DE102019118819A1 - Device for therapeutic movement support of a patient and for relieving the weight of the lower extremities of a patient, and movement device - Google Patents

Abstract

The present invention relates to a device (10) for therapeutic movement support of a patient during movement in a horizontal x / y plane and for relieving the weight of the lower extremities of a patient, comprising: - at least one first rope (11) for movement support and weight relief of the patient; - at least one first drive unit (12), which is connected to the first cable (11) in a force-transmitting manner for the transmission of a tensile force; 11); - at least one second movement device (15) with at least one second deflection unit (16) for guiding, in particular deflection, of the first rope (11); - a node unit (17) which is connected to the first rope (11) in a tensile force-transmitting manner and can be connected to the patient in order to absorb forces occurring when the patient moves, wherein d The first rope (11) extends from the first drive unit (12) to the first deflection unit (14), which deflects the first rope (11) in the direction of the second deflection unit (16), the first rope (11) extending from the first deflection unit (14) extends to the second deflection unit (16), which deflects the first rope (11) to the node unit (17), wherein at least one second rope (18), which carries the second movement device (15), so that the second movement device (15) is movable on the second rope (18) in the y-direction, the first rope (11) between the second deflection unit (16) and the node unit (17) having a rope angle, in particular a vertical rope angle, which is in the x-direction and in y direction is constant regardless of a position of the node unit (17) in a movement range (19). The invention also relates to a movement device.

Description

The invention relates to a device for therapeutic movement support of a patient and for relieving the weight of the lower extremities of a patient and a movement device. A device according to the preamble of claim 1 and the preamble of claim 27 is for example from the WO 2017/005661 A1 known.

In the rehabilitation of patients with neurological impairments, movement training in the form of gait and balance training is essential. In order to facilitate movement training, devices are known which take up part of the body weight by means of ropes in order to relieve the lower extremities of the patient. Such devices allow movement training of the patient in a three-dimensional movement range. The patient has the opportunity to move within this range of motion supported by weight. A device for weight relief is, for example, from DE 20 2007 015 508 U1 known.

Furthermore, devices for movement training of patients are often designed to exert active forces on the patient during movement, so that the patient has to follow predetermined movement patterns. From the aforementioned WO 2017/005661 A1 For example, a device for recording the body weight of a patient and for exerting forces on a patient is known. The device comprises two ropes, several drive units and deflection devices as well as a knot. The ropes are each connected to the node in a force-transmitting manner by one of the deflection devices. The node is coupled to the patient. Furthermore, the drive units are connected to the ropes for setting a rope force in such a way that a resultant force can be transmitted to the patient via the knot.

Another device for relieving the weight of patients is for example from WO 2013/117750 A1 known. The device comprises several ropes, drive units and deflection devices as well as a knot which is coupled to the free ends of the ropes and to the patient. The ropes extend from the drive units via the deflection devices to the knot to which the ropes are directly connected by the rope ends.

In the above-mentioned devices, two of the deflection devices are each movably arranged in such a way that they move laterally with the patient in the longitudinal direction of movement. The weight relief or exertion of force when the patient moves transversely to the longitudinal direction of movement is set via the rope lengths of the ropes and the drive units. Such devices are conventionally built into existing premises. The mostly limited drive power of the drive units results in a dependency of the maximum usable room width on the maximum available room height. In other words, a maximum usable range of motion for the patient transversely to the longitudinal direction of motion is limited by the maximum drive force of the drive units.

This has the disadvantage that the space available for exercise training of the patient cannot be fully utilized. Furthermore, if the patient is in a strongly lateral position in the area of movement, high rope forces are required in order to exert a horizontal force in the transverse direction of movement on the patient or to absorb the patient's body weight. In particular, if the patient falls in such a position, this results in uneven catching, as a result of which the patient swings to the shorter side. This disadvantageously leads to an increased energy requirement for the drive units. Furthermore, the devices have the disadvantage that they also catch the patient unevenly in the event of a malfunction, for example due to a broken rope, which increases the risk of injury to the patient.

The invention is therefore based on the object of specifying a device for therapeutic movement support and weight relief for patients, which, thanks to an improved structure, reliably supports the patient during movement training, has increased safety for the patient in the event of a malfunction, and saves costs and weight. The invention is also based on the object of specifying a movement device.

According to the invention, this object is achieved with regard to the device by the subject matter of claim 1 or by the subject matter of claim 27. With regard to the movement device, the above-mentioned object is achieved by the subject matter of claim 26.

• - wenigstens ein erstes Seil zur Bewegungsunterstützung und Gewichtsentlastung des Patienten;
• - wenigstens eine erste Antriebseinheit, die mit dem ersten Seil zur Übertragung einer Zugkraft kraftübertragend verbunden ist;
• - wenigstens eine erste Bewegungseinrichtung mit wenigstens einer ersten Umlenkeinheit zur Führung, insbesondere Umlenkung des ersten Seils;
• - wenigstens eine zweite Bewegungseinrichtung mit wenigstens einer zweiten Umlenkeinheit zur Führung, insbesondere Umlenkung des ersten Seils;
• - eine Knoteneinheit, die mit dem ersten Seil zugkraftübertragend verbunden ist und mit dem Patienten verbindbar ist, um bei einer Bewegung des Patienten auftretende Kräfte aufzunehmen. Das erste Seil erstreckt sich von der ersten Antriebseinheit zur ersten Umlenkeinheit, die das erste Seil in Richtung der zweiten Umlenkeinheit umlenkt. Ferner erstreckt sich das erste Seil von der ersten Umlenkeinheit zur zweiten Umlenkeinheit, die das erste Seil zur Knoteneinheit umlenkt.

Specifically, the object is achieved by a device for therapeutic movement support of a patient during movement in a horizontal x / y plane and for relieving the weight of the lower extremities of a patient, the device comprising the following:

• - at least one first rope for movement support and weight relief of the patient;
• - At least one first drive unit which is connected in a force-transmitting manner to the first cable for transmitting a tensile force;
• - At least one first movement device with at least one first deflection unit for guiding, in particular deflecting, the first rope;
• - At least one second movement device with at least one second deflection unit for guiding, in particular deflecting, the first rope;
• - A node unit which is connected to the first rope in a tensile force-transmitting manner and can be connected to the patient in order to absorb forces that occur when the patient moves. The first rope extends from the first drive unit to the first deflection unit, which deflects the first rope in the direction of the second deflection unit. Furthermore, the first rope extends from the first deflection unit to the second deflection unit, which deflects the first rope to the node unit.

According to the invention, the device has at least one second cable which carries the second movement device, so that the second movement device can be moved on the second cable in the y-direction of a movement range. Between the second deflection unit and the node unit, the first cable has a cable angle, in particular a vertical cable angle, which is constant in the x-direction and in the y-direction regardless of a position of the node unit in the range of motion.

The invention has several advantages. A tensile force can be easily and quickly transferred from the first drive unit to the node unit and thus to the patient during operation through the first rope. Furthermore, the first rope is inexpensive and has a low weight.

The first rope is deflected by the first and the second deflection unit from the first drive unit to the node unit. The node unit forms the interface between the device and the patient, the patient being coupled in a force-transmitting manner to the node unit during operation. The knot unit is not to be understood in the sense of a rope knot, but rather as a unit with which the first rope is brought together in order to transfer tensile forces to the patient during operation for movement support and weight relief.

The first movement device has the first deflection unit and the second movement device has the second deflection unit. The first movement device and the second movement device can be moved independently of one another. The deflection units lead the first rope from the first drive unit to the node unit and stabilize it in addition to the deflection function.

In operation, the node unit is coupled to a patient to transmit the tensile force of the first rope. The first drive unit applies a tensile force to the node unit through the first rope. The tensile force or the vertical force component of the tensile force counteracts the weight of the patient's body, thereby relieving the patient's lower extremities. This enables the patient to walk without having to carry their full body weight. There is also the possibility of transmitting a tensile force to the knot unit through the first rope in order to exert an active force on the patient. It is advantageous here that unpredictable movement situations are simulated in order to train the patient's balance or reflexes. The patient has to perform a stable walking movement against the pulling force acting on him.

The first rope forms a primary rope, in particular a main rope, through which the first drive unit actively applies a tensile force to the node unit, in particular the patient, during operation. The first rope has a pulling function and a carrying function with respect to the patient. In other words, when a tensile force is applied to the node unit, the weight of the patient is relieved by the first rope and the body weight is thus at least partially absorbed or carried by the first rope.

In contrast to the first rope, the second rope only has a support function in relation to the patient. During operation, the vertical force component of the tensile force of the first rope is absorbed by the second rope through the load-bearing function of the latter, so that the load on the first rope is advantageously relieved. The second rope forms a secondary rope through which the vertical force component of the rope pulling force of the first rope is absorbed during operation. The first rope and the first drive unit can therefore be made smaller, so that costs and weight can be saved. Furthermore, in the event of a fault in the first rope, for example in the event of a broken rope, the patient is better supported by the second rope. For this purpose, the device can have further first ropes. Patient safety is thus increased.

The first rope and the second rope are physically separated from one another. The second rope is provided independently of the first rope. In operation, the second movement device is on the second rope moved in y-direction of the range of motion. The second rope carries the second movement device and at least partially absorbs the patient's body weight during gait training. In addition, the second rope has a guiding function so that the second movement device is moved safely and stably in the y-direction.

When set up, the device spans a three-dimensional movement area in which the patient can move with movement support during gait training. The range of motion extends in an x-direction, in a y-direction and in a z-direction, the x-direction and the y-direction running in a horizontal plane. The movement area has at least two longitudinal sides and at least two broad sides, wherein the longitudinal sides can extend in the x direction and the broad sides can extend in the y direction. In this case, the x-direction corresponds to the longitudinal direction of the movement area and the y-direction corresponds to the transverse direction of the movement area. Alternatively, it is also conceivable that the longitudinal sides extend in the y direction and the broad sides extend in the x direction. In this variant, the y-direction corresponds to the longitudinal direction of the movement area and the x-direction corresponds to the transverse direction of the movement area. In general, it is also conceivable that the long sides and the broad sides are of the same size, so that the horizontal x / y extensions of the long sides and broad sides form a square.

The first movement device serves to move the second movement device and the node unit in the x-direction of the movement area. The second movement device is used to move the node unit in the y-direction of the movement area. In other words, the two movement devices serve to follow the node unit or the patient when moving in the x / y direction of the movement area.

The second movement device can be moved independently of a movement of the first movement device in the x direction on the second cable in the y direction. In other words, during operation the second movement device and thus the node unit follows the patient in the y-direction independently of a movement of the first movement device in the x-direction. This also applies when an active pulling force is exerted on the patient.

If the patient moves in the movement area in the x-direction and / or in the y-direction during gait training, the first and / or the second movement device follow the patient in such a way that the patient is securely held by the node unit. If an active pulling force is exerted on the patient, the patient is also held securely by the knot unit. The patient is thus carried by the first and the second movement device in the movement area at each x / y position by the node unit or subjected to an active tensile force.

The first cable extends from the first drive unit via the first deflection unit of the first movement device and the second deflection unit of the second movement device to the node unit, the first cable having a cable angle, in particular a vertical cable angle, between the second deflection unit and the node unit. This type of cable guide advantageously contributes to the fact that the cable layer or the cable angle, in particular vertical cable angle, of the first cable regardless of the size, in particular the length and width, in the x / y direction of the range of motion and the x / y -Position of the node unit in the range of motion is constant.

In contrast to the devices according to WO 2017/005661 A1 and WO 2013/117750 A1 the device according to the invention has a steep cable angle independent of an x / y position of the patient in the range of motion towards the node unit. During exercise training, a reduced drive power to be applied by the first drive unit is therefore required in order to reliably support the patient in the range of motion. This saves energy and thus costs. Furthermore, the first drive unit can be controlled by the constant cable angle of the first cable in the movement area at every x / y position of the movement area, independently of an x / y position of the patient. The device thus has increased efficiency due to the lower drive power required and the spatially independent control of the first drive unit. The device can be used efficiently in existing rooms of buildings regardless of the spatial conditions.

In the movement support of the patient during gait training, the first rope between the second deflection unit and the node unit has a constant rope angle, in particular a vertical rope angle. The rope angle is enclosed between the first rope and a horizontal x / y plane. Because of the second movement device that is movable in the y-direction, the cable angle, in particular vertical cable angle, is the same in operation at every x / y position in the movement area. The cable angle, in particular vertical cable angle, is independent of a width and length of the range of motion in the x / y direction. Due to the constant rope angle, the second rope and the second movement device, the patient is thus securely held or movement supported in the movement area at every x / y position.

Furthermore, the constant cable angle is dependent on a height position, in particular in the z direction, of the node unit. The height position is defined by the height of the respective patient. With a constant height position of the node unit, the cable angle is constant regardless of a position of the node unit in the x-direction and in the y-direction of the movement area. In other words, with the height position of the node unit between the second deflection unit and the node unit remaining the same, the first cable has a cable angle which is the same at every position in the x-direction and in the y-direction of the movement area.

In operation, a distinction is made between two patient movement situations. If the patient moves with a constant or even speed through the range of motion during gait training, this corresponds to a standard training situation. In the event of a rapid, jerky movement of the patient, for example due to a fall or tripping, the patient is held by the knot unit or the pulling force of the first rope.

In this special situation, the rope angle of the first rope changes briefly because the first rope is lengthened for cushioning and thus the knot unit is moved downwards in the z-direction. The extension of the first rope can be 10cm to 20cm. This is necessary to prevent injury to the patient from being caught too hard. In this case, for example, if the patient falls, the vertical cable angle between the second deflection unit becomes steeper, as a result of which the second movement device and thus the second cable absorb the patient's body weight in an improved manner. The patient is caught gently and safely. The node unit then moves back to the starting height position.

Other special situations can arise when the patient stoops or doing therapeutic exercises in which it is necessary to change the height position of the node unit. Other height-changing special situations are possible. In general, the rope angle of the first rope is constant again after a special situation. In other words, the special situation has no influence on the constant rope angle in a standard training situation. The rope angle, in particular the vertical rope angle, of the first rope is constant or the same in the standard training situation.

Preferred embodiments of the invention are specified in the subclaims.

In a particularly preferred embodiment, the first rope has a free end which is connected to the node unit for power transmission. More specifically, the first rope extends from the first drive unit via the first deflection unit and the second deflection unit to the node unit, the first rope ending at the node unit. The first rope can be attached to the knot unit in a structurally simple manner through the free rope end. The free end of the first rope can be directly connected to the node unit. The free end of the first rope can be connected to the node unit with a force fit and / or a friction fit. The free end of the first rope can be connected to the knot unit by clamping. It is advantageous here that the free rope end of the first rope transfers the rope pulling force directly to the knot unit, so that a fast and almost loss-free transfer of force is made possible between the first rope and the patient. In general, it is also conceivable that the first rope is indirectly connected to the node unit by the free ends. Here, at least one intermediate component is provided between the first cable and the node unit, which connects the first cable to the node unit in a tensile force-transmitting manner.

In a further particularly preferred embodiment, the node unit is arranged centrally in the z-direction, in particular in the vertical direction, below the second movement device, independently of a position of the node unit, in particular in the x-direction and in the y-direction, in the movement area. In other words, the second movement device is arranged in the z-direction above the node unit independent of a position of the node unit in the x-direction and y-direction of the movement area.

If the patient moves in the movement area in the x-direction and / or in the y-direction during gait training, the second movement device follows the patient in such a way that the patient is held centrally below the second movement device. If an active force is exerted on the patient, the patient is also held centrally below the second movement device by the node unit. The central arrangement of the node unit and thus of the patient is understood to mean that the patient is arranged centrally in a horizontal x / y plane below the second movement device. It is advantageous here that the patient is effectively relieved of weight or movement-supported during gait training by the co-moving second movement device at every horizontal x / y position in the movement area.

In a preferred embodiment, at least two first movement devices are provided, which are arranged opposite one another and can be moved in the x direction of the movement area, in particular parallel to one another. The second rope is stretched in the y-direction between the two first movement devices. The second rope is arranged transversely, in particular orthogonally, to the x-direction of the movement area. The second movement device on the second cable can be moved in the x direction. The first rope and the second rope are physically separated from one another.

During gait training, the node unit moves along with the patient in the x-direction and in the y-direction through the first movement devices and through the second movement device. The node unit to which the patient is connected can thus follow the patient in the x / y direction when walking and use an active force to specify a walking direction. This has the advantage that the patient is relieved of weight and movement supported at every x / y position in the range of motion.

Alternatively, it is also conceivable that the at least two first movement devices can be moved in the y direction of the movement area, in particular parallel to one another. Here, the second rope is stretched in the x direction between the two first movement devices.

In a further preferred embodiment, the second rope has two free ends which are each fastened to a first movement device under tension. The second rope is arranged in a fixed position in the y-direction. In other words, the second rope is immobile in the y direction. The free ends of the second rope can be firmly connected to the first movement devices. The free ends of the second rope can be firmly connected to the first movement devices by clamping and / or by at least one adapter element. The second rope can be put under tension between the two first movement devices by at least partially rotating the adapter element. It is advantageous here that the cable ends of the second cable can be attached to the first movement devices in a simple, constructive manner, and thus the costs are kept low.

The first movement devices preferably each comprise a further deflection unit which deflects the second rope at the respective first movement device. In this variant, the second rope has two free ends which are attached to the second movement device under tension. The second rope can be moved in the y-direction by the further deflection unit of the first movement devices and the attachment of the two free ends to the second movement device. In other words, the two free ends of the second rope move with the second movement device when the second movement device moves in the y-direction of the movement area. Depending on the direction of movement of the patient, the second rope can pull the second movement device in the y-direction through the rope ends in order to follow the patient. In other words, the second rope can pull the second movement device in the transverse direction of movement of the patient. This improves the response behavior of the second movement device when moving in the y direction. The second movement device thus follows the patient precisely and without delay in the y-direction, so that the patient's sense of security during gait training is increased.

More preferably, the second rope forms a rope loop with two parallel rope sections which are arranged in a horizontal plane or a vertical plane. In other words, the rope loop is preferably arranged lying in a horizontal x / y plane, the two parallel rope sections running in the horizontal x / y plane. The rope sections are arranged horizontally next to one another. Alternatively, the rope loop can be arranged lying in a vertical plane. The two parallel rope sections run in the vertical plane. The rope sections are arranged vertically one above the other.

In a preferred embodiment, the second movement device has at least one movement device, in particular a rope pulley, through which the second movement device is movably guided in the y-direction of the movement area on the second cable. The second movement device preferably rolls on the second cable during a movement in the y direction by the movement means. The moving means can be formed by a pulley. The second movement device can have at least two, in particular four, rope pulleys, by means of which the second movement device can be moved in the y direction by rolling on the second rope. As a result of the rolling or the low rolling friction, the second movement device can advantageously react quickly and precisely to the walking direction of the patient, so that the patient is supported safely and stably.

In an alternative embodiment, the second movement device is firmly connected by clamping on the second rope. The second movement device is moved by moving the second rope in the y-direction. The clamping connection increases the positional stability of the second movement device, which enables safe and effective movement support for the patient.

In a preferred embodiment, the first drive unit puts the first rope under tension during operation in such a way that the first rope due to the rope reaction forces that occur on the first deflection unit and the second deflection unit moves the first movement device and / or the second movement device in the x-direction and / or y-direction depending on a direction of movement of the node unit. In other words, by means of the first drive unit, the first movement device and the second movement device can be moved in the horizontal x-direction and the horizontal y-direction via the cable reaction forces on the deflection units. This has the advantage that there is no need for a drive for moving the movement devices in the x-direction and in the y-direction, which saves costs. Furthermore, a structural design of the device is simplified as a result.

The first drive unit applies a rope force to the node unit in order to support the patient during gait training or to take up his body weight, so that the weight of the lower extremities is relieved. If the patient walks through the range of motion during operation, in particular in the x-direction and / or y-direction, the first drive unit reacts to the change in position of the node unit. The first drive unit can be configured in such a way that a constant tensile force is applied to the first cable regardless of a direction of movement of the patient. The first drive unit can be designed in such a way that, during operation, a required cable force to support the patient's movement is essentially constant, regardless of an x / y position in the movement range. Furthermore, the first drive unit can be configured to change the rope length of the first rope depending on a direction of movement of the patient with a constant rope force. In other words, the first drive unit controls the rope length of the first rope depending on the position of the node unit in the range of motion. In special situations, for example in the event of a fall, the first drive unit can briefly extend the rope length of the first rope in order to achieve a soft catching of the patient.

The first movement device preferably has at least one second drive unit which is arranged on the first movement device and moves the first movement device and the second movement device in the x-direction during operation. The second movement device also preferably has at least one third drive unit which is arranged on the second movement device and moves the second movement device in the y-direction during operation. The second and third drive units can each form a linear drive. The second drive unit is used to move the movement devices in the x direction of the movement range in order to follow the patient during gait training. Furthermore, the third drive unit serves to move the second movement device in the y direction of the movement area. The patient is thus advantageously supported at every horizontal x / y position in the range of motion. It is also advantageous that control of the first drive unit is significantly simplified since the movement of the node unit in the x / y direction is carried out by the second and third drive units.

In a preferred embodiment, the respective deflection unit has at least one rope pulley which deflects the first rope. The rope pulley deflects the first rope easily and stably and with low friction losses. Furthermore, the pulley is inexpensive to purchase, which keeps the overall costs low.

In a particularly preferred embodiment, the second movement device has a rigid frame on which the at least one movement means and the at least one second deflection unit are arranged. In other words, the movement means and the second deflection unit are attached to the rigid frame. The second deflection unit deflects the first rope at a fixed position on the frame towards the node unit. The second deflection unit is relatively spaced from the node unit. The second deflection unit is at a constant distance from the node unit, so that the cable angle, in particular vertical cable angle, of the first cable between the second deflection unit and the node unit is constant. The special situations described above are excluded here, the rope angle, in particular vertical rope angle, of the first rope being constant again after such a special situation. The second rope also bears the weight of the rigid frame. In particular in the case of a special situation such as, for example, a fall of the patient, the force occurring and the weight of the frame is absorbed by the second rope.

The second deflection unit can be arranged on an underside of the frame facing the node unit. Furthermore, the movement means can be arranged on an upper side of the frame facing away from the node unit. In other words, the second deflection unit and the movement means can be arranged opposite one another in the z-direction on the frame.

The frame has the advantage that it can be manufactured easily and inexpensively. Furthermore, the frame advantageously has a low weight with high stability at the same time. The frame can advantageously serve as a carrier for other components, such as measuring instruments and drives.

The frame can be formed by a profile frame. The frame can be in cross section be rectangular. The frame can be square. The frame can be designed symmetrically. The frame is movably or firmly connected to the second rope by the at least one moving means. The frame can have at least one transverse side on which at least two movement means are arranged. The movement means can be arranged at a distance from one another on the transverse side. The second cable can have a horizontal cable section between the two movement means, regardless of a position in the y-direction.

In a preferred embodiment, the second deflection unit is arranged on the rigid frame in such a way that, during operation, the second rope absorbs the vertical rope forces of the first rope. This has the advantage that, for example, if the patient falls, the forces that occur are introduced into the rigid frame via the first rope and the second deflection unit and transferred to the second rope. The first rope as well as the first drive unit are relieved and can therefore be designed precisely for the movement support according to requirements, without having to take into account force peaks in the vertical direction. This significantly improves the efficiency of the device. Furthermore, costs are saved.

In a further preferred embodiment, the first movement devices are each formed by a slide which can be moved in the x direction and on which the first deflection unit and / or the further deflection unit for the second cable are arranged. The slide can be guided movably by a rail in the x-direction of the movement area. The carriage can be pivotable to the second deflection unit. As an alternative or in addition, the first deflection unit can be pivotable relative to the second deflection unit. The carriage follows the node unit when the patient moves in the x direction of the movement area.

In a further preferred embodiment, the first deflection unit deflects the first rope to the second deflection unit in an essentially horizontal direction, in particular two-dimensionally, and the second deflection unit deflects the first rope towards the node unit in at least one horizontal and one vertical direction, in particular three-dimensionally. In other words, the first cable runs from the first deflection unit to the second deflection unit essentially in a horizontal plane. The second deflection unit deflects the first rope in such a way that the first rope has a height offset and a lateral offset from the second deflection unit to the node unit. Between the first deflection unit and the second deflection unit, the first rope can have a horizontal rope section which is vertically spaced from the node unit. This type of cable guide has the advantage that the cable position or the cable angle are constant regardless of the size, in particular the length and width, the range of motion and the position of the node unit in the range of motion. The device can thus be used efficiently in existing rooms of buildings regardless of the room dimensions.

The node unit preferably has at least one third deflection unit, which deflects the first rope and, during operation, applies a tensile force to the node unit. The second movement device also preferably has at least one fourth deflection unit and the first movement device has at least one fifth deflection unit, the first rope extending from the third deflection unit to the fourth deflection unit, which deflects the first rope in the direction of the fifth deflection unit. The first rope then extends from the fourth deflection unit to the fifth deflection unit, which deflects the first rope in the direction of at least one fourth drive unit. The fourth drive unit is connected in a force-transmitting manner to the first cable in order to transmit a further tensile force. In other words, the first cable extends from the first drive unit via the first and second deflection units to the third deflection unit of the node unit. The first cable extends from the third deflection unit via the fourth and fifth deflection unit to the fourth drive unit. The first cable extends continuously from the first drive unit via the node unit to the fourth drive unit. In other words, the first and fourth drive units are connected to one another by the first cable, with the node unit being able to be subjected to a tensile force by the first cable. It is advantageous here that only a single, continuous first rope is required to support the patient's movement, which simplifies the structure of the device.

In a particularly preferred embodiment, the device comprises at least four, in particular exactly four, first ropes for movement support and weight relief of a patient and at least four, in particular exactly four, first drive units, each of which is force-transmittingly connected to one of the first ropes for transmitting a tensile force. Furthermore, the device preferably has at least four, in particular exactly four, first movement devices, each with at least one first deflection unit and at least one second movement device with at least four, in particular exactly four, second deflection units for deflecting the respective first cable. Furthermore, a node unit is preferably provided, which is connected to the four first cables in a tensile force-transmitting manner. The respective first rope extends from the associated first Drive unit for the first deflection unit, which deflects the first rope in the direction of the second deflection unit. The first rope also extends from the first deflection unit to the second deflection unit, which deflects the first rope to the node unit. It is advantageous here that the tensile force required to support the patient's movement on the node unit can be precisely adjusted by the four first drive units and the four first ropes. The patient's body weight can thus be better recorded at every position in the range of motion.

In a further particularly preferred embodiment, the first cables between the second deflection units and the node unit each have a cable angle, in particular a vertical cable angle, which is constant in the x-direction and in the y-direction regardless of a position of the node unit in the range of motion. In other words, in the movement support of the patient during gait training, the four first ropes between the respective second deflection unit and the node unit have a constant rope angle. The rope angle is enclosed between the respective first rope and a horizontal x / y plane. The rope angle is dependent on a height position, in particular in the z direction, of the node unit. The height position is determined by the height of the respective patient. With a constant height position of the node unit, the cable angle is constant regardless of a position of the node unit in the x-direction and in the y-direction of the movement area. In other words, with the height position of the node unit between the second deflection unit and the node unit remaining the same, the four first cables have a cable angle which is the same at every position in the x-direction and in the y-direction of the movement area.

In a preferred embodiment, the first ropes each have a free end which is connected to the node unit for power transmission. In other words, the first four ropes end at the node unit. The free ends of the first cables can be directly connected to the node unit. The free ends of the first ropes can be frictionally connected to the node unit. The free ends of the first cables can be connected to the node unit by clamping. It is advantageous here that the first ropes with the free rope ends directly transfer the rope tensile force to the knot unit, so that a fast and almost loss-free power transmission between the first rope and the patient is made possible. It is also conceivable that the first four ropes are indirectly connected to the node unit by the free rope ends.

In a further preferred embodiment, the second movement device has a rigid frame on which the four second deflection units are arranged such that the four first cables on the frame are deflected at a fixed distance from one another towards the node unit. The second deflection units are relatively spaced from the node unit. The second deflection units are at a constant distance from the node unit, so that the cable angles, in particular vertical cable angles, of the first cables between the second deflection units and the node unit are constant. The special situations described above are excluded here, with the rope angles, in particular vertical rope angles, of the first ropes being constant again after such a special situation.

This has the advantage that the deflection points of the first ropes on the frame are always at the same distance from one another and thus the rope angles between the second deflection units and the junction unit are constant.

Preferably, two of the first movement devices, which are arranged movably on a common longitudinal axis, are connected to one another by an intermediate element, in particular a rod or an intermediate rope. The two first movement devices form a longitudinal movement pair which is arranged to be movable in the x direction of the movement area. The first deflection units of the two movement devices in each case have a constant distance from one another during operation.

Furthermore, the two first movement devices are preferably kept under tension during operation by the cable reaction forces of the at least one first cable or of at least two first cables on the first deflection units, so that the first movement devices are at a constant distance from one another. The constant distance can correspond to the distance between the second deflection units on the rigid frame, so that the first cables are deflected essentially orthogonally from the first deflection units to the second deflection units in the horizontal x / y plane to the x direction.

In one embodiment, at least four second ropes are provided which hold or move the second movement device in a floating manner in the movement area. For this purpose, four further drive units can be provided, which apply a tensile force to the respective second rope. This has the advantage that the movement means of the second movement device are dispensed with and costs are saved by reducing the number of components. It is also advantageous here that the second ropes lower the second movement device, for example in the event of a fall or during therapeutic exercises can. In this case, the rope angle remains constant even in these special situations. Another advantage is the simplification of the control of the first drive units.

According to the independent claim 26, the invention relates to a movement device for therapeutic movement support and weight relief of a patient when moving in an x / y plane with a frame, at least two movement means and at least four deflection units which are arranged on the frame at a fixed distance from one another. The deflection units are designed to deflect a cable to a node unit for movement support and weight relief of a patient, in particular three-dimensionally, which is arranged centrally between the deflection units. In addition, the movement means are arranged on the frame and can be connected to at least one load-bearing rope, so that the movement device can be moved in the y-direction through the load-bearing rope. Reference is made here to the advantages explained in connection with the device. In addition, the movement device can alternatively or additionally have individual features or a combination of several features mentioned above with regard to the device.

• - ein oder mehrere erste Seile, wobei jedes erste Seil wenigstens ein Seilstück aufweist;
• - wenigstens eine erste Antriebseinheit und wenigstens eine erste Umlenkeinheit, wobei sich das Seilstück von der ersten Antriebseinheit zu der ersten Umlenkeinheit erstreckt und von dieser umgelenkt wird; und
• - wenigstens ein Verbindungsmittel, das mit dem Seilstück verbunden ist und mit einem Patienten verbindbar ist, um Kräfte und/oder Momente auf den Patienten auszuüben und/oder aufzunehmen.

According to the independent claim 27, the invention relates to a device for therapeutic movement support of a patient during movement in a horizontal x / y plane and for relieving the weight of the lower extremities of a patient comprising:

• one or more first ropes, each first rope having at least one piece of rope;
• - At least one first drive unit and at least one first deflection unit, wherein the piece of cable extends from the first drive unit to the first deflection unit and is deflected by this; and
• - At least one connecting means that is connected to the piece of rope and can be connected to a patient in order to exert and / or absorb forces and / or moments on the patient.

According to the invention, at least one first deflection means is provided, which is arranged between the first deflection unit and the connecting means and can be moved along in a movement area in the direction of movement of the patient. The piece of rope extends from the first deflection unit to the first deflection means. The first deflection means deflects the piece of rope in such a way that the piece of rope between the first deflection means and the connecting means has a rope angle, in particular a vertical rope angle, which is constant in the x-direction and in the y-direction regardless of a position of the connecting means in the range of motion. The first deflection means corresponds to the second movement device according to claim 1. Furthermore, the connection means corresponds to the node unit according to claim 1.

In a particularly preferred embodiment, the first deflecting means has a rigid frame which deflects the piece of rope at a fixed position towards the connecting means.

In a preferred embodiment, the rope piece has a free end which is connected to the connecting means for power transmission.

In a further preferred embodiment, at least one second deflection unit and at least one second drive unit or at least one winch are provided, the piece of cable extending from the deflection means to the second deflection unit and being deflected by the latter. The piece of rope is connected to the first deflection unit, and the piece of rope from the second deflection unit is deflected to the second drive unit or to the winch, the piece of rope extending from the first drive unit to the second drive unit or to the winch.

The invention is explained in more detail below with further details with reference to the accompanying drawings. The illustrated embodiments represent schematic examples of how the device according to the invention and the movement device according to the invention can be configured.

• 1 eine Draufsicht einer Vorrichtung nach einem bevorzugten erfindungsgemäßen Ausführungsbeispiel;
• 2 eine erste Seitenansicht, insbesondere in Längsrichtung, der Vorrichtung gemäß 1;
• 3 eine zweite Seitenansicht der Vorrichtung gemäß 1, wobei eine Bewegungseinrichtung und weitere Teile der Vorrichtung gezeigt sind;
• 4 eine Draufsicht einer Vorrichtung nach einem weiteren bevorzugten erfindungsgemäßen Ausführungsbeispiel;
• 5 eine erste Seitenansicht, insbesondere in x-Richtung, der Vorrichtung gemäß 4; und
• 6 eine zweite Seitenansicht der Vorrichtung gemäß 4, wobei eine Bewegungseinrichtung und weitere Teile der Vorrichtung gezeigt sind.

In these show

• 1 a plan view of a device according to a preferred embodiment of the invention;
• 2 a first side view, in particular in the longitudinal direction, of the device according to 1 ;
• 3 a second side view of the device according to 1 wherein a moving device and further parts of the device are shown;
• 4th a plan view of a device according to a further preferred embodiment of the invention;
• 5 a first side view, in particular in the x direction, of the device according to FIG 4th ; and
• 6th a second side view of the device according to 4th , wherein a moving device and further parts of the device are shown.

The 1 to 3 each show a schematic representation of a device 10 for therapeutic movement support of a patient during movement in a horizontal x / y plane and for relieving the weight of the lower extremities of the patient according to a preferred embodiment of the invention.

The device 10 includes a three-dimensional movement area when assembled 19th , in which the patient can move with support during gait training. The range of motion 19th extends in an x direction, in a y direction and in a z direction, the x direction and the y direction running in a horizontal plane. The range of motion 19th has two long sides 36 and two broadsides 37 on. According to the 1 to 3 extend the long sides 36 in the x-direction and the broad sides 37 in the y-direction of the range of motion 19th . In other words, the x-direction corresponds to the longitudinal direction of the range of motion 19th and the y-direction is the transverse direction of the range of motion 19th . The long sides 36 the range of motion 19th can alternatively also extend in the y-direction and the broad sides 37 in X direction. In this alternative variant, the y-direction corresponds to the longitudinal direction of the range of motion 19th and the x-direction of the transverse direction of the movement area 19th .

According to 1 is the device 10 shown in a top view. The device 10 has four first ropes 11 for movement support and weight relief for the patient and four first drive units 12 on, each with one of the first ropes 11 are connected to transmit a tensile force to the patient. Two of the first drive units each 12 are on each of the long sides 36 the range of motion 19th arranged opposite one another in the x direction.

Furthermore, the device 10 four first movement devices 13 on each of which a first deflection unit 14th and another deflection unit 23 is arranged. The first deflection unit 14th is used to guide, in particular deflect, the first rope 11 on the first movement device 13 . On the other deflection unit 23 will be discussed in more detail later.

As in 1 is shown, each form two of the first movement devices 13 a pair of longitudinal movements 32 . The first two movement devices 13 of the longitudinal movement pair 32 are on a common longitudinal axis L. movably arranged. As in 1 recognizable, the longitudinal axis extends L. in the x-direction of the range of motion 19th . In other words, the first are moving devices 13 or the carriage 29 arranged to be movable in the x direction. There is one of the two pairs of longitudinal movements 32 on one of the two long sides 36 the range of motion 19th arranged. The longitudinal movement pairs 32 are on the long sides 36 the range of motion 19th arranged opposite one another. The longitudinal movement pairs 32 are in the x direction, in particular the longitudinal direction, along the longitudinal axis L. movable parallel to each other.

The longitudinal movement pairs 32 are arranged at a distance from one another in the y direction or in the transverse direction. The distance between the two pairs of longitudinal movements 32 defines the size of the broad sides 37 the range of motion 19th . In other words, limit the longitudinal movement pairs 32 the range of motion 19th along the length, especially in the y-direction. To limit the range of motion 19th to clarify in the y-direction are in 2 schematic side walls SW shown. These are also in 5 evident.

The first two movement devices 13 of the longitudinal movement pairs 32 are through an intermediate element 31 connected with each other. The intermediate element 31 is formed by an intermediate rope. The first two movement devices 13 each pair of longitudinal movements 32 are in operation or during gait training of the patient due to the rope reaction forces of the first four ropes 11 at the associated first deflection units 14th continuously tensioned in opposite x-directions. The first movement devices 13 each pair of longitudinal movements 32 thus have a constant distance from one another during operation. Alternatively, the intermediate element 31 be formed by a rigid element, in particular a rod.

The device 10 further comprises a second movement device 15th and a node unit 17th . The node unit 17th is with the first four ropes 11 Connected to transmit traction and to the body KP of a patient can be connected for movement support and weight relief. The second movement device 15th serves to move the node unit 17th in the y-direction of the range of motion 19th . The first movement devices 13 or the two pairs of longitudinal movements 32 serve to move the second movement device 15th and the node unit 17th in the x direction, in particular in the longitudinal direction of the range of motion 19th . In other words, the movement devices serve 13 , 15th to this, the node unit 17th when the patient moves in the x / y direction of the range of motion 19th to follow, so that the patient is in the range of motion at every horizontal x / y position 19th is continuously supported.

The first drive units 12 move the first ropes during operation 11 so under tension that the first ropes 11 through the occurring rope reaction forces at the first deflection units 14th and the second deflection units 16 the first movement device depending on a direction of movement of the patient 13 and / or the second movement device 15th moved in the x-direction and / or in the y-direction. In other words, the first are drive units 12 controllable in such a way that the movement devices 14th , 15th during gait training of the knot unit 17th or follow the patient when he is in the range of motion 19th emotional.

The second movement device 15th has a rigid frame 28 and four second deflection units 16 for guiding, in particular redirecting, the respective first rope 11 on. The four second deflection units 16 are on the rigid frame 28 arranged spaced from each other. On the second movement device 15th or the frame 28 will be discussed in more detail later.

As in 1 can be seen, have the first deflection units 14th and the second turning units 16 one pulley each 27 on the first four ropes 11 redirect. The deflection units 14th , 16 can also have more than one pulley 27 to divert the first four ropes 11 exhibit.

According to 1 to 3 the first four ropes extend 11 from the first drive units 12 to the first deflection units 14th that the respective first rope 11 in the direction of the second deflection units 16 redirect. Then the first ropes extend 11 from the first deflection units 14th to the second deflection units 16 who have favourited the first ropes 11 to the node unit 17th redirect. The four second deflection units 16 steer the first ropes 11 at a fixed position on the frame 28 to the node unit 17th around. The first ropes 11 each have a free end 21st on that with the node unit 17th is force-transmitting connected. In other words, the first four ropes extend 11 from the first drive units 12 via the deflection units 14th , 16 to the node unit 17th , with the first four ropes 11 on the node unit 17th end up.

The node unit is in operation 17th with the body KP of a patient connected. When the patient is gait training, the first drive units 12 and the first ropes 11 the node unit 17th A requirement-specific tensile force is applied so that the patient's lower extremities are relieved of weight. This allows the patient to move within the range of motion 19th move without having to carry your full body weight. Furthermore, active tensile forces can be exerted on the patient in order to train the patient's balance or reflexes.

According to the 1 to 3 assign the first four ropes 11 between the second deflection units 16 and the node unit 17th each has a cable angle, in particular a vertical cable angle, which is independent of a position of the node unit in the x-direction and in the y-direction 17th in the range of motion 19th is constant. The rope angle is between the first ropes 11 and an imaginary horizontal x / y plane included. The rope angle is dependent on a height position, in particular in the z direction, of the node unit 17th .

The height position is defined by the height of the respective patient. The rope angle is therefore with a constant height position of the node unit 17th regardless of a position of the node unit 17th in the x-direction and in the y-direction of the range of motion 19th constant. In other words, the first ropes show 18th with the same height position of the node unit 17th between the second deflection units 16 and the node unit 17th at each position in the x-direction and in the y-direction of the range of motion 19th is equal to. Only in special situations, for example if the patient falls or stoops, does the rope angle of the first ropes change 11 briefly in order to catch the patient gently and safely or to allow the patient the necessary freedom of movement to practice his therapeutic exercises.

According to the 1 to 3 steer the first four deflection units 14th the first ropes 11 to the second deflection units 16 in a substantially horizontal direction, in particular two-dimensionally, around and the second deflection units 16 the first ropes 11 to the node unit 17th in a horizontal and a vertical direction, in particular three-dimensionally. In other words, the first ropes extend 11 from the first deflection units 14th to the second deflection units 16 essentially in a horizontal plane. The first ropes 11 are through the first deflection units 14th in the direction of the second deflection units 16 horizontally deflected essentially orthogonally to the x-direction or longitudinal direction. The second deflection units 16 steer the first ropes 11 in such a way that this is from the second deflection units 16 to the node unit 17th have a height offset and a lateral offset in the x-direction and in the y-direction. Between the first deflection units 14th and the second deflection units 16 show the first ropes 11 a substantially horizontal section of rope extending from the knot unit 17th is vertically spaced.

According to 2 is the node unit 17th vertically below the second moving device 15th arranged. The node unit 17th is independent of a position of the node unit 17th in the x-direction and y-direction of the range of motion 19th centrally below the second movement device 15th arranged. In other words, is the node unit 17th vertically below the second moving device 15th arranged in the middle in x / y direction. This is in 1 good to see.

The device 10 according to 1 to 3 also has two second ropes 18th on which the second movement device 15th wear so that the second movement device 15th on the second ropes 18th in the y direction, in particular the transverse direction, of the range of motion 19th is movable. The second ropes 18th and the first four ropes 11 are physically separated from each other.

The two second ropes 18th are in the y-direction between the two pairs of longitudinal movements 32 curious; excited. There is a second rope in each case 18th between two first movement devices arranged opposite one another in the y-direction, in particular the transverse direction 13 the two long sides 36 curious; excited. The respective second rope 18th extends between the further deflection units 23 of the two first movement devices arranged opposite one another in the y-direction 13 . The other deflection units 23 steer the second ropes 18th at the first movement devices 13 or the two pairs of longitudinal movements 32 in the direction of the second movement device 15th around. The other deflection units 23 are each formed by a pulley, which is the second rope 18th on the first movement device 13 diverts.

As in the 1 to 3 can be seen, have the second ropes 18th two free rope ends each 22nd on that on the rigid frame 28 the second moving device 15th are attached under tension. The second ropes 18th each form a rope loop 24 with two parallel rope sections 25th .

According to 1 shows the rigid frame 28 a square shape in cross section. The frame can be formed by a profile frame. The frame can have a rectangular cross section. The frame 28 is symmetrical. The frame 28 has two transverse sides that extend in the y-direction or in the transverse direction of the movement area 19th extend.

The second movement device 15th has a total of four means of movement 26th on which the second movement device 15th in the y-direction of the range of motion 19th on the second ropes 18th lead flexibly. Specifically, the second movement device 15th four pulleys 33 when the patient moves in the y-direction on the second rope 18th roll off. Two of the four pulleys each 33 are the transverse side of the rigid frame 28 arranged. The frame 28 is through the pulleys 33 with the second ropes 18th movably connected. The second deflection units 16 are on the rigid frame 28 arranged so that in operation the second ropes 18th the vertical rope forces of the first ropes 11 take up. The two pulleys each 33 are on the associated second rope 18th arranged. According to 2 shows the associated second rope 18th between the two pulleys 33 a horizontal section of rope 34 on.

When the patient is gait training, the vertical rope component of the patient's weight or the force that occurs, for example in the event of a fall or when an active force is exerted on the patient, is passed through the first ropes 11 via the second deflection units 16 in the rigid frame 28 initiated and over the pulleys 33 on the second ropes 18th transfer. This makes the first ropes advantageous 11 as well as the first drive units 12 relieved.

The 4th to 6th each show a schematic representation of a device 10 for therapeutic movement support of a patient during movement in a horizontal x / y plane and for relieving the weight of the lower extremities of the patient according to a further preferred exemplary embodiment according to the invention.

In contrast to the device 10 according to the 1 to 3 instructs the device 10 according to the 4th to 6th two second ropes 18th on that with the free ends 22nd each on the first movement devices arranged opposite one another in the y-direction 13 are attached. In other words, the ends of the rope end 22nd of the two ropes 18th at the first movement devices 13 and not, as in the 1 to 3 shown on the rigid frame 28 the second moving device 15th . Instead of the other deflection units 23 instructs the device 10 according to 4th to 6th at the first movement devices 13 at least one fixed bearing element each 35 at which the respective rope end 22nd is fixed under tension.

List of reference symbols

10

contraption

11

first rope

12

first drive unit

13

first movement device

14th

first deflection unit

15th

second movement device

16

second deflection unit

17th

Node unit

18th

second rope

19th

Range of motion

21st

free end of the first rope

22nd

free ends of the second rope

23

further deflection unit

24

Rope loop

25th

Rope sections

26th

Means of Movement

27

Pulley

28

rigid frame

29

Sledge

31

Intermediate element

32

Longitudinal movement pair

33

Pulley

34

horizontal rope section

35

Fixed bearing element

36

Long side

37

Broadside

L.

Longitudinal axis

KP

Body of a patient

SW

side walls

QUOTES INCLUDED IN THE DESCRIPTION

This list of the documents listed by the applicant was generated automatically and is included solely for the better information of the reader. The list is not part of the German patent or utility model application. The DPMA assumes no liability for any errors or omissions.

Patent literature cited

• WO 2017/005661 A1 [0001, 0003, 0023]
• DE 202007015508 U1 [0002]
• WO 2013/117750 A1 [0004, 0023]

Claims (30)

Device (10) for therapeutic movement support of a patient during movement in a horizontal x / y plane and for relieving the weight of the lower extremities of a patient, comprising: - at least one first rope (11) for movement support and weight relief of the patient; - At least one first drive unit (12) which is connected in a force-transmitting manner to the first cable (11) for transmitting a tensile force; - At least one first movement device (13) with at least one first deflection unit (14) for guiding, in particular deflecting, the first cable (11); - At least one second movement device (15) with at least one second deflection unit (16) for guiding, in particular deflection, of the first rope (11); - A node unit (17) which is connected to the first cable (11) in a tensile force-transmitting manner and can be connected to the patient in order to absorb forces occurring when the patient moves, the first cable (11) extending from the first drive unit (12) to the first deflection unit (14) which deflects the first rope (11) in the direction of the second deflection unit (16), wherein the first rope (11) extends from the first deflection unit (14) to the second deflection unit (16) which the first rope (11) deflects to the node unit (17); characterized by at least one second rope (18) which carries the second movement device (15), so that the second movement device (15) on the second cable (18) can be moved in the y-direction of a movement area (19), the first cable (11) between the second deflection unit (16) and the node unit (17) has a cable angle, in particular a vertical cable angle, which is constant in the x-direction and in the y-direction regardless of a position of the node unit (17) in the range of motion (19) is. Device according to Claim 1 , characterized in that the first rope (11) has a free end (21) which is connected to the node unit (17) for power transmission. Device according to Claim 1 or 2 , characterized in that the node unit (17) is arranged centrally in the z-direction, in particular in the vertical direction, below the second movement device (15) regardless of a position of the node unit (17), in particular in the x-direction and in the y-direction . Device according to one of the preceding claims, characterized in that at least two first movement devices (13) are provided, which are arranged opposite one another and can be moved in the x direction of the movement area (19), in particular parallel to one another, the second rope (18 ) is stretched in the y direction between the two first movement devices (13). Device according to one of the preceding claims, characterized in that the second cable (18) has two free ends (22) which are each fastened to a first movement device (13) under tension. Device according to one of the preceding claims, characterized in that the first movement devices (13) each comprise a further deflection unit (23) which deflects the second rope (18) at the respective first movement device (13), and the second rope (18) has two free ends (22) which are attached to the second movement device (15) under tension. Device according to one of the preceding claims, characterized in that the second rope (18) forms a rope loop (24) with two parallel rope sections (25) which are arranged in a horizontal plane or a vertical plane. Device according to one of the preceding claims, characterized in that the second movement device (15) has at least one movement means (26), in particular a rope pulley, by which the second movement device (15) in the y-direction of the movement area (19) on the second Cable (18) is movably guided. Device according to one of the preceding claims, characterized in that the second movement device (15) rolls on the second cable (18) during a movement in the y-direction by the movement means (26). Device according to one of the preceding claims, characterized in that the first drive unit (12) puts the first rope (11) under tension during operation in such a way that the first rope (11) due to the rope reaction forces occurring at the first deflection unit (14) and the second deflection unit (16) moves the first movement device (13) and / or the second movement device (15) in the x-direction and / or y-direction depending on a direction of movement of the node unit (17). Device according to one of the preceding claims, characterized in that the first movement device (13) has at least one second drive unit which is arranged on the first movement device (13) and in operation the first movement device (13) and the second movement device (15) in x-direction moves. Device according to one of the preceding claims, characterized in that the second movement device (13) has at least one third drive unit which is arranged on the second movement device (13) and moves the second movement device (13) in the y-direction during operation. Device according to one of the preceding claims, characterized in that the respective deflection unit (14, 16) has at least one rope pulley (27) which deflects the first rope (11). Device according to one of the preceding claims, characterized in that the second movement device (15) has a rigid frame (28) on which the at least one movement means (26) and the at least one second deflection unit (16) are arranged, the second deflection unit (16) deflects the first rope (11) at a fixed position on the frame (28) towards the node unit (17). Device according to Claim 14 , characterized in that the second deflection unit (16) is arranged on the rigid frame (28) in such a way that the second rope (18) absorbs the vertical rope forces of the first rope (11) during operation. Device according to one of the preceding claims, characterized in that the first movement devices (13) are each formed by a carriage (29) which can be moved in the x direction and on which the first deflection unit (14) and / or the further deflection unit (23) for the second rope (18) are arranged. Device according to one of the preceding claims, characterized in that the first deflection unit (14) deflects the first cable (11) to the second deflection unit (16) in a substantially horizontal direction, in particular two-dimensionally, and the second deflection unit (16) the first Rope (11) deflects towards the node unit (17) in at least one horizontal and one vertical direction, in particular three-dimensionally. Device according to one of the preceding claims, characterized in that the node unit (17) has at least one third deflection unit which deflects the first rope (11) and applies a tensile force to the node unit (17) during operation. Device according to one of the preceding claims, characterized in that the second movement device (15) has at least one fourth deflection unit and the first movement device (13) has at least one fifth deflection unit, the first rope (11) extending from the third deflection unit to the fourth deflection unit which deflects the first rope (11) in the direction of the fifth deflection unit, the first rope (11) extending from the fourth deflection unit to the fifth deflection unit, which deflects the first rope (11) in the direction of at least one fourth drive unit, the fourth Drive unit for transmitting a further tensile force is connected to the first cable (11) in a force-transmitting manner. Device according to one of the preceding claims, characterized by - at least four first ropes (11) for movement support and weight relief of a patient; - At least four first drive units (12), each of which is connected in a force-transmitting manner to one of the first cables (11) for transmitting a tensile force; - At least four first movement devices (13) each with at least one first deflection unit (14) for guiding, in particular deflecting, the respective first rope (11); - At least one second movement device (15) with at least four second deflection units (16) for guiding, in particular deflection, of the respective first rope (11); and - a node unit (17) which is connected to the four first ropes (11) in a tensile force-transmitting manner, the respective first rope (11) extending from the associated first drive unit (12) to the first deflection unit (14), which the first rope (11) deflects in the direction of the second deflection unit (16), the first rope (11) extending from the first deflection unit (14) to the second deflection unit (16) which deflects the first rope (11) to the node unit (17). Device according to Claim 20 , characterized in that the first cables (11) between the second deflection units (16) and the node unit (17) each have a cable angle, in particular a vertical cable angle, which in the x-direction and y-direction independently of a position of the node unit ( 17) is constant in the range of motion (19). Device according to Claim 20 or 21st , characterized in that the first ropes (11) each have a free end (21) which is connected to the node unit (17) for power transmission. Device according to one of the Claims 20 to 22nd , characterized in that the second movement device (15) has a rigid frame (28) on which the four second deflection units (16) are arranged in such a way that the four first cables (11) on the frame (28) are at a fixed distance from one another are deflected towards the node unit (17). Device according to one of the preceding claims, characterized in that each two of the first movement devices (13), which are movably arranged on a common longitudinal axis (L), are connected to one another by an intermediate element (31), in particular a rod or an intermediate rope. Device according to one of the preceding claims, characterized in that the two first movement devices (13) in operation by the rope reaction forces of the at least one first rope (11) or of at least two first ropes (11) on the first deflection units (14) continuously in opposite directions x-directions are kept under tension, so that the first movement devices (13) have a constant distance from one another. Movement device (15) for therapeutic movement support and weight relief of a patient during movement in an x / y plane with a frame (28), at least two movement means (26) and at least four deflection units (16) on the frame (28) in one are arranged at a fixed distance from one another, the deflection units (16) being designed to deflect a cable (11) to a node unit (17) for movement support and weight relief of a patient, in particular three-dimensionally, which is centrally arranged between the deflection units (16), and the movement means (26) are arranged on the frame (28) and can be connected to at least one load-bearing rope (18), so that the movement device (15) can be moved in the y-direction through the load-bearing rope (18). Device (10) for therapeutic movement support of a patient during movement in a horizontal x / y plane and for relieving the weight of the lower extremities of a patient, comprising: - one or more first ropes (11), each first rope having at least one rope piece; - At least one first drive unit (12) and at least one first deflection unit (14), wherein the piece of cable extends from the first drive unit (12) to the first deflection unit (14) and is deflected by this; and - at least one connecting means (17) which is connected to the piece of rope and can be connected to a patient in order to exert and / or absorb forces and / or moments on the patient, characterized in that at least one first deflecting means (15) is provided , which is arranged between the first deflection unit (14) and the connecting means (17) and can be moved along in a movement area (19) in the direction of movement of the patient, the piece of rope extending from the first deflection unit (14) to the first deflection means (15) , wherein the first deflection means (15) deflects the piece of rope in such a way that the piece of rope between the first deflection means (15) and the connecting means (17) has a rope angle, in particular a vertical rope angle, which is independent of in the x-direction and in the y-direction a position of the connecting means (17) in the range of motion (19) is constant. Device according to Claim 27 , characterized in that the first deflection means (15) has a rigid frame (28) which deflects the piece of rope at a fixed position towards the connecting means (17). Device according to Claim 27 or 28 , characterized in that the piece of rope has a free end (21) which is connected to the connecting means (17) for power transmission. Device according to Claim 27 or 28 , characterized in that at least one second deflection unit and at least one second drive unit or at least one winch are provided, the rope piece extending from the first deflecting means (17) to the second deflecting unit and being deflected by this, the rope piece with the first deflecting unit (14) is connected, and the piece of rope is deflected from the second deflection unit to the second drive unit or to the winch, the piece of rope extending from the first drive unit (12) to the second drive unit or to the winch.

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