EP1112731B1 - Therapy apparatus - Google Patents

Abstract

The therapy device (1) has at least one body support element (2) operated by a movement drive (17) for providing continuous passive limb movement, under control of therapy program specific to the patient, which is stored on a data carrier (19), entered in a program reading device (18), linked to the drive control.

Description

The invention relates to a therapy device for Treatment of a shoulder and / or Elbow joint and to carry out a continuous passive body movement at one Patients with a trained as a bracer Body support element attached to a seat having device carrier by means of shoulder pivot joints held such that the Intersection of their joint axes approximately in Shoulder area of a patient lies.

Such therapy devices are already in different Executions known. That's the way you already have Therapy devices created, for example, after Operations in the area of the shoulder, elbow or knee joint for continuous passive Serve joint mobilization.

From EP 0 147 645 is already a therapy device known for the treatment of a shoulder or Elbow joint serves and for supporting or supporting the arm one Bracer has. The bracer is in the head area the patient is connected to a support frame, which in turn attaches to the patient's body can be. Between the support frame and the bracer Pivoting drives are arranged such that a vertical pivoting movement and a horizontal pivoting movement or superimposed, combined movements of the Poor for movement therapy are possible.

By turning an upper portion of the support frame 180 ° is either a right-sided or left-side arrangement of the support frame possible. To the Paging of the previously known therapy device must about it but also the connections between the individual Parts of the bracer awkward solved and this Components in a mirror image position again be assembled. Finally, the handling requires and programming the prior art therapy device a not inconsiderable expense, which an operation by the Can complicate patients themselves.

From DE 299 00 429 U1 a therapy device is known which has a chair, the backrest a gear tray for a body support member, or forms. This Body support element is for adaptation to a patient's body adjustable and to these by means of a respective support for upper and forearm fixable. Furthermore, in particular three Swivel joints to carry out a continuous passive body movement provided to the patient. Problematic in the therapy device according to DE 299 04 429 U1, however, is the arrangement of at least one of the pivot joints in the head area of the patient, what of this as annoying can be felt and, where appropriate, the swivel range of the body support member limits.

From US 5 163 451 is already a therapy device of initially known type, which is used to treat a Shoulder or elbow joint serves. The US 5 163 451 previously known therapy device has one, with an office chair comparable seating on, on a commercial CPM device for controlled passive movement of the Shoulder joint is held. The commercial CPM device is designed here so that the patient's arm is in two, at right angles to each other arranged vertical planes is pivotable, wherein the one vertical pivot plane to passive abduction / adduction of the Schuler and the other vertical pivoting plane to the outward and inward Offered the shoulder is provided.

To get a proper relative position between the Seating and attached CPM machine on the one hand and on the seat On the other hand, ensuring patients is the CPM device according to US Pat. No. 5,163,451 after releasing a Adjusting screw rotatable about a horizontal axis of rotation. These If necessary, the axis of rotation is outside the distance Sitting surface arranged. Because the rotation axis only for positioning of the CPM device, but not to the passive movement of the Shoulder joint is provided is with the US 5 163 451 previously known therapy device a passive movement of the shoulder neither possible nor possible in a horizontal pivoting plane intended.

It is therefore the object to provide a therapy device, which is characterized by a particularly simple handling distinguished.

The achievement of this task is in the Therapy device of the type mentioned in that a first, an approximately horizontal pivot plane predetermining Shoulder swivel joint so below the seat for the sitting patient is arranged or positionable, that the hinge axis passes through the seat, that the Bracer with the first shoulder swivel joint over one in particular bent or angled connecting arm with the bracer is connected, and that between the Bracer and the connecting arm a second, one about vertical pivot plane predetermining shoulder swivel joint is arranged.

The therapy device according to the invention thus has a first, an approximately horizontal pivot plane predetermining shoulder swivel joint on, so under the seat is arranged, that the hinge axis of the seat interspersed. The therapy device according to the invention has also via a second shoulder swivel joint, which specifies the arm rail about a vertical pivot plane. These two shoulder pivot joints of the invention Therapy device thus allow in the context of a comprehensive Exercise therapy a vertical pivoting movement and a Horizontal pivoting movement and beyond superimposed combined movements of the arm. That's it with his joint axis the shoulder joint of the patient crossing and arranged below the seat first Shoulder swivel joint with the bracer especially over a curved or angled connecting arm connected.

To the horizontal adduction or anteversion and the horizontal abduction or retroversion of the Shoulder joint manually to the desired angle to be able to adjust, it is advantageous if the first Shoulder swivel joint as a manually adjustable and fixable swivel joint is designed. It is possible Also, that the first shoulder swivel joint has a motor Actuator or rotary actuator is assigned. Likewise that Swivel joint for an ante or retroversion be executed motor.

To the shoulder joint of the patient also a To be able to perform a rotational movement, it is advantageous when the bracer is wearing a forearm rest when the Forearm support via a, a rotational movement predetermining third shoulder swivel joint connected to the bracer is and if the hinge axis of the third shoulder swivel joint approximately through the intersection of the first and the second shoulder pivot joint extends.

Provided the first shoulder swivel joint as a manual Swivel joint is designed, can be the desired Adjust the angle particularly precisely when the first shoulder swivel joint a scale for reading the set Shoulder swing angle is assigned.

If continuous abduction, adduction, elevation and / or rotational movements of the shoulder joint desired it is beneficial if the first, the second and / or the third shoulder pivot a motor Have swivel drive.

The easy handling of the therapy device according to the invention is favored when the equipment rack as a dental chair designed for the patient who has a seat as well has a backrest and if the backrest to align the patient's shoulder with respect to the second shoulder pivot adjustable in its backrest inclination and is determinable.

To the hinge axis of the second shoulder pivot joint so to be able to align these through the shoulder joint of the Patient runs, the backrest only needs of her front neutral position in a corresponding Backrest inclination adjusted and fixed.

Another proposed invention provides that the Bracer has at least two rail parts, one of which front free rail part carries a forearm pad that the forearm rest as well as at least the one associated with it Rail part for the optional treatment of the right or the left arm of a patient in a mirror image position can be used that the at least two rail parts over a first rotary and / or pivot joint movable and are firmly connected with each other and that the Forearm support by means of a second pivot on the front free rail part rotatable about its longitudinal axis and is held fixed.

Such an embodiment allows a fast Paging in the therapy device according to the invention, without that particularly competent personnel are needed. To the Bracer from the right arm to the left arm of a patient to be able to create, only the front rail part in pivoted a horizontal or a vertical plane Then, the forearm rest on the front twist free rail part and on the patient facing side of the arm splint to be able to bring. Thus is a page change in the therapy device according to the invention possible by a few simple steps. The handling of the Therapy device according to the invention is thereby essential facilitated.

To the patient's arm in an angled and preferably right-angled position of upper and lower arm To be able to treat it, it is advantageous if the first and the second pivot each having a rotation angle of at least 90 ° and preferably at least about 180 °.

The rail parts of the therapy device according to the invention can be in their relative position to each other particularly set securely and firmly if the first and / or second Swivel joint by means of a detent or friction clutch in her Rotary position can be fixed.

Thus, the therapy device can be brought in a correct position both in the treatment of the right and the left arm of the patient without the rail parts of the bracer must be changed in length and reoriented, it is advantageous if the longitudinal center axes of the engaging on the second shoulder pivot joint portion of the connecting arm on the one hand and the rail part of the arm rail on the other hand are arranged approximately in the pivoting plane of the second shoulder pivot joint.
For the same purpose, a further embodiment according to the invention provides that the longitudinal center axis of the forearm support are arranged in their offset by 180 ° rotational positions and the axis of rotation of the second pivot about in a plane.

It is particularly advantageous if the bracer is optional on one of two opposite sides of the Treatment chair is releasably attachable. One sees preferred development according to the invention that the Connecting arm at least two detachably connectable arm parts has that on both sides of the treatment chair a first Shoulder pivot joint is provided, and that each first Shoulder swivel joint a first arm of the Verbindungsarmes carries that over at least a second Arm part of the connecting arm with the arm rail detachable is connectable.

Thus, the patient during his treatment of an arm his other arm can be conveniently stored, it is appropriate if by the first provided on both sides of the chair Shoulder swivel joints alternately a swivel joint the bracer and one on the opposite chair side arranged pivot joint with an armrest detachable is connectable.

The two arm parts of the connecting arm can also be very easy to join together without tools, though acting on one of the first shoulder pivot joints and that associated with the bracer or armrest Arm part telescopically mesh.

To the therapy device according to the invention in a simple manner adjust the body measurements of the patient and the second To be able to position the shoulder pivot joint such that whose axis of articulation crosses the shoulder joint of the patient, it is useful if the interlocking arm parts in Adjustable lengthwise and fixable with each other are connected.

For a targeted therapy with fixed Movements, it is useful if the arm splint for Carrying out a continuous passive body movement on a patient by means of at least one movement drive is movable, wherein at least one movement drive with a Control device is in control connection.

It is particularly advantageous if the control device has a control program reader and if in the control program reader machine-readable control program data carriers are read, on each of which, one for each patient individual control program is stored.
By inserting the control program data carrier into the control program reading device and reading the data stored on the control data carrier data into the controller, the therapy device according to the invention according to the physician recommended therapy and treatment values, such as those required for postoperative mobilization of a shoulder joint and for a continuous adduction, abduction, elevation or rotational movement or pivoting angle provided for an anteversion or retroversion are automatically controlled. By exchanging the control program data carriers, the device can be adapted to the therapy proposals assigned to the next patient with little effort, without the need for further expert personnel.

For example, the control disk may be referred to as Punched cards or similar machine-readable data carriers be educated. The handling of the invention Therapy device, however, is much easier if the Control program disk as Magnetstreifen- and / or Chip card are formed.

Further features of the invention will become apparent from the following description of an inventive Embodiment in conjunction with the claims and the drawing. The individual characteristics can be individually or separately to several in an embodiment according to the invention be realized.

Fig.1

ein Therapiegerät zur kontinuierlichen passiven Bewegung des Schulter- und des Ellenbogengelenkes eines Patienten, wobei das Therapiegerät in Figur 1 zur Behandlung des rechten Armes eines Patienten ausgerichtet ist,

Fig.2

das Therapiegerät in einer Zwischenposition während des Seitenwechsels und

Fig.3

das Therapiegerät aus Figur 1 und 2, das nach dem Seitenwechsel nun zur Behandlung des linken Armes des Patienten ausgerichtet ist.

It shows:

Fig.1

a therapy device for the continuous passive movement of the shoulder and elbow joints of a patient, wherein the therapy device in FIG. 1 is aligned for the treatment of the right arm of a patient,

Fig.2

the therapy device in an intermediate position during the page change and

Figure 3

the therapy device of Figure 1 and 2, which is now aligned after the page change for the treatment of the left arm of the patient.

In the figures 1 to 3, a therapy device 1 is shown that for continuous passive movement of the shoulder and the Elbow joint of a patient is used. Such movement therapy For example, it can be used to treat postoperative conditions as well as for the treatment of injuries and illnesses of the Shoulder joint be indicated.

The therapy device 1 has a serving as a body support member Bracer 2, on a device carrier by means of shoulder pivot joints 3, 4 is held such that the intersection of their Joint axes located approximately in the shoulder region of a patient. Of the Equipment carrier is designed here as a treatment chair 5.

While a first shoulder pivot 3 a horizontal Schwenkebene pretends, a second shoulder pivot 4 allow a vertical pivoting movement of the arm rail 2.

In Figures 1 to 3 it can be seen that the first shoulder pivot joint 3 arranged below the seat 6 of the patient is. This first shoulder pivot joint 3 is therefore in the head area the patient does not interfere in the way. The bracer 2 is at the first Shoulder pivot joint 3 held by a connecting arm 7, wherein between the arm rail 2 and the connecting arm 7, the second Shoulder pivot 4 is arranged.

The treatment chair 5 serving as a device carrier has a seat surface 6 and a backrest 8. Around the patient's shoulder like this to be able to align that the hinge axis of the second shoulder pivot joint 4 passes through the shoulder joint of the patient, the backrest 8 is adjustable in its backrest tilt and fixable.

To the bracer 2 optionally on one of two opposite Sides of the treatment chair 5 to attach releasably, is on both sides of the treatment chair 5 each have a first shoulder pivot joint 3 provided.

Each of these shoulder pivot joints 3 carries a first, approximately L-shaped Angled arm part 9, in which a second arm part 10 of essentially two-part connecting arm 7 is inserted. Of the provided on both sides of the treatment chair 5 first Shoulder pivot joints 3 is alternately a pivot joint 3 with the bracer 2 and one on the opposite side of the chair arranged pivot joint 3 with an armrest 11 detachably connectable. Both the armrest 11 and the bracer 2 is each associated with a second arm part 10.

The telescopically interlocking arm parts 9, 10 are in Longitudinally adjustable and fixable with each other connected to the treatment chair 5 to the body dimensions of the patient adapted and the height of the second shoulder pivot joint 4 such can be adjusted until the hinge axis through the Shoulder joint of the patient runs. By such a height adjustment of the shoulder swivel joint 4 and by setting a corresponding backrest tilt can be the shoulder pivot joints 3, 4 exactly on the position of the shoulder joint to be treated be aligned with the patient.

By comparing Figures 1 to 3 it is clear that in the here illustrated therapy device 1 a side change of the arm splint 2 can be done quickly and easily. These are the with the Bracer 2 and connected to the armrest 11 arm parts 10 the L-shaped arm part 9 of the corresponding shoulder pivot joint 3 solved and exchanged against each other. The in Figure 1 originally still on the right side of the treatment chair 5 Bracer 2 is now in the shown in Figure 2 Intermediate position held on the left side of the chair. The bracer 2 has two rail parts 12, 13, which via a first pivot 14 are interconnected. By pivoting 180 ° is the front free rail part 12 is brought into a position in which it is at right angles to the rail part 13 inwards to the treatment chair 5 points.

At the front free rail part 12 is a forearm rest 15 provided by means of a second pivot 16 to the Rail longitudinal axis of the rail part 12 can be rotated. By Twisting the forearm rest position 15 on the rail part 12 by 180 ° can the forearm rest 15 finally brought into a functional position in which they are on the side facing the patient the rail part 12 is arranged.

The handling of the therapy device 1 shown here is much easier when the first and the second pivot 14, 16 and possibly also the first shoulder pivot joint 3 each by means of a detent or friction clutch in its rotational position are definable.

The patient's arm to be treated with his on the Forearm rest 15 fixed forearm in a nearly rectangular angled arm position held. To the shoulder joint of the Patients undergoing continuous passive elevation, abduction or to be able to perform adduction movement, the second one has Shoulder pivot 4 a pivot drive 17. At the Elbow joint of the patient is a continuous passive To perform rotational movement is the forearm support 15 via a likewise equipped with a pivot drive 17 Swivel joint 20 is held on the front free rail part 12. While with the first shoulder pivot 3 antebeziehungsweise Retroversion and while with the second shoulder swivel joint 4 an abduction or adduction movement of the shoulder joint can be performed with help the third shoulder pivot joint 20 is a rotation of the Achieve shoulder joint. As well as the second shoulder swivel joint 4 and the third shoulder pivot joint 20 can also provided on both sides of the treatment chair 5 shoulder pivot joint 3 each be equipped with a rotary actuator.

The pivot drives 17 are available with a control device in Control connection having a control program reader 18. In the Control program reader 18 are machine-readable control program data carriers 19 readable, on each of which one, for each patient individual control program is stored. As FIG. 1 shows, are these control disk 19 here as a smart card educated.

The therapy device 1 can be adapted to the individual body measurements of Adapt patients. By adjusting and fixing the arm parts 9, 10 can be the second shoulder pivot joint 4 in its height adapt to the shoulder joint of the patient. Through a change the backrest tilt on the treatment chair 5, the first Shoulder pivot joint 3 and the second shoulder pivot joint 4 are aligned so that their joint axes themselves cutting in the shoulder joint of the patient. Finally, too the respective telescopically formed rail parts 12, 13 in adjustable in length and fixable, so that the bracer Align 2 to the individual arm length of the patient.

The therapy device 1 shown here is characterized by its particularly easy and convenient handling.

Claims (19)

1. Therapy apparatus (1) for treatmg a shoulder and/or elbow joint and for performing a continuous passive body movement on a patient, having a body supporting element in the form of an arm rail (2) which is held on an apparatus carrier comprising a seat area (6) by means of shoulder swivel joints (3, 4, 20) in such a way that the point of intersection of the axes of the joints is located substantially in the shoulder region of a patient, while the arm rail (2) is connected to the first shoulder swivel joint (3) via a connecting arm (7) for connection to the arm rail, said arm being, in particular, curved or bent, and in that between the arm rail (2) and the connecting arm (7) is provided a second shoulder swivel joint (4) which defines a substantially vertical pivoting plane, characterised in that a first shoulder swivel joint (3) defining a substantially horizontal pivoting plane is mounted or positionable underneath the seat area (6) for the sitting patient such that the axis of the joint passes through the seat area (6).
2. Therapy apparatus according to claim 1, characterised in that the first shoulder swivel joint (3) is constructed as a manually adjustable and fixable swivel joint.
3. Therapy apparatus according to claim 1 or 2, characterised in that a scale for reading off the shoulder pivot angle is associated with the first shoulder swivel joint (3).
4. Therapy apparatus according to one of claims 1 to 3, characterised in that the arm rail (2) carries a support (15) for the lower arm, in that the lower arm support (15) is connected to the arm rail (2) via a third shoulder swivel joint (20) which defines a rotary movement and in that the pivot axis of the third shoulder swivel joint (20) extends substantially through the point of intersection of the first and second shoulder swivel joints (3, 4).
5. Therapy apparatus according to one of claims 1 to 4, characterised in that the first, second and/or third shoulder swivel joint (3, 4, 20) has/have a motorised swivel drive.
6. Therapy apparatus according to one of claims 1 to 5, characterised in that the arm rail (2) has at least two rail sections (12, 13), a front free rail section (12) of which carries a lower arm support (15), in that the lower arm support (15) and at least the rail section (12) attached thereto can be used in a mirror-symmetrical position for treating either the right or the left arm of a patient selectively, in that the minimum of two rail sections (12, 13) are connected via a first rotary and/or swivel joint (14) so as to be movable and fixable to one another, and in that the lower arm support (15) is held by means of a second rotary joint (16) on the front free rail section (12) so as to be rotatable and fixable about the longitudinal axis thereof.
7. Therapy apparatus according to one of claims 1 to 6, characterised in that the first and the second rotary joint (14, 16) each have a rotation angle of at least 90° and preferably at least about 180°.
8. Therapy apparatus according to one of claims 1 to 7, characterised in that the first rotary joint (14) permits rotation or swivelling of the rail sections (12, 13) acting thereon in a substantially horizontally oriented plane of rotation or swivelling.
9. Therapy apparatus according to one of claims 1 to 8, characterised in that the first and/or second rotary joint (14, 16) can be secured in their rotational position by means of a latching or frictional coupling.
10. Therapy apparatus according to one of claims 1 to 9, characterised in that the central longitudinal axes of the part (10) of the connecting arm (7) acting on the second shoulder swivel joint (4) on the one hand and of the rail section (13) of the arm rail (2) on the other hand are disposed substantially in the pivoting plane of the second shoulder swivel joint (4).
11. Therapy apparatus according to one of claims 1 to 10, characterised in that the central longitudinal axis of the lower arm support (15) in its rotational positions offset by 180° and the rotation axis of the second rotary joint (16) are disposed substantially in one plane.
12. Therapy apparatus according to one of claims 1 to 11, characterised in that the arm rail (2) can be releasably fixed selectively to one of two opposite sides of the treatment chair (5).
13. Therapy apparatus according to one of claims 1 to 12, characterised in that the connecting arm (7) has at least two releasably connectable arm sections (9, 10), in that a first shoulder swivel joint (3) is provided on both sides of the treatment chair (5) and in that each first shoulder swivel joint (3) carries a first arm section (9) of the connecting arm (7), which is releasably connectable to the arm rail (2) via at least one second arm section (10) of the connecting arm (7).
14. Therapy apparatus according to one of claims 1 to 13, characterised in that of the first shoulder swivel joints (3) provided on either side of the treatment chair (5), alternately one swivel joint (3) is releasably connectable to the arm rail (2) and one swivel joint (3) provided on the opposite side of the chair is releasably connectable to an arm rest (11).
15. Therapy apparatus according to one of claims 1 to 14, characterised in that the arm section (9, 10) acting on one of the first shoulder swivel joints (3) and the arm section (9, 10) connected to the arm rail (2) or to the arm rest (11) fit together telescopically.
16. Therapy apparatus according to one of claims 1 to 15, characterised in that the arm sections (9, 10) engaging in one another are joined together so as to be adjustable in the longitudinal direction and fixable.
17. Therapy apparatus according to one of claims 1 to 16, characterised in that the arm rail (2) is movable by means of at least one motion drive (17) for performing a continuous passive body movement on a patient, while at least one motion drive (17) is operatively connected to a control device.
18. Therapy apparatus according to one of claims 1 to 17, characterised in that the control device has a control programme reading device (18) and machine-readable control programme data carriers (19) on which individual control programmes for each patient can be stored can be read into the control programme reading device (18).
19. Therapy apparatus according to one of claims 1 to 18, characterised in that the control programme data carriers (19) are in the form of magnetic strip and/or chip cards.

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