EP3050550B1 - Device for the training and treatment and/or support for the lower extremities of the body of a human being - Google Patents

Description

The invention relates to a device for the therapeutic treatment or training of the lower extremities of a human.

Devices for therapeutic treatment or training of the lower extremities of a person are for example out DE 10 2006 035 715 A1 . DE 20 2008 001 590 U1 and DE 10 2009 022 560 A1 known.

The therapy of high-grade weakness of the lower extremities, e.g. after a stroke is difficult and often unsuccessful. Conventional physiotherapy is laborious and usually aims to relieve spasticity-related muscle spasms and exercise to prepare for walking in the seat and posture, e.g. to strengthen the weight transfer to the affected leg. This procedure often results in the patient not repeatedly practicing the walking and thus the foot and leg movements underlying the walking.

Modern scientific concepts of rehabilitation favor a repeated, if possible active practice of walking as early as possible, or if not yet practicable, practicing at least some movement sequences of walking with the feet and legs. For stroke patients it was shown that the repeated active, isometric and isotonic dorsiflexion of the feet and legs with respect to the regression of the motor function of the entire lower extremities was superior to a conventional therapy. Even greater successes could be achieved if the patient repeatedly practiced walking himself. Passive movements of paralyzed limb sections receive, on the one hand, the mobility of the movement segment and the memory of the brain in the sequence of movements.

A double-sided practice of the healthy side and the weakened side of the lower extremities is superior to a one-sided practice of the weakened side. The co-movement of Non-weakened side exerts a promoting influence on the activation of the responsible for the use of the paralyzed limb brain structures in the parietal lobe.

For the treatment of the healthy and the weakened side of the lower extremities, mechanical and electromechanical devices are known in the art. This is exemplified DE 36 18 686 A1 . DE 85 28 083 U1 . DE 81 09 699 U1 and DE 195 29 764 A1 directed. These known therapy devices include cranks that are operated by the patient. These cranks only allow asynchronous tracking of the weakened side. Asynchronously tracked movements do not reflect the variety of real movements. The desired transfer of the learning effect in connection with movement sequences from the brain lobe of the healthy to the affected side is only possible to a limited extent. Variations of the movements are excluded due to the rigid mechanical connection of the construction elements.

In addition, robotic systems are known for therapeutic purposes that include control systems that measure patient forces during exercise. Different evaluations of the parameters for determining minimum natural movements or forces and complete comparisons with predefined programs are possible. Such robot systems are out DE 100 28 511 A1 as well as the initially mentioned DE 10 2006 035 715 A1 . DE 20 2008 001 590 U1 and DE 10 2009 022 560 A1 known.

Other robotic systems that are used for therapeutic treatment and / or support of the lower extremities of a human during walking are used EP000001137378 A1 and EP000001322272 B1 known.

In the robot system according to DE 100 28 511 A1 the degree of freedom for lateral pivoting of the foot plates is not required per se and has also proved in exercises as disadvantageous. The lateral pivoting of the foot plates causes a complicated and expansive structure, which makes it difficult for the therapist to access the patient. The from the DE 10 2006 035 715 A1 known robot-based running simulator has proven to be in need of improvement in terms of everyday practicality. Moreover, according to the systems DE 100 28 511 A1 and DE 10 2006 03 5 715 A1 access to the patient more difficult.

DE 20 2008 001 590 U1 discloses a human gait training device with five-link kinematics mounted on a linearly driven carriage. The kinematics are driven by a recirculating ball screw on the carriage.

DE 10 2009 022 560 A1 describes a robot system with a swivel arm and two carriages, wherein the height adjustment of the swivel arm via a connecting rod by the relative movement of the two carriages via a ball screw, takes place.

In the systems according to EP000001137378 A1 and EP000001322272 B1 the movement takes place via an exoskeleton, which via drives in the area of the hip and knee joints leads the lower extremities synchronously to a treadmill. These robot systems are limited to the movement of walking in the plane.

DE 20 2008 001 590 U1 discloses a device according to the preamble of claim 1.

Another training device for medical therapy and rehabilitation of body muscle parts of patients is known from DE 200 12 489 U1 ,

The invention has for its object to provide a device for the therapeutic treatment and / or training of the lower extremities of a person can be simulated with the various stress situations that occur in everyday life. The device is intended to allow a good access of the therapist to the patient.

According to the invention, this object is achieved by the device according to claim 1.

The invention has the advantage that the mechanics of the movement devices is simple and compact. The reduced height of the mechanism facilitates the therapist's access to the patient.

With the device according to the invention, a successful therapy on the one hand by the frequent repetition of exercise elements and on the other hand by the transmission of learning effects of the responsible for the healthy limb side of the brain on the responsible for the weakened limb brain side or the brain area responsible can be achieved. For example, a single movement within the entire gait cycle can be specifically isolated and repeatedly practiced by the patient. Also, the device of the present invention allows the leg and back muscles to be strengthened to further improve the patient being well advanced and to train healthy people. The device according to the invention provides the prerequisite for enabling running training or running therapy either in a given everyday environment or evaluating the therapy performance in real time, whereby different everyday simulations, for example climbing stairs, entering, are made possible by the robust and simply constructed mechanism of a sidewalk or situations in which the patient stumbles.

Preferred embodiments of the invention are specified in the subclaims.

The linear drive may include a power transmission element that couples the first carriage to the fixed frame. The linear drive may comprise a driven chain, which is mounted on the carriage on the one hand and on the frame on the other hand, whereby the horizontal movement of the carriage is achieved in a simple manner.

In a preferred embodiment, the carriage travels along two or more guide rails. As a result, the carriage can be made wider, which leads to the fact that the mechanics gain in stability, as the burden is better distributed by the patient on the movement mechanics.

In a preferred embodiment, the stationary frame includes height-adjustable feet in the region of the guide rails of the carriages. As a result, any unevenness in the floor can be compensated and the invention can also be used on uneven ground.

The first rotary drive may include a power transmission element that couples the pivot arm to the carriage. The height adjustment of the pivot arm is variable by actuation of the force transmission element. The coupling of the swivel arm with the carriage by a force transmission element has the advantage that the height adjustment of the swivel arm takes place directly via the first rotary drive.

In a preferred embodiment, the height movement of the swivel arm by a system, in particular a force storage device, supported, which can store energy and can feed back to the mechanics if necessary. This allows drives and Kraftübertragungselemente, specifically the first rotary actuator, are installed with less space and energy supply requirements, whereby the mechanics gain in compactness and the use is guaranteed in any environment.

An energy storage device is for example a spring element, in particular a tension or compression spring, which acts via a guide on a lever arm, which is firmly connected to the Schenkarm. Thereby, the mechanism can be designed so that the height movement of the pivot arm is supported in its mechanical unfavorable position by the energy of the bias of the spring element.

The first rotary actuator for the height adjustment may be spaced from the pivot arm and coupled thereto by a power transmission means. As a result, the first rotary drive can be arranged at a position favorable for the movement or for the center of gravity. The power transmission can be applied by the first rotary drive, for example, by a gear belt system on the carriage also spaced from the pivot arm on the swing arm itself. The first drive pulley can be attached to the first rotary drive. The second drive pulley may be attached to the swing arm. The power transmission then takes place via the belt from the gear of the first rotary drive to the gear of the swivel arm and thereby on the swivel arm itself.

The second rotary drive may comprise a power transmission element which couples the retaining means to the pivot arm. The rotation of the holding means is variable by actuation of the force transmission element. The coupling of the holding means with the swivel arm by means of a force transmission element has the advantage that the rotation of the holding means takes place directly via the rotary drive.

The second rotational drive for the inclination change can be arranged spaced from the holding means and coupled thereto by a power transmission means. As a result, the second rotary drive can be arranged at a position which is favorable for the center of gravity. The power transmission from the second rotary drive, for example, by a gear belt system spaced from the holding means are applied to the holding means itself. The first drive pulley can be attached to the second rotary drive. The second drive pulley may be attached to the support member. The power transmission is then via the belt from the gear of the second rotary drive to the gear of the holding element and thereby to the holding element itself.

In a preferred embodiment, the retaining means may be movably mounted along the force transmitting member and adjusted via a locking mechanism. This adjustment of the holding means allows the holding means to be precisely adjusted to the crotch width.

The arrangements of the respective drives described above, taken separately and in combination with one another, allow a simple construction of the respective movement device, which has a small footprint.

In a preferred embodiment of the invention, an adjusting device is arranged above the movement device, which is adapted to change the center of gravity of a person connected to the holding means people. This embodiment has the advantage that a control of the body center of gravity of a patient is possible by the adjusting device. Thus, on the one hand, the displacement of the center of gravity of the body occurring in the course of human locomotion, that is to say during locomotion, can be simulated along the direction of locomotion, which takes place in the vertical and lateral direction. On the other hand, the control of the center of gravity allows the correct execution of the therapeutic movement, thus preventing postural damage caused by compensatory movements of the patient. Another advantage of controlling body center of gravity is that balance can be maintained in critical situations such as (simulated) tripping, slipping or under conditions where the proprioceptive component is disturbed. Repeated practice of these situations is necessary to minimize the risk of falls and falls for patients. The three-dimensional control of the center of gravity, which is possible in this embodiment, and the option of influencing the proprioceptive component of the patients by means of perturbations, create the conditions for a safe, repeatable and targeted training. The perturbations of the proprioceptive component are performed by the retaining means, in particular the foot plates, which are connected to the feet of the patients. These can be moved to any position along the three degrees of freedom. In addition, vibrations can be realized by the holding means.

• Fig 1
  eine perspektivische Ansicht einer Vorrichtung nach einem erfindungsgemäßen Ausführungsbeispiel;
• Fig. 2
  eine Seitenansicht der Vorrichtung gemäß Fig. 1;
• Fig. 3
  eine Vorderansicht der Vorrichtung gemäß Fig. 1
• Fig. 4
  eine Draufsicht der Vorrichtung gemäß Fig. 1
• Fig. 5
  eine perspektivische Ansicht der Verschlussvorrichtung zur Positionierung der Haltemittel

The invention will be explained in more detail below with reference to exemplary embodiments with reference to the attached schematic drawings. In these show:

• Fig. 1
  a perspective view of a device according to an embodiment of the invention;
• Fig. 2
  a side view of the device according to Fig. 1 ;
• Fig. 3
  a front view of the device according to Fig. 1
• Fig. 4
  a plan view of the device according to Fig. 1
• Fig. 5
  a perspective view of the closure device for positioning the holding means

In Fig. 1 there is shown an apparatus which may be used for the therapeutic treatment and / or training of the lower extremities of a human during any movement of human locomotion in everyday situations or specific training conditions. The device is particularly well suited for training the lower extremities of neurological patients and has two driven, controllable movement units 11a, 11b. The two movement units 11a, 11b are each connected to a fixed frame 12. The moving units 11a, 11b have holding means 13a, 13b, for example foot plates with bindings, in which the feet of the patients are held. The movement devices 11a, 11b and thus the holding means 13a, 13b can be moved independently of one another along calculated movement sequences. Asynchronous or synchronous movements are possible.

The device comprises a frame 34, on which the patient is connected to the adjusting device for changing the body center of gravity, and that with the stationary frame 12 is firmly connected. The frame 34 comprises two arms 35a, 35b which extend in a vertical direction from bottom to top, wherein the arms 35a, 35b are connected to the stationary frame 12 approximately at the height of the moving means 11a, 11b. At the upper end of the arms 35a, 35b there is provided a horizontally arranged connecting element 36 which connects the arms 35a, 35b. Arranged on the arms 35a, 35b approximately at the level of the forearms of the respective patient and vertically adjustable two side rails 37a, 37b are movably mounted. The side rails 37a, 37b serve as handles for patients who can cling to the side rails 37a, 37b.

The movement devices 11a, 11b each have a pivot arm 14, which is pivotable in different elevations. The pivot arm 14 is articulated pivotably on a single carriage 15, which is guided by a linear guide 16. The linear guide 16 is fixedly connected to the fixed frame 12 and forms a rail in which the carriage 15 is slidably disposed. How out Fig. 1 . Fig. 2 and Fig. 4 can be seen, the pivot arm 14 is movably connected at one end to the carriage 15 via the first rotary drive 17.

The pivot arm 14 is rotatably connected in each case with one of the holding means 13a, 13b. The connection point between the holding means 13a, 13b and the pivot arm 14 is located at the other, second longitudinal end of the pivot arm 14th

The pivot arms 14a, 14b extend in the longitudinal direction of the respective linear guide 16. The pivot arms 14a, 14b are each movable on a circular path which runs along the longitudinal direction of the respective linear guide 16. The pivot arms 14a, 14b are each rotatably connected to the carriage 15 via the first rotary drive 17. The position of the pivot point of the respective pivot arm can be arranged arbitrarily.

The pivot arms 14a, 14b can each be supported by a force storage system 20, which is attached at one end to the carriage 15 and at the other end with the pivot arm and is able to store energy and due to the movement mechanics. Such a system comprises, for example, a tension or compression spring 21, which acts on the pivot arm 14 and the carriage 15 along a guide element 22 which is movably mounted on the pivot arm 14 and the carriage 15. Other embodiments are possible.

In the apparatus shown in the figures, the force storage device 20 is formed in the form of a compression spring 21 which is biased in the most unfavorable position of the swing arm. In other words, the compression spring 21 is biased when the respective pivot arm 14a, 14b is disposed in the horizontal lower position. If the pivot arm 14a, 14b pivoted by the first rotary drive 17 upwards, this movement is supported by the compression spring 21, which relaxes it.

As can be seen in the figures, the spring or generally the energy storage device 20 is fastened on the one hand to the carriage 15, specifically to an L-shaped holding arm 22a. In this case, a first leg of the support arm 22a extends in the longitudinal direction of the linear guide 16. The shorter second leg of the support arm 22a extends perpendicular thereto and is connected to a first end of the force storage device 20, specifically the spring 21. The second end of the spring 21 is connected to one end of the swing arm 14a, 14b. The connection between the pivot arm 14a, 14b and the spring 21 is designed so that the spring exerts a torque on the pivot arm 14a, 14b. For this purpose, the spring with a (not shown) lever on the pivot arm 14a, 14b fixedly connected.

The spring 21 is guided by a guide rod 22. The guide rod 22 is located in the spring 21. The guide rod 22 is on the one hand on the support arm 22a and on the other hand attached to the pivot arm 14a, 14b. For the length compensation, the guide rod 22 is telescopic. Other leadership options are possible.

Instead of the compression spring 21, a tension spring can be used. This is then to be arranged accordingly on the opposite side and to connect to the carriage or the swivel arm.

Generally, the pivot point on the pivot arm 14 is articulated in an area or at a location which is arranged between the connection of the respective pivot arm 14a, 14b with the carriage 15 and the connection of the pivot arm 15 with the holding means 13a, 13b.

By the rotational movement of the pivot arm 14, the angle between the pivot arm 14 and the carriage 15 is changed. As in Fig. 1 . Fig. 2 and Fig. 4 based on shown pivoting arms 14a, 14b, is moved by increasing the angle of the pivot arm 14 upwards, wherein the holding means 13a, 13b is a circular path about the pivot point of the pivot arm 14 on the carriage 15 and generally about a horizontal axis which is transverse to the direction of movement , describes. As a result, the height position of the second longitudinal end of the pivot arm 14 and thus of the holding means 13a, 13b connected to the second longitudinal end is changed.

Due to the articulation of the pivot arm 14 on the carriage 15 this is taken by a movement of the carriage 12, whereby the horizontal movement of the entire movement device 11a, 11b is achieved.

Like from the Fig. 1 . Fig. 2 and Fig. 4 To recognize, the carriage 15 has a linear drive 18 which is provided for changing the longitudinal position or horizontal position of the respective holding means 13a, 13b. The first linear drive 18 comprises a first power transmission means 23a, which connects the carriage 15 with the stationary frame 12 for power transmission. The first power transmission means 23a may comprise a driven toothed belt 24 which is connected on the one hand to the movable carriage 15 and on the other hand to the stationary frame 12. For driving the toothed belt 24, an electric motor is provided in each case. The linear drive 18 can also be realized by other means, for example by a driven chain, by a rack or by hydraulic or pneumatic cylinders.

The first rotary drive 17 is associated with the carriage 15 and couples it with the pivot arm 14. For this purpose, a second force transmission element 23b is provided, which acts on the one hand on the first carriage 15 and on the other hand on the pivot arm 14. The second power transmission element has the function to take the pivot arm 14 with a movement of the carriage 15. In this case, the second force transmission element 23b acts as a push and pull element. In addition, by the second power transmission element 23b, a force from the pivot arm 14 are transmitted to the carriage 15 and vice versa, when the second power transmission element 23b is actuated. In this case, the angle between carriage 15 and pivot arm 14, and thus the altitude of the respective pivot arm 14a, 14b is changed.

The linear drive 18 forms a main drive, which moves the carriage 15 together with the first rotary drive 17 relative to the stationary frame 12. The first rotary drive 17, in particular the second force transmission element 23b acts as a driver, which transmits the driving force of the linear drive 18 to the pivot arm 14. In addition, the first rotary drive 17 acts as a height drive for the vertical movement of the pivot arm 14, as described above.

The second power transmission means 23b, for example in the form of a transmission, is rotatably connected to the carriage 15 and provides for the entrainment and height adjustment of the pivot arm 14th

In the embodiment according to Fig. 1 the first rotary drive 17 is fixed to the carriage 15 and coupled to the power transmission means 23b. Other power transmission elements, such as a rack or hydraulic / pneumatic actuators are possible. In general, the force transmission element 23b has a dual function and acts both as a driver and for the height adjustment of the pivot arm 14th

In the case of the movement device 11a arranged on the right in the forward direction, the carriage 15 is located, with the pivoting arm 14a projecting in the forward direction toward the frame 12. An orientation of the pivot arms 14a, 14b to the frame 12 is possible in any direction. As a result, other orientations of the pivot arm, for example, the frame vertically downwardly projecting covered.

To adjust the inclination of the holding means 13a, 13b, a second rotary drive 19 is provided, which cooperates with the respective rotatably arranged holding means 13a, 13b. The rotary drive 19 is arranged in the region of the front end of the pivot arms 14a, 14b. The connection of the rotary drive 19 with the respective holding means 13a, 13b is effected by a third force transmission element 23c, for example in the form of a transmission. Other power transmission elements, such as a rack or hydraulic / pneumatic actuators are possible. The force transmission element 23c acts both as a driver and for the tilt adjustment of the holding elements 13th

The rotary drive 19 can also be arranged in the region of the rear end of the pivot arms 14a, 14b. The connection of the rotary drive 19 with the respective holding means 13a, 13b takes place in this case by the third force transmission element 23c via a belt, which on the one hand on a drive pulley on the pivot arm 14 and on the other on a driven pulley, which is connected to the holding means 13a, 13b, is arranged. By the rotary drive 19, the inclination of the holding means 13 a, 13 b is adjusted and adapted to the respective position of the pivot arm 14. Ultimately, all possible tilt positions are variably adjustable, which are required for the simulation of training and everyday situations.

The movement of the holding means 13a, 13b takes place in a work plane extending in the sagittal direction, wherein a work space has proved to be expedient, the forward movement in the range of 0-800 mm, in particular at 650 mm, the height movement in the range of 0-400 mm, in particular at 250 mm and the pivoting movement of the holding means 13a, 13b in a range of - allows 80 ° to + 30 °.

The pivoting movement of the holding means 13a, 13b takes place about a horizontally extending axis. The horizontal axis is moved by the operation of the linear drive 18 in the horizontal and the first rotary drive 17 in the vertical direction.

The holding means 13a, 13b can be positioned along the horizontal axis 25 via a guide 26 and a shutter 27 so that the distance between the holding means 13a, 13b corresponds to the physiological step width of the patients. This ensures that the patients correctly load the joints during the exercise and the training effect is maximized, since no evasive movements or adaptation on the part of the patient are necessary during the execution of the movement sequence predetermined by the invention. Such a closure device is in Fig. 5 shown, wherein the horizontally extending axis 25 is given by a rack on which the guide 26, by operating the shutter 27 in the form of a screw, is firmly misunderstood and thereby a displacement along the horizontal axis 25 is no longer possible.

To simulate the everyday situations of human locomotion, the lower limb holding means 13a, 13b can be simulated with the patient standing and secured on it, both by programmed defaults of the control and by the patient in the case of compliant footplates. It can be varied between the programmed movement and the guided by the patient movement. alternative For example, a holding means 13a can be controlled by the patient and the other holding means 13b by programmed specifications.

In the embodiment according to Fig. 1 an adjusting device 28 is provided, which is arranged next to the movement devices 11a, 11b. The adjusting device 28 is located above the linear guides 16, so that the movement devices 11a, 11b, in particular the holding means 13a, 13b can be moved under the adjusting device 31. The adjusting device 28 is adapted to control the center of gravity of the body or to change the center of gravity of a person connected to the holding means 13a, 13b. The adjusting device 28 allows both a change in the body center of gravity in the vertical and in the transverse direction. For this purpose, the adjusting device 28 comprises a vertical drive 29 which cooperates with a belt 30. The strap 30 is connected to a patient carrying strap (not shown). The vertical drive allows a change in the length of the vertical portion of the belt 30 so that the center of gravity of the patient is variable in the vertical direction. The working space of the mechanism or of the adjusting device 31 for the change in focus is based on a zero position +/- 10 cm. Other areas are possible. An example of the embodiment of the adjusting device 28 is shown in FIG Fig. 1 . Fig. 2 and Fig. 3 shown and may include a rotary drive, which raises the belt 30 via a roller system 31 and thus controls the center of gravity of the patient vertically. A deflation of the patient or an extension of the belt 33 is also possible.

Other means for lifting and lowering the belt 30 are possible.

To control the transverse component of the center of gravity, a transverse drive 32 is provided which has a rotary drive connected to a disk 33. On the disc 33, a rope is attached (not shown), the ends of which extend to the patient. The rope is deflected by an unillustrated roller system and engages at both ends, for example by carabiners, on lateral loops of the patient's belt. By rotation of the disc 33, the patient is drawn by shortening one of the two cable ends in the transverse direction. A possible working space for the center of gravity displacement enabled by the transverse drive 32 is, for example, based on a zero position, +/- 15 cm. Other areas are possible.

The control of the center of gravity in the forward or backward direction is effected by the relative movement of the holding means 13a, 13b or the foot plates relative to the suspension point of the adjusting device 28. The position of the carriage 15 can be freely controlled on the linear guide 16. In this case, the suspension point of the patient in a direction parallel to the linear guide 16 is fixed, so that a corresponding displacement of the center of gravity is possible. The possible by the carriage length working space is based on a zero position +/- 10 cm. Other areas are possible.

The device allows a highly variable and flexible therapy or training of the lower extremities, wherein the device is simple and compact and thus provides good access to the patient.

LIST OF REFERENCE NUMBERS

11a, 11b

movers

12

frame

13a, 13b

holding means

14a, 14b

swing arms

15

traveling carriage

16

linear guide

17

First rotary drive

18

linear actuator

19

Second rotary drive

20

Power storage device

21

feather

22

guide element

22a

holding arm

23a, 23, b, 23c

Power transmission elements

24

toothed belt

25

axis

26

guide

27

shutter

28

adjustment

29

vertical drive

30

belt

31

roller system

32

Transversalantrieb

33

disc

34

frame

35a, 35b

poor

36

connecting element

37a, 37b

side rails

Claims (12)

1. An apparatus for training and therapeutic treatment and/or support of a human's extremities with driven controllable movement devices (11a, 11b), which are connected to a stationary frame (12) and have holding means (13a, 13b) for attachment to an extremity, these being movable independently of one another along predetermined movement patterns, wherein the movement devices (11a, 11b) each have a pivot arm (14a, 14b), which can be aligned in different height positions and is connected at one end to a movement carriage (15) that is movable along a linear guide (16) and at the other end to one of the holding means (13a, 13b), each being rotationally movable, wherein the movement carriage (15) is guided by the linear guide (16), and the linear guide is fixedly connected to the stationary frame, wherein a linear drive (18) is provided for changing the horizontal position of the respective holding means (13a, 13b), a first rotary drive (17) being provided for changing the height position of the respective holding means (13a, 13b) and a second rotary drive (19) being provided for changing the inclination of the respective holding means (13a, 13b), wherein the pivot arms (14a, 14b) are each movable on a circular path along the longitudinal direction of the respective linear guide (16), wherein the movement carriage (15) is movable together with the first rotary drive (17) relative to the stationary frame (12) by means of the linear drive (18), the first rotary drive (17) acting as an entraining element for the pivot arm (14a, 14b) which transfers the driving force of the linear drive (18) to the pivot arm (14a, 14b) and in addition the first rotary drive (17) acts as a drive for the height movement of the pivot arm (14a, 14b), characterized in that the second rotary drive (19) is attached to the pivot arm (14a, 14b) or to the holding means (13a, 13b), and couples the holding means (13a, 13b) and the pivot arm (14a, 14b).
2. The apparatus according to claim 1, characterized in that the linear guide (16) has multiple guide rails along which the movement carriage (15) is disposed to be movable.
3. The apparatus according to claim 1 or 2, characterized in that the first rotary drive (17) comprises a second force transfer element (23b), which is attached to the movement carriage (15) and connects it to the pivot arm (14a, 14b) in a rotationally movable manner, wherein the alignment of the pivot arm (14a, 14b) is adjustable by actuation of the second force transfer element (23b).
4. The apparatus according to claim 1 or 2, characterized in that the first rotary drive (17) comprises a second force transfer element (23b), which is attached to the pivot arm (14a, 14b) and connects this to the movement carriage (15) in a rotationally movable manner, wherein the alignment of the pivot arm (14a, 14b) is adjustable by actuation of the force transfer element (21b).
5. The apparatus according to any one of claims 1 to 4, characterized in that the pivot arm (14a, 14b) is connected to a force storage device (20) to support the first rotary drive (17).
6. The apparatus according to claim 5, characterized in that the force storage device (20) has at least one spring (21), which is attached at one end to the movement carriage (15) and at the other end to the pivot arm (14a, 14b).
7. The apparatus according to claim 6, characterized in that the spring (21) acts along a guide element (22), which is attached movably to the pivot arm (14a, 14b) at one end and to the movement carriage (15) at the other end.
8. The apparatus according to any one of claims 1 to 7, characterized in that the linear drive (18) comprises a first force transfer element (23a) which couples the movement carriage (15) to the stationary frame (12).
9. The apparatus according to any one of claims 1 to 8, characterized in that the linear drive (18) comprises a driven toothed belt (24), which is connected to the movement carriage (15).
10. The apparatus according to any one of claims 1 to 9, characterized in that the second rotary drive (17) comprises a third force transfer element (23c), which couples the pivot arm (14a, 14b) to the holding means (13a, 13b).
11. The apparatus according to at least one of claims 1 to 10, characterized in that the holding means (13a, 13b) is disposed to be movable along its own axis (25) via a guide (26), and the distance from the pivot arm (14a, 14b) is adjustable by means of a closure (27).
12. The apparatus according to at least one of claims 1 to 11, characterized in that an adjusting device (31) is disposed above the movement device (10a, 10b), which is adjusted to change the center of gravity of the body of the person connected to the holding means (13a, 13b).

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