CN101296673B - 用于对人造肢体实施功能分析的方法 - Google Patents

用于对人造肢体实施功能分析的方法 Download PDF

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CN101296673B
CN101296673B CN2006800400046A CN200680040004A CN101296673B CN 101296673 B CN101296673 B CN 101296673B CN 2006800400046 A CN2006800400046 A CN 2006800400046A CN 200680040004 A CN200680040004 A CN 200680040004A CN 101296673 B CN101296673 B CN 101296673B
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artificial limb
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M·普施
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Otto Bock Healthcare GmbH
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/50—Prostheses not implantable in the body
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/50—Prostheses not implantable in the body
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    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30359—Pyramidally- or frustopyramidally-shaped protrusion and recess
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/50—Prostheses not implantable in the body
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    • A61F2002/7635—Measuring means for measuring force, pressure or mechanical tension
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/50—Prostheses not implantable in the body
    • A61F2/76—Means for assembling, fitting or testing prostheses, e.g. for measuring or balancing, e.g. alignment means
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/50—Prostheses not implantable in the body
    • A61F2/76—Means for assembling, fitting or testing prostheses, e.g. for measuring or balancing, e.g. alignment means
    • A61F2002/7615—Measuring means
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    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0033—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit

Abstract

本发明涉及一种用于对装备有人造肢体(30)的人实施功能分析的方法，其中，该人造肢体(30)在基本功能方面可调整并且模块式地构造有至少一个尤其是用于可实现附加功能的可拆卸的功能件(33)，在无费事的外部仪器和测量装置的情况下，所述功能分析的实施这样实现：取代该可拆卸的功能件(33)安装一个传感器装置(33′)，该传感器装置适配于对于安装该功能件重要的尺寸；通过该传感器装置(33′)来测量在使用该人造肢体(30)期间的力、加速度和/或力矩并且用于优化该人造肢体的基本功能的调整；在保持最佳调整的情况下该传感器装置(33′)用该功能件(33)来替换。

Description

用于对人造肢体实施功能分析的方法
本发明涉及一种用于对装备有人造肢体的人实施功能分析的方法，其中，该人造肢体在基本功能方面可调整并且模块式地构造有至少一个用于可实现附加功能的可拆卸的功能件。
人造肢体以开发水平非常高的实施形式使用。对于从患者安全性角度考察特别重要的、用于包括人造膝关节在内的下部肢体的假肢，使用例如对于功能“行走”和“站立”精良的技术，这些技术一方面可实现可靠的站立并且另一方面可实现在行走时与自然行走尽可能良好适配的运动过程。为此例如需要在考虑患者的通常的触发力的情况下例如通过大腿残肢的运动可实现对小腿的完全牵引，但在此避免小腿件猛烈地止挡在限制伸展运动的止挡上。显然在此必要时使用累进的减振装置，但仅当这种减振装置在其减振计量方面对于相应患者调整正确时这种减振装置才保证期望的功能。类似的也适用从站立触发行走运动以及适用从行走过渡到可靠站立。
已经公知，这种假肢的功能通过传感器来控制，这些传感器基于所测量的力、加速度、力矩或类似量测定从行走运动阶段到其它阶段的过渡或从行走运动到站立运动的过渡以及反过来测定并且为下一个功能阶段实施假肢调整。这种假肢的一个例子是以申请人的名称C-Leg开发和销售的腿假肢。但这种开发水平高的假肢需要调整过程来使假肢的功能与相应患者的适配优化。这种调整可在考虑患者在使用假肢时的主观感觉的情况下进行。但其缺点在于，患者的主观感觉是波动的并且感觉的量化几乎不可能。假肢调整的优化因此必须按照试验-错误原理来进行，以便由此接近最佳调整。
已经公知了可用客观形式实现对用假肢照料的患者进行站立和行走分析的装置。为此需要费事并且因此昂贵的测量系统，这种测量系统仅可在少数实验室中例如在康复中心提供。对于通过矫形外科机械师对假肢进行标准适配，这种测量系统是支付不起的，由此，标准适配在无这种测量系统帮助的情况下即基本上基于患者的主观感觉来进行。
本发明的任务在于，在无费事的测量仪器的情况下允许对人造肢体进行功能分析。
为了解决该任务，根据本发明，开头所述类型的方法的特征在于：取代可拆卸的功能件安装一个传感器装置，该传感器装置适配于对于安装该功能件重要的尺寸，通过传感器装置来测量在使用人造肢体期间的力、加速度和/或力矩并且用于优化人造肢体的基本功能的调整，在保持最佳调整的情况下传感器装置用功能件来替换。
本发明由此可实现在完全能工作的假肢上实施测量，该假肢为患者的使用而设置并且与患者相适配。假肢因此可在任意长的时间上由患者带有所安装的传感器装置地使用，以便可通过对测量值的分析处理来确定：是否假肢的调整仍可优化以及是否例如在假肢使用较长时间时产生患者行走行为的变化并且因此符合目的地要另外调整假肢。
与专门的测量假肢的重要区别在于，专门的测量假肢通常用来获得用于患者的首次测量值以便制造合适的假肢。这种测量假肢不是与患者个别适配并且因此仅可用来获得用于特殊患者的第一依据。据此，根据本发明使用为患者制造并且完全适配的、就假肢基本功能而言完全能工作的假肢。
通过构造紧凑并且测定可靠数据的传感器装置，在本发明的范围内，假肢的设置用于附加功能的功能件可拆卸并且可用在其安装尺寸方面适配的传感器装置来替换。不言而喻，在此必须这样构造传感器装置，使得该传感器装置在相对运动对于使用不可察觉的情况下就足以进行测量。因此优选具有应变片、压电元件或类似装置的传感器装置的构型，在所述应变片、压电元件或类似装置中，几分之一毫米范围内的相对运动或变形足够用于产生测量信号。
腿假肢上的可拆卸的功能件的一个例子是转动适配器，该转动适配器直接安装在膝关节上方，以便尤其是可在坐着时实现小腿相对于大腿转动，由此例如使腿交叉着的坐姿轻松。为了实施功能分析，患者可舒适地放弃该附加功能，该附加功能不影响腿假肢的基本功能，即在行走过程期间以及在站立状态期间的基本功能。但不言而喻，也可在模块式地构造的假肢中使构成小腿件和大腿件的管段缩短精确的尺寸，该尺寸对于安装传感器装置是必需的。在传感器装置拆卸的情况下则可在缩短的管段上用法兰连接一个相应的加长段或者将缩短的管段用一个较长的管段来替换。
用传感器装置替换的功能件也可以是用于承载的模块件、例如管模块。所替换的模块件对于基本功能不是决定性的，例如这可以是膝关节或人造脚的确定滚动过程(Abrollvorgang)的件。传感器装置由此也可与其余模块件相组合地构造，其中，重量和重量分布应基本上相应于所替换的模块件。这种传感器装置的一个例子是具有其余小腿管的测量传感器，由此替换一个腿假肢的完整的小腿管。
尽管在上述说明中首先探讨了用于下部肢体的假肢，但可毫无问题地看出，本发明也可有利地用于上部肢体的假肢，即臂假肢、手假肢和肩假肢。
在所有情况下，可通过该传感器装置本身或也通过一些附加地安装在假肢中的传感器获得附加测量数据，例如转动速率、角度位置和角度变化等等。
下面要借助于附图中所示的实施例和对特别适用于实施本发明的传感器装置的说明来详细描述本发明。附图表示：
图1传感器装置的第一部分的立体侧视图；
图2从斜下方观察根据图1的第一部分的立体视图；
图3传感器装置的第二部分的立体侧视图；
图4从斜下方观察根据图3的第二部分的立体视图；
图5由这两个部分组成的传感器装置的立体侧视图；
图6从斜下方观察根据图5的传感器装置的立体视图；
图7传感器装置对于轴向负荷(z方向)的示意性剖面视图，其中示意性地示出了第二法兰上的线形的压缩区域；
图8根据图7的用于绕水平轴线(x轴线)的转矩的视图；
图9根据图7的用于起作用的侧向力的示意性视图；
图10根据图7的用于绕垂直轴线(z轴线)的转矩的示意性视图；
图11具有转动适配器的腿假肢的侧视图；
图12根据图11的侧视图，在该侧视图中，转动适配器已用根据图1至图10的传感器装置替换。
图1至图6说明了根据本发明的传感器装置的一个实施例的结构。该传感器装置包括一个第一部分1，该第一部分由一个帽状的圆柱形连接器2和一个连接在该连接器上的正方形的法兰3构成。正方形的法兰3在其角部上具有一些用于(未示出的)固定螺钉的通孔4。
帽状的连接器2构造有圆柱形的壳壁5，一些螺纹孔6处于该壳壁中，它们各彼此错位90°转角。帽状的连接器2在其上侧上具有一个圆柱形的底部7并且在其下侧上具有一个圆环状的突缘8，该圆环状的突缘一体地与矩形的法兰3相连接并且加强该矩形的法兰。
图2说明，帽状的连接器2具有一个构造得近似矩形的接收空间9，该接收空间用于接收一个校准适配器，该校准适配器具有四个倾斜的校准面，穿过螺纹孔6旋入的校准螺钉压在这些校准面上。
这种校准适配器10构造在传感器装置的第二部分11上。第二部分11具有一个正方形的第二法兰12，该第二法兰的尺寸相应于第一法兰3的尺寸。这两个法兰3、12通过一些一体地成形在第二部分上的接片13彼此相连接，这些接片在第二法兰12的角部上向下延伸，由此，这些接片在帽状的连接器2的径向外部靠置在第一法兰3上。接片13从它们的下侧起各设置有一个螺纹盲孔，这些螺纹盲孔可与第一法兰3的通孔4对准。
图3和图4还允许看到，接片12具有矩形横截面并且朝它们的自由端部即向下通过朝两个接片13之间的中间空间15指向的斜坡16而变细。
校准适配器10位于第二法兰12的背离接片13的上侧17上。该校准适配器以公知方式构造成倒棱锥台的形式并且由此具有四个倾斜延伸的平的校准面18，这些校准面为了校准目的可与校准螺钉共同作用。校准适配器10过渡到具有增大的直径的底座19，该底座以拱曲的面形成到正方形的第二法兰12的过渡。
校准适配器10形成传感器装置的第二连接器。由此在正方形的第二法兰12的对角方向上，在该第二连接器10与设置在第二法兰12的角部中的接片13之间，各存在一个通孔形式的槽口20，应力或拉伸区域的下面详细描述的构型可受所述槽口的影响。
图5和图6示出了处于装配好的状态(但没有固定螺钉)中的由这两个部分1、11组成的传感器装置。可以看到，在第一连接器2的接收空间9与形成第二连接器的校准适配器10之间仅需要2至3cm的小结构高度。
图7至图10各示意性地示出了根据图1至图6的传感器装置的垂直剖面，但示意性地示出了作为传感器元件的、粘接在法兰12的两个表面上的应变片21。
在图7至图10中各位于下面的俯视图说明了这样定位应变片21，使得这些应变片由于线形的压缩区域22或拉伸区域23而在它们的长度方面变化，由此产生变化了的电阻。
图7说明了在z方向上、即在用于小腿的管骨架假肢的轴向方向上的力作用的情况。处于第二法兰12的上侧17上的应变片21在此处于压缩区域22中，这些压缩区域线形地从通孔20平行于第二法兰12的棱边分别朝相邻的棱边延伸。据此取向的应变片21由此在压缩方向上改变它们的电阻值。
根据图8，校准适配器10被加载以绕相对于绘图平面(x方向)垂直的轴线的转矩。该转矩对于位于上侧17上的应变片21在转矩所指向(参见图8中所绘入的箭头Mx)的侧上导致压缩，而它在位于对面的侧上导致拉伸区域23的形成。
图9示出了在绘图平面(y方向)中作用在校准适配器10上的侧向力，通过该侧向力仅形成相对于作用力垂直的拉伸区域23和压缩区域22，而其余的应变片21无测量信号地保持在第二法兰12的上侧17上。
在图10中所示的在z方向上作用的转矩Mz下在每个槽口20处产生压缩区域23和拉伸区域22，其中，在转矩Mz的方向上观察，压缩区域23总是在拉伸区域22前面90°。
借助于所示的例子可看到，通过作为传感器元件的应变片21可确定地探测所产生的不同的力或力矩。
第二法兰12的下侧上的应变片21各产生与第二法兰12的上侧17上的应变片21的信号互补的信号，由此，这些信号在适当相加的情况下可有助于测量信号的放大。
图11示出了一个公知的腿假肢30，该腿假肢具有一个用于大腿残肢的接收喇叭筒31。在接收喇叭筒中装入适宜皮肤的衬里32，该衬里建立与大腿残肢的无疼痛接触。
一个转动适配器通过通常的校准棱锥体连接在接收喇叭筒31的下端部上。转动适配器33与小腿件34的连接也通过一个校准棱锥体来进行。
小腿件34构造成如以奥托·博克保健有限公司的名称“C-Leg”公知的计算机控制的假肢件。小腿件34包括一个多中心的膝关节35，该膝关节构造成公知形式的四连杆机构。在小腿件34上向下连接着一个模块管36，该模块管建立与无关节的人造脚37的连接，该人造脚的可能结构也已公知，在此不必详细描述。不仅人造脚37而且腿假肢都设置有装饰性覆层38、39。
假肢30的主功能在于对于假肢30的各个不同的使用者可实现尽可能自然的行走行为和可靠的站立以及舒适的坐下。转动适配器33在假肢30的主功能期间被锁止并且当在小腿件34上施加小负荷时可被解锁。通过转动适配器33可使假肢30的小腿相对于大腿扭转，尤其是当假肢30的使用者坐着时。
为了适配假肢30以及必要时在以后的阶段中为了检验假肢30，转动适配器33可用在此用33′标记的如在图1至图10中已经描述的传感器装置来替换。通过用传感器装置33′替换转动适配器33，如果传感器装置33′的安装尺寸相应于转动适配器33的安装尺寸，则假肢30的基本功能保持不变。仅取消了小腿相对于大腿扭转的附加功能，但由此假肢30的主功能即行走、站立和坐下时的行为不受影响。因此借助于传感器装置33′可求得为患者个别适配并且完全功能卓越的假肢30上的、对假肢33的功能进行分析处理所需的数据。传感器装置33′在此也可用于假肢的首次适配，即短时间使用，如同用于长时间支持带有专门为其适配和调整的假肢30的患者的运动一样。

Claims (4)

1.用于对装备有人造肢体(30)的人实施功能分析的方法，其中，该人造肢体(30)在基本功能方面可调整并且模块式地构造有至少一个可拆卸的功能件(33)，其特征在于：取代该可拆卸的功能件(33)安装一个传感器装置(33′)，该传感器装置适配于对于安装该功能件重要的尺寸；通过该传感器装置(33′)来测量在使用该人造肢体(30)期间的力、加速度和/或力矩并且用于优化该人造肢体的基本功能的调整；在保持最佳调整的情况下该传感器装置(33′)用该功能件(33)来替换。
2.根据权利要求1的方法，其特征在于：所述人造肢体(30)具有用于实现附加功能的可拆卸的功能件。
3.根据权利要求1或2的方法，其特征在于：作为人造肢体(30)使用腿假肢。
4.根据权利要求3的方法，其特征在于：使该传感器装置(33′)与设置在人造膝关节上方的转动适配器(33)的尺寸相适配。
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