EP1586291B1 - Gerät um die Höhe eines Gewichts sowie eine auf dieses Gewicht wirkende Entlastungskraft zu regulieren - Google Patents

Gerät um die Höhe eines Gewichts sowie eine auf dieses Gewicht wirkende Entlastungskraft zu regulieren Download PDF

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Publication number
EP1586291B1
EP1586291B1 EP04405236A EP04405236A EP1586291B1 EP 1586291 B1 EP1586291 B1 EP 1586291B1 EP 04405236 A EP04405236 A EP 04405236A EP 04405236 A EP04405236 A EP 04405236A EP 1586291 B1 EP1586291 B1 EP 1586291B1
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EP
European Patent Office
Prior art keywords
cable
force
weight
height
length adjustment
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
EP04405236A
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English (en)
French (fr)
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EP1586291A1 (de
Inventor
Gery Colombo
Rainer Bucher
Robert Riener
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Hocoma AG
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Hocoma AG
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Filing date
Publication date
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Priority to EP04405236A priority Critical patent/EP1586291B1/de
Priority to DE602004012959T priority patent/DE602004012959T2/de
Priority to AT04405236T priority patent/ATE391482T1/de
Priority to US11/107,641 priority patent/US20050239613A1/en
Publication of EP1586291A1 publication Critical patent/EP1586291A1/de
Application granted granted Critical
Publication of EP1586291B1 publication Critical patent/EP1586291B1/de
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    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B71/00—Games or sports accessories not covered in groups A63B1/00 - A63B69/00
    • A63B71/0009—Games or sports accessories not covered in groups A63B1/00 - A63B69/00 for handicapped persons
    • 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
    • A61H2201/01—Constructive details
    • A61H2201/0192—Specific means for adjusting dimensions
    • 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
    • A61H2201/50—Control means thereof
    • A61H2201/5058—Sensors or detectors
    • A61H2201/5061—Force sensors
    • 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
    • A61H3/00—Appliances for aiding patients or disabled persons to walk about
    • A61H3/008—Using suspension devices for supporting the body in an upright walking or standing position, e.g. harnesses
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B22/00—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements
    • A63B2022/0094—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements for active rehabilitation, e.g. slow motion devices
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B21/00—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices
    • A63B21/00181—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices comprising additional means assisting the user to overcome part of the resisting force, i.e. assisted-active exercising
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B22/00—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements
    • A63B22/02—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements with movable endless bands, e.g. treadmills
    • A63B22/0235—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements with movable endless bands, e.g. treadmills driven by a motor
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B2220/00—Measuring of physical parameters relating to sporting activity
    • A63B2220/10—Positions
    • A63B2220/13—Relative positions
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B2230/00—Measuring physiological parameters of the user
    • A63B2230/62—Measuring physiological parameters of the user posture
    • A63B2230/625—Measuring physiological parameters of the user posture used as a control parameter for the apparatus
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B69/00—Training appliances or apparatus for special sports
    • A63B69/0064—Attachments on the trainee preventing falling

Definitions

  • the present invention relates to a device and a process for adjusting the height of and the relief force acting on a weight, especially on the weight of a patient within a locomotion training means to be used for walking therapy of paraparetic or hemiparetic patients.
  • the invention relates to an automatic unloading device that allows unloading an object attached to one end of a rope by a precise counter force.
  • the invention relates to a device and a process which can be used within a locomotion training of patients with walking impairments in any phase of rehabilitation.
  • said type of unloading system can be used for different applications but is preferably intended for the use in body weight supported treadmill training.
  • This type of training is for example being used to train neurologically impaired patients to walk again during rehabilitation. For such incomplete paraplegic patients the possibility exists of improving walking ability up to normality by means of an adequate locomotion training.
  • the required therapy at present takes place on a treadmill, where walking is first made possible for the patient by defined weight relief and partially by additional assisting guidance of the legs by physiotherapists ( Wickelgren, I. Teaching the spinal cord to walk. Science, 1998, 279, 319-321 ).
  • EP 1 137 378 discloses an automatic machine which is used in treadmill therapy (walking therapy) of paraparetic and hemiparetic patients and which automatically guides the legs on the treadmill.
  • Said machine consists of a driven and controlled orthotic device which guides the legs in a physiological pattern of movement, a treadmill and a relief mechanism.
  • the knee and hip joints of the orthotic device are each provided with a drive.
  • Said orthotic device is stabilized on a treadmill with stabilizing means in such a manner that the patient does not have to keep his/her equilibrium.
  • the orthotic device can be adjusted in height and can be adapted to different patients.
  • the unloading is achieved by a counterweight that is attached to the other end of a rope, which is connected to the patient by a harness.
  • This is by definition a simple method and the results are often acceptable for regular treadmill training.
  • One disadvantage is occurring if the patient has to be suspended by a large amount of his body weight. If a large mass has to be attached on the other side of the rope the inertia of the mass is causing large forces during the up and down acceleration of the body.
  • Prior art discloses devices to provide a reliable positioning of the device height, but are cumbersome to adapt to different patients. Another limitation of this approach is furthermore the limited liberty of changes to be made in the course of the application of the walking program for the patient. Some of such a devices are described in documents: US-A-5273502 and WO-A-96/09094 .
  • One object of the invention is therefore to describe a device allowing faster response times and more precise determination of the height of the patient's position and of the relief force.
  • the present invention relates on the insight that the functions of the cable adjustment means have to be separated to be able to achieve an electronically controlled fast adjustment of the relief force.
  • the features according to claim 1 uses two different cable length adjustment means. One is provided to adjust the length of the cable to define the height of the suspended weight. The other is provided to adjust the length of the cable to define the relief force acting on the suspended weight.
  • the invention enhances the control of height and relief force through the separation of the functions.
  • the height of the weight depends on the patient, whether he is a tall or a small person. This is adjusted at the beginning of a training session.
  • the corresponding device can act slowly, even manually.
  • the relief force has to be controlled during the actual therapy.
  • the second cable length adjustment means divides the necessary relief force in a first static part, providing an approximate force response, and a second dynamic part, providing the fast fluctuations of the relief force while the patient is walking.
  • the different devices are motorized and connected to a computer means with memory, the memory comprising database entries for different patients (height of suspension and intended general relief force) and different walking therapies (fine tuned relief force programs). This allows a quick and reliable determination and adjustment of the height for different patients and of the relief force within the training program of every patient.
  • a benefit of the device according to the invention is therefore that any patient can readily mount the apparatus to use the treadmill therapy, which is very easy to adjust for his needs. No special preparation of the treadmill, and no dedicated elastic means are required.
  • Fig. 1 shows a perspective view of a device for adjusting the height of and relief force acting on a weight according to one embodiment of the invention.
  • the device comprises two main components: one static part 1 and another dynamic part 2.
  • the static component 1 comprises a winch 10 controlling a primary cable 11 to which the patient is attached.
  • the primary cable 11 fixed at the turning sleeve of the winch 10 is running preferably parallel to the longitudinal main axis 20 of the dynamic part 2 of the device. Said longitudinal main axis 20 is directed vertically to the ground.
  • Cable 11 is redirected by a fixed roller 12 towards the dynamic part 2 of the device, engages the moving roller 21 being part of said dynamic part 2 and leaves the dynamic part 2 as adjusted cable portion 13 of the cable 11.
  • the cable 11 is then leaving the device redirected by one or more fixed rollers 14; the corresponding prolongation of the cable 11 has received the reference numeral 30.
  • a patient who intends to use a known apparatus for a treadmill therapy e.g. according to EP 1 137 378 , is attached in said prolongation 30 of the cable 11 in a harness (not shown) oriented vertically.
  • the winch 10 is statically suspending the patient so he can not fall and therefore is also responsible for the safety of the patient per se.
  • winch 10 is used to statically adjust the length of cable 11 provided to said harness, it is also possible to fix cable 11 at the location of the winch 10 and to provide a drive unit connected to the fixation of a roller upstream of the dynamic part 2, e.g. roller 12, so that said roller 12 can be moved in direction of longitudinal axis 20.
  • a roller or a combination of rollers downstream of the dynamic part 2, e.g. roller 14, being mounted with a drive unit so that said roller(s) 14 can be moved in direction of longitudinal axis 20 to adjust the length of the cable 11 provided to attach a patient.
  • the static part 1 comprises a unit connected to the frame 32.
  • the static part 1 does not act directly on the cable.
  • Said unit is provided to move frame 32 in the direction of longitudinal axis 20. With a fixed end of cable 11 said movement of frame 32 moves roller 21 and therefore lengthens or shortens the free cable 13.
  • All these alternative units for winch 10 can constitute the static part 1 of the device to provide a static adjustment of the length of the cable 11 provided in said prolongation 30 which corresponds to the intended height of the harness for use in a walking therapy.
  • the dynamic part 2 comprises an elastic means.
  • the elastic means of the embodiment is a spring means 22 provided as two helicoidal springs provided on either side of a central spindle 23. Beside the use of helicoidal springs 22 it is also possible to use different types of elastic means, being able to exert a force in the approximate range of the intended weight to be attached to the prolongation 30 of the cable 11.
  • Springs 22 are attached between a bottom plate 24 and a top plate 25.
  • the bottom plate 24 is attached to a spindle drive 31 connected with spindle 23 engaging a thread within bottom plate 24.
  • Spindle drive 31 shows a handle but can also be motorized and connected to a control unit.
  • Top plate 25 is connected to a pulley 21, pulling the cable 11 down. Through use of the redirection of cable portion 13 the rollers 12, 14 and 21 have the function of a pulley-block. It can be intended to use even more redirections to translate the adjustment of the cable length of the prolongation 30 into a much smaller movement of the pulley 21.
  • the linear drive 26 is controlled by said electronic control unit, e.g. provided as a computer system, through a closed loop controller in such a way, that the force acting on the force transducer 27 can be controlled precisely.
  • the force acting on the force transducer 27 is directly proportional to the force acting on cable 13 at the harness.
  • the force transducer 27 can also be mounted to measure the force acting on the pulley 14, on the pulley 12 or near the patient at the other side 30 of the cable 11, being the connecting link to a harness supporting the patient (weight 40).
  • a treadmill training of a neurologically impaired patient can be performed as follows: First the patient, attached to the other side 30 of the cable 11 with a harness, would be suspended over the walking surface by the winch 10 (static unloading system 1) until standing.
  • the amount of unloading is defined by the control unit.
  • a small motor attached to the spindle drive 31 that determines the tension of the springs 22 would then extend the springs 22 up to a length that more or less corresponds to the desired unloading of the patient. Like this the dynamic system is already unloading the patient nearly with the desired force.
  • This closed loop control of body weight support allows for perfect accommodation of partial weight bearing exercise.
  • the up and down movement of the patient causes the force to be not constant during the training if only the springs 22 were attached. Therefore the linear drive 26 will adjust the position of the pulley 21 online, as controlled by the close loop controller, so the force acting on the rope 11 will be constant, or corresponding to a desired force trajectory, during the whole training.
  • the device can only guarantee a precise, desired unloading, as long as the weight can be adjusted by the linear drive 26. This is not possible anymore, if the patient moves up or down too much, meaning that the linear drive 26 is approaching the end of the range of motion. This is detected by the control unit, as the movement of the linear drive 26 is measured with a position sensor, e.g. a ultrasound transducer mounted beneath top plate 25. The control unit can therefore readjust the position of the patient with the winch 10 in terms to bring the linear drives 26 back into the range of operation.
  • a position sensor e.g. a ultrasound transducer mounted beneath top plate 25.
  • Fig. 2 shows a schematic diagram of the electronic controller unit in combination with the device according to Fig. 1 .
  • the winch 10, the actuator 26, e.g. the linear drive, and the bias means 31, e.g. the spindle drive, are shown receiving an controller signal I and outputting a signal proportional to a well-defined force F or position x.
  • the boxes of Fig. 2 showing a actual device according to Fig. 1 have received the same reference numeral, although it is clear for someone skilled in the art that the boxes of Fig. 2 further comprise the electronic controller components to deliver the control signals mentioned.
  • Numeral 40 is used to define the weight of e.g. a human subject to use the treadmill for which the device for adjusting the height of and the relief force acting on said weight 40 is provided.
  • a position sensor 34 (not shown in Fig. 1 ) measures x real and outputs x measured .
  • the force sensor 27 measures F real and outputs F measured .
  • the (static) position of the cable x measured is input to the winch controller 35, acting via a control signal I winch on the winch 10 to define the predetermined height, which can be input to the winch controller 35 via a key means or an electronic signal of said electronic control unit comprising the walking program for a patient.
  • the key means or an electronic signal of said electronic control unit comprising the walking program for a patient generates the input F desired .
  • a mixer 36 is provided to output the difference signal of F desired and F measured .
  • Said difference signal F diff is input to a force controller 37 outputting the corresponding control signal I drive which is fed to the actuator 26 to dynamically change the length of the cable 13 to control the force relief.
  • F desired is also the input to the spring load controller 38, outputting a signal I springs to bias means 31, which in turn moves bottom plate 24 to adjust the static weight compensation by springs 22.
  • the length of the springs 22 is controlled with the bias means 31 to move the bottom plate 24 into a position that the tension of the springs 22 is such that patient is unloaded approximately by the desired force F desired .
  • the spring load controller 38 has therefore a far slower response than the force controller 37.

Claims (4)

  1. Vorrichtung zur Einstellung der Höhe von einem Gewicht (40) und von der auf dieses Gewicht wirkenden Entlastungskraft, insbesondere auf das Gewicht eines Patienten innerhalb eines Lokomotions-Trainingsmittels für den Einsatz in der Gehtherapie von paraparetischen und hemiparetischen Patienten, wobei das besagte Gewicht durch ein Kabel (11, 30) gestützt wird, mit einem ersten die Kabellänge einstellenden Mittel (1), um eine Einstellung der Länge des Kabels (11) zu liefern, um die Höhe (x) des besagten aufgehängten Gewichts (40) zu definieren, mit einem zweiten die Kabellänge einstellenden Mittel (2), um eine Einstellung der Länge des Kabels (11) zu liefern, um die Entlastungskraft (F) zu definieren, die auf das aufgehängte Gewicht (40) wirkt, wobei das erste die Kabellänge einstellende Mittel (1) ein Windenmittel (10) umfasst, welches an einem freien Ende des Kabels (11) vorgesehen ist oder ein bewegliches Rollenmittel (12, 14) umfasst, welches stromaufwärts oder stromabwärts des Eingriffspunktes des zweiten die Kabellänge einstellenden Mittels (2) angeordnet ist oder ein Versatzmittel für das zweite die Kabellänge einstellende Mittel (2) umfasst, wobei das zweite die Kabellänge einstellende Mittel (2) ein elastisches Mittel (22) umfasst, um eine Gegenkraft auf das aufgehängte Gewicht mit einem Wert im Bereich der vorgesehenen Entlastungskraft zu liefern, dadurch gekennzeichnet, dass die Vorrichtung ein Stellglied (26) umfasst, der eine Kraft parallel zur Richtung der Gegenkraft liefert, die von dem elastischen Mittel (22) geliefert wird, wobei die Addition der zwei Kräfte den Wert der vorgesehenen Entlastungskraft bestimmt.
  2. Vorrichtung nach Anspruch 1, dadurch gekennzeichnet, dass sie weiterhin einen Kraftumwandler (27) umfasst, der mit einer Steuereinheit verbunden ist, die mit dem besagten Stellglied (26) verbunden ist, um die Entlastungskraft zu steuern, vorzugsweise in Gestalt einer einen geschlossenen Regelkreis umfassenden Steuereinheit.
  3. Vorrichtung nach Anspruch 2, dadurch gekennzeichnet, dass ein Vorspannmittel (31) parallel mit dem Stellglied (26) angeordnet ist.
  4. Vorrichtung nach Anspruch 2 oder 3, wobei die Steuereinheit (35, 37, 38) angepasst ist, um Daten in Bezug auf die Höhe (x) des Patienten und der vorgesehenen Entlastungskraft (Fdesired) zu erhalten, um ein erstes die Kabellänge einstellendes Mittel (1) zu aktivieren, um eine Einstellung der Länge des Kabels (11) zu liefern, um die Höhe (x) des aufgehängten Gewichts (40) zu definieren, und um ein zweites die Kabellänge einstellendes Mittel (2) zu aktivieren, um eine Einstellung der Länge des Kabels (11) zu liefern, um die Entlastungskraft (F) zu definieren, die auf das aufgehängte Gewicht (40) wirkt, wobei der Kraftumwandler (27), der in Serie mit dem elastischen Mittel (22) des zweiten die Kabellänge einstellenden Mittels (2) angeordnet ist und der mit der Steuereinheit verbunden ist, angepasst ist, um einen Kraftmesswert des unterstützten Gewichts zu erzeugen und um die besagten Werte an die Steuereinheit zu übermitteln, die mit dem besagten Stellglied (26) des zweiten die Kabellänge einstellenden Mittels (2) verbunden ist, wobei die Steuereinheit das Stellglied (26) steuert, um eine Kraft parallel zur Richtung der Gegenkraft zu liefern, die von dem elastischen Mittel (22) geliefert wird, wobei die Addition der zwei Kräfte den Wert der vorgesehenen Entlastungskraft zu jedem Zeitpunkt bestimmt.
EP04405236A 2004-04-16 2004-04-16 Gerät um die Höhe eines Gewichts sowie eine auf dieses Gewicht wirkende Entlastungskraft zu regulieren Expired - Lifetime EP1586291B1 (de)

Priority Applications (4)

Application Number Priority Date Filing Date Title
EP04405236A EP1586291B1 (de) 2004-04-16 2004-04-16 Gerät um die Höhe eines Gewichts sowie eine auf dieses Gewicht wirkende Entlastungskraft zu regulieren
DE602004012959T DE602004012959T2 (de) 2004-04-16 2004-04-16 Gerät, um die Höhe eines Gewichts sowie eine auf dieses Gewicht wirkende Entlastungskraft zu regulieren
AT04405236T ATE391482T1 (de) 2004-04-16 2004-04-16 Gerät um die höhe eines gewichts sowie eine auf dieses gewicht wirkende entlastungskraft zu regulieren
US11/107,641 US20050239613A1 (en) 2004-04-16 2005-04-15 Device and process for adjusting the height of and the relief force acting on a weight

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
EP04405236A EP1586291B1 (de) 2004-04-16 2004-04-16 Gerät um die Höhe eines Gewichts sowie eine auf dieses Gewicht wirkende Entlastungskraft zu regulieren

Publications (2)

Publication Number Publication Date
EP1586291A1 EP1586291A1 (de) 2005-10-19
EP1586291B1 true EP1586291B1 (de) 2008-04-09

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EP04405236A Expired - Lifetime EP1586291B1 (de) 2004-04-16 2004-04-16 Gerät um die Höhe eines Gewichts sowie eine auf dieses Gewicht wirkende Entlastungskraft zu regulieren

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Country Link
US (1) US20050239613A1 (de)
EP (1) EP1586291B1 (de)
AT (1) ATE391482T1 (de)
DE (1) DE602004012959T2 (de)

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US9808668B2 (en) 2013-06-21 2017-11-07 Hocoma Ag Apparatus for automated walking training

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DE602004012959T2 (de) 2008-10-23
ATE391482T1 (de) 2008-04-15
DE602004012959D1 (de) 2008-05-21
US20050239613A1 (en) 2005-10-27

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