EP2241302B1 - Vorrichtung zur Rehabilitation von Patienten mit motorischen Störungen - Google Patents

Vorrichtung zur Rehabilitation von Patienten mit motorischen Störungen Download PDF

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Publication number
EP2241302B1
EP2241302B1 EP10003231.7A EP10003231A EP2241302B1 EP 2241302 B1 EP2241302 B1 EP 2241302B1 EP 10003231 A EP10003231 A EP 10003231A EP 2241302 B1 EP2241302 B1 EP 2241302B1
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EP
European Patent Office
Prior art keywords
walking
patient
guide
bars
motor
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Not-in-force
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EP10003231.7A
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English (en)
French (fr)
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EP2241302A1 (de
Inventor
Jorge Cardile
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Individual
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Individual
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Priority claimed from ARP090101047A external-priority patent/AR071041A1/es
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Publication of EP2241302A1 publication Critical patent/EP2241302A1/de
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H1/00—Apparatus for passive exercising; Vibrating apparatus ; Chiropractic devices, e.g. body impacting devices, external devices for briefly extending or aligning unbroken bones
    • A61H1/02—Stretching or bending or torsioning apparatus for exercising
    • A61H1/0237—Stretching or bending or torsioning apparatus for exercising for the lower limbs
    • A61H1/0255—Both knee and hip of a patient, e.g. in supine or sitting position, the feet being moved in a plane substantially parallel to the body-symmetrical-plane
    • A61H1/0262—Walking movement; Appliances for aiding disabled persons to walk
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H1/00—Apparatus for passive exercising; Vibrating apparatus ; Chiropractic devices, e.g. body impacting devices, external devices for briefly extending or aligning unbroken bones
    • A61H1/02—Stretching or bending or torsioning apparatus for exercising
    • A61H1/0237—Stretching or bending or torsioning apparatus for exercising for the lower limbs
    • A61H1/0266—Foot
    • 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
    • A63B21/00178—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices for active exercising, the apparatus being also usable for passive exercising
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B22/00—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements
    • A63B22/06—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements with support elements performing a rotating cycling movement, i.e. a closed path movement
    • A63B22/0664—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements with support elements performing a rotating cycling movement, i.e. a closed path movement performing an elliptic movement
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B69/00—Training appliances or apparatus for special sports
    • A63B69/0064—Attachments on the trainee preventing falling
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/12—Driving means
    • A61H2201/1207—Driving means with electric or magnetic drive
    • A61H2201/1215—Rotary drive
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/14—Special force transmission means, i.e. between the driving means and the interface with the user
    • A61H2201/1436—Special crank assembly
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/16—Physical interface with patient
    • A61H2201/1602—Physical interface with patient kind of interface, e.g. head rest, knee support or lumbar support
    • A61H2201/1614—Shoulder, e.g. for neck stretching
    • A61H2201/1616—Holding means therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/16—Physical interface with patient
    • A61H2201/1602—Physical interface with patient kind of interface, e.g. head rest, knee support or lumbar support
    • A61H2201/1619—Thorax
    • A61H2201/1621—Holding means therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/16—Physical interface with patient
    • A61H2201/1602—Physical interface with patient kind of interface, e.g. head rest, knee support or lumbar support
    • A61H2201/1628—Pelvis
    • A61H2201/163—Pelvis holding means therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/16—Physical interface with patient
    • A61H2201/1602—Physical interface with patient kind of interface, e.g. head rest, knee support or lumbar support
    • A61H2201/164—Feet or leg, e.g. pedal
    • A61H2201/1642—Holding means therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/16—Physical interface with patient
    • A61H2201/1602—Physical interface with patient kind of interface, e.g. head rest, knee support or lumbar support
    • A61H2201/165—Wearable interfaces
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/16—Physical interface with patient
    • A61H2201/1602—Physical interface with patient kind of interface, e.g. head rest, knee support or lumbar support
    • A61H2201/165—Wearable interfaces
    • A61H2201/1652—Harness
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/16—Physical interface with patient
    • A61H2201/1657—Movement of interface, i.e. force application means
    • A61H2201/1671—Movement of interface, i.e. force application means rotational
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/16—Physical interface with patient
    • A61H2201/1657—Movement of interface, i.e. force application means
    • A61H2201/1676—Pivoting
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H3/00—Appliances for aiding patients or disabled persons to walk about
    • A61H3/008—Using suspension devices for supporting the body in an upright walking or standing position, e.g. harnesses
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B22/00—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements
    • A63B22/06—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements with support elements performing a rotating cycling movement, i.e. a closed path movement
    • A63B22/0664—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements with support elements performing a rotating cycling movement, i.e. a closed path movement performing an elliptic movement
    • A63B2022/067—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements with support elements performing a rotating cycling movement, i.e. a closed path movement performing an elliptic movement with crank and handles being on opposite sides of the exercising apparatus with respect to the frontal body-plane of the user, e.g. the crank is behind and handles are in front of the user
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B71/00—Games or sports accessories not covered in groups A63B1/00 - A63B69/00
    • A63B71/0009—Games or sports accessories not covered in groups A63B1/00 - A63B69/00 for handicapped persons
    • A63B2071/0018—Games or sports accessories not covered in groups A63B1/00 - A63B69/00 for handicapped persons for wheelchair users
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B22/00—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements
    • A63B22/0015—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements with an adjustable movement path of the support elements
    • 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
    • A63B2225/30—Maintenance

Definitions

  • the present invention relates to a new device that may be employed in the medical, physical training and/or rehabilitation field and, more particularly, the invention refers to a new apparatus for rehabilitation and/or re-education of an impaired patient, preferably an individual or patient with dysfunction in the lower limbs, to induce walking movements, develop balance and train muscles, preferably in handicapped persons with gross motor impairments, wherein the apparatus is effective in helping correct the postural (stance) structure and also attaining the exact reproduction of human walking, efficiently inducing the movement of the joints of the foot, heel, ankle, knee and hips, all of them with high participation in the walking movements.
  • stance postural
  • the disabilities that affect the lower limbs basically hinder or limit displacement and the two-legged stance.
  • the technical solutions available to persons with motor dysfunctions, for walking rehabilitation purposes can be generally classified in mobile and fixed devices that have been aimed at helping patients recover their walking capabilities, without, however, efficiently achieving the right motor coordination, balance control of the limbs and torso, correction of the body posture and strengthening of the atrophic limbs.
  • the known mobile equipment uses the patient's own force to move, using devices commonly known as walkers.
  • the systems are based mainly on the force that the patient must exert with the upper limbs on the device that serves as a support to maintain the two-legged stance.
  • the devices are a kind of a support or cart moving over some sort of rollers or wheels and the patient must exert the necessary force against the floor to move. It is obvious that the patient must be capable of standing up and walk, at least slightly and this is not possible for patients having strong neurological disorders with practically no muscles in conditions to support the body weight or to move the legs to get a minimal walking distance.
  • the above systems do not provide any type of step regulation or limb movement sequence.
  • DE 102005014204 to Steinert Chistoph entitled “Old person's natural heading movement stimulator produces movement of lower extremity/limb in frequency and with dynamics of walking, where movements of ankle joint is effected in frequency of heading movement”
  • FR 2691127 to of Michel Sarciron entitled “Medical re-training aid to assist patient in controlling feet” disclose devices to primarily stimulate joints and, in particular, ankles.
  • US Patent 6,666,798 to Borsheim discloses an apparatus for rehabilitation of a functionally impaired leg of a patient suffering from paralysis, adapted for receiving also an attendant, both, patient and attendant exercising on a treadmill, with the apparatus comprising leg brackets adjacent to the patient's and attendant's knees, a connecting member coupling the leg brackets to transmit motion from an attendant's leg to a patient's leg.
  • the apparatus also including an ankle appliance having an upper extension and a lower extension proximate the ankle is attached to a patient's foot and an ankle brace is similarly attached to an attendant's foot.
  • the coordinated leg and ankle movement allows a patient's paralysis damaged leg to duplicate the walking motion of an attendant's leg.
  • the apparatus also uses handrails in the treadmill and a suspension strap to keep the patient in a suspended position to allow leg movement without the hindrance of up to full body weight.
  • This apparatus does not teach neither suggests the possibility of varying the height of the strap to permit the body weight of the patient to be transmitted to the legs to better train the lower limbs supporting at least part of the natural body weight.
  • the belt of the treadmill runs always in the same direction without guiding the patient's feet to emulate the entire walking movement, namely along a closed loop.
  • Document US219439 discloses an apparatus with the features of the preamble of claim 1.
  • the apparatus comprises a harness for supporting the patient, with the patient having their feet affixed to a couple of walking bars to really reproduce the movements of the lower limbs when walking, with the harness being pending from an upper part of the apparatus including height regulating means for moving the harness up and down to have the patient's body weight unloaded on the legs reduced or increased for better training of the legs.
  • the apparatus comprises a support structure such as a chassis 2 of a light and resistant construction and material, of aluminium or steel for example, having a base 3, a top or upper end 4 and a plurality of columns 5, 6, 7, 8.
  • the chassis 2 is resistant and capable of supporting at least the weight of a patient and the components.
  • Walking bars 9, 10 are provided, with the walking bars 9, 10 being mounted to move along a path emulating, duplicating or copying the natural walking movement, such as up and down and back and forth along a closed movement loop, such as a seesaw movement, for example.
  • Walking bars 9, 10 may be made of any suitable material such as steel or aluminium and preferably of a hollow metal profile to be resistant and of a light weight to support the patient's weight. The weight of the patient will be controllably unloaded, partially or totally, on the walking bars 9, 10.
  • each walking bar 9, 10 has a respective rear end 11, 12 connected to motor means 13 and a respective front end 14, 15 slidably connected to respective front guide means 16, 17.
  • the sliding connection between front ends 14, 15 of walking bars 9, 10 are preferably established by a bracket 18, 19 having, at a lower edge thereof, a rotary shaft (not shown) with end rollers of which only one roller 20 is shown in bracket 19, and only one roller 21 is shown in bracket 18, see Figures 3 and 6 . While not shown, the rotary shafts in brackets 18, 19, are provided with rollers opposite and associated to rollers 20, 21 to properly slide along front guide means 16, 17.
  • rollers 20, 21 run along front guide means 16, 17, with each guide 16, 17 comprising a "C" profile member, as shown in Figure 3 , firmly affixed to a front end of the chassis 2.
  • Guides of front guide means 16 and 17 are respectively facing to each other by their open sides to slidably receive the end roller 20 with its opposite roller (not shown), and roller 21 with its opposite roller (not shown), of each bracket 18, 19.
  • Motor means 13 preferably comprise a crank and connecting rod mechanism driven by an electric motor 22, or a motor and speed reducing gearbox, mounted in a base member 23, forming part of the chassis 2.
  • Motor 22 actuates a pulley 24, a belt 25 and a pulley 26 which in turn moves a crank connecting rod comprising a couple of rods 27, 28 which are preferably extensible and regulated through a regulating assembly formed by orifices 29 and knob 30, as it is well known.
  • Connecting rods 27, 28 are connected to ends 11, 12 of the walking bars 9, 10 by respective journalled or bearing connection with only one of them, namely connection 31, being shown.
  • the length of connecting rods 27, 28 defines the walking step distance or path, which would be regulated according to the kind of dysfunction, age and size of the patient, by means of the regulating means 29, 30.
  • the height of pulley 26 may be also regulated by extensible arms 32 with regulating means that can be like means 29, 30.
  • ends 11, 12 are shown as cut and made of a hollow rectangular metal profile, the ends and the entire walking bars 9, 10 may be made of solid bars, and other design, with no cuts, is possible.
  • a crank-connecting-rod mechanism has been shown to provide a circular or looped movement, it will be apparent to any person skilled in the art that other mechanisms may be employed.
  • this mechanism may be replaced by a couple of gears, a leading gear and a rear gear, and at least one chain running around them, along an elliptical or ovoid path, with ends 11, 12 of bars 9, 10 being connected to both sides of the chain, to particular links of the chain, by respective journalled connection, in order to follow the elliptical loop of the chain.
  • the closed path defined by the chain will be as close as possible like a walking movement.
  • Caps 33, 34 may be made of any suitable material to protect the covered mechanisms, such as a plastic, resistant and light material.
  • the patient will step on the walking bars 9, 10 in a left and a right foot retaining means 35, 36 pivotally connected to left and right walking bars 9, 10 respectively.
  • foot retaining means 35, 36 move together with the walking bars 9, 10 along the closed loop or step distance path, to copy the movement of a walking step.
  • Left and right foot retaining means 35, 36 comprise a left and a right foot plate assemblies 37, 38 pivotally connected to left and right walking bars 9, 10 respectively.
  • each foot plate assembly 37, 38 is comprised of two foot plates pivotally connected to each other, namely an upper foot plate 39 for receiving the left foot of the patient, and upper foot plate 40 for receiving the right foot of the patient, as well as a lower foot plate 44, in the left side, see Figures 9 , 10 , and a lower foot plate 45, in the right side, see Figures 11 , 12 .
  • Each foot of the patient must be firmly affixed to each upper foot plate 39, 40 and, for that purpose, a left boot 41 and a right boot 42 may be provided in the upper foot plates 39, 40 to receive the feet of the patient comfortably.
  • the patient's feet with their own shoes may be retained in the upper foot plates 39, 40 by other fastening means.
  • boots 41, 42 may represent the feet of the patient and the fastening means may comprise respective ribbons 43 affixed at the upper foot plates 39, 40 for embracing the feet of the patient and retaining the feet in the upper foot plates 39, 40.
  • Ribbons 43 may be provided, as it is well known, with any adherence means such as hook-and-loop retaining means. Ribbons 43 have been shown only for one boot 42 representing a foot in Figure 5 , for clarity purposes, but it is evident that the same will be provided for both feet.
  • Upper foot plates 39, 40 and lower foot plates 44, 45 are pivotally connected to each other and to the respective walking bar 9, 10 by double hinged means.
  • Left lower foot plate 44 has a front edge hinged, by a hinge 46, see Figure 9 , to walking bar 9, thus being capable of pivoting at hinge 46 and moving to a position as shown in Figures 12 , 13 .
  • lower foot plate 44 has a rear edge hinged, by a hinge 47, see Figures 7 , 8 , 12 , 13 , to a rear edge of upper foot plate 39, forming a rear hinged connection, to be capable of pivotally moving around hinge 47 to have a position as shown in Figures 9 , 10 .
  • right upper and lower foot plates 40, 45 are pivotally connected in like manner by a leading hinge 50, see Figure 11 , and a rear hinge 51, see Figure 13 .
  • Upper foot plates 39, 40 have respective front curved edges 48, 49 to be guided and slidably move along and onto front guide stops 52, 53 as detailed disclosed below.
  • upper and lower foot plates 39, 44 and 40, 45 have been disclosed as being connected to each other and to the walking bars 9, 10 by means of a double-hinge mechanism, it will be apparent to any skilled person in the art that any other tilting or oscillating mechanism may be adopted.
  • upper foot plates 39, 40 may be mounted in respective central transverse axis, placed at a distance above the walking bars 9, 10, or onto a semicircular block onto the walking bars 9, 10, to force the patient to keep the feet as horizontal as possible at least until the upper foot plate 39, 40 is tilted under the action of the front and rear guide stops 52, 53, 54, 55 reference to which is made below.
  • Front and rear guide stops 52, 53, 54, 55 are provided in the chassis 2 and associated to the walking bars 9, 10 to force the foot plates to tilt according to the walking movement.
  • the apparatus 1 is provided with front guide stop 52 for the left foot and front guide stop 53 for the right foot, in each walking bar 9, 10.
  • Front guide stops 52, 53 are adjustably placed at a front end of step distance path "SD", see Figure 10 .
  • a rear guide stop 54 for the left foot and rear guide stop 55 for the right foot, in each walking bar 9, 10 are adjustably placed at a rear end of step distance path "SD”.
  • Guide stops 52-55 will cause foot plates 39, 40, 44, 45 move up and down when reaching the ends of the step distance path in order to copy as close as possible the natural walking movements.
  • the foot will be forced to move in the articulations or joints of the heel and the ankle.
  • Front guide stop 52 for the left foot will be described in detail as long as the front guide stop 53 for the right side is identical.
  • Front guide stop 52 comprises a curved front guide stop plate 56, made of any resistant material, such as steel or any other suitable metal.
  • Front guide stop plate 56 is firmly affixed to respective rear ends of a couple of extensible arms 57, 58 which have their leading ends pivotally connected at joint 59, 60, to any convenient part of the chassis 2, by any appropriate bearing means well known in the art.
  • Arms 57, 58 may include adjusting means to regulate the length of the arms in order to move front guide stop plate 56 back and forth to a desired position to adjust the step distance according to the particular treatment or patient.
  • Adjusting means indicated by reference 61 may be a well known mechanism of a plurality of orifices and knob to move and fix a relative position between two arm lengths 62, 63.
  • Front guide stop plate 56 must accompany the up and down movement of walking bar 9 while permitting the back and forth movement of the walking bar 9.
  • a transverse roller 64 see Figure 6
  • a spring 65, 66 see Figures 5 , 10
  • spring 65, 66 keep front guide stop plate 56 under a resilient force urged against walking bar 9
  • transverse roller 64 keeps front guide stop plate 56 in position relative to walking bar 9 to guarantee that front curved edge 48, see Figure 10 , will always move onto front guide stop plate 56 when reaching the plate 56 in the forth movement of the walking bar 9.
  • Rear guide stop 54 comprises two curved rear U-shaped guides, indicated by general references 67, 68, facing to each other by their open sides.
  • Rear guides 67, 68 include respective horizontal guide lengths 69, 70, and curved and upwardly extending guide lengths 71, 72, see Figure 8 , 13 .
  • the rear edge of plate 44 is provided with guide follower ends, such as rollers at the end thereof, which rollers run into the upward guide lengths 71, 72 to cause the patient's foot move upwardly at the rear part of the walking movement as shown in Figures 12 , 13 illustrating the left foot in that position. Since the guide follower ends, namely the rollers, of plate 44 do not appear in the drawings, reference is made to the rollers of plate 45, identical to the rollers of plate 44, with one of which being shown in Figures 8 , 13 and indicated by reference 73.
  • rear guide stop 54 is provided with a rear carriage 74 firmly affixed, by welding for example, to rear guide stop 54 and including upper rollers 75, 76 and a lower roller 77, at both upper and lower sides of walking bar 9, to keep rear guide stop 54 and walking bar 9 together during the movement of the walking bar 9.
  • horizontal guide lengths 69, 70 are provided with a lower roller 78.
  • rear guide stop 54 is pivotally connected to the walking bar 9, with the U-shaped guides being slidably resting onto the walking bar 9.
  • the rear guide stop 54 With the purpose of keeping the rear guide stop 54 in place, to define the rear end of the walking step distance, the rear guide stop 54, and more particularly carriage 74, is pivotally connected to respective rear ends of side arms 79, 80, see Figures 9 , 10 , which arms have respective leading ends pivotally connected at a joint 81, only one is shown, at convenient parts of the chassis 2, such as a transverse beam 82. More particularly, arms 79, 80 are extensible arms comprised of arm lengths 83, 85, left arm, and 84, 86, right arm. To adjust the length of side arms 79, 80 respective adjusting means may be provided. For example, a well known orifices and knob adjusting means 87, as generally indicated in Figures 9 , 10 , may be a good alternative. The rear end of arm length 83 will be pivotally connected to carriage 74 at a joint 88.
  • leading guide stops 52, 53 and the rear guide stops 54, 55 have been illustrated and disclosed as being different of each other, it is important to remark that the leading and rear guide stops 52-55 may be identical or the leading guide stop 52, 53 may be arranged at the place of the rear guide stop 54, 55, and viceversa.
  • the leading guide stops 52, 53 may comprise, like the rear guide stops 54, 55, a couple of facing "U" shaped guides, such as guides 67, 68, within which a pair of followers or rollers may run, such as rollers 73.
  • curved leading edges 48, 49 would not be necessary.
  • upper foot plates 39, 40 may be provided with any kind of a leading sliding means or rolling cylinder that causes the plate move upwardly onto the guide stop.
  • the front guide stop 52 When the foot reaches front guide stop 52, the front guide stop 52 impels the instep (forefoot) upwards because the front curved edge 48, with foot plate assembly 37 moving forth, enters into contact with the front guide stop plate 56 which causes upper foot plate 39 to move upwards and pivot around hinge 47, see Figure 9 .
  • rollers of plate 44 see as a reference rollers 73 of the right foot, are guided upwardly along upward guide length 71, 72 which causes foot plate assembly 37, namely plates 39, 44, move upwardly and pivoting together around hinge 46 pivotally fixed to walking bar 9.
  • the rear guide stop 54 pushes the heel upwards, thus triggering the movement in the symphysis of the foot during walking.
  • rear guide stops 54, 55 are provided with side panels 54A and 55A, see Figure 8 , defining a protection for the feet.
  • the apparatus 1 is provided with a stationary panel affixed to the chassis 2 and located in the gap between the walking bars 9, 10.
  • the apparatus 1 may be provided with patient's supporting means for supporting and keeping the patient in a desired position.
  • These means may comprise parallel bars, if the patient is in conditions to keep his/her body sustained by the arms, or, preferably, may comprise a supporting harness, generally indicated at 89 only in Figure 14 for clarity purposes, pending from the upper end 4 of the apparatus 1 and/or connected to columns 5-8.
  • Harness 89 may be of any type capable of appropriately sustaining and supporting the patient and placing him in the desired position but preferably, the harness 89 is connected to upper belts 90 to keep the patient sustained from the shoulders and torso belts 91 to be affixed to the patient's torso, from the waist and/or groin and/or hips.
  • the harness 89 is connected to harness motor means 92, which may comprise a crank handle, as illustrated or an electric motor capable of moving the harness up and down.
  • harness motor means 92 which may comprise a crank handle, as illustrated or an electric motor capable of moving the harness up and down.
  • upper belts 90 are connected to a rotating shaft 93, operated by the crank handle, to roll up the belts.
  • a longitudinal and lateral adjustment of the patient position may be carried out by means of rear torso belts 94, 95 and leading torso belts 96, 97.
  • Motor means 92 and shaft 93 also may move along guide bars 98, 99, by supports 100, 101, to further correct the position of the harness 89 longitudinally.
  • the apparatus 1 in addition to chassis 2, has a side chassis or side portion 102 for receiving patients in wheel chairs.
  • Side portion 102 also is comprised of columns 103, 104 and a base 105 open to define an entrance 106 for a wheelchair, stretcher and the like.
  • the upper end 4 of the apparatus 1 has a pair of guide beams 107, 108 and a frame 109 which is capable of moving along the guide beams 107, 108 to be placed in a position to receive a patient, shown in Figure 14 , and a position to support the patient during treatment, shown in Figure 15 .
  • Harness motor means 110 such as an electrical motor, is mounted in frame 109 to actuate a rotary shaft 111, to move the harness up and down. Harness motor means 110 and rotary shaft 111, move with frame 109 along the guide beams 107, 108 which thus define a motor guide for moving the harness motor means 110 between the above described positions.
  • the apparatus 1 preferably designed to support higher weights in a shorter design, is also comprised of a chassis 2 with a base member 23 and with a left walking bar 9 and a right walking bar 10 with their respective leading ends having rollers 20, 21 running along front guide means 16, 17.
  • the walking bars 9, 10 are also provided with the same front guide stops 52, 53 and rear guide stops 54, 55, as well as the foot plate assemblies 37, 38.
  • rear ends 11, 12 of the walking bars 9, 10 are pivotally connected to a respective left intermediate walking bar 112 and a right intermediate walking bar 113, both moving up and down and back and forth along a closed movement loop.
  • Each intermediate walking bar 112, 113 has a respective rear end 114, 115 connected to motor means 116 that may be like the one shown in Figure 4 or may comprise a motor 117 connected to a speed reducing gear box 118 to move a gear box 119 which in turn is connected to connecting rods 120, 121.
  • Connecting rods 120, 121 are preferably extensible rods with length adjusting means 122, 123 of the type well known in the art.
  • Connecting rods 120, 121 are pivotally connected at joints 124, 125 to rear ends 114, 115 of intermediate bars 112, 113.
  • connection between walking bars 9, 10 to their respective intermediate walking bars 112, 113 is through pivoting connections 126, 127 including respective brackets 128, 129 provided with respective adjusting means 130, 131 to permit the movement of the brackets 128, 129 along intermediate walking bars 112, 113 to adjust the relative position between walking bars 9, 10 and intermediate walking bars 112, 113 with the result that the closed movement loop to copy a natural step movement is adapted to the patient biometric parameters.
  • front ends 132, 133 of intermediate bars 112, 113, respectively, are provided with rolling means, such as rollers 134, 135, shown in phantom lines in Figure 16 , running along and into respective front intermediate guide means, of which only one intermediate guide means 136, for left intermediate walking bar 112, is shown.
  • the apparatus of the invention provides a range of services in treating patients suffering motor dysfunctions, neurological disorders, standing disorders and the like that is superlative as compared to other devices of the prior art.
  • the new design and combination of components provides a wider range of movements and adjustments to different patients, also stimulating the standing equilibrium.
  • No rods or complex retaining means are necessary to affix to the legs of the patient but only simple straps for example, are necessary to brace the patient's feet to firmly retain the same in the walking bars.
  • the feet Since only the feet are affixed to the walking bars, the feet follow the movement of the walking bars along the closed loop copying the natural walking movement thus causing the feet, with all their joints, to move accordingly.
  • the movement to the legs is imposed at the feet and not to the entire extension of the legs.
  • the patient after some treatment sessions, feels that he/she can move the legs to accompany the feet movement.

Claims (15)

  1. Vorrichtung (1) zur Rehabilitation von Patienten mit motorischen Störungen, insbesondere von Patienten, die an motorischen Störungen in den Beinen leiden, mit:
    einer Unterstützungsstruktur, wie beispielsweise einem Rahmen (2);
    einem linken und einem rechten Gehbalken (9, 10), die am unteren Teil des Rahmens (2) montiert sind;
    einem linken und einem rechten Fußhaltemittel (35, 36), die jeweils für eine Bewegung mit den Gehbalken (9, 10) durch Auf- und Abbewegen und Vor- und Zurückbewegen entlang eines Schrittlängenweges (SD) einer geschlossenen Bewegungsschleife, schwenkbar mit dem linken und rechten Gehbalken (9, 10) verbunden sind;
    dem linken und dem rechten Fußhaltemittel (35, 36), die entsprechende linke und rechte Fußplattenanordnungen (37, 38) aufweisen und
    einem Patientenhilfsmittel zur Unterstützung des Patienten,
    dadurch gekennzeichnet, dass
    die Vorrichtung einen vorderen Führungsanschlag (52, 53), der dem jeweiligen Gehbalken (9, 10) an einem vorderen Ende des Schrittlängenweges (SD) zugeordnet ist, und einen hinteren Führungsanschlag (54, 55) aufweist, der den jeweiligen Gehbalken (9, 10) an einem hinteren Ende des Schrittlängenweges zugeordnet ist, um zu bewirken, dass die Fußplattenanordnungen (37, 38) sich an den Enden des Schrittlängenweges (SD) auf und ab bewegt, wobei jede Fußplattenanordnung (37, 38) eine untere Fußplatte (44, 45) aufweist, die mit einer Vorderkante gelenkig an dem Gehbalken (9, 10) gelagert ist, und mit einer Hinterkante gelenkig an einer Hinterkante einer oberen Fußplatte (39, 40) gelagert ist, die eine Schwenkverbindung bilden, wobei die Hinterkante der unteren Fußplatte (44, 45) Führungsschienen (73) aufweist, die im hinteren Führungsanschlag (54, 55) geführt werden.
  2. Vorrichtung (1) nach Patentanspruch 1, des Weiteren mit:
    Befestigungselementen (41, 42, 43) in der linken und in der rechten Fußplattenanordnung (37, 38) zum Halten der Füße des Patienten während einer Behandlung.
  3. Vorrichtung (1) nach Patentanspruch 1 oder 2, wobei beide Gehbalken (9, 10) jeweils ein hinteres Ende (11, 12), das mit einer Motoreinheit (13) verbunden ist, und ein vorderes Ende (14, 15) aufweisen, das gleitend mit einer vorderen Führung (16, 17) verbunden ist.
  4. Vorrichtung (1) nach Patentanspruch 3, wobei die Motoreinheit (13) eine Kurbelwelle und einen Pleuelmechanismus aufweist.
  5. Vorrichtung (1) nach Patentanspruch 3 oder 4, des Weiteren mit einem Rahmen (2), wobei die vordere Führung (16, 17) der Gehbalken (9, 10) an einem vorderen Ende des Rahmens (2) und die Motoreinheit (13) an einem hinteren Ende des Rahmens (2) montiert ist.
  6. Vorrichtung (1) nach Patentanspruch 1, wobei die obere Fußplatte (39, 40) eine vordere, geschwungene Kante (48, 49) aufweist, um an dem vorderen Führungsanschlag (52, 53) entlang zu gleiten.
  7. Vorrichtung (1) nach Patentanspruch 6, des Weiteren mit einem Rahmen (2), wobei der vordere Führungsanschlag (52, 53) schwenkbar mit dem Rahmen (2) verbunden ist.
  8. Vorrichtung (1) nach Patentanspruch 7, wobei der vordere Führungsanschlag (52, 53) beider Gehbalken (9, 10) jeweils eine gebogene vordere Führungsplatte (56), die gleitend auf dem Gehbalken (9, 10) aufliegt, aufweist.
  9. Vorrichtung (1) nach Patentanspruch 1, wobei der hintere Führungsanschlag (54, 55) beider Gehbalken (9, 10) jeweils zwei gebogene, hintere U-förmige Führungen (67, 68) aufweist, die sich gegenüber liegen und schwenkbar mit den Gehbalken (9, 10) verbunden sind, wobei die hinteren U-förmigen Führungen (67, 68) gleitend auf dem Gehbalken (9, 10) aufliegen und wobei die hinteren U-förmigen Führungen (67, 68) die Führungsschienen (73) aufnehmen.
  10. Vorrichtung (1) nach Patentanspruch 2, wobei die Befestigungselemente (41, 42, 43) Bänder (43) aufweisen, die an der Fußplattenanordnung (37, 38) befestigt sind, um die Füße des Patienten zu halten.
  11. Vorrichtung (1) nach Patentanspruch 1, wobei die Patientenhilfsmittel einen Stützgurt (89) aufweisen, der von einem Gurtantrieb (92) an einem oberen Ende (4) der Vorrichtung (1) herabhängt, um den Stützgurt (89) auf und ab zu bewegen.
  12. Vorrichtung (1) nach Patentanspruch 11, wobei die Vorrichtung (1) einen Seitenabschnitt (102) für den Einstieg von Patienten in Rollstühlen, Krankentragen oder Ähnlichem aufweist.
  13. Vorrichtung (1) nach Patentanspruch 12, wobei das obere Ende (4) der Vorrichtung (1) und der Seitenabschnitt (102) eine Motorführung (107, 108) aufweisen, um den Gurtantrieb (92) zwischen einer Position zur Aufnahme eines Patienten aus einem Rollstuhl, einer Krankentrage oder Ähnlichem und einer Position oberhalb der Gehbalken (9, 10) zu verfahren.
  14. Vorrichtung (1) nach einem der vorhergehenden Patentansprüche, wobei der linke und der rechte Gehbalken (9, 10) jeweilige hintere Enden (11, 12) aufweisen, die für Auf- und Abbewegungen und Vor- und Zurückbewegungen entlang einer geschlossenen Bewegungsschleife zu jeweiligen linken und rechten Zwischenbalken (112, 113) schwenkbar verbunden sind.
  15. Vorrichtung (1) nach Patentanspruch 14, wobei die jeweiligen Zwischenbalken (112, 113) ein hinteres Ende (114, 115), das mit einer Motoreinheit (116) verbunden ist, und ein vorderes Ende (132, 133) aufweisen, das gleitend mit vorderen Zwischenführungen (136) verbunden ist.
EP10003231.7A 2009-03-25 2010-03-25 Vorrichtung zur Rehabilitation von Patienten mit motorischen Störungen Not-in-force EP2241302B1 (de)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
ARP090101047A AR071041A1 (es) 2009-03-25 2009-03-25 Dispositivo para la educacion y rehabilitacion de marcha y desarrollo de equilibrio
ARP090010048 2009-05-21
ARP090003586 2009-09-04

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EP2241302A1 EP2241302A1 (de) 2010-10-20
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CN102225034B (zh) * 2011-04-25 2013-07-10 中国科学院合肥物质科学研究院 步态康复训练机器人控制系统
CN102225033B (zh) * 2011-04-25 2013-07-10 中国科学院合肥物质科学研究院 一种步态康复训练机器人
CN102579229B (zh) * 2012-03-02 2013-11-27 王俊华 步态康复训练机械人
CN102579225B (zh) * 2012-03-31 2013-11-27 王俊华 平衡康复训练机械人
CZ2012305A3 (cs) * 2012-05-10 2014-02-26 Michael Nikolaus KrĂĽsselin Závěsné zařízení k transportu a nadlehčení pacientů, zejména k dynamickému odlehčení či statickému zavěšení pacientů s různými typy poškození pohybového aparátu
IT201700095769A1 (it) * 2017-08-24 2019-02-24 C O R P O 53 S R L Dispositivo per la rieducazione della motricità nelle disfunzioni posturali
IT201800003887A1 (it) * 2018-03-23 2018-06-23 Nimble Robotics S R L Dispositivo di blocco di una scarpa per un sistema per la riabilitazione del cammino, esoscheletro e sistema comprendente tale dispositivo
CN109966709A (zh) * 2019-04-23 2019-07-05 王盛 一种基于视本体反馈的步态训练设备
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CN112957617B (zh) * 2021-01-27 2023-04-11 中国人民解放军联勤保障部队第九二〇医院 一种家用便携式多功能康复治疗仪

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