EP0884038A2 - Device for aiding physically handicapped persons to stand up and to assume other body positions - Google Patents

Abstract

The unit assists a handicapped person in standing and other body positions by a unit with a mechanical coupling (1) to a wheel chair and having a seat (5) fastened to the housing body (7) to be movable by a drive so as to bring the user into a standing position. In any position, the seat prevents the user from falling back. The seat is preferably adjusted to the same height as the wheelchair seat before transfer and handrails (10) are provided which can be reached when the unit is coupled to the wheelchair. A table (8) is also adjustable in height with the seat.

Description

The invention relates to a medical-technical device, which physically disabled people who need to use a wheelchair gives significant support in their therapy efforts. The independent use of the device by the disabled is a fundamental Thought of the device design.

Stehens" gilt für motorisch behinderte Menschen, welche zum Beispiel Lähmungen oder ähnliches bis zur Gürtelpartie haben und noch über intakte oder genügend gute Oberkörperstützung verfügen. Die Therapie wird täglich ca. eine Stunde angewandt und wirkt sich positiv auf verschiedene Körperfunktionen aus. Menschen, die im Rollstuhl sitzen, bekommen durch die ständige Sitzhaltung Kontrakturen, das heißt Sehnenverkürzungen. Dadurch wird die totale Streckung von Hüft-, Knie- und Fußbereich beeinträchtigt. Operative Maßnahmen werden für die Behebung solcher Folgen angewandt. Unter anderem werden Stehtherapien eingesetzt um Kontrakturen vorzubeugen beziehungsweise die Bildung zeitlich hinauszuzögern. Auch die Knochensubstanz an sich regeneriert sich nur durch Belastung. Bei Nichtbelastung, also z.B. bei Rollstuhlfahrern, ist eine Entmineralisierung der Knochen und somit eine erhöhte Bruchgefahr gegeben Außerdem ist das Stehen gut für die Kreislaufanregung, -stabilisierung, für die innere Organtätigkeit z.B. die Verdauung und Atmung;der Stützapparat des Körpers wird angeregt, die Muskelbildung gefördert und sensomotorische Erfahrungen werden möglich. Der Perspektivwechsel ist von besonderer sozialer Bedeutung. Auch ist die statische Körperaufrichtung ein Erfolgserlebnis und von stimulierender Bedeutung für die weitere aktive Mitarbeit bei Therapiebemühungen.The therapy form of the

Standing "applies to people with motor disabilities who, for example, suffer from paralysis or the like up to the belt area and who still have intact or good upper body support. The therapy is used for about one hour daily and has a positive effect on various bodily functions. People who are in the Sitting in a wheelchair gets contractures, ie shortening of the tendons due to the constant sitting posture. This affects the total extension of the hip, knee and foot area. Surgical measures are used to remedy such consequences. Standing therapies are used, among other things, to prevent contractures or education The bone substance itself also only regenerates through exercise, and when not under load, for example in wheelchair users, demineralization of the bones is given and thus an increased risk of breakage. Standing is also good for stimulating and stabilizing the circulatory system , for internal organ activity, for example digestion and breathing; the body's support system is stimulated, muscle development is promoted and sensorimotor experiences are possible. The change of perspective is of particular social importance. Static body erection is also a sense of achievement and of stimulating importance for further active participation in therapy efforts.

According to the importance of standing therapy, standing devices were developed and are used in the various embodiments offered.

Well-known medical-technical devices include, for example, sloping boards. The The person concerned lies horizontally or at an angle and is then brought into a standing position. For this it is necessary to use a suitable mounting bracket or straps Establish connection of the disabled with the therapy device by an auxiliary person.

Standing bars are also part of the state of the art. A person with them can largely deal with them pull up a healthy upper body. Such devices are mainly used come when people have to learn to stand again after an accident. For the severely disabled These standing bars are hardly or not suitable for people who already have contractures.

There are also quite elaborate standing devices with a lot of locking screws. The Basic principle of these standing devices z. B. is the following: The standing device is on a large area Bottom plate arranged. There is a hole pattern in the base of the plate for the Foot fixation at a certain distance. At table height there is a table top that can be used while standing (e.g. children stay for approx. 1 hour daily of school lessons in the device.). To the right and left of the person are upholstered in standing position Spars attached to support while standing. There is one at the table arched padded pad facing the upper body. So a hold from behind padded thoracic pads are provided.

After all locking levers have been operated, the disabled person feels despite the generous Upholstery and use of polished poles like in a cage. This captivity encourages Fears and aversion to standing therapy. To get from the wheelchair to the first Assistants are required to be able to reach the standing position in the standing device. Then they are Disabled people have to wait for helpers to free them from the standing device and put in the wheelchair. This is the only way to enable mobility for the disabled again.

As a conclusion from the use of the known therapy devices for learning or Relearning standing must be determined that the process of use is often a leaves a negative impact on the disabled. This view is used by doctors, physiotherapists and represented psychologists. The opinion can also be found among employees of a physically handicapped school.

For disabled young people who are constantly dependent on helpers, is among the preconditions previously explained make it difficult for adults to develop a detachment. That is precisely why every self-employment gained, learned and made possible special meaning.

Taking into account the previous statements, it is therefore the object of the invention to provide a standing or To create support device for the physically disabled, which independent use of the Device by independently getting in and out of the wheelchair to the device and back, as well also the self-operated orientation enables. The device is said to be ergonomic Allow adjustment and adjustment for different physical conditions. With the use of the device, the therapy should be significantly upgraded in quality.

According to the invention the object is achieved as follows, with regard to the basic Thoughts on claim 1 and in the further embodiment of the invention Solution is referred to claims 2 to 5.

The device is designed in such a way that it can be erected from sitting to standing, where you can pause in any position in between. In the inventive Solution is the criterion of getting out at any time a focus. The inhibition threshold for use it is more easily overcome, the feeling of being "connected" which can form pressure pads through knee, abdominal and hip fixation becomes partial balanced.

The construction of the device is divided into the following basic elements, on their constructive detailed execution is only partially or hardly received, because there are many detailed solutions that are incapable of protection are conceivable.

The device has a coupling. This connects the device to the wheelchair, with which this due to its own weight and the extension of the lever law the stability of the Device stabilized. With the coupling, rollers of the standing device are braked at the same time. The connected wheelchair means more safety for the user.

A base plate with foot fixation inevitably belongs to the device and is only intended to supplement it be mentioned.

The device also includes a foot fixation on the base plate. The inside of the foot and the toe area is placed on a kind of stop, the foot frame is with an opening designed to the rear so that it is easy to get on and off. On the outside a movable wall under spring tension is attached to the foot frame. This Wall causes the shoe to be fixed with pressure pads, so the instep is also secured. When getting on and off, the wall tension is preferably mechanical With the help of a lever, to be loosened by the wall sloping to the side.

Knee pads are mounted in a wooden shell with Velcro. Thus, possible Replace cotton covers quickly. The knee pads can be placed in a field of approx. 10 cm adjust the height and depth. The distance from the center is done by sliding on a crossbar and tightening a ball joint. Through the ball joint there is also one any inclination of the knee pad possible in itself. This is for example with a Straining of the legs is necessary.

To support the ischial bones and the gluterius muscles, a 20 cm wider becomes light concave shaped seat used. The material is made of PUR foam, just like all of them other body contact points of the device.

It must be pointed out as very essential that, among other things, with accompanying support the seat enables the erection from sitting to standing, in each Position in between can also be stopped.

The standing device body consists of a metal arch and is reminiscent of a fitness device, trained as a "stationary bike". The mechanism of a gas pressure spring is in the body arranged, which acts on the seat post by steel cables and waves. Likewise with this Adjustment mechanism acted on the height adjustment of the table. The gas pressure spring works expediently with a force of 500 Newton on the seat and table guide.

The mechanism of the seat and table is carried out by releasing a gas pressure lock, similar to an office chair. The position snaps by moving in the reverse direction and can be released by pressing the handle again. When changing positions from standing to sitting, a switch is flipped to reverse the system to make it work.

The thoracic pad has a joint near the table so that it swings out horizontally Direction is possible. A safety mechanism causes the swing out and after itself the disabled person has brought them into the standing position they have chosen, Back pad.

You get up from the muscles in your upper body, especially your arms. Generous stable handrails were installed to pull up and support facilitate. At this point it should be pointed out that the seat only moves when Getting up from the sitting position follows, so not actively in the sense of a pushing device Standing attempts supported. The seat is turned at knee height. This supports the physiological movement of the leg joints and thus reduces excessive stress on the knee joints, as is the case with belt-supporting systems. How nice said, can pause in any position when getting up; the standing process accompanying seat makes this possible. If you do not intend to fall back during the When you get up, the seat provides the necessary safety in every position. When straining the seat (e.g. in the event of overexertion and suddenly sinking back), this snaps into a fixed position Locking and prevents sinking down.

If the user wants to go back to the wheelchair level, the handle is locked unlocked and the seat can slowly lower again. The fallback protection also occurs here again if the user reacts too quickly.

• Das Gerät dient zur Aufrichtung einer körperbehinderten Person vom Sitzen bis zum Stehen, wobei die Person jede beliebige Position dazwischen (Stehsitzen) auf Dauer einnehmen kann. Dabei kommt es mit ansteigender Höhe Sitzes zu einer zunehmenden Belastung des Beinbereiches durch das eigene Körpergewicht. Somit kann das Gerät auch bei Rehablitationen von Knochenbrüchen und Bänderrissen im Beinbereich eingesetzt werden.
• Die Stehtherapie wird durch die vorher genannten Eigenschaften auch für Personen möglich, die bereits Kontrakturen aufweisen (Sehnenverkürzungen, die durch das Sitzen und das damit verbundene Nichtstrecken der Beine hervorgerufen werden; diese müssen bei einem körperbehinderten Menschen bis zum 20. Lebensjahr etwa 4-5 mal operativ behandelt werden), also keine vollständige Stehlage mehr einnehmen können. Dadurch ist eine längere Therapie gegen die Kontrakturen möglich, und die Anzahl der notwendigen Operationen läßt sich voraussichtlich reduzieren.
• Durch das Andocken des Rollstuhls an das Stehgerät ist ein selbständiges Benutzen durch eine körperbehinderte Person möglich. Der Benutzer kann sich selbst auf den Sitz des Stehgerätes vorschieben und die Fuß- sowie Rückenpolsterfixierungen schließen. Bisher waren mindestens zwei Hilfspersonen für diesen Vorgang erforderlich.
• Auch das Aufrichten vom Sitzen zum Stehen kann vom Benutzer selbst gesteuert werden. Durch Drücken einer der Handgriffe wird eine Arretierung gelöst und der Benutzer zieht sich durch eine Armkraft nach vorne bzw. nach oben. Dieser Vorgang ist ein Teil der Therapie. Dabei wird der Sitz durch eine Gasdruckfeder mitgeliftet und untstützt so den Aufstehvorgang.

In summary, the advantages of the invention compared to previous standing devices should be mentioned, even if certain advantages in connection with the previous statements have been briefly mentioned for better understanding.

• The device is used to straighten a physically handicapped person from sitting to standing, whereby the person can permanently take any position in between (standing). As the height of the seat increases, the weight on the leg area increases. This means that the device can also be used for the rehabilitation of broken bones and torn ligaments in the leg area.
• Thanks to the properties mentioned above, standing therapy is also possible for people who already have contractures (tendon shortenings caused by sitting and the associated non-stretching of the legs; these have to be done 4-5 times in a physically disabled person up to the age of 20 can be treated surgically), i.e. can no longer take up a full standing position. Thereby, a longer therapy against the contractures is possible, and the number of operations required can probably be reduced.
• By docking the wheelchair to the standing device, independent use by a physically disabled person is possible. The user can push himself onto the seat of the standing device and close the foot and back cushion fixations. So far, at least two assistants were required for this process.
• Raising from sitting to standing can also be controlled by the user. By pressing one of the handles, a lock is released and the user pulls forward or upward by arm force. This process is part of the therapy. The seat is lifted by a gas pressure spring and thus supports the getting up process.

The invention will now be explained using an exemplary embodiment.

The illustration shows the device to support standing in a perspective view.

1

Kupplung für Rollstuhl

2

Grundplatte

3

Fußfixierung

4

Kniepelotten

5

Sitz

6

Sitzholmen

7

Gerätekorpus

8

Tisch

9

Thoraxpelotte

10

Handläufe.

The reference symbols used mean:

1

Wheelchair clutch

2nd

Base plate

3rd

Foot fixation

4th

Knee pads

5

Seat

6

Seat posts

7

Device body

8th

table

9

Thoracic pad

10th

Handrails.

On the base plate 2, which is provided with small wheels, are the assemblies of the device arranged.

In extension of the seat post 6, a coupling 1 is arranged so that a mechanical Connection (positive and non-positive) enables connection to the wheelchair at seat height.

The foot fixations 3 are placed on the base plate 2.

Lockable ball-and-socket joints allow the knee pads 4 to be adjusted for the disabled.

The seat 5 is adjustable in height. This allows the device seat 5 to be the same for the time being Height as the wheelchair seat can be adjusted.

The device body designated with the position symbol 7 consists of an open at the bottom U-shaped steel profile. This steel profile is arched. Located in the body 7 the mechanics of a gas pressure spring, which is attached to the seat posts by means of steel cables and rods 6 and the mechanism for carrying the table 8 acts. The table is in the extent to which the disabled moves up or down.

The thorax pad 9 provides support, security and, if necessary, the disabled Relief during therapy.

The handrails 10 are an important tool to keep the upper body largely healthy to be able to independently take the required starting position for the therapy.

At the start of therapy, the disabled person makes the mechanical connection without outside help between the wheelchair and the therapy device. This mechanical connection is used by the disabled only resolved again after he had gone into his own strength after completing the therapy Wheelchair. Getting into and out of the device independently is psychological a very important aspect. The knowledge of being able to get back into the Being able to use a wheelchair and thereby being mobile adds to the feeling of being confined using the device.

As already mentioned, the seat 5 of the standing device can be adjusted to the same height as the seat of the wheelchair. Therefore, the handicapped person can use the handrails 10 on the seat 5 move. After foot fixation 3, the handicapped adjusts himself to his options accordingly. The standing position is with the thorax pad 9 by pressing the Secured for the disabled. The foot fixation 3, the knee pads 4 and the possibility of supporting - If necessary - on the handrails 10, gives the disabled person additional security. However, the seat 5 is crucial for safety, since the seat 5 accompanies the standing process and prevents falling back.

Due to the possibility to use the device from sitting to standing up to standing, the result is a new quality of equipment. So there is a different degree of tendon stretching as well as different levels of bone stress due to the stepless position selection of sitting or the backrest pad possible. This enables sensorimotor experiences to be experienced and you can reach up to a completely axial standing position with full physical load will. That means, also for people with existing contractures, which no longer this device is suitable. In the hospital, the device is stepless Stress from your own body weight on the leg and foot area for therapy for convalescents can be used with broken bones.

Claims (5)

Device to support standing and other postures of the physically challenged People, characterized in that the standing device with a clutch (1) for the mechanical connection is provided with a wheelchair, a seat on the housing body (7) is so movably attached that during the raising of the disabled in the Standing position of the seat (5) via an appropriate drive uprighting into the Standing position accompanied and the seat (5) in any position of the disabled in the sense of a Fallback protection is implemented. Device according to claim 1, characterized in that the adjustment of the seat (5) before the Therapy to the height is such that the seat (5) and the seat of the wheelchair are at the same height are located. Device according to claim 1, characterized in that handrails (10) are designed such that they are in a sitting position in a wheelchair with a mechanical connection between the wheelchair and the device are easily accessible. Apparatus according to claim 1, characterized in that the table (8) is of such a height is adjustable that an analog with the height adjustment of the seat (5) Height adjustment of the table (8) takes place. Device according to claim 1, characterized in that the thorax pad (9) is close to the table (8) with a preferably horizontally pivotable joint with safety mechanism is provided such that an independent operation of the disabled when opening and The thoracic pad (9) is closed.

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