DE202008011251U1 - Arrangement for training movement sequences - Google Patents

Abstract

arrangement (1) to train movements of the upper and / or lower Extremities, characterized by at least two differently formed Means (2, 3, 4, 5) for moving the extremities, which different complex movements with different degrees of freedom enable, and a central data processing system (6) with the facilities (2, 3, 4, 5) is connected.

Description

The The present invention relates to an arrangement for exercising movements the upper and / or lower extremities as well as the trunk.

such Arrangements can to be used for a variety of different health promoting activities, in the following, in particular the use of such an arrangement for the treatment of neurological, geriatric and / or orthopedic Disorders of patients is described. All uses The arrangement has in common that they improve the Upper limb function, trunk and / or lower extremities, So the arms, the trunk and / or the legs should lead. A special Field of application is the treatment of stroke patients, their upper and / or lower extremities after a stroke often have acute, subacute and / or chronic dysfunction. Similar functional disorders but also occur in geriatric and / or orthopedic Illnesses on.

adversely is that so far it is in the neurological, geriatric and orthopedic Rehabilitation hardly systematized apparatus approaches to treatment the said malfunctions gives.

Therefore It is the object of the present invention to provide an arrangement for Exercise of movements the upper and / or lower extremities, with the a very efficient treatment of dysfunction of the upper and / or lower extremities possible is how studies have already proven.

These The object is achieved by an arrangement of the type mentioned, which by at least two differently configured devices for moving the extremities, which different complex movements with different degrees of freedom enable, as well as a central data processing system with the facilities is connected is marked.

The inventive design the arrangement for training movements of the upper and / or lower extremities offers the advantage that treatment success can be achieved in a relatively short time are, since the differently trained facilities, of which preferably a number suitable for the particular type of application of the arrangement is present, over the central data processing system interact, so a to enable very targeted and individual treatment of patients. For example, in the central data processing system be stored individual training program, which certain requirements a physician, occupational therapist or physiotherapist as a training parameter contains. The Arrangement can thereby monitor the training progress or success automatically and instruct a patient to be treated accordingly. By the targeted according to the invention Use of collaborative facilities is a very efficient one Treatment of dysfunctions the upper and / or lower extremities possible, allowing for rehabilitation needed Time can be significantly reduced. The inventive arrangement is also alike in the stationary, semi-stationary and outpatient area as well as in connection with nursing institutions used.

The inventive arrangement preferably has a for their number of suitable number of different trained facilities, which to achieve a desired Treatment success optimally interact. This is a sequential and graduated treatment possible, whereby the individual treatment stages are optimally adapted to one another can be. The progress of this treatment can be very simple Way by means connected to the institutions central Monitor data processing equipment, which is preferably capable of given with currently detected training parameters to automate the treatment as far as possible, while at the same time a much more efficient treatment compared to the prior art provided.

The respectively used for moving the extremities preferably so matched to each other that a patient The institution may start its training according to the degree of its Disease equals, meaning that expediently is a more serious illness should start with a simpler workout than one lighter. A patient leads at a given institution a certain movement often in succession until after a suitable number of similar workouts a desired one Treatment success preferably by means of the central data processing system is detectable. Then the patient can move to another facility change, which allows a slightly more complicated movement, as well by a common one repeated execution a certain movement a further step of mobilization a limb to reach. In particular, this step-like treatment with synergistic treatment stages allows a very targeted and optimal treatment of a patient, taking desired Stop treatment successes relatively quickly.

One Patient, for example, in the course of a rehabilitation after a Stroke for the treatment of stroke dysfunction on an arrangement according to the invention trained, connects the affected limb with a corresponding suitable means for moving the same, wherein the extremity means the facilities can essentially perform a positively driven movement. This forced guidance makes it is possible To provide facilities that different complex movements with different Allow degrees of freedom. The number of degrees of freedom can be preferably vary slightly, to an optimal adaptation of the arrangement according to the invention to their respective Carry out the application to be able to.

To an advantageous embodiment of the invention, each device a base unit and an operating unit on, with the operating unit is movable relative to the base unit. In such a device For example, it is a stationary device to which a patient to mobilizing extremity with the operating unit connects and thus movements together with the operating unit relative to the base unit can. The relative movement of the actuator unit to the base unit represents a component of the complex made possible by the device Movement process, wherein the actuator also actuators which can be used to create additional degrees of freedom or a Adaptation to special needs also and preferably independently from the relative movement of the rest operating unit are movable to the base unit. The relative movement of the actuator to the base unit essentially determines a degree of freedom of the Movement, which is a forced guidance of the extremity during the movement means the same in a particular direction.

A Further advantageous embodiment of the invention provides that at least one device has a drive unit, which with the operating unit connected is. This makes it possible for a limb, which almost complete paralyzed is, in a passive way, set in motion to the Mobilization of this limb to start. Make progress in such treatment a limb a, it may for example be provided that the drive unit, which is designed as a servomotor, is turned off and the patient now actively activates the same movements at the corresponding one Device performs. Such a training success is especially due to the frequent repetition created a same movement.

According to one further advantageous embodiment of the invention has at least a device has an evaluation unit which is connected to the actuating unit connected is. By this embodiment of a device is, for example the detection of motion parameters, such as the number the carried out Movements or similar, possible. For example, a training program is through the evaluation unit specifiable which a patient to create the desired Perform success should be what can be monitored by the evaluation unit. The device is preferably over the evaluation unit is connected to the central data processing system, so that centralized monitoring the training can be done in total. Based on the data obtained by the evaluation unit Signals can be the central data processing system, for example to head the appropriate facility for a specific exercise program to realize. It is conceivable that the central data processing system the drive unit of the device is determined as a function of the so far achieved training success controls.

Conveniently, At least one device has a sensor with which the Actuation of Actuator monitorable is. By this configuration can be detected, for example, whether in a passive operation an actuating unit using a drive unit, a resistor from the exercising extremity is generated, after which, for example, by means of the evaluation and / or the central data processing system an emergency shutdown the device can be used to prevent injury to the limb. through a sensor can Furthermore, the number of movements and dynamics of the movements recorded in detail and sent to the evaluation unit for further evaluation and / or the central data processing system for the further processing of be forwarded to this training data.

It is further considered advantageous if the actuating unit is actuatable simultaneously with both upper or lower extremities, wherein the movements of the upper and lower extremities are coupled to each other or independent of each other. As a result, both a synchronous and an asynchronous movement of the upper or lower extremities is possible, so that a wide variety of training programs can be performed on a corresponding device. In particular, embodiments are conceivable in which a healthy limb moves along a paretic extremity (master-slave principle). It can also be provided that the paretic limb must overcome an initial resistance at the beginning of the movement. The amplitude and the speed of the movement as well as the resistance to be overcome are preferably via the evaluation unit and / or the central data processing system individually adjustable to allow movements that are ideally adapted to the individual degree of the disease.

It is further advantageous if at least one device is a stimulation unit that is on the actuator unit is arranged. Such a stimulation unit can, for example generate electrical stimuli or vibrations and on certain parts the extremity, such as the finger berry, leave to work, which is the training effect further improved. Such tactile-dynamic stimulation can for example, on one hand, especially the fingers, a paretic Extremity applied become. This can be independent or together with a movement of the other extremity. This stimulation is preferably also dependent predetermined training parameters by the evaluation and / or the central data processing system generated.

Of It is further suggested that the base unit of at least a device height adjustable and / or inclinable. This allows a patient both while standing, as well as sitting a corresponding facility easily In addition, it can also be used to optimally adapt the device to the respective height of a Patients take place.

Preferably At least one device is connected to a display unit. Such a presentation unit can be, for example, a display be any embodiment of a device, which for example the number of performed or still to be performed Movements or other parameters of a training progress represents. In particular, it is possible that the presentation unit has a monitor or with a such interacts over the video recordings of certain movements of the corresponding to exercising limb, such as piano-playing fingers. hereby there is an additional Stimulation of mirror neurons, since own movements with the shown Movements are associated. For example, becomes optimal treatment is a combination of tactile-dynamic stimulation chosen with the presentation of video recordings, giving a quick setting a desired one Favor treatment success can. The presentation unit is preferably by means of Evaluation unit and / or the central data processing system controlled.

From Advantage is further considered if at least one device For varying the resistance of the actuating unit. Also thereby lets in consecutive workouts by increasing the Resistance to movement individually to the respective circumstances Create a customized training session for a very effective workout carry out to be able to.

To a further proposal has at least one device of a Signaling unit on. This can signal, for example, whether a performed Movement corresponds to the predetermined motion parameters, which, for example by a sensor and an evaluation unit connected thereto and / or central data processing system can be monitored. For example, can be signaled whether a movement, such as an extension of a Arms, to a predetermined extent. The patient will This gives a simple means of control, that he is signaling by a certain state of motion can control whether the movement performed by him with one for the desired Training success of sufficient intensity occurs.

The review and Evaluation of the training success or progress, for example, by means of various assessment methods, such as the Fugl-Meyer engine score test, Box and Block Test, Action Research Arm Test (ARAT). Appropriate Programs to carry out Such methods are suitable, for example, in the be stored central data processing system.

With The present invention further relates to a use of the arrangement according to one of the aforementioned embodiments for the treatment of neurological, geriatric and / or orthopedic Disabilities, especially of the arms and for training arm and hand movements, proposed.

It shows that with the present invention a very efficient Rehabilitation of paretic extremities is possible by placing an order is used in the at least two devices a graduated Allow training process, by means of a central connected to the institutions Data processing system an evaluation and monitoring of the entire training success or progress can be made. To achieve this goal are various combinations of the above-described embodiments of Arrangement possible. It is clear to a person skilled in the art that the devices not explicitly mentioned May have embodiments which allow a graded treatment of the type described above.

Further advantages and features of the present invention will be apparent from the in the 1 illustrated embodiment of the invention erläu tert, where 1 a schematic representation of an embodiment of the inventive arrangement shows.

1 schematically shows an embodiment of the inventive arrangement 1 to train movements of the upper extremities. In this embodiment, the arrangement 1 four facilities 2 . 3 . 4 and 5 on which with a central data processing system 6 via a data line 7 are connected. In front of the facilities 2 . 3 . 4 respectively. 5 is a chair 8th placed on which a patient can sit while exercising.

A training course by means of such an arrangement 1 has the following procedure: First, a patient who has a paretic upper limb, takes before the device 2 on a chair 8th Place to start treatment with this device 2 To be able to execute motion sequences with the least possible complexity and a small number of degrees of freedom. These low-complexity movements are often repeated until a desired mobilization effect occurs, which is from the central data processing system 6 is monitored by means of suitable software. These are in the central data processing system 6 stored training parameters, which is compared with the currently recorded training progress to determine whether a desired degree of mobilization has been achieved and a change to another device 3 . 4 or 5 is possible, the one opposite the institution 2 allows more complex movement of the upper paretic extremity. The device 2 preferably has a drive unit, not shown, with which the paretic arm is moved passively at the beginning of the training, wherein by means of a sensor, not shown, and an evaluation device, not shown on the device 2 the resistance to movement can be monitored to prevent injury to the paretic limb during passive movement by the drive unit.

Is a desired training progress by means of the central data processing system 6 determine the patient may be the first training level at the institution 2 finish and set up 3 This is a mechanical arm trainer that moves both arms, with the healthy arm carrying the paretic arm. The one by the institution 3 possible movement is more complex and active than the one through the facility 2 enabling a gradual build-up of limb mobility. Will again by means of the central data processing system 6 found that by means of the device 3 mobilization progress to be achieved, the patient can set up 4 which is also designed as a mechanical arm trainer, in which the arms are moved independently. In this case, a rectified or an alternating movement is possible. The by the device 4 possible movements are in turn more complex than those caused by the device 3 are possible, so that continues to be a graded build the mobility of the patient. After re-determining a desired training success during the training level at institution 4 , the patient changes to the institution 5 which is used in particular for mobilizing the hand and acts on the sensory motor system using a stimulation unit. By means of drive units, asynchronous movements of the fingers are generated, while at the same time a tactile-dynamic stimulation of the fingertip takes place and additionally a vibratory stimulus is applied. Also the mobilization result, which by means of the device 5 is generated via the central data processing system 6 monitored, so that overall by the arrangement 1 a very targeted and efficient as well as largely automated mobilization of a paretic extremity can take place.

Claims (12)

Arrangement ( 1 ) for the exercise of movements of the upper and / or lower extremities, characterized by at least two differently formed devices ( 2 . 3 . 4 . 5 ) for moving the extremities, which allow different complex movements with different degrees of freedom, and a central data processing system ( 6 ), with the facilities ( 2 . 3 . 4 . 5 ) connected is. Arrangement ( 1 ) according to claim 1, characterized in that each device ( 2 . 3 . 4 . 5 ) comprise a base unit and an operating unit, wherein the operating unit is movable relative to the base unit. Arrangement ( 1 ) according to claim 2, characterized in that at least one device ( 2 . 3 . 4 . 5 ) has a drive unit which is connected to the actuating unit. Arrangement ( 1 ) according to claim 2 or 3, characterized in that at least one device ( 2 . 3 . 4 . 5 ) has an evaluation unit which is connected to the actuating unit. Arrangement ( 1 ) according to one of the preceding claims, characterized in that at least one device ( 2 . 3 . 4 . 5 ) has a sensor with which the actuation of the actuating unit can be monitored. Arrangement ( 1 ) according to one of the preceding claims, characterized in that the actuating unit can be actuated simultaneously with both upper or lower extremities, wherein the movements of the upper and the lower extremities are coupled together or independent of each other. Arrangement ( 1 ) according to one of the preceding claims, characterized in that at least one device ( 2 . 3 . 4 . 5 ) has a stimulation unit which is arranged on the actuating unit. Arrangement ( 1 ) according to one of claims 2 to 7, characterized in that the base unit of at least one device ( 2 . 3 . 4 . 5 ) is adjustable in height and / or inclinable. Arrangement ( 1 ) according to one of the preceding claims, characterized in that at least one device ( 2 . 3 . 4 . 5 ) is connected to a display unit. Arrangement ( 1 ) according to one of the preceding claims, characterized in that at least one device ( 2 . 3 . 4 . 5 ) comprises a unit for varying the resistance of the actuating unit. Arrangement ( 1 ) according to one of the preceding claims, characterized in that at least one device ( 2 . 3 . 4 . 5 ) has a signaling unit. Use of the arrangement ( 1 ) according to one of the preceding claims for the treatment of neurological, geriatric and / or orthopedic disabilities, in particular the arms and for exercising arm and hand movements.