EP2949306B1 - Système de pré- et post-traitement de patients ayant une prothèse de la hanche - Google Patents

Système de pré- et post-traitement de patients ayant une prothèse de la hanche Download PDF

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Publication number
EP2949306B1
EP2949306B1 EP14170292.8A EP14170292A EP2949306B1 EP 2949306 B1 EP2949306 B1 EP 2949306B1 EP 14170292 A EP14170292 A EP 14170292A EP 2949306 B1 EP2949306 B1 EP 2949306B1
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EP
European Patent Office
Prior art keywords
support
patient
drive
leg
movement
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EP14170292.8A
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German (de)
English (en)
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EP2949306A1 (fr
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Ikonum & Co KG GmbH
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Ikonum & Co KG GmbH
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Publication of EP2949306A1 publication Critical patent/EP2949306A1/fr
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H1/00—Apparatus for passive exercising; Vibrating apparatus; Chiropractic devices, e.g. body impacting devices, external devices for briefly extending or aligning unbroken bones
    • A61H1/02—Stretching or bending or torsioning apparatus for exercising
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H1/00—Apparatus for passive exercising; Vibrating apparatus; Chiropractic devices, e.g. body impacting devices, external devices for briefly extending or aligning unbroken bones
    • A61H1/02—Stretching or bending or torsioning apparatus for exercising
    • A61H1/0237—Stretching or bending or torsioning apparatus for exercising for the lower limbs
    • A61H1/0244—Hip
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H1/00—Apparatus for passive exercising; Vibrating apparatus; Chiropractic devices, e.g. body impacting devices, external devices for briefly extending or aligning unbroken bones
    • A61H1/02—Stretching or bending or torsioning apparatus for exercising
    • A61H1/0237—Stretching or bending or torsioning apparatus for exercising for the lower limbs
    • A61H1/0244—Hip
    • A61H2001/0248—Hip by separating the legs laterally
    • 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
    • A61H2201/01—Constructive details
    • A61H2201/0119—Support for the device
    • A61H2201/0138—Support for the device incorporated in furniture
    • A61H2201/0142—Beds
    • 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
    • A61H2201/01—Constructive details
    • A61H2201/0173—Means for preventing injuries
    • A61H2201/0176—By stopping operation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/12—Driving means
    • A61H2201/1207—Driving means with electric or magnetic drive
    • A61H2201/1215—Rotary drive
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/14—Special force transmission means, i.e. between the driving means and the interface with the user
    • A61H2201/1481—Special movement conversion means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/14—Special force transmission means, i.e. between the driving means and the interface with the user
    • A61H2201/1481—Special movement conversion means
    • A61H2201/149—Special movement conversion means rotation-linear or vice versa
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/16—Physical interface with patient
    • A61H2201/1602—Physical interface with patient kind of interface, e.g. head rest, knee support or lumbar support
    • A61H2201/1623—Back
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/16—Physical interface with patient
    • A61H2201/1602—Physical interface with patient kind of interface, e.g. head rest, knee support or lumbar support
    • A61H2201/164—Feet or leg, e.g. pedal
    • 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
    • A61H2203/00—Additional characteristics concerning the patient
    • A61H2203/04—Position of the patient
    • A61H2203/0425—Sitting on the buttocks
    • A61H2203/0431—Sitting on the buttocks in 90°/90°-position, like on a chair
    • 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
    • A61H2203/00—Additional characteristics concerning the patient
    • A61H2203/04—Position of the patient
    • A61H2203/0425—Sitting on the buttocks
    • A61H2203/0437—Sitting on the buttocks with stretched legs, like in a bed
    • 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
    • A61H2203/00—Additional characteristics concerning the patient
    • A61H2203/04—Position of the patient
    • A61H2203/0443—Position of the patient substantially horizontal
    • A61H2203/0456—Supine

Definitions

  • the invention relates to a system for the prevention and aftercare of hip joint patients.
  • hip problems can occur in patients today. If these are diagnosed in good time and the diagnosis allows, targeted movement of the joint and muscles can have a preventive effect or at least alleviate the symptoms.
  • hip joint surgery up to the replacement of a hip joint. After an appropriate intervention, the patient is usually followed up.
  • Prevention and aftercare can be done through active movement, ie the patient moves his legs or joints himself. Often, however, the patient's active movement of the legs is limited or, at least temporarily, hardly possible in appropriate situations.
  • passive approaches can be added, either to support or to replace the active movement, at least until the patient is able to move again.
  • Mechanical aids can be used for passive movement, for example one or both legs of the patient.
  • the invention provides a system for pre-treatment and post-treatment of hip joint patients, comprising: a first support element that can be moved in a first plane, on which at least one leg of the patient or the body of the patient can be supported and fixed; a second support element which can be moved in a second plane, on which the patient's body or at least one leg of the patient can be supported and fixed; wherein the first and the second support element are movable relative to one another; at least one first drive for moving at least a part of the first or at least a part of the second support element relative to the second or relative to the first support element from a first position to a second position and back again, both the first and the second position in the first Level or in the second level.
  • the patient typically lies or sits on one of the two support elements.
  • One or both of the patient's legs accordingly lie on the other of the two support elements.
  • the leg in question belongs to the half of the patient's body that includes the hip joint to be treated before or after.
  • the leg to be treated is also referred to below.
  • the relationship between the leg and the hip joint to be treated should also be understood.
  • the patient's leg to be treated essentially points in the distal direction. The relative movement of the two support elements relative to one another makes it possible to move the patient's leg or legs relative to his body or to move the patient's body relative to his legs.
  • the first and / or the second support elements can comprise one or more parts, that is to say they can be constructed in several parts. At least one of the parts of the first and / or at least one of the parts of the second support element can be movable. In this way, a movement can be achieved, which essentially takes place in the first level or in the second level can. A back and forth movement between a first predefined position and a second predefined position can thereby be ensured.
  • the positions can be changed, for example a leg can gradually be moved further outwards from the center of the body.
  • Both support elements can also be moved in the course of a treatment, as a result of which great flexibility can be achieved.
  • the first and / or the second support element can comprise at least one support point and one support; wherein the patient's leg or the patient's body can be placed and fixed on the support; wherein the support can touch the support point and can be movable relative to the support point in a translatory and / or rotary movement in the first or in the second plane; wherein the at least one first drive can be designed to move the support with respect to the support point from the first position to the second position and back again.
  • the support point can be a fulcrum about which the support can be rotated.
  • the patient can sit on a rotating chair that is rotatable about the pivot point.
  • the first and / or the second support element can comprise a support surface and the support can comprise lubricants or rolling means with which the support can be slidable or rolling on the support surface.
  • the underlay can additionally be provided on its underside, for example, with a lubricious layer or film or plate as a lubricant or rollers as a rolling agent.
  • the friction for example static friction, sliding friction or rolling friction, of the support compared to the support surface can thus be reduced, so that the support can be moved more easily on the support surface. This means that as little kinetic energy as possible is lost due to friction on the contact surface.
  • the system can further comprise: at least one second drive for moving at least a part of the first or at least a part of the second support element relative to the second or relative to the first support element from a third Position in a fourth position and back again, both the third and the fourth position in the first level and in the second level.
  • Two movements can thus take place, on the one hand with the aid of the first support element from the first to the second position and possibly back again, and on the other hand with the aid of the second support element from the third to the fourth position and possibly back again.
  • Each of the two movements can be done independently of the other.
  • One or both movements can be stopped if necessary. If one of the two movements is stopped, the other movement can continue.
  • the first and / or the second support element can comprise a fixing element which is designed to fix the patient's leg on the first and on the second support element, respectively.
  • the second drive can move the first or the second support element relative to the second or relative to the first support element such that the movement between the third and fourth positions essentially in the direction of the longitudinal axis of the leg or in the direction of the longitudinal axis of the upper body of the Patient.
  • the movement of the first support element relative to the second support element can typically take place in such a way that the leg to be treated is carefully moved away from the patient's body.
  • An extension force / tensile force can be built up.
  • the first and / or the second support element can be locked so that a position once found can be held with a corresponding extension force.
  • the extension force / tensile force typically acts along the leg, ie in the direction of the patient's leg axis, in such a way that the patient's hip joint to be treated can be relieved.
  • the first drive can be designed in the system to control the movement path and / or the amplitude and / or the speed of the movement and / or the acceleration of the first or the second support element.
  • the second drive can be designed in the system to control the movement path and / or the amplitude and / or the speed of the movement and / or the acceleration of the first or of the second support element.
  • the first and / or the second drive can each comprise a control unit, for example a computer. However, a central control unit can also be present in the system. It is also possible to connect an external control unit to the system.
  • One or more of the following movement parameters can be controlled and monitored, for one or both drives: movement path, movement speed, change in movement speed, amplitude / deflection of the movement in the respective plane, predefined forces and duration of the movement. Changes to one or more of these movement parameters can be carried out at intervals, that is, for a predefined period of time corresponding to a predefined number of movements. This allows a great variability and adaptability of the system with regard to the specific conditions for the user / patient to be achieved.
  • the system can therefore also be used at different times and phases, for example in the early phases of the treatment or also in the more advanced phases of the treatment.
  • the system can thus be used for prophylaxis and / or for pre- and / or postoperative treatment.
  • the first drive and / or the second drive can be a manual and / or an electromechanical drive and / or a drive by means of force generation by spring preload, and / or pneumatic and / or hydraulic force generation and / or by force generation by means of own weight and / or by weights.
  • the different types of drive for the first and / or the second drive allow a desired extension force to be preset and applied in a simple and effective manner.
  • the preset extension force or tensile force can thus be kept practically constant or can be specifically varied during operation.
  • a suitable drive type for the first and / or the second drive can be selected.
  • the first and / or the second support element can comprise at least one guide means, wherein the support can be movable along the guide means.
  • the support can be moved in a controlled manner, that is to say guided, along a guide means, for example a guide rail or a guide rod or a guide groove.
  • a guide means for example a guide rail or a guide rod or a guide groove.
  • the support can comprise a slide that can be moved along the guide rail.
  • the first or the second drive can be provided on or on the support in such a way that the first or the second drive can / can move with the support.
  • the first or the second drive can move the support via a force transmission means, for example a drive belt or a chain.
  • the first and / or the second support element can comprise a first guide means and a second guide means, the support being movable along the first guide means and along the second guide means in the first and in the second plane and the movement of the support along the first guide means substantially perpendicular to the movement along the second guide means; wherein the first drive is designed to move the support along the first guide means and further with a third drive which is configured to move the support along the second guide means.
  • the support can be moved to the desired, predetermined coordinates, in particular Cartesian coordinates (x, y), by means of the first and the second guide means, which are provided perpendicular to one another.
  • the movements in the x direction or y direction can thus be decoupled.
  • the movement can take place automatically by means of the drives.
  • the type and design of the third drive can correspond to the first drive or the second drive.
  • the system can further comprise at least one control unit which can be designed to control the at least one first drive and / or the at least one second drive and / or the third drive and which can be designed to be used when the first and / or to monitor the forces occurring in the second support element and, if predefined tolerances and / or predefined maximum values of the forces are exceeded Switch off movement and relax the forces; and the system may further include an emergency shutdown that may relax forces upon intervention by the patient or a caregiver.
  • at least one control unit which can be designed to control the at least one first drive and / or the at least one second drive and / or the third drive and which can be designed to be used when the first and / or to monitor the forces occurring in the second support element and, if predefined tolerances and / or predefined maximum values of the forces are exceeded Switch off movement and relax the forces; and the system may further include an emergency shutdown that may relax forces upon intervention by the patient or a caregiver.
  • a safety shutdown can either be implemented separately and, for example, be independent of the control unit or be integrated in the control unit.
  • the safety shutdown can switch off the rotary or translational movement instantly if predefined maximum values of speed, amplitude, forces, extension force or frequency are exceeded.
  • Shutdown can also take place if deviations from the preset parameters, that is to say fluctuations, become greater than predefined tolerances allow.
  • the shutdown can also be triggered by the patient himself if the patient does not feel comfortable during the treatment.
  • the forces can be relaxed or completely switched off during a safety shutdown.Thus, the passive burden on the patient can be quickly reduced to practically zero and the treatment can be continued as soon as the parameters of the system or the patient's needs have been checked or the patient with the Want to continue treatment.
  • the control unit and / or the safety shutdown can be provided electromechanically in the system and / or comprise a computer.
  • the first support element can be a bed and the support of the second support element can be movable on the bed, the bed and the second support element forming a unit.
  • the Figure 1 shows a first embodiment of a system for preventive and follow-up care of hip joint patients.
  • a patient P lies on a first support element 11.
  • the support element 11 can be designed as a bed or bed.
  • a leg B of the patient P lies on a further, second support element 13.
  • the right leg B of the patient P is shown.
  • the left leg of patient P could also have been considered for all the exemplary embodiments shown.
  • the patient's hip to be treated is the right hip. Accordingly, it would be the left hip for the left leg.
  • the second support element 13 can, as in Figure 1 indicated, be shaped so that it can accommodate the patient's leg B and leg B can rest sufficiently firmly on or in the second support element 13 and can also enable the patient P to be as comfortable as possible.
  • the second support element 13 is movably provided on the first support element 11.
  • the second support element 13 lies practically on the first support element 11.
  • the surface of the first support element 11 can be prepared for a movement of the support element 13, so that the second support element 13 can slide or roll on the surface of the first support element 11.
  • the second support element 13 can, as indicated by arrows 15, be moved with the leg B resting on it essentially in the plane of the surface of the first support element 11. In particular, it can be moved from a first position to a second position and back again.
  • the first and second positions can each be predefined positions. However, the positions can be changed during treatment.
  • the movement of the second support element 13, on which the leg B rests, can typically be carried out carefully from the center of the body to the outside. As a result, leg B and thus the corresponding hip joint of the patient can be moved as part of a therapy.
  • the second support element 13 can be moved by means of a drive (not in Figure 1 shown).
  • the Figure 2A shows a further embodiment of a system for preventive and follow-up care of hip joint patients.
  • Figure 2B is a detailed view from the Figure 2A shown.
  • the support 21A is placed on a support point 21C on the support support 21B and can be rotated about the support point 21C.
  • the patient P does not lie on a couch, but lies or sits on or in a support element 21.
  • the support element 21 has in the Figure 2A the shape of a chair, such as a treatment chair.
  • the treatment chair 21 comprises a support 21A and a support point 21C and / or a support support 21B.
  • the pad 21A contacts the pad point 21C at the tip of the pad post 21B.
  • the support bracket 21B can be columnar or frustoconical.
  • the leg B of the patient P lies on a support element 23.
  • the support element 23 can be adjustable in height. The distance between the support element 23 and the treatment chair 21 can also be adjustable.
  • the support 21A can be rotated in relation to the support point 21C of the support support 21B.
  • the support point 21C is a fulcrum about which the support 21A is rotatable.
  • the movement of the support 21A with respect to the support point 21C of the support support 21B is indicated by the arrows 25.
  • the movement can take place again from a first position to a second position and back again.
  • the first and second positions can each be predefined positions.
  • the rotational movement of the support 21A with respect to the support point 21C of the support support 21B can be done by a drive.
  • the drive can be provided in the support 21B.
  • FIG 3 A further development of a system 30 for the prevention and aftercare of hip joint patients is shown.
  • the Figure 3 is based on that in the Figure 1 shown embodiment.
  • a patient P lies on a first support element 31, which can comprise a couch, for example.
  • the leg B of the patient P rests on a support element 33.
  • the reference numeral 35 designates arrows which indicate a movement of the support element 33 in the plane of the surface of the first support element 31.
  • an arrow 37 is shown.
  • An extension force / tensile force can be built up on the leg by moving the element 33 in the indicated arrow direction of the arrow 37.
  • the extension force typically acts along the leg in the direction of the patient's leg axis P.
  • the hip joint of the patient P to be treated can be relieved.
  • the force to be applied is a static force. That is, this force is typically held while movement of the support member 33 is carried out in the direction indicated by the arrows 35.
  • FIG 4 is a further development of the embodiment according to the Figures 2A and 2 B shown with different directions of movement.
  • a treatment chair 41 which is the treatment chair 21 from the Figures 2A and 2 B can correspond.
  • the patient P lies on a support 41A which touches a support point of a support bracket 41B.
  • the support 41B can be made of the support 21B Figure 2 correspond.
  • the point of contact (in Figure 4 not shown) can be the point of contact Figure 2B correspond.
  • the leg B of the patient P is placed on a support element 43.
  • the treatment chair 41 is rotatable with respect to the point of contact of the support bracket 41B. The rotational movement is indicated by the arrows 45.
  • a movement of the support element 43 is indicated by the arrow 47.
  • the movement of the support element 43 in the direction of the arrow 47 typically takes place along the leg axis of the patient P away from the body of the patient P.
  • an extension force can thus be applied to leg B of patient P.
  • Leg B can be suitably fixed on support element 43, for example with the aid of an ankle cuff or ankle cuff.
  • the extension force which is indicated by the arrow 47, can be held while the movement of the treatment chair, which is indicated by the arrows 45, can be carried out.
  • the patient's hip joint to be treated can thus again be relieved by the applied extension force while the movement is carried out in accordance with the arrows 45.
  • FIG 5 is a further development of the system according to the first embodiment Figures 1 and 3 shown.
  • a system 50 for pre- and post-treatment of hip joint patients is shown. Similar to the Figures 1 and 3rd Patient P lies on a support element 51. Leg B of patient P lies on a further support element 53. This support element is in Figure 5 but supported separately, for example (not shown here). A support can, for example, as in the Figures 2 or 4th be provided. A movement of the further support element 53 is indicated by the arrows 55. This is again a movement of the leg B of the patient P in the plane of the element 51.
  • the element 51 is in Figure 5 divided practically horizontally into two parts. The element 51 comprises an upper part 51A and a lower part 51B.
  • the patient lies on the surface of the upper part 51A.
  • the upper part 51A is movable relative to the lower part 51B.
  • the surface 51A can be moved substantially horizontally relative to the lower part of the element 51, which is designated by the reference symbol 51B. The movement can essentially take place in the direction of the longitudinal axis of the patient's upper body.
  • At least the upper part 51A of the support element 51 is moved away from the support element 53 in the direction of the arrow 57.
  • Leg B of patient P rests on support element 53 and is typically fixed there.
  • a tensile force can be applied to the leg to be treated and thus to the hip joint to be treated.
  • the hip joint of patient P can be relieved with the help of the tensile force / extension force.
  • the support element 53 can be moved independently of the movement of the upper part 51A of the support element 51, as indicated by the arrows 55.
  • the movement of the leg B carried out with the aid of the support element 53 is essentially independent of the tensile force applied to the leg B with the aid of the support element 51.
  • the Figure 6 shows a further embodiment of a system 60 for preventive and follow-up care of hip joint patients.
  • the patient sits in an upright position on the element 61.
  • the patient's legs essentially point downwards.
  • the patient practically takes a standing position.
  • the patient with the leg that is not to be treated can rest on a base element 61A.
  • the leg B to be treated is received by a support element 63.
  • the support element 63 can be moved outwards according to the arrows 65 from the center of the patient's body.
  • a drive 68 can be used, which can enable a rotary movement about a pivot point 68P.
  • weights 69 shown on the outside of the element.
  • the weights 69 can exert a tensile force on the patient's leg B to be treated due to their own weight.
  • leg B is typically suitably fixed in support element 63.
  • the tensile force can act essentially along the patient's leg axis.
  • the tensile force acts essentially independently of the movement of the support element 63, which is indicated by the arrows 65.
  • the traction is essentially is a static force and is held while the movement, which is substantially perpendicular thereto, of the element 63 can be carried out.
  • FIG 7A is a further development of the system according to the Figures 1 and 3rd shown.
  • a system 70 for preventive and follow-up care of hip joint patients A patient P lies on a first support element 71.
  • the leg B which is to be treated in the course of the treatment, lies on a further support element 73.
  • the support element 73 comprises a support 73A and a support surface 73B.
  • the support surface 73B is shown as being placed on the support element 71.
  • the support surface 73B can also represent a table surface, as exemplified in FIGS Figures 8A , 9 , 10A and 11A is shown.
  • a guide means 79 is shown on the support surface 73B.
  • the guide means 79 has teeth, so that it can be used as a toothed rack for a drive.
  • Leg B of patient P lies on a support 73A.
  • the pad 73A can in turn be suitably molded onto the shape of the patient's leg B.
  • a drive 78 is provided on the support 73A.
  • the drive 78 includes a gear 78A, for example.
  • the gear 78A of the drive 78 is designed such that it can mesh with the rack 79A of the guide means 79.
  • the pad 73A is movably provided on the pad 73B.
  • the drive 78 can engage the gear 78A in the rack 79A and move the support 73A in the plane of the support surface 73B.
  • Figure 7A also shows a holding element 76 with an element 76A movable in the holding element. These elements are in Figure 7B explained further.
  • FIG. 7B 10 is a detailed view of the embodiment of system 70 of FIG Figure 7A shown.
  • Leg B of patient P rests on support 73A.
  • the drive 78 can move the support 73 along the guide means 79 by means of the gear 78A.
  • the gear 78A of the drive meshes with the rack 79A.
  • the drive can be a manual or an electromechanical drive.
  • Element 76 includes an ankle cuff 76F and, for example, a support rod 76A.
  • this handrail is configured such that the foot cuff can be attached to the handrail 76A.
  • the support rod 76A can be inserted in a piston-like manner in a cylinder 76B.
  • Element 76 may further include a drive. This allows the support rod 76A to be moved hydraulically or pneumatically. By applying a hydraulically or pneumatically generated force, a tensile force can be exerted on the leg B via the holding rod 76A can be transmitted if the leg B is fixed to the support rod 76A with the foot cuff 76F. It is also possible to generate an extension force with weights or own weights, as in Figure 6 explained in more detail.
  • FIG 8A is a further development of the system according to the Figures 1 and 3rd outlined.
  • the system 90 for pre- and post-treatment of hip joint patients as in Figure 8A shown is a variant of the drive from the Figures 7A and 7B shown.
  • the structure shown essentially shows that in Figure 7A shown construction.
  • the patient P lies on a support element 91.
  • the leg B to be treated lies on a further support element 93.
  • the support element 93 is designed, for example, like a table with table legs with rollers 93L.
  • a support 93A is movably provided on a support surface 93B of the support element 93.
  • a guide means 99 is similar to the guide means 79 in FIG Figure 7A and 7B arched.
  • a drive 98 is provided on the pad 93A and is as in FIG Figure 7A and 7B moved with the edition 93A.
  • a holding element 96 with a holding rod 96A corresponds to the holding element 76 and the element 76A Figure
  • the drive 98 has a gear 98A which drives a toothed belt 99A.
  • the toothed belt 99A is connected to the guide means 99. It runs around one or more deflection rollers 93C.
  • the gear 98A By driving the gear 98A, the driving force of the drive 98 is transmitted to the toothed belt and thus to the guide means 99.
  • the pad 93A is moved in the plane of the surface of the table 93B.
  • a pulling force can be applied again by means of the holding element 96.
  • An electric, pneumatic or hydraulic drive can be used, as in Figure 7A and 7B shown. It is also possible to provide a drive with springs or weights.
  • FIG 9 shows a further development of the system for the prevention and aftercare of hip joint patients according to Figure 8A .
  • system 90 'is shown system 90 'is similar to system 90 Figure 8A .
  • couch 91 shown is in Figure 9 Not shown. It goes without saying that the lounger is made of Figure 8A for a system 90 'as in Figure 9 shown, can be used.
  • a table 93 ' is shown which is similar to table 93 of Figure 90A.
  • the table 93 ' can be placed on a bed 91 or on a corresponding support element such as a bed. In particular, the table can be pushed over at least part of the bed 91 so that a table top plate 93B 'is above the bed surface of the bed.
  • the table 93 ' is provided with swivel castors 93L on its legs.
  • the swivel castors 93L can be rotated through 360 °.
  • the table 93 'can be moved up and positioned as desired on a bed, a bed or a suitable support element.
  • the swivel castors 93L can be locked.
  • the table 93 'can thus be locked in a certain position.
  • the table 93 'can be adjustable in height to match the height of the bed 93 Figure 8A or to be adapted to the additional height of a patient lying on the couch 93.
  • the table 93 'in Figure 9 includes platen 93B '.
  • the support plate 93B ' is typically fixed on a frame.
  • a support surface 93C' is shown on the support plate 93B '. This can be fixed in relation to the support plate 93B '.
  • the bearing surface 93C ' is similar in shape to a section from a circular ring.
  • a guide means 99 is provided on the support surface 93C ', which guides the guide means 99 from the Figures 8A and 8B corresponds.
  • the guide means 99 is in Figure 9 formed in the form of a guide rail.
  • a support 93A ' is provided on the support surface 93C'.
  • the pad 93A 'can slide or roll along the guide means with a castor.
  • the pad 93A 'can slide or roll on the pad 93C'.
  • the support surface 93C 'can have rollers on its underside with which it contacts the support surface 93C'.
  • a drive 98 is shown.
  • the drive 98 can move the support 93A 'by means of a toothed belt, cf. Figure 8B .
  • the drive is provided on the support 93A ', so that the drive 93A' follows the movement of the support 93A '. For example, a movement of the support 93A 'relative to the support surface 93C' can take place continuously.
  • the support 93A ' comprises guides 93F' which hold a support plate 93P1, 93P2.
  • the support plate 93P1, 93P2 can be made in several parts. In the example shown in Figure 9 the platen includes a knee pad 93P2 and a foot pad 93P1.
  • the support plate 93P1, 93P2 can be displaced perpendicular to the guide means 99 in order to be able to adapt the support to the leg B of the patient P.
  • Figure 9 also shows a support bar 96A 'as a fixative.
  • a foot cuff can be attached to it, which can be attached to the patient's foot.
  • a control and monitoring unit (not shown), for example a computer or control device, can control the movement of the drive 98 in accordance with a predetermined program, so that the movement of the support 93A 'and thus of the patient's leg lying on it can be carried out repeatedly is.
  • the control and monitoring unit can control and change the amplitude of the movement of the support and / or the frequency of the movement of the support 93A ', for example according to a predetermined treatment plan.
  • FIGS Figures 10A and 10B is a further development of the system according to Figures 1 and 3rd shown.
  • the patient P lies on a first support element 81.
  • the leg B to be treated lies on a second support element 83.
  • the second support element 83 comprises a support surface 83B, which is part of a table that approaches the first support element 81 can be rolled.
  • the table corresponds to the table as in Figure 8A shown.
  • the table has legs with castors 83L.
  • a support 83A is movably provided on the support surface 83B.
  • the pad 83A may be adapted to a shape of a leg.
  • a guide means 89 is provided in the form of a guide rod.
  • This guide rod 89 is essentially straight.
  • a drive 88 enables the support 83A to move along the guide rod 89.
  • the guide rod 89 guides the support 83A substantially linearly in the plane of the support surface 83B.
  • a suitable translatory movement for moving the leg B of the patient P can thus be provided.
  • the drive is in Figure 10B explained in more detail.
  • the support 83A shown has a groove or elongated hole 83L in its front part.
  • a guide body 89A is provided on the rod 89.
  • This guide body 89A has a pin 89B which engages in the groove or the elongated hole 83L.
  • the drive 88 can drive the guide body 89, for example, by means of a thread.
  • the guide rod 89 can be designed as a threaded rod.
  • the guide body 89A is moved along the guide rod 89.
  • the drive 88 is provided stationary on the side of the table.
  • FIGS Figures 11A and 11B are a further development of the system according to Figures 1 and 3rd shown.
  • the embodiment in the Figures 11A and 11B is similar to the embodiment shown in FIGS Figures 10A and 10B is shown.
  • the Figures 11A and 11B shows a system 100 for the prevention and aftercare of hip joint patients, which has an alternative drive in comparison to the drives that the Figures 7A , 7B , 8A , 8B , 9 , 10A and 10B are shown by way of example.
  • the patient lies down P on a first support element 101.
  • the leg B to be treated lies on a second support element 103.
  • the second support element 103 comprises a support surface 103B which is part of a table.
  • the table can be rolled up to the first support element 101.
  • the table corresponds to the table as in Figure 10A shown.
  • the table includes table legs with 103L castors.
  • a support 103A is movably provided on the support surface 103B.
  • the pad 103A may be adapted to a shape of a leg.
  • a guide means 109 is provided in the form of a guide rod. This guide rod 109 is essentially straight.
  • Another guide rod 111 is provided essentially parallel to the guide rod 109.
  • the guide rods 109 and 111 guide the support 103A substantially linearly in the plane of the support surface 103B.
  • a suitable translatory movement for moving the leg B of the patient P can thus be provided.
  • a drive 108 enables the support 103A to be moved along the guide rods 109 and 111.
  • the support 103A is not provided directly on the guide rods 109 and 111, but is provided on a further guide means 112.
  • the guide means 112 comprises, for example, a frame 112R and a guide rod 112S.
  • the guide rod 112S is provided substantially perpendicular to the two guide rods 109 and 111.
  • the guide rods 109 and 111 are suitably connected to the guide means 112. For example, they run guide rods 109 and 111 through frame 112R.
  • the support 103A is suitably connected to the guide rod 112S so that the support 103A is movable by means of the guide rod 112S.
  • pad 103A is connected to guide rod 112S at at least one point 112F with a suitable fastener.
  • Movement by means of the guide rod 112S is indicated by arrow 110P in FIGS Figures 11A and 11B indicated.
  • the other movement (ie perpendicular to the first movement 110P) by means of the guide rods 109 and 111 is indicated by the arrow 108P.
  • the two directions of movement are perpendicular to each other in this plane.
  • the two directions of movement, which are indicated by the arrows 108P and 110P are decoupled by the construction used with the aid of the guide rods 109 and 111 on the one hand and the guide rod 112S on the other.
  • the arrows 108P and 110P can be identified, for example, with x and y coordinates or coordinate axes.
  • the guide means 112 can comprise a drive 110.
  • the guide rod 112S can be driven by the drive 110.
  • the drive 110 can be provided similar to the drive 108.
  • the drive 110 is not moved when the support 103A is moved in the direction of the arrow 110P by means of the guide rod 112S.
  • the guide means 112 is also moved when the support 103A is moved by means of the guide rods 109 and 111.
  • FIG 11A is also similar to that in the Figures 7A , 7B , 8A , 8B , 10A and 10B a foot cuff 106F is shown.
  • the foot cuff can be suitably attached to a handrail (not shown).
  • the foot cuff can be hung over the handrail.
  • a drive can also be provided.
  • the holding rod can thus be moved hydraulically or pneumatically, for example.
  • the direction of movement is indicated by arrow 106P.
  • a tensile force can be transmitted to the leg B by means of the drive, provided the leg B is fixed to the support rod with the foot cuff 106F. It is also possible to generate an extension force with weights or own weights, as in Figure 6 explained in more detail.
  • the drives 108 and 110 shown can be controlled by means of at least one control and control unit, for example a computer. It goes without saying that such a control and control unit can be combined with all the embodiments shown.
  • the control and control unit can control each of the drives in all shown embodiments.
  • the control and control unit can be integrated into the system and, for example, can be combined with one or more of the drives or as a separate unit that communicates with the drives via signal lines or wirelessly. It is also possible to use an external computer, for example a laptop, tablet PC or a suitable smartphone for control.
  • the control and monitoring unit monitors the forces occurring during the movement of the leg, both for the movement of the support and for the extension force.
  • at least one or more of the drives can include a safety shutdown. If forces occur during the movement of the leg that exceed predefined tolerances and / or predefined maximum values, the respective movement of the leg can be switched off automatically. The extension force can thus be relaxed and movement of the leg can either be stopped immediately or the leg can be carefully moved back to the starting position.
  • the safety shutdown can also include an emergency button for the patient. If the patient feels, for example, the movement of his leg and / or the extension force as too stressful or painful, he can switch off the respective drives and the associated forces manually.
  • a safety device for example a Emergency stop switch may be provided. For example, the patient can have a separate emergency stop button in hand or within reach. With the help of this emergency switch, the patient can independently switch off the drives quickly.

Landscapes

  • Health & Medical Sciences (AREA)
  • Epidemiology (AREA)
  • Pain & Pain Management (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Rehabilitation Therapy (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)
  • Accommodation For Nursing Or Treatment Tables (AREA)

Claims (13)

  1. Système (10, 20, 30, 40, 50, 60, 70, 80, 90, 90', 100) pour le pré et post-traitement des patients ayant une prothèse de la hanche, comprenant
    un premier élément de support (11, 21, 31, 41, 51, 61) qui est mobile dans un premier plan, sur lequel au moins une jambe (B) d'un patient (P) ou le reste du corps du patient (P) peut être soutenu et fixé sans ladite au moins une jambe (B);
    un deuxième élément de support (13, 23, 33, 43, 53, 63) qui est mobile dans un deuxième plan, sur lequel le reste du corps du patient (P) peut être soutenu et fixé sans la ou les jambes (B) du patient (P);
    dans lequel les premier et deuxième éléments de support sont mobiles l'un par rapport à l'autre; et
    au moins un premier entraînement pour déplacer au moins une partie du premier élément d'appui par rapport au deuxième élément d'appui ou au moins une partie du deuxième élément d'appui par rapport au premier élément d'appui, dans chaque cas d'une première position à une deuxième position et inversement, la première position et la deuxième position se trouvant toutes deux dans le premier plan ou toutes deux dans le deuxième plan; de telle sorte qu'au moins une jambe du patient est mobile par rapport au reste du corps du patient (P) sans ladite au moins une jambe (B) ou que le reste du corps du patient (P) sans ladite au moins une jambe (B) est mobile par rapport à ses jambes;
    au moins un deuxième entraînement pour déplacer au moins une partie du premier élément de support par rapport au deuxième élément de support ou au moins une partie du deuxième élément de support par rapport au premier élément de support, d'une troisième position à une quatrième position et inversement;
    dans lequel la troisième et la quatrième position se trouvent toutes deux dans le premier plan ou toutes deux dans le deuxième plan;
    dans lequel le premier plan correspond au plan de la surface du premier élément de support et le deuxième plan correspond au plan de la surface du deuxième élément de support;
    dans lequel le deuxième entraînement déplace le premier élément de support par rapport au deuxième élément de support ou le deuxième élément de support par rapport au premier élément de support de telle sorte que le mouvement entre les troisième et quatrième positions se fasse sensiblement dans la direction de l'axe longitudinal de ladite au moins une jambe ou dans la direction de l'axe longitudinal du haut du corps du patient de telle sorte qu'une force d'extension soit accumulée le long de la jambe;
    dans lequel, lors du déplacement d'au moins une jambe du patient de la première à la deuxième position et de nouveau par rapport au reste du corps du patient (P) sans qu'au moins une jambe (B) ne maintienne la force d'extension accumulée.
  2. Système selon la revendication 1,
    dans lequel lesdits premier et/ou deuxième membres de support comprennent chacun au moins un point de support (21C) et un support (21A, 41A, 73A, 83A, 93A, 93A', 103A);
    dans lequel la jambe du patient ou le reste du corps du patient (P) peut être posé et fixé sur le support sans la jambe (B);
    dans lequel le support (21A, 41A, 73A, 83A, 93A, 93A', 103A) est en contact avec le point d'appui (21 C) et est mobile par rapport au point d'appui (21 C) dans un mouvement de translation et/ou de rotation dans le premier ou le deuxième plan; et
    dans lequel ledit au moins un premier entraînement (68, 78, 88, 98) est adapté pour déplacer le support (21A, 41A, 73A, 83A, 93A, 93A', 103A) par rapport au point d'appui (21C) de la première position à la deuxième position et inversement.
  3. Système selon la revendication 2, dans lequel le point d'appui est un point de pivot autour duquel le support peut tourner.
  4. Système selon la revendication 2, dans lequel le premier et/ou le deuxième élément de support comprend une surface de support (73B, 83B, 93B, 93B') et le support comprend des moyens de glissement ou de roulement par lesquels le support est mobile par glissement ou roulement sur la surface de support (73B, 83B, 93B, 93B').
  5. Système selon la revendication 1, dans lequel le premier et/ou le deuxième élément de support comprend un élément de fixation (76F) adapté pour fixer ladite au moins une jambe du patient sur le premier ou le deuxième élément de support, respectivement.
  6. Système selon au moins une des revendications 1 à 5, dans lequel le premier entraînement est conçu pour contrôler la trajectoire de mouvement et/ou l'amplitude et/ou la vitesse de mouvement et/ou l'accélération du premier ou du deuxième élément de support.
  7. Système selon au moins l'une des revendications 1 ou 6, dans lequel le deuxième entraînement est conçu pour contrôler la trajectoire de mouvement et/ou l'amplitude et/ou la vitesse de mouvement et/ou l'accélération du premier ou du deuxième élément de support.
  8. Système selon au moins une des revendications 1 à 7, dans lequel le premier entraînement et/ou le deuxième entraînement comprend un entraînement manuel et/ou électromécanique et/ou un entraînement par génération de force par précontrainte de ressort, et/ou une génération de force pneumatique et/ou hydraulique et/ou une génération de force par poids mort et/ou par poids.
  9. Système selon au moins une des revendications 2 à 8, dans lequel le premier et/ou le deuxième élément de support comprend au moins un moyen de guidage, dans lequel le support est mobile le long du moyen de guidage.
  10. Système selon la revendication 9, dans lequel le premier ou le deuxième entraînement est prévu sur ou à l'appui, de telle sorte que le premier ou le deuxième entraînement se déplace avec l'appui; ou
    dans lequel le premier ou le deuxième entraînement déplace le support par l'intermédiaire d'un moyen de transmission de puissance (99A) tel qu'une courroie ou une chaîne d'entraînement.
  11. Système selon les revendications 9 ou 10, dans lequel le premier et/ou le deuxième élément de support comprend un premier moyen de guidage (109, 111) et un deuxième moyen de guidage (112, 112S), dans lequel le support est mobile le long du premier moyen de guidage (109, 111) et le long du deuxième moyen de guidage (112) dans le premier et dans l'autre cas dans le deuxième plan, et le mouvement du support (103A) le long du premier moyen de guidage (109, 111) est sensiblement perpendiculaire au mouvement le long du deuxième moyen de guidage (112, 112S); dans lequel ledit premier entraînement (108) est adapté pour déplacer ledit support (103A) le long dudit premier moyen de guidage (109, 111), et comprenant en outre un troisième entraînement (110) conçu pour déplacer ledit support (103A) le long dudit deuxième moyen de guidage (112, 112S).
  12. Système (1) selon la revendication 11, comprenant en outre au moins une unité de commande qui est conçuée pour commander ledit au moins un premier entraînement et/ou ledit au moins un deuxième entraînement et/ou le troisième entraînement et qui est conçue pour surveiller les forces se produisant pendant le mouvement du premier et/ou du deuxième élément de support et pour arrêter le mouvement et relâcher les forces lorsque des tolérances prédéfinies et/ou des valeurs maximales prédéfinies des forces sont dépassées; et comprenant en outre un arrêt d'urgence qui peut relâcher les forces lors de l'intervention du patient ou d'un soignant.
  13. Système (1) selon l'une des revendications 2 à 12, dans lequel le premier élément de support est un canapé et le support du deuxième élément de support est mobile sur le canapé de sorte que le canapé et le support forment une unité.
EP14170292.8A 2014-05-28 2014-05-28 Système de pré- et post-traitement de patients ayant une prothèse de la hanche Active EP2949306B1 (fr)

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DE102015119395A1 (de) * 2015-11-11 2017-05-11 Universität Rostock Bewegungsschiene zur Mobilisierung eines Knie- und/oder eines Hüftgelenks
CN106859920A (zh) * 2017-04-25 2017-06-20 洛阳理工学院 一种多功能髋关节康复机
CN108771607B (zh) * 2018-06-13 2021-02-05 青岛大学附属医院 一种产后盆骨底肌肉修复训练器材
CN112515917B (zh) * 2020-12-04 2022-07-22 吉林省前卫医院 一种用于脑梗死患者下肢康复的自动化锻炼装置

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US3661149A (en) * 1970-05-27 1972-05-09 Charles A Ferries Mechanical exercising device
DE4132818A1 (de) * 1991-10-02 1993-04-08 Knoll Ernst Feinmech Bewegungsschiene
US5300090A (en) * 1992-09-03 1994-04-05 Challenge Machinery (Proprietary) Ltd. Exercise machine
JP4487054B2 (ja) * 1998-12-17 2010-06-23 バイオフィリア研究所有限会社 下肢機能訓練装置
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