EP1768637B1 - Dispositif de reeducation des deficiences motrices de patients notamment de la marche - Google Patents

Dispositif de reeducation des deficiences motrices de patients notamment de la marche Download PDF

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Publication number
EP1768637B1
EP1768637B1 EP05773250.5A EP05773250A EP1768637B1 EP 1768637 B1 EP1768637 B1 EP 1768637B1 EP 05773250 A EP05773250 A EP 05773250A EP 1768637 B1 EP1768637 B1 EP 1768637B1
Authority
EP
European Patent Office
Prior art keywords
user
harness
disconnectable
straps
connection
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.)
Not-in-force
Application number
EP05773250.5A
Other languages
German (de)
English (en)
French (fr)
Other versions
EP1768637A1 (fr
Inventor
Thierry Albert
Christian Salaün
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.)
ALBERT, THIERRY
SALAUEN, CHRISTIAN
Original Assignee
Individual
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Priority claimed from FR0405700A external-priority patent/FR2870746B1/fr
Application filed by Individual filed Critical Individual
Publication of EP1768637A1 publication Critical patent/EP1768637A1/fr
Application granted granted Critical
Publication of EP1768637B1 publication Critical patent/EP1768637B1/fr
Not-in-force legal-status Critical Current
Anticipated expiration legal-status Critical

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Classifications

    • 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
    • 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
    • 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
    • A61H2201/0173—Means for preventing injuries
    • 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
    • A61H2201/12—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
    • A61H2201/1628—Pelvis
    • A61H2201/163—Pelvis 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
    • 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
    • A61H2201/1635—Hand or arm, e.g. handle
    • 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
    • A61H2201/165—Wearable interfaces
    • 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—Appliances for aiding patients or disabled persons to walk about 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
    • A63B71/00—Games or sports accessories not covered in groups A63B1/00 - A63B69/00
    • A63B71/0054—Features for injury prevention on an apparatus, e.g. shock absorbers
    • A63B2071/0072—Limiting the applied force, torque, movement or speed
    • 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
    • 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
    • A63B21/40—Interfaces with the user related to strength training; Details thereof
    • A63B21/4001—Arrangements for attaching the exercising apparatus to the user's body, e.g. belts, shoes or gloves specially adapted therefor
    • A63B21/4009—Arrangements for attaching the exercising apparatus to the user's body, e.g. belts, shoes or gloves specially adapted therefor to the waist
    • 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
    • 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
    • A63B22/0285—Physical characteristics of the belt, e.g. material, surface, indicia
    • 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
    • A63B22/04—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements with movable multiple steps, i.e. more than one step per limb, e.g. steps mounted on endless loops, endless ladders
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B3/00—Parallel bars or similar apparatus

Definitions

  • the present invention relates to a device for the rehabilitation of motor impairments of patients. It applies more particularly, but not exclusively, to the rehabilitation of walking.
  • the goal of rehabilitation by a physiotherapist is to stimulate sensory-motor function and body coordination in order to improve limb and trunk movements.
  • the work of the walk begins then after a certain delay and is done on the ground with a permanent gestural correction performed in an oral and physical way.
  • Different tools such as a walker, canes, parallel bars, splints can be used at different stages of progression.
  • This system has advantages, in particular, the possibility of practicing a reeducation of walking much earlier and more intensively (in terms of speed and endurance) than what is done with a progression and a traditional technique. Indeed, the smooth running of the carpet forced to a greater regularity of movements of the lower limbs during walking. The body weight can be more or less lightened to reduce, in the early times, the difficulties of equilibration.
  • the document US5526893 which describes a rehabilitation device comprising a height-adjustable shoulder belt to adapt to the morphology of the patient to provide an optimum support generating the least possible stress for the user.
  • a treadmill associated with body lightening means is a bulky material especially in height because the traction points and the attachment straps of the harness constituting the body lightening means are located above each shoulder, this device therefore always has a bulky part located above the head of the person. Part of the device is also located in front or on the sides of the body, this size is a disadvantage in the case where the device is installed in a small room.
  • Such a device has the advantage of preventing any fall but also the disadvantage of over-securing the user who has no imbalance to catch up. But walking is largely based on an ability to catch a fall forward including the advancement of a foot and swinging arms. Therefore, in this device, an important element of rehabilitation is not exploited.
  • the claimed invention aims to solve these disadvantages by leaving a certain freedom to the user while securing against falls.
  • this device proposes a device for the rehabilitation of motor deficiencies of a user in a vertical position, this device comprising a harness provided with connection means intended to be worn by the user, means for lightening the body weight of the user. user having straps disconnectably attached to said connecting means and suspension members of said straps at suspension points, said apparatus further comprising reeducation means consisting of a treadmill, a step simulator or a simulator of cross-country skiing.
  • the harness may comprise a belt element, support straps and / or leg support attached to said belt element and connecting means to the lightening means, these means being disconnectable and fixed at the waist member.
  • Said belt member may be located at or below the user's center of gravity.
  • Said connecting means of the belt to the lightening means may be n number distributed over the belt member.
  • said means for connecting the harness to the lightening means may be two in number, each being located on one side of the belt member so as to secure and lift the user while maintaining a certain instability of the user favorable to the rehabilitation.
  • this instability may be further controlled: said means of connection of the harness may be in number greater than two, in particular the number of four distributed on the sides of the belt element so that two of the means are on one side, one in front, the other behind the user and the other two on the other side, one in front, the other behind the user.
  • the vertical projection of the user's center of gravity is located in the vicinity of the center of a lift polygon, that is to say a polygon formed by the vertical projection, in a horizontal plane, connecting means of the harness on the lightening means.
  • the device according to the invention makes it possible to keep the user inside the polygon thus creating a zone of reduced stability so as to retain a possibility of causing the user to make an effort to maintain his equilibrium.
  • Said user holding means may also comprise support bars that allow the user to support with its upper limbs and thus increase its stability. They can be adjustable in height and / or width.
  • Said bars may be mobile or fixed.
  • Moving bars from front to back will be able to reproduce a movement of forward and backward arms as is the case in normal walking.
  • These bars may include means on which the user, his wheelchair, can support to lift and settle in the device according to the invention.
  • Said means for lightening the body weight of the user may comprise straps driven so as to exert an upward pulling force on the holding means.
  • the pulling force is applied by means of a winder around which one end of the straps is wound, the other end being disconnectably attached to the holding means of the user.
  • Means for adjusting the traction force may be provided so as, on the one hand, to maintain a constant traction force during exercise, the center of gravity moving during walking, and on the other hand, adapting said traction force to the user and / or the therapeutic indication.
  • Said prevention means may comprise straps and / or bars in order to prevent any lateral and / or frontal and / or rear falls.
  • Removable marks may be provided on the surface of the treadmill to give an indication of where to put the foot during walking thus prompting the user to achieve a certain length of step.
  • the device according to the invention is much less bulky than the devices of the prior art, so it can be installed and used in the patient's home. Indeed, the height of the device does not exceed the height of the horizontal plane passing through the lower end of the sternum, so there is no structure of the device above the shoulders of the user which reduces its overall size. Moreover, with a harness, the installation constraints are less important than with a harness wrapping around the pelvis, the abdomen and a part of the thorax.
  • the device according to the invention may be foldable and / or removable.
  • the device comprises two lateral uprights 1 of parallelepipedic section located on either side of a conveyor belt 2 possibly connected to each other by a horizontal part 3 passing under the conveyor belt, this part 3 being able to lengthen or retract in order to of allow adjustment of the spacing of the two uprights closer to the trunk of the user.
  • each of the uprights may comprise at least two moving parts in vertical translation with respect to each other, one vertical 5 and the other bent 6, and comprising fixing means relative to different levels. to account for the height of the user so that the upper end of the uprights is at the level of the umbilicus.
  • This end comprises complementary disconnectable connection means 10 of disconnectable connection means 11 located on said harness of which equips the user ( Figure 3 ).
  • This harness Ba also comprises a belt member C, holding straps and / or supporting legs S attached to said belt member C.
  • the ends of the straps 1 are slightly above the position of the shoulder belt so as to exert an upward pulling force on the shoulder belt.
  • an intermediate pulley 13 at the elbow 4 of the amount 1 may be provided.
  • each winder 8 may also be located at the upper end of the lateral uprights 1.
  • These reels can be operated and held in position using mechanical means or an electric motor.
  • Fall prevention means are also attached to the ends of the lateral uprights. They comprise at least two straps 14, anterior, a posterior, one end of each strap being fixed at the upper end of a lateral upright 1 and the other end of each strap being fixed at the level of the upper end of the other side jamb.
  • These straps 14 are positioned so as to be located at the height of the umbilicus one facing the lumbar region, the other facing the abdomen. These straps each comprise disconnectable connection means 15 to allow easier installation of the user.
  • Bars or lateral support bars 16 or anterior 17 worn in front of the user can be provided, these bars or handles being mounted on the lateral uprights and the user can thus grasp them with the hands in order to take support ( Figure 2 ).
  • figure 4 illustrates another embodiment of the device according to the invention.
  • the lateral uprights 18, 18 ' are fixed relative to each other.
  • Each upright comprises two vertical bars 19, 19 ', 20, 20' interconnected at their vertices by a horizontal bar 21, 21 'whose axis is collinear with the axis of travel x of a carpet rolling 22.
  • Each horizontal bar 21, 21 ' comprises two double-curvature bars, anterior respectively 23, 23' and posterior 24, 24 ', vertically oriented, the lower ends of these double-curved bars are fixed on the horizontal bars 21, 21 'by means of a hinge 25 having a "rotational" axis collinear with that of the horizontal bars 21, 21', the upper ends of these double-curved bars 23, 23 ', 24, 24' are also connected by a horizontal bar 26, 26 'by means of a hinge 25' identical to that already described, this bar being at a height greater than the minimum fixing height of the Baudrier Ba.
  • the double-curved bars 23, 24 of a lateral upright 18 are situated in opposite pairs of double-curved bars 23 ', 24' of the other lateral upright 18 '.
  • Traction straps 27, 27 ' which are fixed on the harness to make it possible to lighten the weight of the user each comprise one of their ends at the level of the base of the lateral uprights which constitute here the base of the treadmill, this end being held in a reel 28, 28 'in order to adjust the traction force provided to support the user's shoulder belt.
  • each of the straps 27, 27 ' is then passed around each horizontal bar 26, 26' which acts as a pulley for returning the strap 27, 27 'towards the harness, the ends of the traction straps and the harness comprising disconnectable connection means 29 and 11, respectively.
  • Straps 30, 31 are also provided as prevention means to prevent a fall of the user forward or backward. They comprise two parts 32, 33 connected by means of disconnectable connection means 34.
  • the anterior straps 30 that is to say located at the height of the umbilicus opposite the abdomen are fixed on the two double curvature bars 23, 23 'located vis-à-vis the front of the horizontal bars 21, 21 '.
  • the posterior straps 31, that is to say located at the height of the umbilicus facing the lumbar region are fixed on the two double curvature bars 24, 24 'located vis-à-vis the back of the horizontal bars 21, 21 '.
  • these straps 30, 31 can be replaced by rigid bars and curved arch-shaped fixed at one end to one of the lateral uprights by means of a vertically oriented hinge allowing to move them to the side during installation of the user.
  • Each strap 7, 27, 27 ' is then directed to a point B defined by a precise position in the extracorporeal space, it is located laterally a few centimeters from the abdomen, in a frontal plane and at a height slightly above above the umbilicus.
  • the point B towards which the strap is moving is between the elbow and the trunk.
  • the point B is included in the bar or the pulley 9, 26, the strap 7, 27, 27 'is supported to change direction join a retractor 8, 28 located at the base of the lateral upright 1, 18, 18 '.
  • This retractor comprises a spiral spring and means for more or less banding said spiral spring (not shown in the figures) in order to to exert a pulling force on the straps (7, 27, 27 '), depending on the mass of the user and / or the therapeutic indication.
  • This traction force can also be kept constant during exercise.
  • Said means for more or less banding said spiral spring may be manual or electric such as an electric motor.
  • This device for pulling the strap can be located anywhere in the device from the moment it allows to exert, at point A, an ascending traction force in the frontal plane to lift the basin.
  • the pelvis is lifted bilaterally which allows the device to support a part of the body mass of the subject.
  • the other specific feature of the device is to ensure the retention of the subject in case of a fall.
  • the wearing of the harness and the ascending traction of the pelvis allows to retain a fall but only partially, in fact the body can still tilt forwards or backwards around an axis connecting the two points A.
  • the straps 14, 30, 31 prevent a complete tilting by holding the body forward and back. Indeed, they join the two points B passing in front and behind the subject at the height of the umbilicus.
  • the horizontal bars 21, 21 ' may have a shape allowing the user in his wheelchair to bear to lift and settle in the device according to the invention. It may be a C-shaped extension.

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  • Health & Medical Sciences (AREA)
  • General Health & Medical Sciences (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Rehabilitation Tools (AREA)
EP05773250.5A 2004-05-26 2005-05-24 Dispositif de reeducation des deficiences motrices de patients notamment de la marche Not-in-force EP1768637B1 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
FR0405700A FR2870746B1 (fr) 2004-05-26 2004-05-26 Dispositif d'encombrement reduit combinant un tapis roulant, un systeme d'allegement de la charge portee et un systeme antichute, destine entre autre aux patients deficients physiques
FR0410279A FR2870747B1 (fr) 2004-05-26 2004-09-29 Dispositif d'amelioration de la motricite notamment de la marche
PCT/FR2005/001276 WO2005117799A1 (fr) 2004-05-26 2005-05-24 Dispositif de reeducation des deficiences motrices de patients notamment de la marche

Publications (2)

Publication Number Publication Date
EP1768637A1 EP1768637A1 (fr) 2007-04-04
EP1768637B1 true EP1768637B1 (fr) 2015-04-08

Family

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Family Applications (1)

Application Number Title Priority Date Filing Date
EP05773250.5A Not-in-force EP1768637B1 (fr) 2004-05-26 2005-05-24 Dispositif de reeducation des deficiences motrices de patients notamment de la marche

Country Status (5)

Country Link
US (1) US8257232B2 (ja)
EP (1) EP1768637B1 (ja)
JP (1) JP2008500083A (ja)
FR (1) FR2870747B1 (ja)
WO (1) WO2005117799A1 (ja)

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FR2870747B1 (fr) 2009-11-20
US20080070757A1 (en) 2008-03-20
WO2005117799A1 (fr) 2005-12-15
US8257232B2 (en) 2012-09-04
FR2870747A1 (fr) 2005-12-02
EP1768637A1 (fr) 2007-04-04

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