EP0715534B1 - Diagnostic and/or therapeutical device for human beings - Google Patents

Abstract

PCT No. PCT/EP94/02839 Sec. 371 Date Jul. 3, 1996 Sec. 102(e) Date Jul. 3, 1996 PCT Filed Aug. 26, 1994 PCT Pub. No. WO95/05871 PCT Pub. Date Mar. 2, 1995A diagnostic and/or therapeutical device for human beings consists of a stationary frame (5) upon which are mounted an actuating arrangement (3) and a support arrangement (2) so as to rotate around a main axis (4) parallel to the supporting surface (5a). The actuating arrangement (3) has at least one actuating element (8) that may be moved by an actuating motor (22) in a predetermined manner with respect to the actuating arrangement (3), as well as means for measuring and displaying or predetermining a resistance offered or to be offered by a person against the movement of the actuating element (8). In order to diversify the possibilities of use of such a device and to allow it to be quickly and accurately adapted to different body sizes, the supporting arrangement (2) is designed as a combined seating and lying frame (10) having a seating plate (11) and a back plate (13) that may be swiveled in relation to the seating plate (11) around an axis parallel to the main axis (4). Adjusting means (26, 27) are provided for moving the seating and lying frame (10) in a vertical plane perpendicular to the main axis (4) in parallel and perpendicular directions (19, 20) in relation to the seating plate (11).

Description

The invention relates to a device for diagnosing and / or treating a person with an actuation and a support device, in which the actuation and / or the support device are rotatably mounted on a fixed frame about a main axis substantially parallel to the installation surface; the actuating device comprises two legs rotatable about the main axis; Means for measuring and indicating or specifying a resistance applied or to be applied by the person against the movement of an actuating element are provided, the support device is designed as a combined lying and seat frame; the combined reclining and seat frame comprises a seat plate and a back plate which is pivotable with respect to the seat plate about an axis parallel to the main axis; Adjustment means for vertical and / or horizontal positioning of the combined reclining and sitting frame are provided; the seat plate is designed as such or in connection with a removable support plate for alternatively receiving the buttocks or the upper body of the patient; and the back plate is designed to alternatively accommodate the upper body or the leg area of the patient.

A device of the type mentioned is from the EP-A-0 166 464 (MAGNONI) known. EP-A-0 166 464 (MA-GNONI) provides a bed for motor rehabilitation of a patient. Mechanical movement arrangements driven by electric motors can be used to cause movements of the patient even against the patient's resistance. Further mechanical arrangements serve to position the bed and the mechanical movement arrangements mentioned above. This allows the bed to be adjusted in height and rotated around a transverse axis. The movement arrangements allow, among other things, bending and stretching movements of the elbows and knees. The patient can perform the latter knee exercises lying on his back or lying on his stomach. Electronic control and monitoring of the exercises is also provided.

Another device is from the AT-PS 394 806 known. In this device, designed for use in a weightless room, a test person provides maximum resistance to the movement of the actuating element. During the movement, in addition to this measurement, corresponding measurements, which are attached to the lever, are used to carry out further measurements, such as brain current measurement, measurement of the myoelectric currents in the loaded muscles and the creation of an electrocardiogram. The physical condition of the test subject can be deduced from these measurements. This is to quantify changes that are caused by a longer stay in the weightless room. This device, designed for minimal space requirements, such as on board a spaceship, naturally does not meet the conditions for routine use under the influence of gravity in people of different physiques, for example in hospitals, where rapid adaptation to every body type and different body dimensions is required.

The object of the invention is to avoid these disadvantages and to further develop the known devices for terrestrial use, a large number of possible variations in use and the rapid and simple adaptation to the person to be examined being possible. According to the invention this is achieved in that in the generic device mentioned in the introduction, the legs can be displaced along the main axis or their spacing can be adjusted and at least one actuating motor and one guide for driving and guiding an actuating element are provided on the legs. The actuating motor can be designed as a torque motor and preferably as a pulsed DC motor. Such a motor delivers a predetermined torque regardless of the selected speed. In particular, such a motor can also apply this torque when it is at a standstill and thus also start up under this torque. This is important because the measuring devices measure the force exerted by the person during the flexion or extension of a joint. The reaction of the test subject immediately after the start of the movement or after a point of reversal of the flexed or extended joints is of particular interest to the physician. It is therefore important that this measuring range is not distorted by the starting behavior of the motor. A side effect is that isometric measurements, ie measurements without macroscopic muscle movement, are also possible in this way.

A measurement that is particularly instructive for the medical professional is provided if a control device is provided which controls the speed curve of the motor according to a curve which is predetermined as a function of the path in such a way that a joint of the test subject, preferably the elbow joint or the knee joint, is constant Angular velocity is moved. With linear Movement of the hand or foot with respect to the shoulder joint or hip means that the speed of the actuating element must be specified in proportion to the arc sine of the path covered. When the actuating element moves via a spindle driven by the motor, this function also applies to the angular speed of the motor.

When the device is used therapeutically, for example for convalescing people after injuries, the resistance to be overcome by the person against the movement of the actuating elements is preset. The regeneration of a person's body tissue can be favorably influenced by gradually increasing the resistance to be set and to be overcome within a therapy program.

It is advantageous if two actuating elements are provided, which are actuated either by the arms or legs of the test subject, the two actuating elements being each driven by a separate actuating motor. In this way, a largely independent measurement for the two arms or legs is possible. Any asymmetrical states of the test person can thus be diagnosed with certainty. It is preferably provided that the actuating device consists of two parallel legs rotatably mounted about the main axis, the inner end faces of which face each other in the direction of the main axis, means for adjusting the axial distance between the two legs being provided.

In order to achieve a large number of adjustment options, provision can further be made for the support device and / or the actuating device to be rotated about the main axis by at least one twisting motor.

In a further embodiment of the invention it is provided that the means for adjusting the axial distance between the legs consist of at least one adjusting motor.

A simple and rapid adjustment is achieved in that the adjustment means for displacing the seat plate of the reclining and seat frame include at least one adjustment motor.

It is also advantageously provided that the back plate has protruding, preferably foldable arm supports on its two longitudinal edges in the region of the arms of a person sitting on the seat plate. It can also be provided that in the area of the shoulders of a person sitting on the seat frame, preferably adjustable shoulder supports are provided on the back plate. In this way, optimal conditions for the introduction of the force of the person on the actuating elements are created.

In a further embodiment of the invention, it is advantageous if the seat plate is designed as a saddle. Furthermore, it can be provided that a support plate can be connected to the front of the seat plate in the same plane with the latter. In the case of a back plate inclined in the plane of the seat plate, a person lying on the back plate, the seat plate and the support plate on the stomach can operate the actuating elements with their hands, which enables special arm exercises.

It is preferably provided that each actuating element can be displaced linearly in the tangential direction with respect to the main axis, as a result of which the person can exert force on the actuating elements in an ergonomically favorable position.

In an extremely advantageous embodiment variant it is provided that the force applied by the person is measured both via strain gauges in the area of the actuating elements and via the current consumption of the actuating motors. This enables fast and accurate data acquisition. The apparatus is controlled by a suitably trained person using the keyboard of the associated control computer.

The keyboard is expediently provided on one side of the reclining and seat frame on the fixed frame. The most important performance diagnostic parameters of individual basic motor properties, such as endurance and strength, are measured. Since the measurement data are always personal, the personal data of the test subject, such as name, gender, height, weight and date of birth, are always recorded when the tests are carried out.

The device allows the effects of physical training on complex functional changes, in particular of the cardiocirculatory system, the muscles and the fluid balance to be examined and controlled under scientific conditions.

After injuries, operations or medical treatments on elements of the musculoskeletal system, the corresponding extremities can be actively and passively trained and measured according to a movement pattern precisely specified by the therapist with regard to path, movement angle and speed of movement. A lying position of the people also makes it possible to partially or completely eliminate the influence of their own weight. A particularly effective and rapid rehabilitation can be achieved by a corresponding, precisely defined increase in movement parameters.

Either both arms or legs can be moved together or individually cyclically or acyclically.

For reliable use, it is favorable that the actuating motors drive spindles which have a sufficiently large pitch so that they are not self-locking. The invention is explained in more detail below on the basis of an exemplary embodiment shown in the figures.

It shows :

Fig. 1

2 shows an axionometric view of the device according to the invention in a possible application position,

Fig. 2

a side view of the device,

Fig. 3

a frontal view of the device,

Fig. 4

3 shows an axionometric representation of the device according to the invention in another application position,

Fig. 5

a side view of the device and

Fig. 6

a front view of the device.

The device 1 consists of the support device 2 and the actuating device 3, which are rotatably mounted about the main axis 4 on a fixed frame 5. The actuating device 3 consists of two legs 6 rotatable about the main axis 4, the inner end faces 6b of which axially oppose each other, each leg 6 each having a guide 7 for an actuating element 8 which is tangential with respect to the main axis 4. The axial distance 9 of the two legs 6 is adjustable.

The support device 2 consists of a combined lying and seat frame 10, which has a saddle-shaped seat plate 11 and a back plate 13 which can be inclined with respect to the seat plate 11 about a pivot axis 12. To the side of the back plate 13 are in the area of the longitudinal edges 14 thereof about a pivot axis 12 parallel axis 15 pivotable and height-adjustable armrests 16 are provided. In the end region 13a of the back plate 13 opposite the pivot axis 12, a height-adjustable head and shoulder support 17 and 18 is attached. The entire reclining and seat frame 10 can be adjusted in a plane normal to the main axis 4 both in the direction of the seat plane 19 and in a direction 20 normal thereon, so that the support device 2 can be matched to any possible body size and to the particular exercise .

The operation of the device 1 and the adjustment and adaptation to different people is carried out by the operating personnel via a control panel 28 provided on the fixed frame.

In the application position of the device 1 shown in FIGS. 1 to 3, the person to be tested or treated is seated on the seat plate 11 and is supported with his back on the back plate 13. The arms rest on the armrests 16, the hands encompassing the two handles 16a. The height of the seat plate 11 and its horizontal position is set to an ergonomic position which is favorable for the person such that the person can operate the actuating elements 8 with the feet. The arm 16, head 17 and shoulder supports 18 are adapted to the person. The lying and seat frame 10 can now be pivoted together with the actuating device 3 or independently of it about the main axis 4 through an angle of up to approximately 110 °. The person can now complete the leg training, trying to exert resistance against the motor-driven actuating elements 8. By pivoting the lying and seat frame 10, the influence of the person's own weight can be partially or completely eliminated. The speed of the actuating elements 8 can be adjusted as desired along a freely selectable path.

If the person is to perform arm exercises, the application position of the device 1 shown in FIGS. 4 to 6 is set. The back plate 13 is rotated with respect to the seat plate 11 about the pivot axis 12 until the back plate 13 and the seat plate 11 lie in one plane. A further support plate 21 is coupled to the front side 11a of the seat plate in the same plane as the seat plate 11. The width of the support plate 21 is smaller in its central region 21a than the width of the seat plate 11. The person takes a prone position on the reclining frame 10a formed by the support plate 21, seat plate 11 and back plate 13, the chest and arm region of the person on the support plate 21 come to rest. The lying frame 10a is now set in the direction 19 and 20 in such a way that the person can operate the actuating elements 8 with his hands in an ergonomically favorable position. The two legs 6 of the actuating device 3 are expediently moved towards one another in the axial direction up to a relatively small distance 9, which results from the person's physical structure. The actuating elements 8 are mounted on the outer surfaces 6a of the legs 6. The armrests 16, the shoulder supports 18 and the headrest 17 can be pivoted or removed into a position which does not impede the person.

As can be seen in FIGS. 2 and 3, an actuating motor 22 is provided in each leg 6 and moves an actuating element 8 along the tangential guide 7 via a spindle 23. Furthermore, a torsion motor 24 for the pivoting movement 2a or 3a of the support device 2 or the actuation device 3 is provided in or on the fixed frame 5. The axial movement of the legs 6 towards and away from one another is caused by the adjusting motor 25 on or in the fixed frame 5. To adjust the seat plate 11 in the direction of the seat plane 19 or normal, there are further motors 26 and 27 in one with the support device 2 pivotable support column 2b housed.

Claims (15)

1. Device for the diagnosis and/or therapy of a person having an operating device (3) and a support device (2), in which

   a) the operating device (3) and/or the support device (2) are mounted on a stationary stand (5) in rotatable manner about a principal axis (4) essentially parallel to the set-up surface (5a);

   b) the operating device (3) comprises two legs (6) which can turn about the principal axis (4);

   c) means for measuring and indicating or specifying a resistance applied or to be applied by the person against the movement of an operating element (8) are provided;

   d) the support device (2) is constructed as a combined reclining or seating support (10);

   e) the combined reclining and seating support (10) comprises a seat plate (11) and a back plate (13) capable of being pivoted about an axis (12) parallel to the principal axis (4);

   f) means of adjustment (26, 27) for the vertical and/or horizontal positioning of the combined reclining and seating support (10) are provided;

   g) the seat plate (11) as such or in combination with a detachable support plate (21) is constructed for the alternative reception of the buttocks or of the upper body of the patient; and

   h) the back plate (13) is constructed for the alternative reception of the upper body or of the leg region of the patient,
   characterised in that

   i) the legs (6) are displaceable along the principal axis (4) or their spacing (9) can be adjusted, and

   j) on each of the legs (6) at least one operating motor (22) and a guide (7) are provided for driving and guiding an operating element (8).
2. Device according to Claim 1, in which the legs (6) are of L-shaped construction and arranged parallel to one another.
3. Device according to Claim 2, in which

   a) the shorter end region of the L-shaped legs (6) is traversed by the principal axis (4); and

   b) the guides (7) are arranged on the longer end region of the L-shaped legs (6).
4. Device according to one of the preceding claims, in which

   a) means for the releasable fastening of operating elements (8) are provided on the legs (6), wherein the fastening means and/or the operating means (8) pass through the guides; and

   b) the operating motor (22) drives the operating elements (8) through the means for fastening.
5. Device according to one of the preceding claims, in which fastening means for operating means (8) and a guide (7) on the inside and outside of each of the legs (6) are provided.
6. Device according to one of the preceding claims having at least one adjustment motor (25) for adjusting the axial spacing (9) of the two legs (6).
7. Device according to one of the preceding claims, in which the guides (7) enable linear guidance of the operating elements (8) in the tangential direction with respect to the principal axis (4).
8. Device according to one of the preceding claims, in which the forces applied by the person are measured through wire strain gauges in the region of the operating elements (8) and/or the power consumption of the operating motors.
9. Device according to one of the preceding claims, in which the operating motors (22) drive spindles (23) which have a sufficiently large ascending slope for the avoidance of self-locking.
10. Device according to one of the preceding claims, in which means for turning the operating device (3) and/or the support device (2) about the principal axis (4) comprise at least one torsion motor (24).
11. Device according to one of the preceding claims, in which the means of adjustment (26, 27) for the vertical and/or horizontal positioning of the combined reclining and seating support (10) comprise at least one adjusting motor (26, 27).
12. Device according to one of the preceding claims, in which on both of its longitudinal edges (14) the back plate (13) possesses projecting, preferably swing-away armrests (16) in the region of the arms of a person seated on the seat plate (11).
13. Device according to one of the preceding claims, in which in the region of the shoulders of a person seated on the seat plate (11) preferably adjustable head and/or shoulder supports (18) are provided on the back plate (13).
14. Device according to one of the preceding claims, in which the seat plate (11) is of saddle-shaped construction.
15. Device according to one of the preceding claims, in which at the front end (11a) of the seat plate (11) means for the connection of a support plate (21) are provided in such a way that the surface (21a) of the support plate (21) joins flush with the surface of the seat plate (11) and running in the same plane.

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