Biomedical Engineering, Vol. 42, No. 4, 2008, pp. 186189. Translated from Meditsinskaya Tekhnika, Vol. 42, No. 4, 2008, pp. 2024. Original article submitted November 30, 2007.
A Multifunctional Computer System for Reflexodiagnosis and Reflexotherapy N. A. Korenevskii, S. A. Filist*, S. G. Emel’yanov, V. N. Shevyakin, and R. A. Krupchatnikov
Although existing commercial systems for reflexodi agnosis and reflexotherapy are rather simple and afford able, they have a number of disadvantages. Systems for reflexodiagnosis usually measure electric impedance or electromotive force (EMF) in biologically active points (BAP) of the human body. One BAP is usually monitored during one diagnostic session without automatic control of temporal and energy changes of meridians or individ ual characteristics of the patient. Although systems for reflexotherapy have multichannel output units, the con trol of the units depends on individual characteristics of patient. It is impossible to rearrange stimulation pulses of the reflexotherapeutic systems under conditions of change of meridian system energy induced by external or internal factors. There are virtually no systems for stimu lation parameter rearrangement in response to human body adaptation to external factors. To avoid these disadvantages, we developed a multi functional computer system for reflexodiagnosis and reflexotherapy. This system combines a multifunctional control unit for the projection zone of BAP monitoring with a reflexotherapy unit. The reflexotherapy parameters are determined by energy characteristics of many projec tion zones, individual patient state, time shifts of energy parameters of meridians, and some other informative parameters. Depending on therapy mode, the therapy can be mediated by monitoring diagnostic electrodes (time separation mode) or special electrodes located above pro jection zones. These special electrodes are functionally coupled to BAP and depend on the pathology. The structural diagram of the computer biocontrol therapy system of reflexotherapist is shown in Fig. 1. This system combines electrophysiological monitoring elec trodes (BAP projection zones) with therapeutic elec trodes. This system contains an electrode unit 1, bidirec
Kursk State Technical University, Kursk,
[email protected] * To whom correspondence should be addressed.
Russia;
Email:
tional switch unit 2, first multiplexor 3 connected to odd numbered inputs of bidirectional switch unit 2 and even numbered electrodes of unit 1, second multiplexor 4 con nected to oddnumbered inputs of bidirectional switch unit 2 and oddnumbered electrodes of unit 1, an optron coupling unit 5, a register 6, a signal shaper 7, address and control unit 8, analogtodigital converters (ADC) unit 9, bus shaping unit 10, therapeutic multichannel shaping unit 11 connected to evennumbered inputs of bidirec tional switch unit, unit for controlling stimulation 12, and decisionmaking and control unit 13 [2]. In the search for acupuncture points, one pair of electrodes of unit 1 is used as a resistance meter. The deci sionmaking and control unit (made as a microcomputer or personal computer) sets the DC monitoring mode. This mode is set as follows: first bus (address bus) sets address of key switching in bidirectional switch unit to upper position. Signal IOW from unit 13 induces genera tion of potential in decisionmaking and control unit for key position switching to upper position. Similarly, unit 8 generates potential switching unit 7 to resistance measur ing mode. Unit 13 in the first bus (address bus) sets inquiry address to register 6 via unit 8. Unit 8 responds to signal IOW from the second bus (control bus) by generat ing signal of code address record from the third bus (data bus) of unit 13 to register 6. Register 6 contains code of the electrode pair (indi cator of cutaneogalvanic resistance). This code through the optron unit is applied to inputs of multiplexor 1 and multiplexor 2. Multiplexor 1 and multiplexor 2 provide commutation of inputs to outputs and to unit 7 (signal shaper). Optron unit 5 provides galvanic decoupling between electrodes and other system units, thereby pro viding electrical safety of the patient. Unit 7 transforms resistance between electrodes into electrical signal applied to the ADC input. The ADC transforms analog signal proportional to interelectrode resistance into dig ital code. This digital code through the bus shaping unit is applied to decisionmaking and control unit 13 for gener ating corresponding readings. The curve of dependence of
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00063398/08/42040186 2008 Springer Science+Business Media, Inc.
Computer System for Reflexodiagnosis and Reflexotherapy
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AB (address bus) E11 E12
Em1 Em2 DB (data bus)
CB (control bus)
Fig. 1. Structural diagram of the biocontrol therapy system.
resistance on the number of ADC reading is plotted on the monitor of unit 13. The projection zone (PZ) or BAP location corresponds to minimal resistance. This allows position of all PZ and BAP to be found. Such positioning is saved as a punchdown list of organ diseases and/or functional systems. The positioning coordinates are used in acupuncture therapy. When positions of all PZ and BAP have been deter mined for diagnosis and therapy, pairs of electrodes of unit 1 are applied to these points. Unit 7 is switched to measuring mode (like in BAP search mode). In the mode of voltage measurement signal of logic 1 is at input 3 of the unit. In the mode of resistance measurement signal of logic 0 is at input 3 of the unit. This unit also provides galvanic decoupling between patient and main system units. Unit 13 organizes a cycle of enquiry of electrode pairs via unit 5. This cycle is accompanied by changes in codes of register 6, thereby controlling multiplexers 3 and 4. The results of the enquiry are sampled in ADC 9 gen erating digital code. This code through bus shaping unit 10 and the data bus are applied to unit 13. Data files about energy state of projection zones (BAP) in the vicinity of electrodes of unit 1 are compiled in unit 13. Analysis of
data files about energy state of projection zones in unit 13 gives rise to BAP therapy programs. These programs are stored in unit 12. Therefore, unit 13 makes decisions on the patient’s state, communicates with the physician, and generates therapy tactics during a treatment session. At the stage of therapy, unit 12 (microcontroller) implements therapy programs store in RAM. These pro grams control therapeutic multichannel shaping unit 11 and electrodes of unit 1 through bidirectional switch unit 2. At the stage of therapy, unit 13 through unit 8 switch es keys of unit 2 to position 2. This connects multichan nel shaping unit to electrodes of unit 1. If the BAP control system is additionally equipped with heart rate and respiration rate sensors, biofeedback control of BAP treatment would be available (like in many bioengineering systems) [3]. The heart rate sensor can be connected to the controller of the personal com puter. The respiration rate sensor can be connected instead of electrode pair 1. A personal computer provides synchronization of heart rate and electrical pulses applied to BAP. The amplitude of the electrical pulses is proportional to respi ration depth. Temporal diagram of biofeedbackcontrol effect on BAP is shown in Fig. 2.
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Fig. 2. Diagram of biofeedbackcontrol effect on BAP.
Electrical pulses applied to BAP are synchronized with pulse wave. The time of the pulses is set by the com puter program depending on therapeutic mode. Filling pulses and modulation amplitude is also determined by the computer program. Because pulse wave increases intensity of microcir culation in the BAP vicinity, it reduces microresistance and increases efficacy of electric acupuncture therapy. Therefore, biofeedbackcontrol BAP therapy of projec tion zones has enhanced efficacy. Software structure of the reflexodiagnosis and reflexotherapy system is shown in Fig. 3. According to this structure, information about projection zones (BAP) through the unit of coupling with object (UCO) is stored in special files. Algorithms of information characters or therapeutic effects are activated when measuring time is over. The algorithm of isolation of information characters generates data for the decisive rule unit and provides diag nosis conclusion. In addition to information about elec trical parameters of PZ, the decisive rule unit deals with results of questionnaire, inspection, and instrumental examination. These results are entered into the computer through keyboard, user interface, and database. The database contains information about electrical parameters of PZ and diagnosis conclusions. The data base also contains handbook of reflexodiagnosis and reflexotherapy, typical treatment procedures, parameters and modes of reflexotherapy, correction temporal tables, situationBAP correlation tables, electronic medical chart of patient, etc. Electrical parameters of PZ and other objective and subjective data via the algorithm of therapy and drivers provide therapy control and control of unit for coupling with object. The user interface enables the physician to view fragments of records of monitored electrical param eters, monitored curves of BAP meridian parameters, to
isolate fragments of monitored curves for further process ing, to view and correct signal parameters, to display lists of informative characters, to compile decisive rules, to add necessary information to patient medical chart, to read patient medical chart, and to refer to handbooks and manuals of the database. During electrotherapy the patient can use the PC keyboard to adapt therapy param eters to personal sensations. The algorithm of PC interaction with physician dur ing diagnosis and decisionmaking and/or effect on patient functional systems is implemented as follows. 1. In extreme situations, it is recommended to organize urgent therapy for elimination of dangerous states. Organization of such therapy requires points of treatment to be selected. After that the patient’s energy state is monitored at meridian points. In case of unstable patient energy state, BAP is corrected repeatedly or other available treatment procedures are used. In case of stable patient energy state, the following point is executed. 2. Two treatment directions are used; first, suppres sion of pain sensation; second, diagnosis and therapy of damaged organs and/or functional systems (p. 3 below). Organization of suppression of pain sensation should be performed using corresponding handbooks and manuals on reflexotherapy of pain. This enables the physician to select optimal therapeutic tactics. BAP affects several human body organs and systems simultaneously. Therefore, positive effects on some organs and systems may be accompanied by negative effects on other organs and systems. Not only the BAP of interest but also other BAP species functionally connected to this BAP should be monitored. This connection is provided by special tables compiled for each meridian [1].
Physician
Patient UCO
User interface
Connection drivers
Input files Algorithm of isolation of information characters
Decisive rule unit
Algorithm of formation of therapeutic effects
Database with handbooks on reflexodiagnosis and reflexother apy including tables of BAP correlation with situation
Fig. 3. Software structure of reflexodiagnosis and reflexotherapy system.
Computer System for Reflexodiagnosis and Reflexotherapy
The rows of the special tables compiled for each meridian contain numbers of meridian BAP. The columns of the special tables contain information about numbers of related BAP not only in this meridian but also in other meridians. The extent of interaction between the BAP of interest and other BAP species is represented by special coefficients contained in the tables. The tables also provide information about situations related to spe cific BAP species. Control points are selected on the basis of maximal coefficients of interaction with BAP of interest Qj. Reflexotherapy is performed after application of elec trodes for reflexodiagnosis and reflexotherapy. If during reflexotherapy the energy parameters of other PZ or meridians were subjected to pathological deformation, the parameters should be corrected. Otherwise, reflexotherapy is repeated or terminated. 3. If a diagnosis is available, the physician uses his/her experience or computer help to select BAP for
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therapy and control. Reflexotherapy mode and parame ters are selected similar to p. 2 above. 4. If a diagnosis is not available, diagnosis starts from search for damaged meridians. When diagnosis is stated, p. 3 of the algorithm is implemented. Thus, the multifunctional computer system for reflexodiagnosis and reflexotherapy described in this work provides correct medical diagnosis and performs ade quate therapy. This therapy provides stable remission in patients with various diseases. REFERENCES 1. N. A. Korenevskii, M. I. Rudnik, and E. M. Rudnik, Energyand Information Principles of Reflexology [in Russian], Kursk (2001). 2. N. A. Korenevskii, S. A. Filist, and V. V. Bunyaev, “A Device for Reflexotherapy”: RF Patent No. 2292864 (2007). 3. T. I. Yakunchenko, Biocontrolled Systems for Chronophysiother apy and Clinical Assessment of Their Efficiency: Doctoral disserta tion [in Russian], Voronezh (2000).
