FR2787315A1 - Orthosis for upper limb has grip mounted on support and actuated by wire loop against return spring - Google Patents

Abstract

The upper limb prosthesis has a grip (10) mounted on a support (11,12) fixed to the end of the forearm. The grip has two relatively movable jaws (10a,b). The grip can be opened against a return spring (16) by a loop (13).

Description

The present invention relates to an orthosis of the distal end of a

  human upper limb. It is intended to be used mainly on C7 quadriplegic patients. It has applications, but not exclusively, in self-urinary catheterization. Patients with limited paralysis of the distal extremity of the upper limb may also

benefit from this invention.

  Quadriplegic patients suffer from paralysis-type motor disorders affecting the effector organs, the control of which is normally voluntary and which normally passes through the nerve fibers of the spinal cord. These disorders are generally the consequence of trauma to the spine, such as a dislocation or fracture with nerve damage. Depending on the height of the attack, along the spinal axis, motor disorders will be more or less extensive. In the case of low, dorsal or lumbar involvement, for example, only the lower body will be paralyzed. If the involvement is higher, for example cervical, the upper limbs may also be affected. Such patients will be called quadriplegics. Depending on the exact level of spinal cord injury, more or less significant motor activity may persist in certain muscle groups of the upper limb. In particular, in the event of damage to the seventh cervical vertebra, C7, the

  patient can still control the extension of his wrist.

  In all cases, these patients have voiding disorders due to the loss of voluntary urinary control. To avoid infections due to urinary stasis, it is recommended that the patient undergo 5 to 6 urinary catheterizations per day. It is however desirable that the patient can carry out this gesture alone, on the one hand, for reasons of economy of personnel and, on the other hand for the autonomy which he can thus acquire as well from the point of view

  material than psychological. A device allowing the patient to realize himself

  even this urinary survey must therefore be offered. Such a device is known from the article by K. ASAYAMA et al. published in the journal Paraplégia (1995) 33,30-33. This device fixed to the distal end of the upper limb comprises a rod on which is placed a metal part having an orifice through which the probe has passed. In a preparatory phase, the patient uses the mouth to install the device. The probe is then introduced into the urethra by a supine pronation movement of the forearm. However, this device has a number of drawbacks. The probe must be passed into the metal part through an orifice which is a complex act for quadriplegic patients. Once the probe has passed through this opening, it is also complex to move it in order to precisely adjust the length between the opening and the end of the probe. On the other hand, this device is suitable only for urinary catheters and cannot be used to handle other objects such as, for example, compresses which can be useful for cleaning the

area to probe.

  Apart from C7 quadriplegic patients, there are patients who have only partial paralysis of the upper limb with persistence of the wrist movement in extension. This can be the case following various traumas, degenerative infections or other. For these patients, a

  device for manipulating objects can also be useful.

  The invention therefore relates to an orthosis of the distal end of a human upper limb, said limb consisting of a forearm, a wrist and a hand comprising at least one finger, said orthosis comprising

a clamp carried by a support.

  According to the invention, the orthosis comprises a passive return means and an active control means, said active control means comprising a non-elastic connection means and a digital ring, said digital ring being passed through at least one finger, the support comprises a fixing means, said fixing means being intended to secure the support at the distal end of the forearm, the clamp comprises at least two spouts movable relatively to each other, said clamp being able to be opened or closed by the actions antagonists of passive recall means and active control means by wrist extension. The extension of the wrist causing an extension of the distance along an axis carried by the forearm, separating the distal end of the forearm,

of the hand and fingers.

  In different embodiments of the invention, the following means, which can be combined according to all the technically possible possibilities, are used: - at least one beak of the clamp is movable in translation relative to the support. - At least one beak of the clamp is movable in rotation relative to another beak. A hinge joining this movable spout either to another spout, fixed or

mobile or support.

  - The passive return means is a spring working in compression.

  - The passive return means is a spring working in stretching.

  - The passive return means is an elastic.

  - The support comprises a rigid axis having a first and a second end, said rigid axis being integral and fixed by means of fixing towards its first end, a fixed beak of the clamp being integral with the rigid axis towards its second end, a movable beak of the clamp being located between the first end of the rigid axis and the fixed beak, the return means being fixed between the movable beak of the clamp and a point along the rigid axis towards the first end, the active control means being fixed on the movable nose of the clamp by means of the non-elastic connection means so that in

  rest position, wrist bent, the clamp is open.

  the support comprises a rigid axis having a first and a second end, said rigid axis being integral and fixed by means of attachment towards its first end, a fixed beak of the clamp being integral with said rigid axis at a point situated along said axis rigid, a movable beak of the clamp being placed between the first fixed beak and the second end of the rigid axis, the return means being placed between the movable beak of the clamp and a point situated between the fixed beak and the first end of the rigid axis, the active control means being fixed on the movable spout via the non-connecting means

  elastic so that in the resting position, bent wrist, the clamp is closed.

  - the tongs are of the sugar tong type.

  - the orthosis is made to measure and includes materials

  thermoformable or heat shrinkable.

  - one or more tongs of the clamp have a structure and a shape

  suitable for the objects to be handled and one or more predefined functions.

  - one or more nozzles are wholly or partly removable and exchangeable.

  - the orthosis is suitable for carrying out a self urinary catheterization.

  The present invention will be better understood on reading the description

  which follows of several embodiments according to Figures 1 to 3 o: Figure 1 shows a first embodiment of the invention o the clamp is open at rest, - Figure 2 a second embodiment of the invention o the clamp is closed at rest, FIG. 3, a particular embodiment of the clamp or the nozzles

  are movable in rotation relatively to each other.

  In a first embodiment of the invention shown in FIG. 1, the orthosis is in relation to the distal end of a human upper limb. This member comprises a forearm 1, a wrist 2 and a hand comprising fingers 3. The support comprises a fixing means 11 intended to be fixedly attached to the forearm 1 and a rigid axis 12 having two ends. The fixing means 11 may include an adjustable strap or any other equivalent means allowing the soldiery attachment to the forearm. The rigid axis 12 is fixed integrally by means of fixing 11 towards its first end. A first nozzle 10Ob of the clamp 10 is fixed on the rigid axis 12 towards its second end. This first nozzle 10b is fixed relative to the support. A second spout 10a is movable in translation along the rigid axis 12. On this movable spout 1 Oa are fixed, in order to be able to exert contrary actions, a return means 16, a spring in this particular embodiment, and a non-elastic connecting means 14, a cord in this particular embodiment. The return means 16 is fixed at its end opposite the movable spout at a point on the rigid axis located towards its first end. The end of the connecting means 14 opposite the movable spout is connected to a digital ring 13 intended to be passed through one or more of the fingers 3. In the position of use, the support of the orthosis is integral with the distal end of the forearm 1 and the digital ring 13 is secured to the hand by means of one or more fingers 3. The orthosis crosses over the wrist 2. At rest, the wrist flexed, the means of recall 16 causes the two nozzles to move away from one another, causing the clamp 10 to open. When the patient extends his wrist, the digital ring 13 and the connecting means 14 exert an action opposite to that of the return means 16 and cause the approximation of the

  movable spout 1 Oa towards the fixed spout 1 Ob which causes the clamp to close.

  In a second embodiment of the invention shown in Figure 2 o the clamp is closed at rest, the fixing means 11 carries a rigid axis 12 having two ends. This rigid axis 12 is integral and fixed to the fixing means 11 towards its first end. A first 10 Ob nozzle is attached to this

  rigid axis at a predefined distance from the second end of this rigid axis.

  A second spout 10a is carried by the rigid axis 12 and is movable in translation along this axis 12. This movable spout 10a is placed towards the second end of this axis 12. A stop may be provided at the second end of the rigid axis to prevent separation at the end of travel of the movable spout 10a from the rigid axis. A return means 16 is fixed on one side to the movable spout 10Oa and on the other side to the fixed spout 1Ob. It is also envisaged the case where the return means 16, for its end opposite to the movable spout, is fixed at any point of the rigid axis 12 towards its first end instead of being fixed to the fixed spout 10b. A non-elastic connecting means 14 is fixed on one side on the movable spout 1 Oa and on the other on a digital ring 13 intended to be passed through one or more fingers 3. When the wrist is at rest, it is ie flexed, the return means 16, a spring in the embodiment, causes the clamp to close by bringing the movable spout 10a towards the fixed spout b. When the patient extends the wrist, the digital ring 13 by means of the connecting means 14 exerts an action contrary to the return means 16 which

  which causes the movable spout 10a of the clamp 10 to move apart.

  In these two exemplary embodiments, the return means which could have been an elastic was a spring working in stretching. It is also envisaged the case where a spring working in compression is used. In this case the position of the spring will be reversed because its action will be opposed to the action of a spring working in stretching. So, for example in the case of Figure 1, the

  compression spring should be placed between the two spouts.

  In these two exemplary embodiments of the invention, the clamp is formed by two spouts consisting of two rigid plates remaining parallel during the opening and closing operations of the clamp. In a particular embodiment of the clamp, it is envisaged the case where one or more nozzles are movable in rotation with respect to each other. FIG. 3 represents such an embodiment of a clamp according to the invention. A first spout 10b is fixed on the rigid axis 12 or directly on the fixing means. The movable spout 10a is fixed to the fixed spout 1 Ob by means of a hinge 10c. A return means 16 and a non-elastic connecting means 14 are fixed to the movable spout 10a. Due to the opposing actions of the return means 16 and the connecting means 14, the movable spout 10a will move in

  rotation about the axis of the hinge 10c, opening or closing the clamp 10.

  In this particular embodiment, it is also envisaged the case where the clamp is open at rest or is closed at rest. As before if a spring is used in place of an elastic, the spring can work in compression or stretching, the arrangement of the spring then being adapted according to

  the principles described here and basic laws of physics known to all.

  In another embodiment, the movable spout 10a can be fixed directly to the rigid axis 12 or the fixing means, by means of the hinge 1 Oc. It is also envisaged in another embodiment of the invention to use a clamp of the sugar clamp type fixed on the rigid axis 12. In this type of clamp, the return means acts on the different nozzles between them, and the opening or closing depending on whether the clamp is open or closed at rest can be obtained by the action of the non-elastic connecting means 14. It is also envisaged the case where the clamp type sugar tongs is directly fixed on the

fixing means.

  In other embodiments of the invention, the tongs of the clamp may have a structure and a shape adapted to the objects to be handled or to one or more predefined functions. For example in the case of urinary self-catheterization, the nozzles may have opposite chutes defining a channel adapted to the probe when the clamp is closed. The spouts may be partially or entirely removable. An exchange then being possible between spouts adapted to such or such use or to be

disposable for near use.

  In other embodiments, the antagonistic device (s) 16 and 14 may act by means allowing reduction or, conversely, reduction of the displacement caused by the extension of the wrist or its return. This could for example be useful in the case of

handling large objects.

  In different examples and embodiments of the invention as they have just been described are given for information only and cannot be

limit the scope of the invention.

7 2787315

Claims (9)

  1. Orthosis of the distal end of a human upper limb, said limb consisting of a forearm (1), a wrist (2) and a hand comprising at least one finger (3), said orthosis comprising a clamp (10) carried by a support, characterized in that: - the orthosis comprises a passive return means (16) and an active control means (13, 14), said active control means comprising a means non-elastic connection (14) and a digital ring (13), said digital ring being passed through at least one finger, - the support comprises a fixing means (11), said fixing means being intended to secure the support to the distal end of the forearm, - the clamp comprises at least two nozzles (10a, 10b) movable relatively to each other, said clamp being able to be opened or closed by the opposing actions 1s of the passive return means and the control means active by wrist extension.   2. Orthosis according to claim 1, characterized in that at least one   clamp nose (1 Oa) is movable in translation relative to the support.   3. Orthosis according to claim 1 or 2, characterized in that at least   a beak of the clamp is movable in rotation relative to another beak.   4. Orthosis according to any one of the preceding claims,   characterized in that the passive return means is an elastic or a spring   working in compression or stretching.   5. Orthosis according to any one of the preceding claims,   characterized in that the support comprises a rigid axis (12) having a first and a second end, said rigid axis being integral and fixed by fixing means (11) towards its first end, a fixed spout (10b) of the clamp ( 10) being integral with the rigid axis towards its second end, a movable spout (10a) of the clamp being located between the first end of the rigid axis and the fixed spout, the return means (16) being fixed between the movable beak (10a) of the clamp and a point along the rigid axis towards the first end, the active control means (13, 14) being fixed on the movable beak of the clamp by means of the connecting means non-elastic (14) so that in position   rest, wrist bent, the clamp is open. 8 2787315   6. Orthosis according to any one of claims 1 to 4,   characterized in that the support comprises a rigid axis (12) having a first and a second end, said rigid axis being integral and fixed by fixing means (11) towards its first end, a fixed spout (10b) of the clamp ( 10) being integral with said rigid axis at a point situated along said rigid axis, a movable spout (10Oa) of the clamp being placed between the first fixed spout and the second end of the rigid axis, the return means (16) being placed between the movable beak of the pliers and a point situated between the fixed beak and the first end of the rigid axis, the active control means (13, 14) being fixed on the movable beak (10a) by the intermediate of the non-elastic connecting means (14) so that   rest position, wrist bent, the clamp is closed.   7. Orthosis according to any one of claims 1 to 4,   characterized in that the tongs are of the sugar tong type.   8. Orthosis according to any one of the preceding claims,   characterized in that it is made to measure and includes materials   thermoformable or heat shrinkable.   9. Orthosis according to any one of the preceding claims,   characterized in that the beaks (10a, 10b) of the clamp (10) have a shape adapted to the objects to be handled or to one or more functions predefined in   during the realization of a self urinary catheterization.