DE202010017701U1 - Device for increasing the mobility of human joints - Google Patents

Abstract

Device for increasing the mobility of human joints with a stretching device (1) which has a stretching unit which can be attached in the region of a joint or a muscular system acting thereon, a force generating device which can be controlled or regulated by means of a control device (40) and a holding device and counter-holding device, the Force generating device for causing an intermittent stretch in the region of the joint and / or the muscles concerned is designed to be controllable or regulatable between a pre-stretch and a metered further stretch.

Description

The invention relates to a device for increasing the mobility of human joints with a stretching device, which has an attachable in the region of the joint or acting on this muscle expansion unit and to actuate a force generating device.

Such a device for increasing mobility is in the DE 696 11 232 T2 shown. This known device is designed for a stretch corset and a neck support in such a way that it should not hinder the movement of a patient in the region of the spine or in the head / neck area. For this purpose, between a breast belt and a hip belt of the Stretch corset or between a headrest and a shoulder support two via a hose communicating pneumatic cylinder arranged as a stretching unit, which can be inflated by means of a manual pump as a force generating device. This device makes it easier for people to move in the area of the spine and neck, but it can not itself cause movement.

One in the DE 40 11 203 C1 shown further device for increasing the mobility of human joints has a inflatable by a fluid support, with the addition of a usual passive exercise and a controlled active exercise is possible. For this purpose, a drain valve is formed on a pad with variably adjustable opening pressure and the limb to be trained can actively compress the pad, wherein the compression pressure can be predetermined according to the opening pressure of the valve. This device is not suitable for stretching muscles or joints.

Limitations of movement and pain in the joints of the limbs and spine are the nature of orthopedic diseases. These phenomena are often associated with morphological changes in the cartilaginous articular surfaces. If one realizes that only muscles are able to cause joint movements, it is obvious that the stiffness and shortening of the musculature plays the leading role in blocking movement. Musculature is not the only tissue involved in blocking joint mobility. The stiffening of the joint capsule also makes a decisive contribution to this. The stiffening of the joint capsule may be a result of a muscle disease, in any case, both processes go hand in hand and cause each other.

This insight is supported by the well-known observation that the type of stiffness is very characteristic of any orthopedic disease. The inner rotation is reversed at the hip joint, the extension at the knee joint. At the hock always shows a fixed Spitzfußstellung. It can be assumed that reducing stiffness and shortening not only reduces the restriction of movement but also reduces the pain.

There are already approaches in the treatment of orthopedic diseases, which are aimed at the extension and extension of the musculature and the joint capsule. These are manual medicine and some physiotherapy strategies. In order to be able to structurally change muscle tissue, a treatment with many hundreds of stretching movements per day is required, which manual medicine is not able to do.

The present invention has for its object to provide a device for increasing the mobility of human joints, with the treatment of muscle tissue and joints is made possible under structural change.

This object is achieved with the features of claim 1. In this case, it is provided that the stretching device has a stretching unit which can be attached in the region of a joint or a musculature acting on it, a force generating device which can be controlled or regulated for its actuation by means of a control device, and a holding device and counter holding device, wherein the force generating device serves to effect an intermittent stretching in the region of Joint and / or the relevant musculature between a pre-stretching and a metered further elongation controllable or adjustable is formed.

With the device thus formed, a metered stretch is made possible with a required multiplicity of stretching movements of the musculature or of the joint under automatic actuation, with handles and maneuvers of manual medicine being comprehensible.

The invention is based on the consideration that a very specific strategy of elongation is to be used in order to be able to structurally change a tissue in the sense of an extension. The tissue, in this case the musculature and joint capsule, must be brought to the limit of the existing extensibility in order to carry out a metered further expansion from this point. The exhaustion of pre-existing extensibility is referred to as pre-stretching. After the dosed stretching beyond the pre-stretching is given back, but only up to the pre-stretching, not until the complete loss of tension. From the point of pre-stretching, the next stretch is now made. The intermittent Character of the stretching is in addition to the metered expansion beyond the pre-stretching addition, a second key operating principle. A constant pull on the fabric could be compared to trying to hammer a nail in such a way that you make a single hammer stroke and hold the hammer on the nail head. By means of the holding device and the counter-holding device, the limbs or the trunk are clamped (as relevant body sections), whereby already the pre-stretching of the musculature and / or the joint capsule can be effected. By means of the expansion unit and the force-generating device that acts on it, the expansion can then be carried out at a specified force.

An advantageous embodiment of the device consists in that the counter-holding device has at least one holding element, against which the force generated by the force-generating device is brought into effect via the expansion unit on the joint or the musculature.

In order to carry out a defined stretching, the measures are also advantageous in that the counter-holding device for supporting a body portion connected to the musculature, such as the limb or trunk, comprises a splint or a corset.

A defined introduction of force in size and direction by means of the expansion unit is achieved in that the counter-holding device comprises an abutment arranged on one side of the expansion unit.

A metered, matched to the respective requirements elongation is advantageously achieved by the formation of the device in such a way that the expansion unit has at least one expandable by supplying air or liquid and reduced by discharging air or liquid pressure chamber and that the force generating device for alternately increasing and reducing the air or fluid pressure is formed.

For the control or regulation of the expansion process, advantageous measures are that the expansion device has closable and openable valves by means of the control device.

By controlling the amount of stretching under the control of the force exerted on the joint or musculature by means of the stretching unit, the pre-stretching can be accurately maintained and a suitably metered stretch can be reliably controlled, the force being always chosen. that no injury to the tissue to be stretched is risked. In this case, the distance achieved during the stretching is usually low initially and increases gradually with the same force.

To achieve an increase in flexibility in the region of the joint or the muscles, the measures are also advantageous in that the frequency of the expansion predetermined by the control device is one to five, preferably two to three, elongation cycles per minute. In this case, different program-controlled, selectable waveforms of the force can be provided.

An adaptation to different areas of the body to be treated and different patients is facilitated by the fact that the counter-holding device has differently designed holding elements, rails, corsets and / or abutments, which are adapted for application to different body sections or limbs.

Further advantageous embodiments are that the force generating device has a central and / or a plurality of decentralized force distribution units associated with a respective expansion unit, wherein different expansion forces can be predetermined for different expansion units.

Furthermore, the measures are advantageous for the structure and mode of operation in that the expansion unit is designed as a bellows with at least one air pocket and that the force-generating device has at least one electrically operated compressor.

An essential difference to other conventional constructions, namely so-called movement rails, consists in the metered expansion on the force. Movement rails are z. B. used to obtain the mobility of this joint immediately after surgery on a joint. However, these conventional devices are designed to achieve a certain range of motion. When applied to the patient, one must set a certain movement rate that is possible at the given time. The procedure is path-controlled. One is not able to effect a well-dosed further stretch beyond the pre-strain. Setting a movement excursion that exceeds the momentary, pathologically reduced extensibility of the tissue would result in great forces causing pain and tissue destruction. These known devices are also unable to hold the pre-stretching. The tissue relaxes completely after each stretch.

The invention will be explained in more detail by means of embodiments with reference to the drawings. Show it:

1 a schematic representation of an arranged on a leg of a patient stretching device,

2 a foot portion of a rail of the device according to 1 with foot picked up,

3 a schematic cross-sectional view of the stretching device and the leg after 1 .

4 Another embodiment of a leg applied to a stretching device,

5 a further embodiment of an applied to a leg stretching device and

6 an extension device applied to the upper body of a patient with a stretching unit arranged in the region of a shoulder joint.

1 shows a device for increasing the mobility of a human joint with one on a limb 2 namely, a leg applied to a patient's stretching device 1 , The stretching device 1 is used to stretch the calf muscles, forcing the forefoot in the direction of the knee joint.

The stretching device 1 has a rail shown in longitudinal section 30 with a first rail section extending below the sole of the foot 31 and a second rail section extending along the flexor side of the lower leg to the thigh 32 with the leg lying in the rail. On the dorsum near the ankle is as a stretching unit of the stretching device 1 a bellows 10 optionally arranged with a plurality of air pockets for forming a pressure chamber with which a force acting on the dorsum of the foot can be generated, wherein on the side facing away from the instep side of the bellows 10 a z. B. with the rail 30 abutment connected by lateral links (not shown) 20 is arranged. The force on the back of the foot is created by inflating the bellows 10 by means of a compressor of a pumping unit 41 created with the bellows 10 over a line 11 , such as B. a hose is connected and present in the range of a control device 40 is arranged. In the line 11 , the pump unit 41 and / or the bellows 10 can have one or more valves 12 (see. 4 ) be arranged to z. B. specify a minimum pressure and / or maximum pressure, wherein the valves by means of the control device 40 formed controllable and can be designed variable in their minimum pressure and / or maximum pressure.

At the in 1 the embodiment shown acts of the expansion unit with the bellows 10 applied force on the dorsum near the ankle, leaving the heel with the relevant force component towards the base of the splint 30 pressed and thus removed from the knee. This results in an elongation of the calf muscles and, if the rail section 32 above the knee joint is connected to the leg, also an extension in the knee joint.

The 2 shows a cross section of the rail 30 in the foot area with foot arranged above the base, that of two side parts 33 of the first rail section 31 is enclosed. 3 shows a cross section of the applied to the leg stretching device 1 , where connections 21 of the abutment 20 on the side panels 33 the rail 30 are shown. The two lateral connections 21 can be articulated with the abutment 20 be connected.

4 shows a similar stretching device 1 as 1 , being in the line 11 a valve 12 is arranged and corresponding parts with corresponding reference numerals as in 1 are designated. By means of the control device 40 can also be a dosed stretch on the bellows 10 be carried out as a stretching unit, in which case the pressure between a minimum pressure and a maximum pressure cyclically z. B. can be changed two to three times per minute and the minimum pressure can be selected in accordance with a pre-stretching of the muscles to be stretched and the maximum pressure in accordance with the predetermined force for a metered expansion beyond the pre-strain addition. By means of the control device, the force required for the elongation is thus controlled or regulated with additional inclusion of sensors and their signals as well as default values as comparison variables in predetermined ranges. To reduce the pressure from the maximum value to the minimum value, for. B. the air over the valve 12 or another valve drained or a suction phase of the pumping unit 41 be used.

The rail 30 is with bandage-like fasteners 34 fixed to the lower leg of the leg. The rail 30 can in this case be designed so that the first rail section 31 with the plate-shaped base opposite the second rail section 32 near the heel is connected by a hinge. The soles of the foot can rest completely on the base and the toe-near end of the foot can be pressed in the direction of the knee to effect the stretching of the calf muscles.

5 shows another embodiment for stretching the calf muscles. Here, the stretching device on the lower leg of the leg by means of a arranged above the ankle sleeve-like holding part 51 and a below the knee in the calf area arranged band-shaped holding means 52 attached, wherein the stretching unit arranged on the flexor side of the leg in the calf area and a coupling mechanism 13 with movably mounted in the longitudinal direction of the lower leg adjusting parts 14 with the holding part 51 and the holding means 52 connected is. Again, the expansion unit has a bellows 10 with one or more inflatable air pockets, over a conduit 11 and a valve assembly having at least one valve 12 to the pump unit (not shown) 41 and control device 40 connected. The control or regulation can be carried out in a corresponding manner, as in connection with the embodiment according to 4 described.

6 shows an embodiment of the device in which the stretching device 1 is applied in the area of the upper body of a patient for stretching a shoulder joint. Here, in the armpit between the upper arm and chest is an adapted bellows 10 arranged as a stretching unit and below the expansion unit is the arm by means of a retaining loop 53 held against lateral lifting on the hull. When inflating the bellows 10 By means of compressed air, the upper arm in the area of the shoulder joint is removed from the trunk and thus causes an expansion in the shoulder joint, in order to normalize the joint play, which amounts to a few millimeters with normal joint.

Again, the elongation is cyclic, z. At a frequency of one to five, preferably two to three, cycles per minute, with the pressure in the expansion unit being controlled or regulated to produce a force between the pre-strain and the metered extension beyond the pre-strain, as described above.

For example, hydraulically actuated expansion units or expansion units operated by motor power or else expansion units operated with other power sources are also suitable, but pneumatically actuated expansion units are to be preferred since they advantageously fulfill the requirements with regard to shape adaptation and temporal and local force distribution.

At the knee joint, in addition to the specified extension in the longitudinal direction of the leg, an equivalent second movement can be promoted by stretching, namely the so-called joint sliding. The shin is pushed forward towards the thigh. The normal joint play allows for this movement about a cm. With a diseased joint, this game can be completely canceled.

In order to effect an elongation of joints and the musculature of the trunk according to the aforementioned criteria, an embodiment with a two-part corset is advantageous, the components of which can be moved against each other by means of a suitable expansion unit to achieve stretching of the back and periodic corrective pressure on curvatures. The pressure on the curvature beyond the pre-strain exerts a curative pull on the musculature of the trunk, whose shortening is responsible for the deformity. Instead of a corset, similar to the shoulder, a less expensive air pocket could be applied under the back of a recumbent patient with an abutment-adapted counter support, inflating the air pocket periodically. For the stretching of the neck muscles a holding device for the head and the shoulder is provided between which a stretching unit also z. B. is arranged with at least one bellows for the periodic elongation.

A further embodiment of the device is that several devices on different muscle groups are used on a patient. Here, a central drive with central pump unit 41 and central control device 40 may be used, wherein the different expansion units can be assigned different pressures for generating adapted expansion forces to adjust the given pre-stretching and metered extension. This can be z. B. done by means of the expansion units associated with respective controllable valves. Alternatively, several pumping units 41 and / or control devices 40 be provided.

The control or regulation by means of the control device 40 can be easily done via suitable microcontrollers and programs.

The device may be configured as a system to treat patients in a practice or to operate devices at home, which patients can treat themselves. The system may include various stretching devices with a common stationary pumping unit or a compressor or with separate pumping units, as well as various holding devices and counter-holding devices with different rails, corsets and orthoses made of plastic or metal, as they are also used in orthopedic technology. For the stretching of the calf muscles, which has central importance, the device z. B. executed so small patients will be able to wear them under their clothes and stretch them synchronized with the appropriate gait phase. For the synchronization a myosensory principle can be used.

The system is advantageously constructed in a modular manner with the above-mentioned constituents and thus can be used according to a modular principle for treating the individual patients at various joints and muscles with easy adaptability.

QUOTES INCLUDE IN THE DESCRIPTION

This list of the documents listed by the applicant has been 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.

Cited patent literature

• DE 69611232 T2 [0002]
• DE 4011203 C1 [0003]

Claims (11)

Device for increasing the mobility of human joints with a stretching device ( 1 ), which can be attached to a joint or to a musculature acting on it, a stretching unit for which it can be actuated by means of a control device ( 40 ) comprises a controllable or controllable force generating device and a holding device and counter holding device, wherein the force generating device for effecting intermittent stretching in the region of the joint and / or the relevant musculature between a pre-stretching and a metered further expansion is controllable or adjustable. Apparatus according to claim 1, characterized in that the counter-holding device comprises at least one holding element against which the force generated by the force generating device via the expansion unit at the joint or the musculature is brought into effect. Device according to claim 1 or 2, characterized in that the counter-holding device for supporting a muscular part of the body connected to the limb or trunk is a splint ( 30 ) or a corset. Device according to one of the preceding claims, characterized in that the counter-holding device arranged on one side of the expansion unit abutment ( 20 ). Device according to one of the preceding claims, characterized, that the expansion unit has at least one expandable by supplying air or liquid and discharging the air or liquid reducible pressure chamber, and in that the force-generating device is designed to alternately increase and decrease the air or fluid pressure. Apparatus according to claim 5, characterized in that the stretching device ( 1 ) has closable and openable valves by means of the control device. Device according to one of the preceding claims, characterized in that the extent of the elongation is determined under the control or regulation of the force exerted on the joint or the musculature by means of the expansion unit. Device according to one of the preceding claims, characterized in that that of the control device ( 40 ) predetermined frequency of the elongation is one to five, preferably two to three elongation cycles per minute. Device according to one of the preceding claims, characterized in that the counter holding device differently shaped holding elements, rails, corsets and / or abutment ( 20 ) adapted to be applied to various body sections or limbs. Device according to one of the preceding claims, characterized in that the force generating device has a central and / or more decentralized arranged in the region of a respective expansion unit force generating units, wherein different expansion forces can be predetermined for different expansion units. Device according to one of claims 5 to 10, characterized in that the expansion unit as bellows ( 10 ) is formed with at least one air pocket and that the force generating device comprises at least one electrically operated compressor.

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