EP3651712B1 - Therapeutic walking trainer - Google Patents

Description

The invention relates to a therapeutic walking trainer. Such gait trainers are intended to help patients who have had hip surgery or who have suffered a stroke to learn how to walk naturally again.

The natural gait cycle consists of a stance phase and a swing leg phase. A gait cycle begins and ends with heel strike. The stance phase includes three sub-phases: a touchdown or landing phase, a stance phase and a push-off phase. The swing leg phase is divided into an early swing leg phase, in which the foot lifts off the ground and the lower leg swings backwards and upwards until the knee joint is flexed by about 60 to 80 degrees. In the subsequent middle swing leg phase, the leg is brought forward in a bent posture with a knee flexion of 60 to 80 degrees. In the final swing leg phase, the foot is now lowered back towards the ground or towards a walking surface, whereby the heel touches down first again.

Stroke patients are usually able to initiate the swing leg phase. Often, however, your own activity is not (yet) sufficient to carry out all sub-phases of the swing leg phase.

the JP 2004 337 275 A describes a gait exerciser that includes two bases with a tread that can be moved back and forth. Here is only the heel - spring-loaded - can be lifted, the front part is provided with a hinge and thus remains stationary with respect to the movable part of the foot receptacle. In the DE 197 25 973 A1 an analogous structure is shown. In the DE 10 2008 007 580 A1 a training device for human gait variants is shown. Also the JP 3 009 889 B1 describes a gait exerciser that is only equipped to lift the heel portion.

Another walking trainer is in the WO 2009/035 176 A1 described, in which a tread is present, which - analogous to a foot lifter - can raise the toe or forefoot separately.

It is therefore the object of the present invention to provide the user with a therapeutic gait trainer that supports him or her even better in (re)learning a natural gait cycle.

This object is achieved with a therapeutic walking trainer having the set of features according to patent claim 1 . Advantageous configurations with expedient developments of the invention are specified in the dependent claims.

For this purpose, in particular, a foot receiving part for receiving at least a partial area of the forefoot of a user or for forming a connection with a toe of a shoe, with at least one base support that can be moved in and/or counter to an adjustment direction, and with an actively and/or passively operable adjustment unit for the relative , Substantially perpendicular to the adjustment oriented adjustment of the foot receiving part with respect to the at least one base support.

This has the advantage that users who have difficulties in moving the bent leg forward in the swing leg phase are offered support. In this phase, the therapeutic walking trainer has a supporting effect by moving or moving in and/or against the direction of adjustment.

In order to allow the user's foot to roll naturally during the stance phase, it has proven to be useful if a free space is formed in or on the basic support, and if the free space is designed in such a way that a base area or a walking area can be walked on by at least part of the user's foot. In a mobile version, this base area or walking area can be the floor, for example, or in a stationary version it can also be the (endless) belt of a treadmill. So that's the end of the therapeutic walking trainer can be operated in a stationary manner, in which case the base support itself does not have to move through space, but instead the walking trainer moves relative to the treadmill surface.

According to the invention, the base support has a tread surface which is designed in such a way that the user's foot or the shoe can step on it. The dimensions of this stepping surface are selected such that a human foot can preferably stand flat on it without protruding beyond the base surface of the base support.

According to the invention, a drive device is assigned to the base support for motorized adjustment or movement of the base support in and/or counter to the adjustment direction. Thus, the forward movement of the user, in particular the swinging leg, is supported by a motor. This motor is preferably in the form of an electric motor that is powered by an accumulator or some other energy source.

Alternatively or additionally, a tension element or a pressure element is provided. A cable, a cord, a chain or the like can be used as a traction element. A preferably rigid pressure rod can be used as the pressure element. The traction element or the pressure element can be operated by a therapist during training, with the swing leg phase of the user or patient being supported by the traction element or the pressure element. In order to swing the foot positioned in the gait trainer in the swing leg phase, the therapist pulls or presses the gait trainer forward with the tension element in the adjustment direction until the patient's heel touches the walking surface again.

In a preferred embodiment, the tension element or the pressure element is coupled or can be coupled to the base support, as a result of which the base support can be pushed, pulled or pushed in and/or counter to the direction of adjustment. This ensures that the traction element can attack at or below the center of gravity of the therapeutic walking trainer in order to avoid tilting.

In another advantageous embodiment of the therapeutic gait trainer, the tension element or the pressure element is or can be coupled to the support bracket in such a way that the base bracket can be pushed, pulled or is pressable.

Some stroke patients are unable to move their anterior shin muscle or the drop foot, which may lead to the so-called stepper gait. In order to support the patient when lifting the foot, it is provided according to the invention that the adjustment unit comprises a support bracket connected at one end to the base bracket and at the other end rotatably or non-rotatably to the foot receiving part. An actuator is assigned to the foot receiving part and/or the support bracket, by means of which the foot receiving part and/or the support bracket can be adjusted between a raised position and a lowered position relative to the base bracket. The adjustment can be done stepwise or continuously. However, stepless adjustment is preferred for fluid raising and lowering of the forefoot. If the foot-receiving part is connected to the support bracket in a rotationally fixed manner, then the foot-receiving part can receive the tip of the foot, so that the foot can be inclined due to the elasticity of the toe. Even if the preferably detachable connection of the toe of the shoe to the foot receiving part is set up, the toe can be elastically deformed—as in the case of a cross-country ski binding. This elastic toe allows the sole of the foot to be tilted or pivoted in relation to the support carrier. In the case of a non-rotatable coupling of the foot receiving part to the support beam, these two components can also be formed in one piece as a foot support beam.

The actuator can additionally be provided with an actuator drive for motorized adjustment of the foot receiving part and/or the support beam. In this embodiment, it is then preferably formed by an electric motor Actuator drive realized that can adjust the support beam and / or the foot receiving part between a raised position and a lowered position. In other words, the actuator acts as a foot lifter. In a healthy person, this task is performed by the tibialis anterior muscle.

In this context, it has proven to be useful if the tension element or the pressure element is coupled or can be coupled to the actuator, that by actuating the actuator by means of the tension element or by means of the pressure element, the foot receiving part and/or the support beam can be moved between the raised and the lowered Position can be adjusted, and that the base support can be pushed, pulled or pushed in and/or counter to the direction of adjustment by actuation of the actuator by means of the tension element or by means of the pressure element. Thus, the actuator can fulfill two different tasks at the same time, namely on the one hand that of a foot lifter, in particular a forefoot lifter, and on the other hand the movement of the entire therapeutic walking trainer during the swing leg phase.

A simple mechanical structure can be achieved in that the actuator is connected in an articulated manner to the base support and in that the actuator is assigned a control element which interacts with a control cam provided on the foot receiving part and/or on the support bracket. The foot receiving part and/or the support beam can be adjusted between the raised and the lowered position by adjusting the control member relative to the control curve.

For example, the actuator is formed as a rocker arm mounted pivotably on the base support, by pivoting of which the foot receiving part and/or the support bracket can be adjusted between the raised position and the lowered position. This has the advantage that a tension element or a pressure element can act on the rocker arm with a force that can simulate the natural lifting movement of the foot.

It has proven to be advantageous if one or more measuring sensors are assigned to the support beam and/or the foot receiving part. This measuring sensor is designed as an inclination sensor, for example. If the inclination sensor is assigned to the support beam, the inclination of the support beam in relation to the base support arranged on the walking surface can be recorded and documented by a control computer. In addition or as an alternative, the inclination sensor can be attached to the foot receiving part, so that its inclination relative to the support beam can be measured and documented by the control computer. In both cases, a display device can provide the user with feedback information about the values recorded by the measuring sensor (biofeedback).

Furthermore, it has proven to be advantageous if the measurement sensor is designed as a torsion sensor that detects the torsion of the support beam and/or the foot-receiving part. This makes it possible to determine whether the user is staying on track; whether he is walking in a straight line.

Furthermore, it makes sense if, alternatively or additionally, a strain sensor (DMS) is provided on the support beam and/or the foot receiving part. This allows the expansion of the individual components to be recorded.

Another preferred embodiment provides that the base support is mounted in a rail, for example in a slide rail. The adjustment direction of the therapeutic walking trainer can be determined by the course of the rail with a rail.

A preferred stationary embodiment of the therapeutic gait trainer is characterized in that the foot receiving part is mounted displaceably with respect to the at least one base support in such a way that the user's foot or toe cap can move laterally with respect to the adjustment direction. A normally healthy person uses a slight sideways (lateral) variation in foot placement in everyday walking to optimally maintain postural control (balance). This embodiment is provided because it causes the user's foot or patient can be moved or shifted a few centimeters to the side or laterally during the swing leg phase.

In order to limit the radius of movement of the lateral displacement, it is provided in a development that a limiting unit is provided which is designed in such a way as to allow a limited lateral deflection of the foot or the toe of the user's shoe. For this purpose, the limiting unit can include stop elements that limit lateral mobility of the foot to approximately 20 cm, preferably to approximately 10 cm, more preferably to approximately 5 cm.

In order to prevent falls, an alternative therapeutic walking trainer is characterized in that a holding device is provided that includes a belt system. In one embodiment, the belt system is designed to secure the user against a fall. Alternatively or additionally, the belt system is designed to relieve part of the person's body weight (partial weight relief), as a result of which the user's legs have to bear less weight. The holding device is preferably formed from a vertical part, a horizontal part and a bending section connecting the vertical part to the horizontal part. As a result, a falling user can be caught or intercepted from above.

Fig. 1

die Seitenansicht eines - nicht von der Erfindung erfassten - mobilen therapeutischen Gehtrainers,

Fig. 2

eine mögliche Draufsicht auf den therapeutischen Gehtrainer nach Figur 1,

Fig. 3a

den therapeutischen Gehtrainer nach Figur 1 in einer Aufsetz-/Landekonfiguration (Standbeinphase),

Fig. 3b

den therapeutischen Gehtrainer nach Figur 1 in einer Standkonfiguration (Standbeinphase),

Fig. 3c

den therapeutischen Gehtrainer nach Figur 1 in einer Abstoßkonfiguration (Standbeinphase),

Fig. 3d

den therapeutischer Gehtrainer nach Figur 1 in einer Konfiguration der frühen Schwungbeinphase (Schwungbeinphase),

Fig. 3e

den therapeutischen Gehtrainer nach Figur 1 in einer Konfiguration der mittleren Schwungbeinphase (Schwungbeinphase),

Fig. 3f

den therapeutischen Gehtrainer nach Figur 1 in einer Konfiguration am Ende der finalen Schwungbeinphase (Schwungbeinphase),

Fig. 4

einen weiteren - nicht von der Erfindung erfassten - mobilen therapeutischen Gehtrainer mit einem Aktor, in Seitenansicht gezeigt,

Fig. 5

eine Draufsicht auf den Gehtrainer nach Figur 4, welcher um Sensoren ergänzt ist,

Fig. 6

eine Seitenansicht auf den Gehtrainer nach Figur 4, welcher um ein Zugelement ergänzt ist,

Fig. 7

einen weiteren - nicht von der Erfindung erfassten - mobilen therapeutischen Gehtrainer, in einer Draufsicht gezeigt,

Fig. 8

einen weiteren, in einer Schiene geführten, aber nicht von der Erfindung erfassten therapeutischen Gehtrainer, und

Fig. 9

eine alternative in einer Schiene geführte, stationäre Gestaltung des therapeutischen Gehtrainers nach Figur 8,

Fig. 10

eine weitere stationäre Ausführungsform eines therapeutischen Gehtrainers,

Fig. 10a-10f

einen Ausschnitt des therapeutischen Gehtrainers aus Figur 10 in unterschiedlichen Stellungen (Fußstellungen des Benutzers),

Fig. 11

eine weitere stationäre Ausführungsform eines therapeutischen Gehtrainers,

Fig. 12a

eine weitere stationäre Ausführungsform eines therapeutischen Gehtrainers am Ende der Schwungbeinphase,

Fig. 12b

den Gehtrainer aus Fig. 12a während der Standphase,

Fig. 12c

den Gehtrainer aus Fig. 12a während der Abstoßphase, und

Fig. 12d

den Gehtrainer aus Fig. 12a während der Schwungbeinphase.

The invention is explained in more detail below using exemplary embodiments illustrated in the drawing; show it:

1

the side view of a - not covered by the invention - mobile therapeutic walking trainer,

2

a possible plan view of the therapeutic walking trainer figure 1 ,

Figure 3a

the therapeutic walking trainer figure 1 in a touchdown/landing configuration (stance phase),

Figure 3b

the therapeutic walking trainer figure 1 in a standing configuration (stance phase),

3c

the therapeutic walking trainer figure 1 in a push-off configuration (stance phase),

3d

the therapeutic walking trainer figure 1 in an early swing leg phase (swing leg phase) configuration,

Figure 3e

the therapeutic walking trainer figure 1 in a middle swing leg phase (swing leg phase) configuration,

Fig. 3f

the therapeutic walking trainer figure 1 in a configuration at the end of the final swing leg phase (swing leg phase),

4

another - not covered by the invention - mobile therapeutic walking trainer with an actuator, shown in side view,

figure 5

a top view of the walking trainer figure 4 , which is supplemented by sensors,

6

a side view of the walking trainer figure 4 , which is supplemented by a tension element,

7

another - not covered by the invention - mobile therapeutic walking trainer, shown in a plan view,

8

another therapeutic walking trainer guided in a rail but not covered by the invention, and

9

an alternative stationary design of the therapeutic walking trainer guided in a rail figure 8 ,

10

another stationary embodiment of a therapeutic walking trainer,

Figures 10a-10f

a section of the therapeutic walking trainer figure 10 in different positions (foot positions of the user),

11

another stationary embodiment of a therapeutic walking trainer,

12a

another stationary embodiment of a therapeutic walking trainer at the end of the swing leg phase,

Figure 12b

off the walking trainer 12a during the stance phase,

Figure 12c

off the walking trainer 12a during the push-off phase, and

Figure 12d

off the walking trainer 12a during the swing leg phase.

The figures show several therapeutic walking trainers, which include a foot receiving part 1 for receiving a partial area of the forefoot of a user or for forming a preferably detachable connection with a toe of a shoe. Furthermore, at least one base support 3 that can be moved in and/or counter to an adjustment direction 4 is provided.

In addition, the therapeutic walking trainers include an actively and/or passively operable adjustment unit 30 for the relative adjustment of the foot-receiving part 1, oriented essentially perpendicularly to the adjustment direction 4, with respect to the at least one base support 3.

Follow the walking trainers Figures 1 to 10 the adjustment unit 30 includes a support beam 2. These support beams 2 are either pivotally connected to the foot receiving part 1 or arranged in a rotationally fixed manner relative to it. Particularly in cases in which a shoe tip is coupled to the foot receiving part 1 according to the principle of a cross-country ski binding, the support beam 2 is preferably mounted in a rotationally fixed manner with respect to the foot receiving part 1 .

In both cases, however, the support beam 2 is pivotally connected to a base support 3 at the other end, with the base support 3 being adjustable or movable in and/or counter to an adjustment direction 4.

When the foot-receiving part 1 is arranged pivotably relative to the support beam 2, a first rotary joint 12 (support-beam-foot-receiving part joint) is provided between the support beam 2 and the foot-receiving part 1, through which a rotation of the foot-receiving part 1 relative to the support beam 2 by a substantially axis 13a arranged perpendicularly to the direction of adjustment 4 is enabled. In a cost-effective variant of the walking trainer, a pin bearing is provided as a pivotable connection between the support beam 2 and the foot-receiving part 1 .

Furthermore, the pivoting connection between the support beam 2 and the base support 3 is present, so that the support beam 2 is mounted pivotably relative to the base support 3 . A second swivel joint 14 (supporting beam-base support swivel joint) is provided here, which can also be rotated about an axis 13b oriented essentially perpendicularly to the adjustment direction 4 . Here, a pin bearing is also provided in a cost-effective embodiment.

As can be seen in particular from the top view of the mobile variant of a therapeutic walking trainer in figure 2 results, a free space 5 is formed on the base support 3, which is designed in such a way that the walking surface 6 or the floor can be stepped on by at least part of the foot 7 of a user. The lower leg 15 and the foot 6 of a user are shown in broken lines in all figures. How out figure 2 results, the foot receiving part 1 is arranged centrally for accommodating at least a partial area of the forefoot of a user. In the present case, this foot-receiving part 1 is pivotably mounted between a plurality of support beams 2, namely a first support beam 16a (on the right-hand side of the foot-receiving part 1) and a second support beam 16b (on the left-hand side of the foot-receiving part 1) arranged on the side of the foot-receiving part 1 opposite the first support beam 16a. The first support beam 16a, which is arranged on the right side of the user's foot in the adjustment direction 4, is in turn connected in an articulated manner to a first longitudinal beam 17a. The second support beam 16b is arranged on the left-hand side of the foot 7 in the direction of adjustment 4 and is in turn connected in an articulated manner to the second longitudinal beam 17b. Furthermore, the first longitudinal member 17a and the second longitudinal member 17b are coupled by a cross member, in particular a rear cross member 18, so that a U-shaped base member 3 is formed overall. In another embodiment, the cross member is arranged on the side of the therapeutic walking trainer facing the foot receiving part 1 and the longitudinal members 17a, 17b, so that this then forms the U-shaped base member 3 as the front cross member 19 .

In order to advance the base support 3, on the one hand a drive device can be provided by which the base support 3 and thus the entire therapeutic walking trainer can be adjusted or moved by motor. Alternatively, however, a pressure element, e.g. a push rod, can act on the base frame, in particular on the rear cross member 18, in order to push the therapeutic walking trainer in the adjustment direction 4 or to pull it in the opposite direction to the adjustment direction 4.

As can be seen from the figures, in the present case rollers 20 are attached to the base support 3, by means of which the therapeutic walking trainer can be moved or adjusted in and/or counter to the adjustment direction 4. In the present case, the rollers 20 are formed by wheels 22 which are arranged on axles 21 and which are connected to the base support 3 . An alternative embodiment provides that individual wheels 22, preferably even all of the wheels 22, can be driven by the drive device. Exactly four of the rollers 20 are provided here, although a different number is also possible. Instead of wheels 22, other sliding elements can also be used be provided, through which the therapeutic walking trainer can be adjusted in and/or counter to the adjustment direction 4 .

Based on Figures 3a to 3f the functionality of all existing therapeutic walking trainers should be explained in more detail. A marking 23 is provided to show that the therapeutic walking trainer is moving on the walking surface 6 . the Figures 3a to 3c show configurations (or positions) of the walking trainer during the standing leg phase and the figures 3d to 3f show configurations (or positions) of the walking trainer during the swing leg phase.

First, the heel of the user - without weight - reaches the floor or the walking surface 6 ( Figure 3a ). In the view from the left, the foot receiving part 1 pivots clockwise slightly in relation to the support beam 2. The load is then transferred to the leg shown, with the sole of the user's foot coming into contact with the ground ( Figure 3b ). In this case, the support beam 2 is pivoted counterclockwise with respect to the base beam 3 in the view from the left, so that it is oriented almost parallel to it. In the middle stance phase, the user's foot 7 is almost below the body's center of gravity and the entire body weight acts on the leg. In a healthy user, the body is propelled by the calf muscles, with a rolling movement of the foot 7 taking place synchronously with the forward displacement of the body until the push-off phase is reached ( Figure 3c ). This forward movement can be supported by the movable or adjustable base support 3.

The stance phase is followed by the swing leg phase, which begins with raising the leg after the stance phase. The thigh is raised by the user's hip flexors and the lower leg is raised by the user's hamstrings, with foot 7 initially remaining passive ( Figure 3d ). In this configuration - in the view from the left - the foot receiving part 1 is pivoted counterclockwise with respect to the support beam 2 . The support beam 1 is in turn pivoted clockwise with respect to the base beam 3 . Both Pivoting can also be motor-assisted in a driven variant.

In the middle phase of the swing leg, increased hip flexion moves the leg forward while the knee is approximately 90 degrees ( Figure 3e ). In Figure 3e the foot receiving part 1 is already pivoted back clockwise relative to the support beam 2 . In addition, in the middle swing leg phase, the toes and the foot 7 are actively lifted, which can be implemented here by pivoting the support beam 2 with respect to the base beam 3 . In this configuration, the foot 7 can be guided forward at a distance from the walking surface 6 , ie in the direction of the adjustment direction 4 . In other words, the therapeutic gait trainer assists the user's foot 7 in an appropriate "trajectory". It is also during this phase that flexion in the hip joint is at its greatest.

In the final swing leg phase, the leg is lowered back towards the walking surface 6, with the knee being actively stretched and the foot 7 being held in a neutral position ( Figure 3f ). The support bracket 2 arranged pivotably on the base bracket 3 supports the user's foot 7 with the heel when it comes into contact with the ground, so that the heel does not hit the walking surface 6 too hard.

The therapeutic gait trainer supports the user's foot 7 in each individual phase, so that an almost natural gait cycle can be achieved with the gait trainer.

In figure 4 a further embodiment of a mobile therapeutic walking trainer is shown, in which case an actuator 9 is provided, by means of which the support beam 2 can be pivoted relative to the base beam 3 . This actuator 9 allows stepless adjustment of the support beam 2 and thus of the foot receiving part 1 relative to the base support 3 between a raised position (cf. Figure 3a ) and a lowered position (cf. Figure 3b ).

In the present case, the actuator 9 is mounted pivotably on the base support 3, in particular on the longitudinal supports 17a, 17b. Furthermore, a control element 10 is formed on the actuator 9, which can be moved along a base area or a control curve 11 on the support beam 2. The support beam 2 and thus the foot receiving part 1 can be raised or lowered by the control member 10 sliding along the cam 11 .

A traction element 8 can be provided for raising or lowering the user's forefoot, as is shown, for example, in figure 6 is shown. Here the pulling element 8 acts on the actuator 9 in the area of the control element 10 . The actuator 9 formed as a rocker arm 24 can be pivoted by a tensile force not acting parallel to the longitudinal direction. In addition to a horizontal force component, this pivoting also provides a vertical force component, by means of which the support beam 2 and thus the foot receiving part 1 can be lifted. The horizontal force component causes the base support 3 to move in and/or counter to the adjustment direction 4. Alternatively or additionally, in addition to the tension element 8 shown, another secondary tension element can be used, through which the base support 3 can then be separated from the (vertical) tension element acting on the actuator 9 is separately adjustable along the walking surface 6. In other words, the pull element 9 then serves to actuate the actuator 9 (actuator pull element) and the second pull element to adjust or move the base support 3.

In figure 5 Another embodiment of a mobile therapeutic walking trainer is shown, which basically has the same structure as that shown in figure 4 is shown. Actuators 9 for adjusting the support beam 2 and thus the foot receiving part 1 are also provided here. In addition - shown schematically - at least one, preferably several sensors 25 are provided for detecting the position of the adjacent, preferably free foot. In the present case, the sensors 25 are in the form of optical camera systems, by means of which the position of the adjacent leg or foot can be detected. The base support 3 serves as a housing for the sensors 25 so that the sensors 25 are accommodated in the base support 3 in other words. Depending on the position of the adjacent leg, intelligent logic and/or control can be used to move the therapeutic walking trainer according to the current gait phase. Farther can be varied and adjusted by a higher-level control computer, the (height) position of the foot receiving part 1 depending on the position of the adjacent leg in the swing leg phase.

In figure 7 another mobile therapeutic walking trainer is shown, which essentially corresponds to the one shown in FIG figure 2 is described. However, it is supplemented by a front cross member 19 so that overall a frame-shaped base member 3 is formed which has a corresponding free space 5 for a foot 7 to pass through. In this design, the user's foot 7 is protected all around by the frame-shaped base support 3 .

the figure 8 FIG. 1 shows a further therapeutic walking trainer which can be operated in a stationary manner and which has a foot receiving part 1 which is arranged in a pivotable manner at a first end 26a of a support beam 2. FIG. At the second end 26b of the support beam 2, a base support 3 is arranged in an articulated or pivotable manner, as was also the case in the previous exemplary embodiments. Deviating from this, however, it is provided that the base support 3 now has sliding elements 27 , which in turn are guided in a guide rail 28 .

Instead of sliding elements 27, wheels 22, in particular driven wheels 22, can also be used in order to be able to adjust or move the therapeutic walking trainer in and/or counter to the adjustment direction 4 in the guide rail 28. This is in accordance with the walking trainer figure 9 to recognize.

In 10 a preferred embodiment of the therapeutic walking trainer according to the invention is shown with an actively and/or passively operable adjustment unit 30 for the relative adjustment of the foot receiving part 1, oriented essentially perpendicularly to the adjustment direction 4, with respect to the at least one base support 3. In the present case, there is one base support for each foot of the user 3 provided. The base brackets 3 of this embodiment are different from those shown in FIG Figures 1 to 9 in that they have a tread 50 designed to be stepped on by the user's foot 7 or shoe. In other words, the base support 3 shows 10 no space 5 up and users can stand on the base 3 themselves. Here, too, a support beam 2 is pivotally attached to the base beam 3 at a rear first end. The other end of the support beam 2 is either pivoted or non-rotatably coupled to the foot receiving part 1, so that the connection of the foot receiving part 1 to the support beam(s) 2 is analogous to the walking trainers already explained above. In the present case, the base supports 3 are guided in rails 70 or in a connecting link. Alternatively or additionally, the tension element 8 can be guided in the rail 70, for example in the form of a chain, a toothed belt, by means of gear wheels, with a cable pull or the like. The tension element 8 is effective between the schematically indicated drive device 40 and the relevant base support 3 . In other words, the traction elements 8 drive the base carrier 3 by motor in and/or counter to the adjustment direction 4 . The embodiment also provides a holding device 60 formed from a vertical part 62 and a horizontal part 63 with a belt system 61 . The vertical part 62 and the horizontal part 63 are connected to one another by a bending section 64 . The belt system 61 attached to the horizontal part 63 serves to hold the user and protects him from a fall. For this purpose, the bending section provides a spring force, so that a falling user is braked by the spring-loaded horizontal part 63 and gently caught by the belt system 61 . Preferably, the belt system 61 is not "under tension" when walking on the therapeutic walking trainer, but only becomes effective in the event of a fall. It therefore does not impede the natural gait cycle carried out on the walking trainer. The foot mounting parts 1 after 10 can also be slidably mounted with respect to the respective base support 3 in such a way that the user's foot 7 or the toe of the shoe can move laterally with respect to the adjustment direction 4 and is limited by a limiting unit. For this purpose, for example, the foot receiving part 1 could be associated with cylindrical tubes that can slide along a cylindrical pin. Figures 10a to 10f show different foot and leg positions of the walking trainer 10 .

In 11 Another therapeutic walking trainer is shown with an adjustment unit 30 that can be adjusted vertically on the side of the user's toe. Here too the base support 3 is provided with a tread surface 50, but the present walking trainer does not require a support support 2. For this reason, the adjustment unit 30 has a vertical guide 31 with an actuator element 32 that can be driven by a motor and that can adjust the foot-receiving part 1 relative to the base support 3 between a raised and a lowered position. This base support 3 with its adjustment unit 30 can also be found on the device 10 be used.

In Figures 12a to 12d another embodiment of a therapeutic walking trainer is shown, in which the base support 3 is pivotally coupled to the support support 2 in the heel area. Furthermore, a linear motor 80 is provided, which is connected to the support beam 2 via a deflection lever 81 . The linear motor 80 can be moved along the linear rail 82 in and/or counter to the adjustment direction 4. The deflection lever 81 uses a deflection wire 83 to ensure that the foot receiving part 1 is lifted.

All gait trainers preferably have the property that the actuators and/or support units to support the natural gait cycle only intervene in cases in which the user actually needs support. So only if the user does not perform the required activity himself.

Reference List

1

foot receiving part

2

support beam

3

base carrier

4

adjustment direction

5

free space

6

walking surface

7

Foot

8th

tension element

9

actuator

10

control member

11

cam

12

first pivot

13a

axis

13b

axis

14

second pivot

15

lower leg

16a

first support beam

16b

second support beam

17a

first longitudinal member

17b

second longitudinal member

18

rear cross member

19

front cross member

20

roll

21

axis

22

Wheels

23

mark

24

rocker arm

25

sensor

26a

first end

26b

second end

27

sliding elements

28

guide rail

30

adjustment unit

31

vertical guidance

32

actuator element

40

drive device

50

tread

60

holding device

61

belt system

62

vertical part

63

horizontal part

64

bending section

70

rail

80

linear motor

81

reversing lever

82

linear rail

83

deflection wire

Claims (10)

1. A therapeutic walking trainer with a foot receiving portion (1) for receiving at least a sub-region of the forefoot of a user or for forming a connection with a toe of a shoe,

   with at least one base carrier (3),

   which is motor-adjustable in and/or against an adjustment direction (4) by means of a drive device (40),

   the base carrier (3) having a tread surface (50) which is designed to be stepped on by the foot (7) of the user or the shoe

   and having an adjustment unit (30), which can be motorized actively and/or passively by means of an actuator drive of an actuator (9), for adjusting the foot receiving portion (1), oriented essentially perpendicularly to the adjustment direction (4), between a raised position and a lowered position,

   characterized in that

   the foot receiving portion (1), receiving at least the sub-region of the forefoot or the connection with a shoe toe, is adjustable relative to the tread surface (50) of the at least one base carrier (3) between the raised and the lowered position.
2. The therapeutic walking trainer according to claim 1, characterized in that a pull element (8) or a push element is provided, which is designed to adjust the base carrier (3).
3. The therapeutic walking trainer according to claim 2, characterized in that the pull element (8) or the push element is coupled or can be coupled to the base carrier (3) in such a way that the base carrier (3) can be pushed, pulled or pressed in and/or against the adjustment direction (4).
4. The therapeutic walking trainer according to claim 3, characterized in that the adjustment unit (30) has a supporting carrier (2) connected at one end in a rotatable manner to the base carrier (3) and at the other end in a rotationally fixed or rotatable manner to the foot receiving portion (1), in that the pull element (8) or the push element is coupled or can be coupled to the supporting carrier (2) in such a way that the base carrier (3) can be pushed, pulled or pressed in and/or counter to the adjustment direction (4) by actuating the supporting carrier (2) by means of the traction element (8) or by means of the pressure element.
5. The therapeutic walking trainer according to any one of claims 2 to 4, characterized in that the pull element (8) or the push element is coupled or can be coupled to the actuator (9), in that the foot receiving portion (1) and/or the supporting carrier (2) can be adjusted by actuating the actuator (9) by means of the pull element (8) or by means of the push element and in that the base carrier (3) can be pushed, pulled or pressed in and/or against the adjustment direction (4) by actuation of the actuator (9) by means of the pull element (8) or by means of the push element.
6. The therapeutic walking trainer according to one of claims 1 to 5, characterized in that the actuator (9) is connected to the base carrier (3) in an articulated manner, wherein the actuator (9) is assigned a control element (10) which interacts with a control cam (11) provided on the foot receiving portion (1) and/or on the supporting carrier (2), and wherein the foot receiving portion (1) and/or the supporting carrier (2) can be adjusted by adjusting the control element (10) relative to the control cam (11).
7. The therapeutic walking trainer according to one of the claims 1 to 7, characterized in that the foot receiving portion (1) is displaceably mounted with respect to the at least one base carrier (3) in such a way that a lateral deflection of the foot (7) or the toe of the user's shoe with respect to the adjustment direction (4) is made possible.
8. The therapeutic walking trainer according to claim 7, characterized in that a limiting unit is provided, which is designed to allow a limited lateral deflection of the user's foot (7) or shoe toe.
9. The therapeutic walking trainer according to any one of claims 1 to 8, characterized in that a holder (60) is provided, which comprises a harness (61).
10. The therapeutic walking trainer according to claim 9, characterized in that the holder (60) is formed by a vertical part (62), a horizontal part (63), and a bent section (64) connecting the vertical part (62) to the horizontal part (63).

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