DE69737893T2 - DEVICE FOR THE PHYSICAL THERAPY OF SHOULDERS - Google Patents

Description

BACKGROUND OF THE INVENTION

The The present invention relates to a physiotherapy device the shoulder, and more specific to an adjustable device to treat tension in the shoulder area or from a "stiffer Shoulder".

Lots physiological circumstances can lead to a suffering, the amateurish "stiff Shoulder "and medically" adherent Capsulitis "is called. These circumstances cause a limited Stretching of the shoulder due to contraction of the tendons, the muscles, the ligaments and the capsule surrounding the joint. The causes can be one Fall, the tearing the bands, surgical procedures on the ligaments, a fracture of the upper arm, etc. The cause is that the tendons and muscles surrounding the common capsule and the musculoskeletal system, contracting downwards and tense up. This suffering occurs most often among the 35- to 75-year-olds on.

The Shoulder consists of the shoulder bone, the shoulder blade and the Connection to the upper arm cooking. The connection forms a joint between the adjacent humerus and the glenoid area of the scapula. The mount is flat and the attachment of the common capsule it's lose. This structure allows a big Stretching motion, however, is prone for one Lack of stability and resistance.

The Shoulder is able to perform three general types of movements: abduction and Adduction, bending and extension and rotation. Abduction and adduction are movements of the arm away and to the middle axis or the longitudinal axis, in the middle level of the body. The middle level of the body is through the front or the back of the body in defined a straight position. Abduction is a movement away from the middle axis, like the movement, with one arm sideways stretched or lifted. Adduction is the opposite Movement i. the movement towards the middle level of the body. During rotation, the arm is rotated about its longitudinal axis, as on a Axis of rotation. The external rotation is the rotation away from the middle one Axis of the body and the internal rotation is the rotation towards the middle axis of the body.

STATE OF THE ART FOR US PATENTS

The U.S. Patent No. 4,669,451 , Bleuth et al. discloses a device for treating shoulder joints. The device is fixed to the body and is able to move the shoulder in a horizontal axis of rotation, as well as a vertical axis of rotation; the two axes intersect in the joint of the diseased shoulder. A unit that generates and transmits additional movement may be provided to pivot two articulated parts of the arm support in the region of the elbow.

The patent US No. 4,651,719 , Funk et al., Describes a compact mobile device for continuously, passive movement of a user's shoulder. The device is designed to produce an abduction, an adduction, as well as a simultaneous rotation. The device generates a continuous, passive movement of the shoulder. The device creates passive abduction and adduction of the arm over the shoulder and also arbitrarily performs simultaneous rotation of the arm. The device is controlled by a mechanical drive.

A passive shoulder training that involves moving a patient's arm back and forth to induce flexion and abduction of the shoulder U.S. Patent No. 5,179,939 Donavan et al. The device is a passive motorized device. Randall et al im U.S. Patent No. 5,335,649 describes a mechanized machine used in the various stretching exercises. Different body parts can be trained.

Going out of the in the patent US-A-5,558,624 It is an object of the present invention to provide a physiotherapy device which is adjustable and easy to use.

BRIEF DESCRIPTION OF THE INVENTION

The DynaSplint ^™ Physical Therapy Device or the Shoulder LPS ^™ (Low-Load, Prolonged-Duration Stress) System is a device designed primarily for the treatment of the "stiff shoulder." This condition is not necessarily painful, but it renders it incapable of In the past, this condition was treated by physiotherapy or surgery under full anesthesia, where the shoulder was forced to remove stiffness.

The DynaSplint ^™ Physiotherapy Device is designed to prevent surgery and allow the patient to return to normal everyday life. The treatment is considered successful if the patient is capable of an abduction by 135 °, an external rotation of 90 ° et and a Beu 180 °. In addition to a shortening of the recovery time, a reduction of the costs for the patient and / or the health insurance is hereby achieved.

The Method according to the invention for the treatment of the stiff shoulder consists of stretching and stretching exercises, the constantly be supplemented by a physiotherapy program. The object of Invention is only about each half an hour per exercise used to release the stiffening of the shoulder.

The physiotherapy device DynaSplint ^TM is a further development of the previous DynaSplint ^TM . The already known clamping elements were used to support the wrist, elbows, knees or ankles, etc., which are mainly simple joints. On the one hand, the shoulder moves in all levels, which is why the new device has to offer more adjustment options. The settings relate to stretching, and allow the patient to perform movements such as stretching, internal and external rotation, abduction and adduction. The device according to the invention combines some movements and is a multiaxial rotation device. Flexion and abduction are combined. Flexion and external rotation are performed at a specific angle. Immediately after adjustment, the shoulder follows the path of low resistance in performing the movements. Having arrived at this point, the device slides back the shoulder just at the right point.

The rigid shoulder physiotherapy apparatus according to the invention differs from the previously known passive device and depends on the movement of the patient. In other words, the patient moves the device instead of being moved by it, since the device according to the invention is not driven by a motor. The DynaSplint ^TM Physiotherapy device is spring-loaded and strives to force the patient's back and pressure the shoulder; however, when relief from stress is desired, the patient can release the tension and simply reduce the discomfort. This is an important feature of the device according to the invention.

The new physiotherapy device is similar to the existing DynaSplint ^TM line. The physiotherapy devices there have multiple settings according to the amount of pressure or tension. There are two movements that use pressure or tension. These are extension and external rotation. There is a tension member that exerts pressure when the arm is raised, a second tension member that exerts pressure when the arm is turned outward, and the tension can be adjusted respectively.

• 1. einstellbare Unterarmstrebe,
• 2. kolbenartige teleskopische Armstreben,
• 3. ein einstellbares Winkelmesser und
• 4. einen Sockel

aufweist.The articulating device for physiotherapy of the shoulder according to the invention may be characterized in that it

• 1. adjustable forearm strut,
• 2. Piston-like telescopic arm braces,
• 3. an adjustable protractor and
• 4. a pedestal

having.

The adjustable forearm strut and the upper arm strut are over a telescopically connected.

The articulated parts of the device move the shoulder and lead to a movement of the arm. To continue an arm movement, the Therapy device a piston-like telescopic upper arm strut one. This telescopic device is precisely designed with bearings and rods. These piston-like telescopic arrangement is a key factor for the Reaching the functionality the rigid shoulder physiotherapy device.

The Device allows a multiaxial rotation of the shoulder. The term multiaxial rotation means that the device for physiotherapy of the stiff shoulder the multiaxial movement of the shoulder joint while maintaining the Position of the device allows. For example, The multiaxial movement involves a vertical abduction and a vertical adduction, a horizontal abduction and a horizontal Adduction, as well as, an external rotation and an internal rotation.

in the The widest sense is in the state of the art Apparatus for physiotherapy of a stiff shoulder on widening directed the stretching movement of a stiff shoulder. The device is an articulated device that provides active multiaxial physiotherapy to treat a stiff shoulder. The articulated device is with a forearm brace and an upper arm brace, as well as with one or more clamping elements provided, the voltage on the shoulder while active multiaxial treatment. As a result of This physiotherapy speeds up the mobility of the shoulder. The shoulder goes to normal mobility in the directions of the bend, stretching, abduction, adduction, horizontal abduction, horizontal adduction, external rotation and internal Turn back.

The articulated device for Physiothera The stiff shoulder pie has tensioning means that presses the shoulder. The clamping devices are positioned at the joint of the elbow and / or the shoulder.

Farther The clamping devices are provided with a unit that the strength of the Quantify voltage quantitatively. additionally For example, the physiotherapy apparatus of the shoulder has an upper arm brace which is a piston-like telescopic strut which the renewal or the shortening the telescopic strut during active multi-axial physiotherapy of a stiff shoulder.

Farther the device has a forearm strut, which with accordingly adjustable means for attaching the arm to the strut provided is.

It There is a pedestal on which an elbow joint and retaining means for attachment said device for the physiotherapy of a stiff shoulder appropriate and local are fixed.

• 1. eine einstellbare Unterarmstrebe,
• 2. eine kolbenartige, teleskopische Armstrebe,
• 3. Haltemittel für ein einstellbares Ellbogengelenk
• 4. und ein Sockel.

More specifically, the invention refers to a hinged physiotherapy apparatus for the stiff shoulder which releases a stiff shoulder. The device enables a multiaxial rigid shoulder physiotherapy in the directions of flexion, extension, adduction, horizontal abduction, horizontal adduction, external rotation and internal rotation. The main components of the device are:

• 1. an adjustable forearm strut,
• 2. a piston-like, telescopic arm brace,
• 3. Holding means for an adjustable elbow joint
• 4th and a pedestal.

The Forearm strut has means that hold the forearm. The telescopic upper arm strut hangs combined with said adjustable forearm strut. The telescopic Upper arm strut is used as a fulcrum to holding means of an adjustable Elbow joint attached in turn to said adjustable Elbow joint mounted on the pedestal. If the patient with the device with the set clamping devices he can use the multiaxial physiotherapy device use a stiff shoulder. The articulated device for physiotherapy a stiff shoulder is equipped with an adjustable tensioning element provided, which generates the voltage of the attached components of the device. The clamping element is provided with a unit for adjustment the quantitative strength the voltage is used. The forearm strut is equipped with means for securing of the arm at the forearm strut provided.

BRIEF DESCRIPTION OF THE PRESENT INVENTION

• 1. Die bevorzugte beachtlich verbesserte Ausführung weist kolbenartige teleskopische Oberarmstrebe auf, die eine Flexion und eine Streckung der Schulter ermöglichen. Die verbesserte kolbenartige teleskopische Strebe weist gegenüber der vorherigen Ausführung eine Reihe von Verbesserungen auf, wie Lagerungen, Begrenzungsplatten und Stangen, die die Reibung verringern. Dementsprechend verbiegt bzw. verdreht sich die Strebe nicht, was einen normalen Gebrauch behindern würde.
• 2. Die bevorzugte Ausführung enthält ein Mechanismus zur Einstellung in Längsrichtung der Oberarmstrebe.
• 3. Eine zusätzliche Ellbogengelenkführung stabilisiert und lenkt das Ellbogengelenk durch Winkeleinstellungen.
• 4. Es gibt eine verbesserte Raste und einen Wächter für ein müheloses Verschieben der Therapievorrichtung von der linken zur rechten Seite des Ellbogengelenkhalters.

A preferred embodiment of the rigid shoulder physiotherapy apparatus according to the invention has some improved properties:

• 1. The preferred remarkably improved design has a piston-like telescopic upper arm stay which allows for flexion and extension of the shoulder. The improved piston-like telescopic strut has a number of improvements over the previous embodiment, such as bearings, limit plates and rods that reduce friction. Accordingly, the strut does not bend or twist, which would hinder normal use.
• 2. The preferred embodiment includes a mechanism for longitudinal adjustment of the upper arm stay.
• 3. An additional elbow joint guide stabilizes and steers the elbow joint through angular adjustments.
• 4. There is an improved detent and guard for effortless movement of the therapy device from the left to the right side of the elbow joint holder.

at a further development of the device defined in claim 1 Physiotherapy according to the state The technology is piston-like telescopic parts to a unit put together, the a first end and a second end, between which a Row of attached, which is replaced by a series of panels so can be that while the phases of stretching and extension of physiotherapy, the with opposing sentences from Rod provided device by contrasting telescopic motion an opposite one mobility conditionally. The second rod and plate series comes as standard connected to said first rod and plate row. The bars and the plates are housed in a tube with which the plates perpendicular to the horizontal center axis of the pipe and the rods to be brought.

The Apparatus for physiotherapy according to the present invention is an articulated device that enables active multiaxial physiotherapy. Most important for these apparatus for physiotherapy are the clamping elements containing which serve while to raise tension in physiotherapy.

The physiotherapy device according to the present invention is an articulating device for active multiaxial physiotherapy. The most essential for the device for physiotherapy are tension elements during physiotherapy apply a tension.

These and other objects of the present invention will become apparent in the following description with reference to the accompanying drawings, in which: 1 - 17 , explained with reference to comparable examples for understanding the inventors.

BRIEF DESCRIPTION OF THE DRAWINGS

1 is a perspective view of the inventive apparatus for physiotherapy of the stiff shoulder according to US-A-5 558 624 ,

2 is a view illustrating the forearm strut.

3 Figure 5 is a blown-up perspective view illustrating the parts of the forearm strut.

4 is a longitudinal sectional view illustrating the spring-loaded clamping unit of the elbow joint, according to line 4-4 of 1 ,

5 Figure 11 is an enlarged perspective view illustrating the assembly of the components of the elbow joint or hinge and the positioning of means.

6 Figure 11 is another perspective view of the elbow joint and the positioning of the means in the opposite direction.

7 and 8th Fig. 3 are views illustrating the extended telescopic arm provided with the expanding foldable cover according to the broken lines of Figs 8th ,

9 is a view of the telescopic arm in the retracted position.

10 - 12 are views of the shoulder joint with the spring loaded shoulder jig.

13 is a sectional view of the cam unit of the spring-loaded tensioning device, taken along the line 13-13 of 11 ,

14 illustrates the calibrated angle measurement, the turning device and the holder.

15 is a view of the pedestal with two elbow joint devices.

16 and 17 are the views that illustrate the use of the device on the right shoulder and left shoulder.

18 Figure 4 is an isometric view of the preferred embodiment of the shoulder physiotherapy apparatus of the present invention.

19 Figure 4 is an enlarged view of the preferred embodiment of the rigid shoulder physiotherapy apparatus with the tubing of the piston-like telescopic subassembly removed to make the piston-like unit more visible.

19A Figure 11 is a side elevational view of the piston-like telescopic upper arm stay in an extended position.

19B Figure 11 is a side elevational view of the piston-like telescopic upper arm stay in a retracted position.

20 For example, a longitudinal profile of the preferred piston-type telescopic upper arm brace subassembly is fully extended, along line 20-20 of FIG 19 , Most of the tube surrounding the boundary plates and rods is blasted to make the piston-like assembly more visible. A linear ball bearing is shown in the longitudinal profile.

20A is an enlarged view of the right side of the telescopic upper arm stay of 20 and shows how the rotating ball of the linear bearings adapted to the counterbore of the boundary plates wind.

21 Figure 11 is a side elevational view of the preferred piston-like telescopic, partially elongated humeral strut unit. The tube has been skipped to improve the view of the piston-like unit. The arrows show the direction of movement of the rods during the reciprocation.

22 is a side elevational view of the device in the fully retracted state. The tube was omitted to improve the view of the piston-like unit.

23 is a cross section along the line 23-23 of 20 ,

24 is a cross section along the line 24-24 of 20 ,

25 is a cross section along the line 25-25 of 20 ,

26 is a plan view of an external limit plate.

27 is a cross section along the line 27-27 the 26 ,

28 is a plan view of a Zwischenbegrenzungsplatte.

29 is a cross section along the line 29-29 of 28 ,

30 is a cross section along the line 30-30 of 28 ,

31 is a plan view of an internal limit plate.

32 is a cross section along the line 32-32 of 31 ,

33 is a cross section along the line 33-33 of 31 ,

34 is a side elevational view of the linear ball bearing with a portion of the bearing wall shown in exploded view illustrating the interior of the linear ball bearing.

35 is a cross section of the linear ball bearing along the line 35-35 of 34 ,

36 is a cross section along the line 36-36 of 19 the cam-operated detent unit provided for adjusting the length of the forearm strut.

37 is an exploded view illustrating the mechanism for adjusting the elbow joint or the angle.

38 Fig. 3 is a perspective view of the means for attaching the preferred piston-like telescopic humeral strut to the shoulder joint.

39 is a cross section along the line 39-39 of 38 to illustrate the inner part of the attachment means for the connection of the preferred piston-like upper arm brace assembly with the shoulder joint.

40 is a perspective view illustrating the detent and the shoulder holder on the protractor, as well as the protractor guide. The housing of the clamping element is shown open to clarify the engagement of the lock in the holder.

41 Figure 4 is a side elevational view illustrating the shoulder holder, the release lever, and the latch of the latch. The housing of the clamping element has been removed for ease of illustration.

42 is a cross section along the line 42-42 of 41 , with removed housing of the clamping element.

43 FIG. 4 is a block diagram showing the shoulder holder and latch with the catch in the locked position. FIG.

44 FIG. 4 is a block diagram showing the latch with the catch in the release position. FIG.

45 is a view illustrating the bracket on the protractor with the disassembled protractor guide.

DESCRIPTION OF THE STATE OF THE TECHNOLOGY

The 1 shows the articulated device for physiotherapy of the stiff shoulder 10 according to the prior art in the extended position. The device 10 is with an articulated forearm strut 12 provided that over joint 14 piston-like, telescopic with the humerus strut 16 interacts. The opposite end of the telescopic upper arm stay 16 is rotatable, as in 18 , to a holder or holding means 19 hinged on a protractor gauge 20 are attached. The protractor gauge 20 is firmly on the back of the socket 21 the device for physiotherapy 10 attached to the treatment of the stiff shoulder.

Both 2 and 3 is an arm cuff 23 by means of screws 24 and the versions 25 , with the forearm brace 12 connected. When using the device for physiotherapy of the stiff shoulder 10 The patient puts his forearm in the cuff 23 and fasten the cuff 23 around the forearm with "Velcro" ^® straps 26 , The forearm brace 12 has an outer part 28 and an inner part 29 , The outer part 28 pushes over the inner part 29 , and the length of the forearm strut 12 can be adjusted to suit the length of the patient's forearm. crossings 31 . 32 in the outer part 28 the forearm brace 12 and the inner part 29 the forearm brace 12 are provided, each take a screw 27 on, with the length of the forearm strut 12 is set (as more clearly from the 2 and 3 seen).

As mentioned earlier, the forearm brace is 12 by means of a hinge 14 with the telescopic upper arm stay 16 connected. Unique to this hinge 14 is an adaptive tensioning element 35 that in detail in the 3 to 6 will be shown.

It will be especially on the 3 and 4 pointed.

The adjustable clamping device 35 (one seated in the apparatus for physiotherapy of the stiff shoulder 10 according to this invention) was already in the U.S. Patent No. 4,508,111 and 4947835 described. However, the jigs of the cited patents have been provided to allow either flexion or extension and these prior devices have been contemplated for elbow, knee and / or ankle therapy, but not for shoulder therapy.

The tensioning device 35 ( 3 and 4 ) is an adjustable tensioning mechanism that is a spring 36 Contains that with an approach 38 connected, which has a cam surface 39 wearing. An adjustable screw 33 abuts a piston 37 at the other end of the tensioning element 36 , The screw 33 when turned correctly, generates a quantifiable force that the tensioning element 36 squeezes or pulls apart. When approaching the maximum extension or bending, a compression in the clamping element 36 ,

The adjustable screw 33 is from an "allen" screw or a countersunk screw against an item 37 , The "Allen" screw is inside the strut 12 firmly attached with a screw thread. The "Allen" screw comes with an Allen key 41 Turned while a countersunk screw is rotated with a conventional screwdriver. Turning the screw 33 generates a larger compression of the clamping element 36 , causing a greater force on the cam surface 39 the strut 12 is exercised. The clamping capability of the tensioning mechanism can range from 0 Kg (0 pound) to the maximum tension of the tensioner. In general, the tension of the tensioning mechanism ranges from 0 k (0 pound) to 22 kg (10 pounds), and the tension exerted by the tension member may vary at any point, from 60 ° flexion to 0 ° flexion of the joint.

In the articulated device 10 , there is at the elbow rotation axis 14 and at the shoulder axis of rotation 18 an adjustable spring-loaded mechanism designed to apply varying degrees of pressure on the elbow and shoulder during physiotherapy. In use, a quantitatively determinable tension force exerted on the cam is applied to the shoulder, the elbow rotation axis, and the shoulder axis of rotation. Depending on the direction of the arrangement of the cam, the pressure is exerted during flexion or extension.

The at the clamping element 36 applied tension can be applied to the in the forearm strut 12 as well as on the shoulder axis of rotation 57 visible scale 40 respectively. 58 be read. The angulation for the elbow and the shoulder is divided into increments of 3, from 3 to 12: 3 on the gauge corresponds to a pressure of 0.15 m-kg (1.05 ft. Lbs); 6 corresponds to a pressure of 0.661 m-kg (2.28 ft. Lbs.); 9 corresponds to a pressure of 0.474 m-kg) (3.43 ft. Lbs.) And 12 corresponds to a pressure of 0.671 m-kg (4.78 ft. Lbs). Print.

At the Use is the applied pressure of the minimum voltage and can elevated if the patient can tolerate a higher voltage.

A unique feature of this device is its ability to the application of a graduated, quantified, adjustable To allow tension and the ability to release the tension, when the limit of flexion or elongation is reached. This can happen without removing the device. To the pressure is enough to reduce it, by any means contrary to the tension in the rail to act and to position the joint in a comfortable position. After a short recovery time, the rail can regain pressure on the tense fabric to achieve a higher degree of flexion in the To achieve joint.

Between the forearm strut 12 and the piston-like telescopic upper arm stay 16 is a means adapted to the angle of attack 43 ( 5 and 6 ), which serves to adjust the angle of the arm to the elbow. The middle 43 has an upper section 44 and a lower section 45 on, by jagged teeth 47 is connected in the register. Around the top section 44 from the lower section 45 to separate, becomes the securing means 48 at the top section 44 solved, and the parts therefore separated to adjust the angle. Once the angle is set, the top 44 and the lower one 45 Section with the securing means 48 be reconnected.

A convenient device of the apparatus for physiotherapy of the stiff shoulder 10 , is a piston-like telescopic upper arm strut 16 ( 7 - 9 ). This piston-like telescopic device allows flexion and extension of the shoulder. In the 7 is the telescopic strut 16 in the extended position and in the 9 is the strut 16 in the withdrawn position. There is a foldable cylinder 52 who is the strut 16 covered as a protective means, in dashed lines in the 8th will be shown.

On the 10 - 13 connects a link 55 the upper arm brace 16 with the spring-loaded shoulder axis of rotation 57 , The arrangement is in a holder 19 fixed with the adjustable protractor 20 on the pedestal 61 the rigid shoulder physiotherapy device 10 be is solidified. The housing 63 the clamping unit serves as in the holder 19 used element to the articulated device for physiotherapy 10 on the pedestal 61 to keep. The housing 63 the jumping unit is secured by means of a lock 64 in the holder 19 fixed. The lock 64 is in the right location by a catch 66 held. Once the device 10 in the holder 19 The device can be moved 25 ° either side of the vertical axis.

This tilt is another tool that enables the device to work in a multi-axial direction. More specifically, the inclination of the device about 25 ° on both sides of the vertical axis with the shoulder axis of rotation 18 ( 1 . 10 and 12 ) gives the patient using the device the opportunity to move the arm in the direction of the abduction. As previously defined, "abduction" is the movement of the arm away from the central axis of the body, such as when an arm is raised or stretched laterally.

The spring-loaded shoulder hinge ( 10 - 13 ) has quantitatively determinable clamping elements, which in cross section in 13 be shown, and is no different from that of the elbow, as it is a spring 36 , an approach 38 , a piston 37 and a tension generating screw 33 to force the approach to apply pressure to the cam surface 29 applied. The pressure on the shoulder is applied when lifting the upper arm. The quantitatively determinable tension of the tension element is at 59 in the case 63 reached with the Allen mother bowl.

The protractor 20 that with the rotation axis 18 is connected with the teaching 65 calibrated to measure the abduction of the arm from the vertical central axis of the body. When using the protractor 20 set at a value that is comfortable for the patient, and takes into account his stiff shoulder and lack of mobility. To the protractor 20 to press to change the angle becomes the protractor lock 69 solved and the protractor 20 by actuation of the holding elements 19 turned. The protractor covers a range of 0 ° to 70 ° to move.

The protractor 20 and the pivotal unit 18 be on a flat pedestal 61 appropriate. The flat base 61 may be formed of wood or plastic or other materials, such as the carrier, the attached parts of the device for physiotherapy 10 supports. A unique property ( 15 ) is that two protractors 20 are provided, one for the left shoulder and the other for the right shoulder. Every protractor 20 has a holder 19 for the therapy device. This allows each a hinged device for physiotherapy 10 used on each side of the socket: one side for the left shoulder and the other side for the right shoulder. On the base is in each case a head and a shoulder support 67 at ( 16 and 17 ) for the comfort of the user. For convenient transport of the physiotherapy device from one place to another are cut carrying handles 68 intended.

DESCRIPTION OF AN IMPROVEMENT THE DEVICE ACCORDING TO THE INVENTION

A new and preferred embodiment of the physiotherapy apparatus for the shoulder 100 shows an improved piston-like telescopic composition for an upper arm strut 12 ,

In a new and preferred embodiment of the physiotherapy apparatus for the shoulder 100 with a piston-like telescopic arrangement for the upper arm is explained here. By this device, the device is according to 1 - 17 , which represents the state of the art, outdated.

In the context of the new and improved device, Hickey ( US 3249212 ) to the closest prior art, which discloses a pulling and pushing device having deux spiral spring sets telescopically disposed along respective parallel bar sets. Hauckley does not suggest the use of the device within a hinged physiotherapy device for treating the shoulder with different bar arrangements.

The 18 and 19 show a preferred embodiment of the device for physiotherapy 100 which has many improvements and advantageous properties.

The most appropriate improvement is a piston-like telescopic humeral strut 102 , In addition, there is an improved cam operated detent mechanism 104 for easy adjustment of the length of the forearm strut 106 , It's also a serrated hinge 108 provided for adjusting the angle of the device on the user's elbow. An arrangement 110 is intended for adjusting the length of the upper arm stay. The preferred embodiment of the device 100 has a handy catch 111 for easy attachment of the therapeutic unit 112 , the holder of the protractor of the left shoulder 113 with the holder of the protractor of the right shoulder 114 , The elbow joints 115 and 116 be with elbow joints guides 117 and 118 provided to the elbow joints 115 and 116 to stabilize and steer during the adjustment of the angle. The Head and shoulder rests 67 ( 16 and 17 ) may in the preferred embodiment of the therapy device 100 be used.

Both 20 - 22 is the piston-like unit 119 the piston-like telescopic arrangement 120 in a cylindrical duct 122 arranged (dashed in 20 ). The cladding tube 122 may consist of a transparent or opaque material. The piston-like telescopic arrangement 120 the upper arm stay 102 has a cylindrical cladding tube 122 on, at each end with external boundary plates 124 . 125 is provided. The boundary plates 124 . 125 are with a hollow carrier ear 127 ( 20 - 22 ) connected. The hollow carrier ear 127 is at the hole 129 in the middle of each external boundary plate 124 . 125 set and extends centrally along the longitudinal axis of the cladding tube 122 , In the illustrated embodiment ( 20 ) is the cylindrical cladding tube 122 on the external limit plates 124 . 125 attached and held by screws, although other fasteners, such as welding or cementing would be effective. The external boundary plates 124 . 125 can with the hollow carrier ear 127 be connected by welding or with fasteners.

In particular from the 20 shows that the cylindrical cladding 122 a left tail 131 and a right tail 132 along which the carrier ear 127 at the hole in the middle 129 each of the circular external boundary plates 124 . 125 is attached. Save the external limit plates 124 . 125 , are inside the tube 122 Rows of circular boundary plates or plates 136 . 137 . 139 . 140 ( 23 - 33 ). As mentioned, at each end of the cladding 122 external boundary plates 124 . 125 attached, and seal the ends 131 and 132 of the cylindrical cladding tube 122 from. Attached in the pipe 122 , inside the circular external boundary plates 124 . 125 , at both ends of the pipe 122 , are intermediate boundary plates 136 and 137 and internal limit plates 139 and 140 , This results in a set of three perimeter plates 134 at each end of the cylindrical duct 122 , The plates 134 are transverse to the longitudinal axis of the cylindrical cladding tube 122 arranged and are on the hollow carrier ear 127 through the center hole 133 in each boundary plate 134 positioned ( 23 - 33 ). The external plates 124 . 125 and the internal plates 139 . 140 be with the hollow carrier ear 127 welded. The intermediate boundary plates 136 and 137 are not welded, but between the welded external plates and the internal plates with ball bearings 141 attached ( 20 - 22 ).

23 - 33 represent the left-sided plates. Each delimiting plate 134 has sets of holes. In the execution according to 26 and 27 has the external plate 124 two cylindrical holes 142 in a horizontal plane. The intermediate plate 136 has four holes; two double opposing cylindrical holes 144 in a horizontal plane and two larger holes 145 in a vertical plane ( 28 - 30 ). An inner plate 139 ( 31 - 33 ) has four holes; two counterbores 147 in a horizontal plane and two larger holes 148 in a vertical plane. The area plates ( 26 - 33 ) are with counterbores 142 . 144 . 147 Mistake. In any case, the opening 150 the counterbores are sized so that the associated bolts 152 hold reliably while the counterbores 151 so they are the sleeve 153 of the ball bearing 141 take up.

The larger vertical holes 145 . 148 in the intermediate and internal disks ( 28 - 33 ) allow the shock absorber 156 and flange 157 at the ends of the rods 152 to pass through smooth during reciprocal movement (arrows 21 ).

Especially on 26 - 33 is the ratio between the holes 150 and counterbores 151 exactly illustrated. The external boundary plate 124 ( 26 ) and the internal limit plate 139 ( 31 ) have cylindrical holes 142 and 147 on while the intermediate boundary plate 136 ( 28 - 30 ) opposed cylindrical bores 160 on the front and back of the plate flat surface 136 Has. The hole 150 in each of the plates 134 Reliably grips the bolts 152 and the counterbore 151 on each surface takes the sleeve 153 a ball bearing 141 on.

According to 19 - 22 becomes the piston-like telescopic arm arrangement 120 with four bars 152 Mistake. There is a set of two parallel bars on the left 162 and a set of two parallel bars on the right 163 , The left-sided rods 162 become in a horizontal plane and the right-sided bars 163 positioned in a vertical plane. Is the subassembly 120 completely stretched ( 19A and 20 ), so the bolts protrude 162 and 163 out of the pipe 122 and the outer area plates 124 and 125 ; is the subassembly 120 in a retracted position, ( 19B and 22 ), there are bolts 162 and 163 inside the cylindrical tube 122 , In the view lt. 21 are the bolts 162 and 163 the subassembly 120 partially extended, ie the bolts are partly inside the pipe 122 and partly outside the tube 122 ,

Four rotating linear ball bearings 141 ( 20 - 22 and 34 - 35 ) are for the bars 152 on each side of the piston-like telescopic upper arm stretcher assembly 120 intended. Camps 141 are located between the boundary plates 134 ( 20A and 20 - 22 ). These bearings are commercially available. The balls 170 and these camps 141 move on rails 171 and lengthwise they touch the bolts 159 standing in four parallel lines 90 ° apart. Within the guides 171 can the bearings 141 many turns make up depending on the distance the bolts 152 during the lifting movement. The ball bearings 141 allow soft, frictionless stroke of the bolt 159 in the lift-push assembly 120 ,

The internal ends of the rods 152 are flanged 157 and with rubber bumpers 156 equipped to impact on the internal boundary plates 139 . 140 to dampen when the rods 152 to damp during the float. There is also a rubber bumper 158 , the jagged hinge 108 is attached ( 22 and 37 ) and a shock absorber 159 at the upper arm arrangement 168 ( 22 and 38 ).

In the piston-like movement ( 21 ) moves the rod set 63 on the right side of the pipe 122 through the vertically arranged large passages 148 the left internal limit plate 139 and the left intermediate boundary plate 136 therethrough. The rod set on the left side 162 follows in the same order as the one on the right 163 , the only difference being that the left bars 162 are horizontal in a rotated position by 90 °. Of course, if necessary, the degree of rotation can be changed.

It will open 19 . 22 and 37 Referenced. the external end 164 the two left-sided rods 162 of the piston-like telescopic arrangement 120 stick out of the cylindrical tube and are on the mounting base 165 a serrated hinge 108 (eg by welding or with screws) fixed ( 22 and 37 ).

The external ends 167 the two right-sided bars 163 the telescopic arrangement protrude on the right side of the cylindrical cladding tube 122 out and are stuck to the device 168 for adaptation of the upper arm length ( 38 and 39 ).

In the final construction of the piston-like telescopic upper arm arrangement 120 , is the left external boundary plate 124 in the left end of the cylindrical cladding tube 122 positioned. The intermediate boundary plate 136 and the internal boundary plate 139 are each inward to the external boundary plate 124 arranged. The holes 150 in the three boundary plates 134 are for holding the rods 152 intended. The counterbores 151 in the boundary plates are for receiving the sleeve 153 of the ball bearing 154 intended. The counterbore of the external plate is in register with the counterbore 160 the opposite of the Zwischenbegrenzungsplatte 136 and the counterbore 151 the internal plate is in register with the counterbore 160 the opposite Zwischenbegrenzungsplatte. The ball bearings 154 the arrangement are in their respective counterbores 151 in the boundary plates 134 held. The holes 150 take the piston-like rods 152 on. The four ball bearings on both sides of the cylindrical casing 122 Take the piston-like rods and fix the distance between the boundary plates with the position of the bearings.

The Boundary plates and the rods at the left end of the tube are identical. The sentences of boundary plates are opposite to each other or each other arranged and rotate each 90 ° about its central axis.

Referring to 19 . 22 and 37 the forearm strut 106 becomes the upper arm stay 172 with a serrated hinge 108 connected. The hinge has an upper serrated section 174 that with a lower jagged section 175 can be connected in register ( 37 ). The left bars 164 the telescopic subassembly 120 be with the mounting base 165 connected to the hinge. The upper jagged section 174 comes with the lower jagged section 175 by means of a bolt 176 connected to a hole 177 in the lower jagged section 175 of the hinge 108 is screwed.

The two sections 174 . 175 of the hinge 108 Make a comfortable angle that fits the elbow of the patient or user.

As in 19 . 22 . 38 and 39 shown, the two piston-like rods are on the right side of the tube 122 outside on the pipe 122 at the registration mark 110 securely fastened for the length of an upper arm. This device 110 to adjust the length of the upper arm has a threaded hole 180 for receiving a screw 181 , Across the threaded hole 180 and at right angles to it runs a channel 182 , The shoulder joint connector 183 is in the channel 182 introduced to a depth that matches the length of the patient's arm, and then the screw 181 in the threaded hole 180 Attracted to the link 183 with the movable pull-out module 120 to fix.

As in the 19 and 36 shown, is the support for the forearm 106 customizable in length. The length is adjusted. by first the larger, outer part 185 the forearm support 106 ( 36 ) telescopically over the smaller, inner part 186 the prop 106 is moved and then the support is locked in the desired position with a pawl. The smaller, inner part 186 the support has receiving holes along its longitudinal direction at regular intervals 188 for receiving the suitably aligned pin of the snap closure or the latch 187 the locking device 190 ,

The cam-operated locking device 190 is securely fastened on the outer tube 185 the forearm support 106 , When used, the length of the forearm support 106 adapted by releasing a cam-operated pin or pawl 187 by clicking on a button 191 is pressed to the latch 187 to solve. The telescopic parts 185 . 186 the forearm support 106 are moved to the desired length and the pawl 187 will snap into a suitable receiving hole 188 , It expressly holds that the assembly 104 the locking mechanism an arrangement of cam 193 , triggering button 191 and the latch held by spring 187 is. In the locked position, when the two parts of the tube of the forearm support are releasably connected, a spring holds 192 the handle 187 in the reception hole 188 of the inner tube 186 the forearm support 106 , To the latch 187 from her recording hole 188 To lift, press the actuated by a cam trigger button 191 , The one with the trigger button 191 connected cam 193 press on the sloping surface 194 the pawl, reducing the contact pressure of the spring 192 is overcome, which the latch 187 holds in the hole. When the force of the spring 192 is overcome, the latch is 187 raised and the outer tube 185 the forearm support 104 is released and can along the surface of the inner tube 186 be moved to length adjustment.

As in 19 and 40 - 44 shown, the assembly is 112 the support for physical therapy connected to an angle element 115 through the holder 113 for the angle element attached to the angle element 115 is attached. On the holder 113 there is a guide 197 ( 41 and 42 ) through which the spring housing 198 At the end of the forearm support is performed to the intended for the upper arm part of the assembly 112 the support for physical therapy with the angle element 115 connect to.

The holder 113 ( 40 - 45 ) of the angle element has except one opening 197 for the spring housing 198 also a holding mechanism 200 consisting of a lever 201 in conjunction with a shaft 202 and a pawl 203 , Lifting and lowering the lever 201 raises and lowers the pawl 203 , A holder 205 on a collar 206 attached to the shaft of the shaft 207 the spring tension housing is mounted, is shaped so that it the pawl 203 picks up when the lever 201 is raised ( 44 ) and is at the same time shaped so that he the pawl 203 picks up when the lever 201 in the lowered position ( 43 ) is located. The holder 205 has an elongated shape to allow lateral movement of the shaft 207 allow the spring tension case and so the lateral movement of the entire assembly 112 support for physical therapy. The collar 206 The latch can be permanently attached to the shaft 207 of the spring tension housing 198 or be secured there by screws or other suitable means. A scale disk 209 of the angle element is locked by the in 40 and 45 shown screw 210 , The arrangement of the dial 209 stabilizes the angle element 115 and gives the angle element 115 more agility.

When using the DynaSplint ^TM Shoulder Device, the therapist gently fastens the patient to the shoulder device using the wrist stabilizer for even, daily use. The therapist then sets the tension for the outer shoulder rotation on the elbow tension element. The abduction angle element is then adjusted by merely adjusting the desired degree of abduction. The elevation component or the shoulder rotational tension is finally set. This is an extremely important feature of the Shoulder Therapy device because of its ability to address the multi-axial and multi-planar biomechanics of the complex shoulder joint. This movement is achieved by synchronized actions of the elevation, external rotation and telescopic components of this apparatus connecting the upper extremity.

Shoulder LPS ^TM system protocol

The Shoulder System is designed to treat advanced Capsulitis / stiff shoulder. The system uses the principles of dynamic load, also referred to as a longer lasting movement under low power sets.

The time required to complete the program from start to finish depends on many factors, including patient history, diagnosis, levels, severity. With the Dynasplint ^TM system, this duration can be three weeks to three months.

• 1. Setzen Sie sorgfältig die aktive und passive Schulterstreckung des Patienten in allen Ebenen, einschließlich Biegung, externe Drehung, Abduktion, horizontale Abduktion und interne Drehung fest. Der Patient benötigt am Anfang eine minimale Biegung von 70°, aktiv oder passiv zur Behandlung mit dem Vorrichtung oder des Schultertherapie-System zur Behandlung der steifen Schulter.
• 2. Nachdem einer richtigen Anpassung zwischen dem Patient und dem System, kann mit täglichen klinischen Anwendungen begonnen werden. Zuerst sollten die Anwendungen jeweils eine Dauer von 10 bis 15 Minuten haben (1 bis 3 mal pro Tag). Das Spannelement für das Heben wird bis 3.0 und das Spannelement für die externe Drehung wird bis 1.0 eingestellt.
• 3. Steigern Sie die Dauer der Anwendung bis zu 15 bis 30 Minuten je Anwendung (2 bis 3 mal pro Tag), wobei die eingestellte Spannung unverändert bleibt. Nach einem ein- bis zweiwöchigen klinischen Einsatz, kann der Patient außerdem mit täglichen Anwendungen zu Hause anfangen. Es kann auch vorteilhaft sein, feuchte Warmanwendungen während des Einsatzes der Vorrichtung zur Physiotherapie DynaSplint^TM durchzuführen. Dieses kann mit Warmpackungen oder heißen, nassen Tüchern erzielt werden. Bei der klinischen Behandlung, können andere Behandlungsinterventionen wie leichte gemeinsame Mobilisierung, leichte passive Streckbewegungen, Ultraschall, elektrische Reizungen etc., eingeleitet werden.
• 4. Nach der maximalen Dauer der Anwendung, steigen Sie die Spannung, soweit sie für den Patienten erträglich ist, in Stufensprüngen von 0.5 bei Extension und externer Drehung. Denken Sie daran, dass die Anwendung aller weiteren DynaSplint LDS^TM-Systeme niemals einen Zeitverlust bedeutet.

The following protocol is recommended:

• 1. Carefully assess the patient's active and passive shoulder extension in all planes, including flexion, external rotation, abduction, horizontal abduction, and internal rotation. The patient initially requires a minimum bend of 70 °, active or passive, for treatment with the device or shoulder therapy system for the treatment of the stiff shoulder.
• 2. Having a proper fit between the patient and the system, daily clinical applications can be started. First, the applications should each have a duration of 10 to 15 minutes (1 to 3 times a day). The lifting clamp is set to 3.0 and the external turning clamp is set to 1.0.
• 3. Increase the duration of the application up to 15 to 30 minutes per application (2 to 3 times a day), whereby the set tension remains unchanged. After one to two weeks of clinical use, the patient can also start home-based daily use. It may also be advantageous to perform moist warm applications during use of the DynaSplint ^™ Physiotherapy apparatus. This can be achieved with warm packs or hot, wet towels. In clinical treatment, other treatment interventions such as mild joint mobilization, mild passive stretching, ultrasound, electrical irritation, etc. may be initiated.
• 4. After the maximum duration of the application, increase the tension, as far as it is bearable for the patient, in increments of 0.5 with extension and external rotation. Keep in mind that using all other DynaSplint LDS ^TM systems will never waste time.

APPLICATION AT HIGH VOLTAGE LEVELS

It There are also many advantages offered by the preferred device for Physiotherapy of the stiff shoulder can be derived.

The Device is unique in that it supports dynamic stretching the shoulder allows. moreover In comparison with the passive motion devices, this one has Device has the advantage that by the additional use of the musculature the recovery progresses faster. The device is seen as a device primarily for treating stiff Shoulder (adhesive capsulitis), however the Device could be used to strengthen the muscles of the arm and shoulder.

It There are also many advantages offered by the preferred device for Physiotherapy of the stiff shoulder can be derived.

Under These advantages can be found in the fact that it is a new piston-like telescopic upper arm brace, which is not during the Use twisted or bent. The use of a special one Type of ball bearings reduces the high friction and facilitates the change the movements. Further, a rotation of the structure of the piston-like telescopic upper arm stay during of normal operation. A long life of the therapy device is thus guaranteed.

The Forearm strut may be in terms of length by an easy to use Catch can be adjusted easily. The elbow joint guide leaves the smooth angle adjustment of the elbow joint too.

Intended is a simple device for quick locking and unlocking the physiotherapy device to the elbow joint holder on the left side of the bottom with the elbow joint holder to connect on the right side or reverse.

Obviously can many changes be made without departing from the basic spirit of the present Deviate from the invention. Accordingly, it will be from the professionals estimated that within the scope of the appended claims, the invention is different specifically described herein.

Claims (6)

An articulated device ( 100 ) for the physical therapy of the shoulder for the improvement of the range of motion of a shoulder, which enables the active multi-axial physical therapy of a shoulder, said device with a forearm strut ( 106 ), which is connected via an elbow joint to a first end of a piston-shaped telescopic upper arm strut and wherein the second end of said piston-shaped telescopic upper arm strut is connected to a shoulder joint and provided with means for supporting the multi-axial rotation of the shoulder the physical therapy device is also provided with one or more tensioning elements for applying tension to the shoulder during active multi-axial physical therapy to thereby improve the mobility of the shoulder and accelerate the return of the shoulder to normal mobility, characterized in that said piston-shaped telescopic upper arm strut consists of opposing sets of several rods ( 162 . 163 ) and several boundary plates ( 124 . 125 ), wherein the piston-shaped telescopic upper arm strut an extension or shortening of the Allows upper arm brace during active multi-axial physical therapy of the shoulder and between its first end and its second end comprises: - a first set of rods ( 162 ), which at the first end portion of the upper arm strut ( 102 ) and which are adapted to move through a first set of boundary plates ( 136 . 139 ) to move through; - a second set of poles ( 163 ) located at the second end region of the upper arm strut (FIG. 102 ) and which are adapted to pass through a second set of boundary plates ( 137 , 140 ) to move through; and - means ( 127 . 141 ) to the first and second sets of boundary plates ( 137 . 140 ) in a fixed spatial relationship to each other. The articulated shoulder physical therapy device according to claim 1, wherein the opposing sets of a plurality of rods and a plurality of restriction plates are housed in a cylindrical cladding tube (10). 122 ) are arranged. The articulated shoulder physical therapy device of claim 1, wherein the plurality of boundary plates have bores ( 150 ) through which the plurality of rods can slide during their reciprocation. The articulated physical therapy device of Shoulder according to claim 1, wherein the tensioning element for exerting pressure on the shoulder at an elbow joint between the forearm strut and the humerus strut is arranged. The articulated physical therapy device of Shoulder according to claim 1, wherein the tensioning element for exerting pressure on the shoulder is arranged on the shoulder joint of the humerus strut. An articulated physical therapy device the shoulder according to claim 1, wherein a clamping element on the shoulder joint and a second clamping element is arranged at the elbow joint.