EP2832336A1 - Orthopedic seat enabling to maintain a patient sitting in said seat in sitting position and half-standing position - Google Patents

Abstract

The present invention relates to an orthopedic seat. According to the invention, the seat (3) and the backrest (5) are rotatably mounted so that they can be arranged and locked alternately in a seated conformation and arranged and locked in a semi-standing conformation in which said rear edge (33) is lifted, said seat comprises knee support means (21, 23) which are shaped and arranged to receive the knees of a patient sitting on said seat, when the latter is in a semi-standing conformation, means maintaining the patient on said seat (3) and / or said backrest (5), said backrest (5) is equipped with first wedging means (91, 93) able to maintain the trunk of the patient in a determined position, said seat (3) is equipped with second wedging means (71, 73 and said backrest (5) is movably mounted in translation in a direction orthogonal to said front edge (31) of said seat (3).

Description

Technical area

The present invention relates to an orthopedic seat usable for the treatment of a patient suffering from cerebral palsy or hypotonia and for alternately maintaining the patient sitting on said seat in the sitting position and in the semi-upright position.

Prior art

Users / patients with cerebral palsy or hypotonia can not sit alone. They need an adapted orthopedic seat that keeps them seated in a sitting position. These patients are cared for by a physiotherapist. One of the physiotherapy exercises is to put the patient in a semi-upright position. The semi-upright position is defined throughout the present application, as being the position in which the bust of the user forms with his gathered thighs an angle substantially greater than or equal to 105 ° and substantially less than or equal to 125 °, preferably substantially equal to at 115 °, the knees are folded so that the calves form with the thighs an angle substantially equal to 90 ° and the feet form a substantially straight angle with the calves. The semi-upright position makes it possible to work the muscles of the patient, the latter being subjected to the weight of his body, in general, resting on his knees.

The document WO 2008065230 describes a device that allows a user sitting on a wheelchair to be placed in the standing position. This device on the one hand, allows the semi-upright position of the user and on the other hand, is to use in addition to the wheelchair, as any rehabilitation equipment.

The document US 2011/0084528 A1 discloses a lordosis treatment device which comprises a support, a seat and a folder movable in rotation relative to each other. This device also has knee supports. This device does not maintain the patient in a semi-upright position but allows the transition from sitting to standing. The swivel seat is used to treat lordosis. This type of device is not usable for patients with cerebral palsy or hypotonia.

The document GB 2,434,525 describes a device that allows the user to put himself in a semi-upright position and which comprises means forming a knee support. This device is not suitable for patients with cerebral palsy or hypotonia.

Objectives of the invention

An object of the present invention is to propose a single device that can be used for patients with cerebral palsy or hypotonia who serves both as an orthopedic seat for holding the patient in a seated position and as physiotherapy exercise equipment. re-education because of the possibility it offers to keep the patient in a semi-upright position.

Another object of the present invention is to provide a device as mentioned above that can be adapted to the size of the patient, whether it is a child or an adult, for example.

Summary of the invention

The present invention provides an orthopedic seat usable for the treatment of patients with cerebral palsy or hypotonia and for alternately maintaining the patient sitting on said seat in the sitting position and in the semi-standing position, said seat having a seat which has a free front edge and a rear edge, a backrest pivotally mounted on said rear edge, a support having a height which extends in a substantially vertical direction and which supports said seat, said seat being rotatably mounted on said support, said seat further comprising knee support means. According to the invention, typically, said seat and said backrest are rotatably mounted so as to be arranged and locked in a seat conformation in which said seat is substantially horizontal and said backrest substantially vertical and arranged and locked in a conformation semi-upright in which said rear edge is raised, said seat forms with a horizontal plane a first angle α substantially greater than or equal to 25 ° and substantially less than or equal to 55 ° and said backrest forms with said seat a second angle β substantially greater or equal to 105 ° and substantially less than or equal to 125 °, preferably substantially equal to 115 °, said knee support means are shaped and arranged to receive the knees of a patient sitting on said seat, when the latter is in semi-standing conformation, said backrest is equipped with first means of wedging able to maintain the trunk of the patient in a determined position, said seat is equipped with second wedging means able to hold the patient's hips and thighs in a determined position, said seat also comprises means for holding the patient on said seat and / or said backrest and said backrest is movably mounted in translation in a direction orthogonal to said front edge.

Thus according to the invention, the seat can move from the sitting conformation to the semi-upright conformation and vice versa, allowing both the maintenance of the patient in a sitting position and its holding in a semi-upright position for its treatment. The seat can therefore take the two abovementioned conformations, alternatively. The backrest is slidably mounted on the seat, it allows to adapt the depth of the seat to the size of the patient and especially allows to wedge the latter in a semi-upright position. Indeed, in the semi-upright position, the patient tends, despite the presence of the means of wedging hips and thighs to slide to the front edge of the seat and his back and often not well supported by the backrest. The fact of being able to reduce the depth of the seat makes it possible to wedge the patient on the seat of the invention.

According to the invention, the seat comprises locking means in position respectively of the seat on the support and the backrest on the seat which allow to maintain the seat in each of the aforementioned conformations. The seat support may advantageously be a rolling support.

The means of maintaining the patient on the seat are not limited according to the invention; it may be a belt attached to the seat and placed on the thighs or pelvis of the patient, a strap attached to the folder and passing in front of the bust of the patient, a combination of these two embodiments or a 3-point harness that passes over the shoulders of the patient and which is fixed at the level of his crotch.

Advantageously, the first and / or second wedging means are mounted adjustable in position on said backrest / said seat. The seat according to the invention can thus be adapted to the morphology of the patient.

Advantageously, the backrest has an adjustable height to adapt to the size of the patient.

Advantageously, the height of said support is adjustable in said vertical direction. It can thus be equipped with hydraulic or other cylinders or simply be formed of several assemblable elements, the number of assembled elements conferring a different height to the support.

Advantageously, said knee support means are slidably mounted relative to said seat, which facilitates the placement of the patient on the seat and the passage of the latter in a semi-upright position; it is thus also possible to vary the angle formed between the thighs and the calves. In addition, by spacing the means forming knee supports of the seat, they do not interfere with the patient, when the latter is in a sitting position.

According to a particular embodiment of the knee support means, they comprise on the one hand, at least one connecting rod whose one end is integral with said support and / or said seat and / or said backrest and the other end supports at least one support member which has a bearing face oriented towards said seat and which is adapted to receive the knees of a patient and secondly, in said semi-upright position, said support face is substantially perpendicular to said seat.

The knee support means may comprise a single support element which may be, for example a sufficiently large plate to receive the two knees placed side by side, or two separate support elements, each receiving a knee.

Advantageously, the support element is pivotally mounted on the end of said connecting rod, which makes it possible to vary the inclination of the support element and to adapt the knee support means to the morphology. of the patient and / or vary the angle formed by the calves and thighs.

Advantageously, said support element is mounted to move in translation on the end of said connecting rod in a substantially vertical direction, which makes it possible to vary the bearing surface of the knees and the position of the support element. according to the height of the seat.

The first and second wedging means are not limited according to the invention. It can be a shell or foam cushion, for example, custom-made for the patient. The shape of the cushion attached to the backrest keeps the chest while the seat cushion keeps the pelvis and thighs of the patient.

According to a particular embodiment, said first wedging means comprise a first and a second lateral backrest wedge, each disposed substantially at an edge of the backrest, substantially facing each other, said backrest lateral wedges extending substantially according to the height of said backrest and in a plane perpendicular to the latter, said backrest comprises a plurality of slots parallel to each other and to said front edge, which define at least one mounting zone, said first and second lateral backing wedges each comprise a plate mounting device disposed in abutment against said mounting area and said first wedging means further comprise fixing means which cooperate with said mounting plate and at least two of said slots of said mounting area for mounting said lateral wedges of folder on said folder.

Advantageously, the seat comprises two mounting zones located partly under the back of the patient and partly beyond his back, towards the longitudinal edges of the backrest, whereby the adjustment in position of the lateral backing wedges can be implemented. when the patient is placed on the seat.

The aforementioned fastening means are not limited according to the invention. It may be bolts and nuts, in which case the plate may have perforations. It may be fastening means that pinch the plate on the mounting area. The plurality of slots adjusts the width of the space between the two backrest wedges by moving the wedges along the length of a slot. It also makes it possible to adjust the inclination of the lateral wedges on the backrest, the plate can be fixed on two adjacent slots or be inclined so as to be fixed on two slots spaced by one or more other slots.

The shape of the backing wedges is not limited according to the invention. They are advantageously shaped to bear against the sidewalls of the patient, substantially at the armpits, for example.

According to another particular embodiment, which may or may not be combined with the preceding, the second wedging means comprise a first and a second lateral seat wedge which extend substantially according to the depth of said seat and in a perpendicular plane to the latter, said first and second lateral seat wedges are arranged face to face on said seat, said seat comprises at least a plurality of slots substantially parallel to said front edge and which define at least one mounting area, said first and second lateral seating wedges comprise a mounting plate disposed in abutment against said mounting zone and said second setting means further comprise fixing means which cooperate with said mounting plate and at least two of said slots for mounting said lateral seating wedges on said seat.

As previously explained with reference to the first wedging means, this embodiment makes it possible to modulate the inclination and the position in depth on the seat of the lateral seat blocks. The shape of the seat blocks is not limited according to the invention. They are high enough to come into contact with the thickness of the thigh of the patient and advantageously have a rear portion curved in a direction opposite to the seat and which can come into contact with the hips of the seated patient, thus stalling his pelvis in a specific ad hoc position. The arrangement of the mounting zone or zones is advantageously such that the position adjustment of the seat blocks can be done with the patient placed on the seat. The mounting area or areas will therefore advantageously placed partially on the part of the seat not covered by the seat cushion. The fixing means are as mentioned above.

Advantageously, said first and second wedging means further comprise cushions made from an impression of the body of the patient and fixed on said lateral backrest and / or seat wedges, said cushions having a shape complementary to the part of the patient's body against which they come in support. The cushions can be made by milling a block of foam, the recess made by milling exactly corresponding to the shape of the body of the patient. The hollow foam block is disposed on the seat, the first and second wedging means are disposed against the block at the same locations as for the patient; the block of foam is then cut and the parts located at the wedges are fixed on the latter, thus forming cushions which perfectly fit the area of the patient's body against which they rest. The attachment of the cushions may be implemented by gluing or by using fastening means comprising a plurality of hooks cooperating removably with a plurality of loops. The type of foam used is not limited according to the invention.

Advantageously, said second wedging means further comprise a central wedge disposed substantially at the middle of the free edge of said seat and adjustably mounted in position according to the depth of said seat. This wedge can be, for example deformable foam for more comfort of the patient. It may have a hole on its upper face so as to allow the mounting of a shelf above the seat.

Advantageously, the seat of the invention comprises footrests disposed in front of said front edge of said seat and lower than the latter. These footpads can, in said semi-upright position, be substantially perpendicular to said bearing surface of the support element of said knee support means. They can also be adjustable in height.

figures

• la Fig. 1 représente une vue en perspective d'un mode de réalisation de l'invention, l'assise et le dossier étant disposés dans une position intermédiaire à la position assise et à la position semi-debout ; et
• la Fig. 2 représente une vue de côté du siège de la Fig. 1.

The present invention, its features and the various advantages it affords will become more apparent on reading the following detailed description of a particular embodiment of the present invention, presented by way of nonlimiting example and which refers to the appended drawings in which:

• the Fig. 1 is a perspective view of an embodiment of the invention, the seat and the backrest being disposed in an intermediate position to the seated position and the semi-upright position; and
• the Fig. 2 represents a side view of the seat of the Fig. 1 .

detailed description

With reference to Fig. 1 and 2 , the seat of the invention comprises a base 1 on which is mounted a seat 3 equipped with a backrest 5. The base 1 comprises a base 11 which extends parallel to the ground S and comprises wheels 13. This base 11 ensures the stability of the seat on the ground S. The support 1 also extends in a vertical direction D, perpendicular to the ground S and which corresponds to the height of the seat and the height of the support 1. The base 11 comprises a vertical tube 15 whose length in the direction D is variable. The seat 3 is pivotally mounted on the end 17 of the tube 15 which is opposite to the base 11.

On the Fig. 1 and 2 , the seat 3 has a front edge 31, free and a rear edge 33, parallel to the front edge 31 and at which is mounted the backrest 5. The seat 3 is pivotally mounted on the end 17 of the tube 15 around the an axis of rotation parallel to the front edge 31. The seat 3 can therefore be tilted towards the front edge 31, the rear edge 33 being raised, or towards the rear edge 33, the front edge 31 being raised (the sitting is thus placed in comfort position, semi-recumbent).

With reference to the Fig. 1 , the seat 3 comprises at its front edge 31 two mounting areas, respectively 35 and 37 which are each disposed at a lateral edge of the seat 3. These mounting areas 35 and 37 comprise a plurality of slots which are all parallel to the front edge 31 and regularly spaced from each other, according to the depth of the seat 3.

As shown on the Fig. 1 , the seat 3 comprises lateral seat blocks 71 and 72. Each lateral seat cushion 71 and 72 comprises a plate 711 and 712 which extends vertically and according to the depth of the seat 3. The height of each plate 711 and 712 is adapted to wedge the thighs of the patient according to the thickness of the latter. Each plate 711, 712 has a rear portion bent upwards and oriented towards the backrest 5 to wedge the hips of the patient. The seat blocks 71 and 72 also comprise armrests 73. The plates 711 and 712 are each mounted on a mounting or mounting plate 75. The plate 75 has a vertical portion 751 which has a plurality of vertically disposed perforations. Each plate 711 and 712 is fixed on the vertical part 751 of a plate 75, the armrest 73 being fixed on a horizontal flange equipping the free end of the vertical part 751. Each plate 75 also comprises a horizontal part (not visible in the figures) which is in contact with the mounting area 35 or 37. This horizontal portion comprises two rows of perforations which allow to fix the plate 75 on the mounting area 35 or 37 by means of bolts and nuts. The plate 75 can thus be fixed, more or less far from the free edge 31 by choosing slots more or less distant from the free edge 31. The length of the slots also makes it possible to vary the angle formed by the two seat blocks 71 and 72 for the same position according to the depth of the seat 3.

As shown on the Fig. 1 , a central shim 74, foam is mounted on the seat 3, substantially at the front edge 31 of the latter. The seat 3 comprises a central slot which extends along its depth and opens at the front edge 31. The shim 74 is slidably mounted in this slot. A bolt-nut system keeps in position the shim 74 after adjustment.

With reference to Fig. 1 and 2 , the backrest 5 is mounted adjustable in position according to the depth of the seat 3. To do this, the seat 3 has two slots 311 (see Fig. 1 ) perpendicular to the front edge 31 and formed near the rear edge 33. The back 5 is slidably mounted in these slots 311. Locking means (not shown) to fix the position of the backrest on the seat. The backrest 5 also has two mounting zones 55 and 57 which are lateral and each disposed at a lateral edge of the backrest 5, substantially close to the upper edge 53 of the latter. The file 5 has a lower portion located at the seat 3 and an upper portion which comprises the two aforementioned mounting areas 55 and 57. The upper portion is slidably mounted on lateral and vertical strips 52, which allows to vary the height The two mounting zones 55 and 57 each comprise a plurality of slots parallel to each other and perpendicular to the height of the backrest 5.

As shown on the Fig. 1 , the backrest 5 has lateral backing wedges 91 and 93. These lateral backing wedges 91 and 93 are fixed by bolts and nuts, each on one of the mounting zones 55 and 57. Each wedge 91 and 93 comprises a plate 911 which extends perpendicular to the backrest 5 and according to the height of the latter. These plates 911 serve to maintain the bust of the patient and are arranged, when using the seat, on either side of the patient's trunk. Each plate 911 is mounted on a plate 95. The plate 95 has a portion 951 which is perpendicular to the backrest 5 is on which the plate 911 is screwed. The plate 911 and the plate 95 both comprise a plurality of perforations making it possible to adjust the space separating the file 5 from the thickness of the plate 911. Each plate 95 also comprises a flat horizontal portion 953 which is fixed on one of the The horizontal portion 953 comprises two rows of perforations which are traversed by bolts passing through the slots of the mounting zone 55, 57. Platinum 95 on the mounting area.

With reference to Fig. 1 and 2 , the seat also comprises means forming knee supports 2 which comprise two rods 21 mounted sliding under the seat 3. Screws 22 (see Fig. 2 ) allow to lock in position the rods 21 relative to the seat 3. The end of the rods 21 which is not mounted under the seat 3 is equipped with a support plate 23 adapted to receive both knees of the patient sitting on the seat of the invention. The rods 21 comprise a rectilinear portion 211 slidably mounted under the seat 1, a portion 212 forming an angle that brings the two rods 21 closer to each other and a U-shaped portion. The opening of the U of the U-shaped portion is oriented towards the seat 3. The free branch of the U supports the support plate 23. The support plate 23 is mounted rotatably on the rod 21 about an axis substantially parallel to the free edge 31 of the seat 3. The support plate 23 also has a fixing slot 231 (see Fig. 1 ) which extends along its width and allows the attachment of the support plate 23 on the rods 21. By moving the support plate 23 according to the slot 231, one can fix the support plate 23 more or less far the bottom U formed by the rods 21. The support plate 23 has a bearing surface 233 facing the seat 3 and whose inclination is adjustable.

As shown on Fig. 1 and 2 , the seat also includes footrests 61 and 63 which are mounted on a bow 18 of the support 1. They are thus adjustable in height on the support 1. The footrests 61 and 62 are inclined and form an angle substantially equal to 30 ° with soil S.

As shown on the Fig. 2 , the seat 3 forms a first variable angle α with a horizontal plane and therefore parallel to the ground S. On the Fig. 1 and 2 , the first angle α is substantially equal to 30 °. The backrest 5 has a lower edge 51 pivotally mounted on the rear edge 33 of the seat 3 and a free upper edge 53. The backrest 5 forms with the seat 3 a second angle β, variable and which is on the Fig. 1 and 2 substantially equal to 90 °. The aforementioned first and second angles vary independently of one another.

The seat of the invention also comprises locking means in position of the backrest and the seat respectively relative to each other and locking means of the seat relative to the support. These means are not visible in the figures. It may be pin, for example, or any other locking means.

A mode of use of the aforementioned embodiment of the seat according to the invention will now be described with reference to Fig. 1 and 2 .

The patient is installed on the seat of the invention. His back comes into contact with the backrest 5 (possibly covered with a cushion) while his thighs and his pelvis come to bear on the seat 3 (also covered with a possibly removable cushion). The position of the lateral backing wedges 91 and 93 and that of the lateral seat wedges 71 and 73 are then adjusted on the different mounting zones that are accessible even when the patient is installed on the seat. The mounting areas are not completely covered by the patient's body or by the cushion which covers possibly the seat 3 and / or the backrest 5. Preferably, the user is installed when the seat 3 is horizontal and the backrest 5 vertical. The feet of the patient are installed in the footrests 61 and 63. The rods 21 are slid so as to move the support plate 23 away from the seat 3, which does not interfere with the installation of the patient. The patient is then attached to the seat.

For the passage in semi-upright position, it is unlocked and rotates the backrest 5 so that it forms with the seat 3 an angle β substantially equal to 115 °. The seat 3 is then unlocked so that it can pivot on the support 1 about an axis parallel to its front edge 31. The rear edge 33 of the seat 3 is lifted. The patient being attached to the seat seat, it does not fall from the latter. The rods 21 are slid under the seat 3 so as to have the support plates 23 against the knees of the patient. The position of the rods 21 is blocked and the inclination of the bearing face 233 and the height position of the support plate 23 are adjusted on the rods 21 by sliding it along the fixing slot 231. the adapted position of the support plate 23 is determined, the support plate 23 is secured to the rod 21, that is to say blocked in rotation and in translation. The patient is thus placed temporarily in a semi-upright position.

To properly stall the back of the patient in a semi-upright position, the file 5 is slid towards the front of the seat so as to effectively support the patient at the lumbar level, in particular by pressing the backrest against the back of the patient. Optionally, it is still possible to adjust the position of the wedging means of the seat.

Claims (11)

Orthopedic seat usable for the treatment of patients with cerebral palsy or hypotonia and for alternately maintaining the patient sitting on said seat in the sitting position and in the semi-upright position, said seat having a seat (3) which has a free front edge (31) and a rear edge (33), a backrest (5) pivotally mounted on said rear edge (33), a support (1) which has a height which extends in a substantially vertical direction ( D) and which supports said seat (3), said seat being rotatably mounted on said support, said seat further comprising knee support means, characterized in that said seat (3) and said backrest (5) are movably mounted in rotation so as to be alternately arranged and locked in a seat conformation in which said seat (3) is substantially horizontal and said backrest (5) substantially vertical and arranged and locked in a semi-upright conformation in which said rear edge (33) is raised, said seat (3) forms with a horizontal plane a first angle α substantially greater than or equal to 25 ° and substantially less than or equal to 55 ° and said backrest ( 5) forms with said seat (3) a second angle β substantially greater than or equal to 105 ° and substantially less than or equal to 125 °, preferably substantially equal to 115 °, in that said knee support means (21, 23 ) are shaped and arranged to receive the knees of a patient sitting on said seat, when the latter is in semi-upright conformation, in that said backrest (5) is equipped with first wedging means (91, 93) adapted to keeping the trunk of the patient in a determined position, in that said seat (3) is equipped with second wedging means (71, 73) able to hold the patient's hips and thighs in a determined position, in that said seat comprises also means for maintaining the patient on said seat (3) and / or said back (5) and in that said backrest (5) is mounted mobile in translation in a direction orthogonal to said leading edge (31). Orthopedic seat according to claim 1, characterized in that said first and / or second wedging means (71, 73; 91, 93) are mounted adjustable in position on said backrest (5) / said seat (3). Seat according to any one of the preceding claims, characterized in that said knee support means (21, 23) are slidably mounted relative to said seat (3). Orthopedic seat according to any one of the preceding claims, characterized in that said knee support means (21, 23) comprise at least one connecting rod (21), one end of which is integral with said support (1) and / or of said seat (3) and / or said backrest (5) and the other end supports at least one support element (23) which has a bearing face (233) facing said seat (3) and able to receive the knees of a patient and in that said semi-upright position, said bearing face (233) is substantially perpendicular to said seat (3). Orthopedic seat according to claim 4, characterized in that said support element (23) is pivotally mounted on the end of said connecting rod (21). Orthopedic seat according to any one of claims 4 and 5, characterized in that said support member (23) is mounted to move in translation on the end of said connecting rod (21), substantially in said vertical direction (D ). Orthopedic seat according to any one of the preceding claims, characterized in that said first wedging means comprise a first and a second lateral backrest wedge (91; 93), each disposed substantially at an edge of the backrest (5). substantially opposite each other, in that said lateral backing wedges (91; 93) extend substantially along the height of said backrest (5) and in a plane perpendicular thereto, in that said backrest (5) comprises a plurality of mutually parallel slots (551; 571) and said front edge (31) defining at least one mounting area (55,57) in that said first and second backrest wedges (91; 93) each comprise a mounting plate (95) disposed in abutment against said mounting zone (55; 57) and in that said first wedging means further comprise fastening means which cooperate with said mounting plates (95) and at least two of said slots (551; 571) of said mounting area ( 55; 57) for mounting said lateral backrest wedges (91; 93) on said backrest (5). Orthopedic seat according to any one of the preceding claims, characterized in that said second wedging means comprise a first and a second lateral seat wedge (71; 72) which extend substantially according to the depth of said seat (3). and in a plane perpendicular to the latter, in that said first and second lateral seat wedges (71; 72) are arranged face to face on said seat (3), in that said seat (3) comprises at least a plurality of slots (351; 371) substantially parallel to said front edge (31) and defining at least one mounting region (35; 37), in that said first and second lateral setting blocks (71; 72) comprise a mounting plate (5) arranged in abutment with said mounting area (71; 72) and in that said second setting means further comprise fixing means which cooperate with said mounting plate (75) and at minus two desd these slots (351, 371) for mounting said lateral seat wedges (71; 72) on said seat (3). Orthopedic seat according to any one of claims 7 or 8, characterized in that said first and second wedging means further comprise cushions made from an impression of the body of the patient and fixed on said lateral wedges of backrest and / or seat and in that said cushions have a shape complementary to the body part of the patient against which they come in support. Orthopedic seat according to any one of the preceding claims, characterized in that said second wedging means further comprise a central wedge (74) disposed substantially at the middle of the free edge (31) of said seat (3) and adjustable mounting in position according to the depth of said seat (3). Orthopedic seat according to any one of the preceding claims, characterized in that it comprises footrests (61, 63) arranged in front of said front edge (31) of said seat (3) and lower than the latter and which are, in said semi-upright position, substantially perpendicular to said bearing face (233) of the support element (23) of said knee support means.

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