EP2672944A2

EP2672944A2 - Device for autonomous retraining in walking

Info

Publication number: EP2672944A2
Application number: EP12708903.5A
Authority: EP
Inventors: Jean-Luc Thome; Guy Caverot
Original assignee: Rise BA SAS
Current assignee: Ba Healthcare
Priority date: 2011-02-10
Filing date: 2012-02-10
Publication date: 2013-12-18
Anticipated expiration: 2032-02-10
Also published as: FR2971419B1; WO2012107700A3; DK2672944T3; EP2672944B1; EP3132786A1; FR3002437A1; WO2012107700A2; FR2971419A1; FR3002437B1

Abstract

The invention relates to a device (10) for retraining in walking, comprising a mobile structure (11) for helping an individual to exercise at least one walking movement, and having means for supporting said individual. According to the invention, said mobile structure (11) comprises a motorized carriage (14) with automatic guidance.

Description

Autonomous ambulatory rehabilitation device

1. Field of the invention

The field of the invention is that of physiotherapy.

More specifically, the invention relates to an autonomous device for outpatient rehabilitation.

The device according to the invention is particularly suitable for the functional rehabilitation of persons who have suffered an acute neurological accident, for example a cerebrovascular accident, a traumatic brain injury or an incomplete spinal cord injury, and persons suffering from neurological pathologies. chronic progressive diseases such as multiple sclerosis or Parkinson's disease.

2. State of the art

Numerous medical studies, based notably on observations of the cerebral cortex, have highlighted the beneficial effect of a walking rehabilitation program for people suffering from a cerebrovascular accident, or in people suffering from Multiple sclerosis or Parkinson's disease ...

These studies show a stimulation of brain plasticity manifested by a reorganization of neural networks, which allows these disabled people to recover at least some of the motor functions of walking which have been altered, and therefore of regain some autonomy.

Proper rehabilitation of walking involves reproducing to a patient a varied set of movements of walking in a precise manner, respecting the physiological rhythm of walking.

We generally distinguish the early stages of reeducation of the walk, during which the patient is exerted to repeat the same movement (s) several times at a suitable speed to allow him to regain the automatism of walking, and the phases of reeducation of the walk more advanced, during which the patient trains progressively to execute sequences of movement more and more complex and whose rate of execution varies.

The movements reproducible by a patient closely dependent on his motor capacity, it is necessary at least in the early phases of rehabilitation, to reduce postural constraints to help the patient to mobilize his residual motor skills.

During a walk rehabilitation session, it is therefore common to suspend the patient, or at least to support the pelvis or trunk of a patient with a harness so as not to carry the full weight of the body on legs.

Rehabilitation techniques are known in which the patient exercises the movements of walking without advancing, supported by a harness suspended from a fixed gantry.

A known technique of reeducation of walking without advancing is to walk the patient on a treadmill.

To help the patient move his legs and feet and control their movements on the treadmill, it is known to involve one or more therapists.

This intervention, however, requires significant physical effort therapists.

Moreover, mobilizing therapists throughout a rehabilitation program to assist a patient to achieve steps has the disadvantage of being very expensive.

In order to overcome these drawbacks, motorized drive mechanisms for the legs and / or feet of the patient have been proposed.

For example, it has been thought to equip each leg of a patient with a functional orthosis forming an exoskeleton, to guide its movement on the treadmill.

A disadvantage of this technique implementing an exoskeleton is that it requires a great effort to the patient, and that it can not be performed only with subjects with good cardiovascular health.

Another disadvantage of this known technique is that the laying or removal of an exoskeleton is a long operation.

Another disadvantage of this technique is that it may not be suitable for elderly patients, who are more reluctant to accept new technology.

There is also known a technique of training the feet of a patient suspended from a fixed gantry according to an "elliptical pedaling" movement.

A common disadvantage of these known techniques of walking rehabilitation without advancing, is that the dynamics of walking on treadmill, or using a device driving the feet of a patient in an elliptical pedaling motion, is different from that on floor. The proprioceptive information received by the central nervous system of the patient during re-education sessions using these known techniques is therefore insufficient to allow complete rehabilitation of the functions of walking.

Another disadvantage common to these techniques of reeducation of walking without advancing, is that they do not allow to exercise the patient to walk on surfaces with relief.

Yet another disadvantage of these known techniques is that they do not allow the patient to perform movements off the sagittal plane, or in other words to exercise the patient to change direction, or to turn on himself. On the contrary, they are limited to repeating a few series of movements that are not very varied.

Another disadvantage of the known techniques of rehabilitation without advancing is that it is necessary to provide a substantial period of time to install the patient before starting a re-education session. In any case, these techniques of reeducation of the march without advancing are mainly devolves to the early stages of reeducation.

There is therefore a demand for solutions for reeducation of walking allowing a patient to move on the ground, and in particular for solutions allowing a patient who has reached an advanced rehabilitation phase to practice walking on a voluntary basis. on the ground, or in other words to natural walking, safely.

It was proposed to support a person with a harness suspended on a shuttle guided on a rail or cable, to allow him to advance on the ground.

A disadvantage of this guided progression technique is that the cost of fitting out a rehabilitation circuit is important.

Another disadvantage of this technique is that it is bulky. This technique of guided progression also has the drawbacks that the path taken by the patient following the rail or the cable is fixed, and that it does not allow to rotate the patient on itself.

A motorized walker was also proposed to support a non-autonomous patient and to help him move on the ground, after having equipped his legs with electrodes to induce their relaxation via electrical stimulations and an exoskeleton to guide their movement.

This technique using a motorized walker is however suitable only in the early stages of gait rehabilitation. In particular, it does not allow the patient to practice walking on his own.

This technique also has the disadvantage of being complex. Another disadvantage of this technique is that it does not allow to simply control the trajectory of the patient. It also does not allow the patient to navigate on his own.

Another disadvantage of this technique is that it does not adapt the speed of progression of the walker to the rhythm of the patient, in the case for example where it feels joint pain or tires quickly.

3. Objectives of the invention

The invention therefore particularly aims to overcome the disadvantages of the state of the art mentioned above.

More specifically, the invention aims to provide an ambulatory rehabilitation device that allows a patient who has lost the autonomy of walking to practice to practice each movement of walking, and in particular to change direction or to rotate on itself.

The invention particularly aims to exercise a patient walking movements in ambulatory situation and on soils of varied nature.

An object of the invention is also, in at least one embodiment of the invention, to allow the patient to go by himself.

Another object of the invention is to provide such a technique that can provide a gradual and / or gradual rehabilitation of a patient, and can be implemented in both early stages of rehabilitation in more advanced phases.

In particular, in at least one particular embodiment of the invention, the purpose of the invention is to provide such a technique that makes it possible to implement novel therapeutic scenarios designed around diversified and complementary exercises.

Yet another objective of the invention is to provide such a technique which makes it possible to adapt the level of assistance provided to the patient.

Yet another object of the invention is to provide such a technique which is compact.

Another object of the invention is to provide such a technique that can be implemented in a city medical office, the home of a patient, and / or outside.

The invention also aims to provide such a technique whose use is simple and acceptable for a patient and / or a therapist. Yet another object of the invention is to provide such a technique which is reliable, safe and safe for a patient.

4. Presentation of the invention

These objectives, as well as others that will appear later, are achieved by means of an ambulatory rehabilitation device comprising a mobile structure for assisting an individual, and in particular a non-autonomous patient, in the exercise of at least one movement of the walk presenting means of supporting said individual.

In the context of the invention, the term "support" means that the individual can be carried completely by the structure, to which he can for example be suspended, but it can also be a partial support allowing reduce the weight of the body on the legs only partially, or support only in the event of a fall or imbalance of the individual.

According to the invention, said mobile structure comprises a motorized carriage with automatic guidance.

Thus, in a novel way, the invention proposes to implement a motorized trolley with automatic guidance to accompany and secure a non-autonomous individual being rehabilitated in its progression on the ground, and allow it to practice natural walking voluntary.

It should be noted that in the context of the invention, the term automatic guidance qualifier, the carriage is able to move on a predefined course without the intervention of the re-educated individual or a third party.

Thanks to the automatic guidance, it is possible to program various rehabilitation sessions, by varying the direction and speed of travel on varied routes, in a particularly simple way.

In addition, a motorized carriage with automatic guidance being autonomous in its movements, the patient or the therapist do not have to intervene to push or direct the carriage.

Advantageously, said support means comprise a support harness capable of gripping at least a portion of the trunk of said individual, preferably a portion of said individual's pelvis, said harness being secured to a deformable support movably mounted relative to the frame of said structure.

For example, it may be provided that the support harness surrounds the pelvis and / or the pelvic girdle of the individual.

Moreover, the level of support of the individual can be adapted by varying the vertical position of the mobile deformable support. For example, in the early phases of rehabilitation, the patient can be suspended from the structure which then supports all its weight, and then as the progress of the patient, it can be expected to gradually reduce the support provided by the harness to the patient , lowering the mobile support.

In addition, a deformable support makes it possible in particular to improve the lateral support of the patient and to prevent an imbalance thereof.

According to a particular aspect of the invention, said deformable support comprises at least one omnidirectional arm secured to a connecting strap with said harness.

We can stretch the strap in all directions, which helps support the patient effectively during his movements.

In a particularly advantageous embodiment of the invention, said deformable support comprising two arms, each of said arms is actuated by a separate motor.

It is thus possible to operate the two arms independently.

Advantageously, said deformable support is attached to one end of a cable of a winch.

There is thus a particularly simple solution for lowering or mounting the deformable support.

Preferably, an ambulatory rehabilitation device such as those described above comprises means for controlling the balance of said individual acting on an actuating motor of said winch and / or said deformable support, comprising means for detecting a variation of the electrical power absorbed by said motor and means for measuring a horizontal displacement of said cable.

It is thus possible to simply and effectively maintain the patient's equilibrium, without equipping it with complex instrumentation, which saves time and improves the comfort of the patient and the medical staff in charge of the patient's rehabilitation.

In at least one particular embodiment of the invention, an ambulatory rehabilitation device such as those described above comprises:

- Means for obtaining at least one information representative of the intensity and / or direction of the force exerted by said individual on a gripping element secured to said structure;

means for delivering a signal comprising said information or said information.

means for generating a setpoint for varying the speed of movement and / or the direction of said carriage from said delivered signal.

Thus, the individual can simply interact with the carriage via a gripping element, such as a handle for example, and send him guidance instructions.

For example, in a particular embodiment of the invention, the patient can control the speed of progression of the motorized carriage with the help of the gripping element, and thus accelerate or otherwise slow down along a predefined course .

In a variant of this embodiment of the invention, it may also be envisaged to set a minimum progression speed of the carriage.

In another particular embodiment of the invention, the patient is given the opportunity to control the speed and direction of the motorized carriage, and thus to accelerate, slow down and change direction as he sees fit. In addition, it is possible, in an advantageous embodiment of the invention, to mount a control member of the carriage, such as a handle, on one side of the device in order to allow the therapist accompanying the patient to control the advance. motorized trolley. Preferably, the control of this member on the carriage has priority over that of the gripping element made available to the patient.

Advantageously, an ambulatory rehabilitation device such as the preceding device comprises means for automatically guiding said carriage comprising means for controlling the means for actuating at least one driving wheel of said carriage as a function of a predetermined movement speed and a predetermined direction of said carriage associated with the position of said carriage, and said variation instruction.

This provides a precise guidance of the carriage.

Advantageously, such an ambulatory rehabilitation device comprises means for identifying a state of imbalance of said individual arranged so as to be able to activate said balance control means, comprising means for comparing said one or more signals delivered by said one or more gripping elements with at least one predetermined reference signal.

In particular, one can immediately restore the balance of a patient who, by a reflex action, violently grips the gripping element when it is unbalanced.

In an advantageous embodiment of the invention, an ambulatory rehabilitation device such as those described above comprises:

means for collecting a plurality of information representative of the position and displacement of at least a portion of the trunk and / or at least a portion of each foot of said individual;

means for determining a datum representative of said individual's gait as a function of said plurality of information; and

automatic guiding means of said carriage comprising means for controlling the actuating means of at least one driving wheel of said trolley according to said data representative of the approach of said individual.

Thus, the patient drives the cart in a totally intuitive and transparent way for him.

This approach of being based on the observation of the patient's gait to guide the carriage is particularly original and innovative compared to known techniques, and provides a great comfort of use to the patient, who can forget the presence of the patient. device, and focus on its progression, safely.

Advantageously, such an ambulatory rehabilitation device comprises:

means for determining a datum representative of the posture of said individual as a function of said plurality of information; and

means for identifying an imbalance state of said individual arranged so as to be able to activate said balance control means, comprising means for comparing said datum with at least one predetermined reference datum.

Observation of the posture of the individual makes it possible in particular to discriminate imbalance situations accurately.

Preferably, said means for determining said data representative of the approach of said individual are configured so as to take into account for the determination of said data at least one parameter specific to said individual belonging to the group comprising:

- anthropometric data;

pathology of said individual;

- stage of rehabilitation of said individual;

- physical condition of said individual.

One can thus propose, with the same device, a rehabilitation program specific to each patient, and which can be arranged according to the state of fatigue of the patient. According to a particular aspect of the invention, said means for obtaining said plurality of information comprises a measuring device belonging to the group comprising at least:

- inertial unit;

- force sensor;

- optical capture device.

In an advantageous embodiment of the invention, the number of these measuring devices is limited to three, and preferably two.

In at least one embodiment of the invention, such a structure has means for calculating at least one comparative datum representative of the displacement of said individual, and in particular the distance traveled or the speed of movement of said individual, and means for displaying said one or more comparative data.

This stimulates the motivation of the patient who realizes the extent of his progress.

5. List of figures

Other features and advantages of the invention will appear more clearly on reading the following description of three embodiments of the invention, given by way of simple illustrative and non-limiting examples, and the appended drawings in which:

FIGS. 1A and 1B are diagrammatic perspective views, respectively front and rear, of an exemplary embodiment of an ambulatory rehabilitation device according to the invention;

FIG. 2 is a detailed view of the deformable mobile support of the ambulatory rehabilitation device presented with reference to FIGS. 1A and 1B;

FIG. 3 illustrates another exemplary embodiment of an ambulatory rehabilitation device of the invention, having two grip handles, in which the patient can take control of the device and walk around freely; Figure 4 is a view of a third exemplary embodiment of an ambulatory rehabilitation device according to the invention guided automatically from the observation of the patient's gait;

FIG. 5 is a synoptic representation of the control system of the ambulatory rehabilitation device presented with reference to FIG. 4.

6. Detailed description of the invention

6.1. Recall of the principle of invention

As already indicated, the principle of the invention is based in particular on the implementation of a motorized trolley with automatic guidance to accompany a non-autonomous individual during a walk on the ground, without having to mobilize a therapist and without provide a complex infrastructure.

In particular, the invention makes it possible to recreate varied ambulation conditions on the ground approaching the voluntary natural walk, allowing complete rehabilitation of the individual and improvement of his endurance. Moreover, it can advantageously be used on a soil with relief, outside a building for example.

6.2. Example of an embodiment of the invention

An embodiment of an autonomous ambulatory rehabilitation device according to the invention is shown in perspective and schematically during a rehabilitation session in FIGS. 1A and 1B, respectively seen from the front and from the front. 'back.

This device 10 comprises a mobile structure 11 assisting a patient 12 suffering from a cerebrovascular accident in the exercise of walking along a predetermined path 13.

The movable structure 11 comprises a self-guided motorized carriage 14, also known by the term agv, whose chassis 141 is surmounted by a gantry 15, at the top of which is mounted a horizontal beam laser sensor 126.

This motorized laser guide truck 14 known per se, whose position is determined by odometry, is designed to follow the path 13 automatically, or in other words without the intervention of the therapist or the patient.

In variants of this embodiment, it may be envisaged to provide an optoguided, wire guided or magnetic guided carriage.

To allow the carriage 14 to automatically adjust its position, three reflective beacons 120 have been placed at locations in the room where the precisely identifiable session takes place.

The path 13 defined by the therapist following the patient specifically for this session is stored in a memory of a supervision unit 125 housed inside the gantry 15. A USB type connector is provided on an amount of the gantry 15 to allow the therapist to connect his personal computer to the supervisory unit 125 and load a new course.

A shell 111 covers the gantry 15 and the frame 141 of the carriage 14. It is pierced with a flared opening 112 to provide a wide field of view to the patient 12.

A support device 16 of the patient 12 is mounted on the gantry 15. This support device 16 comprises a deformable mobile stem 115 suspended at the end of a cable 121 winding on a winch 116 fixed to the top of the gantry 15.

As can be seen in Figure 2, in a detail view, the bracket 115 is formed of a platform 21 carrying two independent omnidirectional telescopic arms 22, 23, and preferably holonomic displacement, each actuated by a separate motor 24 or 25.

A double strap 118 is attached to each of the arms 22 and 23. The ends of each double strap 118 are connected to a panty harness 119 enclosing the patient's pelvis 12. The support harness 119 can be moved up or down, so as to decrease or on the contrary increase the weight supported by the legs of the patient 12, by winding or unwinding the cable 121 of the winch 116.

In this embodiment of the invention the position of the cable 121 is slaved according to the measurement of the intensity of the electric current called by the drive motor 122 of the winch 116 so as to maintain this weight, and therefore the load supported by the cable 121, constant.

It should be noted that gradually, at each new session of the rehabilitation program, the therapist may decide to reduce the support provided by the harness based on the progress of the patient.

When the patient has regained sufficient autonomy to no longer need to be relieved by the harness, maintaining the wearing of the harness remains useful to the patient to deal with a loss of balance or a decrease in capacity occurring during one session, following fatigue or joint pains, and needing to restore support.

The actuation of the bracket 115 and the winch is controlled by a real-time electronic controller 17 embedded on the structure 11, shown in dashed lines in Figures 1A and 1B.

Advantageously, the situations in which the patient is out of equilibrium are identified by measuring the horizontal displacements of the cable 121 and by detecting the abrupt variations in the electrical power absorbed by the drive motor 122.

For this purpose, the controller 17 continuously acquires signals delivered by a position sensor making it possible to measure the position of the cable 121 and by an ammeter sensor measuring the value of the intensity of the current called by the drive motor 122 of the winch 116.

When the horizontal displacement or the variation of the intensity measured exceeds a predetermined reference threshold, a control signal of the actuating members of the bracket 115, and in this case of the two actuating motors 24 and 25 of the arms 22 is generated by the controller 17, in order to move the straps 118 and thus act on the position of the pelvis of the patient 12 to restore the balance of the patient.

The bracket is also equipped with a mechatronic or optical sensor for example to measure the inclination of the cable relative to the vertical (not shown in Figure 1) whose data are used by the supervision unit 125 to determine the position of the patient's bust.

The displacement of the carriage 14 is also controlled by the on-board real-time controller 17.

This controller 17 has a communication interface with the on-board supervision unit 125, which provides it with data for guiding the truck.

The supervision unit 125 is advantageously built around a modular software architecture, which is therefore scalable and easy to reconfigure.

The controller 17 makes it possible to control an electric servomotor 18 driving in rotation and directing two drive wheels with differential drive 142 mounted on the rear of the carriage 14 according to the control instructions received from the controller 17. In a variant of this embodiment, it can also be envisaged to mount each of the driving wheels in a specific motor-steering turret, equipped with a geared motor acting on the direction of the wheel and a geared motor for driving the wheel in rotation to the forward or backward.

The servomotor 18 is supplied with electricity by a rechargeable battery 19, for example of the acid-lead gel or lithium-ion type. Load pads 110 mounted outside the frame 141 of the carriage 14 allow recharging the battery 19 without disassembly.

At the front of the carriage 14, a free running wheel 143 is mounted in the axis of the carriage which allows the structure 11 to marry small radii of curvature and to turn on itself, and facilitates the advance backwards. In this particular embodiment of the invention, the structure 11 has a fixed grip handle 114, allowing the patient 12 to adjust the instantaneous speed of the carriage 14 on the path 13.

This handle 114 is advantageously equipped with force sensors (not shown in FIGS. 1A and 1B) measuring the intensity of the forces exerted on it by a patient's hand 12, connected to an interface of the controller 17.

It suffices for the patient to tighten the handle 114 harder to increase the speed of movement of the structure, or on the contrary to release the pressure on the handle to slow down.

On this path, the controller 17 is programmed so that the speed of movement of the patient is substantially proportional to the intensity of the clamping it exerts on the handle.

The patient can thus simply adjust the speed of execution of each step according to his ability to walk. He can also respond to requests from the therapist who asks him to accelerate on certain portions of the course.

For this session, maximum values of the instantaneous speed and the average speed of the carriage were parameterized by the therapist and stored in a memory of the supervision module 125, in order to limit the efforts to be provided by the patient and to prevent him gets tired too quickly. In addition, a minimum advance speed of the carriage has been adjusted, in order to force the patient to maintain his effort throughout the length of the course, and work his endurance.

It should be noted that, for safety reasons and in order to prevent the patient from falling, it is expected that the controller 17 automatically controls the stopping of the carriage if the analysis of the signals delivered by the force sensors equipping the handle 114 reveals that the patient tightly and strongly tightened the handle. Indeed, if he loses his balance, the patient will grip the handle reflexively. It can be seen in FIG. 1A that the shell 111 carries a display console 113 which delivers to the patient 12 information on its progress and its performances, which confers to a certain extent a playful aspect to the re-education session, and allows to encourage the patient and / or to reinforce his motivation.

The information output by the console 113 is, for example, the speed of travel, the trajectory, the amplitude of the strides, the contact forces, etc.

It is also expected that the patient can watch a sequence of exercises performed previously on the screen of the console 113.

It should be noted that, advantageously, the therapist can also use this console as a control console, in order to adjust certain parameters of the session.

In this embodiment of the invention, safety devices, such as for example a laser scanner, intended to prevent an impact with an object or a person, and to alert the therapist when a shock is imminent are provided . For example, when an obstacle is detected in front of the truck by photosensitive detectors mounted on the front portion of the hull, the truck gradually slowed down. In the event of an impact with an object or with the therapist registered by mechanical sensors equipping the carriage 14, the truck stops automatically.

6.3. Second exemplary embodiment of the invention

FIG. 3 is a detailed view of another example of an ambulatory rehabilitation device 31 according to the invention, constituting a variant of the embodiment detailed above, enabling the patient to take control of the automatic guided carriage and to move about. freely in the room.

This device 31 has a structure identical to the structure 11, furthermore advantageously equipped with a second fixed grip 33 instrumented with force sensors. In this particular embodiment of the invention, multi-axis force sensors are arranged in sufficient numbers and in a suitable arrangement on each handle to allow a measurement of the direction and intensity of the forces exerted on each of the handles by one or other of the patient's hands 32.

In a variant of this particular embodiment of the invention, it may also be envisaged to provide force return handles, also called kinesthetic handles or haptic handles, not requiring the implementation of force sensors. In particular, they may be force-return handles containing an electric motor that provides resistance to the rotation of an outer ring handled by the patient.

As in the embodiment described above, the patient can vary the speed of advance of the carriage along a predetermined path by grasping one or other of the handles 114 and 32.

When grasping the two handles 114 and 33, the patient 32 controls both the forward speed and the direction of the carriage 34, and can thus move autonomously in the room.

To command the carriage 34 to turn to the left or to the right, it is then enough for the patient 32 to exert an asymmetrical action on the handles 114 and 33, more supported at the handle on the side towards which a turn must be initiated.

When the patient releases one of the two handles, the carriage automatically switches to automatic guidance. The device 31 is then automatically directed by the shortest path to a position of the preset course, before resuming the course of the course.

In a variant, it can also be envisaged that the ambulatory rehabilitation device is permanently controlled manually by the patient, and that it stops, or that it is programmed to progress in a straight line, when the patient releases the patient. one of the handles.

6.4. Third exemplary embodiment of the invention Another exemplary embodiment of an ambulatory rehabilitation device according to the invention is shown with reference to FIG.

In this particularly novel embodiment of the invention, the automatic guidance of the carriage 41 of the rehabilitation device 40 is operated by means of an estimate of the patient's gait 42, which is interpreted as a reflection of the traveling intentions. of the patient.

This estimation of the patient's gait is based on the determination of a data representative of this approach. It is obtained by a real-time simulation of the dynamic behavior of a virtual dummy representing the patient 42, based in particular on a digital reconstruction of the posture of the patient 42.

To enable this reconstruction, the patient is instrumented with a limited number of sensors. It has indeed cleverly chosen to equip the portion of the harness 43 in contact with the patient's back of an inertial unit 44, and each foot of the patient of another inertial unit 45.

In variants of this embodiment of the invention, it may also be provided to equip the patient with photoelectric capture motion sensors, to detect the movement of the patient's legs and / or pelvis, or any other sensor. known to measure the position and / or movement of an area of the lower body of the patient.

As can be seen in FIG. 5 which details the control system of the ambulatory rehabilitation device 40, the data provided by the inertial units 44 and 45 concerning the position and the displacement of the patient's pelvis and feet are collected regularly by the patient. supervision module 51. These data are used within this supervision module by a software application 52 based on a dynamic modeling of the virtual manikin representing the patient to animate this virtual model.

The virtual digital mannequin model implemented in this embodiment of the invention is constructed by coupling a model kinematics of the 45-degree-of-freedom skeleton built around a tree chain of rigid elements in articular abutment, with a biomechanical model taking into account anthropometric parameters such as gender, age, and patient size, and integrating parameters specific to the pathology of the patient, allowing to assign an envelope, or skin, the manikin and manage its interaction with the external environment.

In variants of this embodiment of the invention, it may also be provided that the biomechanical model used for determining the representative data of the patient's gait takes into account the stage of rehabilitation and / or the physical condition of the patient. -this.

The animation of this manikin results from the integration of the equations of a dynamic model of the movement.

The forces exerted by the patient on the device 40 are calculated within the software application 52 and optimization strategies by quadratic criterion, consisting for example of minimizing muscle fatigue, are applied to manage the equilibrium of the manikin so Reflex and generate instructions transmitted to the controller 53 controlling the actuation of the arms of the mobile deformable stem 46 and / or the winch 47.

The application 52 also automatically determines a datum representative of the patient's gait from which is extracted the patient's intention to change direction, or to accelerate or slow down, for example. It then transmits a guidance instruction including directional data and speed data to the controller 53, which in turn controls the driving motor of the driving wheels of the carriage 41 accordingly.

The structure of the ambulatory rehabilitation device 40 thus moves transparently for the patient without his having to interact directly with it.

It can further be seen in FIG. 4 that the patient, who is not required to grasp a handle to guide or adjust the speed of the carriage 40, can swing his arms along the body, in a normal natural walking position.

The software application 52 also advantageously makes it possible to monitor the patient's posture by calculating a datum representative of the patient's posture, and to identify whether the patient is in a state of imbalance of the patient, by comparing this datum with a base. predetermined reference data.

6.5. Other optional features and advantages of the invention In variants of the embodiments of the invention detailed above, it may also be provided:

in the event of a fall, to capture the movement of the patient with the aid of an optical marker, such as an infra-red reflective ball, an accelerometer, or a magnetic marker;

to transmit to the device the information relating to the course of the session from a remote terminal via a wifi link.

In another variant, it may be envisaged, without departing from the scope of the invention, to place the gantry and the shell in the back of the patient, so that the patient gradually forgets that he is assisted by a machine, for example s it is an older person who is more reluctant to use new technology.

Claims

An ambulatory rehabilitation device (10; 31; 40) comprising a movable structure (11) for assisting an individual in the exercise of at least one movement of the step with support means for said individual, characterized in said movable structure (11) comprises a motorized self-guided carriage (14; 34; 41).

2. ambulatory rehabilitation device according to claim 1, characterized in that said support means comprise a support harness (119) adapted to grip at least a portion of the trunk of said individual, preferably a portion of the pelvis of said individual, said harness (119) being secured to a deformable support (115) mounted movably relative to the frame of said structure (11).

3. ambulatory rehabilitation device according to claim 2, characterized in that said deformable support (115) comprises at least one omnidirectional arm (22; 23) secured to a connecting strap (118) with said harness (119).

Ambulatory rehabilitation device according to claim 3, characterized in that, said deformable support (115) comprising two arms (22; 23), each of said arms (22; 23) is actuated by a separate motor (24; 25). .

5. ambulatory rehabilitation device according to any one of claims 2 to 4, characterized in that said deformable support (115) is attached to one end of a cable (121) of a winch (116).

6. ambulatory rehabilitation device according to claim 5, characterized in that it comprises means for controlling the balance of said individual acting on an actuating motor (122) of said winch (116) and / or on said deformable support (115), comprising means for detecting a variation of the electrical power absorbed by said motor (122) and means for measuring a horizontal displacement of said cable (121).

7. ambulatory rehabilitation device according to any one of claims 1 to 6, characterized in that it comprises: - Means for obtaining at least one information representative of the intensity and / or direction of the force exerted by said individual on a gripping element (114,33) secured to said structure (11);

means for delivering a signal comprising said information or said information.

means for generating an instruction for varying the speed of displacement and / or the direction of said carriage (14; 34; 41) from said delivered signal.

8. ambulatory rehabilitation device according to claim 7, characterized in that it comprises means for automatically guiding said carriage (14; 34; 41) comprising means for controlling the actuating means of at least one driving wheel ( 142) of said carriage as a function of a predetermined travel speed and a predetermined direction of said carriage (14; 34; 41) associated with the position of said carriage (14; 34; 41) and said variation setpoint.

9. ambulatory rehabilitation device according to claim 8 when dependent on claim 6, characterized in that it comprises means for identifying a state of imbalance of said individual arranged so as to activate said control means of equilibrium, comprising means for comparing said one or more signals delivered by said one or more gripping elements (114,33) with at least one predetermined reference signal.

10. Ambulatory rehabilitation device according to any one of claims 1 to 6, characterized in that it comprises:

automatic guiding means of said carriage comprising means for controlling the means for actuating at least one wheel motor (142) of said carriage (41) according to said data representative of the approach of said individual.

11. Ambulatory rehabilitation device according to claim 10 when dependent on claim 6, characterized in that it comprises: - means for determining a data representative of the posture of said individual according to said plurality of information ; and

means for identifying an imbalance state of said individ u arranged so as to be able to activate said means for controlling the equilibrium, comprising means for comparing said datum with at least one predetermined datum.

12. Ambulatory rehabilitation device according to one of claims 10 and 11, characterized in that said means for determining said data representative of the gait of said individual are configured so as to be taken into account for the determination of said data at least one parameter specific to said individual belonging to the group comprising:

- anthropometric data;

- pathology of said individual;

- stage of rehabilitation of said individual;

- physical condition of said individual.

13. An ambulatory rehabilitation device according to any one of claims 10 to 12, characterized in that said means for obtaining said plurality of information comprises a measuring device belonging to the group comprising at least:

- inertial unit (44; 45);

- force sensor;

- optical capture device.