EP0814744B1 - Appareil de therapie et d'entrainement - Google Patents

Appareil de therapie et d'entrainement Download PDF

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Publication number
EP0814744B1
EP0814744B1 EP96910001A EP96910001A EP0814744B1 EP 0814744 B1 EP0814744 B1 EP 0814744B1 EP 96910001 A EP96910001 A EP 96910001A EP 96910001 A EP96910001 A EP 96910001A EP 0814744 B1 EP0814744 B1 EP 0814744B1
Authority
EP
European Patent Office
Prior art keywords
lower leg
therapy
equipment according
training equipment
arrangement
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired - Lifetime
Application number
EP96910001A
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German (de)
English (en)
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EP0814744A1 (fr
Inventor
Andreas Hassler
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
HASSLER, ANDREAS
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Individual
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Filing date
Publication date
Priority claimed from DE19509465A external-priority patent/DE19509465C1/de
Priority claimed from DE1995131833 external-priority patent/DE19531833C2/de
Application filed by Individual filed Critical Individual
Publication of EP0814744A1 publication Critical patent/EP0814744A1/fr
Application granted granted Critical
Publication of EP0814744B1 publication Critical patent/EP0814744B1/fr
Anticipated expiration legal-status Critical
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    • AHUMAN NECESSITIES
    • A63SPORTS; GAMES; AMUSEMENTS
    • A63BAPPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B23/00Exercising apparatus specially adapted for particular parts of the body
    • A63B23/035Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously
    • A63B23/04Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously for lower limbs
    • A63B23/0405Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously for lower limbs involving a bending of the knee and hip joints simultaneously
    • A63B23/0417Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously for lower limbs involving a bending of the knee and hip joints simultaneously with guided foot supports moving parallel to the body-symmetrical-plane by translation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61HPHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H1/00Apparatus for passive exercising; Vibrating apparatus; Chiropractic devices, e.g. body impacting devices, external devices for briefly extending or aligning unbroken bones
    • A61H1/02Stretching or bending or torsioning apparatus for exercising
    • A61H1/0237Stretching or bending or torsioning apparatus for exercising for the lower limbs
    • A61H1/024Knee
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61HPHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H1/00Apparatus for passive exercising; Vibrating apparatus; Chiropractic devices, e.g. body impacting devices, external devices for briefly extending or aligning unbroken bones
    • A61H1/02Stretching or bending or torsioning apparatus for exercising
    • A61H1/0237Stretching or bending or torsioning apparatus for exercising for the lower limbs
    • A61H1/0255Both knee and hip of a patient, e.g. in supine or sitting position, the feet being moved together in a plane substantially parallel to the body-symmetrical plane
    • A61H1/0259Both knee and hip of a patient, e.g. in supine or sitting position, the feet being moved together in a plane substantially parallel to the body-symmetrical plane moved by translation
    • AHUMAN NECESSITIES
    • A63SPORTS; GAMES; AMUSEMENTS
    • A63BAPPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B21/00Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices
    • A63B21/0004Exercising devices moving as a whole during exercise
    • AHUMAN NECESSITIES
    • A63SPORTS; GAMES; AMUSEMENTS
    • A63BAPPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B21/00Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices
    • A63B21/02Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices using resilient force-resisters
    • A63B21/055Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices using resilient force-resisters extension element type
    • A63B21/0552Elastic ropes or bands
    • AHUMAN NECESSITIES
    • A63SPORTS; GAMES; AMUSEMENTS
    • A63BAPPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B21/00Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices
    • A63B21/40Interfaces with the user related to strength training; Details thereof
    • A63B21/4001Arrangements for attaching the exercising apparatus to the user's body, e.g. belts, shoes or gloves specially adapted therefor
    • A63B21/4011Arrangements for attaching the exercising apparatus to the user's body, e.g. belts, shoes or gloves specially adapted therefor to the lower limbs
    • AHUMAN NECESSITIES
    • A63SPORTS; GAMES; AMUSEMENTS
    • A63BAPPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B21/00Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices
    • A63B21/40Interfaces with the user related to strength training; Details thereof
    • A63B21/4001Arrangements for attaching the exercising apparatus to the user's body, e.g. belts, shoes or gloves specially adapted therefor
    • A63B21/4011Arrangements for attaching the exercising apparatus to the user's body, e.g. belts, shoes or gloves specially adapted therefor to the lower limbs
    • A63B21/4015Arrangements for attaching the exercising apparatus to the user's body, e.g. belts, shoes or gloves specially adapted therefor to the lower limbs to the foot
    • AHUMAN NECESSITIES
    • A63SPORTS; GAMES; AMUSEMENTS
    • A63BAPPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B21/00Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices
    • A63B21/40Interfaces with the user related to strength training; Details thereof
    • A63B21/4023Interfaces with the user related to strength training; Details thereof the user operating the resistance directly, without additional interface
    • A63B21/4025Resistance devices worn on the user's body
    • AHUMAN NECESSITIES
    • A63SPORTS; GAMES; AMUSEMENTS
    • A63BAPPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B23/00Exercising apparatus specially adapted for particular parts of the body
    • A63B23/035Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously
    • A63B23/03516For both arms together or both legs together; Aspects related to the co-ordination between right and left side limbs of a user
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61HPHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/12Driving means
    • A61H2201/1207Driving means with electric or magnetic drive
    • A61H2201/1215Rotary drive
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61HPHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/12Driving means
    • A61H2201/1253Driving means driven by a human being, e.g. hand driven
    • A61H2201/1261Driving means driven by a human being, e.g. hand driven combined with active exercising of the patient
    • A61H2201/1269Passive exercise driven by movement of healthy limbs
    • A61H2201/1276Passive exercise driven by movement of healthy limbs by the other leg or arm
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61HPHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/16Physical interface with patient
    • A61H2201/1602Physical interface with patient kind of interface, e.g. head rest, knee support or lumbar support
    • A61H2201/164Feet or leg, e.g. pedal
    • A61H2201/1642Holding means therefor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61HPHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/16Physical interface with patient
    • A61H2201/1657Movement of interface, i.e. force application means
    • A61H2201/1676Pivoting
    • AHUMAN NECESSITIES
    • A63SPORTS; GAMES; AMUSEMENTS
    • A63BAPPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B21/00Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices
    • A63B21/00058Mechanical means for varying the resistance
    • A63B21/00069Setting or adjusting the resistance level; Compensating for a preload prior to use, e.g. changing length of resistance or adjusting a valve
    • AHUMAN NECESSITIES
    • A63SPORTS; GAMES; AMUSEMENTS
    • A63BAPPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B21/00Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices
    • A63B21/02Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices using resilient force-resisters
    • A63B21/04Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices using resilient force-resisters attached to static foundation, e.g. a user
    • A63B21/0407Anchored at two end points, e.g. installed within an apparatus
    • A63B21/0428Anchored at two end points, e.g. installed within an apparatus the ends moving relatively by linear reciprocation
    • AHUMAN NECESSITIES
    • A63SPORTS; GAMES; AMUSEMENTS
    • A63BAPPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B22/00Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements
    • A63B22/20Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements using rollers, wheels, castors or the like, e.g. gliding means, to be moved over the floor or other surface, e.g. guide tracks, during exercising
    • A63B22/201Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements using rollers, wheels, castors or the like, e.g. gliding means, to be moved over the floor or other surface, e.g. guide tracks, during exercising for moving a support element in reciprocating translation, i.e. for sliding back and forth on a guide track
    • A63B22/203Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements using rollers, wheels, castors or the like, e.g. gliding means, to be moved over the floor or other surface, e.g. guide tracks, during exercising for moving a support element in reciprocating translation, i.e. for sliding back and forth on a guide track in a horizontal plane
    • AHUMAN NECESSITIES
    • A63SPORTS; GAMES; AMUSEMENTS
    • A63BAPPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B2208/00Characteristics or parameters related to the user or player
    • A63B2208/02Characteristics or parameters related to the user or player posture
    • A63B2208/0242Lying down
    • A63B2208/0252Lying down supine
    • AHUMAN NECESSITIES
    • A63SPORTS; GAMES; AMUSEMENTS
    • A63BAPPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B23/00Exercising apparatus specially adapted for particular parts of the body
    • A63B23/035Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously
    • A63B23/04Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously for lower limbs
    • A63B23/0494Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously for lower limbs primarily by articulating the knee joints

Definitions

  • the present invention relates to a therapy and training device for positively guided knee joint movement with one Lower leg mounting arrangement and a guide arrangement, which are pivotally connected to one another via a joint device are.
  • Knee injuries and related knee surgery often require long-term immobilization of the knee joint, leading to a general weakening of the leg muscles and leads to restricted movement. Therefore, at treatment of knee injuries or after knee surgery appropriate medical aids are used, should undo the movement restrictions or by performing certain movement exercises during training counteract movement restrictions.
  • motor rails used for joint rehabilitation so-called motor rails used.
  • the motor rails serve to take up the diseased leg and are with provided a drive device that a pivoting Lower leg absorption compared to a thigh absorption enables. This essentially becomes one of weight loads free knee joint movement causes mobility of the knee without damaging the cruciate ligaments Weight loads is trained.
  • a disadvantage of the known Motor rail is felt that on the one hand in the Normally an electric drive is required to move the motor rail and on the other hand the healthy leg from the movement is excluded, so that especially in the case of longer periods Rehabilitation measures an inherently unnecessary weakening the muscles of the healthy leg. With a The motor track is therefore only a passive exercise of muscles and tendons possible.
  • Motor rails due to their motor drive expensive to buy, which one Implementation of such, generally desirable, rehabilitation measures outside of hospital facilities with high level of technical equipment and a corresponding Budget stands in the way. Motor rails also prove to be in their Handling and individual adaptation to the patient as expensive, so that for these activities usually the use by trained nursing staff.
  • WO-A-93/04655 is an exercise apparatus for forced guidance Knee joint movement with a lower leg mounting arrangement and a guide arrangement known, the articulation device to transmit one caused by muscle strength Has pivot drive on the lower leg receiving arrangement.
  • the swivel drive caused by the muscular strength of the arms, so that the Joint device enabling power transmission between a Manual drive device and with the lower leg mounting arrangement connected guide arrangement.
  • the present invention has for its object a To propose a device that allows the legs to be exercised, in which the legs by one by the muscular strength of the Legs caused drive to be moved.
  • the guide arrangement acts in the device according to the invention together with the lower leg mounting arrangement, that as a result of a pivoting movement of one lower leg The other lower leg is also forced to knee flexion becomes.
  • the inventive Therapy and training device is the drive to Force-relieved movement of the sick leg by a force-operated Movement of the healthy leg, so that on the one hand an external drive can be dispensed with, results in another a certain training effect at the same time on the healthy leg to strengthen the leg muscles, both the Movement of the sick as well as the movement of the healthy leg is an effective thrombosis prophylaxis.
  • lower leg mounting arrangement used here should also include the possibility of the lower leg to be fixed outside on a rail-like device. What is essential is a defined fixation of the lower leg, which enables the movement described above.
  • the guide arrangement designed as a thigh socket and the lower leg socket is used for motion-linked recording of both Lower leg, such that when the one lower leg due to knee flexion the other lower leg is positively guided.
  • this therapy and Training device can therefore be a force-relieved movement of the sick leg through a power-operated movement of the healthy leg.
  • About the coupling of movements between the healthy and the sick leg will move of the healthy leg with the sick leg.
  • the therapy and training device can also be used as a pure or sports equipment to train the leg muscles use both legs.
  • the hinge device is arranged so that its Axis of rotation is coaxial to the pivot axis of the knee joints ensures that the knee joints are free of moments and Shear forces are caused by an offset of the axis of rotation Swivel axis occur.
  • the lower leg receptacle in a heel area with a glide or Roller guide is provided so that it is possible to take the lower leg with a knee movement over one accordingly move trained underground.
  • This training makes it possible to include the therapy and training device to use the patient's lying arrangement, in which the patient's buttocks and heels essentially in one Level and the movement of the sick leg over one Angling the healthy leg is achieved.
  • a roller guide that has less demanding requirements the levelest possible formation of the subsurface, can the therapy and training device in a patient's bed to be used.
  • the proved to be particularly advantageous for the therapy of the sick leg proves, the joint device of the therapy and Exercise equipment with two variable angle stops his.
  • the hinge device with a locking device for variable adjustment of a fixed knee bending position is provided.
  • the joint device is equipped with a movement counter is, for example, as an inductive rotation angle sensor can be formed is a particularly simple possibility created that performed with the therapy and training device Monitor exercise training.
  • a loading device that is particularly advantageous Is designed as a spring device to be arranged.
  • the spring device allows by simply changing the Spring preload an exact specification of the movement training strain on the healthy leg.
  • the spring device as a tension spring, so as a spring elastic Rope, be trained.
  • the therapy and training device can be a compression spring be provided. So in the first case it is essentially possible strain the squat, and in the second case there is the possibility to strain the knee extensor and train accordingly so that it is on the healthy leg can perform a differentiated muscle training.
  • Both in terms of movement training for the sick leg or knee joint as well as regarding muscle training for the healthy leg can be the therapy or training effect improve even further if in addition to being particularly advantageous
  • the lower leg could lead to tension in the knee area, can the lower leg with at least one in their arrangement changeable relative to the lower leg receptacle Leadership. This will result in knee flexion superimposed movements of the lower legs possible, so that the Lower leg not only in one swivel plane but also are movable across.
  • Both the lower leg mount and the thigh mount can be bowl-shaped, for example made of plastic be with guides for length-adjustable inclusion of swivel arms connected to the articulation device. Especially It is advantageous if the guides are integral in the lower leg receptacle and the thigh socket are. This reduces the number of parts on the one hand Therapy and training equipment. On the other hand, in corresponding amount of assembly work when assembling the Therapy and training equipment.
  • the hinge device is designed so that two in Swivel joints arranged outside the knee are provided which each have two swivel arms for connection to the thigh mount or the lower leg receptacle are particularly torsion-resistant with minimal effort Structure of the therapy and training device enables.
  • For setting a predetermined by the spring device Load can be made changeable at least one spring pivot point his.
  • the embodiment according to claim 22 has a guide arrangement on that as the hinge axis of a hinge assembly is trained.
  • the pivot axis is in its relative arrangement changeable relative to a patient's hip pivot.
  • the device enables an active Exercise with a natural, physiological movement.
  • the reciprocal resulting from the coupling of movements Initiation of movement promotes cartilage and tendon formation.
  • the device can be changed without any changes both as a passive movement device and as an active training device use so that, for example, as it progresses Rehabilitation of the knee seamlessly on a Exercise can be changed by active movement of the knee joint can.
  • the middle position of the lower leg shots as an angle of rotation position related to the pivot axis of the pivot assembly is adjustable, a rest position for if necessary the patient's legs, in which both legs are bent to the same extent are free to choose according to individual patient needs to be able to take special account of.
  • the device is not just a therapy device but also as a training device for building or restoring to be used by leg muscles, it proves proved to be particularly advantageous if a loading device is provided, at least in phases against the Swiveling movement on at least one lower leg holder acts.
  • a loading device is provided, at least in phases against the Swiveling movement on at least one lower leg holder acts.
  • Effect of the device reinforces that the muscles of the healthy leg used to propel the sick leg is trained.
  • the effect is also increased, that by operating the healthy leg the sick leg passively practiced as a result of crossed exercise of the quadriceps becomes.
  • the load device is also adjustable, this can be done in a particularly simple manner on the skills and adapt the patient's needs.
  • Such a loading device can, for example, by a corresponding Spring or spring / damper device may be formed.
  • the swivel assembly as a transmission for power transmission is formed between the lower leg receptacles it turns out to be particularly advantageous, the swivel assembly or to apply a gear load to the gear unit. This can be done for example by means of an integrated in the transmission Torque brake happen.
  • the gear load or the brake is an advantage.
  • the swivel assembly with a height adjustment coupled it is possible to the desired swivel range not only by setting the end positions of the Swiveling movement of the lower leg shots, but also through a height adjustment of the swivel arrangement or the swivel axis to influence.
  • the Swiveling movements of the lower legs with swiveling movements of the Feet overlap around the ankle axis of rotation, creating an effective Thrombosis prophylaxis can be achieved because of the activation the calf pump promotes venous blood flow.
  • the footrests are motion-locked, such that a pivoting movement of one footrest is opposite directional pivoting movement of the other footrest causes, it is also possible, for example, analogous to exercise therapy the device for movement therapy on a knee joint to be used on an ankle.
  • the installation of the device on the patient is special relieved that the lower leg receptacles bowl-shaped are formed with at least one shell opening oppositely arranged fastening device. This makes it possible to insert the lower legs into the lower leg receptacles insert and with the help of the fastening device secure in this.
  • the therapy and training device 10 has a lower leg receiving arrangement 11, which is positively guided relative to a guide arrangement designed here as a guide rail 12 by means of a joint device 13 which connects the lower leg receiving arrangement 11 to the guide rail 12.
  • FIG. 2 shows the lower leg mounting arrangement 11 suitable here for parallel accommodation of both lower legs 14, 15 with the articulated device 13 arranged thereon, which engages in the guide rail 12.
  • the articulation device 13 has an articulated lever 16 which is double cranked here and which is rigidly connected at one end to a heel part 17 ( FIG. 1 ) of the lower leg receiving arrangement 11.
  • a circular articulated disk 18 is arranged, which is rigidly connected to the articulated lever 16 in the example shown here, which has a particularly simple design.
  • the articulated disk 18 is inserted into a guide slot 19 of the guide rail 12, which is designed here as a square tube with a longitudinal slot 20 for carrying out the articulated lever 16.
  • the articulation device 13 enables horizontal longitudinal guidance in the direction of the double arrow 21, which can be superimposed with a pivoting movement about a central axis 22 of the articulated disk 18 in the direction of the double arrow 23.
  • the therapy and training device 10 shown in FIG. 1 thus enables a sequence of movements as is necessary to carry out a flexion and extension of the legs of the patient shown in FIG. 1 , with no further movements, for example transversely to the longitudinal direction of the guide rail 12 possible are.
  • FIGS. 3 and 4 show a therapy and training device 24, which is a counter movement of the Lower leg 14, 15 allows.
  • the therapy and training device 24 has a lower leg receiving arrangement 25 with two lower leg receiving means 26, 27, each of which has a joint device 13 of the type shown in FIG. 2 on its heel parts 17. Both joint devices 13 are guided with their joint disks 18 in a respective guide rail 12, which are arranged lying against one another with their closed high sides 28, so that the longitudinal slots 20 for carrying out the joint levers 16 are each arranged on the outside.
  • the lower leg receptacles 26, 27 are motionally coupled via a cable deflection device 29 connecting the articulated levers 16 of the lower leg receptacles 26, 27.
  • the cable deflection device 29 has two at one end a guide rail assembly 30 consisting of two guide rails 12 is formed, arranged deflection rollers 31, 32, over which a rope 33 is guided, the articulated lever 16 such connects with each other, regardless of the direction a longitudinal movement of the one articulated lever 16 in the associated Guide rail 12 an opposing longitudinal movement of the other articulated lever 16 in the associated guide rail 12 causes. This is triggered by a movement of the healthy leg picked up in the lower leg receptacle 26, a corresponding counter-movement of the sick, in the other Lower leg receptacle 27 induced leg.
  • the articulated disks 8 can be arranged on the articulated levers 16 with ball bearings or even designed as ball bearings themselves.
  • FIG. 5 shows a therapy and training device 110 that is installed on a patient lying in a lying position.
  • the therapy and training device 110 shown here is in a middle knee flexion position with a knee flexion angle of approximately 110 °.
  • the therapy and training device 110 has a thigh receptacle 111 for receiving both thighs 112, 113 and a lower leg receptacle 114 for receiving both lower legs 115, 116 of the patient.
  • the thigh receptacle and the lower leg receptacle are connected to one another via swivel arms 117, 118 and 119, 120 of a joint device 121.
  • the lower leg receptacle 114 is in a heel area 122 provided with a roller guide 123, which is in a pivoting movement about an axis of rotation 124 of the joint device 121 Rolling the lower leg receptacle 114 back and forth on a surface 158 in the direction of arrow 125.
  • the axis of rotation 124 is coaxial with a pivot axis 171 of the knee joints arranged.
  • the underground 158 can be through a room floor or another underground can be formed, the a rolling of the roller guide 123 enables. So can a bed mattress serve as a base 158.
  • the thigh receptacle 111 To rest the thighs 112, 113 and the lower leg 115, 116 on the thigh mount 111 or the lower leg mount 114 during the entire relative movement of the Lower leg mount 114 compared to the thigh mount 111, the thigh receptacle 111 has a Thigh fixation 126 and the lower leg fixture 114 a lower leg fixation 127.
  • a spring device acting here as a tension spring in the form of a rubber-elastic rope 128 can be installed, which converts the therapy and training device 110 from a knee flexion in the direction of a Knee extension only possible by overcoming the spring force of the rope 128.
  • a spring device 128 acting as a tension spring which forces the therapy and training device 110 from a knee extension position to a knee flexion position.
  • muscle training for the healthy leg which primarily strains the thigh muscle called the extensor.
  • a compression spring is used for the spring device 128, it is possible to superimpose a muscle building training for the flexor of the healthy leg on the movement training of the sick leg.
  • a damper device 129 is provided between the thigh receptacle 111 and the lower leg receptacle, which is shown only schematically here and makes it possible, regardless of the deflection of the Spring device 128 dependent spring force course to cause a uniform relative speed movement between the thigh receptacle 111 and the lower leg receptacle 114. 5 formed as separate add-on parts, it is also possible to integrate both the spring device 128 and the damper device 129 into the joint device 121.
  • FIG. 6 and 7 which show the therapy and training device 110 in a knee extension position ( FIG. 6 ) and a knee bending position ( FIG. 7 ), further details of the therapy and training device 110 become clear.
  • the thigh receptacle 111 and the lower leg receptacle 114 each have a thigh pad 130 or one Lower leg receptacle 131, which is designed to match and are roughly bowl-shaped. Different from the Thigh receptacle 111 has lower leg receptacle 114 next to the lower leg support 131 on a foot shell 132, the is removably connected to the lower leg support 131.
  • Both the thigh pad 130 and the lower leg pad 131 have laterally outside on side wall areas 133, 134 guides 135, 136 for receiving the swivel arms 117, 118 or 119, 120 of swivel joints 137, 138 of the joint device 121 on.
  • the swivel arms 118, 120 are the swivel arms with locking teeth 139 provided that when inserting the swivel arms 117-120 in the Guides 135, 136 with spring catches designed in the manner of a pivoting key 140 interact. The spring catches snap when inserted 140 automatically into the locking teeth 139.
  • the swivel joints 137, 138 are each provided with two stop pins 142, 143 which, taken together, each form an angle stop 144 and 145 on a swivel joint 137 and 138, respectively.
  • the stop pins 142, 143 can be arranged in any relative position on a swivel joint 137 or 138, so that in one case they can form an angle stop 144, 145 for a maximum knee bending position and in another case an angle stop 144, 145 for a minimum knee bending position.
  • the respective limiting position is defined by the stop of the stop pins 142, 143 against one another.
  • FIG. 6 shows the stop pins 142, 143 of the swivel joint 137 in a relative arrangement in which they form an angle stop 144 for the knee extension position, whereas the stop pins 142, 143 of the swivel joint 138 are in a relative arrangement in which they form an angle stop 145 form for the maximum knee bending position, as can be seen from FIG. 7 .
  • both the thigh support 130 and the lower leg support 131 are provided with a spring linkage 146 and 147, which are designed to be essentially identical.
  • a bottom wall region 148 of the thigh support 130 and a corresponding bottom wall region of the lower leg support 131 have a total of six fastening bores 139, into which two fastening pins 150 of the spring linkage 146 can be inserted.
  • a specific relative arrangement of the spring linkage 146 on the thigh support 130 or the lower leg support 131 can be selected. The prestressing of an elastic cable 128 arranged between the spring linkages 146 and 147 can thus be set.
  • the spring linkage 147 is located on the Lower leg support 131 on the top.
  • the spring linkage 147 also a center guide for the Foot shell slidably disposed on the lower leg support 131 132 formed.
  • the spring linkage serving as a central guide 147 serve the guides 135, 136 on the side wall areas 133, 134 of the lower leg support 131 for lateral Guiding the foot shell 132.
  • the foot shell 132 has a center console 155 which is pushed onto the spring linkage 147.
  • the spring linkage 147 has at least one spring catch 152 which interacts with corresponding catch cutouts 153, 154 in the center console 155.
  • Fig. 6 shows that the spring catch 152 of the spring linkage 147 is engaged in the front catch cutout 153 of the center console 155, so that the foot shell 132 is virtually in its extended position relative to the lower leg support 131. This creates a further possibility of adaptation to the patient's anatomy in the region of the lower leg receptacle 114.
  • the foot shell 132 is separated by the center console 155 two cup-shaped foot guides 156, 157 on the about a transverse to the axis of rotation 124 of the articulation device 121
  • the vertical axis 151 can be pivoted within the foot shell 132 are. This makes it possible to correct malpositions, such as an "X” or an "O" position, so that with exercise therapy no tension in the Knees of the patient occur.
  • the roller guide is in the heel area 122 of the foot shell 132 133 provided with three rollers 163.
  • Rolls 163 are here relatively wide and are therefore particularly suitable for Unroll on a soft, compliant surface, like one Bed mattress.
  • the thigh support 130 in the central bottom wall region 148 and on the top of the guides 135, 136 and the foot shell 132 on the center console 155 and on the top of their side consoles 159, 160 are provided with fastening holes 161, which serve to receive locking nipples 162 of the thigh fixation 126 or the lower leg fixation 127.
  • the thigh fixation 126 is identical to the lower leg fixation 127 and is shown in FIG. 9 .
  • the thigh fixation 126 or the lower leg fixation 127 has a base part 165 which extends over the locking nipple 162 into the top of the bottom wall portion 148 of the thigh pad 130 or the center console 155 of the foot shell 132 an elastic, releasable locking with the mounting holes 161 can be used.
  • the thigh fixation 126 or lower leg fixation 127 shown in FIG. 9 has, starting from the base 165, an elastic belt 166 which can optionally be strapped over one or the other thigh 112, 113 or one or the other lower leg 115, 116 of the patient ( Fig. 5 ), the locking nipples 162 at the end of the belt 166 for elastically releasable locking with the corresponding mounting holes 161 on the top of the guides 135, 136 of the thigh support 130 and the side panels 159, 160 of the foot shell 132.
  • the thigh fixation 126 or the lower leg fixation 127 can also be provided with two belts, so that both thighs 112, 113 or both lower legs 115, 116 can be strapped onto the thigh support 130 or the lower leg support 131 ,
  • FIG. 8 shows a possible embodiment of a swivel joint 137, 138 with the swivel arms 117, 119 and 118, 120 attached to it.
  • the actual swivel joint 137 and 138 is formed by swivel eyes 167 formed on the swivel arms 117, 119 and 118, 120, 168 are formed, which are pressed against each other by inserting latching rings 169, 170 which engage with one another on both sides such that they can slide on one another.
  • the locking rings 169, 170 are provided with the stop pins 142, 143 already described with regard to their function. It is clear from the illustration according to FIG. 8 that the function of the swivel arms provided with swivel arms is achieved with a minimal number of parts.
  • FIG. 10 shows a therapy device 210 with a pivot joint arrangement 212 arranged on a support device 211 and two lower leg receptacles 214, 215 arranged on a pivot axis 213 of the pivot joint arrangement 212, of which the lower leg receptacle 215 is only shown by its longitudinal axis for reasons of clarity.
  • the lower leg receptacles 214, 215 are coupled to one another via the swivel joint arrangement 212 in such a way that an upward pivoting movement of the lower leg receptacle 214, as indicated in FIG. 10 by the arrow 216, necessarily a downward pivoting movement of the lower leg receptacle 215, as indicated in FIG. 10 by the arrow 217 causes.
  • the lower leg receptacles 214, 215 are designed such that when patient legs 221, 222 are received, an arrangement of knee joint axes KG of the patient legs that is congruent with the pivot axis 213 of the therapy device 210 results or can be adjusted. Such a setting can be achieved in the therapy device 210 shown in FIG. 10 by a receiving shell 225 of the lower leg receptacle 214 which can be changed in its position relative to the pivot axis 213.
  • the lower leg receptacles 214, 215 can be dimensioned such that, with average limb anatomy, a largely congruence between the patient's knee axis of rotation KG and the axis of rotation 213 of the therapy device 210 can be achieved from the outset, that is to say without the need for adjustment.
  • the spatial position of the swivel axis 213 is fixed via the support device 211, which can be changed horizontally in its position, so that with a congruent arrangement of the swivel axis 213 and knee joint axes KG, these are arranged spatially fixed next to a hip joint axis of rotation HG of the patient are and a change in the knee bending angle ⁇ only by pivoting the lower leg receptacles 214, 215 about the pivot axis 213 of the pivot assembly 212 via the pivoting movement range 218.
  • the limits of the swivel movement range 218 are defined by a lower end position U and an upper end position O of the lower leg receptacles 214, 215.
  • a central position M the lower leg receptacles 214 and 215 move in opposite directions in the therapy device 210 shown in FIG. 10 in a common plane parallel to a surface defined, for example, by a bed mattress 228, so that a comfortable rest position for the patient is possible in this central position ,
  • a common hinge axis 213 are by weight the patient's lower leg around the swivel axis 213 acting load moments compensated, so that movement the lower leg over the swivel range 218 with the least possible Force is executable.
  • FIG. 11 shows a schematic representation of the functional principle of the swivel joint arrangement 212 used as a transmission in the therapy device 210.
  • the swivel joint arrangement 212 shown in FIG. 11 it is designed as a bevel gear transmission with two torsionally rigid arms 229, 230 of the lower leg receptacles 214 , 215 connected drive wheels 231, 232, which are mounted on the hinge axis 213 in the housing 233 of the hinge arrangement 212.
  • a transmission wheel 234 is arranged on a transmission axis 235 arranged perpendicular to the swivel axis 213 in the housing 233.
  • a clockwise swiveling movement of the swivel arm 230 about the swivel axis 213 triggered by the patient's healthy leg causes a corresponding counterclockwise swiveling movement of the swivel arm 229, taking the in the patient's sick leg accommodated in the lower leg receptacle 215 connected to the swivel arm 229.
  • the movements of the swivel arms 229, 230 are positively guided via the swivel joint arrangement 212, so that each swivel movement of one swivel arm 229 or 230 results in an opposite swivel movement of the other swivel arm 229 or 230.
  • the swivel joint arrangement 212 shown in FIG. 11 is also provided with an adjustable loading device 236, which makes it possible to superimpose an oppositely directed load torque 238 as a transmission load on the transmission torque 237 transmitted by the transmission wheel 234.
  • the loading device 236 has a brake disk 239 which is rigidly connected to the transmission wheel 234 and which is provided with brake shoes 240, 241, the action of which on the brake disk 239 can be adjusted via an actuating device 242 arranged on the outside of the housing 233.
  • an adjustable stop device 243 with two stops 244, 245, which are set such that they limit the swivel deflection of the swivel arm 230 in both directions and thus the end positions O and U ( FIG. 10 ) of the lower leg receptacles 214, Define 215.
  • the entire housing 233 can be designed to be pivotable about the pivot axis 213 in order to adjust the central position M shown in FIG .
  • FIGS. 12, 12 and 13 show in a further embodiment a therapy device 246 in a central position configuration ( FIG. 12 ) and an end position configuration ( FIG. 13 ).
  • the therapy device 246 has a base-shaped support device 247 with V-shaped feet 248, 249 and a base 250 arranged thereon, which is provided with a lockable lifting device (not shown in FIGS. 10, 12 and 13) and thus a change the height h of the hinge axis 213 of the hinge arrangement 212 above the surface formed, for example, by the bed mattress 228.
  • One arranged on the outside of the base Locking device 252 is used to lock the selected Height h.
  • Receiving shells 254, 255 are attached to the swivel arms 229, 230 via a releasable connecting device 253, each of which forms a lower arm receptacle 256, 257 with a swivel arm 229 or 230.
  • the connecting device 253 has a clamping screw 258 screwed into the swivel arms 229, 230, which penetrates a clamping slot 259 arranged laterally in the lower leg receptacles 256, 257, so that when the clamping screw 258 is loosened, a relative movement of the receiving shells 254, 255 both in Longitudinal direction of the pivot arms 229, 230 (arrow 260) and a pivoting movement of the receiving shells 254, 255 about the clamping screw 258 (arrow 261) is possible.
  • the receptacle shells 254, 255 also have foot receptacles or foot supports 262, 263 in addition to the lower leg receptacles 256, 257.
  • foot supports 262, 263, approximately L-shaped holding brackets 264, 265 are arranged at a distance from the inner surface of the lower leg receptacles 256, 257, which securely transmit power between the patient's leg and the respective lower leg receptacle 214 or 215, even during an active upward movement should ensure.
  • the holding brackets 264, 265 are open to the outside, so that after the spacing of the holding brackets 264, 265 from the lower leg receptacle 256 or 257 has been adjusted once, they no longer have to be released and an entry or exit for the patient into the lower leg receptacles 214 , 215 is easily possible by lateral insertion or removal of the lower leg in the lower leg receptacle 256, 257.
  • the shell-shaped lower leg receptacles 256, 257 have recesses 268, 269 in a calf area which enable the lower legs to be particularly conveniently stored in the lower leg receptacles 256, 257 for the patient.
  • FIGS. 12 and 13 also make it clear that, because of the relatively small number of parts, a particularly inexpensive manufacture of the therapy device is possible. This applies in particular to the case in which the stand configuration shown in FIGS . 12 and 13 with a pedestal-shaped support device 247 is chosen for the arrangement of the therapy device on the bed of a patient, but a hanging configuration in which the swivel arrangement with one above the patient bed or connected to this, not shown here, gallows device. It is only essential that a position of the swivel axis 213 defined in its relative arrangement to the hip joint axis of rotation HG is created.
  • FIG. 14 shows the kinematic relationships in a therapy device 270 which has a pivot axis 271 which can be moved concentrically about the hip pivot axis HG of the patient.
  • the kinematics shown in FIG. 14 make it possible to use the pivoting movement of the lower leg about the pivot axis 271 at the same time for a displacement of the pivot axis 271 on a movement path 280 which is concentric with the patient's hip pivot axis HG, in order to be able to simulate the movement sequence of running.
  • a lower leg receptacle 272 is shown in FIG.
  • the pivoting movement range is shown.
  • the lower leg receptacle 272 is connected by rods 273, 274 via a slide guide 275 to a stationary guide rod 276, which here runs horizontally.
  • rods 273, 274 shown in FIG. 14 it is of course also possible to connect a rigid arm, not shown here, to the lower leg receptacle 272 and to articulate it to the sliding guide 275 in order to achieve the same result kinematically.
  • FIG. 15 shows a schematic representation of a possibility of forming a support device 277, which enables kinematics as shown in FIG. 14 with movement of the pivot axis 271 on a movement path 280 concentric to the hip pivot axis HG of the patient.
  • the pivot axis 271 is received in a horizontally acting slide guide 278, the slide guide 278 being guided in a base 280 so as to be vertically displaceable via a lifting rod 279.

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Claims (38)

  1. Appareil d'entraínement thérapeutique et de rééducation destiné à mouvoir l'articulation du genou par un guidage forcé, comprenant un dispositif de réception des jambes (11, 25, 114) et un système de guidage (12, 111, 213), ainsi qu'un système à articulation (13, 121, 212) destiné à transmettre au dispositif de réception des jambes un pivotement activé par la force musculaire, caractérisé en ce que le système à articulation (13, 121, 212) relie le système de guidage (12) au dispositif de réception des jambes (11, 25), de telle sorte qu'un mouvement de pivotement de l'une des jambes (14), à la suite d'une flexion du genou, induit un mouvement de l'autre jambe (15) par un guidage forcé.
  2. Appareil d'entraínement thérapeutique et de rééducation selon la revendication 1, caractérisé en ce que le système de guidage est conçu sous forme de rail de guidage (12) et est assemblé avec le dispositif de réception des jambes (11, 25) par l'intermédiaire d'un dispositif de pivotement (13) guidé de manière à coulisser le long du rail de guidage (12).
  3. Appareil d'entraínement thérapeutique et de rééducation selon la revendication 2, caractérisé en ce que le dispositif de réception des jambes (11) est destiné à recevoir les deux jambes (14, 15) avec un couplage de leurs mouvements, de telle sorte qu'un mouvement de pivotement de l'une des jambes (14) entraíne dans le même sens l'autre jambe (15).
  4. Appareil d'entraínement thérapeutique et de rééducation selon la revendication 2, caractérisé en ce que le dispositif de réception des jambes (25) comporte deux logements pour les jambes (26, 27), destinés à recevoir chacun une jambe (14, 15) et chaque logement pour les jambes (26, 27) est assemblé au rail de guidage par l'intermédiaire d'un dispositif de pivotement (13), de telle sorte qu'un mouvement de pivotement de l'un des logements pour les jambes (26) induit un mouvement de pivotement, orienté dans le sens inverse, de l'autre logement pour les jambes (27).
  5. Appareil d'entraínement thérapeutique et de rééducation selon la revendication 1, caractérisé en ce que le dispositif de guidage est conçu sous forme de logement pour les cuisses, et le dispositif de réception des jambes (114) est destiné à recevoir les deux jambes (115, 116) avec un couplage de leurs mouvements, de telle sorte qu'un mouvement de pivotement de l'une des jambes (115), à la suite d'une flexion du genou, induit un mouvement de l'autre jambe (116) par un guidage forcé.
  6. Appareil d'entraínement thérapeutique et de rééducation selon la revendication 5, caractérisé en ce que le système à articulation (121) est disposé de manière telle que son axe de rotation (158) est disposé coaxialement à l'axe de pivotement (171) de l'articulation des genoux.
  7. Appareil d'entraínement thérapeutique et de rééducation selon la revendication 5 ou 6, caractérisé en ce que le dispositif de réception des jambes (114) est muni d'un guidage à glissière dans une zone de talon (122) .
  8. Appareil d'entraínement thérapeutique et de rééducation selon la revendication 5 ou 6, caractérisé en ce que le dispositif de réception des jambes (114) est muni d'un guidage à roulettes (123) dans une zone de talon (122).
  9. Appareil d'entraínement thérapeutique et de rééducation selon l'une ou plusieurs des revendications précédentes, caractérisé en ce que le système à articulation (121) comporte deux angles de butée (144, 145) variables destinés à définir une zone de flexion du genou.
  10. Appareil d'entraínement thérapeutique et de rééducation selon l'une ou plusieurs des revendications précédentes, caractérisé en ce que le système à articulation (121) comporte une unité de blocage destinée à régler de manière variable une position définie de flexion du genou.
  11. Appareil d'entraínement thérapeutique et de rééducation selon l'une ou plusieurs des revendications précédentes, caractérisé en ce que le système à articulation (121) est muni d'un compteur de mouvements, qui est conçu, de préférence, sous forme de compteur inductif de l'angle de rotation.
  12. Appareil d'entraínement thérapeutique et de rééducation selon l'une ou plusieurs des revendications 5 à 11, caractérisé en ce qu'un dispositif à ressort (128) est disposé pour agir entre le logement pour les cuisses (111) et le dispositif de réception des jambes (114).
  13. Appareil d'entraínement thérapeutique et de rééducation selon la revendication 12, caractérisé en ce que le dispositif à ressort est conçu sous forme de câble de traction à ressort (128).
  14. Appareil d'entraínement thérapeutique et de rééducation selon la revendication 12, caractérisé en ce que le dispositif à ressort est conçu sous forme de ressort de pression.
  15. Appareil d'entraínement thérapeutique et de rééducation selon l'une ou plusieurs des revendications 5 à 14, caractérisé en ce qu'un dispositif amortisseur (129) est disposé de manière à agir entre le logement pour les cuisses (111) et le dispositif de réception des jambes (114).
  16. Appareil d'entraínement thérapeutique et de rééducation selon l'une ou plusieurs des revendications précédentes, caractérisé en ce que le dispositif de réception des jambes (114) est muni d'au moins un guidage (156, 157) à orientation variable par rapport au dispositif de réception des jambes (114) pour compenser les positions incorrectes du membre inférieur.
  17. Appareil d'entraínement thérapeutique et de rééducation selon l'une ou plusieurs des revendications précédentes, caractérisé en ce que le dispositif de réception des jambes (114) et le logement pour les cuisses (111) sont conçus en forme de coques avec des coulisses (135, 136), de préférence intégrées dans lesdites coques, destinées à recevoir des bras pivotants (117, 118, 119, 120) de manière à pouvoir varier leur longueur, lesquels bras sont assemblés avec le système à articulation (121).
  18. Appareil d'entraínement thérapeutique et de rééducation selon l'une ou plusieurs des revendications 5 à 17, caractérisé en ce que le système à articulation (121) comporte deux articulations rotoïdes (137, 138), disposées dans la zone extérieure du genou, contre chacune desquelles sont formés deux bras pivotants (117, 118 et 119, 120), destinés à être assemblés avec le logement pour les cuisses (111) et le dispositif de réception des jambes (114).
  19. Appareil d'entraínement thérapeutique et de rééducation selon l'une ou plusieurs des revendications 5 à 18, caractérisé en ce que le logement pour les cuisses (111) est muni d'un dispositif de fixation des cuisses (163) susceptible d'être utilisé alternativement pour les deux cuisses (112, 113).
  20. Appareil d'entraínement thérapeutique et de rééducation selon l'une ou plusieurs des revendications précédentes, caractérisé en ce que le dispositif de réception des jambes (114) est muni d'un dispositif de fixation des jambes (164) susceptible d'être utilisé alternativement pour les deux jambes (115, 116).
  21. Appareil d'entraínement thérapeutique et de rééducation selon l'une ou plusieurs des revendications 12 à 20, caractérisé en ce qu'il est possible de faire varier au moins un point d'articulation à ressort (146, 147) du dispositif à ressort (128).
  22. Appareil d'entraínement thérapeutique et de rééducation selon la revendication 1, caractérisé en ce que le dispositif de guidage est conçu sous forme d'un axe de rotation (213) d'un système à articulation rotoïde (212), et il est possible de faire varier l'axe de rotation (213) dans sa position relative par rapport au point de rotation de l'articulation de la hanche (HG) d'un patient, des logements pour les jambes (214, 215 ; 256, 257 ; 272), destinés à former le dispositif de réception des jambes, étant articulés sur le système à articulation rotoïde (212), lesquels sont couplés dans leurs mouvements de telle sorte qu'un mouvement de pivotement de l'un des logements pour les jambes (214 ; 256 ; 272) autour de l'axe de rotation (213) entraíne un mouvement de pivotement, orienté dans le sens opposé, de l'autre logement pour les jambes (215 ; 257 ; 272).
  23. Appareil d'entraínement thérapeutique et de rééducation selon la revendication 22, caractérisé en ce que le mouvement de pivotement est effectué dans une plage de pivotement (218) qui comporte une position médiane (M), dans laquelle les logements pour les jambes (214, 215 ; 256, 257 ; 272) sont placés dans une position de pivotement identique.
  24. Appareil d'entraínement thérapeutique et de rééducation selon la revendication 23, caractérisé en ce que les positions finales (O, U) de la plage de pivotement (218) peuvent être réglées par rapport à la position médiane (M).
  25. Appareil d'entraínement thérapeutique et de rééducation selon la revendication 23 ou 24, caractérisé en ce que la position médiane des logements pour les jambes (214, 215 ; 256, 257 ; 272) peut être réglée comme une position d'angle de rotation par rapport à l'axe de rotation (213) du système à articulation rotoïde (212).
  26. Appareil d'entraínement thérapeutique et de rééducation selon l'une ou plusieurs des revendications 23 à 25, caractérisé en ce que la position médiane (M) et/ou les positions finales (O, U) peuvent être bloquées.
  27. Appareil d'entraínement thérapeutique et de rééducation selon l'une ou plusieurs des revendications précédentes, caractérisé en ce que le couplage des mouvements des logements pour les jambes (214, 215 ; 256, 257 ; 272) est effectué par l'intermédiaire du système à articulation rotoïde (212) conçu sous forme d'engrenage.
  28. Appareil d'entraínement thérapeutique et de rééducation selon l'une ou plusieurs des revendications précédentes, caractérisé en ce qu'il est prévu un système de charge (236), de préférence réglable, qui agit au moins par phases, à l'encontre du mouvement de pivotement, sur au moins un logement pour les jambes (214, 215 ; 256, 257 ; 272).
  29. Appareil d'entraínement thérapeutique et de rééducation selon l'une ou plusieurs des revendications 22 à 28, caractérisé en ce que le système à articulation rotoïde (212) peut être sollicité par une charge de l'engrenage (237), de préférence réglable.
  30. Appareil d'entraínement thérapeutique et de rééducation selon l'une ou plusieurs des revendications 22 à 29, caractérisé en ce que le système à articulation rotoïde (212) est couplé à un dispositif de réglage de la hauteur.
  31. Appareil d'entraínement thérapeutique et de rééducation selon l'une ou plusieurs des revendications 22 à 29, caractérisé en ce qu'il est possible de faire varier le long d'une voie de déplacement (280) la disposition relative de l'axe de rotation (213) par rapport au point de rotation de l'articulation de la hanche (HG).
  32. Appareil d'entraínement thérapeutique et de rééducation selon l'une ou plusieurs des revendications 22 à 31, caractérisé en ce que les logements pour les jambes (214, 215 ; 256, 257) sont variables dans leur orientation par rapport à l'axe de rotation (213).
  33. Appareil d'entraínement thérapeutique et de rééducation selon l'une ou plusieurs des revendications 22 à 32, caractérisé en ce que les extrémités libres des logements pour les jambes (214, 215 ; 256, 257) sont munies de pieds de support (262, 263).
  34. Appareil d'entraínement thérapeutique et de rééducation selon la revendication 33, caractérisé en ce que les pieds de support (262, 263) peuvent pivoter autour d'un axe disposé transversalement à l'axe longitudinal des logements pour les jambes (214, 215 ; 256, 257 ; 272).
  35. Appareil d'entraínement thérapeutique et de rééducation selon la revendication 34, caractérisé en ce que les pieds de support (262, 263) sont couplés dans leurs mouvements, de telle sorte qu'un mouvement de pivotement de l'un des pieds de support induit un mouvement de pivotement, orienté dans le sens opposé, de l'autre pied de support.
  36. Appareil d'entraínement thérapeutique et de rééducation selon la revendication 34, caractérisé en ce que les pieds de support (262, 263) sont couplés dans leurs mouvements avec les logements pour les jambes (214, 215 ; 256, 257 ; 272), de telle sorte qu'un mouvement de pivotement d'un logement pour les jambes induit un mouvement de pivotement, orienté dans le sens opposé ou dans le même sens, du pied de support disposé contre le logement pour les jambes correspondant.
  37. Appareil d'entraínement thérapeutique et de rééducation selon l'une ou plusieurs des revendications 22 à 36, caractérisé en ce que les logements pour les jambes (256, 257) sont conçus en forme de coque et sont munis d'au moins un dispositif de fixation (264, 265) disposé en face d'une ouverture de la coque.
  38. Appareil d'entraínement thérapeutique et de rééducation selon la revendication 37, caractérisé en ce que le dispositif de fixation est conçu sous forme d'étrier de retenue (264, 265) ouvert latéralement.
EP96910001A 1995-03-20 1996-03-20 Appareil de therapie et d'entrainement Expired - Lifetime EP0814744B1 (fr)

Applications Claiming Priority (5)

Application Number Priority Date Filing Date Title
DE19509465 1995-03-20
DE19509465A DE19509465C1 (de) 1995-03-20 1995-03-20 Therapie- und Trainingsgerät
DE19531833 1995-08-29
DE1995131833 DE19531833C2 (de) 1995-08-29 1995-08-29 Übungs- und Therapiegerät zur zwangsgeführten Kniegelenkbewegung
PCT/EP1996/001209 WO1996029040A1 (fr) 1995-03-20 1996-03-20 Appareil de therapie et d'entrainement

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EP0814744A1 EP0814744A1 (fr) 1998-01-07
EP0814744B1 true EP0814744B1 (fr) 2002-07-03

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US (1) US6416448B1 (fr)
EP (1) EP0814744B1 (fr)
AT (1) ATE219916T1 (fr)
DE (1) DE59609409D1 (fr)
WO (1) WO1996029040A1 (fr)

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WO1999003440A1 (fr) 1997-07-16 1999-01-28 Alexander Stohr Attelles et ortheses pneumatiques permettant d'executer des mouvements
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US7270629B1 (en) 2004-10-05 2007-09-18 Hyde Kramer Exercise device for toning horseback riding muscles and associated methods
US7314435B2 (en) * 2005-02-07 2008-01-01 Schlosser Frank J Apparatus for training a body part of a person and method for using same
ES1059715Y (es) * 2005-03-03 2005-09-01 De Castro Fernandez Jo Jimenez Dispositivo para la sincronizacion de movimientos en ejercicios realizados con los miembros superiores y/o inferiores.
US7762963B2 (en) * 2005-10-24 2010-07-27 Paul Ewing Therapeutic device for post-operative knee
US8192377B2 (en) * 2006-04-25 2012-06-05 Ripperger Iii Frank J Physical therapy device
US8602943B2 (en) 2009-12-29 2013-12-10 Atlin Aps Exercise apparatus and a brake mechanism
US9011296B2 (en) * 2012-07-26 2015-04-21 Charles A. Peralo Therapeutic exercise apparatus with multiple selectively interlockable sliding platforms
US10182957B2 (en) * 2014-06-18 2019-01-22 Ossur Hf Continuous passive motion device
CN105078705A (zh) * 2015-08-25 2015-11-25 广西大学 一种螺纹螺杆式腿部舒筋活络理疗装置
US10420691B2 (en) * 2016-02-24 2019-09-24 Richard Stewart Knee range of motion device utilizing tangential joint translation and distraction
CN107174484A (zh) * 2017-07-07 2017-09-19 广州辛群科技有限公司 膝关节康复装置
AT520510B1 (de) * 2017-08-08 2019-09-15 Gregor Schaffarik Vorrichtung zur Anwendung in der Therapie
GB201717009D0 (en) * 2017-10-16 2017-11-29 Turner Jennifer-Jane Portable therapeutic leg strengthening apparatus using adjustable resistance
US10661118B2 (en) * 2017-11-15 2020-05-26 DiJon X. Wilson Perfect squat
CN108095976B (zh) * 2018-02-06 2023-09-29 吉林大学 一种具有被动回弹功能的仿生膝关节康复训练装置
US11135118B2 (en) * 2018-05-11 2021-10-05 Pavel Ivanov Passive range of motion device
CN109011384B (zh) * 2018-07-25 2020-06-16 青岛大学附属医院 一种分离式骨科腿部康复架
US10682543B1 (en) * 2019-05-31 2020-06-16 Jamie Alvarez Systems and methods for passive, active, and resistance range of motion and stretching apparatus
CN111067543A (zh) * 2019-12-31 2020-04-28 中航创世机器人(西安)有限公司 一种卧式踏步式康复训练机器人的人机交互系统
CN112704844A (zh) * 2020-08-31 2021-04-27 无锡市第九人民医院 一种膝关节僵硬用康复训练装置
CN112674989A (zh) * 2021-01-12 2021-04-20 上海市杨浦区中心医院(同济大学附属杨浦医院) 一种自主控制式膝关节康复器械
CN113288681A (zh) * 2021-06-18 2021-08-24 杭州程天科技发展有限公司 一种多功能康复站
CN116251330B (zh) * 2022-10-19 2023-09-01 天津医科大学总医院空港医院 一种膝关节康复训练机
CN115645228B (zh) * 2022-12-09 2023-03-28 杭州大力神医疗器械有限公司 一种膝关节康复活动治疗仪
CN117462319B (zh) * 2023-11-07 2024-05-10 苏州市广济医院(苏州市精神卫生中心、苏州市心理卫生中心) 一种医用精神科护理腿部约束装置

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Also Published As

Publication number Publication date
US6416448B1 (en) 2002-07-09
EP0814744A1 (fr) 1998-01-07
ATE219916T1 (de) 2002-07-15
WO1996029040A1 (fr) 1996-09-26
DE59609409D1 (de) 2002-08-08

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