EP2087926A1 - Dispositif et procédé de réadaptation d'articulation - Google Patents

Dispositif et procédé de réadaptation d'articulation Download PDF

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Publication number
EP2087926A1
EP2087926A1 EP08151136A EP08151136A EP2087926A1 EP 2087926 A1 EP2087926 A1 EP 2087926A1 EP 08151136 A EP08151136 A EP 08151136A EP 08151136 A EP08151136 A EP 08151136A EP 2087926 A1 EP2087926 A1 EP 2087926A1
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EP
European Patent Office
Prior art keywords
user
output shaft
practitioner
exercise
operator
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.)
Withdrawn
Application number
EP08151136A
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German (de)
English (en)
Inventor
André PREUMONT
More Avraam
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.)
Universite Libre de Bruxelles ULB
Original Assignee
Universite Libre de Bruxelles ULB
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
Application filed by Universite Libre de Bruxelles ULB filed Critical Universite Libre de Bruxelles ULB
Priority to EP08151136A priority Critical patent/EP2087926A1/fr
Priority to US12/742,220 priority patent/US20100298097A1/en
Priority to PCT/EP2008/065509 priority patent/WO2009063027A1/fr
Publication of EP2087926A1 publication Critical patent/EP2087926A1/fr
Withdrawn legal-status Critical Current

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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
    • 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
    • A63B21/005—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices using electromagnetic or electric force-resisters
    • A63B21/0056—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices using electromagnetic or electric force-resisters using electromagnetically-controlled friction, e.g. magnetic particle brakes
    • 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
    • A63B21/00058—Mechanical means for varying the resistance
    • A63B21/00076—Mechanical means for varying the resistance on the fly, i.e. varying the resistance during exercise
    • 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
    • A63B21/002—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices isometric or isokinetic, i.e. substantial force variation without substantial muscle motion or wherein the speed of the motion is independent of the force applied by the user
    • A63B21/0023—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices isometric or isokinetic, i.e. substantial force variation without substantial muscle motion or wherein the speed of the motion is independent of the force applied by the user for isometric exercising, i.e. substantial force variation without substantial muscle motion
    • 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
    • A63B21/4017—Arrangements for attaching the exercising apparatus to the user's body, e.g. belts, shoes or gloves specially adapted therefor to the upper limbs
    • 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
    • A63B21/4017—Arrangements for attaching the exercising apparatus to the user's body, e.g. belts, shoes or gloves specially adapted therefor to the upper limbs
    • A63B21/4021—Arrangements for attaching the exercising apparatus to the user's body, e.g. belts, shoes or gloves specially adapted therefor to the upper limbs to the wrist
    • 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
    • A63B21/4027—Specific exercise interfaces
    • A63B21/4033—Handles, pedals, bars or platforms
    • A63B21/4035—Handles, pedals, bars or platforms for operation by hand
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B23/00—Exercising apparatus specially adapted for particular parts of the body
    • A63B23/035—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously
    • A63B23/12—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously for upper limbs or related muscles, e.g. chest, upper back or shoulder muscles
    • A63B23/14—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously for upper limbs or related muscles, e.g. chest, upper back or shoulder muscles for wrist joints
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B23/00—Exercising apparatus specially adapted for particular parts of the body
    • A63B23/035—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously
    • A63B23/12—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously for upper limbs or related muscles, e.g. chest, upper back or shoulder muscles
    • A63B23/16—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously for upper limbs or related muscles, e.g. chest, upper back or shoulder muscles for hands or fingers
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B24/00—Electric or electronic controls for exercising apparatus of preceding groups; Controlling or monitoring of exercises, sportive games, training or athletic performances
    • A63B24/0003—Analysing the course of a movement or motion sequences during an exercise or trainings sequence, e.g. swing for golf or tennis
    • A63B24/0006—Computerised comparison for qualitative assessment of motion sequences or the course of a movement
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B24/00—Electric or electronic controls for exercising apparatus of preceding groups; Controlling or monitoring of exercises, sportive games, training or athletic performances
    • A63B24/0062—Monitoring athletic performances, e.g. for determining the work of a user on an exercise apparatus, the completed jogging or cycling distance
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B24/00—Electric or electronic controls for exercising apparatus of preceding groups; Controlling or monitoring of exercises, sportive games, training or athletic performances
    • A63B24/0003—Analysing the course of a movement or motion sequences during an exercise or trainings sequence, e.g. swing for golf or tennis
    • A63B24/0006—Computerised comparison for qualitative assessment of motion sequences or the course of a movement
    • A63B2024/0009—Computerised real time comparison with previous movements or motion sequences of the user
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B24/00—Electric or electronic controls for exercising apparatus of preceding groups; Controlling or monitoring of exercises, sportive games, training or athletic performances
    • A63B24/0062—Monitoring athletic performances, e.g. for determining the work of a user on an exercise apparatus, the completed jogging or cycling distance
    • A63B2024/0068—Comparison to target or threshold, previous performance or not real time comparison to other individuals
    • 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
    • A63B21/002—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices isometric or isokinetic, i.e. substantial force variation without substantial muscle motion or wherein the speed of the motion is independent of the force applied by the user
    • 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
    • A63B2220/16—Angular positions
    • 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
    • A63B2220/30—Speed
    • 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
    • A63B2220/50—Force related parameters
    • A63B2220/54—Torque
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B2225/00—Miscellaneous features of sport apparatus, devices or equipment
    • A63B2225/09—Adjustable dimensions
    • A63B2225/096—Adjustable dimensions automatically adjusted according to anthropometric data of the user
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B2225/00—Miscellaneous features of sport apparatus, devices or equipment
    • A63B2225/20—Miscellaneous features of sport apparatus, devices or equipment with means for remote communication, e.g. internet or the like
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B2225/00—Miscellaneous features of sport apparatus, devices or equipment
    • A63B2225/50—Wireless data transmission, e.g. by radio transmitters or telemetry

Definitions

  • the present invention is related to a joint rehabilitation device permitting the evaluation of the joint of the leg or the arm such as the hand, the wrist, the foot, the ankle, the knee or the elbow.
  • the present invention is also related to a method for using such rehabilitation device as a telemedicine tool.
  • the present invention is related to a computer program for performing such method.
  • Joints are essential components of the human skeleton that enable humans to perform plenty of actions that are essential for his survival and the quality of his life. Preventing joints from accelerated ageing or rehabilitating joint after injury, surgery or illness are then a key action in the field of human well-being.
  • Joint dysfunction may result from injury, trauma, illness or other causes and usually requires, among other therapies, some physical rehabilitation involving range of motion and strength exercise of the affected joint.
  • rehabilitation devices are usually large, heavy, expansive and stationary which again forces patient to perform exercises in clinics or medical private offices.
  • US Pat. No. 6 117 093 discloses a hand and wrist rehabilitation device based on the use of a magnetic fluid controllable resistance brake.
  • the user has a set of tool elements by which he applies a torque to the brake, these elements providing a grip for user's hand.
  • the user controls the resistance of the brake thanks to a knob placed at the front panel of the device.
  • the magnetic fluid controllable resistance brake is housed in a small portable case that possesses a clamp to mount the device to the table.
  • the device described in this document does not allow to properly control the path of the movement as recommended by the practitioner for ensuring a suited therapeutic effect. Indeed, the user can only control the resistance of brake but does not control the rotating speed of the brake which does not allow to use the device in isokinetic mode.
  • the device does not allow to program a predefined isotonic pattern.
  • the tool elements described in this document only limits the movements of user's hand but they do not put any physical constraints on the movement of user's wrist and arm.
  • the nature of the tools gripped by user's hand can not be uniquely associated to a defined coordinated movement of user's hand, wrist, elbow and arm such as pronation/supination, abduction/adduction or flexion/extension.
  • the device described in this document does not allow keeping track of user's performances, letting user exercising on his own without any feedback to the practitioner.
  • US Pat. No. 4 765 315 discloses a muscle exercise and rehabilitation device.
  • This device includes a movable fixture against which a torque can be applied; a particle brake clutch that provides a brake action against the actuating force; a control circuit that modulates the supply of braking current thereby enabling the apparatus to work at least in an isokinetic, isometric or isotonic mode.
  • the angular range of movement of the movable fixture and the operating mode - isokinetic, isometric and isotonic - are defined using a control box placed at the front panel of the device.
  • the device described in this document does not allow an accurate and repeatable human joint location relatively to the output shaft. Moreover, the said device does not allow processing and storage of user's performances, and cannot be programmed.
  • a portable device for rehabilitation that can be use in isokinetic, isometric, and isotonic mode; that can be easily configured by the user following practitioner advises; that offers tools to perform spatially defined paths of movement following practitioner advises and that allows a survey or an evaluation by the practitioner or the therapist.
  • no telemedicine tools achieves these requirements.
  • a first aim of the present invention is to provide a device and a method for rehabilitation exercises for the joints of the arm or of the leg that do not have the drawbacks of the state of the art.
  • the device should be portable so that the patient can take it at home.
  • a further aim of the present invention is that it still permits the therapist or the practitioner to perform an evaluation of said exercises performed at home.
  • the present invention aims to provide a device and a method for rehabilitation which offer a reproducibility of the measurement relating to the exercises performed by the patient.
  • Said device and said method should of course be a device and a method which are particularly safe and can not be misused by the patient in particular when he is alone.
  • Another aim of the present invention is to provide a device and a method which allow the practitioner to evaluate the movement performed by the patient directly in real time if necessary.
  • the present invention is related to a device, a method and a computer program as described in the claims.
  • the present invention is related to a device for exercise rehabilitation and evaluation of a joint of the arm or the leg comprising at least:
  • the embedded control means have 3 operation modes being the isometric, isotonic or isokinetic modes.
  • controllable resistance means are magnetically controllable resistance means, such as controllable MR-fluid resistance means or controllable MR-fluid brake means.
  • the magnetically controllable resistance means are a magneto-rheological brake in the form of a stator delivering a controllable magnetic field and embedding a rotor with a gap there between and containing a magneto-rheological fluid, interconnected at its center with said output shaft supported by the stator.
  • said output shaft bores a hole in its center, enabling to fill in the inner space of the rotor with the rheological fluid.
  • the tool means are plugged in and/or removed from the rotable output shaft.
  • the device further comprises
  • said mechanical positioning means are adapted to user's morphology.
  • said precision mechanical positioning means enables to achieve an accurate and repeatable human joint location relatively to the output shaft.
  • said housing of the controllable resistance means comprise adjustable clamping means for securately fixing the device to a table or a support.
  • said communication interface is connected to the external interface through an USB cable, Bluetooth or WIFI protocols or serial port interface.
  • said external interface of the user can be any hand-held electronic device comprising a processor, such as a personal digital assistant (PDA).
  • PDA personal digital assistant
  • said external interface of the practitioner is any type of computer.
  • said practitioner is able to remotely modify parameters of the control unit through the external interface of the user which is programmed using the external interface of the practitioner.
  • the user is able to connect a PDA directly to the control device using the communication interface to retrieve and record in real-time information acquired by data acquisition means.
  • the user is able to connect a PDA directly to the control device using the communication interface to display visual feedback relative to user performances.
  • the practitioner is able to connect a computer directly to the external interface of the user in order to retrieve the movement parameters previously recorded by this external interface and to analyse the physical performance of the user.
  • the practitioner is able to modify parameters of the control unit in real-time using the external interface of the practitioner by the communication interface.
  • the practitioner is able to connect a computer directly to the control device using the communication interface to retrieve in real-time information acquired by the data acquisition means.
  • the practitioner is able to connect a computer directly to the control device using the communication interface, and to perform recording of the movement parameters and to analyze the physical performance of the user.
  • the present invention relates to a method for using a device as described here above as a telemedicine tool, comprising the steps of
  • this method should not be considered as a therapeutical method but as a telecommunication method wherein said rehabilitation device is used by the user and an analysing centre round the physical performance of the user analysed.
  • the present invention is related to a computer program comprising a code able to execute the method described here above.
  • the present invention is intended to be used as a portable rehabilitation device that comprises a magneto-rheological fluid-based brake that operates in isotonic, isometric and isokinetic modes, a fixation plate, a mechanical position system and several handles; all these component being portable as a whole by the user from the practitioner office to a convenient place for the user, for example by using a regular case.
  • the said portable device comprises sensors and controllers electronics that enable to program and to tune the brake in order to operate in isotonic, isometric ,and isokinetic modes and to perform acquisition of data related to user's performances.
  • the present invention is used in combination with a hand-held computer for the user and a computer for the practitioner that both run specific software enabling the importation and the storage of acquired data from the rehabilitation device, the configuration of the latter following practitioner instruction, the access to the list of exercises to be performed by the user, the display of real-time performance to the user and/or to the practitioner.
  • the device comprises a housing (1) attached with two manual knobs (5) to a fixation plate (8); the latter possessing two clamps (6) that enables fixation to a table; and a mechanical positioning system (2) attached to the fixation plate (8) with two manual knobs (7).
  • a handle (3) is connected - thanks to a fixation knob (4) - to an output shaft (9) extending from the housing (1).
  • the output shaft (9) is connected to a controllable resistance device, described below, that provides selectable resistance to the rotation of the output shaft (9).
  • the device comprises a magneto-rheological brake as the controllable resistance device that comprise a rotor (10) interconnected at its center with the output shaft (9) embedded in a stator (11); this two mechanical parts are in contact through a magneto-rheological fluid (13) (MR fluid) composed of micron-sized magnetic particles, located inside an insulating liquid carrier.
  • MR fluid magneto-rheological fluid
  • the viscosity of the MR fluid depends on the magnetic field to which the MR fluid is exposed, the magnetic field being produced by a coil (12) wound on a spool embedded in the stator (11).
  • the current supply to the coil (11) is controlled by a electronic control device (18) which is connected to two precision sensing device.
  • the first one is a stress gauge or a force sensor (17) that produces a force signal corresponding to the torque applied by the user on the output shaft (9); whereas the second is an encoder (19) that produces two signals corresponding respectively to the angular position of the output shaft (9) and to the angular velocity of the output shaft (9).
  • the electronic control device (18) analyzes these signals and consequently adapts the current, and per se the resistance of the brake in accordance with the selected mode of operation; i . e . isometric, isotonic or isokinetic.
  • the rotor (10) and the stator (11) are embedded in a case (14). Washers (15) placed in sandwich between the case and the stator prevents any leakage of MR fluid. Ball bearings (16) support the output shaft (9) for rotation relative to the case.
  • the device comprises the mechanical positioning system (2) is composed of six main elements: a lower plate (20), a middle plate (21), an upper plate (25), a millimeter graduated jack (29), a lower arm attachment (30) and an elbow blocking part (31).
  • the lower plate (20) comprises two manual knobs (7) used to fix it to the fixation plate (8) and a linear guide (22) that linked the lower plate (20) with the middle plate (21).
  • the position of the middle plate (21) along the X axis - defined as the axis running along the length of the lower plate (20) - is precisely adjustable using graduated gorges (24) equipped with a manual knob (23).
  • the upper plate (25) is also linked with the middle plate (21) using a linear guide (26).
  • the position of the upper plate (25) along the y axis - defined as the axis perpendicular to the x axis within the plane of the upper plate (25) - is precisely adjustable using graduated gorges (27) equipped with a manual knob (28).
  • the millimeter graduated jack (29) has its bottom plate connected to the upper plate (25); the position of the top plate of the millimeter graduated jack (29) is adjusted following the Z axis, defined as the axis perpendicular to the plane containing the axis X and Y.
  • the lower arm attachment (30) and the elbow blocking part (31) are screwed onto the top plate of the millimeter graduated jack (29), the size of these two elements depends on user's morphology.
  • the mechanical positioning system (2) - as described here above - can be fixed to the fixation plate (8) in several manner relatively to axis of the output shaft (9), depending on the type of exercise to be performed by the user.
  • the said mechanical positioning system is used in combination with the device.
  • the resolution of position in the X, Y, Z directions is 1mm. This system is used to locate the wrist joint always in the same way relatively to the device output axis. It should enable the device to achieve a coefficient of variance smaller or equal to 20% between two identical measurements whatever the value measured.
  • the mechanical positioning (9) system is attached to the fixation plate (8) such as the user's arm is perpendicular to the axis of the output shaft (9).
  • the mechanical positioning (9) system is attached to the fixation plate (8) such as the user's arm is perpendicular to the axis of the output shaft (9) as depicted in Figure 5 and Figure 12 .
  • the mechanical positioning (9) system is attached to the fixation plate (8) such as the user's arm is parallel to the axis of the output shaft (9) as depicted in Figure 6 and Figure 13 .
  • the mechanical positioning (9) is not required as shown in Figure 7 and Figure 14 .
  • the user applied a force to the output shaft (9) using a handle (3) that is grasped by the user.
  • a handle (3) that is grasped by the user.
  • several handle are available.
  • FIG 8 and Figure 15 displays a handle that is used for hand and fingers rehabilitation exercises and mainly composed of two handles (40,41) forming a pliers.
  • the handle is fixed to the output shaft (9) with a fixation knob (4) whereas two small knob (42) allow to fix the handle to the housing (1).
  • Figure 9 and Figure 16 displays a handle dedicated to flexion/extension exercises that is composed of narrow plate (45), a fixation knob (4) - screwed at the centre of this plate on one side - and a grip (44) that is fixed to the plate on the other side.
  • the position of the grip (44) is adjusted using graduated gorges (43) hollowed in the plate.
  • the handle is fixed to the output shaft (9) with the fixation knob (4).
  • Figure 10 and Figure 17 displays a handle that is used for adduction/abduction exercises and similar to the one used for flexion/extension exercises.
  • the only difference concerns the fixation of the grip that is realised using an additional element with triangle shape (46) and that allows the grip to be perpendicular to the axis defined by the output shaft.
  • Figure 11 and Figure 18 displays a handle dedicated to pronation/supination exercises and that is composed of narrow plate, a fixation knob (4) - screwed at the centre of this plate on one side - and a U-shaped grip (47) that is fixed to the plate on the other side.
  • the position of the grip (47) is adjusted using graduated gorges (43) hollowed in the plate.
  • the handle is fixed to the output shaft (9) with the fixation knob (4).
  • Figure 19 displays a schematic view of three main device components and their internal components. Three components are the mechanical hardware, the user interface and the embedded electronics.
  • Figure 20 displays the three overlapping control loops that are used to command the device.
  • the first control loop is a current loop used to compensate for the electrical time delay related to the use of coils to generate the magnetic field inside the brake.
  • the second control loop is a torque loop used to compensate for the non-linearity between the current applied to the brake and its output torque, the hysteresis cycle and the remanent magnetic field.
  • the third control loop is a motion loop used to control the motion of the output shaft according to the selected exercise mode (isometric,isotonic,isokinetic) and type (pronation/supination, abduction/adduction, flexion/extension, hand, finger).
  • the exercise controller is thus different for each exercise mode.
  • the user interface is the MASTER device and the device, the SLAVE device. This means that all messages coming from the device microcontroller are an answer to a request from the user interface.
  • the messages exchanged vary from one exercise mode to another.
  • the protocol used to perform this communication is the SLIP protocol.
  • the joint rehabilitation device can be used in several conditions either in the presence of an operator of the said device or in absence of an operator or in any place suitable for the user such as alone at home.
  • the first user scenario is the case when the device is connected to the operator's COMPUTER.
  • the first operation to be performed is to physically connect the device to the COMPUTER either trough physical means such as a USB or SERIAL interface or through wireless means such as a WIFI or Bluetooth interface. Then the operator must start the software and switch the device on. If for any reason, the device is not connected to the COMPUTER (and/ or not powered on) when the software is started, the operator is first asked to connect the device to the COMPUTER (and/or to switch it on) before going further. He is also offered the possibility to use the software without the device but then he will not be able to start any exercise until the device is connected to the COMPUTER.
  • the operator is first asked to remove from the device any exercise handle that may still be connected to it.
  • the position sensor used in the device is an incremental encoder. It means that the position is measured relatively to a reference position that has to be identified each time the device is powered on. In order to calibrate the position sensor, the operator is asked to perform a complete revolution with the handle of the device. It enables the sensor to detect the index pulse. Knowing where this index pulse is located (from factory settings), the zero position can be retrieved. Alternatively, the operator can be asked to position the handle at a specific angle (by aligning visual markers located on both output axis and external housing). Once this is done, the operator clicks on a button allowing the software (and the device) to record this position as the reference position.
  • the signal provided by the force sensor may be shifted due to temperature; it has to be reset periodically.
  • the operator is asked to position the output axis in such a way that gravity can not have any influence on the measurement due to dissymmetry in the output axis (a visual marker can be used).
  • the output axis is then left free and the operator specifies it to the software by clicking on a button.
  • the measured force value at that moment is then considered by the device as the zero signal. Such a procedure has to be followed each time the device is powered on.
  • the operator can have an access to the user database managed by the software. He can either select an existing user or enter a new user in the database.
  • the operator has to provide the following information to the software: first name, last name, ID number, birth date, height, weight, sex, preferred side, involved side. This data can also be edited and modified later on.
  • the operator can have access to the "exercise menu" where he can specify the exercises to be performed by the user and set the corresponding parameters. It is important to note that the operator is able to define exercises in advance for future exercise sessions.
  • various parameters can be set. Some parameters are the same for all the exercise modes: date of the exercise, exercise type (flexion/extension, adduction/abduction, pronation/supination), number of trial repetitions, rest period duration after trial repetitions, number of effective repetitions, rest period after effective repetitions, tested side (involved/not involved), type of user interface used (COMPUTER or PDA) (in this case COMPUTER will be selected).
  • the specific parameters are for example: the angle of measurement, the duration of measurement or the direction of measurement (agonist/antagonist).
  • the specific parameters are for example: the start angle (beginning of Range Of Movement - ROM), the stop angle (end of ROM), the torque profile for the agonist motion (constant, parabolic,%), the torque profile for the antagonist motion (constant, parabolic,%), the maximum torque value for the agonist motion or the maximum torque value for the antagonist motion.
  • the specific parameters are for example: the start angle (beginning of ROM), the stop angle (end of ROM), the speed limit for the agonist motion (constant, parabolic,%) or the speed limit for the antagonist motion (constant, parabolic,). If an exercise has not already been performed, the operator is still able to modify any of its parameters
  • the operator connects the appropriate handle to the output axis of the device using the manual knob. Then he fixes the user forearm to the lower arm attachment of the mechanical positioning system using hook-and-loop fasteners such as Velcro@ strips while making sure that his elbow is properly blocked by the elbow blocking part.
  • the lower arm attachment can have various standard sizes in order to fit to various morphologies.
  • the user is translated in the three directions (X,Y,Z) in order to position the axis of the wrist to be exercised in front of the output axis of the device.
  • the location of the axis of the wrist to be exercised is identified by the operator using conventional palpation methods.
  • the X,Y,Z translations are blocked. If flexion/extension or adduction/abduction exercises are performed, the distance between the handle and the output axis is also fixed in order to fit to the dimensions of the hand of the user.
  • the operator can store in the database the mechanical settings used to position the wrist of the user in front of the axis of the device. These mechanical settings consist of the value of the positions in the three directions X, Y, Z (+ position of the handle for the flexion/extension and adduction/abduction exercises).
  • This method enables the user to always position his wrist in the same way relatively to the output axis, for a given exercise, every time he uses the device. It is important to note that thanks to this positioning method the operator needs to perform a palpation of the wrist axes only once for each user and for each exercise type.
  • the exercise can be started.
  • the operator has now access to the list of exercises previously defined and scheduled for the current day (exercises for future days are not displayed in order to avoid confusion).
  • Exercises can be performed one at a time (which means that the sequence of exercises can be chosen by the operator) ("single set") or all of them can be performed one after the other according to the sequence in which they have been defined (“all sets").
  • the operator In order to start the exercise, the operator has to click on the "start trial” button. The user then performs the trial repetitions. Data transmission from the embedded electronics is also started in order to provide real-time visual feedback - on the display of COMPUTER - to the user and operator. These repetitions are followed by a predefined rest period where data transmission is stopped. Once the rest period is over, the operator has to click on the "start exercise” button in order to launch the effective repetitions. Data transmission is again started and the user performs the effective repetitions. During the effective repetitions, transmitted data is also recorded in the user database for further analysis.
  • the operator is also able to stop the exercise while it is being performed.
  • the software informs the user on the repetition status (SUCCEEDED or FAILED) and if the repetition is failed, it tells the user why so he can take the corrective measures for the next repetitions. It should be noted that only the data from the succeeded repetitions will be used for further data computation.
  • the user can remove his forearm from the device after unfastening the hook-and-loop fasteners such as Velcro@ strips.
  • the operator can have access to extended computed data corresponding to the exercise that has been realised.
  • the operator In order to display this data, the operator must open the "user history" window where he can select the relevant exercise from a list of all the exercises previously performed by the user.
  • the exercises of this list can be sorted according to any of the parameters used to define the exercises in order to facilitate data retrieval. It should also be noted that the operator has the possibility to delete an exercise from the list, in case he considers it as not relevant.
  • the operator can choose to either display the corresponding computed data or export them to spreadsheet program such as Excel®. If the selected exercise corresponds to an exercise conducted with the involved side, a comparison is automatically made with the performances achieved with the uninvolved (valid) side for the same exercise mode and type (if this data exists).
  • the software also offers the possibility to print a report containing all the displayed computed data and relevant information concerning the selected exercise.
  • the operator can select a new user (or create a new one) from the database and repeat the entire procedure. Alternatively, he can also switch off the device and close the software.
  • access to previous exercise results can also be done at any other time and can even be done without the device being connected to the COMPUTER. Such a feature enables the operator to conduct further analysis and comparison of exercise results.
  • the joint rehabilitation device can be connected to a PDA.
  • the first operation to be performed by the operator is to select an existing user (or create a new user) in the user database managed by the software located on the operator COMPUTER.
  • the procedure to be followed is identical to the one required when the device is used directly in combination with the COMPUTER.
  • the operator checks (and stores in the database) the required mechanical settings for the user concerned using a procedure identical to the one followed when the device is used directly in combination with the COMPUTER. This has to be done only once for each user and for each exercise type. It can be done using a device located in the operator's practice, which is not especially the one that will be used by the user.
  • the operator has to load the exercises on the user PDA. This is done through the "PDA interface” window of the "exercise” menu.
  • Various loading options are offered to the operator such as exercise loading with PDA connected to the operator COMPUTER (WIFI, Bluetooth,%)(option 1), exercise loading through memory card (connected to the COMPUTER through a memory card reader) (option 2) or exercise loading through the Internet (option 3).
  • a copy of the entries in the user database corresponding to all the scheduled exercises to be performed by the user alone (in the coming days) is sent to the PDA (either directly for option 1, or indirectly for option 2 and 3).
  • the exercises are sent to the PDA in a specific file format such that they will be recognized by the exercise database located on the PDA.
  • the exercise files are directly copied into the proper directory of the PDA memory card and will thus be directly incorporated into the exercise list.
  • this update of the exercise list will, of course, be effective only when the memory card will be inserted into the PDA.
  • the exercise files are loaded and stored on a secured website that can be accessed by the PDA when the "load new exercises" button is pressed within the PDA software.
  • This procedure requires that the PDA can be connected to the Internet (either through a GSM connection of through an external modem via WIFI or Bluetooth).
  • the software automatically transfers the exercises files from the secured website to the proper directory of the PDA memory card and stops the connection at the end of the file transfer after having sent a message to the website specifying that the data has been properly transferred.
  • the software located on the COMPUTER asks to the operator to specify them before loading the exercise files to the PDA. This data is also loaded on the PDA.
  • the first operation to be performed is to switch the PDA and the device on.
  • the software commanding the device and managing the exercise database is automatically started.
  • the first operation (automatically) performed by the software is to check whether the device is switched on or not and to check if the connection between the device and the PDA is properly working. If not, an error message is sent to the user.
  • the PDA automatically presents to the user the exercise to be performed (which has been previously defined by the operator). At the same time, all the parameters relative to this exercise are sent to the embedded microcontroller of the device to make it ready to properly control the MR-brake according to the exercise to be performed.
  • the PDA asks the user to check if the mechanical positioning system is in the proper position. For that purpose, the user has to check the current value of the X,Y,Z settings and compare them with the values provided by the PDA. The user also has to check if the mechanical positioning system is properly located relatively to the device and if the proper handle (with the proper setting) is connected to the output axis of the device. If any of these settings differ from the information given by the PDA, the user performs the required adjustments.
  • the user fixes his involved forearm to the lower arm attachment of the mechanical positioning system using hook-and-loop fasteners such as Velcro@ strips while making sure that his elbow is properly blocked by the elbow blocking part.
  • the user In case of emergency, the user is also able to stop the current exercise while it is being performed.
  • the software on the PDA informs the user on the repetition status (SUCCEEDED or FAILED) and if the repetition is failed, it tells the user why so he can take the corrective measures for the next repetitions. It should be noted that only the data from the succeeded repetitions will be used for further data computation on the operator COMPUTER.
  • the user can remove his forearm from the device after unfastening the hook-and-loop fasteners such as Velcro@ strips.
  • exercise data stored on the PDA is directly transferred to the proper directory on the operator COMPUTER and will thus be directly incorporated in the list of exercises previously performed by the user that can be accessed by the operator through the "user history" window.
  • a secured website is automatically accessed by the PDA at the end of each exercise session. Exercise data is then loaded and stored on this website until the operator connects his computer to the website and retrieves the exercise data by clicking on the "acquire exercise data" button from the "PDA interface” window after having selected the user concerned in the "user” menu.
  • the software automatically transfers the exercise data from the secured website to the proper directory on the operator's COMPUTER and stops the connection at the end of the file transfer after having sent a message to the website specifying that the data has been properly transferred.
  • the operator can have access to extended computed data corresponding to the exercises that have been performed at home by the user.
  • the operator has to select the relevant exercise from the list of all the exercises previously performed by the user (located in the "user history" window) in the same way as when the device is directly connected to his COMPUTER.
  • the acquired data - such as position, speed, torque, time - can either be transmitted to the COMPUTER in real-time when the operator is directly connected to the machime through any I/O interface available or later on, by connecting the PDA - or directly its memory stick containing the acquired data - to the COMPUTER through any appropriate means.
  • the said data can be computed in order to provide to the operator information on the performances achieved by the user that can be compared to previously obtained data.
  • the acquired data can either be transmitted to the computer in real-time when the operator's computer is directly connected to the device through a USB or serial connection or later on, by connecting the PDA (or directly its memory stick containing the acquired data) to the computer through any appropriate means.
  • this data has been transmitted to the computer, it can be computed in order to provide to the operator useful information on the performances achieved by the user that can be compared to previously obtained data.
EP08151136A 2007-11-13 2008-02-06 Dispositif et procédé de réadaptation d'articulation Withdrawn EP2087926A1 (fr)

Priority Applications (3)

Application Number Priority Date Filing Date Title
EP08151136A EP2087926A1 (fr) 2008-02-06 2008-02-06 Dispositif et procédé de réadaptation d'articulation
US12/742,220 US20100298097A1 (en) 2007-11-13 2008-11-13 Joint rehabilitation device and method
PCT/EP2008/065509 WO2009063027A1 (fr) 2007-11-13 2008-11-13 Dispositif et procédé de rééducation articulaire

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
EP08151136A EP2087926A1 (fr) 2008-02-06 2008-02-06 Dispositif et procédé de réadaptation d'articulation

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EP2800611A4 (fr) * 2012-01-06 2015-12-16 Icon Health & Fitness Inc Dispositif d'exercice comportant une liaison de communication pour une connexion avec un dispositif informatique externe
CN106109165A (zh) * 2016-06-21 2016-11-16 北京工业大学 一种六自由度自适应腕关节康复装置
CN108836750A (zh) * 2018-07-06 2018-11-20 张志军 主被动两用式手指康复训练装置
CN109431745A (zh) * 2018-11-12 2019-03-08 上海市东方医院 一种踝关节康复装置及其训练方法
CN111000573A (zh) * 2019-12-30 2020-04-14 中国科学院合肥物质科学研究院 一种手部精细动作能力测试与训练装置
WO2021000614A1 (fr) * 2019-07-02 2021-01-07 南方科技大学 Système d'entraînement de coordination alternée et procédé de commande
WO2024003918A1 (fr) * 2022-06-29 2024-01-04 Bioxtreme Ltd. Système et procédé d'exercice de rééducation de la main

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP2800611A4 (fr) * 2012-01-06 2015-12-16 Icon Health & Fitness Inc Dispositif d'exercice comportant une liaison de communication pour une connexion avec un dispositif informatique externe
CN106109165A (zh) * 2016-06-21 2016-11-16 北京工业大学 一种六自由度自适应腕关节康复装置
CN108836750A (zh) * 2018-07-06 2018-11-20 张志军 主被动两用式手指康复训练装置
CN108836750B (zh) * 2018-07-06 2020-12-25 韩海霞 主被动两用式手指康复训练装置
CN109431745A (zh) * 2018-11-12 2019-03-08 上海市东方医院 一种踝关节康复装置及其训练方法
WO2021000614A1 (fr) * 2019-07-02 2021-01-07 南方科技大学 Système d'entraînement de coordination alternée et procédé de commande
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CN111000573A (zh) * 2019-12-30 2020-04-14 中国科学院合肥物质科学研究院 一种手部精细动作能力测试与训练装置
CN111000573B (zh) * 2019-12-30 2023-04-11 中国科学院合肥物质科学研究院 一种手部精细动作能力测试与训练装置
WO2024003918A1 (fr) * 2022-06-29 2024-01-04 Bioxtreme Ltd. Système et procédé d'exercice de rééducation de la main

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