BR202018074087U2 - ACTIVE AND PASSIVE MOBILIZATION EQUIPMENT FOR FEET AND ANKLES - Google Patents

Abstract

the present utility model describes a new equipment characterized by being portable and having a configuration that allows the application of active and passive dorsiflexion and plantiflexion movements, with control of the application of a predetermined constant load and range of motion and, therefore, , dispenses with manual operation, allowing the execution and control of movements to be performed by the patient himself so that he does not always need the intervention of a specialized professional. this equipment can be used by a patient who is sitting or lying down and can be applied in configurations for individual use or suitable for several patients, in a hospital or clinic. the present utility model is indicated for prevention and medical, physiotherapeutic and physical educator treatments in order to maintain the amplitude of movements of dorsiflexion and plantar flexion, avoid muscle and tendon shortening, facilitate venous return in a situation of temporary and or permanent immobility and prevent calcaneus pressure ulcers. the equipment also allows it to be connected to an electronic system for programming amplitude, frequency, speed and loads to be used in active and / or passive movements and enables the collection of user data that can be transmitted over the internet to a computer, monitor or devices, as well as electrodes can be applied to generate tension stimuli (transcutaneous electrical nerve stimulation) that promote analgesia. this mobilization equipment is preferably made of anodized aluminum, making it a portable and resistant equipment that can be manufactured on an industrial scale at a low cost.

Description

Descriptive Report of “ACTIVE AND PASSIVE MOBILIZATION EQUIPMENT FOR FEET AND ANKLES”

UTILITY MODEL FIELD

[001] The present utility model describes a new equipment characterized by being used to perform, actively and passively, dorsiflexion and plantiflexion movements of human ankles. The device is portable and has the possibility of being used by a patient or any user who is sitting or lying down, and can be adaptable to any patient or user, be it a single patient or user with any height and weight, in the configuration of single equipment, or be suitable for several patients or users, such as in a hospital, clinic, company, office, on airplanes, buses or automobiles during trips, residence, in the collective use version, so that the patient (s) or user ( s) can (d) perform the movement of dorsiflexion and plantiflexion, actively and / or passively. During the dorsiflexion and plantiflexion movements, a constant load can be used for the movement or not (in the case of the option for the active movement), regulate the movement speed, (in the case of the option for the automatic passive movement) and define the amplitude movement appropriate to the patient (s) and / or user (s) (in both active and passive cases). The use of this equipment does not require manual operation, so there is no need to always have a specialized professional to perform this task, which can instead be performed by the patient (s) or user (s) ), depending on the need of the patient or user and, if applicable, the severity of the injury.

[002] The present utility model is indicated to maintain the amplitude of movements of dorsiflexion and plantar flexion, to facilitate venous return of the lower limbs, through the movements of the feet, ankle and calf joint; avoid muscle and tendon shortening. The device also has the important function that patients or users who have diseases

Petition 870180154152, of 11/23/2018, p. 8/24 of 13 cardiovascular patients (examples: peripheral arterial disease, angina, myocardial revascularization, etc.) perform their cardiovascular and muscle strengthening exercises of the lower limbs under strict and precise control in relation to the load, time to perform the exercises and with load constant (the same load, without load variation, during the entire cycle of plantar flexion and dorsiflexion) and this load may be pre-determined by the professional (doctor, physiotherapist and / or physical educator) who will be indicating and prescribing the exercises for the patient and / or user. It is also indicated to prevent pressure ulcers.

STATEMENT OF TECHNICAL STATUS

[003] In several situations, patients may be affected by reduced mobility of the legs and feet, such as hospitalizations and prolonged surgeries, prolonged travel by plane, bus or car, long working hours in a sitting position (in offices and companies); weakening of the lower limbs due to disability or senility; cardiovascular diseases (eg, peripheral arterial disease, myocardial revascularization, etc.); neurological diseases (Ex: cerebrovascular disease), recovery from surgery; among other reasons.

[004] When the movements of the feet and ankles are permanently or temporarily restricted in various situations, such as: prolonged hospitalizations, travel, prolonged surgery, it can result in injuries that, if not properly treated, can perpetuate, further aggravating mobility problems in walking, the individual's balance and the control of feet, fingers and ankles, as well as causing shortening of tendons and muscles. The prolonged immobility of the lower limbs can cause deficiency in the irrigation of the extremities of the organism and deep venous thrombosis, even leading to amputations and death in the event of a thrombus dislocating and causing pulmonary thromboembolism.

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[005] Prolonged immobility affects the person's entire organism and impairs health and quality of life. Prolonged immobility in patients with neurological diseases (eg, cerebrovascular disease - stroke, spine surgery, cerebral palsy, etc.) and or cardiovascular diseases (eg, peripheral arterial disease, myocardial revascularization, myocardial infarction) where the person is very immobilized time or need to perform cardiovascular training exercises safely, as it is necessary to strictly control the load imposed during exercise, exercise time, and range of dorsiflexion and plantiflexion movements.

[006] In addition, if people do not perform their exercises for various reasons, their health condition may be aggravated, and may even evolve with death due to prolonged immobility / sedentary lifestyle.

[007] People who need to exercise, but are unable to move to clinics, gyms or exercise standing on treadmills or outside the home (eg, peripheral arterial disease, single-limb amputees, morbid obesity, people with weakness muscle or lower limbs, etc.) these people will suffer general damage to their health and even death as a result of several factors related to immobility.

[008] Currently, there are many treatments for these cases and include manual ankle mobilization by physiotherapists to facilitate venous return, maintain the range of plantar flexion and dorsiflexion movements, avoid muscle and tendon shortening and prevent calcaneus pressure ulcers.

[009] Despite being used for several purposes, manual mobilization is not the most appropriate form of treatment, as it presents drawbacks that are still a problem that deserves to be overcome. For example, manual mobilization always needs to be performed by a professional physiotherapist to perform the maneuvers, which results in low

Petition 870180154152, of 11/23/2018, p. 10/24 of 13 effectiveness of the treatment inherent to manual techniques, in addition to the high cost of maintaining the professional and his logistics and the difficulties in keeping the patient faithful to the commitment of the physiotherapy sections that can be quite long.

[010] Current techniques for therapy through mobilization are based on Continuous Passive Movement (CPM) and equipment has been developed to promote therapy, for example, the Orthomed Continuous Passive Movement Apparatus, for knee and hip, which allows stimulation of the quadriceps, hips and dorsiflexion movement of the feet, indicated for rehabilitation of lower limbs, gain of range of motion, stretching of the posterior chain and resistance training and muscle strengthening of the lower limbs. [008] Some solutions are found in the state of the art, but none of them comes close to the present utility model. An example is the document US4807874, which refers to a rehabilitation equipment by means of active movement with regulation of weight and range of motion and which anticipates the concept of plantar flexion and ankle dorsiflexion with control of range of motion, but does not it is an automatic mobilizer, in addition to being a heavy, non-portable device, difficult to transport and use and highly expensive.

[011] Document US6277057 also describes an active ankle movement device that provides a desired range and resistance of movement to result in the rehabilitation of the patient's ankle. Despite describing a portable, simple and inexpensive equipment, it is not able to measure and / or guarantee constant load to the movement, by means of straps and dynamometers, nor to measure the range of movements, it only makes its adjustment.

[012] The document US6350246 describes a device for the foot and ankle that allows the movements of plantiflexion and dorsiflexion with adjustment

Petition 870180154152, of 11/23/2018, p. 11/24 of 13 amplitude, however, does not promote continuous automated movements, it only limits the movement in a given amplitude.

[013] The document US5474520, in turn, describes a mechanically operated equipment through an electronic control that performs the movements of plantiflexion and dorsiflexion. However, in its operation, it is necessary that the patient sits on a bench positioned by a health professional at the correct distance and has the inconvenience of not being portable, not allowing the operation by the patient himself, resulting in greater difficulty of use and hygiene. It also does not make it possible to perform manual exercises with precise, limited and constant load.

[014] In addition, document US6758825 describes a portable equipment, with a different configuration than the present utility model, which uses automatic passive planting movement and ankle dorsiflexion with range of motion regulation and electrical control, however, it does not perform active movement with load measurement and control.

[015] US4842265 refers to a multi-mode CPM-based foot manipulation device, which produces alternating or simultaneous dorsiflexion of the feet, consists of two pedals, but does not allow active movement with a personalized range of motion or application of constant load.

[016] The document US2007027410 describes a machine of continuous and active passive movement for the ankle and that provides passive and active extension and flexion of the ankle, besides the free movement of the ankle. This equipment has an actuator connected to the upper and lower ankle attachment points, so that the activation of the actuator can extend or flex the ankle and the flexion and extension limits can be programmed or physically limited. The equipment has a microcontroller that is

Petition 870180154152, of 11/23/2018, p. 12/24 of 13 communicates with the actuators that inform about the ankle joint and the applied force and that is attached to a control panel that can be operated by the patient, doctor, or other professional. It is capable of alternating passive or dorsiflexion movement in a passive or active way, with regulation of range of motion and resistance to movement. In addition, their electronic movement recording systems are capable of sending data to a computer. Alternatively, it can be controlled manually, so that continuous active movement can be performed. This equipment, however, is connected to support and plates that prevent a portable configuration, in addition to involving in its construction, specific and expensive devices and sensors.

[017] The document WO2008101062 also describes a machine of continuous and active passive movement for the ankle with use in the prevention of deep venous thrombosis, in a configuration different from that of the present equipment, but which also performs the active and passive movements of the dorsi and plantiflexion, with automatic control and the measurement of the applied load is given by a pressure sensor and an articular angle sensor assists the control of movement, barring it when the established limits are reached. This equipment is electrical, requiring a battery or power source and a recharging device that takes advantage of ankle movements for recharging is attached to it.

[018] Although some solutions to the problem have already appeared in the state of the art, there is still a need for equipment with provisions that allow its portable use in hospitals, clinics, companies, homes, airplanes, buses, automobiles, etc; that allows the use by bedridden and lying patients, and at the same time that it is used effectively for patients who can sit but are unable to perform cardiovascular exercises in the standing position and / or who have difficulty

Petition 870180154152, of 11/23/2018, p. 13/24 of 13 moving to clinics, gyms, as is the case with lower limb amputees; patients in the postoperative period of lower limb revascularization, patients with peripheral arterial disease, patients undergoing rehabilitation, providing, therefore, both the continuous passive movement of the feet and ankles, as well as active mobilization and with the advantage of providing load control and regulation of the amplitude of the dorsi and plantiflexion movements, when necessary.

SUMMARY OF THE UTILITY MODEL

[019] Surprisingly, the present utility model brings functional improvement to allow both the continuous passive movement of feet and ankles, as well as the active movement with constant, programmed load, in a portable and easy to operate equipment and adding necessary functional characteristics as required. describes below.

[020] The present utility model describes a new portable equipment characterized by having a configuration that allows the application of active and passive dorsiflexion and plantiflexion movements, with constant and predetermined load application control and range of motion, which can be used by user (s) and / or patient (s) who are sitting or lying down, and adaptable to a single patient / user with any height and weight or to be suitable for multiple patients / users, in the collective use version.

[021] In the present configuration, the individual (s) can perform the dorsiflexion and plantiflexion movements in an active and / or passive way, due to the action of a rotary motor. Still, it allows the movement options with the use of a load or not (in the case of the option for the active movement), to regulate the movement speed (in the case of the option for the automatic passive movement) and allows to determine the amplitude of the movement that the individual

Petition 870180154152, of 11/23/2018, p. 14/24 out of 13 performs or must perform for adequate treatment (in both active and passive cases).

[022] The use of this equipment may dispense with manual operation, therefore, there is no need to always have a specialized professional to perform this task, which can instead be performed by the patient himself.

[023] The present utility model is indicated for physiotherapy treatments that aim to maintain the amplitude of movements of the individual's dorsiflexion and plantar flexion, in order to avoid muscle and tendon shortening and prevent ankle joint deformities. Facilitate venous return in procedures that impose long periods of immobility, by applying the movements of the feet, ankle and calf joint. It is also indicated to prevent calcaneus pressure ulcers, since it moves the ankle region.

[024] The present utility model is also indicated for carrying out active dorsiflexion and plantiflexion exercises with constant load, predetermined in patients or users who need to exercise.

[025] The present equipment is characterized by being, according to FIGURE 1, of a frame (1) that contains an arrangement of two pedals (2) connected to a graduated disc (3) and connected to dynamometers (4) fixed to the frame , by a set of tensioning belts (5) and pulleys (6), these, in turn, coupled to a rotary motor that can be controlled to perform traction on the belts and enable passive movement automatically and controlled when the motor is on, and active, when the motor is off, in addition to allowing the determination of the force applied to the movement, the control of the force that must be applied to overcome the equipment and the determination of the amplitude of the dorsiflexion and pantiflexion movements.

Petition 870180154152, of 11/23/2018, p. 15/24 of 13

[026] The control of the load in movement is performed by a dynamometer connected to each pedal. It allows the application of load in the active movement of 0 to 8 kg and the system of tensioning belts allows the application of constant load regardless of the angle of movement.

[027] The equipment also allows coupling to it an electronic system that can allow the programming of amplitude, frequency, speed and loads to be used in active and / or passive movements and enables the collection of user data that can be transmitted over the internet. to a computer, monitor or devices.

[028] The apparatus of the present utility model also allows coupling electrodes by assigning additional functions such as: emission of transcutaneous electrical stimulation waves (TENS) that are intended to promote analgesia, transmission of electrical stimuli that generate stimulation of fibers inhibiting pain. The programming of the parameters of these stimuli will appear on the device's display and this information may be transmitted to monitors, tablets, smartphones, etc.

[029] Furthermore, the present mobilization equipment is made of anodized aluminum, which makes it a portable and resistant equipment, which can find employment in different physical therapy environments and can also be used by medical professionals, physiotherapists and independent physical educators. It is a very interesting configuration for manufacturing on an industrial scale at a low cost, since aluminum is easily modeled on ordinary mechanical lathes and the anodizing process is also quite common.

DESCRIPTION OF THE FIGURES

[030] FIGURE 1 represents the ankle mobilization equipment consisting of a frame (1) that contains an arrangement of pedals (2)

Petition 870180154152, of 11/23/2018, p. 16/24 of 13 connected to a graduated disc (3) and connected to dynamometers (4) fixed to the frame, by a set of tensioning belts (5) and pulleys (6) coupled to a rotary motor that can be controlled to perform the belt traction and automatically and passively enable passive movement - when the engine is on, and active - when the engine is off; in addition to allowing the determination of the force applied to the movement, the control of the force that must be applied to overcome the equipment and the determination of the amplitude of the dorsiflexion and pantiflexion movements.

[031] FIGURE 2 shows the view of the same equipment, in which the connection of the graduated disc (3) to the dynamometer (4) by means of tensioning belts (5) and pulleys (6) can be seen. The functioning of the equipment that allows the realization of active movements of dorsiflexion and plantiflexion controlled and with constant load is inferred from these connections that communicate the pedals to the dynamometer and the graduated disc. The graduation of the disc (7) also allows the determination of the amplitude of the dorsiflexion and plantiflexion movements. FIGURE 2 still presents the frame (1), which is the support structure of the equipment, which contains all the mechanical and electronic components of the device, so that there is no risk that these components have any contact with the patient's foot, ensuring greater safety and ease of cleaning.

DETAILED DESCRIPTION OF THE UTILITY MODEL

[032] The present utility model describes a new portable foot and ankle mobilizing equipment characterized by having a configuration that allows the application of active and passive dorsiflexion and platiflexion movements, with control of the application of constant load and range of motion and which, therefore, dispenses with manual operation. In this new configuration, there is no need to always have a professional

Petition 870180154152, of 11/23/2018, p. 17/24 of 13 specialized to perform these movements of dorsiflexion and plantiflexion to the individual, reducing costs for hospitals, clinics and users. The use of the device allows that, instead of the ankle movements being performed by a physical therapist, they can be performed by the individual, actively, depending on the particular need of each person and, if applicable, the severity of the injury.

[033] This equipment can be used by patients / users who are sitting or lying down and can be applied in configurations for individual use or for groups, as the equipment is adaptable to any individual, be it a single individual with any height and weight, in configuration of single equipment, or be suitable for several individuals, in a hospital, clinic, company or residence in the collective use version, so that the patient (s) can perform the dorsiflexion and plantiflexion movements, in an active and / or passive way, in which a load can be used for the movement or not, in a controlled and constant way (in the case of the option for the active movement), regulate the movement speed (in the case of the option for the passive - automatic movement) ) and define the range of motion appropriate to the patient / users (in both active and passive cases). The control of the load is given by means of a dynamometer connected to the pedals by means of tensioning straps, as shown in FIGURE 2 and the measurement of the range of motion is given by the graduation on the disc, as shown in FIGURE 2.

[034] The present equipment is characterized by being, according to FIGURE 1, of a frame (1) that contains an arrangement of two pedals (2) connected to a graduated disc (3) and connected to dynamometers (4) fixed to the frame by a set of tensioning belts (5) and pulleys (6), these, in turn, coupled to a rotary motor that allows the alternation between treatment by performing passive and active movements.

Petition 870180154152, of 11/23/2018, p. 18/24 of 13

[035] The rotary motor can be controlled to perform traction on the belts and enable passive movement automatically when the engine is started, and active when the engine is turned off, in addition to allowing the determination of the force applied to the movement, the control of the force that must be applied to overcome the equipment and the determination of the amplitude of the dorsiflexion and pantiflexion movements. In the configuration of this physiotherapy equipment, active movement can be performed without an increase in load (application of zero load) or with a pre-determined constant load throughout the cycle of movement of dorsiflexion and plantiflexion. Through the dynamometer, the load in the active movement can be controlled to vary from 0 to 8 kg and the system of tensioning belts allows the application of constant load regardless of the angulation of the movement, unlike what would happen if it were a system of traction springs , in which the greater the degree of movement, the greater the force that the patient should apply. Still, in the configuration in which it is presented, the equipment allows the patient to be treated in a sitting or lying position, which expands the spectrum of its use to patients with more serious injuries, kept in decubitus, for example, in hospitalizations.

[036] The present utility model is indicated for physiotherapy treatments in order to maintain the amplitude of movements of dorsiflexion and plantar flexion, avoid muscle and tendon shortening and facilitate venous return in procedures that impose long periods of immobility, through application of the movements of the feet, ankle and calf joint. It is also indicated to prevent calcaneus pressure ulcers, since it moves the ankle region. It is also applied to patients or users who are instructed to perform dorsiflexion and plantiflexion exercises using constant and predetermined loads.

Petition 870180154152, of 11/23/2018, p. 19/24 of 13

[037] The equipment also has an electronic system attached to it that can allow the programming of amplitude, frequency, rest time interval between dorsiflexion and plantiflexion, speed and loads to be used in active and / or passive movements and enables the collection of user data that can be transmitted over the internet to a computer, monitor or devices.

[038] Electrodes can also be coupled to the equipment of this utility model, being able to assign an additional function of emission of transcutaneous electrical stimulation waves (TENS), which is a therapeutic modality that promotes analgesia, through the emission of electrical stimuli applied to the skin through electrodes positioned on or near painful areas. The transmission of electrical stimuli generates stimulation of the fibers, inhibiting pain. In the equipment of the present utility model, the programming of the parameters of these stimuli will appear on the device's display, and, for example, such information can be transmitted to monitors, tablets and smartphones.

[039] The present mobilization equipment is made of anodized aluminum, making it a portable and resistant equipment, which can be used in physiotherapy clinics, hospitals and home care or even by independent physiotherapists. Still, there is the possibility of being manufactured on an industrial scale with low cost, since aluminum is easily modeled in common lathes and the anodizing process is also quite common.

Claims (1)

1. “ACTIVE AND PASSIVE MOBILIZATION EQUIPMENT FOR FEET AND ANKLES”, characterized by a configuration that allows the application of active and passive dorsiflexion and platiflexion movements, with constant load application and range of motion control and, therefore, , dispenses with manual operation which consists, according to FIGURE 1, of a frame (1) containing an arrangement of two pedals (2) connected to a graduated disc (3), this connected to dynamometers (4) fixed to the frame by a set of tensioning belts (5) and pulleys (6), these, in turn, coupled to a rotary motor that allows the alternation between prevention and treatment through the execution of passive and active movements.