EP2713980A1 - Vorrichtung für kooperative handfunktionsübungen in der rehabilitation und entsprechende verfahren - Google Patents

Vorrichtung für kooperative handfunktionsübungen in der rehabilitation und entsprechende verfahren

Info

Publication number
EP2713980A1
EP2713980A1 EP12724110.7A EP12724110A EP2713980A1 EP 2713980 A1 EP2713980 A1 EP 2713980A1 EP 12724110 A EP12724110 A EP 12724110A EP 2713980 A1 EP2713980 A1 EP 2713980A1
Authority
EP
European Patent Office
Prior art keywords
handles
handle
simulate
sensor means
locking
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP12724110.7A
Other languages
English (en)
French (fr)
Inventor
Volker Dietz
Robert Riener
Alessandro Rotta
Markus WIRZ
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Eidgenoessische Technische Hochschule Zurich ETHZ
Universitaet Zuerich
Original Assignee
Eidgenoessische Technische Hochschule Zurich ETHZ
Universitaet Zuerich
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Eidgenoessische Technische Hochschule Zurich ETHZ, Universitaet Zuerich filed Critical Eidgenoessische Technische Hochschule Zurich ETHZ
Priority to EP12724110.7A priority Critical patent/EP2713980A1/de
Publication of EP2713980A1 publication Critical patent/EP2713980A1/de
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B23/00—Exercising apparatus specially adapted for particular parts of the body
    • A63B23/035—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously
    • A63B23/12—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously for upper limbs or related muscles, e.g. chest, upper back or shoulder muscles
    • A63B23/14—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously for upper limbs or related muscles, e.g. chest, upper back or shoulder muscles for wrist joints
    • A—HUMAN NECESSITIES
    • 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
    • A61H1/0274—Stretching or bending or torsioning apparatus for exercising for the upper limbs
    • A61H1/0285—Hand
    • 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
    • A63B21/00185—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices using resistance provided by the user, e.g. exercising one body part against a resistance provided by another body part
    • 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
    • A63B21/15—Arrangements for force transmissions
    • A63B21/157—Ratchet-wheel links; Overrunning clutches; One-way clutches
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B21/00—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices
    • A63B21/40—Interfaces with the user related to strength training; Details thereof
    • A63B21/4027—Specific exercise interfaces
    • A63B21/4033—Handles, pedals, bars or platforms
    • A63B21/4035—Handles, pedals, bars or platforms for operation by hand
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B21/00—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices
    • A63B21/40—Interfaces with the user related to strength training; Details thereof
    • A63B21/4041—Interfaces with the user related to strength training; Details thereof characterised by the movements of the interface
    • A63B21/4049—Rotational movement
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B23/00—Exercising apparatus specially adapted for particular parts of the body
    • A63B23/035—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously
    • A63B23/03516—For both arms together or both legs together; Aspects related to the co-ordination between right and left side limbs of a user
    • A63B23/03533—With separate means driven by each limb, i.e. performing different movements
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B23/00—Exercising apparatus specially adapted for particular parts of the body
    • A63B23/035—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously
    • A63B23/12—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously for upper limbs or related muscles, e.g. chest, upper back or shoulder muscles
    • A63B23/16—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously for upper limbs or related muscles, e.g. chest, upper back or shoulder muscles for hands or fingers
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B24/00—Electric or electronic controls for exercising apparatus of preceding groups; Controlling or monitoring of exercises, sportive games, training or athletic performances
    • A63B24/0062—Monitoring athletic performances, e.g. for determining the work of a user on an exercise apparatus, the completed jogging or cycling distance
    • A—HUMAN NECESSITIES
    • 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
    • A61H2201/50—Control means thereof
    • A61H2201/5058—Sensors or detectors
    • A61H2201/5061—Force sensors
    • 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
    • A61H2201/50—Control means thereof
    • A61H2201/5058—Sensors or detectors
    • A61H2201/5069—Angle sensors
    • 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
    • A61H2205/00—Devices for specific parts of the body
    • A61H2205/06—Arms
    • A61H2205/065—Hands
    • 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
    • A61H2205/00—Devices for specific parts of the body
    • A61H2205/06—Arms
    • A61H2205/065—Hands
    • A61H2205/067—Fingers
    • 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
    • A61H2230/00—Measuring physical parameters of the user
    • A61H2230/60—Muscle strain, i.e. measured on the user, e.g. Electromyography [EMG]
    • 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
    • A63B2022/0092—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements for training agility or co-ordination of movements
    • 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
    • A63B2022/0094—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements for active rehabilitation, e.g. slow motion devices

Definitions

  • the invention relates to the field of rehabilitation methods and apparatus for functional training such as stroke.
  • the invention relates to a device to train in particular bilateral, cooperative hand functions such as opening/closing a bottle or a can.
  • Such daily living tasks are performed in a natural way against different levels of resistance.
  • This novel device functional training for example of stroke subjects, can be optimized as it represents a frequently movement task during daily living.
  • Bilateral training herein means that both hands are involved in a task.
  • Cooperative training means that, during bilateral training, one hand serves/supports the other one for the completion of that task. For example during cooperative training, one hand holds an item and counteracts against the forces exerted on that item by the other hand.
  • the device which couples manipulative movements of both sides.
  • the device comprises means to switch between cooperative (i.e. coupled) and bilateral non-cooperative (i.e. un-coupled) training.
  • the device may also be used for unilateral training. Therefore, in one embodiment of the invention, the device comprises two exchangeable handle portions (1 ), shaft portions (2) and clutch systems (3) that are structured and arranged to transmit motion from the handle portions to the shaft portions.
  • the clutch systems allow adjustment of the resistance force between the shaft portion and the handle portions.
  • the device comprises two shaft portions and locking means (6) that is structured and arranged to optionally lock or release the movement of the two shaft portions against each other.
  • the device comprises angular rotation sensors (4) to measure the angular position of the handles.
  • the device comprises a belt (7) to translate the rotation of the handles to the angular rotation sensors.
  • the device comprises torque sensors (5) to measure the torque which is applied by the patient. If the main shaft is locked, the sensors measure only the torque at the left or right side, applied by the left or right hand, respectively. When unlocking the main shaft, both sensors measure the same torque.
  • the exchangeable handle portions may have a form of a nut to simulate the movement of putting a screw and a nut together, or a form of a pen to simulate the movement of open/close a screwable pen, or a form of a crank handle, or comprise a lever, or comprise two pin simulating a different crank handle, or comprise a wheel, or a plate, or may simulate a key, or simulate a corkscrew, or simulate the bottom of a bottle or a big handhold, or simulate the upper part of a bottle or a small handhold
  • the device comprises a virtual reality system by projecting moving signals on a screen which have to be followed by the subject.
  • virtual reality is implemented for the training of uni-and bilateral daily living tasks.
  • implementation of virtual reality comprises fine to gross finger/hand movements.
  • Figure 1 shows a schematic illustration of an embodiment of a device for cooperative/non-cooperative hand movements
  • Figure 2 shows a schematic illustration of a second embodiment of a device for cooperative/non-cooperative hand movements
  • Figure 3 shows a technical drawing of an embodiment of a device for
  • Figure 4 shows various exchangeable handles of a device for cooperative/non- cooperative hand movements
  • Figure 5 shows EMG responses in muscles in both arms following unilateral non- noxious ulnaer nerve stimulation during cooperative training with the device of Figure 1 .
  • Figure 6 shows EMG responses in muscles in both arms following unilateral non- noxious ulnaer nerve stimulation during non-cooperative training with the device of Figure 1 .
  • B EMG response in muscles of left arm
  • the novel device allows to train cooperative and non-cooperative movements of either the hand and fingers or the whole arm for rehabilitative purposes.
  • the specific involvement of upper extremity muscles and joints during task completion and mode of bilateral cooperation is determined by the size of the exchangeable handle portions and the task to be performed by a virtual reality presentation and feedback information:
  • Fine finger and hand movements are involved by twisting a screw (one hand) in a nut (other hand or alternative device).
  • virtual reality is implemented for the training of daily living tasks.
  • This implementation of virtual reality should comprise fine to gross finger/hand movements.
  • the particular embodiments of the device shown below were chosen in order to have a simple device which allows for unilateral and bilateral (cooperative/non- cooperative) hand movements, respectively, and for sensing the most important biomechanical signals (torque and position of both sides).
  • Bilateral manipulative hand movements become coupled (cooperative) or uncoupled (non-cooperative) by the device.
  • the cooperative movements can be exerted at different force levels.
  • the device allows to train different daily living tasks.
  • the device represents a very compact solution, which results in the required mechanical stiffness and which allows an easy replacement of the handles and other mechanical components.
  • torque sensor, clutch portion and angular rotation sensor enable to record torques and rotation of the handles not only in the uncoupled but also in the coupled arrangement.
  • the device of Figure 1 may be used primarily for research purposes.
  • the device of Figure 2 is especially suited for the application as a training device.
  • Figure 1 shows a schematic illustration of a preferred embodiment of the device. It comprises by the following components:
  • Main shaft shown solid, implemented in a device by several shafts and couplings
  • Variable slipping clutches (adjustable by hand) 4) Angular rotation sensors to measure the angular position of the handles.
  • the sensors are mounted to the housing of a device.
  • Torque sensors to measure the torque which is applied by the subject. If the main shaft is locked in the middle, the sensors measure only the torque at the left or right side, applied by the left or right hand, respectively. When unlocking the main shaft, both sensors measure the same torque.
  • FIG. 2 shows a schematic illustration of a slightly modified embodiment of the device. This device comprises the following components
  • Main shaft shown solid, implemented in a device by several shafts and couplings
  • Angular rotation sensors to measure the angular rotation of the handles.
  • the sensors are mounted to the housing of a device on the one side and to the handles on the other side.
  • Torque sensors to measure the torque which is applied by the subject. If the main shaft is locked in the middle, the sensors measure only the torque at the left or right side, applied by the left or right hand, respectively. When unlocking the main shaft, both sensors measure the same torque.
  • Figure 3 shows a technical drawing of the device of Figure 1 . It comprises the following components:
  • Main shaft consisting of: 2.1 ) Coupling to connect the torque sensor with the slipping clutch.
  • Angular rotation sensors to measure the angular position of the handles.
  • the sensors are mounted to the housing of the device.
  • Torque sensors to measure the torque which is applied by the subject. If the main shaft is locked in the middle, the sensors measure only the torque at the left or right side, applied by the left or right hand, respectively. When unlocking the main shaft, both sensors measure the same torque.
  • Figure 4 shows the following examples of exchangeable handles of the device for unilateral and bilateral (non-cooperative or cooperative) hand movements:
  • the application of the device in the neurorehabilitation (e.g. stroke subjects) will be based on research studies to explore the effect of different manipulative tasks of both hands on the neuronal coupling/uncoupling of the two arms.
  • FIG. 5 A pilot study has been performed to asses if an unilateral nerve stimulation results in senseful bilateral arm muscle responses with the device of Figure 1 , by having the patient perform a movement equivalent to opening a bottle.
  • Figures 5 and 6 show the task-specific EMG responses in hand flexor and hand extensor muscles on both sides following unilateral non-noxious ulnaer nerve stimulation of the right hand, averaged over 18 stimulations.
  • the electrical stimulus was randomly released 100ms after the onset of cooperative (coupled mode) and non- cooperative (un-coupled mode) hand movements.
  • the EMG responses of the left hand muscles are
  • Non-noxious electrical stimuli may be applied in a random order to the dig. II and V/ ulnar nerve of the right hand, shortly after the start of an uni- (against the resistance force of the device instead of that of the contralateral hand) or bilateral opening/closing hand movement.
  • Upper and lower arm muscle EMG activity is recorded from both sides.
  • the reflex EMG responses to the stimuli are expected to be stronger in the muscles of both sides during a bilateral, cooperative task, indicating a neural coupling of the two arms.
  • transcranial magnetic stimuli may randomly be applied to the hand area of the right hemisphere, (triggered) shortly after the start of the non- cooperative/ cooperative movement.
  • the EMG responses in the arm muscles of both sides are expected to be stronger in the cooperative task. This is based on 1 . the anatomical evidence, that there are from each hemisphere strong neural connections to the contralateral-but also to the ipsilateral sides on supraspinal and spinal levels (14) which might play a major role during bilateral tasks and 2. on the fact of a task-dependent neuronal coupling of upper and lower limbs during locomotion (for review see (4)).
  • the device may be applied for rehabilitation purposes.

Landscapes

  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biophysics (AREA)
  • Epidemiology (AREA)
  • Pain & Pain Management (AREA)
  • Rehabilitation Therapy (AREA)
  • Animal Behavior & Ethology (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Rehabilitation Tools (AREA)
EP12724110.7A 2011-05-25 2012-05-16 Vorrichtung für kooperative handfunktionsübungen in der rehabilitation und entsprechende verfahren Withdrawn EP2713980A1 (de)

Priority Applications (1)

Application Number Priority Date Filing Date Title
EP12724110.7A EP2713980A1 (de) 2011-05-25 2012-05-16 Vorrichtung für kooperative handfunktionsübungen in der rehabilitation und entsprechende verfahren

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
EP11167554 2011-05-25
PCT/EP2012/059200 WO2012159970A1 (en) 2011-05-25 2012-05-16 Device for cooperative hand function trainings in rehabilitation and corresponding method
EP12724110.7A EP2713980A1 (de) 2011-05-25 2012-05-16 Vorrichtung für kooperative handfunktionsübungen in der rehabilitation und entsprechende verfahren

Publications (1)

Publication Number Publication Date
EP2713980A1 true EP2713980A1 (de) 2014-04-09

Family

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Family Applications (1)

Application Number Title Priority Date Filing Date
EP12724110.7A Withdrawn EP2713980A1 (de) 2011-05-25 2012-05-16 Vorrichtung für kooperative handfunktionsübungen in der rehabilitation und entsprechende verfahren

Country Status (3)

Country Link
US (1) US20140087921A1 (de)
EP (1) EP2713980A1 (de)
WO (1) WO2012159970A1 (de)

Families Citing this family (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20140274595A1 (en) * 2013-03-13 2014-09-18 Philip Patti Weightlifting bar system
JP6763541B2 (ja) * 2016-09-07 2020-09-30 株式会社イープル 関節運動訓練装置及び関節運動訓練方法
US10507155B1 (en) * 2017-01-13 2019-12-17 Gaetano Cimo Tremor suppression apparatus and method using same
US10195097B1 (en) * 2017-01-13 2019-02-05 Gaetano Cimo Neuromuscular plasticity apparatus and method using same
CN112206130B (zh) * 2020-11-10 2022-11-25 周彦丽 一种神经内科康复用训练装置
CN112973033A (zh) * 2021-03-30 2021-06-18 西安建筑科技大学 一种桌面式上肢康复作业训练器

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US3211453A (en) * 1962-11-21 1965-10-12 Will Hav Mfg Co Hand, wrist and arm exerciser
US5167596A (en) * 1992-03-02 1992-12-01 Dennis Ferber Hand-held exerciser
US5536223A (en) * 1994-06-27 1996-07-16 Ferber; Dennis A. Exercise device
US6773378B2 (en) * 2000-12-14 2004-08-10 Steven O. Ross Exercise device with true pivot point
EP1520605A1 (de) * 2003-10-03 2005-04-06 Michael Jeffery Amann Übungsvorrichtung und Handgriff für Übungsvorrichtung
EP1827349A1 (de) * 2004-11-30 2007-09-05 Eidgenössische Technische Hochschule Zürich System und verfahren für die kooperative armtherapie sowie rotationsmodul dafür

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Also Published As

Publication number Publication date
WO2012159970A1 (en) 2012-11-29
US20140087921A1 (en) 2014-03-27

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