EP1121085B1 - Attelle de mobilisation d'un membre inferieur - Google Patents
Attelle de mobilisation d'un membre inferieur Download PDFInfo
- Publication number
- EP1121085B1 EP1121085B1 EP99950808A EP99950808A EP1121085B1 EP 1121085 B1 EP1121085 B1 EP 1121085B1 EP 99950808 A EP99950808 A EP 99950808A EP 99950808 A EP99950808 A EP 99950808A EP 1121085 B1 EP1121085 B1 EP 1121085B1
- Authority
- EP
- European Patent Office
- Prior art keywords
- cradle
- tibial
- base
- segment
- rod
- 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
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL 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
- A61H1/00—Apparatus for passive exercising; Vibrating apparatus ; Chiropractic devices, e.g. body impacting devices, external devices for briefly extending or aligning unbroken bones
- A61H1/02—Stretching or bending or torsioning apparatus for exercising
- A61H1/0237—Stretching or bending or torsioning apparatus for exercising for the lower limbs
- A61H1/0255—Both knee and hip of a patient, e.g. in supine or sitting position, the feet being moved in a plane substantially parallel to the body-symmetrical-plane
- A61H1/0259—Both knee and hip of a patient, e.g. in supine or sitting position, the feet being moved in a plane substantially parallel to the body-symmetrical-plane moved by translation
Definitions
- the present invention relates to the medical field and relates to materials used for orthopedic or rehabilitation treatments functional of the lower limbs.
- the proposed material is generally made up in the form of a splint comprising a base or base supporting a structure articulated composed of a crural segment or cradle connected by an articulation to a leg segment or cradle most often equipped, like the crural cradle, with a hammock for receiving and supporting the corresponding part of the lower limb mobilize.
- Such splints called articulated as opposed to fixed splints, do not allowing the immobilization in determined posture of a lower limb, are intended to allow mobilization in flexion-extension at least for two of the joints of a lower limb, namely the hip joint and the knee.
- This last type of material is generally called a splint of passive mobilization, since it is responsible for causing flexion and extension of the lower limb without the muscular systems of the latter are responsible for such a movement.
- the axis of articulation of the crural segment on the base or the base is not located in exact coincidence with the anatomical axis of the joint hip. It is frequent to note a shift of plan compared to that support of the base, but also a shift in the same plane.
- Such a non-coincidence has a consequence which is that the effective length of the crural segment between its articulation on the base and the axis articulation with the leg segment, appears longer than that of the bone segment of the limb to be rehabilitated and, more particularly, the length of the femur between the coxo-femoral axis and the knee.
- any displacement in extension results in an offset between the trajectories in arcs of a circle described by these points of articulation.
- the object of the invention is to propose a constructive solution which allows precisely to solve the problem thus posed.
- the means according to the invention are particularly designed to respond, in addition to the above problem, there is a second requirement frequently imposed on the personnel responsible for the commissioning of such splints and who is that of the need to be able or to have to adjust the length of the leg segment according to the length of the corresponding bone segment of the limb to be rehabilitated.
- the object of the invention by the means used to regulate the previous problem, opens a possibility of automatic adjustment of such length.
- the object of the invention is also designed to take into account a observation frequently made in the field of rehabilitation, when the functional rehabilitation treatment, following a major trauma, leaves the lower limb in a passive level of work involving no voluntary muscular effort, mainly in the thigh muscles.
- the object of the invention is precisely to choose technical means which, if necessary, can be implemented to provide a first type of response to such a finding, without claiming to be a substitute for effective and efficient means of functional rehabilitation of the quadriceps muscles.
- An additional object of the invention is therefore to propose means techniques capable of offering several rehabilitative functionalities that can be considered independently or simultaneously.
- FR-A-2 085 118 shows a splint for mobilizing the leg. There is a footrest which is brought back to a position of less extension by straps without using behind the scenes.
- the mobilization splint of a member lower of the type comprising a base carrying an articulated structure composed a crural segment or cradle articulated at one end of the base and a cradle or leg segment linked to the crural cradle by an axis of articulation orthogonal to the direction of a rail defined by the base for guiding the cradle, a means motorization interposed between the base and the articulated structure to move the leg segment relative to the rail according to an alternative rectilinear displacement and a footrest adapted at the end of the leg segment or cradle opposite the cradle crural, is characterized in that, according to the invention, said footrest is mounted on the cradle leg through at least one slide with interposition of a elastic return means always tending to return the footrest to a position lesser extension relative to the cradle.
- Fig. 1 shows a so-called passive mobilization splint of a lower limb which can be either a right limb or a left limb, since the illustrated splint reveals a symmetrical construction.
- the splint comprises a base or base 1 which is intended to rest on a support surface, such as 2, of any suitable nature and advantageously constituted by the mattress of bedding.
- the base or base 1 comprises a proximal part 3 with which it supports an articulated structure 4 composed of a segment or crural cradle 5 connected by a hinge 6 to the proximal part 3 .
- the crural segment 5 is composed of two longitudinal members or the like 7 possibly connected together by a spacer and able to be fitted with a flexible element for supporting the thigh of a lower limb, for example, a hammock 8 in any appropriate material.
- the structure 4 is also composed of a leg segment 9 which is articulated in the extension of the crural segment 5 by means of trunnions or pivots 10 which define between them a pivot axis x-x ' which is orthogonal to the general direction of the base or base 1 .
- the leg segment 9 is constituted by two longitudinal members or the like 11 possibly connected by a transverse spacer 12 and also capable of being fitted with a flexible support mattress, such as a hammock 13 .
- the end portion of the leg segment 9 opposite the pins 10 carries a footrest 14 formed by a support 15 optionally adjustable in orientation along an axis y-y ' substantially parallel to the axis x-x' .
- the support 15 carries a sole 16 which can be adjusted in orientation in the double direction of the arrow f 1 by means of any suitable means known in the art involving, for example, a pivot and a tightening button.
- the plate carries a sole 17 possibly adjustable in the double direction of the arrow f 2 and, preferably, made in the form of an open shell to allow the establishment and support of the foot of the lower limb to be rehabilitated.
- the structure 4 is carried at the level of the leg segment 9 by a carriage 18 supported by a guide track 19 materialized by the base or the base 1 in a rectilinear direction which is orthogonal to the axis x-x ' .
- the structure 4 is associated with motorization means, such as those designated by the general reference 20 , to act on the structure so as to control a movement of the carriage 18 in alternating rectilinear travel on the track 19 to drive the structure 4 from of a complete extension in a flexion movement and vice versa, as is known to those skilled in the art.
- motorization means 20 which can be controlled from a remote control unit 21, can be adapted on one of the pivots 10 or even be placed in relation to the carriage 18 by involving then an appropriate transmission.
- a mobilization splint of the above type generally, or at least, frequently occurs during its installation, a situation of the type illustrated in FIG. 2 , in which by sliding, inadvertence or impossibility of positioning, the articulation 6 between the crural segment and the base 1 is not in coincidence with the coxo-femoral articulation 22 of the member 23 to be rehabilitated.
- Such a situation also involves a length of crural segment 5 which is different from the length of the femoral articular segment of the limb 23 , so that two types of offsets can occur between axes 6 and 22 , namely an offset N relative to the plane of the base and an offset n in a plane perpendicular to this plane.
- the difference between the trajectories t 1 and t 2 can be variable but, in all cases, results in non-optimal functional conditions.
- Fig. 2 clearly shows that the offset of the trajectories t 1 and t 2 has the consequence that, in the extended position, the knee trajectory t 2 is located behind the trajectory t 1 relative to the distal end of the base and that, as a result, the footrest 17 gradually disappears forward relative to the foot which is no longer supported nor, if necessary, supported.
- the object of the invention is to propose means which make it possible to compensate for this progressive deviation during the trajectory, so as to restore, over the entire trajectory, a support between the foot and the footrest 17 , whatever the difference between the trajectories t 1 and t 2 .
- each rod 30 is provided with an end collar 31 and slides in a tubular plug 32 closing the distal end of the beam 11 , so as to constitute a sliding bearing for the rod 30 .
- the spar 11 delimits a blind bore which defines, with the rod 30 , an annular gap 33 capable of receiving an elastic return member 34 constituting a means always tending to act on the rod 30 , so as to urge it in the direction of the arrow f 3 to give it a position of least extension relative to the spar 11 .
- Such a position of lesser extension is, for example but not exclusively, determined by the supply bearing the collar 31 on the bottom of the bore of the beam 11 .
- the elastic members 34 are advantageously constituted by helical springs placed under compression stress.
- the plug 32 can be made in the form of a plain bearing, or even a ball bushing and is fitted on the end of the beam 11 , advantageously removable to facilitate the mounting of the rod 30 , as well as that spring 34 .
- the useful length between the axis x -x ' and the axis y-y' is adjusted, for example, by means of the position of the support 15 on the rods 30 , in such a way that it is less than the length of the tibial segment 25 of the lower limb 23 , so that in this position, the footrest 17 is urged in partial extension stroke against the antagonistic action of the spring or springs 34 which are subjected to a stress greater than that which they undergo in the position of least extension, as mentioned above.
- the offset between the trajectories t 1 and t 2 shows that that t 2 followed by the knee 24 tends to lag behind that t 1 followed by the axis x-x ' .
- the delay taken by the trajectory t 2 causes a retreat of the foot which is faithfully followed by the footrest 17 urged in the retraction stroke and of lesser extension by the spring or springs 34 whose preload d he origin was accentuated by the adjustment carried out as said previously.
- Fig. 4 shows that it may be advantageous to constitute the plug 32 in the form of a smooth or ball bearing, adjustable, for example by thread-tapping, in the direction of the arrow f 5 relative to the spar 11.
- Such an adjustment makes it possible, when it is desirable, to modify the restoring force of the spring 34 and to consider, for example, using the means according to the invention to offer a possibility of active mobilization which would be voluntarily maintained by the patient to cause the footrest 17 to recede against the antagonistic action of the spring or springs 34 , so as to stress the muscular function of the quadriceps.
- Fig. 4 shows that in certain cases, it may be advantageous to provide a possibility of adjusting the abutment position with lesser extension, other than by bringing the collar 31 to bear on the bottom of the bore of the spar 11 .
- Such a possibility of adjustment can intervene by a nut 36 , for example formed by two half-collars assembled by a deformable hoop 37 elastically forcing the half-collars to occupy a tightened state on the rod 30 in an axial immobilization position in which each half -collar is engaged by a rib 38 in notches 39 of a series presented axially by the rod 30.
- FIG. 5 An alternative embodiment of such a means is illustrated in FIG. 5 in which the tubular proximal part of the spar 11 has one or more series of holes 40 allowing the engagement of a pin 41 on which the collar 31 comes to bear.
- Fig. 1 highlights a simplified variant embodiment of the means according to the invention.
- each rod 30 - spar 11 assembly is associated with an elastic return means constituted by a spring 34 which is interposed under prior stretching constraint between an anchoring ring 42 carried by the rod 30 , or even the support 15 , and a bar with holes 43 carried by the beam 11 near the journal 10 .
- the members 34 can be springs of all suitable types and, in particular, elastic cables of the type of those known commercially under the name of SANDOW.
- a variant may also consist in replacing the helical springs of FIG. 3 by elastic cables housed inside the rods 30 which are then tubular, and so that one of the ends is integral with said rod, while the other is linked to the tube 11.
- the object of the invention finds a preferred application for splints of knee rehabilitation
Description
Claims (10)
- Attelle de mobilisation d'un membre inférieur, du type comprenant une embase (1) portant une structure articulée (4) composée d'un segment ou berceau crural (5) articulé (6) à une extrémité de l'embase et d'un berceau ou segment jambier (9) lié au berceau crural par un axe d'articulation (x-x') orthogonal à la direction d'un rail (19) défini par l'embase pour le guidage du berceau jambier, un moyen de motorisation (20) interposé entre l'embase et la structure articulée pour mouvoir le segment jambier relativement au rail selon un déplacement rectiligne alternatif et un repose-pied (17) adapté en bout du segment ou berceau jambier à l'opposé du berceau crural,
et où ledit repose-pied est monté sur le berceau jambier par l'intermédiaire d'au moins une coulisse (11, 30) avec interposition d'un moyen de rappel élastique (34) tendant toujours à ramener le repose-pied dans une position de moindre extension relativement au berceau jambier. - Attelle selon la revendication 1, caractérisée en ce que le moyen de rappel élastique est rapporté extérieurement.
- Attelle selon la revendication 1, caractérisée en ce que le moyen de rappel élastique est inclus à la coulisse.
- Attelle selon l'une des revendications 1 à 3, caractérisée en ce que le moyen de rappel élastique est associé à un organe (32) de réglage de sa force de rappel.
- Attelle selon l'une des revendications 1 à 4, caractérisée en ce que le moyen de rappel élastique est complété par un organe (36 ou 41) de réglage de la position de butée en moindre extension du repose-pied.
- Attelle selon l'une des revendications 3 à 5, caractérisée en ce que le moyen de rappel élastique est constitué par un ressort hélicoïdal (34) enfilé concentriquement sur une tige (30) montée télescopiquement dans un longeron (11) au moins en partie tubulaire du berceau jambier (9), ledit ressort étant monté sous contrainte entre un collet (31) de la tige et un bouchon tubulaire (32) adapté sur le longeron pour former un palier de coulissement de la tige.
- Attelle selon la revendication 6, caractérisée en ce que le bouchon-palier est réglable en position axiale par rapport au longeron pour constituer le moyen de réglage de la force du ressort.
- Attelle selon la revendication 5, caractérisée en ce que l'organe de réglage de la position de butée est constitué par une butée réglable (36) adaptée entre la tige et le longeron.
- Attelle selon la revendication 8, caractérisée en ce que la butée réglable est constituée par une broche (41) traversant l'un d'une série de trous (40) pratiqués dans le longeron pour constituer un appui pour le collet de la tige.
- Attelle selon la revendication 8, caractérisée en ce que la butée réglable est constituée par une noix (36) à ouverture élastique s'adaptant sur une série de crans ou analogues (39).
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
FR9813467 | 1998-10-23 | ||
FR9813467A FR2784893B1 (fr) | 1998-10-23 | 1998-10-23 | Attelle de mobilisation d'un membre inferieur |
PCT/FR1999/002567 WO2000024354A1 (fr) | 1998-10-23 | 1999-10-22 | Attelle de mobilisation d'un membre inferieur |
Publications (2)
Publication Number | Publication Date |
---|---|
EP1121085A1 EP1121085A1 (fr) | 2001-08-08 |
EP1121085B1 true EP1121085B1 (fr) | 2004-03-10 |
Family
ID=9532052
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP99950808A Expired - Lifetime EP1121085B1 (fr) | 1998-10-23 | 1999-10-22 | Attelle de mobilisation d'un membre inferieur |
Country Status (8)
Country | Link |
---|---|
EP (1) | EP1121085B1 (fr) |
JP (1) | JP2002528176A (fr) |
AT (1) | ATE261292T1 (fr) |
AU (1) | AU771107B2 (fr) |
CA (1) | CA2347986A1 (fr) |
DE (1) | DE69915503D1 (fr) |
FR (1) | FR2784893B1 (fr) |
WO (1) | WO2000024354A1 (fr) |
Families Citing this family (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
KR20070063501A (ko) * | 2004-10-12 | 2007-06-19 | 가부시키가이샤 히타치 메디코 | 지속적 타동 운동 장치 |
US10420691B2 (en) * | 2016-02-24 | 2019-09-24 | Richard Stewart | Knee range of motion device utilizing tangential joint translation and distraction |
CN110898395B (zh) * | 2019-11-26 | 2023-08-29 | 合肥荣事达电子电器集团有限公司 | 一种健身用腿力锻炼设备及其使用方法 |
Family Cites Families (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE2015054C3 (de) * | 1970-03-28 | 1975-07-17 | Bimler, Dr. Med. Rudolf, 2190 Cuxhaven | Bewegungsschiene für Beine |
US4665899A (en) * | 1984-09-27 | 1987-05-19 | Joint Mobilizer Systems Corp. | Apparatus for articulating the knee and hip joints |
AT388287B (de) * | 1986-01-21 | 1989-05-26 | Soevegjarto Harald | Einrichtung zur gestuetzten bewegung des beines eines patienten |
FR2759901B1 (fr) * | 1997-02-27 | 1999-07-09 | Smith & Nephew Kinetec Sa | Dispositif pour produire un deplacement passif continu |
-
1998
- 1998-10-23 FR FR9813467A patent/FR2784893B1/fr not_active Expired - Fee Related
-
1999
- 1999-10-22 WO PCT/FR1999/002567 patent/WO2000024354A1/fr active IP Right Grant
- 1999-10-22 AU AU63450/99A patent/AU771107B2/en not_active Ceased
- 1999-10-22 CA CA002347986A patent/CA2347986A1/fr not_active Abandoned
- 1999-10-22 JP JP2000577967A patent/JP2002528176A/ja active Pending
- 1999-10-22 AT AT99950808T patent/ATE261292T1/de not_active IP Right Cessation
- 1999-10-22 EP EP99950808A patent/EP1121085B1/fr not_active Expired - Lifetime
- 1999-10-22 DE DE69915503T patent/DE69915503D1/de not_active Expired - Lifetime
Also Published As
Publication number | Publication date |
---|---|
EP1121085A1 (fr) | 2001-08-08 |
AU771107B2 (en) | 2004-03-11 |
DE69915503D1 (de) | 2004-04-15 |
ATE261292T1 (de) | 2004-03-15 |
AU6345099A (en) | 2000-05-15 |
FR2784893A1 (fr) | 2000-04-28 |
CA2347986A1 (fr) | 2000-05-04 |
FR2784893B1 (fr) | 2001-01-26 |
JP2002528176A (ja) | 2002-09-03 |
WO2000024354A1 (fr) | 2000-05-04 |
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