EP1959909B1 - Device for moving limbs - Google Patents

Abstract

The invention relates to a device for moving limbs, particularly human extremities. Said device comprises at least one receiving unit (51) that is provided with a hollow space with an opening (52) and a bottom area (53) on which a plurality of actuators (54) are disposed, a regulation and control unit (55), by means of which the individual actuators (54) can be triggered such that cyclical movement patterns are generated, and at least one orthosis unit (56) that encompasses at least one support element (57) and at least one power element (58). The orthosis unit (56) and the receiving unit (51) are connected to each other via at least one joint (59).

Description

The invention relates to a device for moving limbs of patients with paralysis phenomena. One goal here is to train the residual canker motor skills of e.g. incomplete paraplegics or patients with a post-stroke condition, with the help of stimuli corresponding to those of a real experienced step. In this case, a walking pattern is generated by in-phase stimulation of foot sole sensory and leg motor skills.

Arrangements of the type mentioned are for example from the patent WO 00/28927 known. Such arrangements permit automatic guidance of the legs in the treadmill therapy of the patients, whereby a movement pattern of the legs is generated via a driven orthosis, a treadmill and a relief mechanism. To relieve the patient, the orthosis is stabilized on the treadmill in such a way that the patient does not have to be able to walk completely and the entire body weight does not have to be worn by the patient himself. Vending machines of this type are very reliable in function, but have a considerable disadvantage on a relatively large footprint, which limits the usability for different applications or have undesirable effects in terms of frequency of use and thus the rehabilitation success. Another disadvantage of such machines is the fact that the training is possible only in vertical, upright body position, which is disadvantageous in patients with above-described Gehichtsrückschränkungen in many respects, since the training sessions due to these vertical Body position can only be of relatively short duration, whereby the rehabilitation success is severely restricted. In the upright posture of patients with paralysis phenomena occurs due to the gravity caused sagging of the blood in the lower extremities, whereby the circulation of certain patients, especially in the early stages of damage to the central nervous system is so impaired that threatening fainting. Such conditions primarily endanger the health of the patients and also limit the duration of training, which significantly reduces the success of rehabilitation. So far, it is tried with apparatuses of the arrangement as in the patent WO 00/61059 shown to solve this problem. The patient training takes place first in a lying position, then in an inclined position and finally in an upright posture. Furthermore, it is considered to be unfavorable that the presence of a therapeutic supervisor is permanently required in such training equipment.

The US 4,834,073 A. further shows a device for moving limbs with a receiving unit, which has a cavity with an opening and a bottom surface, a control and control device and at least one orthosis unit, which contains at least one support element and at least one force element, wherein the orthosis unit and the receiving unit via at least one joint in connection.

The object of the present invention is to provide a device for the movement of limbs, with which the rehabilitation success can be significantly increased, in particular in a simple manner, with a space-saving construction.

This object is achieved by a device having the features of claim 1.

Advantageous embodiments and preferred embodiments of the invention are specified in the subclaims.

The above object is achieved by a device for moving limbs, in particular human extremities, with at least one receiving unit, which has a cavity with an opening and a bottom surface, wherein a plurality of actuators are arranged on the bottom surface, a regulation and control unit, with which the individual actuators are controllable such that cyclic movement patterns are generated, and / or at least one orthosis unit, which contains at least one support element and at least one force element, wherein the orthosis unit and the receiving unit are connected via at least one joint, solved.

With such an arrangement can be dispensed with the use of a treadmill, whereby the space requirement of such a device compared to a known arrangement is significantly reduced. The feasibility of training in a sitting position allows patients to complete longer training sessions, resulting in higher training results in less time. This reduces the application time of the therapy, after which the training equipment is more quickly available to a new patient. In addition, a high reproducibility of the movement pattern and a higher comfort for the patient can be ensured.

Furthermore, the device may be characterized in that cyclic movement patterns are formed in the form of at least one wavefront that propagates in a longitudinal direction, a transverse direction, and / or a combination of said directions of the floor surface. As a result, stimulus patterns can also be generated in the diagonal direction by overlapping the longitudinal and transverse directions. This can be a stimulation of a part of the sole of the foot up to the complete Sole be generated in which a realistic stimulus pattern of a step is generated; without requiring an actual appearance of the patient on a floor surface, such as on a treadmill. As a result, the device can be optimized so that a use in the home area is made possible, since the space requirement is reduced. The stimulation of the sole of the foot creates a natural gait pattern without the need for an actual appearance of the patient. Thus, the patient can preferably complete training sessions in a sitting position, whereby the effect of blood loss and the associated complications can be prevented.

Furthermore, the device may be characterized in that the orthosis unit may communicate with another orthotic unit via at least one joint. This results in the advantage that further limbs of the limb can be moved in a controlled manner, whereby the realism of the movement pattern is increased and the rehabilitation success is improved.

Furthermore, the force element of the device by means of the control and control unit can be controlled such that it generates a relative movement between at least one orthosis unit and another orthotic unit and / or the receiving unit. As a result, the controllability and controllability of the force elements can be provided in a particularly simple manner.

Furthermore, the orthosis unit can have at least one fastening means. This can be in a particularly simple manner, the adaptability of the entire device or the Ortheseneinheit be provided to the anatomical conditions of the patient.

Furthermore, the receiving unit of the device can have at least one adjustment means on at least one inner surface, which can be regulated in such a way by means of the regulation and control unit that a predetermined force which is substantially perpendicular to the inner surface of the adaptation unit can be generated. In this case, the value of the predetermined force can be set to a constant, time-based and / or event-based variable value. It can thus be ensured that the pressure exerted by the adaptation unit on the surface of the limbs can be regulated in such a way that the formation of pressure points and other injuries such as abrasions on the limbs of the patient can be prevented. In particular, the generation of a constant surface force, the risk of pressure points on the limbs of the patient, due to volume changes of the limbs during movement, can be prevented. Furthermore, such an adjustment means ensures an adaptive fixation of the limb in the receiving unit, depending on the extent / volume of the limb, whereby a large-scale connection is created. In addition, the limb located in the receiving unit can be pressed onto the bottom surface of the receiving unit by the adjustment means. This results in the advantage that the stimulation of the limb, which is formed by the movement pattern in the form of at least one wavefront propagating in the floor surface, can be enhanced.

Furthermore, the fastening means of the device can have at least one adaptation means which can be adjusted by means of the control and control unit can be regulated such that a predetermined, substantially perpendicular to a surface of the fastening means force can be generated. In a particularly simple manner, the wearing comfort of the entire device for the patient can thus be increased.

Furthermore, the device may be characterized in that the actuators used, the force elements and the adjustment means are pneumatically, hydraulically, mechanically and / or electrically actuated. Thus, a high variability in the drivability of the device can be ensured, whereby the device is adaptable to the respective ambient conditions with respect to the power supply.

Furthermore, the device can receive at least one akre in the receiving unit, receive at least one distal extremity section in a first orthotic unit, and receive at least one proximal limb section in a second orthotic unit. This can ensure that the movement of an entire, upper and / or lower limb can be regulated.

Furthermore, the device may be characterized in that the geometric dimensions of the receiving unit and / or the orthotic unit can be adjusted continuously and / or discretely. Thus, the adaptability of the device to the anatomical conditions of different patients can be further increased.

Furthermore, the device may be characterized in that the receiving unit for receiving a foot, a first An orthosis unit for receiving a lower leg and a second orthosis unit for receiving a thigh is used, wherein the force that can be generated by the accommodating means in the receiving unit, on at least a part of the foot surface and the force generated by the located in the attachment means adjustment means can be applied to at least a part of the surface of a thigh, and / or lower leg.

Furthermore, the device may be characterized in that a further joint may be provided on a second orthotic unit such that the entire device has at least one rotational degree of freedom. Thereby, the entire device can be pivoted in a particularly simple manner, for example, a vertical axis, so that access to the device is made easier, especially for wheelchair users. In addition, the application of the device to a patient is greatly facilitated thereby, whereby no further operating personnel must be consulted for help.

Furthermore, the device may be characterized in that at least one seat is provided, which can be adjustable in height by means of level elements. Additionally or alternatively, the seat may have a seat back which can be varied in its inclination via adjusting elements. During the movement of the orthotic units to each other, the knee joint and the ankle joint are actively guided, whereby the hip joint is moved only passively. By changing the seat height and / or by varying the inclination of the seat back of the range of motion, for example, the hip angle can be adjusted patient-specific.

In summary, the advantages of the invention will be mentioned here. By combining a stimulation of the sole of the foot with the motor movement of the upper and lower leg, a realistic gait pattern can be generated. Thereby, the present device can be used by patients in a sitting position, whereby the duration of the individual training sessions is extended. On the one hand, this results in the advantage that the rehabilitation successes can be achieved more quickly and, on the other hand, the advantage that no additional therapeutic supervisors have to be called in. Equally, the comfort experienced by the patient is increased by the high adaptability of the device to the anatomical conditions. Furthermore, due to the space-saving design, the device can be used in the home.

• Figur 1 den Gesamtaufbau der Vorrichtung zum Bewegen von Gliedmaßen;
• Figur 2 den schematischen Aufbau einer Aufnahmeeinheit;
• Figur 3 die prinzipielle Reizmustererzeugung in einer Extremität;
• Figur 4 eine Schnittdarstellung der Aufnahmeeinheit;
• Figur 5 zeigt eine Übersicht der Gerätekomponenten;
• Figur 6: zeigt eine Abbildung einer Basiseinheit;
• Figur 7: zeigt eine Abbildung einer Basiseinheit mit der Option Fußplatte;
• Figur 8: zeigt eine Abbildung der Basiseinheit mit der Option Noppenrolle.

Advantageous embodiments and further details of the present invention will be described below with reference to various embodiments with reference to the figures. For example and schematically show:

• FIG. 1 the overall structure of the limb moving device;
• FIG. 2 the schematic structure of a recording unit;
• FIG. 3 the principle stimulus pattern generation in a limb;
• FIG. 4 a sectional view of the receiving unit;
• FIG. 5 shows an overview of the device components;
• FIG. 6 : shows an illustration of a base unit;
• FIG. 7 : shows an illustration of a base unit with the footplate option;
• FIG. 8 : shows an illustration of the base unit with the Nappy Roller option.

In the FIG. 1 schematically the overall structure of the device is shown, wherein a receiving unit 51 is connected via a first joint 59, with a first orthosis unit 56. Furthermore, this first orthosis unit 56 is connected via a second joint 59 to a second orthosis unit 56. The said orthotic units 56 each have support elements 57 which function as a supporting basic structure of the orthosis units 56. Two force elements 58 are respectively arranged on the orthotic units 56, the force elements 58 being permanently connected to the respective support element 57 at a first end and being connected to the support element 57 at a second end in such a way that a linear displaceability of the second end relative to the support member 57 is made possible. In addition, two force elements 58 are connected to each other at their second ends via, for example, a toothed belt. The timing belt is deflected over a roller. This pulley is in communication with a hinge 59th

The force elements on the first orthosis unit 56 are able to apply tensile forces in order to bend the receiving unit 51 relative to the first orthosis unit 56 produce. The force elements on the second orthosis unit 56 are capable of applying tensile forces to produce an angling of the first orthosis units 56 to the second orthosis unit.

Furthermore, fastening means 60 are provided on the support elements 57 of the orthotic units 56, with which in each case an orthosis unit 56 can be attached to a limb of a patient. Force elements 58 are provided on the second orthosis unit 56, wherein the force elements 58 are connected at a first end to the support elements 57 of the orthosis units 56 and at another end via a connecting member to the first orthosis unit 56 via a connecting member such that upon generation of a Tensile force in the respective force element 58 is an angle of the first orthosis unit 56 relative to the second orthosis unit 56 takes place.

In the in the FIG. 1 shown force elements 58 are artificial, pneumatic muscles that can apply a tensile force in the longitudinal direction by contraction. By this tensile force of the toothed belt, which connects two force elements 58, set in motion. Due to the static friction between the toothed belt and the deflection roller, a rotational movement of the deflection roller is generated. Due to the connection between the deflection roller and the respective joint 59, the joint performs such a rotational movement that a pivoting movement of the receiving unit 51 relative to the first orthosis unit 56 and a pivoting movement of the orthosis units 56 is performed to each other. To be able to reverse this first movement, further force elements 58 are arranged, which by contraction in Longitudinal one of the first opposite movement can generate.

In one embodiment, not shown, the force elements may be designed as mechanical, pneumatic, hydraulic and / or electrical power elements. In this case, such an arrangement is conceivable that electrical force elements are located within the joints 59 and perform the movements described above.

The support members 57 are hereby formed of profiled aluminum. In further, not shown embodiments of the invention, the profiles of the support members 57 may be formed square, circular or U-shaped. In a further embodiment, the support members 57 may be formed of plastic.

The fastening means 60 are formed from plastic and comprise an adjustable locking mechanism.

With the aid of a control and control unit 55, force element valves 64 can be controlled in such a way that the pressure on the pneumatic force elements 58 can be varied via force element pressure lines 63 such that contraction movements of the force elements are produced. The compressed air supply of the lines via a pressure accumulator 65. In another embodiment, not shown, instead of the pressure accumulator 65, a pressure supply source to be connected to the device. The regulation of the force element valves 64 takes place as a function of sensor signals of the force element sensors 62 and the rotary encoder 72. An actuator sensor 66 can be used Actuator valves 68 are controlled such that the pressure and thus the extent in the actuators 54 can be varied. In this case, the actuator sensor 66 supplies a signal to the control and control unit 55, which controls the actuator valves 68. Furthermore, an adjustment means sensor 69 and an adjustment means valve 70 is provided, which is connected via a pressure line 71 to the adjustment means 61 and can be operated in a regulated manner via the regulation and control unit 55. The control and control unit 55, the force element valves 64 and the pressure accumulator 65 are provided in a housing 76 which is connected at its upper end via level elements 77 with a seat 73. With the aid of the control and control unit 55, the level elements 77 can be controlled such that the seat 73 can vary its height with respect to the footprint of the device on which the entire device rests. The housing is connected via sliding elements 78 with the footprint in combination. The displacement elements 78 are designed in the form of rollers. In a further embodiment, not shown, the displacement elements 78 may be wheels, skids and / or sliding elements. With the housing 76 is a control / display instrument 74 in connection, with which the patient can specify parameters to the control and control unit 55, and / or read information relating to the training or the equipment conditions. Thus, the patient can be displayed in the form of a feedback function, the current training success for self-control. By his own, voluntary or involuntary movement of the musculature, the patient can apply a force to the orthotic units 57. This results in setpoint deviations in the force elements 58 and hinges 59, which are detected via the force element sensors 62 and the rotation angle sensors 72 and are assessed as positive or negative cooperation of the patient. Depending on this evaluation the patient receives feedback on a control / display instrument about the correctness and / or quality of his or her contribution. The device also includes the ability to record relevant data on the training history and possibly read them out with telemetric methods.

The receiving unit 51 is connected via a further displacement element 78 with the contact surface area in connection. As a result, in the case of movements of the first orthosis unit 56 with respect to the second orthosis unit 56, the friction between the receiving unit 51 and the footprint can be significantly reduced. In a further, not shown embodiment of the invention, instead of the displacement element 78, a linear guide mechanism may be provided, with which the receiving unit 51 can be guided in a controlled linear manner with respect to the footprint. Thereby, a lateral tilting of the device can be prevented.

The hinges 59 are connected to rotational angle sensors 72, which in turn output a sensor signal to the control and control unit 55, for detecting the position or the state of motion of said hinges 59.

Continue in the FIG. 1 not shown, the attachment means 60 comprise adjustment means which are adjustable for adjusting the attachment means 60 to the limbs of the respective patient. The adjustment means 75 for the adjustment means comprise a measuring and an actuator, with the pressure in the adjustment means of the patient is constantly adjustable. The pressure is not controlled by the control unit 55. In another, not shown Embodiment, the pressure in the adjustment means may be controlled by the control unit 55.

FIG. 2 shows a longitudinal section through the receiving unit 51. The receiving unit 51 has an opening 52 through which a foot can be introduced. In the bottom surface 53 of the receiving unit 51 actuators 54 are provided, which extend transversely to the longitudinal direction of the receiving unit 51. About the control and control unit 55, the actuator valves 68 can be controlled such that pressure fluctuations in the individual actuators 54 may occur. By varying the circumference of each actuator 54, a force pulse may be generated at a particular location of the floor surface. A flow in the receiving unit 51, which rests on the bottom surface 53, thereby experiences a force pulse. Due to the separate controllability of the individual actuators 54, a force as a function of time and place can be variably applied to the sole of the foot of a patient. In this case, the actuators 54 are designed in the form of juxtaposed, high-strength hoses. In this case, optionally, multiple, adjacent and / or non-adjacent actuators 54 can be actuated simultaneously or individual actuators 54 independently of one another.

In a further, not shown embodiment of the receiving unit 51, the actuators 54 may be designed in the form of mini cylinders.

On the inner surface of the receiving unit 51 in the areas that do not form the bottom surface 53, an adjustment means 61 is provided. The adjustment means 61 is connected via an adjustment medium pressure line 71 with a Adjustment means valve 70 which is connected to the control and control unit 55. By means of an adaptation means sensor 69, the pressure in the adaptation means 61 can be regulated as desired, so that a constant pressure can be exerted on the foot located in the reception unit 51. Furthermore, however, it is also possible to regulate the adaptation means 61 in such a way that an in constant pressure regulation of the adaptation means takes place.

In another embodiment, not shown, further actuators of the same type as the actuators 54 are positioned in the longitudinal direction of the receiving unit 51. By controlling with the aid of the control and control unit 55 of these actuators arranged in the longitudinal direction, a location-dependent and time-dependent force curve in the transverse direction of the receiving unit 51, in whose bottom surface 53 are generated. By combining the control of the transversely and longitudinally positioned actuators, a combination of a longitudinal and / or transverse location and time-dependent force curve can be generated.

In a further, not shown embodiment of the present invention may be provided on the bottom surface 53 of the receiving unit 51, a pressure measuring film in order to detect the actual pressure at any point of the sole of the foot can.

FIG. 3 shows schematically the generation of a physiological stimulus pattern for generating a step in the sole of the foot. In this case, the actuators 54 are arranged in the form of juxtaposed, high-strength hoses transversely to the Fußlängsrichtung. By controlling the actuators 54, a location and time-dependent force function on the Foot sole be applied. In principle, any desired course of force can be realized, but preferably the force propagates in the form of a wavefront from the heel area to the area of the toe tips over the entire sole of the foot. The actuators 54 are arranged in the form of adjacent hoses, wherein two adjacent hoses have different lengths.

FIG. 4 shows the sectional view of the receiving unit 51 along a section line BB, the in FIG. 2 is shown. In the bottom surface of the actuators 54 are arranged, which can be controlled via the Aktuatorventile 68 in response to a sensor signal which is received by a control and control unit 55. An adjustment means 61 generates a force on a foot or a hand located between the actuators 54 and a surface of the adapter 61. As a result, the force generated by the actuator 54 can be further increased, for example, to a sole of the foot or a palm of the hand.

The invention further includes the following aspects.

The improvement of impaired everyday motor skills and abilities is considered to be the primary goal in the rehabilitation of patients with neurogenic disorders, such as spin lesion or stroke. The restoration of walking ability is of central importance here, the high significance of this ability is obvious. But also in other patient groups, such as orthopedic or geriatric patients, who have a longer immobilization phase behind them, early, intensive mobilization has a central therapeutic as well as functional significance. At the moment, mainly physiotherapeutic measures are important for the rehabilitation success.

The most extensive investigation is the locomotion training using a treadmill in incomplete paraplegic and stroke patients. Since initially there are mostly significant problems, arbitrary initiate rocking movements, they are supported either by a walking robot, an active Stehbrett or manually. For reasons of the therapist load, the non-reproducible gait pattern and the time limit, the automatic locomotion therapy is to be preferred.

Although locomotion therapy has now become the state of the art in the rehabilitation of neurological patients, the biochemical functional mechanisms are still poorly understood. It is widely believed that there is a reorganization of neural processes. In particular, the reaction of a spinal pattern generator (Central Pattern Generator CPG) is speculated. On the basis of extensive animal experimental results, the rough functional mechanisms of this neural network, which is fundamentally connected with the generation of cyclic motion sequences, can be described. While the CPG receives an input from the brain in the physiological state and produces a rhythmic output, a reactivation in the pathological state can take place in the same way as a repeated and intensive sensory stimulation. It has been shown that a physiological, step-phase-related load on the lower extremities is a decisive factor for the activation of the CPG.

Depending on the abilities and performance of the patient, his limbs are either passive or active or assistively moved. The devices are based on a rotary drive, which can perform computer-controlled various movement trajectories, for example, to relax the muscles or to reduce spasticity reactions. To generate independent movements in multiple joints, electrical and / or pneumatic drives are possible.

So that the home trainer can perform physiological movements, a model-based trajectory generation and control is implemented. For this purpose, the knowledge of a sufficiently accurate model of the electric drives and the pneumatic muscles is used.

Furthermore, the mechanism, apparatus and method for generating physiological relevant force signals for lower limb stimulation may be characterized by therapeutic functions, patient safety, comfortable handling, and modular design, including, but not limited to, the device components base unit, foot plate option, option Noppenrolle, computer and power supply can be marked.

Furthermore, the base unit can by a thigh orthosis 1, drives 2, 3 at the attachment points 4, 5 and the attachment points 6 for the boom 7 via drive belt or rods 8, 9 and rotary encoder 10 with bearing (11) to the boom 12 for the lower leg orthosis 13 be marked to the attachment points 14 of the lower leg orthosis 13.

Furthermore, the device with the option foot plate, by the means of electric or pneumatic drive 21 via one of the lower leg braces 13 mounted in the attachment points 20, 22 movably mounted 23, 27 foot plate 26 made generating a mechanical pressure or vibration stimulus of the lower extremities detected by force sensors 24, 25 to be characterized.

Furthermore, the device with the option Noppenrolle by the means of electric or pneumatic actuators 32, 33 with drive belt or rod 34 via a attached to the lower leg orthosis 13 in the attachment points 30, 31 rotatably mounted 35, with rotary encoder 36 monitored Noppenrollenaufhängung 37, consisting of stored 44 nub roller 42 with a transverse bar 38 fixed drive 43 and spring 40 and the force sensors 39, 41, made generating a mechanical stimulus to the physiological pressure load of the lower limb may be characterized.

Furthermore, the device can be characterized by the implementation of controls, regulations and trajectory generation for the generation of physiologically reproducible movement trajectories and monitoring of patient safety with a computer with a connected user interface.

Furthermore, the device can be characterized by the space-saving provision and distribution of the power supply for the electric and / or pneumatic drives in accordance with the signals generated by the computer.

In FIG. 6 the reference numeral 1 denotes a thigh orthosis. Reference numeral 2 designates an (el., Pneumatic.) Drive connected to a computer for rotation of the lower leg orthosis. The reference numeral 3 denotes an optional (el., pneumatic.) drive connected to a computer for rotation of the lower leg orthosis. Reference numeral 4 denotes attachment points for driving the lower leg orthosis. Reference numeral 6 designates fastening points for fastening the arm 7 to a thigh orthosis. Reference numeral 7 denotes a cantilever of the thigh orthosis. Reference numeral 8 denotes an optional drive belt or a drive rod. Reference numeral 9 denotes a drive belt or a drive rod. Reference numeral 10 denotes a rotary encoder connected to a computer. Reference numeral 11 denotes a bearing having a rotational degree of freedom. Reference numeral 12 denotes the boom of a lower leg orthosis. Reference numeral 13 denotes a lower leg orthosis. The reference numeral 14 denotes the attachment points of the boom of the lower leg orthosis.

In FIG. 7 the reference numeral 1 denotes a thigh orthosis. The reference numeral 2 denotes a (el., Pneumatic.) Drive, which is connected to a computer for rotation of the lower leg orthosis. The reference numeral 3 denotes an optional (el., Pneumat.) Drive, which is connected to a computer for rotation of the lower leg orthosis. Reference numeral 4 denotes attachment points for driving the lower leg orthosis. Reference numeral 6 designates fastening points for fastening the arm 7 to a thigh orthosis. Reference numeral 7 denotes a cantilever of the thigh orthosis. Reference numeral 8 denotes an optional drive belt or a drive rod. Reference numeral 9 denotes a drive belt or a drive rod. Reference numeral 10 denotes a rotary encoder connected to a computer. The reference numeral 11 denotes a bearing with a rotational degree of freedom. Reference numeral 12 denotes the boom of a lower leg orthosis. Reference numeral 13 denotes a lower leg orthosis. The reference numeral 14 denotes the attachment points of the boom of the lower leg orthosis. The reference numeral 20 denotes an attachment point of the drive of the foot plate. The reference numeral 21 designates an (el., Pneumatic.) Drive of the foot plate, which is connected to a computer. Reference numeral 22 denotes attachment points of the guide of the foot plate. Reference numeral 23 denotes the guide of the foot plate. Reference numeral 24 denotes a force sensor connected to a computer. Reference numeral 25 denotes an optional force sensor connected to a computer. Reference numeral 26 denotes the foot plate. Reference numeral 27 denotes a monovalent bearing.

In FIG. 8 reference numeral 30 denotes the attachment points of the drive of the stimulus option. Reference numeral 31 denotes the attachment points of the drive of the stimulus option. Reference numerals 32 and 33 denote (el., Pneumatic) drive of the stimulus option connected to a computer. Reference numeral 24 denotes a drive belt or a drive rod. Reference numeral 35 denotes a rotary encoder connected to a computer. Reference numeral 36 denotes a bearing having a rotational degree of freedom. Reference numeral 37 denotes a knobbed roller suspension. Reference numeral 38 denotes a crossbar which is firmly connected to the Fußreizoption. Reference numeral 39 denotes a force sensor connected to a computer. Reference numeral 40 denotes a spring. Reference numeral 41 denotes an optional force sensor connected to a computer. Reference numeral 42 denotes a knobbed roller. Reference numeral 43 denotes a (el., Pneumatic.) Drive a nub roller, which is connected to a computer. Reference numeral 44 denotes a monovalent bearing.

Claims (14)

1. A device for moving limbs, especially human limbs, comprising:

   - at least one receiving unit (51) including a cavity having an opening (52) and a bottom surface (53),

   - a regulating and controlling unit (55) and

   - at least one orthotic unit (56) including at least one supporting member (57) and at least one force member (58) wherein said orthotic unit (56) and said receiving unit (51) are connected via at least one joint,

   characterized in that a plurality of actors (54) are arranged on said bottom surface (53) and that said individual actors (58) can be driven by said regulating and controlling unit (55) such that cyclic moving patterns are generated.
2. The device according to claim 1, characterized in that said cyclic moving pattern is formed in the shape of at least one wave front propagating in at least one of the longitudinal direction and the transverse direction of the bottom surface (53).
3. The device according to at least one of the preceding claims, characterized in that said orthotic unit (56) is connected to another orthotic unit (56) via at least one joint (59).
4. The device according to at least one of the preceding claims, characterized in that said force member (58) can be driven by means of said regulating and controlling unit (55) such that it generates a relative movement between at least one orthotic unit (56) and another orthotic unit (56) or said receiving unit (51).
5. The device according to at least one of the preceding claims, characterized in that said orthotic unit (56) further comprises at least one fastening means (60).
6. The device according to at least one of the preceding claims, characterized in that said receiving unit (51) comprises on at least one inner surface at least one adapting means (61) which can be driven by means of said regulating and controlling unit (55) such that a predetermined force is generated which is substantially perpendicular to said inner surface of said adapting means (61).
7. The device according to at least one of the preceding claims, characterized in that said fastening means (60) comprises at least one adapting means which can be controlled by means of said regulating und controlling unit (55) such that a predetermined force is generated which is substantially perpendicular to a surface of said fastening means (60).
8. The device according to at least one of the preceding claims, characterized in that said actors (54), said force members (58) and said adapting means (61) can be actuated pneumatically, hydraulically, mechanically and/or electrically.
9. The device according to at least one of the preceding claims, characterized in that said joint (59) is a hinge joint.
10. The device according to at least one of the preceding claims, characterized in that said receiving unit (51) is provided to receive at least one of the acra, a first orthotic unit is provided to receive a distal portion of an extremity and a second orthotic unit is provided to receive a proximal portion of an extremity.
11. The device according to at least one of the preceding claims, characterized in that the geometric dimensions of said receiving unit (51) and/or of said orthotic unit (56) are adjustable in a continuous and/or discrete way.
12. The device according to at least one of the preceding claims, characterized in that said receiving unit (51) is provided to receive a foot, a first orthotic unit is provided to receive a shank, and a second orthotic unit is provided to receive a thigh,
    wherein the force generated by said adapting means (61) located in said receiving unit (51) is applied to at least a part of the foot area and the force generated by said adapting means located in said fastening means (60) is applied to at least a part of the surface of a thigh and/or a shank.
13. The device according to at least one of the preceding claims, characterized in that another joint is provided on a second orthotic unit such that the whole device comprises at least one rotatory degree of freedom.
14. The device according to at least one of the preceding claims, characterized in that further a seat (73) is provided which is adjustable in height by means of levelling members.

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