EP1904015B1 - Device for carrying out physiotherapeutic treatment - Google Patents

Description

The invention relates to a device according to the preamble of claim 1.

Such a device is in the US 4,563,003 described. In the training device described there sits on a cam, a lever that has to be pivoted by a human arm to train the upper arm muscles about its axis of rotation. A running over the cam pulley is acted upon by vertically displaceable weights. An electric motor is provided which has a punch which acts downward to increase the pulling force exerted by the weights.

The US 6,123,680 describes a physiotherapeutic treatment apparatus for a human body employing a centrifuge that generates a centrifugal acceleration that accelerates a weight radially outward. The weight force thus generated is transmitted via a pull rope to a body part of the human body.

The invention is a further development of the DE 10214 996 A1 known device for the treatment of an arm with a holder for fixing the forearm to be treated in the elbow region and with an attacking on the wrist of the arm tension member, by means of which a directed in the direction of extension of the forearm train is applied in a predetermined tension on the forearm. The device has an elongate device housing. On the device housing, a holder, a tension member and a control panel is arranged. These enumerated elements lie in the longitudinal extension of the device housing one behind the other. The holder can be moved manually in the longitudinal extension of the device housing, since it is arranged on a rail. When the desired position has been reached, the holder can be fixed on the rail by means of a lever screw. From an electric motor driven gear, the tension member can be displaced from the bracket in the direction of the control panel. Thus, a tensile force can be exerted on a clamped arm in the holder, which is also fixed to the tension member via a collar, since the tension member is displaced from the holder in the direction of the control panel. Below the device housing, a base is arranged. The invention has for its object to improve the generic device nutzsvorteilhaft and to increase the therapeutic success.

Solves the task of each individual claim alone as well as any combination of any claim with any other claim.
Claim 1 initially and essentially provides that the tension is applied by one or more weights acting on the tension member via a tension transmission means, wherein the tensile force acting on the wrist can be varied at the beginning, during and / or at the end of the treatment by a counterforce applied by a motor or can be canceled.
The following details are preferred: The traction cable forms the traction transfer means. The traction cable is guided in particular via a deflection roller. At least one weight is guided in one leg of the device. At the train transmission means, in particular on the traction cable a perforated pull rod is attached. This passes through a plurality of superimposed weight plates, which are provided with an opening. The weight plates have coupling openings for the passage of a coupling pin. The coupling pin can be inserted so far into a coupling opening, into a hole of the drawbar. Through the coupling pin a weight plate and the overlying is tied to the pull rod. A cuff associated with the tension member is provided for attachment of the wrist. The tension member comprises a slide on which the pull transmission means acts on one side and a counter force transmission means, in particular in the form of a rope, on the opposite side. The counterforce transmission means exerts the counterforce on the tension member. Furthermore, the counter-force transmission means can shift the tension member by motor to an initial position. An electric motor engages the tension member to apply the counterforce and / or zurückververlagern the tension member. The electric motor may be a linear drive, a threaded spindle or a winch. The motor drive, the counterforce applies or the rearward displacement causes, has a switchable freewheel, which acts on the tension member. The opposing force applying or the rearward displacement causing motor drive engages via a damped releasable coupling on the tension member.

Such a device is used, for example, for the treatment of carpal tunnel syndrome. Treatment with this device can eliminate surgery. Since surgery always involves risks, the treatment of carpal tunnel syndrome with the device is a good alternative.

Instead of a pull rope, the tension transmission means may also be formed by a chain, a cable or a lever mechanism. For example, a pull rod could attack the carriage. Instead of the pulley then a lever could be provided. For example, the pull rod could engage an arm of an angle lever, which is pivotally mounted about an axis. On the other arm of this angle lever, a further pull rod may be hinged, which is connectable to the weights. It is also conceivable to transfer the tensile force hydropneumatically. For this purpose, a pneumatic cylinder can attack the carriage. This is connected to a pipe or a hose with another pneumatic cylinder to which the weights attack. The power transmission can be done via negative pressure, but preferably via overpressure. The weights then exert on the cylinder a compressive force and the cylinder or piston on the carriage also a compressive force. Technically, however, these forces cause a pull on the patient's arm.

The counterforce can be applied by a rope, a cable, a chain or a lever gear on the carriage. It can also be applied hydropneumatically to the carriage. The motor drive is in this case a pump. It is also conceivable to transfer the forces via spindles or worm gears.

Fig.1

die Vorderansicht der Vorrichtung in der Ausgangsposition, die teilweise im Schnitt dargestellt ist,

Fig. 2

eine Draufsicht der Vorrichtung entsprechend der Blickrichtung II aus Figur 1,

Fig. 3

eine Seitenansicht der Vorrichtung entsprechend der Blickrichtung III aus Figur 1,

Fig. 4

eine Ansicht entsprechend der Figur 1, jedoch wurde hier das Zugglied in eine Anfangsposition verlagert,

Fig. 5

eine Ansicht entsprechend der Figur 4, jedoch ist hier ein Arm eingespannt,

Fig. 6

eine Ansicht entsprechend der Figur 5, wobei jetzt die Vorrichtung eine Zugkraft auf den Arm ausübt (Seil 27 ist i. W. spannungsfrei),

Fig. 7

eine Draufsicht der Vorrichtung mit eingespanntem Arm, entsprechend der Blickrichtung VII aus Figur 6 und

Fig. 8

wie die Vorrichtung transportiert werden kann.

The invention just described will be explained in more detail with reference to an embodiment. Show it:

Fig.1

the front view of the device in the starting position, which is partially shown in section,

Fig. 2

a plan view of the device according to the viewing direction II FIG. 1 .

Fig. 3

a side view of the device according to the viewing direction III FIG. 1 .

Fig. 4

a view corresponding to the FIG. 1 but here the tension member has been moved to an initial position,

Fig. 5

a view corresponding to the FIG. 4 , but here is an arm clamped,

Fig. 6

a view corresponding to the FIG. 5 in which now the device exerts a pulling force on the arm (rope 27 is normally tension-free),

Fig. 7

a plan view of the device with clamped arm, according to the viewing direction VII FIG. 6 and

Fig. 8

how the device can be transported.

The device 1 is in the FIGS. 1 to 3 shown in the starting position. The device 1 according to the invention is essentially constructed as it is in the aforementioned document the DE 10214 996 A1 has been described. It consists essentially of a device housing 2 with the holder 3 arranged thereon, the tension member 4 and the control panel 5. Below the device housing 2, a base frame 6 is arranged.

The elongate device housing 2 has a rail 7 on its upper side. One end of the rail 7 lies in the end region of the device housing 2. The rail 7 extends from there to approximately the middle of the longitudinal extension of the device housing 2. In the FIG. 1 is the end of the rail 7 in the left end portion of the device 1. On the rail 7, the holder 3 is slidably mounted. It can be displaced in the longitudinal extension of the device housing 2. Mittelst a lever screw 8, the holder 3 can be fixed in any position on the rail 7. In the course direction of the rail 7, these two laterally arranged switching buttons 9 follow. They are arranged approximately in the middle of the device 1. By pressing these buttons 9, the patient can interrupt the treatment.

In the direction of the rail 7 behind the buttons 9 is the tension member 4. This is as in the DE 10214 996 A1 built up. It consists essentially of a column 10, an overlying shoe 11 and arranged thereon a traverse 12. Sideways of the shoe 11, a lever screw 13 is arranged. This protrudes through a slot 14 into a threaded bore of the column 10. By means of the lever screw 13, the set height of the shoe 11 can be fixed. Towards the holder 3, a pivot bearing 15 is arranged on the column 10. To this pivot bearing 15, the tension member 4 can pivot when an overload protection has triggered 16. The overload protection 16 can be formed by a bolt which simply shears off at too high a load.

Like in the FIG. 3 can be seen, the traverse 12 is pivotally fixed about a pivot point 17 on the shoe 11. Below the pivot point 17 is an arcuate slot 18 is arranged. The arcuate slot 18 extends concentrically to the pivot point 17. Through the slot 18, a clamping screw 19 projects into the shoe 11. With the clamping screw 19, the cross member 12 can be fixed in any angular position to the shoe 11. The maximum angular positions of the traverse 12 are limited by the respective end of the arcuate slot 18.

The tension member 4 is guided in a longitudinal slot 20. The leadership of the tension member 4 in the device housing 2 may for example be constructed as in the DE 10214 996 A1 has been described. Traverse 12 extends transversely to the longitudinal extent of device housing 2.

In the other end region of the device housing 2, the control panel 5 is arranged. In the FIG. 3 It can be seen that on the control panel 5, an emergency stop button 21, an initial button 22, a start button 23, a buzzer 24 and a display 25 are arranged.

In case of malfunction, the device 1 can be immediately switched off by means of the emergency stop button 21. To move from the starting position ( Figure 1 to 3 ) to the initial position ( FIG. 4 . FIG. 5 ), the initial button 22 must be pressed. So that the treatment can be started, then the start button 23 must be pressed. The display 25 displays the individual repetitions in two digits. When a series or treatment is completed, an audible signal will sound from the buzzer 24.

In the device housing 2 below the tension member 4, a carriage 26 is arranged. The tension member 4 is attached to the carriage 26. It extends through the longitudinal slot 20. By means of the carriage 26, the tension member 4 is guided in the longitudinal slot 20. On the side of the carriage 26, which faces the holder 3, engages a counter force transmission means 27 at. The counterforce transmission means 27 is formed by a rope. On the other side of the carriage 26, which faces the control panel 5, engages a train transmission means 28 at. This is also formed by a rope. Both ropes 27, 28 extend in the housing 2 and are not visible from the outside.

On the rope 27 engages a motor drive in the form of an electric motor 29. The electric motor 29 drives a winch 51. Both are arranged in the end region of the device housing 2 below the rail 7. The electric motor 29 and the winch 51 are connected to each other via a switchable freewheel. Furthermore, the coupling between the electric motor 29 and the winch 51 can be released damped.

The rope 28 is guided by means of a deflection roller 30 in the direction of a supporting leg 31 of the undercarriage 6. The deflection roller 30 and the pillar 31 are arranged below the control pulse 5. The pillar 31 consists of a hollow body in which superimposed weight plates 32 are arranged. In the embodiment, fifteen weight plates 32 are stacked. From top to bottom is a weight plate 32 with 6 kg, six stacked with 1 kg and eight with 1.5 kg. You need to select 6 kg, 7 kg to 12 kg each in 1 kg increments and 13.5 kg to 24 kg each in 1.5 kg increments. It is possible to set a weight of 6 kg to 24 kg. The weight plates 32 have a central opening 33. The openings 33 extend in the extension direction of the support leg 31, that is perpendicular to the direction of extension of the device housing 2. Furthermore, the weight plates 32 still have coupling openings 34. The coupling openings are perpendicular to the openings 33, ie in the longitudinal direction of the device housing. 2

In the initial position of the device 1 protrudes through each opening 33 of the weight plates 32 a perforated pull rod 35 therethrough. The pull rod 35 has holes 52 at the location of the coupling openings 34. This is connected to the train transmission means 28. To the weight plates 32 with the pull rod 35 to connect, a coupling pin 36 must be inserted into a coupling hole 34 of a weight plate 32 and through a hole 52 of the pull rod 35. Thus, the coupling pin 36 extends through the weight plate 32 and the pull rod 35. As a result, the weight plate 32, which is penetrated by the coupling pin 36, connected to the tie rod 35. Furthermore, the weight plates 32, which are above the coupling pin 36, entrained by the pull rod 35. So that the coupling pin 36 can be inserted into the weight plates 32, the leg 31 has a longitudinal slot 37.

Below the standing leg 31, a cross member 38 is arranged ( FIG. 3 ). Like in the FIG. 1 can be seen, adjustable feet 39 are mounted laterally on the cross member 38. These can be adjusted by means of the thread so that the device 1 is safe on the floor 40. To then fix the feet 39, a lock nut 41 is provided. Side of the feet 39 in the longitudinal direction of the device 1, a roller 42 is arranged in each case. The rollers 42 face the end of the device 1, which also receives the control panel 5. On the pillar 31 below the device housing 2, a knob 43 is arranged. The button 43 moves the device 1 from the initial position ( FIGS. 4 . 5 ) to the starting position ( FIGS. 1 to 3 ).

Parallel to the pillar 31, a further leg 44 is disposed below the bracket 3. The two legs 31, 44 are connected to a connecting bracket 45 with each other. The connection carrier runs parallel to the longitudinal extent of the device housing 2. As in the FIG. 3 can be seen, the leg 44 has a narrower cross-section than the leg 31. On the side facing away from the pillar 31, the leg 44 has a handle 46. The handle 46 runs in the basic position ( Figure 1 to 7 ) is approximately parallel to the leg 44. Below the device housing 2, the handle 46 by means of a hinge 47 pivotally hinged to the leg 44.

In the following part, the operation of the embodiment will be explained in more detail:

Starting from the FIGS. 1 to 3 the device 1 is in the starting position. In this position, the therapist can choose the weight for the treatment. This requires the coupling pin 36, which is then inserted into the desired weight plate 32. Thus, the weight plate 32 is coupled to the pull rod 35. Likewise, the weight plates 32 located above the coupling bolt 36 are then also dragged by the pull rod 35. The weight division, for example, be readably mounted on the outside leg 31 from the outside.

To move the device 1 to the initial position, the initial button 22 must be actuated. By pressing the start button 22, the electric motor 29 is activated. The electric motor 29 engages by means of the winch 51 on the cable 27. By rolling the rope 27 on the winch 51, which is driven by the electric motor 29, the carriage 26 is displaced with the tension member 4 as far as possible in the direction of the holder 3. When the tension member 4 has taken the initial position, the electric motor stops. The displacement path of the carriage 26 with the tension member 4 arranged thereon is limited by the longitudinal slot 22. In this position, a right-angled arm 48 can be fixed in the holder 3 by means of bands 49. One band 49 is wrapped around the upper arm and the other band 49 is placed around the forearm. Furthermore, a cuff 50 is placed around the wrist of the arm 48, which is then secured to the crossbar 12. The palm of the hand is upwards. This position is in the FIG. 5 clarified. There is also seen that the holder 3 has such a distance from the tension member 4 that the sleeve 50 does not exert any tensile force on the arm 48. The position of the holder 3 to the tension member 4 can be varied on the rail 7. Subsequently, the holder 3 with the lever screw 8 fixed on the rail 7. The height of the traverse 12 to the arm 48 can also be adjusted. It must be solved only the lateral lever screw 13 on the shoe 11 and the shoe 11 can be varied in height. The height variation is limited by the length of the slot 14. If you have reached the desired height, so you can fix the shoe 11 by means of the lever screw 13 in its height.

When the device 1 has been optimally adjusted to the patient, the counterforce transmission means 27 is slowly released by operating the start button 23. This is possible because the coupling between the electric motor 29 and the winch 51 can be solved damped. As a result, only slowly builds the tensile force on the arm 48. In the FIGS. 6 and 7 the pulling force applied by the weight plates 32 acts on the arm 48. The time between starting the process and reaching the end position (FIG. FIG. 6 . 7 ), with the tension still about 2 sec. is maintained, is about 7 sec. After the lapse of time, the electric motor 29 turns on again and relocated by winding the rope 27 on the winch the carriage 26 with the tension member 4 back to the initial position. Thereafter, the electric motor 29 switches off and the clutch slowly releases the pulley 51 so that the traction force can build up again. This process is repeated, for example, ten times. Moving to the initial position until the train starts again takes about 5 seconds.

The repetitions are displayed on the display 25. After completion of the ten repetitions, an acoustic signal sounds from the buzzer 24. The device 1 is again in the initial position, which in FIG. 5 has been clarified. Now the position of the traverse 12 can be changed. This is in FIG. 3 shown schematically. This will move the wrist to a different position. For this purpose, the clamping screw 19 must be solved and then the traverse 12 can be pivoted about the pivot point 17. The maximum position of the traverse 12 is through the arcuate Slot 18 limited. When the desired position of the cross member 12 has been achieved, the crosshead 12 can be fixed by means of the clamping screw 19. After pressing the start button 23 again the example. Ten repetitions are performed. After completing the ten repetitions, the position of the traverse 12 can be varied again. A common treatment on this device 1 provides three sets of ten repetitions.

Through the two buttons 9, the patient can stop the treatment. If the button 9 is pressed, the tension member 4 moves back to the initial position. After pressing button 9 again, treatment continues until the ten repetitions have been completed. If a treatment has been completed and a new patient needs a different weight, it must be determined from the position in FIG. 4 has been shown, the button 43 are operated on the leg 31. By pressing the button 43, the electric motor 29 is caused to move the device 1 in the position FIGS. 1 to 3 shift accordingly. Only in this position, it is possible to make a weight change without lifting the weights.

In the FIG. 8 is shown how to move the device 1 easily. Maneuvering the handle 46 about the pivot point of the hinge 47 that about the handle 46 is positioned at right angles to the leg 44. The handle 46 abuts under the device housing 2. Now, the device 1 can be lifted on the handle 46. In this case, the weight shifts from the legs 31, 44 on the two rollers 42. In this position, the in FIG. 8 has been shown, the device 1 can be easily moved over the rollers 42. Once you have reached the desired position, you let the device 1 slowly down and folds the handle 46 to the leg 44 zoom. Now you can align the device 1 by means of the feet 39, which are then fixed by means of a lock nut 41.

In the device 1 is also as in the aforementioned DE 10214 996 A1 an overload protection 16 installed in the tension member 4. If an excessive load is exerted on the arm 48 during a treatment for any reason, the overload safety device 16 triggers and allows pivoting of the tension member 4 in the direction of the holder 3 via the pivot bearing 15. This removes the load from the arm 48.

In the embodiment described above, the tensile force was transmitted via a cable 28 from the weights carrying tie rod 35 to the carriage 26. But there are also alternatives conceivable, with which the weight of the weights 32 can be transmitted to the tension member 4. For example, instead of the pull cable 28, a cable or a chain may be provided. An alternative to the deflection roller 30 is an angle lever. This angle lever can have two mutually perpendicular lever arms. This angle lever is pivotable about a pivot axis which is associated with the apex of the two lever arms. On each of the two lever arms, a pull rod can attack. One drawbar is connected to the tension member and the other to the weights. The one tie rod can attack, for example, on the carriage 26. The other tie rod may be the tie rod 35 carrying the weights. But it can also be a hinged to the pull rod 35 coupling rod, which is connected to the corresponding arm of the angle lever.

As an alternative to these solutions, the weight of the weights 32 can also be transmitted pneumatically and in particular hydropneumatically to the tension member 4. For this purpose, for example, on the carriage 26 a pulling piston or a thrust piston of a piston / cylinder unit attack. This piston / cylinder unit is connected via hoses or pipes with a second piston / cylinder unit, which is acted upon by the weights 32.

Just as the tensile force acting on the tension member 4 can act via various power transmission means, the restoring force applied by the electric motor 29 can also be transmitted to the tension member 4 via the various power transmission means. Again, instead of a pull cable 7, a cable or a chain can be used. The motor 29 can drive a winding drum. But it can also be a linear drive here. In the same way, a hydropneumatic drive can also be provided here in order to shift the tension member 4 back in the direction of the holder 3. For this purpose, on the tension member 4 and in particular on the carriage 26 a piston / cylinder unit attack. This may be a pulling piston or a thrust piston. If the tensile force is also transmitted via a piston / cylinder unit, a double-piston arrangement is recommended here. The retraction force is applied in this case via a pump or a second piston-cylinder unit.

As an alternative to the types of drive described above, a spindle gear can also be used.

Claims (11)

1. Apparatus (1) for physiotherapeutical treatment of an arm (48) of the human body, comprising a holder (3) for fixing the lower arm in the region of the elbow by means of straps (49) and comprising a traction element (4) by means on the wrist of the arm (48), and by means of which a traction of a predeterminable tension, directed in the direction of extent of the lower arm, is exerted on the lower arm, characterized in that the tension is applied by one or more weights (32) acting on the traction element (4) via a tension transmitting means (28), wherein the apparatus is arranged in such a way that the pulling force action on the wrist is cancelled by a counteracting force applied by an electric motor (29) at the start and at the end of the treatment and is varied during the treatment.
2. Apparatus (1) according to claim 1, characterized in that the traction element (4) comprises a carriage (26) on which the tension transmitting means (28) acts on one side and a counteracting force transmitting means (27) acts on the opposite side, in order to exert the counteracting force on the traction element (4).
3. Apparatus according to claim 1 or 2, characterized in that the tension transmitting means (28) comprises a traction cable, which is guided in particular over a deflecting roller (30).
4. Apparatus according to one of the preceding claims, characterized in that the at least one weight (32) is guided in a standing leg (32) of the apparatus (1).
5. Apparatus according to one of the preceding claims, characterized by a traction rod (35) provided with holes secured to the tension transmitting means (28), in particular to the traction cable, which traction rod passes through openings (33) of a multiplicity of weight-exerting plates (32) disposed one above the other, which weight-exerting plates (32) have coupling openings (34) for a coupling bolt (36) to be passed through into a hole (52) of the traction rod (35), in order to arrest the weight-exerting plate (32) and those lying above it on the traction rod (35).
6. Apparatus according to one of the preceding claims, characterized by a cuff (50) associated with the traction element (4) for securing the wrist, on the traction element (4).
7. Apparatus according to one of the preceding claims, characterized in that the traction element (4) comprises a carriage (26) on which the tension transmitting means (28) acts on one side and a counteracting force transmitting means (27), in particular in the form of a cable, acts on the opposite side, in order to exert the counteracting force on the traction element (4) and/or to displace the traction element (4) in a motorized manner into an initial position.
8. Apparatus according to one of the preceding claims, characterized in that an electric motor (29) acts with a linear drive, a threaded spindle or a cable winch (51) on the traction element (4) in order to apply the counteracting force and/or displace the traction element (4) back.
9. Apparatus according to one of the preceding claims, characterized in that the motor drive (29) applying the counteracting force or bringing about the return displacement acts on the traction element (4) via a switchable freewheeling mechanism.
10. Apparatus according to one of the preceding claims, characterized in that the motor drive (29) applying the counteracting force or bringing about the return displacement acts on the traction element (4) via a coupling that can be released in a damped manner.
11. Apparatus according to one of the preceding claims, characterized by a travel roller (42), which is provided on a standing leg (31) having the weights (32) and can be brought into contact with the floor (40) supporting the apparatus (1) by tilting the apparatus (1) about the standing leg (31).

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