EP2625977A1 - Marching supporting device - Google Patents

Abstract

The device (10) has a textile combination (11) that conforms to part of bust and shoulders (19), and a part of lower extremities (26). Two elastic straps (15, 16) are allowed to form a closed trajectory, where each strap connects the shoulders with the opposite lower extremity. The two straps cross each other on the chest (30) and on the back of the body. A set of crossings is provided, where one crossing is arranged on a frontal face, and another crossing is arranged on a dorsal face. A set of slides (17, 18) is placed in combination along the trajectory of the straps.

Description

The present invention relates to a walking aid device for persons who have partially lost the use of the muscles of at least one lower limb.

More specifically, the present invention relates to a device adapted to initialize and / or assist movements of triple flexion hip / knee / ankle of the leg during walking.

The invention is intended for persons who have partially lost the use of at least one lower limb. More specifically, these people have lost the ability to flex the hip and / or knee and / or ankle, which significantly handicaps them for walking.

• Les pathologies ou traumatismes centraux : ils enraidissent le membre inferieur (spasticité) et interdisent plus ou moins sa triple flexion (hanche/genou/cheville) : De telles pathologies et de tels traumatismes sont par exemple la sclérose en plaques, l'hémiplégie ou la maladie de Strumpell Lorrain. Les muscles enraidis tiennent la jambe raide et s'opposent trop fortement aux muscles antagonistes, entrainant une jambe difficile, voire impossible, à fléchir volontairement.
• Les pathologies ou traumatismes périphériques : ils ramollissent le membre inferieur à travers la paralysie flasque des muscles concernés. Ils rendent donc impossible la levée de la jambe, nécessaire à la marche physiologique. De telles pathologies et de tels traumatismes sont par exemple la sciatique paralysante, la maladie de Charcot Marie Tooth, le syndrome de Guillain Barre ou les polynévrites. Ici, les muscles touchés par la paralysie sont trop faibles et ne peuvent élever contre pesanteur le membre inferieur.

There are two kinds of disabilities that lead to losing the lower limb lifting function:

• Pathologies or central traumatisms: they stiffen the lower limb (spasticity) and prohibit more or less its triple flexion (hip / knee / ankle): Such pathologies and such traumatisms are for example multiple sclerosis, hemiplegia or Strumpell Lorrain disease. The stiff muscles hold the leg stiff and oppose too strongly to the antagonistic muscles, causing a difficult or impossible leg to flex voluntarily.
• Pathologies or peripheral trauma: they soften the lower limb through the flaccid paralysis of the affected muscles. They thus make impossible the lifting of the leg, necessary for physiological walking. Such pathologies and such traumatisms are, for example, paralyzing sciatica, Charcot Marie Tooth disease, Guillain Barre syndrome or polyneuritis. Here, the muscles affected by the paralysis are too weak and can not raise the lower limb against weight.

Known treatments for such pathologies or traumas are conventional orthopedic rigid or semi-articulated orthoses, orthopedic shoes or anti-stepping splints. These devices make it possible to take support on this limb by blocking it completely but oppose, by this blocking, to the action of the muscles. In addition, these devices weigh down the total weight of the leg and therefore not the action of dynamic survey against gravity of this lower limb during walking.

It is also known devices for assisting the movements of the human body, such as the device described in document W02008 / 122,873 . However, the forces generated by said device form "agonist / antagonist" pairs which balance out. Such a device is therefore appropriate to assist a healthy muscular system, but not to compensate for a deficient and / or asymmetrical muscular system.

On the contrary, the present invention aims to restore the motor skills of patients having partially lost the use of leg muscles, by the action of a device in the form of a garment. This garment has elastic straps reproducing the trajectory of the main muscles of the walk.

More specifically, the present invention relates to a device for assisting the movements of the human body, said device comprising: a textile suit capable of marrying at least a portion of the bust and shoulders, and at least a portion of the lower limbs of the human body ; two elastic straps each forming a closed path, each of said straps connecting a shoulder with the opposite lower limb, said two straps crossing one another on the chest and on the back of the suit. Furthermore, the trajectory of each strap crosses itself above and below a knee of the suit, one of said crossovers being on one front face of the suit and the other crossing on one side dorsal of said combination. In addition, the elastic straps are able to slide in slides arranged on the combination, along the trajectories of said straps.

The elastic straps are arranged to follow the anatomical path of the main muscles of the walk. The slides allow traction of the elastic straps without pulling on the suit.

The operation of the device requires the upright position of the wearer. Indeed, the device according to the invention acts by the constraint of the body weight that will stretch the elastic straps at the time of full load, that is to say when the lower member is in full support on the ground . As the foot lifts to advance the leg, the elastic straps contract. The straps thus assist the uprising of said non-bearing leg, as well as the simultaneous flexion of the hip, knee and possibly the ankle.

According to a preferred form of the invention, at the level of the lower limbs, each strap crosses itself above the knee on a front face of the combination. In addition, each strap crosses itself below the knee on a dorsal side of the suit.

Thus, the action of the strap during its contraction tends to bring the heel back towards the back of the body, and the thigh towards the front of the body. It would be possible, however, to have the crosses on the leg in reverse, that is to say above the knee at the back of the suit, and below the knee at the front of the suit. This arrangement would have the effect of projecting the foot forward at the time of contraction of the strap.

According to one embodiment of the invention, each strap is fixed integrally to the combination in at least one point. This attachment keeps the strap in position and prevents it from turning on itself inside its slide.

The point of attachment of the strap is preferably located at the shoulder. More preferably, the strap is fixed integrally to the combination in at least a second point, located lower than a knee of the lower limb opposite said shoulder.

According to one embodiment of the invention, the path of at least one of the two straps passes under the sole of the foot of the corresponding lower limb.

Preferably, at the level of said sole, the strap is split into two parallel straps, one of the straps passing under a front portion of the foot and the other under a rear portion of said foot. This arrangement tends to reproduce the action of muscles that stabilize the foot during walking, thus reducing the risk of sprains.

According to another embodiment of the invention, at least one of the two straps is connected to a leg strap of a foot orthosis, said bracelet being located at a calf of the combination. Said leg strap is connected to a sole of the foot by an elastic cylinder. Such a foot orthosis is for example described in the document EP1382317 or the document FR2953129 , in the name of the Applicant.

This other embodiment allows to combine the dynamic action of the cylinder and that of elastic straps to restore traction during walking.

According to one embodiment of the invention, the combination is at least partially formed of an elastic textile capable of exerting compression on the body of the wearer. The combination can notably produce a compression effect of the lower limbs and / or draining massage, for a better comfort of the patient.

• Figure 1 : une représentation schématique d'un dispositif selon un mode de réalisation de l'invention, porté par un patient vu de face ;
• Figure 2 : une représentation schématique du dispositif de la figure 1, porté par un patient vu de dos ;
• Figure 3 : une vue de détail, schématique, d'un dispositif selon un autre mode de réalisation de l'invention.

The invention will be better understood on reading the description which follows and on examining the figures which accompany it. These are given as an indication and in no way limitative of the invention. The figures show:

• Figure 1 : a schematic representation of a device according to one embodiment of the invention, worn by a patient seen from the front;
• Figure 2 : a schematic representation of the device of the figure 1 , worn by a patient seen from behind;
• Figure 3 : a schematic detail view of a device according to another embodiment of the invention.

The Figures 1 and 2 show a schematic representation of a device 10 according to one embodiment of the invention, carried by a patient.

The device 10 comprises a textile combination 11, preferably formed of an elastic material. In the embodiment shown at figure 1 , the combination 11 comprises a superior element 12, adapted to fit at least a portion of the bust and the shoulders of a human body. The element 12 has for example the shape of a jersey straps, which may further comprise sleeves.

The combination 11 further comprises a lower element 13 adapted to fit at least a portion of the lower limbs of the human body. The element 13 has for example the shape of a tights.

In another embodiment of the invention, the combination 11 is formed in one piece and is for example in the form of an academic leotard.

According to one embodiment of the invention, the combination 11 comprises a liner 14.

The device 10 further comprises two elastic straps (15, 16) each forming a closed path. Each strap (15, 16) is slidable in a slide (17, 18) fixed to the surface of the combination 11. The slides (17, 18) are preferably sewn on the combination 11.

The slides (17, 18) have substantially the shape of flattened tubes, in which the straps (15, 16) pass. Said slides are preferably continuous to protect the straps, including friction against the combination 11 or against other clothing of the patient, carried over the device 10.

Alternatively, the slides may have one or more discontinuities, to give punctual access to the straps (15, 16).

Preferably, each strap (15, 16) is fixed integrally to the combination 11 in at least one point. The strap is for example sewn on the combination in this point, through the slide. In this way, the strap can not turn on itself inside the slide.

For example, a strap 15 is attached to the suit 11 at a point 19 located on the right shoulder. The slide 17, in which the strap 15 slides, is arranged obliquely on the chest of the suit, then bypasses the left thigh 26 above the left knee 27. The slide 17 then bypasses the left calf 28 from the back and joins the left ankle inside the foot.

At the level of the medial malleolus 20, the strap 15 and the slide 17 split into two parallel branches (21, 22) which pass under the left foot 32. The anterior branch 21 passes under the forefoot relative to a vertex of the arch. The posterior branch 22 passes under the back of the foot, substantially at the heel.

The branches (21, 22) meet at the level of the external malleolus 23.

The strap 15 may be sewn to the suit 11 through the slider 17 at the sole of the foot 32 or at the malleoli (20, 23). However, such a seam is not essential, since the splitting of the strap 15 into two branches (21, 22) restricts the possibilities of movement of said strap inside the slide 17.

The slide 17 then goes up bypassing the left calf by the back. The trajectory of said slide 17 crosses itself at a point 24 at the back of the calf, under the left knee. However, the two parts of the strap 15 passing through the point 24 are isolated from each other by the slide 17.

After point 24, the slide 17 bypasses the left leg from the inside at the knee and passes again on the front of the thigh. The trajectory of the slide 17 crosses itself at a point 25 located in front of the left thigh. However, as in point 24, the two parts of the strap 15 passing through the point 25 are isolated from each other by the slide 17.

The trajectory of the slide 17 then bypasses the left hip and obliquely crosses the back of the combination 11, to find the point 19 at the right shoulder.

Similarly, a strap 16 is attached to the combination 11 at a point 29 located on the right shoulder ( Figures 1 and 2 ). The slideway 18, in which the strap 16 slides, follows a path symmetrical to that of the slideway 17.

The slides (17, 18) intersect at a point 30 on the chest of the suit 11, as well as at a point 31 on the back of said suit. In these points (30, 31), the slides (17, 18) are simply superimposed and do not communicate with each other.

Preferably, the point 30 is substantially located in the lower portion of the sternum and the point 31 is substantially located between the shoulder blades.

The length of the elastic straps (15, 16) is configured so that when the patient is standing with both feet on the floor, as on the Figures 1 and 2 the body weight stretches said straps. Each strap (15, 16) can be configured with a specific length and tension, depending on the disability of the corresponding lower limb.

The patient is considered to raise his or her left foot 32 to advance the corresponding leg. Released from the body weight - which is then transferred to the right leg - the strap 15 contracts. This contraction exerts a traction force on the left calf 28 and the left thigh 26, through the lever arm formed by the fixed point 19 on the right shoulder. The action of the strap 15 causes the uprising of the thigh 26 forwards, the lifting of the calf 28 towards the rear, as well as the flexion simultaneous left hip, left knee 27 and ankle (20, 23).

When the patient rest his left foot on the ground, the body weight is again worn on the left leg. The elastic strap 15 therefore stretches again and the leg unfolds.

The trajectory of the straps (15, 16) at the torso substantially reproduces the path of the psoas muscle that starts from the spine and pulls on the lower limbs to raise them during walking.

The passage of the straps (15, 16) above the shoulders generates an important lever arm for the dynamic action on the legs.

In addition, the connection made between a shoulder and the opposite leg allows to impose a scapulo-humeral counter-rotation during walking. In other words, the device of the figure 1 imposes a rotation of the shoulders which opposes that of the pelvis during the walk, as in a person with normal motricity.

In order to obtain such a counter-rotation, it is preferable for the strap to be fixed to the combination in at least one fixed point, located for example at the level of the shoulder.

The crossing of the straps at the front of the thighs reproduces the path of the muscular bundles of the vast internal and external quadriceps.

Consider the case where a strap 15 is attached to the combination 11 in at least two points, one 19 at the shoulder and the other at the foot 32 or the bottom of the calf 28. It is then possible independently adjust the tension of two parts of the strap 15, a first 15a of said parts connecting the point 19 to the foot 32 passing on the chest, a second portion 15b connecting the point 19 to the foot 32 passing on the back.

Thus, an appropriate adjustment of the elastic tension of the corresponding strap portion allows the leg to be rotated inwardly or outwardly, depending on the needs of the patient.

The crossing 24 of the straps at the back of the calf generates a projection behind the foot when walking. The device 10 thus prevents the knee 27 from being placed in recurvatum, that is to say, to lock back when walking. Such a recurvatum disrupts the fluidity of walking and can cause knee injuries.

In addition, it is possible to fix the combination of pieces of flexible materials but not extensible, to limit the amplitude of certain joint movements. For example, such a room can be attached to the back of the knee to avoid recurvatum.

Preferably, the elastic textile forming the combination 11 is able to exert a compression on the body of the wearer. For example, the tights 13 may exert a restraining and / or massage effect on the lower limbs.

The figure 3 shows a schematic representation of detail of a device 110 according to another embodiment of the invention, carried by a patient.

The device 110 is similar to the device 10, except for the location of the patient's left calf, shown in FIG. figure 3 . In the description which follows, the various elements of the device 110 are identified by the same references as the corresponding elements of the device 10 described above.

In the device 110, below the crossover point 24 at the back of the calf, the two portions (15a, 15b) of the strap 15 of the left leg are connected to an orthosis 40 fitted to the left foot 32. The orthosis 40 comprises a 41 leg strap and a foot sole 42, connected together by a structure 43. The structure 43 comprises a resilient jack 44 offset on the back of the leg and foot. The jack is longitudinally extendable to pivot the sole 42 around the hinge of the ankle of the foot 32.

Such an orthosis is known from the prior art. It is for example described in patents EP1382317 and FR2953129 , in the name of the Applicant.

The parts (15a, 15b) of the strap 15 of the device 110 are preferably connected to an upper portion 45 of the strap 41. According to one embodiment of the invention, the point 24 of crossing of the parts (15a, 15b) to the back of the calf corresponds to a point of attachment of said branches with the bracelet.

Preferably, on each lateral edge of the foot 32, the orthosis 40 comprises two straps (46, 47) connecting the sole 42 and the bracelet 41. A first strap 46 connects the bracelet to an anterior portion of the sole; a second strap 47 connects the bracelet to a posterior part of the sole. A boundary between said anterior and posterior portions substantially corresponds to a crown of the foot arch.

Thus, the orthosis 40 of the device 110 has a comparable effect at the bottom of the strap 15 of the device 10 described above.

In addition, an orthosis 40, as described in the patents EP1382317 and FR2953129 , has the ability to handle all the dynamic movements of the foot and ankle while walking, preventing foot position crashes (sprains) when walking in rough terrain.

In addition, an orthosis 40, by its jack system, can absorb the energy transmitted by the shock wave when the heel impacts the ground, avoiding injuries to the ankle / knee / hip and back (sciatica, cruralgie, etc.).

Claims (7)

Device (10, 110) for assisting the movements of the human body, comprising: a textile suit (11) adapted to fit at least a portion of the bust and shoulders, and at least a portion of the lower limbs of the human body, - two elastic straps (15, 16) each forming a closed trajectory, each of said straps connecting one shoulder (19) with the opposite lower limb (26), said two straps crossing one another on the chest (30) and on the back (31) of the suit,
the trajectory of each crossing strap itself (15a, 15b) above (25) and below (24) of a knee (27) of the suit, one of said crossovers being on a front face of the combination and the other crossing on a dorsal surface of said combination,
the elastic straps being able to slide in slides (17, 18) formed on the combination, along the trajectories of said straps. Device according to claim 1, such as at the level of the lower limbs, each strap crosses itself above the knee (25) on a front face, and below the knee (24) on a dorsal surface , of the combination. Device according to claim 1 or claim 2, such that each strap is fixed integrally to the combination in at least one point located at a shoulder. Device according to one of the preceding claims, such that the path of at least one of the two straps (15) passes under the sole of the foot of the corresponding lower limb. Device according to claim 4, such that at the level of said sole, the strap is split into two parallel straps (21, 22), one of the straps passing under a front part of the foot and the other under a part rear of said foot. Device according to one of the preceding claims, such that at the level of a calf of the combination, at least one (15) of the two straps is connected to a wrist strap (41) of an orthosis (40) foot, said leg strap being connected by an elastic jack (44) to a sole (42) foot. Device according to one of the preceding claims, such that the combination is at least partially formed of an elastic textile, able to exert a compression on the body of the wearer.

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