EP3903756A1 - ORTHOPAEDIC WALKING ASSISTANCE DEVICE, WHICH CAN BE USED FOR LEARNING TO WALK AGAIN, OF THE TYPE COMPRISING MEANS FOR SEPARATING THE PATIENTýS THIGHS - Google Patents

Abstract

The present invention relates to a walking rehabilitation device, of the type comprising a base (1) equipped with casters spaced along the width and length of said base, said device comprising two movable arms (91, 93) forming a pedal, each arm ( 91; 93) comprising a first end rotatably mounted on said device about an axis parallel to the width of said base (1), said device further comprising a wedging element for the patient's foot or leg (6) , said wedging element (6) being adjustable and lockable in position according to the width of the device. Characteristically, the device also comprises means for spacing the thighs or legs (87, 871, 9) of the patient on either side of said saddle support (7), which make it possible to modify the spacing of the thighs. of the patient and are adjustable and lockable in position according to the width of said device and are able to follow the reciprocating movement of the patient's lower limbs held by said wedging elements (6) and by said spacing means (87, 871, 94) , when the patient is installed on said device and the adjustment of the position of said wedging element according to the width of the device is independent of the adjustment of the means for separating the patient's thighs.

Description

Prior art

The document EP 3 598 961 A1 describes an orthopedic device for assisting with ambulation and which can be used for the rehabilitation of walking, in particular for patients with multiple disabilities and with motor problems.

This device comprises a base which comprises casters, a saddle support equipped with a saddle and articulated arms arranged on either side of the saddle support. The end of each of the articulated arms comprises a wedging element for the foot or the leg of the patient which is mounted adjustable in position according to the width of the base. This wedging element makes it possible to spread the legs of the patient on either side of the saddle, thus avoiding friction between the saddle and the patient's thighs.

However, it turns out that for some patients, it is necessary to separate both the thighs and the legs of the patient. Indeed, it turns out that for some patients who have low muscle tone, a single blocking point at the level of the thighs or at the level of the leg creates tension on the patient's knees because the legs are no longer aligned with the legs. thighs.

Furthermore, the aforementioned document describes a motorized embodiment of the device. In this embodiment, the articulated arms include a motor on each of their articulations. These motors should then be controlled to simulate walking and train the patient's lower limbs. It turns out that the motors being too numerous, their control with a view to simulating walking is complicated. These motors are more fragile and it is difficult to connect them to a power source.

It also turns out that the device described in the aforementioned document is difficult to steer, either by the patient or by a caregiver who pushes the device.

In addition, when the device is provided with a toe block, the patient has difficulty moving and encounter problems in changing direction. The document WO 2012/049442 A1 describes a walking rehabilitation device which comprises a base equipped with casters spaced according to the width and the length of the base. These measures has a harness that supports the patient's buttocks. The patient's thighs are inserted into straps which cannot be pulled apart from each other. This device therefore does not make it possible to adjust the distance between the patient's thighs. This device does not include a pedal.

The document JP 2007 014698 A1 describes a device which allows the patient to walk. This device does not include a saddle holder, nor any element for wedging the patient's foot or leg, which can be adjusted and locked in position according to the width of the device. This device does not include a pedal.

The document US 9,907,721 B2 describes a device which does not include any means for wedging the patient's leg or thighs. This device does not include a pedal.

The document CN 107 874 984 A describes a walking aid device which includes a belt retaining the patient. The patient's legs are held at two support posts, which cannot be pulled apart. This device does not include a pedal.

The document KR 2018 0123939 A describes a device for assisting with ambulation which comprises an exoskeleton mounted on a movable support comprising casters. The two uprights on which the lower limbs of the patient are fixed cannot be separated from one another, so as to adjust the distance between the patient's thighs. This device does not include a pedal.

An aim of the present invention is to resolve any one of the drawbacks linked to the use of the device of the prior art.

In particular, an object of the present invention is to provide a device for assisting with ambulation which comprises a pedal and makes it possible to separately adjust the spacing of the feet and legs of the patient or the spacing of the thighs and feet. / patient's legs. Such a device makes it possible to adapt perfectly to the morphology of the patient and to his pathology. Indeed, the presence of the pedal implies precise positioning of the different parts of the patient's lower limbs so as not to cause lesions when using the device.

The present invention relates to a walking rehabilitation device, of the type comprising a base equipped with casters spaced along the width and length of said base, which defines the width and length of said device, a saddle support optionally equipped with a saddle , which surmounts said base and extends substantially vertically, along the height of said device, said device comprising two arms movable crankset, arranged on either side of said saddle support, each arm comprising a first end rotatably mounted on said device about an axis parallel to the width of said base, said device further comprising a wedging element of the patient's foot or leg, said wedging element being adjustable and lockable in position according to the width of the device.

Characteristically, according to the invention, the device also comprises means for spacing the thighs or legs of the patient on either side of said saddle support, said means for spacing the thighs making it possible to modify the spacing of the legs. thighs or legs of the patient, said means for spacing the thighs or legs are adjustable and lockable in position according to the width of said device and said spacing means are able to follow the reciprocating movement of the lower limbs of the patient held by said elements wedging and by said thigh or leg spacing means, when the patient is installed on said device and the adjustment of the position of said wedging element according to the width of the device is independent of the adjustment of the thigh spacing means of the According to a particular embodiment, the wedging element is mounted on the free end of each of the movable arms forming a pedal.

The position of the thigh or leg spacing means is not limited according to the invention. They can be mounted on the movable arms forming the bottom bracket or on the saddle support.

The presence of the means for separating the thighs or the legs of the patient makes it possible to position the thighs, legs, knees and feet of the patient in an alignment which respects the physiology of the joints. The knees in particular can thus be put in a position which does not prevent walking and which does not cause injury to the joint. The spacing means also make it possible to correct the position of the patient's hips, which determines the position of the latter's lower limbs. The leg or foot wedging element and the means for separating the thighs or the leg form means for guiding the leg during the walking movement.

When the spacing means are mounted on the saddle support, they are easier to adjust because they are closer to the thighs or legs.

According to a particular embodiment of the thigh spacing means, which can be combined with any one of the embodiments, they comprise two branches which extend on either side of the saddle support according to the width of the device and the free end of which may be more or less apart from said saddle support according to the width of the device and locked in position, said free end of said branches comprising a thigh or leg fixing element, mounted to rotate around it. an axis parallel to the width of the device.

The fixing element serves to fix, by clamping, for example, the thigh or the leg of the patient. It can be rotatably mounted directly on the end of the branch. It can also be rotatably mounted on the end of the branch by means of an upright which is rotatably mounted about an axis parallel to the width of the device. It can, moreover, be mounted to rotate or pivot on the end of the upright. It could be a tieback, for example.

Advantageously, said spacing means are adjustable and lockable in position depending on the length and / or height of said device.

This can be obtained, for example by mounting one end of the branches, movable on the saddle support along the length of the device and lockable in position. The spacing means may also comprise a tube slidably mounted in the saddle support and carrying the two branches. The sliding tube makes it possible to easily and simultaneously adjust the position of the two branches of the thigh spacing means according to the length of the device.

The two branches being movable in rotation about an axis parallel to the width of the device, it is possible to adjust the position of the ends of the branches which carry the thigh fixing element according to the height of the device.

According to a variant that can be combined with any one of the embodiments of the invention, when the fixing element is mounted on the free end of the branch by means of an upright, it is advantageously mounted adjustable in position. on the upright which connects it to the branch and its position on said upright can be locked, by means, for example, of locking means. It is thus possible to easily adjust the position of the thigh or leg fixing element without having to modify the position of all the thigh or leg spacing means depending on the length of the device.

According to another embodiment of the spacing means, the thigh or leg fixing element is mounted to rotate about an axis parallel to the width of the device, adjustable in position along the length of this axis and lockable in position on this axis. This axis is integral with the device and can in particular be mounted on the saddle support. The rotational articulation of the fastening element makes it possible to follow the reciprocating movement of the patient's lower limbs, without hindering walking and ensuring good support for the thighs or legs.

The axis of rotation can be mounted to slide on said device, in particular near the saddle support or under the latter.

The thigh or leg fixing element can in all embodiments be mounted on a ball joint.

Advantageously, the means for separating the thighs or the legs are arranged at the rear of the saddle support. They are thus easily accessible.

According to a particular variant, when the spacing means comprise branches, each of said branches comprises two parts articulated with respect to one another along parallel axes, said parts forming a deformable parallelogram, one of said articulated parts comprises a threaded rod passing through a thread formed in said part, said threaded rod makes it possible to deform the parallelogram formed by said parts, thus modifying the distance of said branch relative to said saddle support, according to the width of said device.

Such means turn out to be easy to fine-tune without acting on the patient. They are also robust and allow the position of the hips and lower limbs to be adjusted independently. Indeed, the spacing of each branch can thus be modified independently of the other. It is common for patients to have positioning problems only at one hip. The spacing means thus make it possible to catch up with the bad position of a single hip without modifying that of the other hip.

The aforementioned threaded rod prevents the branches from tightening towards the saddle support, for example due to the movements of the patient. Advantageously, this variant can also include means for blocking the spacing of the branches which prevent the branches from deviating from one another along the width of the device. These locking means may comprise a second rod provided with a stop and which passes through the other part, the length of the rod inserted between the two parts being adjustable and the second rod being able to be blocked in position on the part. The two parts are thus locked in position relative to each other. By modifying the length of the portion of the rods inserted between the parts, we can reposition them around their axes and vary the spacing of the branches according to the width of the device. A spring or an elastically deformable stud can be placed between the part and the stop of the second rod to act as a shock absorber. The blocking is thus more flexible. Such a blockage is sometimes necessary depending on the pathology of the patient.

Whatever the embodiment of the means for separating the thighs or the legs, they can comprise synchronization means which make it possible to prevent the two legs of the patient from being aligned; in fact, the patient must always have one leg in front and one leg behind. These synchronization means may, for example, comprise a pulley on which slides and a link which connects the two branches of the thigh or leg spacing means, independently of the structure of the branches of the spacing means. The latter may or may not be as mentioned above.

Advantageously, said base has a U-shape, the opening of which is advantageously placed towards the front of the device, the saddle support being mounted inside the U. Such a base turns out to be perfectly stable.

Advantageously, whatever the embodiment of the device of the invention, it comprises a central beam which extends along the length of said base and said second end of each of said movable arms is slidably mounted along said central and pivoting beam. along an axis parallel to the width of the device. The presence of the central beam makes it possible to fix the two ends of the movable arms, which makes the crankset more robust and undeformable.

According to a particular embodiment, which can be combined with any one of the embodiments of the invention, said device comprises means for driving the arms forming the crankset, said driving means being adapted to alternately drive said mobile arms in a rotational movement combined with a translation. The pedal being activated due to an external force, it causes the displacement of the device of the invention and the walking of the patient. The drive means may, for example, be means for driving the ends of the movable arms in reciprocating rotation. The alternative drive is obtained by means of gears chosen and known to those skilled in the art.

Said drive means may comprise one or two rotary motors and / or at least one wheel connected to said movable arms, able to come into contact with the ground and to be driven in rotation by the movement of said device on the ground.

The motor or motors can be electrically connected to a supply battery mounted on the device of the invention.

Advantageously, the motor or motors include a safety device which blocks their rotational movement when the patient exerts a force on one or both of the movable arms.

When the device has two motors, the movement of the crankset will reproduce the movement of walking. With a single motor, this movement is partially reproduced. It is in fact more difficult, by means of gears, to obtain the movement of walking.

The foot or leg wedging element may be that described in the prior art. The foot wedge can be mounted adjustable on a perforated rod at the end of the sole (heel). It can also be mounted according to its width. It can, in this case, comprise two sliding plates one inside the other, as explained in more detail in the description of a particular embodiment of the footrest.

According to a particular embodiment of the element for wedging the patient's foot or leg, it comprises a footrest which comprises a sole, the lower surface of which is equipped with at least one rotary hooking element, said element. hook being made of an elastically deformable material and mounted to rotate about an axis passing through the plane defined by the sole and forming a non-zero angle with the longitudinal dimension of said sole.

Advantageously, the aforementioned angle is between 5 and 15 ° with a straight line parallel to the length of the footrest.

Advantageously, said element for wedging the patient's foot or leg is mounted on the movable arm by means of a mounting element comprising damping means capable of damping the vertical movements of said wedging element. The damping means may include a spring mounted between two stops so as to be able to deform elastically according to the height of said device. Advantageously, the device comprises direction guide means, said guide means being in particular chosen from a handlebars integral with a wheel capable of touching the ground and arranged at the front of said device, a bidirectional wheel optionally coupled to rollers motorized rear equipping said base and / or coupled to gripping means allowing a helper to push said device, and / or it comprises means for controlling said means for guiding in the direction and / or means for triggering / stopping said means of 'drive said movable arms, said control means and said trigger / stop means are chosen independently of one another from a joystick, sensors arranged on the saddle when said device comprises a saddle, sensors fitted to means for maintaining the patient's bust and means forming a gyroscope positioned so as to be able to be activated by said patient.

The bidirectional wheel can be a multidirectional wheel. This wheel may be the wheel which is used for driving the crankset in rotation; it then has two functions: setting the pedal unit in motion when a helper pushes the device on the ground and guiding the device in the direction of the device, which is always set in motion by the helper, the bidirectional wheel effectively allows the 'helping to change direction.

The handlebars are indicated for patients able to use their arms and hands. The sensors are best suited for patients who can only oscillate their torso, front to back and left to right. In this case, the device may not include a handlebar.

• La [Fig. 1] représente une vue tridimensionnelle de profil d'un premier mode de réalisation particulier ;
• La [Fig. 2] représente un mode de réalisation particulier des moyens d'écartement des cuisses du patient ;
• La [Fig. 3] représente une vue tridimensionnelle partielle du dessous du mode de réalisation représenté sur la fig. 1 ;
• La [Fig. 4] représente une vue partielle en trois dimensions d'un second mode de réalisation, les moteurs étant remplacés par une roue bidirectionnelle ;
• La [Fig. 5] représente partiellement un troisième mode de réalisation qui comporte des moyens de maintien du buste du patient ; et
• La [Fig. 6] représente un troisième mode de réalisation des moyens d'écartement des cuisses ou des jambes du patient.

The present invention, its characteristics and the various advantages which it provides will appear better on reading the description which follows and which refers to three particular embodiments, presented by way of illustrative and non-limiting examples and which refers to the following. accompanying drawings in which:

• The [ Fig. 1 ] represents a three-dimensional profile view of a first particular embodiment;
• The [ Fig. 2 ] represents a particular embodiment of the means for separating the patient's thighs;
• The [ Fig. 3 ] is a partial three-dimensional view from below of the embodiment shown in FIG. fig. 1 ;
• The [ Fig. 4 ] shows a partial three-dimensional view of a second embodiment, the motors being replaced by a bidirectional wheel;
• The [ Fig. 5 ] partially represents a third embodiment which comprises means for maintaining the patient's bust; and
• The [ Fig. 6 ] shows a third embodiment of the means for separating the patient's thighs or legs.

With reference to the Fig. 1 , a particular embodiment of the device of the invention will now be described. In this embodiment, the device comprises a base 1 which has the general shape of a U, the opening of the U being towards the front of the device, the front being defined according to the direction of movement of the device. The base 1 comprises two rear wheels 11 and two front casters 13, which are mounted to pivot freely about a vertical axis. The device has a beam central 3 integral with the base 1 and which extends between the two branches of the U formed by the base 1. Two rotary motors 5 are mounted on either side of the central beam 3 and connected to an electric power supply battery 51 , mounted on top of the central beam 3. This battery 51 is optionally removable and can be recharged without the presence of the device of the invention. The device also comprises a saddle support 7, which extends vertically and on which a saddle made of polymeric material can be fixed. For clarity, the saddle is not shown on the fig. 1 . The saddle support 7 comprises a hollow tube 71 (arranged at the end of a substantially vertical tube not visible on the fig. 1 ) which extends horizontally along the length of the device and an articulated vertical tube 73 on which a backrest or attachment means for the patient's chest can be mounted. The saddle can be fixed on the tube 71.

With reference to the fig. 1 , the device also comprises two movable arms each mounted on one side of the central beam 3. Each arm comprises a first segment 91, one end of which is mounted to rotate about a horizontal axis extending along the width of the device (c 'that is to say the width of the base 1). On the second end 912 of each of the first segments 91 is mounted the first end of a second segment 93. The first end of the second segment 93 is mounted to rotate about a horizontal axis which extends along the width of the device. The second end 932 of the second segment 93 is mounted to rotate about a horizontal axis which extends along the width of the device, on a part 933, which is slidably mounted on a horizontal rail 34 fitted to the front of the central beam. 3. The two segments 91 and 93 form a connecting rod and constitute a crankset; the rotary motors 5 rotate each of the first segments 91. Each first segment 91 drives the second end of the second segment 93 in translation. Each second segment 93 comprises a connecting piece 4, substantially vertical, which will be more fully detailed with reference to the fig. 3 . The end of the connecting piece 4 not mounted on the second segment 93 comprises a footrest 6 which extends along the length and the width of the device. This footrest 6 is mounted adjustable in position according to the width of the device. Its position can be modified and then fixed according to the width of the device. The footrest 6 will be more fully described with reference to fig. 3 .

The foot wedge 6 can also be mounted adjustable in position as described in the document of the prior art.

In the embodiment shown in fig. 1 , the central beam 3 comprises two portions mounted to slide one inside the other and whose relative position can be fixed by nut-bolt systems. It is thus possible to vary the length of the central beam 3 as a function of the morphology of the patient. Likewise, the first segment 91 has a series of perforations at its first end. These perforations make it possible to vary the length of the portion of the first segment 91 which extends between the point of rotation and the second segment 93. It is thus possible to vary the amplitude of the translational movement of the end of the second. segment 93, this movement corresponding to the patient's stride. Likewise, the saddle support 7 is mounted adjustable in height and / or inclination relative to the base 1, as indicated in the document of the prior art. The connecting piece 4 also comprises a series of perforations which make it possible to vary the distance between the footrest 6 and the second segment 93. The footrest 6 is mounted so as to be able to rotate on the end of the linkage piece 4. Its angular position is variable and can be fixed; it therefore also comprises angular blocking means (not shown) which make it possible to block its angular position relative to the connecting piece 4.

With reference to the fig. 2 , a particular embodiment of the means for separating the thighs or the legs of the patient 8 will now be described. According to this embodiment, the spacing means 8 comprise a horizontal tube 81 capable of being slid in the hollow tube 71 of the saddle support 7. The tube 81 is fixed in position in the tube 71 by nut-bolt systems, for example. The tube 81 is extended at one of its ends by a tube 82 which is vertical on the fig. 2 . The end of the vertical tube 82 is provided with an axis of rotation 83, parallel to the width of the device. This axis of rotation 83 is horizontal and perpendicular to the tube 81. Branches 85 are mounted to be movable in rotation about the axis 83. Bolts 86 and washers make it possible to fix the position of the branches 85 on the axis 83. Each branch 85 is formed of two parts 851, the two ends of which are movably mounted around horizontal axes on the fig. 2 , and parallel to the tube 81, respectively X1, X2, X3 and X4. The two parts 851 can thus be more or less separated from the center line D of the spacing means 8. The spacing of the branches 85 is adjusted via a wheel 855 which is fitted to the end of a threaded rod 856. The end free of the threaded rod 856 comes into abutment on a portion of the external part. By turning the wheel 855, the length of the threaded rod portion 856 which separates the two parts is modified; we thus deforms the branch 85, which has the effect of moving its end carrying the fixing element of the thigh or of the leg 94 away from the center line D. The more the threaded rod 856 is pressed in between the two parts 851 , the more the branch 85 is spread outwards. An extension segment 852 extends the branch 85 and is mounted to rotate about a horizontal axis 84 parallel to the axis of rotation 83. The extension segment 852 can also be locked in rotation by tightening a nut. The free end of the extension segment 852 is equipped with a fixing element by clamping the leg or thigh 94 (or clamping ring or also called the thigh fixing element). This fixing element 94 has a ball joint 940 which allows the clamping element to be oriented through a rotation of almost 360 °. According to a variant not shown, the fixing / clamping element 94 and its ball 940 are slidably mounted on the extension segment 852 and can be locked in position along the length of the latter. This makes it possible to adapt the position of the clamping element 94 according to the morphology of the patient, his thighs being more or less distant from the rear of the saddle support 7.

On the fig. 2 , the locking means extend vertically but when the tube 81 is inserted into the tube 71, the branches 85 are rotated around the axis 83 to bring them into a substantially horizontal plane, parallel to the base 1. It is thus possible to insert the patient's thighs into the clamping elements 9.

With reference to the fig. 3 , a particular embodiment of the patient's foot wedging element and of the connecting piece 4 will now be described. On the fig. 3 , the second segment 93 has longitudinal slots 936 through which the connecting piece 4 is mounted. The position of the connecting piece 4 is therefore adjustable along the second segment 93. The position of the connecting piece 4 can be locked. , for example, with nut-and-bolt systems which tighten the connecting piece 4 on the second segment 93 or using a bolt-nut system passing through the slots 936 and on which the piece 4 comes into abutment so as to prevent its translation in the slots 936. The part 4 comprises a plate 41, one end of which carries the footrest 6 and the other end is fixed to the second segment 93 as previously explained. The plate 41 comprises a stop 410 which extends horizontally, according to the thickness of the plate. The plate 41 is fixed on the second segment 93 by means of a fastening part 412 which forms with the part 4 a space allowing the sliding of the connecting part 4 on the second segment 93, from bottom to top, according to the width. of the second segment 93. A spring 42 is arranged between the thickness of the fastening part 412 and the stopper 410. The spring 42 has one end resting on the stopper 410 and the other resting on the thickness of the fastening part 412. This spring 42 allows the part 4 to move along its longitudinal dimension (that is to say vertically) relative to the second segment 93. The passage formed by the plate 41 and the fixing part 412 is wider than the width of the second segment 93 and allows including this vertical displacement. The spring 42 therefore allows the connecting piece 4 to absorb shocks and unevenness in the ground when moving the footrest 6.

With reference to the fig. 3 , the footrest 6 will now be described. The foot wedge 6 has a sole and is mounted at the end of the connecting piece 4 along its width. The sole is defined as the surface on which the patient places his foot. The length of the footrest 6 is defined according to the length of the device. The footrest 6 comprises two hollow plates 61 and 63 which slide one inside the other and can be locked in position, by a screw-nut system, for example. These two plates 61 and 63 make it possible to modify the width of the footrest 6 which makes it possible to position the patient's foot in alignment with his leg and his thigh. The underside of the sole of the foot wedge 6 comprises two rollers 66 made of an elastically deformable material. The rollers 66 are mounted to pivot about an axis substantially parallel to the length of the footrest. Their axis of rotation preferably forms an angle of between 5 and 15 ° with a straight line parallel to the length of the footrest 6. The elastically deformable material allows good grip of the sole of the footrest 6 on the ground. The rollers 66 being pivoting, they allow the footrest 6 to roll on the ground according to its width. The inclination of their axis of rotation allows the footrests 6 to easily roll on the ground during changes of direction of the device of the invention.

According to a variant not shown, which can be combined with any one of the embodiments of the device of the invention, the footrest 6 comprises a plate forming a sole which is fixed along one of its edges, to the footrest 6 by a hinge. which is parallel to the width of the footrest 6. The plate forming the sole is articulated and can therefore be lifted and blocked above the footrest 6, its edge being integral with the hinge. A footrest 6 comprising a plate forming an articulated sole enables the patient's foot to be properly fixed when the latter cannot be positioned at an angle of 90 ° with the leg.

In all the embodiments, the footrest 6 comprises means for fixing the patient's foot which are not shown in the aforementioned figures, for the sake of clarity and simplification.

With reference to the fig. 4 , a second embodiment will now be described. The elements in common with the first embodiment are referenced identically. On the fig. 4 , the saddle support 7 has not been fully shown. In this second embodiment, the movable arm has only one segment 91, one end 912 of which is mounted to slide and pivot on the central beam 3 as described with reference to the first embodiment. The other end of the first segment 91 is rotatably mounted on a wheel 500. The wheels 500 are therefore arranged on either side of the central beam 3. The second end of the segment 91 is rotatably mounted on the wheel 500 around of an axis parallel to the width of the device. The wheels 500 are bidirectional. They comprise rollers 501 which are able to roll along the width of the device, the wheel 500 rolling along the length of the device. This embodiment comprises rear casters (not shown) which are motorized and actuated by control means allowing the patient to modify the direction of movement of the device of the invention, one caster advancing while the other recedes. This embodiment may also include, in addition to motorized rear castors or as a replacement, gripping means allowing a helper to push the device of the invention. The wheels 500 also make it possible to set the segments 91 in motion, which simulate the movement of walking.

With reference to the fig. 5 , an embodiment which comprises means for maintaining the patient's bust will now be described. The device is not fully reproduced on the fig. 4 . The elements in common with the other embodiments are referenced identically. The saddle support 7 is fitted with a rigid plastic saddle 710. The saddle 710 which extends vertically, above the saddle support 7 at the level of the patient's chest and back. The saddle also comprises two lateral sides 711 provided with closure means which cooperate with the portion coming into contact with the patient's chest. The saddle support 7 is pivotally mounted on the end of a substantially vertical tube forming part of the base 1; its angular position can be locked, once adjusted. The support 1 comprises gripping handles 120 allowing a caregiver to push the device of the invention. At the rear of the saddle 710, there is a pulley 715, mounted under the tube 81. A cord passes over the pulley and connects the two thigh tightening elements 9. The two thigh tightening elements 94 are therefore linked by the cord which helps the patient in walking. In fact, when the patient advances one lower limb, the other lower limb will be pulled back by the cord and the pulley, which gives him invaluable help. The thigh or leg spacing means comprise branches 87 which slide in the saddle support 7, depending on the width of the device, on each side of the saddle support 7 and along its length. The brackets or branches 87 can be locked in position for example, by means of a threaded screw system which clamps them against a horizontal wall of the saddle support 7. The free end of each bracket 87 carries the thigh tightening ring 94, which is mounted on the bracket 87 by means of a perforated post 871 which allows the height adjustment of the ring 94. The ring 94 is mounted on the post 871 by means of a screw and a nut. The perforated post 871 is also rotatably mounted on the bracket 87, about an axis parallel to the width of the device, so as to be able to follow the movement of the lower limbs of the patient.

With reference to the fig. 6 , a third embodiment of the thigh or leg spacing means will now be described. The elements in common with the other embodiments are referenced identically. This embodiment comprises a pierced tube 80 which is crossed by the vertical tube which supports the horizontal tube 71 of the saddle support 7. Locking means, not shown, make it possible, by clamping, for example, to lock the pierced tube in position. 80 on the vertical tube of the saddle support 7; the position of the tube 80 is therefore adjustable according to the height of the device of the invention and lockable. The pierced tube 80 is integral with two rails 880 and 882 which extend on each side of the tube 80, parallel to the length of the device of the invention. A fixing plate 871 is slidably mounted on the first horizontal rail 880 and can be locked in position on this rail. An identical mounting plate 871 is slidably mounted and lockable in position on the second rail 882. The thigh or leg attachment element 94 is mounted on the mounting plate 871 by means of a Y axis which s' expands according to the width of the device. The thigh or leg attachment member 94 is mounted on the end of the Y axis by means of a ball joint. Screws and nuts, not shown, make it possible to hold the fixing plate 871 in position on the rail 880 or 882, once the adjustment has been made. The fixing element 94 is also adjustable in position according to the width of the device; it can in fact slide on the aforementioned Y axis, which is a threaded axis which makes it possible to modify the position of the fixing element 94 along the length of the axis. A nut then makes it possible to lock the fixing element 94 in position on the Y axis, allowing the latter to be adjusted according to the width of the device. The pierced tube 80 therefore allows the adjustment of the spacing means according to the height of the device; the rails 880 and 882 allow their adjustment according to the length of the device and the Y axis and the nuts allow the adjustment according to the width of the device. The ball joint on which the fixing element 94 is mounted enables the latter to follow the movements of the patient's legs, which are moved by the movable arms forming a pedal or by the patient himself.

In a variant not shown of any one of the aforementioned embodiments, the device comprises a handlebar which actuates a front wheel. This device allows patients who can use their arm to direct the device of the invention.

When the device comprises means for setting in motion the movable arms forming a crankset (motor or rear wheel), it also comprises means for triggering / stopping these means for setting in motion. These triggering / stopping means can be, for example, a joystick, a button or a joystick. These control means can also comprise a tactile sensor arranged on the saddle, at the level of the patient's thorax and / or a tactile sensor arranged at the level of the patient's back. The patient can thus, by leaning forward or backward, trigger or stop the means for setting in motion.

When the device comprises means for changing the direction of its movement, the device comprises means for controlling these means. These control means may include, for example, touch sensors placed on the lateral flanks 711 of the saddle 710. These sensors are coupled to motorized rear castors which go due to their reverse rotation (one advancing, the other backward) change the path / direction of movement of the device. Such a device allows a patient unable to use his hands / arms to move with the device of the invention with the possibility of changing direction.

An example of use of the device of the invention will now be described.

The first step is to adjust the various elements of the device. The length of the central beam 3, the height of the saddle, its inclination, the distance separating the footrests 6 from the movable arm, the position of the thigh fixing ring 9 are adjusted. The patient is then placed on the saddle and one maintains his torso with the means for maintaining the torso which possibly form part of the saddle. We fix the thighs of the patient in the rings 94 and the feet on the footrests 6. When the thigh spacing means are as shown in the figure fig. 2 , it is possible to finely adjust the distance between the thighs simply by actuating the knobs 855. If the device comprises one or more wheels 500, a helper can, by pushing the device, drive the movable arms and thus simulate walking. The wheel 500 is bidirectional, the helper can change the direction of movement of the device of the invention.

If the device has one or two motors, the patient can himself trigger the operation of the motors by pressing his torso forward so as to press a sensor which will start the motor or motors. A rearward sensor makes it possible to stop the engine (s).

If the device has lateral sensors, the patient can steer the device of the invention by swinging his chest to the right or to the left. Motorized rear casters and 500 wheels allow for direction change.

Claims (10)

Walking rehabilitation device, of the type comprising a base (1) equipped with casters spaced along the width and length of said base, which defines the width and length of said device, a saddle support (7) possibly equipped with a saddle, which surmounts said base (1) and extends substantially vertically, according to the height of said device, said device comprising two movable arms (91, 93) forming a crankset, arranged on either side of said saddle support (7) , each arm (91; 93) comprising a first end rotatably mounted on said device about an axis parallel to the width of said base (1), said device further comprising a wedging element for the foot or the leg of the patient (6), said wedging element (6) being adjustable and lockable in position according to the width of the device, characterized in that it also comprises means for separating the thighs or legs (87, 871, 9) of the patient on either side of said support saddle (7), in that said spacing means (87, 871, 94) make it possible to modify the spacing of the patient's thighs and are adjustable and lockable in position according to the width of said device, in that said means of spacers are able to follow the reciprocating movement of the patient's lower limbs held by said wedging elements (6) and by said spacing means (87, 871, 94), when the patient is installed on said device and in that the adjustment of the position of said wedging element according to the width of the device is independent of the adjustment of the means for separating the patient's thighs. Device according to Claim 1, characterized in that the said means for separating the thighs or the legs comprise two branches (85, 87) which extend on either side of the saddle support (7) according to the width of the device. and the free end of which may be more or less apart from said saddle support (7) depending on the width of the device and locked in position, said free end of said branches (85, 87) comprising an element for fixing the thigh or the leg (94), mounted to rotate about an axis parallel to the width of the device. Device according to Claim 2, characterized in that each of said branches (85) comprises two parts (851), articulated with respect to one another along parallel axes, said parts (851) forming a deformable parallelogram, the one of said articulated parts (851) comprises a threaded rod (856) passing through a thread formed in said part, said threaded rod makes it possible to deform the parallelogram formed by said parts (851), thus modifying the spacing of said branch (85) by relative to said saddle support, according to the width of said device. Device according to any one of the preceding claims, characterized in that said thigh or leg spacing means (87, 871, 94) are adjustable and lockable in position according to the length and / or height of said device. Device according to any one of the preceding claims, characterized in that it comprises a central beam (3) which extends along the length of said base (1) and in that said second end of each of said movable arms (93; 91) is slidably mounted along said central beam (3) and pivoting about an axis parallel to the width of the device. Device according to any one of the preceding claims, characterized in that it comprises drive means (5; 500) of said arms (9) forming the crankset, said drive means (5; 500) being adapted to drive alternately said movable arms (9) in a rotational movement combined with a translation. Device according to Claim 6, characterized in that the said drive means (5; 500) can comprise one or two rotary motors (5) and / or at least one connected wheel (500) to said movable arms (91), capable of come to touch the ground and to be rotated by the movement of said device on the ground. Device according to any one of the preceding claims, characterized in that it comprises a footrest (6) which comprises a sole, the lower surface of which is equipped with at least one rotating attachment element (66), said element hook (66) being made of an elastically deformable material and mounted to rotate about an axis passing through the plane defined by the sole and forming a non-zero angle with the longitudinal dimension of said sole. Device according to any one of the preceding claims, characterized in that said patient's foot or leg wedging element (6) is mounted on said movable arm (91; 93) by means of a mounting element (4 ) comprising damping means (42) capable of damping the vertical movements of said wedging element (6). Device according to any one of the preceding claims, characterized in that it further comprises guide means (120, 500) in the direction of said device, said guide means being in particular chosen from a handlebars integral with a handlebar. wheel capable of touching the ground and arranged at the front of said device, a bidirectional wheel optionally coupled to motorized rear wheels fitted to said base (1), and / or coupled to gripping means allowing a helping to push said device and / or in that it comprises means for controlling said direction guide means and / or means for triggering / stopping said means for driving said movable arms (91), in that said means control and said trigger / stop means are chosen independently of one another from a joystick, sensors arranged on the saddle when said device comprises a saddle, sensors fitted with means for maintaining the patient's chest and means forming a gyroscope positioned so as to be able to be activated by said patient.

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