CN101453963B - 具有可调阻尼的被动假膝关节的控制方法 - Google Patents

具有可调阻尼的被动假膝关节的控制方法 Download PDF

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CN101453963B
CN101453963B CN2007800164921A CN200780016492A CN101453963B CN 101453963 B CN101453963 B CN 101453963B CN 2007800164921 A CN2007800164921 A CN 2007800164921A CN 200780016492 A CN200780016492 A CN 200780016492A CN 101453963 B CN101453963 B CN 101453963B
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M·普施
S·扎林
H·博伊滕
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Otto Bock Healthcare GmbH
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Abstract

本发明涉及一种在弯曲方向和伸展方向上具有可调阻尼的被动假膝关节的控制方法，该被动假膝关节用于使假肢装置与上楼梯动作相适配，该假肢装置具有一个大腿杆和一个假脚，该大腿杆和该假脚固定在假膝关节上，所述控制具有以下步骤：探测假脚的低力矩的抬高；将弯曲阻尼在抬高时相中降低到适合于在平面中行走的水平以下，将伸展阻尼在着地和髋伸开时相中时间错开地提高到用于在平面中行走的摆动时相控制的阻尼以上的水平。

Description

具有可调阻尼的被动假膝关节的控制方法
技术领域
本发明涉及在弯曲方向上具有可调阻尼的被动假膝关节的控制方法，该被动假膝关节用于使假肢装置与上楼梯动作相适配，该假肢装置具有上侧的连接装置和一个到假脚的连接元件，所述上侧的连接装置和该连接元件固定在该假膝关节上。
背景技术
需要膝假肢的假肢穿戴者在调节其假肢时必须在弯曲阻尼和伸展阻尼方面作出折衷，因为被动假膝关节仅针对确定的应用优化，由此不可实现或者特别难于实现显著不同的运动模式。因此，在平面中行走的运动过程需要与上楼梯明显不同的阻尼特性，多种具有弯曲阻尼和伸展阻尼的被动假膝关节是针对所述在平面中行走而设计的。因此，假肢穿戴者用传统膝关节假肢这样上楼梯：站在楼梯前面，将健康腿抬高到第一个台阶上并且将对侧腿拖到同一个台阶上。行走速度的提高必要时可通过将健康腿着地到每第二个台阶上来实现，但这非常吃力。
发明内容
本发明的任务在于，提供一种用于被动膝关节的控制方法，对于假肢穿戴者而言通过它可交替地登楼梯。
为此，本发明提出一种在弯曲方向上具有可调阻尼的被动假膝关节的控制方法，该被动假膝关节用于使假肢装置与上楼梯动作相适配，该假肢装置具有一个上侧的连接装置和一个到假脚的连接元件，所述上侧的连接装置和该连接元件固定在该假膝关节上，所述控制方法具有以下步骤：
-探测假脚的低力矩的抬高，并且
-将弯曲阻尼在抬高时相中降低到适合于在平面中行走的水平以下。
在被设计用于在平面中行走的传统膝关节假肢中，假膝关节的所需的低伸展阻尼导致在上楼梯时在高压力下突然伸展，由此对假肢穿戴者有不可接受地高的冲击负荷。在设置有假肢的腿的高压下也不可进行平衡，因为三个关节即脚关节、膝关节和髋上下叠置，假肢穿戴者仅可直接控制髋关节。在抬高假脚以达到较高一级的楼梯台阶时就产生了问题：假脚被引导到踏步踢板上或较高一级的楼梯台阶的下棱边上，因为用于在平面中行走的摆动时相控制中的所需弯曲阻尼使得不能达到较高一级的楼梯台阶的上侧。设置在主动膝关节中的用于抬高脚的弯曲驱动装置和伸展驱动装置在通过设置有假肢的腿来使膝伸直和身体抬高时是非常费事且非常困难的。此外，用于在平面中行走的摆动时相控制在这种主动假膝关节中受到很强的限制。
根据本发明的控制提出，在弯曲方向上具有可调阻尼的被动假膝关节首先提出探测假脚的低力矩的抬高，该被动假膝关节用于使假肢装置与上楼梯动作相适配，该假肢装置具有上侧的连接装置和一个到假脚的连接元件，所述上侧的连接装置和该连接元件固定在假膝关节上。在探测假脚的低力矩的抬高之后，将弯曲阻尼在抬高时相中降低，确切地说降低到适合于或优化用于在平面中行走的水平以下。由于通过降低弯曲阻尼来降低弯曲阻力，在抬高假脚时可达到允许假脚踏在较高一级的台阶上的膝角。在髋弯曲和假脚低力矩地抬高时，在被动假膝关节中由于假脚的惯性而可实现一个膝角，该膝角在髋前移时或在通过重力相应伸展时足以超过楼梯棱边并且使假脚在楼梯台阶上定位。在此有利的是，这样设计假肢中的质量分布：使得质心尽可能地设置在远中，例如设置在到假脚的连接元件中或设置在假脚本身中。为此例如可将膝系统的控制单元设置在远中而不是设置在膝附近，由此可在不通过在假脚中设置额外重量来增加假肢重量的情况下在低力矩地抬高假脚时实现期望的膝弯曲效果。
在着地和髋伸开时相中设置有假肢的腿伸开，在降低弯曲阻尼之后，在所述着地和髋伸开时相期间将弯曲阻尼以及必要时伸展阻尼提高到用于在平面中行走的摆动时相控制的阻尼以上的水平，由此可以进行不仅髋关节的而且膝关节和脚关节的受控制的伸展或伸开。
在超过楼梯棱边之后，膝通过重力伸开。为了可实现处于楼梯台阶上方的假脚定位，将弯曲阻尼在假膝关节伸开之前提高，由此可以通过可由患者直接控制的髋角进行假脚的定位。
将弯曲阻尼在着地时相以及必要时髋伸开时相中优选提高到最大值，以便减弱或避免在髋伸开力矩不足够的情况下下降。在此提出，将弯曲阻尼在着地和髋伸开时相中保持，直到髋完全伸开。
为了容易地定位假脚而提出，在抬高、着地和髋伸开时相期间调节伸展阻尼，以便在抬高时相期间避免假膝关节由于重力而伸开或假脚下落，并且以便在着地和髋伸开时相期间可使脚受控制地着地。如果伸展阻尼在髋伸开时相期间完全停止，则患者会不自然地向上跃起，这会在膝关节的最大伸展中导致冲击和突然中断。无伸展阻尼地抬高假脚可在开放式楼梯中、即在没有踏步踢板(Setzstufe)的情况下导致假脚移动到较高一级的楼梯台阶下方。
优选根据膝角的变化提高弯曲阻尼，所述膝角为连接元件与大腿之间的屈曲角。只要一达到通常比在摆动时相控制中适合于在平面中行走的膝角大的确定的膝角，就提高弯曲阻尼。作为替换方案或者作为补充，可根据作用在连接元件上的轴向力提高或降低弯曲阻尼。如果在膝近似伸直的情况下轴向力以足够快速的程度降低直到近似于0，则这是引入上楼梯过程的指示。
作为补充或者作为替换方案，在轴向力下降的同时腿即大腿或小腿和髋的垂直加速可由用来激活用于上楼梯的相应的弯曲阻尼控制和伸展阻尼控制的触发来进行。此外，足够快速的髋弯曲在轴向力小或不存在的情况下可引起膝屈曲。取代轴向力还可检测膝伸开力矩、脚踝力矩或所述力和力矩的组合，以便可实现上楼梯模式。
低力矩的抬高的探测可纯机械地通过测头或通过力传感器或力矩传感器进行。测头例如可构造成一个支承在导向装置中的滑动件，该滑动件仅当假脚几乎垂直抬高时移动到使弯曲阻尼降低的转换位置中。力或力矩的测量可通过公知的传感器装置来进行。作为替换方案，低力矩的抬高可通过测量假脚的水平加速度和检测膝关节中的屈曲来进行。在假脚的水平加速度小的情况下，即在几乎垂直地抬高的情况下，与在平面中行走的情况不同地进行假膝关节中的大屈曲，这指示上楼梯。此外，可检测假脚中的前脚掌力矩，以便确定假肢使用者是否在行走期间想在水平方向上运动——这引起假脚中非常高的前脚掌负荷，或者确定是否在假脚着地时进行轴向力的降低以及膝关节中的弯曲。
为了达到在抬高之后超过台阶高度所需的弯曲，在抬高时相中通过被预加载的弹簧或其它力储存机构进行弯曲支持。如果在弯曲阻尼的降低完成之后经过了一定的时间，也可通过一个弹簧支持自由伸展。这出于安全原因是必需的，以便在错误地触发上楼梯模式时不陷入到不期望的阻尼控制中。
优选当假脚在抬高之后又着地时，例如当测得轴向力的提高时，提高弯曲阻尼以及必要时提高伸展阻尼。作为替换方案，在膝角近似保持恒定的情况下可提高伸展阻尼和弯曲阻尼。
弯曲阻尼可在抬高时相中降低到最小值，由此，在任何系统中起作用的阻尼由于摩擦不再提高。
不仅低力矩或无力矩的抬高的探测而且弯曲阻尼的降低的探测可机械地进行，不同阻尼的变化也可机械地进行，以便可实现尽可能简单的假肢结构。
附图说明
下面借助于附图详细说明一个实施例。
图1至图6示意性地示出了用被动膝关节假肢交替上楼梯的过程。
具体实施方式
图1中示出了一个带有膝关节假肢2的假肢穿戴者1，该膝关节假肢通过上侧的连接装置固定在大腿残肢上。假腿20与健康的对侧腿4站在一个楼梯台阶前面。
为了达到较高一级的台阶，必须绕楼梯棱边引导假脚6。如通过箭头7所示的主动的髋屈曲支持通过箭头8所示的被动的膝屈曲，该被动的膝屈曲由于假脚6的惯性以及从假膝关节2到假脚6的连接元件3的惯性而产生。为此需要最小的弯曲阻尼，以便在髋弯曲之后假脚6不向前摆动和朝踏步踢板运动或者运动到楼梯台阶5下方。在如图2中所示的抬起时相中目的在于，尽可能垂直向上地引导假脚6，必要时通过向后的轻微运动引入。对抬高的探测在此通过连接元件3与大腿之间的屈曲角α来进行或者通过在假脚6不弯曲的情况下连接元件3中的轴向力的减小来进行。上楼梯模式以及由此弯曲阻尼降低到低于正常摆动时相控制的值、优选降低到最小值也可通过假脚6向后的水平运动结合髋屈曲来探测。
在超过楼梯棱边并且如图2中所示的抬高时相结束之后，需要在楼梯台阶上可靠定位假脚6。为此必须使假脚6向前运动，这可以通过基于重力的伸展来进行。为此可以减小伸展阻尼，如果这在抬高时相中还没有进行的话。在伸开之前在弯曲和伸展中被充分阻尼的假膝关节2可实现通过假肢穿戴者1定位假脚6，其方式是改变髋角。在降低和髋伸开时相中，弯曲和伸展优选被强烈阻尼，以便除了控制着地之外还防止在髋伸开力矩不足的情况下自发回落。伸展保持被阻尼，以便可控制髋和膝伸开时的速度。这在图3中示出。
在图4中，着地时相结束。假肢穿戴者1可以通过髋伸开力矩开始膝伸开。膝伸开可通过健康脚的伸展来支持。
图5中示出了通过施加髋力矩而增加的膝伸开。增加的膝伸开使有效杠杆缩短并且使通过髋伸开进行的膝伸开容易。
图6中示出了设置有膝关节假肢2的腿的完全伸展。对侧腿4被引导从假腿20旁边经过并且放置到较高一级的台阶上，由此可用被动膝关节假肢交替上楼梯。
因此这样调节所述控制：在抬高假脚6期间调节弯曲阻力，该弯曲阻力允许可实现假脚6踏在紧下一个台阶上的膝角α。通过弹簧机构支持弯曲可使抬高和台阶高度的超过容易。
如果在通过探测到低力矩的抬高而触发上楼梯模式之后不要进行任何动作，则调节自由伸展，其中，自由伸展的调节根据时间进行。该时程(Zeitglied)也可机械地进行。如果健康腿首先着地并且第二个楼梯台阶才要由设置有假肢的腿超过，则低力矩的抬高的探测可通过惯性来进行。如果首先进行假脚的放松并且然后进行假膝关节中的屈曲，则应调节上楼梯。抬高时相之后、即髋伸开时相期间伸展方向上的以及弯曲方向上的阻尼都被保持，直到达到或者探测到假膝关节的完全伸展。

Claims (17)

1.在弯曲方向上具有可调阻尼的被动假膝关节的控制方法，该被动假膝关节用于使假肢装置与上楼梯动作相适配，该假肢装置具有一个上侧的连接装置和一个到假脚的连接元件，所述上侧的连接装置和该连接元件固定在该假膝关节上，所述控制方法具有以下步骤：
-探测假脚的低力矩的抬高，并且
-将弯曲阻尼在抬高时相中降低到适合于在平面中行走的水平以下。
2.根据权利要求1所述的控制方法，其特征在于：将伸展阻尼和/或弯曲阻尼在着地和髋伸开时相中提高到用于在平面中行走的摆动时相控制的阻尼以上的水平。
3.根据权利要求2所述的控制方法，其特征在于：将弯曲阻尼在着地时相中提高到最大值。
4.根据权利要求2或3所述的控制方法，其特征在于：将弯曲阻尼在着地和髋伸开时相中保持，直到髋完全伸开。
5.根据权利要求2或3所述的控制方法，其特征在于：根据膝角的变化提高弯曲阻尼，所述膝角为连接元件与大腿之间的屈曲角。
6.根据权利要求1-3之一所述的控制方法，其特征在于：根据作用在所述连接元件上的轴向力提高或降低弯曲阻尼。
7.根据权利要求1-3之一所述的控制方法，其特征在于：在抬高、着地和髋伸开时相期间调节伸展阻尼。
8.根据权利要求1-3之一所述的控制方法，其特征在于：所述低力矩的抬高的探测通过力传感器或力矩传感器来进行。
9.根据权利要求1-3之一所述的控制方法，其特征在于：所述低力矩的抬高的探测通过测量假脚的水平加速度和检测假膝关节中的屈曲来进行。
10.根据权利要求1-3之一所述的控制方法，其特征在于：所述低力矩的抬高的探测通过检测假脚中的前脚掌力矩来进行。
11.根据权利要求1-3之一所述的控制方法，其特征在于：在抬高时相中通过被预加载的弹簧机构进行弯曲支持。
12.根据权利要求1-3之一所述的控制方法，其特征在于：当假脚在抬高之后又着地时，开始提高弯曲阻尼和伸展阻尼。
13.根据权利要求12所述的控制方法，其特征在于：着地通过所述连接元件中或假脚中的轴向力测量来探测。
14.根据权利要求1-3之一所述的控制方法，其特征在于：将弯曲阻尼在抬高时相中降低到最小值。
15.根据权利要求1-3之一所述的控制方法，其特征在于：在弯曲阻尼的降低完成之后受时间控制地调节所述被动假膝关节的自由伸展。
16.根据权利要求15所述的控制方法，其特征在于：所述自由伸展受弹簧支持。
17.根据权利要求15或16所述的控制方法，其特征在于：该时间控制机械地或电子地进行。
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US20100228360A1 (en) 2010-09-09
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CN101453963A (zh) 2009-06-10
CA2651124C (en) 2015-01-20
JP2009536050A (ja) 2009-10-08
JP4718635B2 (ja) 2011-07-06
ES2349878T3 (es) 2011-01-12
TWI386194B (zh) 2013-02-21
EP2015712B1 (de) 2010-08-11
ATE476943T1 (de) 2010-08-15
US9248031B2 (en) 2016-02-02
TW200808279A (en) 2008-02-16
US20160030203A1 (en) 2016-02-04
RU2404730C2 (ru) 2010-11-27
CA2651124A1 (en) 2007-11-15
DE102006021802A1 (de) 2007-11-15
DE502007004728D1 (de) 2010-09-23
US20190274849A1 (en) 2019-09-12

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