first measurement of muscle tissue activity is performed, and after stimulating muscle tissue, a second measurement of muscle tissue activity is performed. Thus, the effect of the stimulus on muscle tissue activity can be determined. The activity values determined before and after the stimulus can be sent to a user interface.
    SUMMARY OF THE INVENTION It would be desirable to be able to find suitable locations for electrical stimulation of muscle tissue in a convenient manner and / or without having to replace an electrode or stimulation equipment.
    It would also be desirable to be able to find a suitable location for electrical stimulation of muscle tissue while a respective muscle is activated. When a muscle is activated, an ideal location for the electrical stimulus may differ from an ideal location for the stimulus in an unactivated state of the muscle.
    It would also be desirable to be able to find a suitable location for electrical stimulation of muscle tissue in a non-static situation, for example, while a respective muscle contracts or relaxes. During the contraction or relaxation of a muscle, a suitable location for stimulating muscle tissue can move. Moving a suitable location to stimulate a specific muscle can also be caused by the activation or contraction or relaxation of a different muscle.
    It would also be desirable to be able to track the movement or change of a suitable location for electrical stimulation of muscle tissue in a non-static situation, as described.
    It would also be desirable to improve muscle stimulation without the need for implantation of electrodes. The implantation of electrodes is an invasive, costly and risky procedure and, therefore, is limited to specific cases.
    In particular, it would be desirable to be able to find a suitable location for electrical stimulation of muscle tissue with equipment that can be applied from the outside to the skin above said muscle tissue.
    It would also be desirable to be able to conveniently locate a suitable location for electrical stimulation of muscle tissue in order to stimulate a specific muscle in a group of muscles.
    In order to better address one or more of these issues, in a first aspect of the invention, a method is provided to provide an electrical muscle stimulus signal to the body tissue that has contact with the muscle tissue, comprising: - positioning of an electrode array comprising a plurality of electrodes in electrical contact with said body tissue; - activation of said electrodes, according to a sequence of activation patterns, each activation pattern defining a subset of electrodes to be activated, each respective subset consisting of at least one electrode, by providing a muscle electrical stimulus signal to said tissue by means of at least one electrode of the respective subset and - alternately with the said activation of electrodes according to an activation pattern, measure a response signal associated with the activation pattern when feeling a property of said muscle tissue, this property it forms a measure for the activity of said muscle tissue in response to the electrical stimulus signal provided by said at least one electrode of the activation pattern to said body tissue in contact with said muscle tissue. For example, the measurement step is performed after each activation step.
    This method allows testing different patterns of electrode activation in relation to its effectiveness in stimulating a target muscle tissue. With this, an activation pattern corresponding to a suitable location for electrical stimulus can be determined automatically. This is advantageous, in particular, in applications in which the said location may change, for example, due to the movement of the muscle tissue under the skin in which the electrode arrangement is arranged. Thus, an adequate activation pattern for a muscle can be determined both in static muscle situations (without contraction or without alteration of muscle contraction) and dynamic (during contraction of the stimulated muscle or contraction and / or relaxation of muscle groups in the same area).
    In addition, the method allows to position the electrode array with a lesser degree of accuracy without affecting the muscle tissue stimulus, since the stimulus of one or more electrodes of the electrode array can be selected depending on the measured response signals, these electrodes are present in a suitable area to provide the stimulus signal. Also, since the electrode array can be positioned with a lesser degree of accuracy, the electrode array can be placed by a person without expert knowledge of the muscular system.
    In addition, placing the electrode array takes less time. In addition, comparatively smaller electrodes can be used to stimulate instead of, for example, a single pair of electrodes large enough to certainly cover the area suitable for stimulation. Large external electrodes can be painful due to the large current and / or voltage required for stimulation. In addition, large electrodes cannot focus on smaller muscle groups. In addition, large electrodes can have side effects, such as stimulating another muscle or other types of nerves under the electrode (for example, pain nerves, sensory nerves).
    For example, the electrodes can be electrode paddles or surface electrodes. This has the advantage of being less invasive than needle electrodes, for example.
    For example, after each activation of electrodes, according to an activation pattern, the provision of the stimulus signal stops or is interrupted and, during a stimulus pause, the response signal is measured.
    In particular, said sequence of activation patterns can be a sequence of different activation patterns. By measuring the response signal associated with the respective activation pattern, an adequate or better adequate activation pattern for electrical stimulation of said muscle tissue can be determined. Thus, the appropriate location or activation pattern for the stimulus can be determined without repositioning the electrode arrangement.
    For example, said body tissue may comprise skin above muscle tissue. Alternatively, for example, said body tissue may be a part of said muscle tissue.
    The activation steps of said electrodes, according to a sequence of activation patterns, and alternately with said activation of electrodes according to an activation pattern, of measuring a response signal associated with the activation pattern, will also be mentioned such as “search steps” or the “search process” to follow. For example, these steps are repeated. When, for example, a suitable location for an electrical stimulus moves within the area covered by the electrode arrangement due to the contraction or relaxation of a muscle, for example, the method allows you to automatically track the appropriate location for the stimulus.
    For example, said measurement of a response signal is an electromyography measurement.
    Useful details of the invention are indicated in the dependent claims.
    For example, the method may further comprise: - selecting at least one of the plurality of electrodes based on the measured response signals. For example, at least one suitable electrode, in particular, more suitable, for stimulating muscle tissue can be selected. For example, at least one electrode can be selected to stimulate muscle tissue. For example, at least one of the plurality of electrodes can be selected based on the magnitude of the measured response signals. However, the selection of said at least one of the plurality of electrodes is not necessarily followed by stimulation of at least one selected electrode. For example, the selection of at least one of the plurality of electrodes suitable for stimulation, based on the measured response signals, may be for the purpose of collecting information, such as to determine an orientation of a body part, as will be further described below .
    For example, based on the selection of at least one suitable electrode to stimulate muscle tissue, a position of the electrode arrangement in relation to said muscle tissue can be determined. Thus, a position of the electrode arrangement in relation to a body part can be determined. Thus, a position of one that is in relation to a fixed position with the arrangement of electrodes can be determined in relation to a body part. For example, said device can be integrated with the array of electrodes. For example, said device may include an accelerometer. Thus, the position of the accelerometer can be determined in relation to a part of the body. Thus, the accelerometer readings can be related to the movement of said body part based on the determined position of the accelerometer. For example, said at least one of the plurality of electrodes is selected based on a suitable criterion for determining muscle activity from the response signal, in particular, a suitable criterion for determining the highest muscle activity from the response signals. answer. For example, said at least one of the plurality of electrodes is selected based on at least one of the criteria among: - a higher peak-to-peak value of the response signal, - an area under the broader curve of the response signal , - a provision for faster response signal increase, and - a faster response rate reduction rate.
    without wishing to be bound by any theory, it is believed that these criteria are expressions of the magnitude of the response signals that indicate the effectiveness of the stimulation of said muscle tissue according to the respective activation pattern. For example, said at least one of the plurality of electrodes can be selected based on a magnitude of muscle activity as represented by the measured response signals. It is believed that the said criteria represent the magnitude of muscle activity in response to the electrical stimulus according to the activation pattern. In addition, it is believed that this activation pattern is an adequate activation pattern to stimulate muscle tissue.
    For example, selecting at least one of the plurality of electrodes based on the measured response signals may comprise comparing all response signals or comparing the magnitude of the response signals.
    For example, at least one of the plurality of electrodes can be selected by selecting at least one of the activation patterns. In addition, for example, a subset of the electrodes can be selected, which corresponds to a combination of at least two of the activation patterns. Thus, the electrodes can be selected corresponding to a combination of the most promising activation patterns for stimulating muscle tissue.
    In one embodiment, the method further comprises: - selective provision by means of said at least one selected electrode and by means of said body tissue a signal of electrical muscle stimulus to said muscle tissue. Thus, the method can be a method of electrical stimulation of muscle tissue. This has the additional advantage that the method allows to automatically determine a suitable location for stimulation and to provide a stimulus signal to the muscle tissue. This can make it possible to stimulate a muscle at a suitable location for stimulation even in an activated muscle situation or, more generally, when the location for stimulation changes after positioning the electrode array.
    For example, in said activation stage of said electrodes, according to a sequence of activation patterns, a signal of electrical muscle stimulus can be provided to said body tissue corresponding to a stimulus intensity that is less than a stimulus intensity " corresponding to the muscle electrical stimulus signal selectively provided by means of at least one electrode selected for stimulus. That is, during the search process for testing the different activation patterns, the stimulus intensity is less than the stimulus intensity in the last step of selective provision of the stimulus signal.
    Thus, the interference of the search process with the current state of muscle tissue is minimized.
    For example, the stimulus intensity in the search steps may be below a threshold of perception.
    For example, the stimulus intensity may be well below a stimulus threshold, but it is low enough not to be felt.
    In one embodiment, the activation steps of said electrodes according to a sequence of activation patterns, measurement, alternately with said activation of electrodes according to an activation pattern, a response signal associated with the activation pattern, and selection of at least one of the plurality of electrodes based on the measured response signals are repeated alternately with the selective provision step through said at least one selected electrode and through said body tissue of a muscle electrical stimulus signal to said tissue muscular.
    This allows selecting electrodes corresponding to a suitable stimulus location when said location moves due to a movement, for example.
    With this, for example, the stimulus that supports a movement can be improved.
    For example, the method may allow tracking of a suitable stimulus location to support a movement.
    In one embodiment, the method further comprises: - determining an orientation of a body part based on the measured response signals.
    For example, guidance is guidance in relation to a specific guidance.
    This can have the advantage of making additional position or motion sensors, such as accelerometers and gyroscopes, redundant to determine an orientation of a body part.
    For example, determining a body part orientation based on the measured response signals can comprise: - determining a state of said muscle tissue based on the measured response signals, and - determining a part orientation of the body based on the determined state of said muscle tissue.
    The state of said muscle tissue is related to the orientation of said body part.
    For example, orientation depends on a state of activation of said muscle tissue.
    For example, by activating said muscle tissue, said body part can be moved.
    In another example, a position of a suitable location for stimulation depends on a state of muscle tissue.
    For example, when an antagonist muscle is activated, said muscle tissue can be moved and, thus, the position of a suitable location for stimulation of said muscle tissue can change.
    For example, the activation steps of said electrodes according to a sequence of activation and measurement patterns, alternately with said activation of electrodes according to an activation pattern, of a response signal associated with the activation pattern, are repeated , the method further comprising: - determining a movement of a body part based on the repeatedly measured response signals.
    For example, a movement of a body part can be determined by sequentially determining an orientation of the body part based on the measured response signals.
    In one embodiment of the method, the step of selecting at least one of the plurality of electrodes based on the measured response signals comprises selecting at least one first electrode and at least a second electrode of the plurality of electrodes based on the measured response signals, and the step of selective provision by means of said at least one selected electrode and by means of said body tissue of an electrical muscle stimulus signal to said muscle tissue comprises providing selectively, by means of at least one of said at least one first electrode selected and said at least one second electrode selected and through the body tissue, a signal of electrical muscle stimulus to at least one muscle tissue of a first muscle and muscle tissue of a second muscle.
    For example, the muscle stimulus signal may be provided to the muscle tissue of a muscle dependent on a state of the muscle tissue of which the same muscle, and / or dependent on a state of the muscle tissue of a different muscle, said state being determined based on the measured response signals. This allows, for example, to improve the safety of stimulation by avoiding the stimulation of an antagonist muscle to an activated agonist muscle. In addition, this improves the cancellation of unwanted muscle activity, such as tremor or spasm activity, by the antagonistic stimulus.
    For example, the muscle stimulus signal can be provided depending on an orientation of a body part that is determined based on the measured response signals. This facilitates the stimulation of muscles to be performed according to a desired movement sequence of one or more parts of the body.
    In a further aspect of the invention, an equipment is provided for electrical stimulation of muscle tissue, said equipment comprising: - an electrode arrangement comprising a plurality of electrodes, for positioning in electrical contact with body tissue that has contact with said muscle tissue ; the arrangement of electrodes being connectable to a signal generator to generate an electrical muscle stimulus signal; - an electrode selector for selecting from the plurality of electrodes one or more electrodes to provide an electrical stimulus signal from a signal generator connected to said body tissue; - a sensor for measuring a signal when sensing a property of said muscle tissue, that property forms a measure for activity of said muscle tissue; and - a control unit to control the electrode selector and to receive a signal from the sensor, the control unit being adapted for: - activation of said electrodes according to a sequence of activation patterns, each activation pattern defining a subset of electrodes to be activated, each respective subset consisting of at least one electrode, when controlling the electrode selector to select at least one electrode of the respective subset to provide a muscle electrical stimulus signal from the signal generator to said body tissue by means of of said at least one electrode, and, - alternately with said activation of electrodes according to an activation pattern, receiving a response signal associated with the activation pattern of the sensor.
    For example, the sensor can be formed by at least one of the plurality of electrodes.
    For example, the electrode array is connectable to the signal generator via the electrode selector.
    For example, electrodes are electrode paddles.
    For example, the equipment still comprises said signal generator.
    For example, the control unit is adapted for: - activation of said electrodes according to a sequence of activation patterns, each activation pattern defining a subset of electrodes to be activated, each respective subset consisting of at least one electrode, at the providing a muscle electrical stimulus signal from the signal generator to said body tissue by means of at least one electrode of the respective subset being selected by the electrode selector, and, alternately with said electrode activation according to an activation pattern, receiving a response signal associated with the sensor activation pattern.
    For example, the control unit comprises separate units, for example, a first control unit for controlling the electrode selector and / or the signal generator, and a second control unit for receiving the respective response signal. For example, the first control unit is an electrical muscle stimulus unit, and the second control unit is an EMG record unit. The units can be two separate units or combined in one case. For example, the signal generator is separate from the equipment and is connectable to the equipment.
    In one embodiment, the control unit is further adapted to select at least one of the plurality of electrodes based on the response signals. For example, the control unit is further adapted to compare the response signals associated with the respective electrodes and received by the control unit and to select at least one of the plurality of electrodes based on a comparison of the response signals.
    In one embodiment, the equipment further comprises a signal processing unit for analyzing a response signal received from the sensor, in which the signal processing unit is adapted to determine a suitable criterion for determining muscle activity from the response signal. . For example, signal processing is adapted to determine at least one of: - a peak-to-peak value of the response signal, - an area under the response signal curve - an increase rate of the response signal, and - a rate of reduction of the response signal.
    The values mentioned are believed to be an indication of a magnitude of muscle tissue activity.
    For example, the signal processing unit is adapted to emit a value corresponding to a magnitude of muscle tissue activity as represented by the measured response signal. For example, the value produced can be one of the values mentioned above.
    For example, the control unit is adapted to carry out the method as described above.
    An additional aspect of the invention is the use of equipment, as described above, for the treatment of a muscle.
    In a further aspect of the invention, a computer program product comprising parts of program code is provided for carrying out a method, as described above, when executed on programmable equipment.
    These and other aspects of the invention will be apparent and illustrated with reference to the embodiments hereinafter described.
    BRIEF DESCRIPTION OF THE DRAWINGS Figure 1 shows a schematic representation of an equipment for electrical stimulation of muscle tissue.
    Figure 2 schematically shows the equipment in Figure 1, an array of electrodes being placed on a user's forearm.
    Figure 3 presents a flowchart of a method to provide an electrical muscle stimulus signal to the body tissue that has contact with the muscle tissue. Figure 4 schematically shows an example of EMG data. Figure 5 schematically presents an additional realization of a method for providing an electrical muscle stimulus signal to the body tissue that has contact with the muscle tissue.
    DETAILED DESCRIPTION OF THE ACHIEVEMENTS The electro-stimulus equipment 1 shown in Figures 1 and 2 comprises an electrode system 10 that can be placed on the skin of an animal, such as a human. In Figure 2, the electrode system 10 is placed on a part of the skin of a user's forearm. However, the electrode system 10 can be placed on another part of the body and can have a shape adapted to the shape of the specific body part. For example, in case the electrode system 10 has to be placed in the vertebral area of the body, the electrode system 10 can be elongated in shape. The electrode system 10 includes, as shown in Figure 1, an array of electrodes 13 with a plurality of electrodes 12 in the form of electrode paddles. Also, in the example in Figure 1, the electrode system includes an opposite electrode 11. The opposite electrode 11 functions as a ground. Alternatively, for example, when stimulating through a subset of the electrodes 12, at least one other electrode 12 can function as an opposite electrode or ground. Thus, the opposite dedicated electrode 11 is optional. For example, the electrodes in the electrode array 13 are positioned along straight lines, forming a rectangular array arrangement. In the example in Figure l1, the matrix is a 3 by 3 matrix; however, the matrix can have other dimensions, for example, smaller or larger. Also, the spacing of the matrix columns can be different from the spacing of the matrix rows. In addition, the matrix can, as shown in the example in Figure 1, be square. In addition, the matrix can have several different numbers than the number of rows. In addition, electrodes 12 can also “be positioned in a non-rectangular position, such as a circular or a triangular arrangement, for example. In the example in Figure 1, the opposite electrode 11 has a closed loop shape and involves the placement of electrodes
    13. However, the opposite electrode 11 can have a different shape and can, for example, follow a winding path between the electrodes 12.
    The electrode system 10 can be placed on the skin so that the electrodes 12 and the opposite electrode 11 make electrical contact with the skin, that is, the body tissue that has contact with the muscle tissue below the skin. The electrode array 13 will then be electrically in contact with said muscle tissue and, in particular, it will be able to receive or transmit an electrical signal to the muscle region below the skin area occupied by the electrode array 13. In particular, the electrodes 12 will be able to inject, through the skin, a current in the muscle tissue in the form of a muscle stimulus signal in order to stimulate the muscle tissue.
    As shown in Figure 1, equipment 1 also includes an operating unit 50, which is connected to the array of electrodes 10 via a connection 18. In the example in Figure 1, connection 18 is a wired connection. However, connection 18 can also be a wireless connection.
    For example, electrode system 10 can be battery operated and include a radio receiver / transmitter.
    The operating unit 50 can receive signals generated by the electrode system 10 and control the operation of the electrode system 10, as explained in more detail below. The electrodes 12 and opposite electrode 11 can be provided on a surface of a flexible, preferably resilient charger. This allows the electrode system to adopt the shape of the body part on which the electrode system 10 is placed. The charger can be provided with electrical components that connect electrodes 12 and opposite electrode 11, via connection 18, to the operating unit 50.
    For example, operating unit 50 includes a housing. Within the housing, a control unit 53 is provided, which is connected to the electrode system 10 via connection 18 and an optional user interface 56. User interface 56 can comprise, for example, a screen that forms a output interface that sends information to a user of equipment 1 and control buttons that form an input interface. For example, the user can provide input to the control unit 53 via user interface 56, for example, desired settings for the operation performed by the equipment. In this example, the output interface allows you to output data visually; however, the data can alternatively or additionally be output as audio or any other suitable way.
    The control unit 53 includes, as shown in Figure 11, an electrode selector 530 for selecting from electrodes 12 in the array of electrodes 13 one or more stimulus electrodes. For example, the electrode system 10 can comprise line selector units and row select units to address the electrodes 10. However, for example, the electrode system 10 can comprise electrode addressing units adapted to independently address the individual electrodes 12 and their combinations. This allows stimulus electrodes to be selected according to any activation pattern or subset of electrodes 12 to be used for stimulus.
    A signal generator 531 is connected to the electrode selector 530. In operation, the signal generator 531 provides a muscle electrical stimulus signal to the stimulus electrode paddles selected by the electrode selector 530 according to an activation pattern. The stimulus signal is transferred by means of the stimulus electrodes 12 to the surface on which the electrode system 10 is placed, for example, the skin. The electrode signal then penetrates through the skin into muscle tissue, in response to which, muscle tissue may contract. In this way, muscle tissue is stimulated.
    The values for the stimulus parameters, such as the amount of current and the duration of the stimulus period, can be determined by the signal generator 531 based on the data stored in a memory of the signal generator 531. The signal generator 531 is connected to a programmable microprocessor 536, which is, for example, adapted to adjust the parameters for the stimulus. For example, values for stimulus parameters can be determined by a user through the user interface
    56.
    The microprocessor 536 is connected to the electrode selector 530 and is adapted to control the electrode selector 530 in order to select the stimulus electrodes according to an activation pattern.
    The microprocessor 536, for example, also comprises a stopwatch to control the order of operation of the microprocessor 536 so that, in operation, a sequence of steps in a method to provide a muscle electrical stimulus signal to body tissue through the electrodes 10 is performed as described below.
    In addition, microprocessor 536 is connected to and / or equipped with memory 533, for example, to store stimulus parameters or data associated with response signals as will be described below.
    In the example in Figure 1, the electrode system 10 includes a separate sensor in the form of two sensor electrodes 30. In this example, the sensor electrodes 30 extend parallel to each other on opposite sides of the electrode system 10 outside the electrode array. 13 and the opposite electrode 11. For example, sensor electrodes are electrode paddles that form strips of, for example, rectangular shape. In the example in Figure 2, the sensor is a bipolar electromyography (EMG - electromyography) sensor.
    The sensor can sense a property of muscle tissue, this property forms a measure for the activity of said muscle tissue. The sensor has a sensor output that is connected to an input of a signal processing unit 537 on the control unit 53. Through the sensor output, the sensor can supply a sensor signal to the signal processing unit 537. The signal processing unit 537 can determine from the sensor signal a measurement value for activity, that is, measure a signal felt by the sensor and produce the value through a processor output to the 536 microprocessor. signal processing unit 537 can produce a value of a magnitude of muscle activity, as represented by a signal measured to microprocessor 536.
    For example, the microprocessor 536 can determine a muscle tissue parameter based on the value determined by the signal processing unit 537 and produce that value in a user-perceivable way on the user interface 56. In addition, for example, an indication whether the electrode array is still positioned above the appropriate location for stimulation can be generated based on the response signals, and can be indicated to the user.
    This is an advantage when the electrode system 10 is a dry electrode system, that is, a system that does not adhere to the skin, such as "glued" electrodes, but also in the case of "glued" electrodes. In a modified embodiment, the sensor is in the form of a single sensor electrode 30 for measuring unipolar EMG.
    Thus, the sensor is a unipolar EMG sensor.
    For example, the sensor may be arranged close to the electrode array 13. In an additional modified embodiment, at least one electrode selectable from the electrodes 12 forms the sensor.
    For example, electrodes 12 have a dual function of electrically stimulating muscle tissue and sensing said muscle tissue property, this property forms a measure for the activity of said muscle tissue.
    For example, the input of signal processing unit 537 is connected to electrodes 12, or is connectable via electrode selector 530 to electrodes 12. For example, at least one electrode of electrodes 12 can function as a unipolar EMG sensor or bipolar.
    Thus, separate sensor electrodes 30 are not required.
    For example, control unit 53 can be adapted to control electrode selector 530 to select at least one electrode 12 to form the sensor to sense said property of muscle tissue by said at least one selected electrode 12, and to receive a reply signal.
    Figure 3 presents a flowchart of an example of a method for providing an electrical muscle stimulus signal to body tissue that has contact with muscle tissue, in particular, the skin above a muscle.
    In a first step 110, the electrode system 10 comprising the array of electrodes 13 is positioned on a desired surface, for example, a part of the skin above a muscle tissue.
    In a second step 112, microprocessor 536 controls electrode selector 530 to select at least one stimulus electrode according to a first activation pattern from a sequence of activation patterns. For example, each activation pattern can consist of a single electrode different from the electrodes 12 to be activated. For example, the sequence of activation patterns is a sequence of electrodes in a specific order. For example, electrodes 12 can be activated row by row and, within each row, column by column in the case of a rectangular electrode array 13. However, microprocessor 536 can also be enabled to control electrode selector 530 to select stimulus electrodes according to an activation pattern consisting of more than one electrode.
    In a third stage 114, a muscle stimulus signal generated by signal generator 531 is provided by means of the stimulus electrode selected by the electrode selector 530 to the skin and, thus, to the muscle tissue in electrical contact with the skin. Thus, muscle tissue can be electrically stimulated. The effectiveness of the stimulus will generally depend on the position of the stimulus electrode or, more generally, on the activation pattern.
    In a fourth step 116, a signal from the sensor is measured by the signal processing unit 537. For example, the measurement step overlaps with the stimulus step. In particular, the signal is measured over a period of time to determine the magnitude of muscle activity. In particular, for example, a signal is measured during that time interval after applying the stimulus signal via the stimulus electrode. Thus, the measured signal includes a response signal associated with the stimulus electrode or, more generally, with the activation pattern for stimulus. For example, the sensor signal is continuously acquired by the signal processing unit 537, and a response signal associated with a specific stimulus electrode is identified based on information about the timing of the application of the respective stimulus signals. For example, this information and, optionally, information about the activation pattern used for stimulus can be provided to the signal processing unit 537 via the microprocessor 536. Instead of using a sensor having the sensor electrodes 30 in Figure 1 , the step of receiving a response signal associated with the activation pattern of the sensor may comprise controlling the electrode selector 530 to select at least one electrode 12 to form the sensor to sense said property of the muscle tissue through said at least a selected electrode 12, and receiving the response signal from said at least one selected electrode 12.
    In a fifth step 118, signal processing unit 537 determines a value of a magnitude of muscle activity as represented by the measured response signal, as will be described below.
    Search steps 112, 114, 116 and 118 are then repeated with the next activation pattern in the sequence of activation patterns being selected in step 112 and the respective at least one electrode being stimulated in step
    114. The steps are repeated for each additional activation pattern in the sequence of activation patterns. In the example of the activation patterns consisting of different individual electrodes, this means that the sequence of steps 112 to
    118 is performed once for each of the nine electrodes 12. The electrodes 12 are activated one after the other and the associated response signals are analyzed.
    However, the response signal measured in step 116 can also be recorded, and steps 112 to 116 can be repeated for the sequence of activation patterns, before analysis step 118 is performed for each response signal.
    Figure 4 shows an example of an electromyography (EMG) signal as received by the sensor's 537 signal processing unit.
    The curve shown in Figure 4 shows acute peaks corresponding to the application of the stimulus signals to the individual electrodes, which are numbered in Figure 4 from 1 to 9. In the gaps between the stimulus, a response signal associated with the respective stimulus electrode is recorded.
    For example, as shown in Figure 4, the stimulus electrodes are sequentially activated at an F frequency.
    For example, signal processing unit 537 determines a peak-to-peak value for each of the response signals associated with different stimulus electrodes or activation patterns.
    In Figure 4, the peak-to-peak value of the response signal associated with electrode number 5 is indicated by a double arrow.
    After a response signal for each electrode stimulus is measured and analyzed, at least one of the electrodes 12 is selected based on the magnitude of muscle activity as represented by the response signals measured in a sixth step 120. In particular, for example, the stimulus electrode that was discovered to have caused the greatest magnitude of muscle activity can be selected.
    In the example in Figure 4, electrode number 5 will then be selected.
    In particular, for example, at least one electrode can be selected to stimulate muscle tissue.
    The microprocessor 536 selects said at least one electrode. In addition, for example, microprocessor 536 can control electrode selector 530 to select said at least one electrode.
    In a seventh step 122, a muscle stimulus signal from signal generator 531 is provided by means of said at least one electrode selected from the electrodes 12 and through the skin to the muscle tissue in order to stimulate the muscle tissue. It is believed that the electrode with the highest response magnitude is the most suitable electrode for stimulating muscle tissue. However, for example, more than one electrode can be selected for stimulation. For example, all electrodes can be selected for stimulation, their associated response signal has a magnitude of muscle activity above a specific limit. In the example in Figure 4, this can result in electrodes number 5 and 6 being selected for stimulation in step 120, it being the response signals with the highest peak to peak value.
    Instead of selecting, in step 120, at least one electrode based on the criterion of a higher peak-to-peak value of the associated response signal, other criteria can be used to select the at least one electrode. Examples of suitable criteria are: the largest area under the response signal curve, the fastest increase rate of the response signal, a faster rate of reduction of the response signal, etc.
    The method in Figure 3, as described so far, can be useful in determining electrodes to stimulate muscle tissue in a static muscle situation. Without wishing to be bound by any theory, it is believed that the location of the electrodes that present the greatest magnitude of muscle activity in response to the stimulus is the most appropriate to stimulate muscle tissue activity. Thus, the at least one stimulus electrode selected in step 120 corresponds to a suitable or more suitable location to stimulate said muscle tissue. It is expected that this location corresponds to the motor point of the respective muscle, that is, the area in which a motor nerve enters the muscle.
    For example, in the method of Figure 3, after stimulating the muscle tissue in step 122, the steps of the method are repeated starting again with the selection of the first stimulus electrode or activation pattern in step 112.
    Thus, the search process of steps 112 to 118 and the process of stimulating steps 120 and 122 are repeated. Thus, a suitable location to stimulate muscle tissue can be tracked in dynamic situations, for example, in a situation in which the muscle contracts or relaxes or is moved due to the activity of an additional muscle.
    For example, search steps 112 to 116 can be performed by a sequence of activation patterns depending on at least one previously selected stimulus electrode. For example, the search can take place on the electrodes in the vicinity of a previously selected stimulus electrode.
    Thus, when the location of a motor point in relation to the surface of the skin changes due to an induced muscle contraction or by the contraction or relaxation of muscle groups in the same part of the body, the described method facilitates tracking the motor point in order to maintain an effective stimulus.
    In addition, for example, a location of the motor point or at least one stimulus electrode selected in step 120 can be displayed on a screen of user interface 56. This can allow you to constantly monitor the location of the motor point in static and dynamic situations .
    In the embodiment described in Figure 3, step 120 of selecting at least one electrode for stimulus and / or step 122 of stimulus can be optional steps. For example, after determining at least one suitable electrode to stimulate muscle tissue in step 120, the method can continue with the search process in steps 112, 114, 116 and 118. This can allow you to monitor the position of a suitable location for stimulation . In this case, the stimulus intensity should be as low as possible, but above the stimulus limit; preferably low enough not to feel the search process and well above the stimulus limit.
    In another modification of the embodiment of Figure 3, the described steps of the method can be performed simultaneously for the muscle tissue of different muscles, for example, different muscles of a group of muscles. Thus, for example, steps 120 and 122 can be performed simultaneously or subsequently to stimulate the muscle tissue of different muscles. For example, in step 120, at least one first electrode can be selected to stimulate a first muscle, and at least a second electrode can be selected to stimulate a second muscle. For example, in step 122, at least one selected electrode is selectively provided with a muscle electrical stimulus signal to the muscle tissue of said first muscle, and at least one selected electrode is selectively provided with a stimulus signal. muscle to the muscle tissue of the second muscle. For example, electrodes or activation patterns associated with a large magnitude of muscle activity are assigned to at least one of the first or second or additional muscles based on predetermined knowledge of the relative orientation of the appropriate locations for stimuli or motor points of the different muscles. This predetermined information can be stored in memory 533, for example. In an additional or alternative way, this information can be gained by analyzing the muscle response to the different stimulus electrodes or activation patterns and entering muscle data through the user interface 56. For example, in the analysis step 118, the user you may be asked to enter information in which the muscle was activated in the previous stimulus stage 114. Permitting to selectively stimulate more than one muscle is advantageous especially for stimulation in an area where multiple motor points are very close together.
    In addition, the simultaneous performance of the steps of the method of Figure 3 for the muscle tissue of different muscles may allow to relate changes in the location of certain motor points to the movements of other motor points or muscles. This is advantageous, for example, in a situation in which the position of a motor point of a first muscle influences the position of motor points of other muscles, for example, antagonistic muscle, according to a certain dependency.
    In addition, the simultaneous performance of the steps of the method of Figure 3 for the muscle tissue of different muscles is advantageous in applications such as re-establishing the hand grabbing function, which requires stimulating different muscles in a specific sequence to achieve a desired movement of hand. The control unit 53 can control said selective supply step 122 by means of the respective at least one electrode selected from an electrical muscle stimulus signal to the muscle tissue of the respective muscle according to a desired activation sequence for the different muscles. For example, the duration and time in which the stimulus occurs for a specific muscle can be determined according to the desired stimulus sequence.
    In addition, stimulation of muscle tissue of different muscles can be carried out depending on a state of a muscle antagonistic to that muscle.
    For example, the stimulation of an agonist muscle and its antagonist can be mutually exclusive.
    This increases the safety of the muscle stimulus.
    In addition, for example, the stimulation of an agonist muscle is performed under the condition that there is no muscle activity of the antagonist muscle detected.
    This allows you to further increase the safety of muscle stimulation.
    In an additional modified embodiment of the method of Figure 3, the stimulus in step 122 can be performed on the condition that the activity of the antagonist muscle has been detected in the respective response signals.
    This can be advantageous in order to cancel a tremor or spasm movement.
    Thus, antagonistic muscle activity, for example, due to tremor or spasm, is measured and the agonist muscle is stimulated in step 122 in the same way to "cancel" the tremor or spasm.
    For example, the steps of the method of Figure 3 can be performed simultaneously for the muscle tissue of an agonist muscle and muscle tissue of an antagonist muscle.
    Figure 5 presents a flowchart of an additional example of a method for providing an electrical muscle stimulus signal to body tissue that has contact with muscle tissue.
    The method is similar to that of Figure 3, but differs from said method in that the stimulus step 122 is the step eight, and between steps 120 and 122, a seventh step 130 is performed to determine an orientation of a body part based on the measured response signals.
    In step 130, for example, a state of muscle tissue is determined based on the response signals measured from step 116 and analysis step 118.
    For example, when a suitable location for stimulation is determined, as described above, that location can be an indication of the state of the muscle. For example, said state of muscle tissue can be a state of orientation of muscle tissue or a part of the body including said muscle tissue or an orientation of a different body part that depends on the state of contraction or relaxation of said tissue muscular.
    Furthermore, for example, in step 130, an orientation of a body part is determined, that is, estimated, based on the determined state of said muscle tissue.
    For example, the orientation of a body part is determined based on the determined state of said muscle tissue and based on the calibration data. The calibration data can be acquired in an initial calibration step in which the user performs a specific movement and / or takes a specific posture and / or activates or relaxes a specific muscle. The calibration data can be stored in memory 533.
    Optionally, the method is continued with stimulus step 122, before the - method steps are optionally repeated starting with step 112 of the search process, as described above. Thus, determining an orientation of a body part can be combined with stimulating muscle tissue. For example, the stimulus can be delivered depending on the given orientation. This allows, for example, to stimulate muscle tissue according to a movement of a part of the body, for example by adapting the stimulus as necessary to achieve a desired movement.
    In a modified embodiment of the method of Figure 5, the steps of the method can be performed simultaneously for muscle tissue of different muscles, similar to what was described above in relation to the method of Figure 3.
    For example, an orientation of a body part can also be determined based on the determined state of the muscle tissue of more than one muscle. For example, suitable locations for stimulation can be determined as described above for muscle tissues of more than one muscle. For example, motor points of the biceps and triceps can be determined and, in step 130, an orientation of the arm can be determined based on the determined states of those muscles.
    In another example, the stimulus in step 122 of the muscle tissue of the individual muscles can be performed according to a sequence of muscle contraction of different muscles in order to achieve a desired movement. For example, in an application to re-establish the hand grab function, a sequence of muscle stimulation is necessary to achieve the necessary movement. For example, the position of the arm and / or hand and / or fingers can be determined by locating the individual muscle motor points, and a sequence of activation of the different muscles can be derived from the positions or orientations determined in the step
    130. This has the advantage that no extra device is needed to determine the orientation of the respective body part, such as an accelerometer or a gyroscope.
    Although the invention has been illustrated and described in detail in the previous drawings and description, this illustration and description should not be considered illustrative or exemplary and not restrictive. The invention is not limited to the disclosed embodiments.
    In particular, each described feature of the equipment according to the invention can be used advantageously with the method according to the invention and vice versa.
    Variations to the revealed realizations can be understood and made by those skilled in the art in the practice of the claimed invention, from a study of the drawings, the disclosure and the attached claims.
    For example, the different elements of the operating unit 50 described as being contained in a housing could also be separated from each other, for example, forming separate devices. In addition, parts of the operating unit could be included in the electrode system 10 or the operating unit could be integrated with the electrode system 10.
    In the claims, the word "comprising" does not exclude other elements or steps, and the indefinite article "one" or "one" does not exclude a plurality. Any reference signs in the claims should not be construed as limiting the scope.
    权利要求:
    Claims (15)
    [1]
    1. METHOD TO PROVIDE AN ELECTRIC STIMULATION SIGN
    MUSCULAR TO THE BODY TISSUE THAT HAS CONTACT WITH THE MUSCULAR TISSUE, characterized by comprising: —- positioning an array of electrodes (13) comprising a plurality of electrodes (12) in electrical contact with said body tissue; —- activation of said electrodes (12) according to a sequence of activation patterns, each activation pattern defining a subset of electrodes (12) to be activated, each respective subset consisting of at least one electrode (12), when providing a muscle electrical stimulus signal to said body tissue by means of at least one electrode (12) of the respective subset and, - alternately with said electrode activation (12) according to an activation pattern, measure a response signal associated with the activation pattern when feeling a property of said muscle tissue, this property forms a measure for the activity of said muscle tissue in response to the electrical stimulus signal provided by said at least one electrode (12) of the activation pattern to said body tissue in contact with said muscle tissue.
    [2]
    2. METHOD, according to claim 1, characterized in that the method further comprises: - selecting at least one of the plurality of electrodes (12) based on the measured response signals.
    [3]
    3. METHOD, according to claim 2, characterized in that said at least one of the plurality of electrodes (12) is selected based on an appropriate criterion to determine muscle activity from the response signal.
    [4]
    4. METHOD, according to claim 2 or 3, characterized in that the method comprises:
    - the selective provision by means of said at least one selected electrode (12) and by means of said body tissue of an electrical muscle stimulus signal to said muscle tissue.
    [5]
    5. METHOD, according to claim 4 characterized in that the activation steps of said electrodes (12), according to a sequence of activation patterns, measurement, alternately with said activation of electrodes (12) according to a activation pattern, of a response signal associated with the activation pattern, and selection of at least one of the plurality of electrodes (12) based on the measured response signals are repeated in an alternative way with the selective provision step through said at least one electrode (12) recently selected and by means of said body tissue of an electrical muscle stimulus signal to said muscle tissue.
    [6]
    6. METHOD according to claim 4 or 5, characterized in that the step of selecting at least one of the plurality of electrodes (12) based on the measured response signals comprises the selection of at least one first electrode and at least a second electrode of the plurality of electrodes (12) based on the measured response signals, and in which the selective provisioning step by means of said at least one selected electrode (12) and by means of said body tissue of a stimulus signal electrical muscle to said muscle tissue comprises selectively providing, through at least one of said at least one first electrode selected and said at least one second electrode selected, and through said body tissue, a signal of electrical muscle stimulation at minus one of the muscle tissue of a first muscle and the muscle tissue of a second muscle.
    [7]
    METHOD, according to any one of claims 1 to 6, characterized in that the method further comprises: - determining an orientation of a body part based on the measured response signals.
    [8]
    8. EQUIPMENT FOR ELECTRIC STIMULATION OF MUSCLE TISSUE, characterized by comprising: - an array of electrodes (13) comprising a plurality of electrodes (12), for positioning in electrical contact with body tissue that has contact with said muscle tissue; the arrangement of electrodes (13) being connectable to a signal generator (531) to generate an electrical muscle stimulus signal; - an electrode selector (530) for selecting from the plurality of electrodes (12) one or more electrodes (12) to provide the electrical stimulus signal from a connected signal generator (531) to said body tissue; - a sensor (30; 12) for measuring a signal when sensing a property of said muscle tissue, that property forms a measure for activity of said muscle tissue; and - a control unit (53) to control the electrode selector (530) and to receive a signal from the sensor (30; 12), the control unit (53) being adapted for: —- activation of said electrodes (12 ) according to a sequence of activation patterns, each activation pattern defining a subset of electrodes (12) to be activated, each respective subset consisting of at least one electrode (12), when controlling the electrode selector (530) to select at least one electrode (12) of the respective subset to provide a muscle electrical stimulus signal from the signal generator (531) to said body tissue by means of said at least one electrode (12), and, - alternately with the said electrode activation (12), according to an activation pattern, receive a response signal associated with the sensor activation pattern (30; 12).
    [9]
    9. EQUIPMENT according to claim 8, characterized in that the control unit (53) is further adapted to select at least one of the plurality of electrodes (12) based on the response signals.
    [10]
    10. EQUIPMENT according to claim 8 or 9, characterized in that it further comprises a signal processing unit (537) for analyzing a response signal received from the sensor, in which the signal processing unit (537) is adapted to determine a suitable criterion for determining muscle activity from the response signal.
    [11]
    11. EQUIPMENT according to any one of claims 8 to 10, characterized in that the control unit (53) is adapted to carry out the method as defined in any one of claims 1 to 7.
    [12]
    12. USE OF AN EQUIPMENT, as defined in any one of claims 8 to 11, characterized by the treatment of a muscle.
    [13]
    13. COMPUTER PROGRAM PRODUCT, characterized by comprising parts of program code to perform a method, as defined in any one of claims 1 to 7, when executed on programmable equipment.
    [14]
    14. DATA CARRIER, characterized by including a computer program to carry out the steps of the method, as defined in any one of claims 1 to 7.
    [15]
    15. COMPUTER, characterized to run a computer program product as defined in claim 13.
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    法律状态:
    2020-07-28| B06F| Objections, documents and/or translations needed after an examination request according [chapter 6.6 patent gazette]|
    2020-09-01| B25D| Requested change of name of applicant approved|Owner name: KONINKLIJKE PHILIPS N.V. (NL) |
    2020-09-08| B06U| Preliminary requirement: requests with searches performed by other patent offices: procedure suspended [chapter 6.21 patent gazette]|
    2020-09-24| B25G| Requested change of headquarter approved|Owner name: KONINKLIJKE PHILIPS N.V. (NL) |
    2020-11-10| B08F| Application dismissed because of non-payment of annual fees [chapter 8.6 patent gazette]|Free format text: REFERENTE A 10A ANUIDADE. |
    2020-12-22| B11B| Dismissal acc. art. 36, par 1 of ipl - no reply within 90 days to fullfil the necessary requirements|
    2021-11-03| B350| Update of information on the portal [chapter 15.35 patent gazette]|
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    EP09175147|2009-11-05|
    PCT/IB2010/054901|WO2011055282A1|2009-11-05|2010-10-29|Electrical muscle stimulation|
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