DE102009003999A1 - Orthotic system for enhancing race walking during paralysis or weakening of lower extremity, has traction mechanisms or rotation hydraulics, by which transmission of active forces is occurred during bending and stretching of knee - Google Patents

Abstract

The orthotic system has traction mechanisms or rotation hydraulics, by which the transmission of active forces is occurred during bending and stretching of knee. The bending and stretching of knee is carried out through kneecaps band or ligamentum patellae by healthy people.

Description

1. Current situation:

At the Healthy man is next to one for the upright walk Variety of muscle action especially the knee-straightening muscles responsible.

These Muscle group (inter alia, quadriceps femoris, rectus femoris) standing up for a secure stand by stretching the knee and in the stretched state (ligamentous stretch stop) the cruciate ligaments pushes. Only through this power train over the Patellar ligament (ligamentum patellae), which is located on the tibiasis (os tibia) can be a safe, upright stand in the lower extremity.

At the Gang cycle we distinguish between stance phase and swing phase of the leg.

In the stance phase, there is another, small division with the following sequence:
Heel strike, mid-stance phase and toe-off.

chronologically takes the stance phase with about 60% the larger Time claim. The faster swing phase with about 40% swings the Lower leg in relation to the thigh again after front.

Special Meaning has the knee-stretching muscles in the stance phase and when going down stairs or downhill. By the muscular tension, the knee joint is held and slowly the walking speed appropriate, bended. Thus, the going down possible from stairs and ramps.

By a variety of diseases and accidents involving nervous, or muscle damage is the function of knee-length stretching Muscles weakened or no longer present. The current tools (Orthoses) have the task of knee protection. The sinking in the Knee while walking should be prevented.

1.1 Current orthotic systems

Current There are systems that use a lock to go with only one allow rigid locked Orthesenkniegelenk. This supply technology is still often used today. A locking pin engages the joint body and snaps when fully stretched one. Triggering can only be done by the patient, by pressing the unlocking bar. By a lever operation, it is possible the Orthesenkniegelenk to unlock for sitting and thus unlock.

Further more modern orthotic knee joints (since August 2008) can recognize the leg position by means of electronics and between and swing phase (forward and back of the orthosis) by means of Differentiate sensor.

Thereby While it is achieved that the orthosis is supported leg while the swing phase swings freely forward and thus simultaneously shortens, but locks the electronic lock at heel strike again and the stance phase of the leg is thus going on until stiff to the next swing phase.

One Another, mechanical system recognizes by heel loading the so-called heel strike in the gait cycle and leads by means of a pressure signal (Push rod) a parking brake, which has a toothing in each flexion of the orthosis knee joint selectively stiffness generated. Thus, under load of the orthosis, although a certain Safety given before the buckling of the joint, however, this is rigid in every situation. A flowing movement is thus not possible.

The prior art also includes an orthosis with therapeutic effect after the DE 4329673 A1 , This disclosure is a system that provides the patient with therapeutic strength training. By deliberately adjusting the resistance force, the patient must apply targeted force to move the orthosis. Here, the transmission of forces through the patellar tendon ligament (ligamentum patellae).

To the The prior art also includes the training of the ankle joint in such a way that the setting angle of the foot (flexion and extension in the upper ankle) can be adjusted This is common in most orthoses available on the market is.

Most of time these ankle joints still have the extra function possibly existing Fußheberschwache or paralysis with a compression spring in the ankle joint the missing muscle function to be replaced.

Of the Invention has for its object to provide an orthosis system, which is a dynamic damping of forces in Orthesenkniegelenk when walking, when leaving the stairs or at ramps or beveled as well as when sitting down. This object is achieved by the features specified in the claims Characteristics solved.

2. The invention:

at the invention explained below is concerned an orthosis system, which is the lost function of the Knee-stretching muscles takes over.

By transferring the normal patellar tendon function by means of Bowden cable ( 2 ) or a rotary hydraulics laterally on the orthotic joints ( 1 or 13 ), thus a better and more physiological movement is allowed. Focus and main feature of the invention is thus the transmission of the forces acting on bending and stretching of the knee by means of traction or rotary hydraulics.

The Figures show:

1 Orthosis on the stairs

2 Orthosis in the stretched state

3 Bowden cable with cylinder and two formations of the orthotic joint

4 Orthosis joint area with two pivot points and toothing

2.1 The construction of the joint

In this bilateral joint according to the invention ( 1 or 13 ) is a cable ( 8th ) or a flat band or a chain on the lower joint body ( 6 ) attached. By a joint on the upper part ( 7 ) attached Bowdenzugröhre ( 2 ) when bending the wire rope ( 8th ) stretched and pulled down. The resulting tensile forces become a hydraulic or pneumatic cylinder ( 3 ), which by pulling the wire ropes ( 8th ) a pressure movement of the piston or cylinder rod ( 3 ) triggers.

An adjustment valve located on the cylinder ( 10 ) allows to set the cylinder pressure resistance. This resistance is determined by the specialist during the fitting of the orthosis. By another position on the adjustment valve ( 10 ) of the cylinder, the hydraulics or pneumatics can also be determined. This allows the patient / user to turn on a stiff position, for example, when performing tasks requiring prolonged standing.

The shape of the Bowden cable lead ( 2 ) can be circular or even in a kind of ellipse ( 12 ) in order to demand more or less resistance to the cylinder depending on the bending state. Due to this elliptical shape ( 12 ) the wire cable ( 8th ) is pulled more with increasing flexion angle, whereby the cylinder must travel proportionally more distance with increasing flexion angle. Thus, an intelligent increase in damping with increasing flexion angle is possible.

The high forces to support or dampen the body weight are in the hydraulic or pneumatic cylinder ( 3 ) absorbed in opposite directions without fixed frame connection. Thus, the orthosis is tension-free and the forces are only from the cylinder unit ( 3 ) collected and carried.

The above-mentioned Bowden cable approach ( 2 ) replaces or complements the function of the ligamentum patellae tendon and the associated muscular weaknesses. By means of a spiral spring located in the printing cylinder, a tendency to straighten up is created, which facilitates the swing phase for the patient / user and swings the lower leg forward in the direction of movement, appropriately in relation to the thigh. An optional damping stop shortly before complete extension can be set in the cylinder.

It is also possible, with the pivot point, shown as joint pivot area with 2 pivot points ( 13 ), in conjunction with a gearing between the thigh ( 7 ) and lower leg member ( 6 ) to make a movement This joint construction offers the opportunity to follow the natural model of a rotational / sliding movement of the human knee joint.

Alternative to the Bowden cable ( 2 ), a rotary hydraulics directly on the orthosis knee joint ( 1 ) to be built in. This rotary hydraulics presses oil into a cylinder, which in turn ensures stance phase damping (buckling resistance).

Due to the bilateral derivation of the forces on the inner and outer joint is also prevented that the orthosis entangled by the applied forces and the shear force is derived to the human knee joint. The position of the hydraulic unit can be freely selected according to the patient's preference and optimal cosmetic option. The flexible Bowden cables ( 2 ) or hydraulic hoses allow a freely selectable position and thus make a cosmetically unobtrusive attachment possible.

The orthoses of the invention ( 1 ) with the associated cylinder can still be equipped with a sensor (electronics), which allows a safe switch between swing and stance phase at the cylinder control.

Suitable for this purpose are pressure sensors on the orthotic sole, strain gauges on the rail system or a commercially available electronic Inclinometer, which has already been explained in the prior art.

The cup setting of the orthosis around the leg should be chosen so that a posterior (dorsal) frame ( 4 ) takes place below the buttocks.

To hold the knee joint, a front abutment at the level of the upper tibial plane ( 5 ) (Tuberositas tibia) necessary. In conjunction with the foot shell of the orthosis, the leg is held in place at three points in the orthosis and the patient has a total, broad-based support for the resulting forces. In order to ensure a good function of the orthosis system, the use of adjustable ankle joints with flexion and extension stop is necessary. These ankle joints ( 11 ) can be equipped with a spring, which replace or supplement a possibly failed Fußheberfunktion.

2.2. Achieved benefits

The construction according to the invention offers the first time Patients with paralysis or weakening of the lower Extremity the possibility of an inconspicuous and gain safe walking and remaining body functions to protect. Due to the great power savings in the Walking, the patient can with equal effort a larger Cover the route. Likewise the muscle and joint apparatus becomes spared the body.

A Improving the gait possibilities generally leads to strengthen the body and gives many patients again the opportunity to be better at social life to be able to participate.

The attached drawings illustrate schematically the function of the orthosis according to the invention Patients.

The individual components of the orthosis according to the invention bear the following reference numbers.

1

orthotic

2

flexible Bowdenzugleitung

3

hydraulic or pneumatic cylinder or cylinder unit

4

dorsal Socket (rear shell)

5

frontal Version (askere dish)

6

Hinge base

7

Joint shell

8th

Wire rope

9

Bowdenzugröhre

10

adjusting on the cylinder

11

ankle

12

elliptical Bowden train line

13

polycentric Pivot points with Bowden cable lead

14

Bowdenzugspannungsgewinde

QUOTES INCLUDE IN THE DESCRIPTION

This list The documents listed by the applicant have been automated generated and is solely for better information recorded by the reader. The list is not part of the German Patent or utility model application. The DPMA takes over no liability for any errors or omissions.

Cited patent literature

• - DE 4329673 A1 [0012]

Claims (13)

Orthosis system for improving the walking in paralysis or weakening of the lower limb, characterized in that the transmission of the forces acting on bending and stretching of the knee, which takes place in healthy people through the patellar ligament (ligamentum patellae), by means of traction or rotary hydraulics. Orthosis system according to claim 1, characterized in that at the lower joint part ( 6 ) a cable ( 8th ) or a flat band or a chain is attached, which with a hydraulic or pneumatic cylinder ( 3 ) and that the orthosis joint ( 1 ) has an inner and an outer joint part. Orthosis system according to claim 2, characterized in that in the cylinder unit ( 3 ) a coil spring is integrated. Orthosis system according to one or more of the preceding claims, characterized in that on the cylinder unit ( 3 ) Adjusting valves ( 10 ) are attached to adjust the cylinder resistance. Orthosis system according to claim 4, characterized in that the adjusting valves ( 10 ) the setting of a stiff position of the orthotic joints ( 1 ) enable. Orthosis system according to one or more of the above Claims, characterized in that the transmission the forces on the traction mechanism is circular. Orthosis system according to one or more of the above Claims, characterized in that the transmission the forces on the tensile mechanics in the manner of an ellipse he follows. Orthosis system according to one or more of the preceding claims, characterized in that the pivot point in the orthotic joint ( 1 ) as joint pivoting area with two joint pivot points ( 13 ) and toothing is formed. Orthosis system according to one or more of the preceding claims, characterized in that the orthosis with respect to the body of the patient / user is tension-free and the resulting forces exclusively from the cylinder unit ( 3 ) and that thereby the cylinder unit ( 3 ) can be arranged freely selectable according to the physical or cosmetic requirements. Orthosis system according to one or more of the above Claims, characterized in that it with a the each movement phase of the leg equipped with sensing sensors is. Orthosis system according to one or more of the above Claims, characterized in that the sensors at least Pressure sensors on the orthotic sole, strain gauges on the rail system or inclinometers. Orthosis system according to one or more of the preceding claims, characterized in that the leg is held at at least three points, namely at the dorsal version ( 4 ) below the buttocks, on the frontal socket ( 5 ) and at the over the ankle joint ( 11 ) connected foot sole. Orthosis system according to one or more of the preceding claims, characterized in that the ankle joint ( 11 ) is equipped with a device that allows adjustment of the angle of the ankle and replaces or complements a dorsiflexion.