DK179003B1

DK179003B1 - Apparatus for training, investigating and re-educating neuro-muscular functions in a subject

Info

Publication number: DK179003B1
Application number: DKPA201600148A
Authority: DK
Inventors: Claus Nygaard Jensen; Jesper K B Heltzen
Original assignee: Robofit Aps
Priority date: 2016-03-10
Filing date: 2016-03-10
Publication date: 2017-08-07
Also published as: EP3426358A1; DK201600148A1; WO2017153232A1

Abstract

The present invention relates to apparatus´ for training, investigating and reeducating neuro-muscular functions in a subject.

Description

Background of the invention

There is a definite need for greatly improved exercise machines in the medical field of physical rehabilitation. The same principles of muscular strength development apply to victims of accident or disease as to athletes. However, rehabilitation patients are in even greater need for highly individualized and carefully regulated exercise. In rehabilitation, the objectives are to achieve the greatest possible increases in muscular strength and mobility, in specific muscles and movements, in the shortest possible time. In cases involving nerve damage or paralysis, a further objective of exercise therapy is the development of nerve pathways to the affected muscles. Recent studies have shown that exercise machines, which are capable of actively moving a paralysis patient's arms or legs in a cyclic motion, called "passive exercise”, can be of great benefit in partially restoring nerve function and mobility. If the same exercise is used on patients recovering from surgery, the advantage is, in addition to the above, a significant reduction of pain in the specific muscles or joints.

Exercise equipment for rehabilitation is at about the same state of advancement as athletic equipment. In fact, standard athletics-oriented machines are often used in rehabilitation clinics. In the cases where specialized machines have been built, their effectiveness is highly limited; largely because they are suitable for only one very specific exercise. Other machines build specifically for rehabilitation, is often very costly. This means that only very few specialized rehabilitation units, such as those in hospitals, can afford to acquire these machines. Hence, only few patients receive the benefit of the specialised equipment.

The complaints about present exercise machines from hospitals and clinics with rehabilitation facilities, and from doctors who specialize in this field are numerous and significant. One common problem is that most machines use weights to provide the resisting force. The inertia of the weights allows the patient to throw or jerk the device in order to avoid exercising through regions of extreme weakness - precisely the regions where exercise is most needed. Other problems mentioned are lack of fine enough variation of resisting force, lack of adaptation to the patient's size, no allowance for the adjustment of the variation of resisting force with position, and general lack of adaptability to the individual patient's specific needs.

Muscular strength is most rapidly developed by using various types of devices and machines, which provide forces to resist movement by the subject. In order to attain a rate of increase of strength and a level of strength greater than those attainable through participation in most sports and other athletic activities, relatively high resisting forces must be used. The most common presently available means for obtaining high-resistance exercise are the pulley-weight machine, the barbell, spring-action devices, and frictional devices, of both mechanical and fluid type.

The highest levels of muscular size and strength are attained through high-resistance exercise of short duration, involving only a few muscle groups at any one time. Complete isolation of individual muscles or muscle groups during exercise tends to produce the highest rate of increase in muscular strength. Exercise in which the subject-exerted force is in a direction opposite to the direction of movement, called "negative or eccentric exercise", is especially effective in development of strength. It is most effective when used in combination with "positive or concentric exercise", in which the subject-exerted force and the movement are in the same direction.

The primary biological mechanism by which muscle fibers are stimulated to grow involves the accumulation of certain biomolecules produced during intense muscular contraction. These biomolecules act as signal transducers sending a signal to the muscle fiber cells resulting in increases in the quantity of the protein-based muscle tissue. Exercise against light resistance has relatively little effect on muscular strength, but, if sustained for sufficiently long periods, it is most effective in increasing muscular endurance.

The amount of force that can be exerted by the arms or legs is highly dependent on their position and angular orientation. It depends both on the direction in which force is being exerted and on the angles of the joints. In order to obtain maximum muscular strength throughout the full range of movement, the resisting forces of an exercise must vary according to the individual's strength potential at any given position along the path of motion. Only a few very expensive machines provide for this kind of variable resistance, and these machines do not provide for variation of the functional relationship between resistance and position. Thus, they do not conform to the individual subject's strength-potential curve, but only to that of some "average" subject profiles. Exercise in which the resisting force does not conform to the subject's particular strength-potential curve results in lower development of strength over certain segments of a path of motion as compared to that over other segments. Exercising a muscle in one position only is not effective in increasing strength at other positions.

The starting and finishing positions of an exercise motion are important. A fully extended starting position is necessary to obtain maximum intensity of muscular contraction during the exercise motion. The longest possible path of motion also allows for increases in flexibility. Due to the large variations in physical dimensions among the subjects, all presently available exercise machines have serious limitations in this respect.

The speed at which an exercise is performed is very important. This is because there are two distinct types of muscle fibers which comprise every skeletal muscle. The red, or slow-twitch, fibers provide forces primarily during slow movements. The white, or fast-twitch, fibers can contract only during relatively fast movements, and are used primarily in high-speed activities such as sprinting or swimming. Muscle performance at high speed cannot be improved by low-speed exercise. Nor can low-speed muscle strength be improved significantly by high-speed exercise. For these reasons, an athlete must train selectively for the particular event or activity in which he specializes.

Exercise done at a fixed speed and with variable resistance is called isokinetic. Conventional exercise machines, which use weights to provide the resisting force, are not very well suited for isokinetic exercise. Because weights have inertia, the speed of the exercise will vary greatly throughout the motion, allowing for optimum speeds and resistances only over a short segment of the full range of motion. There are some machines presently available, which are primarily intended for isokinetic exercise. Most of them make use of fluid technology to provide exercise in which resisting force is dependent only on speed.

In order to achieve maximum rates of strength increase, muscles must be exercised independently, and with high intensity. In order to maximize strength increases throughout a movement required in some athletic event, or, to be more specific, to maximize the integral of strength with respect to displacement along this path of motion, a high-resistance exercise must be used, and the path of motion must be very similar to that of the movement required in the event. US4678184 discloses an apparatus for training, investigating and re-educating neuro-muscular functions in a subject. The apparatus comprises: a frame fixed on a support; a work member, supported by said frame, for interfacing with a subject to be exercised; a non-drivable motor means ratable in a motor direction first and second mechanical transmission means arranged in parallel between the motor means and the work member; said first mechanical transmission means being provided for driving said work member in a first direction of motion, depending upon the motor direction, and comprising a controllable force coupler; said second mechanical transmission means being provided to drive said work member in a second direction of motion opposed to said first direction of motion, and comprising a unidirectional drive means for rendering said second mechanical transmission means operative when an absolute value of the ratio between the work member speed and the motor means speed exceeds a preselected threshold; and means for controlling said motor means and said controllable force coupler as a function of predetermined parameters.

It is therefore desirable to provide an apparatus that can overcome all or some of the above problems.

Summary of the invention

One aspect relates to an apparatus for training, investigating and re-educating neuro-muscular functions in a subject, the apparatus comprising: - a work member for interfacing with a subject to be exercised and comprising a rotary drum on which a cable is wound, said cable having a cable end being adapted for attachment to grasping means for grasping by said subject; - optionally, grasping means for grasping by said subject; - an electric motor adapted for driving the rotary drum in a cable unwinding and rewinding operation; - a first electronic detector configured to continuously transmit data on the positions associated with the work member and/or with the grasping means; - a second electronic detector configured to continuously transmit data on the forces associated with the work member; and - a processor; wherein the processor is configured to a) continuously receive the data from the first electronic detector on the positions associated with the work member and/or with the grasping means and b) configured to continuously receive the data from the second electronic detector on the forces associated with the work member; and wherein the processor is configured to instruct the electric motor to change from a cable unwinding operation to a cable rewinding operation, or vice versa, in response to the combination of data received from the first and second electronic detector.

In one or more embodiments, the position associated with the work member is estimated using the motor position.

Disclosed herein is an apparatus for training, investigating and re-educating neuromuscular functions in a subject. The apparatus comprises a work member for interfacing with a subject/subject to be exercised or investigated. The work member comprises a rotary drum on which a cable is wound. The work member may in one or more embodiments comprise attachment means for attaching the rotary drum to a supporting frame.

The cable has a cable end being adapted for attachment to grasping means for grasping by said subject.

The apparatus may also comprise grasping means for grasping by said subject.

In one or more embodiments, the cable end is adapted for attachment to the cable of a weight-training machine. This allows for a nearly complete reuse of the weighttraining machine (such as the framework and grasping means), except for the weights. Furthermore, in one or more embodiments, the weights may be retained, such that the subject can switch from normal weight training to training according to the present invention.

In one or more embodiments, the cable has a cross-section that is essentially circular. This is an advantage over flat cables, which are more restricted in the working angle towards the rotary drum. When using flat cables, the subject will have to stand in line with the rotary drum when pulling the cable.

In the present context, the term “essentially circular” is to be understood broadly and should even include elliptical, oval, and other geometries that vary from a precise circular shape.

In one or more embodiments, the cable has a cross-section that is circular.

In one or more embodiments, the cable is a static cable as opposed to a dynamic cable (or elastic cable). This is important, as any elasticity will affect the electronic sensors and result in errors in calculation/direct measurement of force and cable position.

The apparatus further comprises an electric motor adapted for driving the rotary drum in a cable unwinding and rewinding operation.

In one or more embodiments, the electric motor is coupled to a gearbox.

The apparatus also comprises a first electronic detector configured to continuously transmit data on the positions associated with the work member and/or with the grasping means. Any type of electronic position detector may be used. The electronic sensor may as an example be configured to calculate the linear distance between the rotary drum and the cable end (adapted for attachment to the cable of a weight-training machine/grasping means) by measuring the number of rotations of the rotary drum.

The apparatus further comprises a processor. The processor is configured to continuously receive the data on the positions associated with the work member and/or with the grasping means. This is important, as knowledge of the position of e.g. the cable end is used in many of the operations of the apparatus.

The processor may also be configured to instruct the electric motor to change from a cable unwinding operation to a cable rewinding operation, or vice versa, in response to received data from the first electronic detector.

In one or more embodiments, the first electronic detector detects and transmits the positions associated with the work member and/or with the grasping means at least 5 times per second, such as at least 10 times per second, such as at least 15 times per second, such as at least 20 times per second, such as at least 25 times per second, such as at least 30 times per second, such as at least 35 times per second, such as at least 50 times per second, such as at least 75 times per second, such as at least 100 times per second, such as at least 150 times per second, such as at least 200 times per second, such as at least 250 times per second, such as at least 300 times per second. The need for a very fast detection and transmission may vary between different operations of the apparatus. If the subject is intended to move the cable at high speed, the first electronic detector must be able to inform the processor accordingly about the positions.

In one or more embodiments, the processor is configured to receive and process data at a speed of at least 5 Hz, such as at least 10 Hz, such as at least 15 Hz, such as at least 20 Hz, such as at least 25 Hz, such as at least 30 Hz, such as at least 35 Hz, such as at least 50 Hz, such as at least 75 Hz, such as at least 100 Hz, such as at least 150 Hz, such as at least 200 Hz, such as at least 250 Hz, such as at least 300 Hz.

In one or more embodiments, the apparatus further comprises a second electronic detector configured to continuously transmit data on the forces associated with the work member; and wherein the processor is configured to continuously receive the data on the forces associated with the work member. This information is important for many of the operations of the apparatus.

In one or more embodiments, the second electronic detector detects and transmits the forces associated with the work member at least 5 times per second, such as at least 10 times per second, such as at least 15 times per second, such as at least 20 times per second, such as at least 25 times per second, such as at least 30 times per second, such as at least 35 times per second, such as at least 50 times per second, such as at least 75 times per second, such as at least 100 times per second, such as at least 150 times per second, such as at least 200 times per second, such as at least 250 times per second, such as at least 300 times per second. The need for a very fast detection and transmission may vary between different operations of the apparatus.

In the following, different non-limiting exercise or measurement examples are used to show the diversity of operations that the apparatus of the present invention is capable of performing. In general, the apparatus is capable of counteracting unwanted actions by the subject/subject, such as application of too much or too little force, and performing the operation too fast or too slow.

Constant speed

The purpose with this type of exercise is to perform isokinetic workout (i.e. workout with constant speed) in concentric (where the muscle fibers contract) and eccentric motion (where the muscle fibers are stretched). The training is particularly suitable for building muscle mass.

Example (Figure 2A): The subject start the exercise in a pre-set cable position where the cable is essentially rewound. The subject grasps the grasping means with his hands and moves his hand(s) downwards, thereby exerting a force on the rotary drum through the cable (pulling on the cable). The exercise will start when the force performed by the subject exceeds a pre-set initiation force. The processor will then instruct the electric motor to unwind the cable at a pre-set speed until a pre-set cable position is reached. This operation allows the subjects arm to move from an essentially horizontally position to an essentially vertical position. This is the concentric part of the exercise.

When the pre-set cable position is reached, and thereby the hand/arm reaches a pre-set position, the processor is configured to instruct the electric motor to change from a cable unwinding operation to a cable rewinding operation. This will result in the arm/hand being returned to its initial position, again at constant speed, while the subject/subject is instructed to exert a force in the opposite direction. This is the eccentric part of the exercise.

During the unwinding operation, the subject/subject may exert too much force on the rotary drum, resulting in an unwanted increase in the cable unwinding speed; or even result in damage to the electric motor. A situation may also appear where the force applied by the subject is below a pre-set minimum force. The apparatus according to the present invention is capable of counteracting such events.

Hence, in one or more embodiments, the electric motor is programmable to operate at constant speed.

In one or more embodiments, the electric motor is programmable to operate at constant speed, and wherein: a) during a cable unwinding operation at constant speed, when the cable is unwound from the rotary drum by the subject at a speed above a pre-set speed, the electric motor is configured to increase torque in the opposite direction of rotary drum rotation until the speed has reached the pre-set speed; and/or b) during a cable unwinding operation at constant speed, when the cable is unwound from the rotary drum by the subject at a speed below a pre-set speed, the electric motor is configured to decrease torque in the opposite direction of rotary drum rotation until the speed has reached the pre-set speed; and/or c) during a cable unwinding operation at constant speed, when the force applied by the subject is below a pre-set minimum force, the processor is configured to instruct the electric motor to apply the necessary torque to maintain the cable position until the pre-set minimum force is reached; and/or d) during a cable unwinding operation at constant speed, when the force applied by the subject is above a pre-set maximum force, the processor is configured to instruct the electric motor to unwind until a pre-set end cable position is reached, and then stop.

During the rewinding operation, the subject/subject may exert too much force on the rotary drum, resulting in an unwanted decrease in the cable unwinding speed; or even result in damage to the electric motor. A situation may also appear where the force applied by the subject is below a pre-set minimum force. The apparatus according to the present invention is capable of counteracting such events.

Hence, in one or more embodiments, the electric motor is programmable to operate at constant speed, and wherein: a) during a cable rewinding operation at constant speed, when the cable is rewound on the rotary drum at a speed above a pre-set speed, the electric motor is configured to increase the torque until the speed has reached the pre-set speed; and/or b) during a cable rewinding operation at constant speed, when the cable is rewound from the rotary drum by the subject at a speed below a pre-set speed, the electric motor is configured to decrease the torque until the speed has reached the pre-set speed; and/or c) during a cable rewinding operation at constant speed, when the force applied by the subject is under a pre-set minimum force, the processor is configured to instruct the electric motor to apply the necessary torque to maintain the cable position until the minimum force is reached; and/or d) during a cable rewinding operation at constant speed, when the force applied by the subject is over a pre-set maximum force, the processor is configured to instruct the electric motor to unwind until a pre-set end cable position is reached, and then stop.

Variable speed

The variable speed operation is considerably more flexible than the constant speed operation.

The purpose of this type of exercise is to build muscle mass, but can be used for a wide range of purposes. Examples are to practice acceleration (explosive movements); to focus the training on a particular part of the movement; or to operate the exercise controlled and slowly at any point on, or part of, the path of movement, where the subject/subject has difficulties and/or pain. Variable speed motion is suitable for both concentric and eccentric exercise.

Example (Figure 2B): This exercise mimics a rowing movement. The subject starts the exercise in a seated position, and with the arms in a horizontal position. In this position, the cable is substantially rewound. The subject then moves the arms towards the torso by pulling on the cable. The exercise will start when the force performed by the subject on the rotary drum exceeds a pre-set initiation force. The speed is variable along the movement and pre-set for optimal rowing speed at a specific position along the path of motion. Thereby, the acceleration of the ore in the water is mimicked. The subject then performs, at a controlled speed and substantially without application of force, the movement towards the starting position. Thus, the focus of this exercise is mainly concentric.

In one or more embodiments, the electric motor is programmable to operate at variable speed as a function of cable position during the cable unwinding operation.

In one or more embodiments, the electric motor is programmable to operate at variable speed as a function of cable position during the cable unwinding operation, and wherein: a) during a cable unwinding operation at variable speed, wherein speed is a function of cable position, when the cable is unwound from the rotary drum by the subject at a speed above a pre-set speed at a specific cable position, the processor is configured to instruct the electric motor to increase torque in the opposite direction of rotary drum rotation until the speed has reached the pre-set speed; and/or b) during a cable unwinding operation at variable speed, wherein speed is a function of cable position, when the cable is unwound from the rotary drum by the subject at a speed below a pre-set speed at a specific cable position, the processor is configured to instruct the electric motor to decrease torque in the opposite direction of rotary drum rotation until the speed has reached the pre-set speed; and/or c) during a cable unwinding operation at variable speed, wherein speed is a function of cable position, when the force applied by the subject is under a pre-set minimum force at a specific cable position, the processor is configured to instruct the electric motor to apply the necessary torque to maintain the cable position until the minimum force is reached; and/or d) during a cable unwinding operation at variable speed, wherein speed is a function of cable position, when the force applied by the subject is over a pre-set maximum force at a specific cable position, the processor is configured to instruct the electric motor to unwind until a pre-set end cable position is reached, and then stop.

In one or more embodiments, the electric motor is programmable to operate at variable speed as a function of cable position during the cable rewinding operation.

In one or more embodiments, the electric motor is programmable to operate at variable speed as a function of cable position during the cable rewinding operation, and wherein: a) during a cable rewinding operation at variable speed, wherein speed is a function of cable position, when the cable is rewound from the rotary drum by the subject at a speed above a pre-set speed at a specific cable position, the processor is configured to instruct the electric motor to decrease torque until the speed has reached the pre-set speed; and/or b) during a cable rewinding operation at variable speed, wherein speed is a function of cable position, when the cable is rewound from the rotary drum by the subject at a speed below a pre-set speed at a specific cable position, the processor is configured to instruct the electric motor to increase torque until the speed has reached the pre-set speed; and/or c) during a cable rewinding operation at variable speed, wherein speed is a function of cable position, when the force applied by the subject is under a pre-set minimum force, the processor is configured to instruct the electric motor to apply the necessary torque to maintain the cable position until the minimum force is reached; and/or d) during a cable rewinding operation at variable speed, wherein speed is a function of cable position, when the force applied by the subject is over a pre-set maximum force, the processor is configured to instruct the electric motor to unwind until a preset end cable position is reached, and then stop.

Constant torque

The purpose of the exercise is to imitate existing weight exercise equipment, but at the same time obtain a more controlled torque during the entire path of motion. This is particularly useful for people with an injured shoulder, where mobility and/or strength is limited (e.g. due to pain).

Example (Figure 2C):

The subject is sitting with the forearm on a turntable to which the apparatus of the present invention is connected. The turntable rotates around the shoulder rotation axis.

Once the subject pulls the turntable, he will be able to rotate the arm inwards, provided that the applied force is larger than the pre-set torque. If the subject applies a force that is equal to the pre-set torque, his arm will not move. Finally, if the subject pulls with a force less than the pre-set torque, his arm will move outwards.

In one or more embodiments, the electric motor is programmable to operate at constant torque.

Variable torque:

The purpose of this type of exercise is to vary the torque along the path of motion. This allows the subject the opportunity to work at maximum strength along the entire path of motion. Alternatively, it allows the subject to relax at specific parts of the path of motion. Subjects suffering from hemiplegia and hemiparesis may also benefit from this type of exercise, since the apparatus according to the invention can be programmed to consider this situation.

In one or more embodiments, electric motor is programmable to operate at variable torque as a function of cable position during the cable unwinding operation.

In one or more embodiments, the electric motor is programmable to operate at variable torque as a function of cable position during the cable rewinding operation.

Variable torque in a static operation:

Sometimes, the physiotherapist wish the apparatus to provide a static force measurement in a given position along a path of motion, that give an indication of the subject's strength in that body position. This may serve as input for the preparation of the final training program.

In one or more embodiments, the electric motor is programmable to operate at variable torque during a static operation.

In one or more embodiments, the electric motor is programmable to operate at variable torque during a static operation, wherein when during a static operation at a fixed cable position, the force applied by the subject on the rotary drum varies, the processor is configured to instruct the electric motor to apply the necessary opposite torque to hold the fixed cable position.

Constant or variable speed assisted operation:

Active assisted operation is used for very mild muscle building exercise, and solely for people with severely reduced muscle mass, mobility, or movement. The subject is typically so disabled that it will not be possible with own forces to conduct an exercise, and therefore needs help in all or parts of the path of motion.

Example (Figure 2D): The patient is sitting in a wheelchair and can only lift a few weight percentages of his own leg. The apparatus is programmed to perform a weight calibration of the subject’s leg as a function of the path of motion. This is important in order to know how much the weight of the leg assists or counteract during the path of motion. Furthermore, the apparatus is configured to measure how much force the patient's leg can apply to the rotary drum through the cable along the entire path of motion. From this information, the apparatus can be pre-set to assist only when the subject applies a minimum force in a given position along the path of motion.

In this example, the subject starts in the lower position and must raise his leg until a pre-set distance/position is reached. When the subject reaches the pre-set top position, the eccentric part of the exercise is completed. The subject must maintain his lifting force while the apparatus unwind the cable to return the leg to its starting position. This is the concentric part of the exercise.

In one or more embodiments, the electric motor is programmable to operate at constant or variable speed during an active assisted operation over a pre-set distance of the cable unwinding operation.

In one or more embodiments, the electric motor is programmable to operate at constant speed during an active assisted operation over a pre-set distance of the cable unwinding operation, and wherein: a) during an unwinding operation, when the cable is unwound from the rotary drum at a speed below a pre-set speed and the force applied by the subject on the rotary drum is less strong than a pre-set force, the processor is configured to instruct the electric motor to decrease the torque in the opposite direction of rotary drum rotation until the speed has reached the pre-set speed; and/or b) during an unwinding operation, when the cable is unwound from the rotary drum at a speed above a pre-set speed and the force applied by the subject on the rotary drum is less strong than a pre-set force, the processor is configured to instruct the electric motor to increase the torque in the opposite direction of rotary drum rotation until the speed has reached the pre-set speed; and/or c) during an unwinding operation, when the cable is unwound from the rotary drum at a speed above/below a pre-set speed and the force applied by the subject on the rotary drum is stronger than a pre-set force, the processor is configured to instruct the electric motor to increase the torque in the opposite direction of rotary drum rotation until the speed is null, and then hold the cable position.

In one or more embodiments, the electric motor is programmable to operate at constant speed during an active assisted operation over a pre-set distance of the cable rewinding operation.

In one or more embodiments, the electric motor is programmable to operate at constant speed during an active assisted operation over a pre-set distance of the cable rewinding operation, and wherein: a) during a rewinding operation, when the cable is rewound from the rotary drum at a speed below a pre-set speed and the force applied by the subject on the rotary drum is less strong than a pre-set force, the processor is configured to instruct the electric motor to decrease the torque in the direction of rotary drum rotation until the speed has reached the pre-set speed; and/or b) during a rewinding operation, when the cable is unwound from the rotary drum at a speed above a pre-set speed and the force applied by the subject on the rotary drum is stronger than a pre-set force, the processor is configured to instruct the electric motor to increase the torque in the direction of rotary drum rotation until the speed has reached the pre-set speed; and/or c) during a rewinding operation, when the cable is rewound from the rotary drum at a speed above/below a pre-set speed and the force applied by the subject on the rotary drum is stronger than a pre-set force, the processor is configured to instruct the electric motor to decrease the torque in the direction of rotary drum rotation until the speed is null, and then hold the cable position.

In one or more embodiments, the processor is configured to count the number of repetitions of a given exercise, and wherein the processor is configured to instruct the electric motor to increase/decrease a pre-set torque and/or speed from one repetition (cycle of unwinding to rewinding or vice versa) to another.

In one or more embodiments, the processor is configured to count the number of repetitions of a given exercise.

Passive training:

The passive training operation is designed to alleviate pain and increase mobility. The subject will be as passive as possible throughout the exercise to allow the apparatus to move the body. The operation loosens the joints and muscles. The operation is suitable for patients who have been in an accident or post-operative patients that need to regain their flexibility in the joints.

Example (Figure 2E): The patient is bedridden, and is as relaxed as possible. The apparatus is pre-set to run through a given path of motion at a given speed for a given time or number of repetitions. In severe trauma, this operation could begin while the patient is in a coma, and will maintain the flexibility of the joints and muscles.

In one or more embodiments, the processor is configured to perform a passive training exercise at a pre-set speed and over a pre-set distance of unwinding and/or rewinding.

In one or more embodiments, the processor is configured to perform a passive training exercise at a pre-set speed and over a pre-set path of motion.

Variable speed and variable subject applied minimum force:

This is the most flexible of the strength-building exercise operations. This type of operation can be used in situations where the subjects muscle strength varies markedly over the path of motion. At the same time the subject may be limited in his path of motion compared to a normal situation (e.g. due to pain). The operation is also used in a situation where there is a specific focus on increasing one type of muscle fibers in one part of the path of motion, and another type in another part of the path of motion.

Example (Figure 2F): In this example, the subject is a wheelchair patient suffering from spasms. Therefore, the patient has difficulty controlling his arm in extreme positions while maintaining a pull on the cable. The apparatus in programmed such that the subject must pull with increasing force/weight in the lower part of the exercise, while force and speed will be significantly reduced in the upper part of the exercise.

In one or more embodiments, the electric motor is programmable to operate at variable subject applied minimum force and speed as a function of cable position during a cable rewinding and/or unwinding operation.

In one or more embodiments, the electric motor is programmable to operate at variable speed and subject applied minimum force as a function of cable position during a cable unwinding operation.

In one or more embodiments, the electric motor is programmable to operate at variable speed and subject applied minimum force as a function of cable position during a cable unwinding operation, and wherein: a) during a cable unwinding operation at variable speed and subject applied minimum force, wherein speed and subject applied minimum force is a function of cable position, when the cable is unwound from the rotary drum by the subject at a speed and force stronger than a pre-set speed and pre-set subject applied minimum force at a specific cable position, the processor is configured to instruct the electric motor to increase torque in the opposite direction of rotary drum rotation until the speed has reached the pre-set speed; and/or b) during a cable unwinding operation at variable speed and subject applied minimum force, wherein speed and subject applied minimum force is a function of cable position, when the cable is unwound from the rotary drum by the subject at a speed below a pre-set speed and at a force above a pre-set subject applied minimum force at a specific cable position, the processor is configured to instruct the electric motor to decrease torque in the opposite direction of rotary drum rotation until the speed has reached the pre-set speed; and/or c) during a cable unwinding operation at variable speed and subject applied minimum force, wherein speed and subject applied minimum force is a function of cable position, when the force applied by the subject is under a pre-set subject applied minimum force at a specific cable position, the processor is configured to instruct the electric motor to apply the necessary torque to maintain the cable position until the minimum force is applied; and/or d) during a cable unwinding operation at variable speed and subject applied minimum force, wherein speed and subject applied minimum force is a function of cable position, when the force applied by the subject is above a pre-set maximum force at a specific cable position, the processor is configured to instruct the electric motor to unwind until a pre-set end cable position is reached, and then stop.

In one or more embodiments, the electric motor is programmable to operate at variable speed and subject applied minimum force as a function of cable position during a cable rewinding operation.

In one or more embodiments, the electric motor is programmable to operate at variable speed and subject applied minimum force as a function of cable position during a cable rewinding operation, and wherein: a) during a cable rewinding operation at variable speed and subject applied minimum force, wherein speed and subject applied minimum force is a function of cable position, when the cable is rewound from the rotary drum by the subject at a speed and force above a pre-set speed and pre-set subject applied minimum force at a specific cable position, the processor is configured to instruct the electric motor to decrease torque until the speed has reached the pre-set speed; and/or b) during a cable rewinding operation at variable speed and subject applied minimum force, wherein speed and subject applied minimum force is a function of cable position, when the cable is rewound from the rotary drum by the subject at a speed below a pre-set speed and at a force above a pre-set subject applied minimum force at a specific cable position, the processor is configured to instruct the electric motor to increase torque until the speed has reached the pre-set speed; and/or c) during a cable rewinding operation at variable speed and subject applied minimum force, wherein speed and subject applied minimum force is a function of cable position, when the force applied by the subject is under a pre-set subject applied minimum force at a specific cable position, the processor is configured to instruct the electric motor to apply the necessary torque to maintain the cable position until the minimum force is applied; and/or d) during a cable rewinding operation at variable speed and subject applied minimum force, wherein speed and subject applied minimum force is a function of cable position, when the force applied by the subject is over a pre-set maximum force, the processor is configured to instruct the electric motor to unwind until a preset end cable position is reached, and then stop.

Increase/decrease of torque and/or speed and/or position from one repetition to another:

In the case where the subject is performing a workout, which is relatively high in performance in relation to his existing muscle mass, it may be necessary to downgrade the torque or speed continuously as the subject’s muscles undergo fatigue from one repetition to another.

Example: If the subject apply 100% of his strength in the first repetition, he will only be able to apply 80-90% of his maximum strength in the subsequent repetition. The apparatus is programmed to consider this situation by reducing the torque and/or speed from one repetition to another with a pre-set percentage.

Max force calibration:

This operation is used to determine the subject's maximum strength as a function of the path of motion. This information can be used directly or indirectly to calibrate the apparatus. The maximum strength varies along the path of motion for every human being. However, the variation is attenuated for patients with nerve damage, as well as for newly operated patients.

Body mass calibration:

This operation is used to determine the impact on the force of gravity on the exercise. This information is used to calibrate many exercises.

One aspect relates to the use of an apparatus according to the present invention for training, investigating and re-educating neuro-muscular functions in a subject.

It should be noted that embodiments and features described in the context of one of the aspects of the present invention also apply to the other aspects of the invention.

Brief description of the figures

Figure 1 shows an apparatus in accordance with various embodiments of the invention; and

Figures 2A-2F show examples of exercises possible with the apparatus of the invention.

Detailed description of the invention

Referring to Figure 1, the apparatus 100 is shown with the work member and processor 500 mounted on a frame. The electric motor 400 is positioned within the rotary drum 220 to provide a compact apparatus. The circular cable 240 is shown in a rewound position.

References 100 Apparatus 220 Rotary drum 240 Cable 400 Electric motor 500 Processor

Claims

An apparatus for training, examining and re-training neuromuscular functions in a subject, the apparatus comprising: - a machine part for interface with a subject to be trained and comprising a rotating drum on which a cable is wound, said cable having a cable end adapted for attachment to gripping agents which the subject may hold; - optional, gripping agents that the subject can hold; an electric motor for driving the rotary drum in a cable roll-out and roll-back operation; - a first electronic detector set to transmit data continuously on the positions associated with the machine part and / or the gripping means; - another electronic detector set to continuously transmit data on the strength associated with the machine part; and - a processor; wherein the processor is set to a) continuously receive data from the first electronic detector on the positions associated with the machine part and / or the gripping means and b) continuously receive data from the second electronic detector on the strength associated with the machine part; and wherein the processor is set to instruct the electric motor to switch from a cable unrolling operation to a cable unrolling operation, or vice versa, in response to the combination of data received from the first and second electronic detectors.

The apparatus of claim 1, wherein the electric motor can be programmed to operate at a constant speed and wherein: a) during a cable unrolling operation at a constant speed when the cable is unrolled from the rotary drum by the subject at a speed higher than a preset speed, the electric motor is set to increase the torque in the opposite direction of the rotation of the rotating drum until the speed has reached the preset speed; and / or b) during a cable unrolling operation at constant speed, when the cable is unrolled from the rotating drum by the subject at a speed lower than a preset speed, the electric motor is set to lower the torque in the opposite direction of the rotating rotating the drum until the speed has reached the preset speed; and / or c) during a cable rollout operation at a constant speed when the force used by the subject is less than a preset minimum power, the processor is set to instruct the electric motor to apply the required torque to maintain the cable position until the preset minimum strength is reached; and / or d) during a constant-speed cable unrolling operation when the force used by the subject is greater than a preset maximum power, the processor is set to instruct the electric motor to roll out until a preset end cable position is reached, and then stop; and / or e) during a cable retraction operation at constant speed when the cable is rolled back on the rotating drum at a speed higher than a preset speed, the electric motor is set to increase the torque until the speed has reached the preset speed. ; and / or f) during a cable retraction operation at constant speed, when the cable is rolled back on the rotating drum by the subject at a speed lower than a preset speed, the electric motor is set to lower the torque until the speed has reached it. preset speed; and / or g) during a cable rollback operation at constant speed when the force used by the subject is lower than a preset minimum power, the processor is set to instruct the electric motor to apply the required torque to maintain the cable position until the minimum strength is reached; and / or h) during a constant-speed cable rollback operation when the force used by the subject is greater than a preset maximum power, the processor is set to instruct the electric motor to roll out until a preset cable position is reached, and then stop.

The apparatus of any one of claims 1-2, wherein the electric motor can be programmed to operate at variable speed determined by a cable position, and wherein: a) during a variable speed cable unrolling operation, where speed is determined by cable position when the cable is unrolled by the rotary drum of the subject at a speed higher than a preset speed at a particular cable position, the processor set to instruct the electric motor to increase the torque in the opposite direction of the rotation of the rotating drum until the speed has reached it. preset speed; and / or b) during a variable speed cable roll-out operation, where speed is determined by cable position when the cable is unrolled from the rotary drum by the subject at a speed lower than a preset speed at a particular cable position, the processor is set to provide the electric motor is instructed to lower the torque in the opposite direction of the rotation of the rotating drum until the speed has reached the preset speed; and / or c) during a variable speed cable unrolling operation, where speed is determined by cable position when the force used by the subject is lower than a preset minimum power at a particular cable position, the processor is set to notify the electric motor that apply the necessary torque to maintain the cable position until the minimum strength is reached; and / or d) during a variable speed cable rollout operation, where speed is determined by cable position when the force used by the subject is greater than a preset maximum power at a particular cable position, the processor is set to notify the electric motor that roll out until a preset end cable position is reached, and then stop; and / or e) during a variable speed cable rollback operation, where speed is determined by cable position when the cable is rolled back on the rotary drum by the subject at a rate higher than a preset speed at a particular cable position, the processor is set to instruct the electric motor to lower the torque until the speed has reached the preset speed; and / or f) during a variable speed cable rollback operation, where speed is determined by cable position when the cable is rolled back on the rotary drum by the subject at a rate lower than a preset speed at a particular cable position, the processor is set to inform the electric motor to increase the torque until the speed has reached the preset speed; and / or g) during a variable speed cable rollback operation, where speed is determined by cable position when the force used by the subject is lower than a preset minimum power, the processor is set to notify the electric motor to apply the required torque to maintain the cable position until the minimum strength is reached; and / or h) during a variable speed cable rollback operation, where speed is determined by cable position when the force used by the subject is greater than a preset maximum power, the processor is set to instruct the electric motor to roll out until a preset end cable position is reached and then stop.

The apparatus of any one of claims 1-3, wherein the electric motor can be programmed to operate at variable torque during a static operation, where, during static operation in a locked cable position, the force used by the subject on the rotary is reached. drum, varies, the processor is set to instruct the electric motor to apply the necessary opposite torque to maintain the locked cable position.

The apparatus of any of claims 1-4, wherein the electric motor can be programmed to operate at variable speed during an actively supported operation over a preset distance of the cable unroll and / or rewind operation.

The apparatus of any one of claims 1-5, wherein the electric motor can be programmed to operate at constant speed during an actively supported operation over a preset distance of the cable unrolling and / or rewinding operation, and wherein: a) during a unrolling operation, when the cable is rolled out from the rotating drum at a speed lower than a preset speed and the force used by the subject on the rotating drum is less than a preset strength the processor is set to notify the electric motor lowering the torque in the opposite direction of the rotation of the rotating drum until the speed has reached the preset speed; and / or b) during a roll-out operation, when the cable is rolled out from the rotating drum at a speed higher than a preset speed and the force used by the rotary drum subject is less than a preset strength, the processor is set to instruct the electric motor to increase the torque in the opposite direction of the rotation of the rotating drum until the speed has reached the preset speed; and / or c) during a roll-out operation when the cable is rolled out of the rotating drum at a speed higher / lower than a preset speed and the force used by the subject on the rotating drum is greater than a preset strength. , the processor is set to instruct the electric motor to increase the torque in the opposite direction of the rotation of the rotating drum until the speed is zero, and so hold the cable position; and / or d) during a rollback operation, when the cable is rolled back on the rotating drum at a speed lower than a preset speed and the force used by the subject on the rotating drum is lower than a preset strength, the processor is set to instruct the electric motor to lower the torque in the direction of rotation of the rotating drum until the speed has reached the preset speed; and / or e) during a rollback operation when the cable is rolled back on the rotating drum at a speed higher than a preset speed and the force used by the subject on the rotating drum is greater than a preset strength, the processor is set to instruct the electric motor to increase the torque in the direction of rotation of the rotating drum until the speed has reached the preset speed; and / or f) during a rollback operation when the cable is rolled back on the rotary drum at a speed higher / lower than a preset speed and the force used by the subject on the rotating drum is greater than a preset strength , the processor is set to instruct the electric motor to lower the torque in the direction of rotation of the rotating drum until the speed is zero and then hold the cable position.

The apparatus of any one of claims 1-6, wherein the processor is set to count the number of repetitions and wherein the processor is set to notify the electric motor of increasing / decreasing a preset torque and / or a preset speed of a repeat. to another.

The apparatus of any of claims 1-7, wherein the processor is set to perform a passive training exercise at a preset speed and over a preset distance of roll-out and / or roll-back.

The apparatus of any of claims 1-8, wherein the electric motor can be programmed to operate at variable speed and minimum strength used by the subject is determined by cable position during a cable roll-out and / or roll-back operation, and wherein: a) during a cable roll-out operation at variable speed and minimum strength used by the subject, where speed and minimum strength used by the subject are determined by cable position when the cable is rolled out of the rotating drum by the subject at a speed and strength greater than a preset speed and a preset minimum strength used by the subject. at a particular cable position, the processor is set to instruct the electric motor to increase the torque in the opposite direction of the rotation of the rotating drum until the speed has reached the preset speed; and / or b) during a variable speed and minimum power cable rollout operation used by the subject, where speed and minimum power used by the subject are determined by cable position when the cable is rolled out from the subject's rotating drum at a speed lower than a preset speed. and a force greater than a preset minimum force used by the subject at a particular cable position, the processor set to instruct the electric motor to lower the torque in the opposite direction of the rotation of the rotating drum until the speed has reached the preset speed ; and / or c) during variable speed and minimum power cable rollout operation used by the subject, where speed and minimum power used by the subject is determined by cable position when the force used by the subject is less than a preset minimum power used by the subject at a particular cable position; the processor is set to instruct the electric motor to apply the required torque to maintain the cable position until the minimum power is applied; and / or d) during a variable speed and minimum power cable rollout operation used by the subject, the speed and minimum power used by the subject being determined by cable position when the force used by the subject is greater than a preset maximum power at a particular cable position, the processor being set to notify the electric motor to roll out until a preset cable position is reached, and then stop; and / or e) during a variable speed and minimum power cable rollback operation used by the subject, where speed and minimum power used by the subject is determined by the cable position when the cable is retracted on the subject's rotating drum at a speed and strength greater than one. preset speed and minimum power used by the subject at a particular cable position; the processor is set to notify the electric motor of lowering the torque until the speed has reached the preset speed; and / or f) during a cable rollback operation at variable speed and minimum strength used by the subject, where speed and minimum strength used by the subject are determined by cable position when the cable is retracted on the rotary drum by the subject at a speed lower than a preset speed. and a force greater than a preset minimum force used by the subject at a particular cable position, the processor set to instruct the electric motor to increase the torque until the speed has reached the preset speed; and / or g) during a cable rollback operation at variable speed and minimum strength used by the subject, where speed and minimum strength used by the subject are determined by cable position when the strength used by the subject is lower than a preset minimum strength used by the subject at a particular cable position. , the processor is set to instruct the electric motor to apply the required torque to maintain the cable position until the minimum power is applied; and / or h) during a cable rollback operation at variable speed and minimum power used by the subject, where speed and minimum power used by the subject is determined by cable position when the force used by the subject is greater than (stronger than) a preset maximum power, the processor is set to instruct the electric motor to roll back until a preset end cable position is reached, and then stop.

Use of apparatus according to any one of claims 1-9 for training, examination and reeducation of neuromuscular functions in a subject.