EP1169003B1 - Dispositif et procede pour une therapie de locomotion - Google Patents

Dispositif et procede pour une therapie de locomotion Download PDF

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Publication number
EP1169003B1
EP1169003B1 EP00914001A EP00914001A EP1169003B1 EP 1169003 B1 EP1169003 B1 EP 1169003B1 EP 00914001 A EP00914001 A EP 00914001A EP 00914001 A EP00914001 A EP 00914001A EP 1169003 B1 EP1169003 B1 EP 1169003B1
Authority
EP
European Patent Office
Prior art keywords
knee
foot
patient
leg
movement
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
EP00914001A
Other languages
German (de)
English (en)
Other versions
EP1169003A1 (fr
Inventor
Volker Dietz
Gery Colombo
Rüdiger RUPP
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.)
Balgrist/Schweiz Paraplegikerzentrum
Original Assignee
Balgrist/Schweiz Paraplegikerzentrum
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Filing date
Publication date
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Publication of EP1169003A1 publication Critical patent/EP1169003A1/fr
Application granted granted Critical
Publication of EP1169003B1 publication Critical patent/EP1169003B1/fr
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

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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
    • A61H1/0218—Drawing-out devices
    • A61H1/0229—Drawing-out devices by reducing gravity forces normally applied to the body, e.g. by lifting or hanging the body or part of it
    • 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 together in a plane substantially parallel to the body-symmetrical plane
    • 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 together in a plane substantially parallel to the body-symmetrical plane
    • A61H1/0262—Walking movement; Appliances for aiding disabled persons to walk
    • 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
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/12—Driving means
    • A61H2201/1207—Driving means with electric or magnetic drive
    • A61H2201/1215—Rotary drive
    • 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
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/16—Physical interface with patient
    • A61H2201/1602—Physical interface with patient kind of interface, e.g. head rest, knee support or lumbar support
    • A61H2201/164—Feet or leg, e.g. pedal
    • A61H2201/1642—Holding means therefor
    • 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
    • A61H2203/00—Additional characteristics concerning the patient
    • A61H2203/04—Position of the patient
    • A61H2203/0406—Standing on the feet
    • 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
    • A61H2203/00—Additional characteristics concerning the patient
    • A61H2203/04—Position of the patient
    • A61H2203/0443—Position of the patient substantially horizontal
    • A61H2203/0456—Supine

Definitions

  • the invention relates to a device and a method for starting locomotion training in patients with mobility problems in an early phase of rehabilitation, according to patent claims 1 and 8, respectively.
  • U.S. Patent No. 4,986,261 (1991) describes an apparatus that also causes hip expansion. However, the knee joints are not moved as in physiological walking. None of the systems described makes it possible to move the legs while at the same time adjusting the patient's inclination.
  • the aim is to create the possibility of continuously bringing the patient's body closer to the vertical position during training.
  • the aim of the device according to the invention is to create a so-called 'active standing table' (tilting table) which enables the movement of the legs of paraplegic patients in a physiological manner similar to walking without the need to straighten it up.
  • Fig. 1 shows a side view of the active standing table with a patient in a vertical position.
  • a base frame is used as the basis, as found on conventional bar tables. It consists of a chassis 1 with rollers 2 and 3 and a height-adjustable frame 6 (e.g. "tilting table Super", Gymna, Belgium). The height of the frame 6 can be adjusted manually or with a drive (not shown).
  • a hinge 7 is attached to the frame 6, with which a leg part 8, consisting of two spars and two cross struts (see FIG. 2), is articulatedly connected to the frame 6.
  • the leg part 8 is in turn connected via a joint 9 to a head part 10 (frame similar to leg part 8), on which there is a lying surface 11 consisting of a wooden board with a foam cover. So that during therapy with the active standing table the angle of the standing table can be continuously increased from the horizontal to the vertical, the leg part 8 can be rotated around the joint 7 with a drive 4 and an angle of inclination ⁇ 1 can be set to treat the patient to be able to carry out different angles of inclination in a known manner.
  • the angle of inclination ⁇ 1 is 90 °, which corresponds to a vertical position of the patient. Due to the adjustability of the angle of inclination ⁇ 1, patients with unstable blood circulation can be treated while lying down and then continuously brought into the vertical position appropriately during the therapy by slightly increasing the angle of inclination ⁇ 1.
  • a mechanism 21 for adjusting the hip extension it is possible to fix an inclination between the leg part 8 and the head part 10, as a result of which a hip extension angle ⁇ 2 is defined.
  • ⁇ 2 is always 180 °, since the head part 10 rests on the frame 6. If the angle ⁇ 1 is now increased, then ⁇ 2 also decreases until the mechanism 21 comes to a stop and the head part is also pulled upwards.
  • the angle ⁇ 2 is 172 °, which gives the patient a hip extension angle of 8 °; preferred values are 12 °.
  • leg part 8 On the leg part 8 there is a knee mechanism 13 with two knee drives 24 and a foot mechanism 14. These two mechanisms can be moved parallel to the leg part on two rails 15 which are fastened on each side of the leg part 8 and thus allow the standing table to be adjusted to the anatomy of different patients.
  • the lying surface 11 In order to be able to carry out therapy, the lying surface 11 is tilted into the horizontal position and brought to the same height as the hospital bed on which the patient to be treated lies with the height adjustment of the base frame. The patient is then transferred to the lying surface 11 so that his upper body comes to rest on the lying surface and his hip joints lie on the lower edge of the lying surface.
  • the fixation belt 16 corresponds to a belt that is used as standard for weight relief during treadmill training for paraplegics (eg treadmill belt "Walker", from Hamster's Falltransportservice, Austria).
  • the knee mechanism 13 is shifted on the rails 15 in such a way that the knee drives 24 come to lie directly under the back of the patient's knees.
  • the knee mechanism is fixed with locking screws 25. Thereafter, the foot mechanism 14 is also shifted so that an extension (extension) of the patient's legs press footplates 19a and 19b down as far as possible (see FIG. 5).
  • the foot mechanism 14 is fixed in the correct position with locking screws 26.
  • knee cuffs 20 are attached to the patient's knees (see Fig. 6). These are attached to the knee drives 24, which pull the patient's knees down or down during therapy. push up. This causes a stretching or a bending of the legs. In the figure, the patient's right leg is shown bent, the left leg is stretched. It should be mentioned that at the beginning of the therapy, the two knee drives 24 are retracted. So the patient can be easily transferred to the standing table. Only at the beginning of the treatment is a knee drive extended and one leg bent. During locomotion therapy, the knee drives 24 are moved up and down alternately, so that the patient's legs move with a movement sequence similar to that which occurs during normal walking. The sensory input (afferents) from the legs for the spinal locomotion centers in the spinal cord provides information similar to that of physiological walking, which stimulates the locomotion centers to activate.
  • Fig. 2 shows the overall view of a first embodiment of an active standing table in a horizontal position.
  • the base frame consisting of a chassis 1 with rollers 2a, 2b, 3a and 3b and the height-adjustable frame 6, can be seen again.
  • the leg part 8 Via the joint 7 is the leg part 8, a frame consisting of two bars 8A and 8A 'and two cross struts 8B and 8B ', connected to the frame 6.
  • the leg part 8 is in turn connected via the joint 9 to the head part 10, on which the lying surface 11 is located.
  • the mechanism 21 for adjusting the hip extension is located at the joint 9.
  • Fig. 3 shows the mechanism for adjusting the hip extension angle in side view.
  • the joint 9 can be seen, each with a part of the leg part 8, the head part 10, the lying surface 11 and the rail 15.
  • An angle 30 is attached to the leg part 8. At this angle 30 there is a limiting screw 31 in a thread.
  • the head part 10 lies on the base frame of the tilting table and the angle ⁇ 2 is 180 °. If the angle of inclination is now increased, the angle ⁇ 2 decreases until the head part 10 rests on the screw head 43 of the limiting screw 31 and the head part is guided upwards. If the limiting screw 31 is now screwed further into the angle 30, the angle ⁇ 2 becomes correspondingly larger, it is unscrewed, correspondingly smaller.
  • a pointer 33 shows on a scale 32 which hip extension angle is set for the patient with the limiting screw. The hip extension angle corresponds to 180 ° - ⁇ 2.
  • FIG. 4A shows the knee mechanism 13 of FIG. 2 in a perspective view.
  • the square tubes 41a are located on each side of a cross member 40. These serve as a guide for the knee mechanism 13 on the rails on the leg part.
  • the cross member 40 has two rectangular cutouts 40 ', in which the two knee drives 24a and 24b are located. The structure of these two drives is identical, which is why only one drive is numbered in the figure.
  • Bearings 42, 43a in which suspension shafts 44b and 45b can rotate freely, are attached to the cross member 40 on the lower side. These suspension shafts are each attached to a base plate 46b.
  • the knee drives can be rotated by this mounting, so that they are moved by the patient's knee movement, around the axis of rotation of the hip joint, when bending or stretching.
  • a motor 47b is fastened in the base plate 46b and two guide tubes 48b are embedded.
  • the structure of the drive by means of the threaded rod is described in detail in Fig. 4B.
  • a guide rod 52b and 53b can be moved up and down. If the linear drive is now moved up or down, a plate 54b and an attached knee pad 55b are also moved up and down.
  • the patient's knees are brought into flexion when the knee pads are moved upwards, and are pulled into an extension when the knee pads are moved downward (see FIG. 6).
  • the two guide rods 52b and 53b which are guided in the guide tubes 48b and 49b, ensure lateral stability of the knee drive, so that the leg extends tends to the side of the patient.
  • the guide tubes 48b and 49b and the threaded rod 51b are mounted in the plate 54b at the upper end and in a plate 62b at the lower end.
  • a protective cover 56a made of rubber protects the patient from injuries to the knee drives.
  • FIG. 4B shows the knee mechanism 13 from FIG. 2 in a side view.
  • the principle of the drive is explained in more detail using this figure.
  • the suspension shaft 44 can be seen on the base plate 46, which allows the knee drive to rotate about the axis indicated by the round arrow.
  • the guide rod 52 can be displaced by the guide tube 48, and the threaded rod 51 can be displaced by the guide 50.
  • the motor 47 which is fixedly mounted in the base plate 46, drives a gearwheel 59 mounted on the guide 50 with a gearwheel 57, via a V-belt 58. There is a thread in gear 59.
  • the threaded rod 51 in the base plate 46 is respectively upward. moved down, as indicated by the straight arrow.
  • the plate with the knee sleeve presses on a contact button 61 and the limit switch 60 signals the control unit that the motor should run in the opposite direction. Then the drive moves up until the lower plate presses a contact button 61 'and the limit switch 60' gives the control unit another signal for switching.
  • Fig. 5 shows the foot mechanism 14 to Fig. 2 in a perspective view.
  • a square tube 69a and 69b is firmly connected to it. These serve as a guide for the foot mechanism on the rails attached to the leg section.
  • the foot mechanism can be screwed in place with the fixing screws 26a and 26b.
  • a footplate 19a and 19b is at the upper end of the T-piece 63 which can be rotated about a bearing at the attachment point on the T-piece.
  • the base plates are identical in structure, all parts appear symmetrically on both sides.
  • the patient's feet can each be inserted into an elastic loop 65a and 65b on the footplates.
  • the foot plates 19a and 19b are each connected to a spring 67a. This is tensioned on a bolt 68a when the footplate is pressed down by the patient (arrow direction). This creates a pressure force on the sole of the patient's foot in the extended phase of the movement cycle, which simulates a weight force similar to that which occurs when walking.
  • the strength of this weight can be adjusted by moving the bolt 68a in the different holes 68a '. When the angle of inclination of the standing table increases, so does the weight that acts on the legs. This effect can be compensated and controlled by pulling the patient more or less upwards with the fixation straps and the fixation belt.
  • Fig. 6 shows a knee cuff to Fig. 2 in perspective.
  • a plate 70 is fixedly attached.
  • a bracket 71 is attached, to which a knee pad 53 can be attached with two clip mechanisms 72 and 72 '.
  • This knee pad 53 is a plastic-covered foam.
  • the clip mechanism keeps the knee pad strong enough to extend the knee when the knee drive is pulled down. However, the connection is released if the patient's knee cannot be stretched for any reason due to incorrect manipulation. This serves as a load protection for the patient's legs and protects him from injuries.
  • the clip mechanism releases the knee pads for loads or tensile forces of 150 - 200 N., preferably of 180 N.
  • a knee cuff consisting of two Velcro strips 73 and 73 ', is attached to the knee pad 53, which allows the patient's knee to be attached to the knee pad by attaching the tapes to the Velcro strip 74.
  • the two ligaments are attached to the knee so that the patient's kneecap is between the ligaments so that no pressure is exerted on them when the leg is extended.
  • Fig. 7 shows the overall view of a second embodiment for an active standing table in a horizontal position.
  • the basic structure is identical to the first embodiment.
  • the patient's legs are not driven by linear drives, but by a cable 80 from an eccentric drive 81, which is described in more detail in FIG. 8.
  • a knee part 82 and a foot part 83 can be moved on the rails 15a and 15b and can thus be adapted to the patient's leg length.
  • FIG. 8A shows the knee mechanism of FIG. 7 in perspective. It consists of the eccentric drive 81, ropes 80a and 80b (nylon ropes) and the knee part 82.
  • a gear 91 is attached to a motor 90.
  • This drives an eccentric 92, in which a pin 94 is inserted. If the eccentric disc 92 now rotates, the pin 94 moves on a circular path.
  • This circular movement moves a carriage 95, in which the pin 94 is guided, back and forth, the carriage in turn being guided in guide rails 96 and 97.
  • the movement of the carriage 95 causes a tensile force on one of the ropes 80a or. 80b.
  • the ropes are guided over rollers 98a, 98b, 99a, 99b, 100a and then pull over a hook 101a, respectively.
  • 101b on the knee cuffs the patient's knees into an extension.
  • Plastic-covered pads 102a and 102b made of foam protect the back of the patient's knees from injury in the extension and press when the ropes 80a and. 80b the knees back towards flexion.
  • the pads are located on a plate 108 which has guide tubes 109a and 109b with locking screws 110a and 110b.
  • On the ropes 80a and 80b is a tensioning device 103a and. 103b attached, with which the ropes can be adjusted in length. This allows the train to hook 101 a, respectively.
  • Velcro strips can be used, similar to that described in FIG. 6.
  • Fig. 8B shows the eccentric drive to Fig. 7 in supervision.
  • the motor 90 can be seen with the gear 91, on which the eccentric disk 92 is located.
  • Various holes 93 are provided in this so that the pin 94 can be inserted into the eccentric disk 92 on different radii.
  • the stroke length of the knee movement can be set to different sizes by the different positions of the pin 94 in the holes 93.
  • Rollers 104 to 107 are mounted on the carriage 95 and support the plate in the guide rails 96 and 97.
  • the two ropes 80a and 80b are also fastened to the slide 95.
  • a much simpler control unit is necessary here, since the motor can simply rotate and the extension or flexion of the leg is automatically obtained.
  • the control unit only controls the speed of motor 90 and so determines the frequency of movement on the patient's leg. In the first embodiment, the control unit must always switch the drives from an upward movement to a downward movement and vice versa when the end positions are reached.
  • FIG. 9 shows the foot mechanism 83 of FIG. 7 in a perspective view.
  • a square tube 121 a and 121 b is firmly connected to this. These serve as a guide for the foot mechanism on the rails attached to the leg section.
  • the foot mechanism can be screwed in place using the fixing screws 122a and 122b.
  • a carrier 123 is fastened on the plate 120 and a second carrier 124 is attached to the upper end thereof.
  • a lever 126a is attached to each of the foot plates, which are connected to one another via a steel cable 127.
  • This steel cable 127 runs over a roller 128 and serves as a reciprocation mechanism.
  • the other moves up.
  • the spring 129 creates a weight force on the patient's sole (afferent Input).
  • a cuff 131 a resp. 131 b which via a connecting part 132 a or. 132b with the footplate 125a or 125b are connected, the patient's leg can be fixed. This way it is stabilized from the side so that it does not tip over to the side when it is bent.
  • a heel bracket 133a resp. 133b protects the patient's foot from being damaged by the footplate 125a or. 125b to slide down.
  • the active standing table With the active standing table according to the invention, it is possible to control the sequence of movements of all joint planes (hips, knees, feet) of the patient's lower extremities in a physiological pattern (kinematics and kinetics) that is similar to walking, if possible.
  • the most important movement variables for successful locomotion therapy are hip extension and the weight load on the sole of the foot during the extension phase of the leg. Both parameters can be individually adapted to the needs of the patient with the active standing table described here.
  • the active standing table can be adapted to the individual size differences of the patients. With locomotion therapy on the active standing table, success can be achieved because training can begin very early, ie even if the patient is not yet allowed to be raised.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Epidemiology (AREA)
  • Pain & Pain Management (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Rehabilitation Therapy (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Orthopedics, Nursing, And Contraception (AREA)
  • Rehabilitation Tools (AREA)
  • Massaging Devices (AREA)

Claims (12)

  1. Dispositif pour la thérapie de locomotion pour la réhabilitation de patients paraparétiques et hémiparétiques, comprenant une table pour position debout qui peut être ajustée en hauteur et en inclinaison, une ceinture de fixation avec des moyens de maintien du patient à la table pour position debout, un mécanisme de moteur pour le mouvement de la jambe du patient, comprenant une pièce de genou et une pièce de pied, caractérisé en ce que la table pour position debout a une pièce de tête (10) qui est réglable par rapport à la pièce de jambe (8), d'où résulte un angle d'extension de la hanche ajustable (β2) pour lequel un mécanisme d'ajustement (21) est prévu; et en ce que la pièce de genou (13) et la pièce de pied (14) sont arrangées pour être déplacées sur des rails (15) sur la pièce de jambe (8); en ce que la pièce de genou (13) a un mécanisme du genou et la pièce de pied (14) a un mécanisme du pied qui sert à établir la force sur la plante du pied pendant l'extension du genou; et en ce qu'une unité de contrôle est prévue pour le chemin du mouvement du mécanisme du genou.
  2. Dispositif selon la revendication 1, où deux moteurs linéaires (24a, 24b) sont prévus pour le moteur de genou dans le mécanisme du genou, qui étendent ou plient les jambes du patient.
  3. Dispositif selon la revendication 1, où un moteur excentrique (81) est prévu pour le moteur de genou dans le mécanisme du genou, qui étend l'une des jambes en alterné; et où les jambes sont encore pliées par des coussins (102a, 102b) du mécanisme du genou et un mécanisme de réciprovocation (126a, 126b, 127, 128) situé sur la pièce de pied.
  4. Dispositif selon l'une des revendications 1-3, où le mécanisme de pied peut générer une force de poids dans la phase d'extension de la jambe, où deux ressorts (67a, 67b; 129a, 129b) sont arrangés pour la production de cette force de poids.
  5. Dispositif selon l'une des revendications 1-4, où l'angle d'extension de la hanche (β2) a une valeur de 0-20°, et de préférence de 12°.
  6. Dispositif selon l'une des revendications 1-5, où la pièce de genou (13) et la pièce de pied (14) peuvent être déplacées sur deux rails (15a, 15b) et, de telle façon que la table active pour position debout puisse être ajustée aux mesures du patient, où toutes les positions ont des marquages avec lesquels les réglages trouvés peuvent être reproduits.
  7. Dispositif selon l'une des revendications 3-6, où un accouplement de clip (71, 72, 72') est installé sur la pièce de genou (13) et se déclipse à une tension de 150-200 N, de préférence 180 N, et protège ainsi le genou d'un surmenage.
  8. Procédé pour l'opération du dispositif selon l'une des revendications 1- 7, où la pièce de genou (13) et la pièce de pied (14) sont déplacées sur la table pour position debout pour ajuster le moteur à la longueur de la jambe du patient; et où une extension de la hanche est prédéterminée par l'angle d'extension de la hanche (β2) et un angle d'inclinaison (β1); et où un mouvement des jambes d'un patient est effectué avec le mécanisme du genou situé sur la pièce de genou (13) et avec le mécanisme du pied situé sur la pièce de pied (14), générant une entrée afférente ou une information sensorielle à la moelle épinière comme celle qui est générée en marche normale; et où une force de poids est produite sur la plante du pied pendant l'extension du genou; et où les moteurs pour les mouvements sont contrôlés par un contrôle qui prédétermine un modèle de mouvement similaire à celui d'une marche physiologique.
  9. Procédé selon la revendication 8, où l'ampleur du mouvement est modifiée par l'unité de contrôle ou par la position de la goupille (94) sur le disque excentrique (92).
  10. Procédé selon la revendication 8 ou 9, où la vitesse du mouvement de la jambe est variée.
  11. Procédé selon l'une des revendications 8-10, où la force de poids agissant sur la plante du pied dans la phase d'extension du mouvement de la jambe est réglée par des ressorts pouvant être déplacés (67a, 67b).
  12. Procédé selon l'une des revendications 8-11, où les positions de la pièce de genou et la pièce de pied sont lues, établies et reconstruites avec des marquages.
EP00914001A 1999-04-07 2000-04-07 Dispositif et procede pour une therapie de locomotion Expired - Lifetime EP1169003B1 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
CH64799 1999-04-07
CH64799 1999-04-07
PCT/CH2000/000203 WO2000061059A1 (fr) 1999-04-07 2000-04-07 Dispositif et procede pour une therapie de locomotion

Publications (2)

Publication Number Publication Date
EP1169003A1 EP1169003A1 (fr) 2002-01-09
EP1169003B1 true EP1169003B1 (fr) 2004-03-31

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EP00914001A Expired - Lifetime EP1169003B1 (fr) 1999-04-07 2000-04-07 Dispositif et procede pour une therapie de locomotion

Country Status (6)

Country Link
US (1) US6685658B1 (fr)
EP (1) EP1169003B1 (fr)
AT (1) ATE262878T1 (fr)
CA (1) CA2369226C (fr)
DE (1) DE50005903D1 (fr)
WO (1) WO2000061059A1 (fr)

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EP2730265A1 (fr) 2012-11-13 2014-05-14 Hocoma AG Appareil de thérapie de locomotion

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EP1169003A1 (fr) 2002-01-09
US6685658B1 (en) 2004-02-03
WO2000061059A1 (fr) 2000-10-19
DE50005903D1 (de) 2004-05-06
CA2369226C (fr) 2007-11-13
ATE262878T1 (de) 2004-04-15

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