WO2008050297A2

WO2008050297A2 - Training device

Info

Publication number: WO2008050297A2
Application number: PCT/IB2007/054314
Authority: WO
Inventors: Gerd Lanfermann; Richard D. Willmann
Original assignee: Koninklijke Philips Electronics N.V.; Philips Intellectual Property & Standards Gmbh
Priority date: 2006-10-26
Filing date: 2007-10-24
Publication date: 2008-05-02
Also published as: WO2008050297A3

Abstract

The invention relates to a training device (10) for patients with physical disabilities. It can be moved on a surface (12) and has a dedicated drive. Moreover, it is equipped with a support shell, on which an extremity (11) of the patient can be at least partially placed.

Description

Training device

FIELD OF THE INVENTION

The invention relates to a device and method for providing therapy to physically disabled patients.

BACKGROUND OF THE INVENTION

Disabilities of extremities in the upper region of the body are the most frequent types of disability . The patients suffer from poor coordination of their extremities and from a weakened muscular system. Essentially two types of therapy for rehabilitation are known. In the first type of therapy, the movement range of the disabled extremity is trained. For this purpose, the patient moves his disabled extremity as far as he possibly can under his own force. If the patient cannot reach the maximum movement range under his own force, a therapist helps him to move the disabled extremity to the end point of the maximum movement range. In the second type of therapy, the patient executes a certain movement under his own force against the resistance of a counter- force. In the course of development, therapists have been replaced by training devices. For instance, US 5466213 A describes an interactive training device which is designed as a robot and on which the patients can train their movement ability. However, this training device is very complicated and expensive. It can therefore be used only in specially equipped therapy centers.

The object of the invention is therefore to provide a training device which makes it possible to carry out the two types of therapy mentioned above and can moreover be used by the patient at home.

SUMMARY OF THE INVENTION

The invention achieves the aforementioned object by means of a training device for patients with physical disabilities, which can be moved on a surface and has at least one drive and a support shell, on which an extremity of the patient can be at least partially placed. The training device according to the invention can be used for patients suffering from paralysis of an arm, a hand, a leg or a foot, for example after a stroke. The training device can be moved on a table, on a floor or on any other surface. It is therefore particularly suitable for use in the patient's home. The at least one drive of the training device can assist the movement of the extremity where necessary or can generate counter- forces which oppose the movement of the extremity. This depends on the respective therapy plan.

The training device may have a measuring device for measuring a force applied by the patient and/or a movement speed. If the patient is to undergo isokinetic or isometric therapy, in which he has to move the training device over the surface with a certain force and/or with a certain movement speed, then a difference in the force applied by the patient and/or in the movement speed can be determined by the measuring device. The at least one drive then balances out the difference. The training device may have a data memory in which the therapy plans and/or therapy results are stored. The data memory may be accommodated in the training device or may be arranged externally, wherein the data exchange may then take place via a radio interface.

Advantageously, the training device has a central processing unit which calls up the therapy plans when necessary, writes the therapy results to the data memory, compares the force and/or movement speed applied by the patient and measured by the measuring device with nominal values, and controls the at least one drive according to the respective therapy plan and the force applied by the patient and/or the movement speed.

The at least one drive may drive at least one wheel and/or at least one ball. Preferably, the at least one wheel and/or the at least one ball is provided with a running surface made of plastic, wherein the plastic has the highest possible level of static friction. This is important so that counter- forces which oppose the movement direction of the extremity can be reliably transmitted to the extremity and to the surface, for example the table. In order to increase the level of static friction, the drive may be equipped with a plurality of wheels and/or a plurality of balls. Particularly good results are achieved if the running surface of the ball is rubberized.

If the training device is equipped with at least one ball, then the at least one ball may be driven by two drives. The two drives generate on the at least one ball tangential forces which in each case act in different directions, so that the training device with the ball can be maneuvered to any desired point on the surface.

In a further embodiment, the at least one drive may have a Cardan joint. The Cardan joint may be fixed at one end to a housing of the training device, which may also perform the function of the support shell, wherein a wheel suspension may be arranged on the Cardan joint at the other end. If, when undergoing therapy on the training device, the patient exerts a force which does not act parallel to the movement direction, then the Cardan joint is inclined transversely to the movement direction. The inclination can be measured, whereupon the patient receives a corresponding signal from the training device.

The extremity of the patient may be cooled and/or electrically stimulated and/or mechanically vibrated by at least one additional therapy module. In this way, the extremity of the patient can be relaxed and cramps can be prevented if the extremity is strained too much during therapy.

In one further development of the invention, the training device may have at least one user interface, for example in the form of a visual and/or acoustic signal device. The visual signal devices may be signal lights and the acoustic signal devices may be loudspeakers. The signal lights may emit light in different colors. The acoustic signals may be transmitted in the form of a synthetic voice, a beep tone, a melody or the like. In this way, certain signals can be transmitted to the patient during therapy. These signals inform the patient as to whether the training device is switched on, whether the movement is jerky or differs from a given preset, whether the pressure with which the extremity is resting on the training device is too strong or too weak and the like.

Advantageously, the training device may have at least one control switch. This can be used to switch the training device on and off. Furthermore, the at least one control switch can be used by the patient to select different operating modes. For example, the patient can select different therapy plans or call up a demonstration program so as to become acquainted with the training device.

As an alternative or in addition, the training device may have a microphone, by means of which voice input can be used to switch the training device on and off and to call up the different operating modes. The training device may have a light source for generating a visible target point. The light source advantageously transmits a strongly bundled light beam so that the target point is clearly visible on the surface. Advantageously, the light source may transmit a laser beam. The target point serves as a guiding point for the patient, towards which he moves the training device. The target point may move or else may be fixed on the surface. The invention further relates to a method for carrying out a movement therapy using the training device as claimed in one of claims 1 to 12, characterized by the following steps: downloading a therapy plan, measuring the force applied by the patient, generating the counter-force.

This method is particularly suitable for carrying out isokinetic or isometric therapy. Advantageously, the counter-force generated in the last method step may be as great as the force applied by the patient, so that a force equilibrium is brought about and the extremity does not execute any movement. However, it is also possible for the counter-force generated by the training device to be lower than the force exerted by the patient. The extremity then moves more slowly in the direction of the force applied by the patient.

Moreover, the invention relates to a method for training a movement range using the training device as claimed in one of claims 1 to 12, characterized by the following steps: downloading the therapy plan, measuring the movement range of the extremity which is reached by the patient, ending the training if the maximum movement range has been reached, - or assisting the movement of the extremity by the drive if the maximum movement range has not been reached.

The training device is therefore suitable for carrying out another frequently used form of therapy.

BRIEF DESCRIPTION OF THE DRAWINGS

For better understanding, the invention will be explained in more detail with reference to the following drawings.

In the drawings:

Fig. 1 shows a plan view of a training device during operation; Fig. 2 shows a schematic diagram of the training device;

Fig. 3 shows a sectional view through a first embodiment of the training device;

Figs. 4A and 4B show a sectional view through a second embodiment of the training device; Fig. 5 shows a sectional view through a third embodiment of the training device;

Fig. 6 shows a front view of a fourth embodiment of the training device;

Fig. 7A shows a plan view of the training device when undergoing isometric or isokinetic therapy; Fig. 7B shows a therapy plan for isometric and isokinetic therapy;

Fig. 8 A shows a plan view of the training device when undergoing therapy for training a movement range;

Fig. 8B shows a therapy plan for therapy for training the movement range.

DETAILED DESCRIPTION OF THE INVENTION

Fig. 1 shows a training device 10, on which an extremity 11, in this case a hand, is placed. During therapy, the training device 10 can be moved on the surface 12, which in the illustrated example is a table. Fig. 2 shows the essential components of a training device 20, the components of which are shown by way of example for all possible embodiments of the training devices according to the invention. The training device 20 has a drive 21 with a measuring device 22 and a control device 23. The training device 20 is also equipped with a data memory 24, additional therapy modules 25, user interfaces 26 and a central processing unit 27. The movement speed of the extremity is measured by the measuring device

22. It can therefore be ascertained whether or not the movement speed of the extremity corresponds to the nominal preset values of the therapy plan. The bearing force acting perpendicularly on the surface 12 (see Fig. 1), with which the extremity presses the training device 20 against the surface 12, can also be measured by the measuring device 22. The force acting parallel to the surface 12, but not parallel to the movement direction of the extremity, can also be measured by the measuring device 22.

The control device 23 activates the drive 21 if the patient is unable to move any further under his own force the extremity to be trained, if the therapy plan requires a counter- force, or if the patient is moving the extremity too quickly or too slowly. If the movement is too slow, the movement of the extremity is assisted by the drive 21, whereas a counter- force opposed to the movement direction of the extremity is generated if the extremity is moved too quickly.

The therapy plans are stored in the data memory 24. The therapy results achieved by the patient may also be stored therein. The data memory 24 may be accommodated in the training device 20 or may be arranged external to the training device 20. If the data memory 24 is arranged externally, it may be connected to the training device 20 by means of a radio interface. The extremity can be cooled and/or electrically stimulated and/or mechanically vibrated by the additional therapy modules 25, so as to relax the extremity and prevent cramps.

The user interfaces 26 may for example be visual and/or acoustic signal devices, by means of which certain signals are transmitted to the patient during therapy.

These signals inform the patient for example as to whether the training device 20 is switched on, whether the movement is jerky or differs from a given preset, whether the pressure with which the extremity is resting on the training device 20 is too strong or too weak, or whether other movement parameters are adhered to. The central processing unit 27 coordinates the surrounding devices 21 to 26 with one another. For instance, the central processing unit 27 downloads the therapy plan from the data memory 24 and sends corresponding commands to the control device 23 so that the therapy plan can be started. As soon as the correct start position is reached, the central processing unit 27 asks the user interfaces 26 to transmit a corresponding signal. The control device 23 receives from the central processing unit 27 a command to activate the drive 21 in the manner prescribed by the therapy plan. Thus, either the movement direction of the extremity can be assisted or a counter- force can be generated. After a certain therapy time, or if the measuring device 22 ascertains that the extremity is suffering from cramp, the central processing unit 25 causes the additional therapy module 25 to cool, electrically stimulate or mechanically vibrate the extremity. Once the end of the therapy plan has been reached, the central processing unit 27 causes the user interface 26 to transmit a corresponding signal.

In one preferred embodiment, a training device 30 has two drives 31 and 32 (see Fig. 3) which drive a ball 33. The two drives 31 and 32 generate tangential forces 34 and 35 which act on the ball 33, wherein in the case shown the tangential forces 34 and 35 act perpendicular to one another. The drive 32 generates the tangential force 35 which permits a forward movement of the training device 30. The drive 31 generates the tangential force 34 by means of which the training device 30 can be steered. The training device 30 with the ball 33 can thus be maneuvered to any desired point on the surface 12 (see Fig. 1).

The ball 33 is advantageously provided with a running surface made of plastic. As a result, the highest possible static friction between the ball 33 and the surface 12 is achieved. Counter- forces which oppose the movement direction of the extremity can thus reliably be transmitted to the extremity and the surface 12.

Figs. 4a and 4b show a training device 40 with a support shell 41 on which the extremity can be placed. A steering drive 42 steers a wheel 43 in a given direction and a movement drive 45 makes the training device 40 move over the surface (not shown in any detail here). A Cardan joint 44 is provided below the steering drive 42. As soon as a force which acts transversely to the movement direction is applied by the extremity, the wheel 43 can tilt by a tilt angle ά on account of the Cardan joint 44. A tilt sensor (not shown in any detail here) which is arranged in the Cardan joint 44 detects a force F which acts non-parallel to the movement direction. The steering drive 42 then controls the wheel 43 according to the tilt angle ά in the direction in which the force F differing from the movement direction acts. The greater the tilt angle, the greater also is the steering movement. Due to the steering movement, the patient notices that he is pressing on the training device 40 with a force F differing from the movement direction. He can then correct the direction of his force. Instead of the steering movement, however, the user interface 26 may also be used to indicate to the patient that he is applying a force F which is not parallel to the movement direction.

As is clear from Figs. 4a and 4b the shell 41 covers the other elements. Only wheel 43 extends from a bottom side of the training device. This is advantageous with relation to a compact design and allows that the shell provides an ideal support for an extremity of a patient, such as a hand.

Fig. 5 shows a training device 50 which is equipped with a light source 51 for generating a visible target point 52. The light source 51 transmits a strongly bundled light beam, which may advantageously be a laser beam, so that the target point is clearly visible. Due to the target point, the patient has a guiding point towards which he can move the training device 50. The target point may be movable or fixed.

Fig. 6 shows a support shell 61, in which control switches 62, a signal light 63 and a loudspeaker 64 are integrated. The control switches 62 can be used for example to switch the training device 60 on and off and to select different operating modes. In this way, the patient can select different therapy plans or call up a demonstration program so as to become acquainted with the training device 60. The signal light 63 may inform the patient as to whether the training device 60 is switched on or whether the movement corresponds to the therapy plan. The patient may also be given instructions relating to the therapy via the loudspeaker 64. Figs. 7A and 7B show the procedure for isometric and isokinetic therapy. The patient sits in front of a table, on the surface 12 of which the training device 10 is placed. The patient places his extremity 11, in this case his hand, on the training device 10 (see Fig. 7A) and starts the therapy. First the therapy plan is downloaded (see Fig. 7B). During the movement of the hand, the force F O applied by the patient is measured. The training device 10 generates a counter- force F l which opposes the movement direction of the hand.

In the case of isometric therapy, the counter- force F l is as great as the force F O applied by the patient. The training device 10 therefore cannot be moved any further by the hand. Isometric therapy serves to strengthen the muscle structure. Since this therapy involves pressure and counter-pressure, the patient in this therapy is aware of the relevant muscles and thus regains awareness of the weakened muscles.

When undergoing isokinetic therapy, the force F O applied by the patient is greater than the counter- force F l generated by the training device 10. The difference between these two forces is constant. The patient can therefore still move the training device 10 with his hand. This therapy also serves to build up the muscles.

Figs. 8 A and 8B show a therapy for training a movement range of the hand. In this therapy, too, the patient sits in front of the table, on the surface 12 of which the training device 10 is placed (see Fig. 8A). First the therapy plan is again downloaded (see Fig. 8B). The therapy plan defines the maximum movement range which the patient has to reach with his hand. The training device 10 measures the distance traveled by the patient under his own force and compares it with the maximum movement range defined in the therapy plan. If the patient reaches the maximum movement range under his own force, the therapy is ended. The training device 10 then sends the patient a corresponding signal via the user interface 26 (see Fig. 2). However, if the patient is unable to reach the maximum movement range under his own force, the training device 10 then uses its drive to move the hand until the maximum movement range is reached. This therapy also serves to strengthen the muscle structure and to improve movement coordination.

It is clear to the person skilled in the art that the scope of application of the present invention is not limited to the examples mentioned above, but rather a number of additions and modifications to the invention are possible without departing from the scope of application of the present invention as defined in the appended claims.

Claims

CLAIMS:

1. A training device (10, 20, 30, 40, 50) for patients with physical disabilities, which can be moved on a surface (12) and has at least one drive (21, 31, 32, 42, 45) and a support shell (41), on which an extremity (11) of the patient can be at least partially placed.

2. A training device (10, 20, 30, 40, 50) as claimed in claim 1, characterized in that it has a measuring device (22) for measuring a force applied by the patient and/or a movement speed.

3. A training device (10, 20, 30, 40, 50) as claimed in claim 1 or 2, characterized in that it has a data memory (24).

4. A training device (10, 20, 30, 40, 50) as claimed in one of claims 1 to 3, characterized in that it has a central processing unit (27).

5. A training device (20, 30, 40, 50) as claimed in one of claims 1 to 4, characterized in that the at least one drive (21, 31, 32, 42, 45) drives at least one wheel (43) and/or at least one ball (33).

6. A training device (30) as claimed in claim 5, characterized in that the at least one ball (33) can be driven by two drives (31 , 32).

7. A training device (40, 50) as claimed in claim 5 or 6, characterized in that the at least one drive (42) has a Cardan joint (44).

8. A training device (20) as claimed in one of claims 1 to 7, characterized in that the extremity of the patient can be cooled and/or electrically stimulated and/or mechanically vibrated by an additional therapy module (25).

9. A training device (20) as claimed in one of claims 1 to 8, characterized in that it has at least one user interface (26) with at least one visual and/or at least one acoustic signal device.

10. A training device (10, 20, 30, 40, 50) as claimed in one of claims 1 to 9, characterized in that it has at least one control switch.

11. A training device (10, 20, 30, 40, 50) as claimed in one of claims 1 to 10, characterized in that it has a microphone.

12. A training device (50) as claimed in one of claims 1 to 11, characterized in that it has a light source (51) for generating a visible target point (52).

13. A method for carrying out a movement therapy using a training device (10, 20, 30, 40, 50) as claimed in one of claims 1 to 12, characterized by the following steps: downloading a therapy plan, measuring a force applied by the patient, generating a counter-force.

14. A method for training a movement range using a training device (10, 20, 30,

40, 50) as claimed in one of claims 1 to 12, characterized by the following steps: downloading the therapy plan, measuring the movement range of the extremity (11) which is reached by the patient, - ending the training if the maximum movement range has been reached, or assisting the movement of the extremity by the drive if the maximum movement range has not been reached.