EP3903756B1 - Orthopädische gehhilfevorrichtung, die zur rehabilitation des gehvermögens verwendet werden kann und mittel zum spreizen der oberschenkel des patienten umfasst - Google Patents

Orthopädische gehhilfevorrichtung, die zur rehabilitation des gehvermögens verwendet werden kann und mittel zum spreizen der oberschenkel des patienten umfasst Download PDF

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Publication number
EP3903756B1
EP3903756B1 EP21169489.8A EP21169489A EP3903756B1 EP 3903756 B1 EP3903756 B1 EP 3903756B1 EP 21169489 A EP21169489 A EP 21169489A EP 3903756 B1 EP3903756 B1 EP 3903756B1
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EP
European Patent Office
Prior art keywords
patient
width
thighs
saddle
saddle support
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Application number
EP21169489.8A
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English (en)
French (fr)
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EP3903756A1 (de
Inventor
Rami Haidar
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Individual
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Individual
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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
    • A61H1/0237—Stretching or bending or torsioning apparatus for exercising for the lower limbs
    • A61H1/0255—Both knee and hip of a patient, e.g. in supine or sitting position, the feet being moved together in a plane substantially parallel to the body-symmetrical plane
    • A61H1/0262—Walking movement; Appliances for aiding disabled persons to walk
    • 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
    • A61H3/00—Appliances for aiding patients or disabled persons to walk about
    • A61H3/04—Wheeled walking aids for patients or disabled persons
    • A61H2003/043—Wheeled walking aids for patients or disabled persons with a drive mechanism
    • 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
    • A61H2201/12—Driving means
    • A61H2201/1253—Driving means driven by a human being, e.g. hand driven
    • 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
    • A61H2201/1628—Pelvis
    • A61H2201/1633—Seat
    • 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
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A61H2201/5058—Sensors or detectors
    • A61H2201/5064—Position sensors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A61H2201/5058—Sensors or detectors
    • A61H2201/5064—Position sensors
    • A61H2201/5066—Limit switches
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A61H2201/5058—Sensors or detectors
    • A61H2201/5069—Angle sensors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H3/00—Appliances for aiding patients or disabled persons to walk about
    • A61H3/04—Wheeled walking aids for patients or disabled persons

Definitions

  • the document EP 3 598 961 A1 describes an orthopedic device to assist with ambulation and which can be used for gait rehabilitation, in particular for multi-disabled patients with motor problems.
  • This device comprises a base which has 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 includes a support element for the patient's foot or leg which is mounted adjustable in position according to the width of the base. This wedging element allows the patient's legs to be spread apart on either side of the saddle, thus avoiding friction between the saddle and the patient's thighs.
  • the aforementioned document describes a motorized embodiment of the device.
  • the articulated arms include a motor on each of their joints. These motors must then be controlled to simulate walking and train the patient's lower limbs. It turns out that there are too many motors and their control for walking simulation is complicated. These motors are more fragile and it is difficult to connect them to an electrical power source.
  • the document WO 2012/049442 A1 describes a walking rehabilitation device which comprises a base equipped with casters spaced according to the width and length of the base. These measures features a harness that supports the patient's buttocks. The patient's thighs are inserted into straps that cannot be moved apart from each other. This device therefore does not allow the spacing of the patient's thighs to be adjusted. This device does not include a pedal.
  • the document JP 2007 014698 A1 describes a device that allows the patient to walk.
  • This device does not include a saddle holder, nor a support element for the patient's foot or leg that is adjustable and lockable in position depending on the width of the device.
  • This device does not include a pedal board.
  • the document US 9 907 721 B2 describes a device which does not include any means of bracing 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 restraining the patient.
  • the patient's legs are held at the level of two support posts, which cannot be moved apart.
  • This device does not include a pedal.
  • the document KR 2018 0123939 A describes a ambulation aid device which comprises an exoskeleton mounted on a mobile support comprising casters.
  • the two uprights on which the patient's lower limbs are fixed cannot be moved away from each other, so as to adjust the spacing of the patient's thighs.
  • This device does not include a pedal.
  • An aim of the present invention is to resolve any of the disadvantages linked to the use of the device of the prior art.
  • an aim of the present invention is to propose a ambulation aid device according to claim 1, which comprises a pedal and makes it possible to separately adjust the spacing of the patient's feet and legs or the spacing patient's thighs and feet/legs.
  • a pedal makes it possible to separately adjust the spacing of the patient's feet and legs or the spacing patient's thighs and feet/legs.
  • Such a device makes it possible to adapt perfectly to the patient's morphology and pathology.
  • the presence of the pedal implies precise positioning of the different parts of the patient's lower limbs so as not to cause injury when using the device.
  • the present invention relates to a walking rehabilitation device, of the type comprising a base equipped with casters spaced according to the width and length of said base, which defines the width and length of said device, a saddle support possibly equipped with a saddle , which surmounts said base and extends substantially vertically, according to the height of said device, said device comprising two arms mobile forming a pedal board, arranged on either side of said saddle support, each arm comprising a first end rotatably mounted on said device around 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.
  • the device also comprises means for spacing the patient's thighs or legs on either side of said saddle support, said means for spacing the thighs making it possible to modify the spacing of the 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 capable of following the reciprocating movement of the lower limbs of the patient held by said elements wedging and by said means for spacing the thighs or legs, 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 spacing the thighs of the patient.
  • the wedging element is mounted on the free end of each of the movable arms forming the pedal board.
  • the position of the means for separating the thighs or legs is not limited according to the invention. They can be mounted on the movable arms forming the crankset or on the saddle support.
  • the presence of means for separating the patient's thighs or legs makes it possible to properly position the patient's thighs, legs, knees and feet in an alignment that 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 damage 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 thigh or leg spreading means form means for guiding the leg during the walking movement.
  • the spacing means When the spacing means are mounted on the saddle support, they are easier to adjust because they are closer to the thighs or legs.
  • the thigh spreading means 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 spaced from said saddle support depending on the width of the device and locked in position, said free end of said branches comprising an element for fixing the thigh or leg, mounted to rotate around an axis parallel to the width of the device.
  • the fixing element serves to fix, by clamping, for example, the patient's thigh or leg. It can be directly mounted to rotate on the end of the branch. It can also be rotatably mounted on the end of the branch via an upright which is rotatably mounted along 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.
  • said spacing means are adjustable and lockable in position according to the length and/or height of said device.
  • the spacing means can also include a tube mounted sliding 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 spreading means according to the length of the device.
  • the two branches being movable in rotation around 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.
  • the fixing element when the fixing element is mounted on the free end of the branch via an upright, it is advantageously mounted adjustable in position on the amount which connects it to the branch and its position on said amount can be blocked, by means, for example, of blocking 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 of the means for spreading the thighs or legs depending on the length of the device.
  • the thigh or leg fixing element is mounted to rotate around an axis parallel to the width of the device, adjustable in position according to 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 rotating articulation of the fixing element makes it possible to follow the alternating 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 slidably mounted 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.
  • the means for spreading the thighs or legs are arranged at the rear of the saddle support. They are therefore easily accessible.
  • each of said branches comprises two parts articulated relative to each other along parallel axes, said parts forming a deformable parallelogram
  • one of said articulated parts comprises a threaded rod passing through a thread provided in said part, said threaded rod makes it possible to deform the parallelogram formed by said parts, thus modifying the spacing of said branch relative to said saddle support, according to the width of said device.
  • Such means prove to be easy to finely adjust without acting on the patient. They are also robust and allow the position of the hips and lower limbs to be adjusted independently. In fact, the spacing of each branch can thus be modified independently of the other. It is common for patients to only have positioning problems in one hip. The spacing means thus make it possible to correct the bad position of a single hip without modifying that of the other hip.
  • this variant can also include means for blocking the spacing of the branches which prevent the branches from moving away from each other according to the width of the device.
  • These blocking means may include 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.
  • 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 blockade is sometimes necessary depending on the patient's pathology.
  • 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 forward and one leg behind.
  • synchronization means can, for example, comprise a pulley on which slides and a link which connects the two branches of the means for spacing the thighs or legs, independently of the structure of the branches of the spacing means. The latter may be as mentioned above or not.
  • said base has a U shape whose opening 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.
  • the device of the invention 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 allows the two ends of the movable arms to be fixed, which makes the crankset more robust and non-deformable.
  • said device comprises means for driving the arms forming the crankset, said drive means being adapted to alternately drive said movable arms in a rotational movement combined with a translation.
  • the pedal being activated due to an external force, it causes the device of the invention to move and the patient to walk.
  • the drive means can for example be means for driving the ends of the movable arms in reciprocating rotation.
  • the reciprocating drive is obtained by means of selected gears 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, capable of touching the ground and being rotated by the movement of said device on the ground.
  • the motor(s) can be electrically connected to a power battery mounted on the device of the invention.
  • the motor(s) include a safety device which blocks their rotational movement when the patient exerts a force on one or both of the movable arms.
  • the movement of the pedal 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 walking movement.
  • the wedging element of the foot or leg may be that described in the prior art.
  • the toe clip 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 toe clip.
  • the element for wedging the patient's foot or leg comprises a foot support which comprises a sole whose lower surface is equipped with at least one rotary gripping element, said element hook being made of elastically deformable material and mounted to rotate around an axis passing through the plane defined by the sole and forming a non-zero angle with the longitudinal dimension of said sole.
  • the aforementioned angle is between 5 and 15° with a straight line parallel to the length of the toe clip.
  • said wedging element for 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.
  • the device comprises means for guiding in direction, said guide means being in particular chosen from a handlebar secured to a caster capable of touching the ground and arranged at the front of said device, a bidirectional wheel possibly coupled to casters motorized rears equipping said base and/or coupled to gripping means allowing a caregiver 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 driving said movable arms, said control means and said triggering/stopping means are chosen independently of each other from a joystick, sensors arranged on the saddle when said device comprises a saddle, sensors equipping 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 can be the wheel used to drive the rotation of the crankset; it then has two functions: setting the pedal in motion when a caregiver pushes the device on the ground and guiding it in the direction of the device, the latter always being set in motion by the caregiver, the bidirectional wheel effectively allows the helping to change direction.
  • the handlebar is indicated for patients able to use their arms and hands.
  • the sensors are best suited for patients who can only oscillate their torso, back and forth and left to right.
  • the device may not include a handlebar.
  • the device comprises a base 1 which has a general U shape, 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 freely pivoting around a vertical axis.
  • the device includes a beam central 3 secured to 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 electrical supply battery 51 , mounted on top of the central beam 3. This battery 51 is possibly removable and can be recharged without the presence of the device of the invention.
  • the device also includes a saddle support 7, which extends vertically and on which a saddle made of polymeric material can be fixed.
  • a saddle support 7 comprises a hollow tube 71 (disposed 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 means for attaching the patient's bust can be mounted.
  • the saddle can be fixed on tube 71.
  • 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 around a horizontal axis extending along the width of the device (c i.e. 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 around a horizontal axis which extends along the width of the device.
  • the second end 932 of the second segment 93 is mounted to rotate around a horizontal axis which extends along the width of the device, on a part 933, which is slidably mounted on a horizontal rail 34 equipping 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 drive each of the first segments 91 in rotation.
  • Each first segment 91 drives the second end of the second segment 93 in translation.
  • Each second segment 93 comprises a connecting part 4, substantially vertical, which will be more fully detailed with reference to there fig. 3 .
  • the end of the connecting piece 4 not mounted on the second segment 93 includes a toe clip 6 which extends along the length and width of the device. This toe clip 6 is mounted adjustable in position depending on the width of the device. Its position can be modified then fixed according to the width of the device. The toe clip 6 will be described more fully with reference to the fig. 3 .
  • the toe clip 6 can also be mounted adjustable in position as described in the prior art document.
  • the central beam 3 comprises two portions mounted sliding 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 depending on the morphology of the patient.
  • 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 translation movement of the end of the second segment 93, this movement corresponding to the patient's stride.
  • the saddle support 7 is mounted adjustable in height and/or inclination relative to the base 1, as indicated in the prior art document.
  • the connecting part 4 also includes a series of perforations which make it possible to vary the distance between the toe clip 6 and the second segment 93.
  • the toe clip 6 is mounted movable in rotation on the end of the connecting part 4. Its angular position is variable and can be fixed; it therefore also includes angular locking means (not shown) which make it possible to lock its angular position relative to the connecting part 4.
  • the spacer means 8 comprise a horizontal tube 81 capable of being slid into 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 movable in rotation around the axis 83.
  • Each branch 85 is formed of two parts 851 whose two ends are mounted movable around horizontal axes on the fig. 2 , and parallel to tube 81, respectively X1, X2, X3 and X4.
  • the two parts 851 can thus be more or less spaced from the center line D of the spacing means 8.
  • the spacing of the branches 85 is adjusted via a wheel 855 which equips the end of a threaded rod 856. The end free of the threaded rod 856 abuts on a portion of the external part.
  • An extension segment 852 extends the branch 85 and is mounted to rotate around 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 tightening the leg or thigh 94 (or tightening ring or also called thigh fixing element).
  • This fixing element 94 includes a ball joint 940 which makes it possible to orient the clamping element according to a rotation of almost 360°.
  • the fixing/tightening element 94 and its ball joint 940 are slidably mounted on the extension segment 852 and are lockable in position according to the length of the latter. This makes it possible to adapt the position of the tightening element 94 according to the morphology of the patient, his thighs being more or less distant from the rear of the saddle support 7.
  • the blocking 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.
  • 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 blocked , for example, with nut-and-bolt systems which tighten the connecting part 4 on the second segment 93 or using a bolt-and-nut system passing through the slots 936 and on which the part 4 abuts so as to prevent its translation in the slots 936.
  • Part 4 comprises a plate 41, one end of which carries the toe clip 6 and the other end is fixed on the second segment 93 as previously explained.
  • the plate 41 includes a stop 410 which extends horizontally, depending on the thickness of the plate.
  • the plate 41 is fixed on the second segment 93 by means of a fixing 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 fixing part 412 and the stop 410.
  • the spring 42 has one end resting on the stop 410 and the other resting on the thickness of the fixing 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 movement.
  • the spring 42 therefore allows the connecting part 4 to absorb shocks and uneven ground when moving the toe clip 6.
  • the toe clip 6 has a sole and is mounted at the end of the connecting piece 4 according to its width.
  • the sole is defined as the surface on which the patient places their foot.
  • the length of the toe clip 6 is defined according to the length of the device.
  • the toe clip 6 comprises two hollow plates 61 and 63 which slide one inside the other and are lockable in position, by a screw and nut system, for example. These two plates 61 and 63 make it possible to modify the width of the toe clip 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 toe clip 6 comprises two rollers 66 of elastically deformable material.
  • the rollers 66 are pivotally mounted around an axis substantially parallel to the length of the toe clip. Their axis of rotation preferably forms an angle of between 5 and 15° with a straight line parallel to the length of the toe clip 6.
  • the elastically deformable material allows good grip of the sole of the toe clip 6 on the ground.
  • the rollers 66 being pivotable, they allow the toe clip 6 to roll on the ground according to its width. The inclination of their axis of rotation allows the toe clips 6 to easily roll on the ground during changes in direction of the device of the invention.
  • the toe clip 6 comprises a plate forming a sole which is fixed along one of its edges, to the toe clip 6 by a hinge which is parallel to the width of the toe clip 6.
  • the plate forming the sole is articulated and can therefore be lifted and blocked above the toe clip 6, its edge being integral with the hinge.
  • a foot support 6 comprising a plate forming an articulated sole makes it possible to securely fix the patient's foot when it cannot be positioned at an angle of 90° with the leg.
  • the foot support 6 comprises means for fixing the patient's foot which are not shown in the aforementioned figures, for the sake of clarity and simplification.
  • the movable arm only comprises a segment 91, one end 912 of which is mounted sliding and pivoting 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 500 wheels are bidirectional.
  • rollers 501 which are capable of rolling 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 moving forward while the other moves backward.
  • This embodiment can also include, in addition to motorized rear wheels or as a replacement, gripping means allowing a caregiver to push the device of the invention.
  • the wheels 500 also make it possible to set in motion the segments 91, which simulate the movement of walking.
  • the 7 saddle support is equipped with a 710 saddle made of rigid plastic.
  • the saddle 710 which extends vertically, above the saddle support 7 at the level of the patient's chest and back.
  • the saddle also includes two lateral sides 711 provided with closing 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 blocked, once adjusted.
  • the support 1 includes gripping handles 120 allowing a caregiver to push the device of the invention.
  • the means for spreading the thighs or legs comprise branches 87 which slide in the saddle support 7, according to the width of the device, on each side of the saddle support 7 and according to its length.
  • the brackets or branches 87 can be locked in position for example, by means of a threaded screw system which pinches them against a horizontal wall of the saddle support 7.
  • each bracket 87 carries the thigh tightening ring 94, which is mounted on the bracket 87 by means of a perforated upright 871 which allows the height adjustment of the ring 94.
  • the ring 94 is mounted on the upright 871 by means of a screw and a nut.
  • the perforated upright 871 is also rotatably mounted on the bracket 87, around an axis parallel to the width of the device, so as to be able to follow the movement of the patient's lower limbs.
  • 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, allow, by tightening, 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 lockable in position on this rail.
  • An identical fixing plate 871 is mounted sliding and lockable in position on the second rail 882.
  • the fixing element of the thigh or leg 94 is mounted on the fixing plate 871 by means of a Y axis which is extends according to the width of the device.
  • the thigh or leg fixing element 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 depending on 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 according to 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 adjustment of the latter 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 allows 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.
  • 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.
  • the device When the device includes means for setting in motion the movable arms forming a crankset (motor or rear wheel), it also includes means for triggering/stopping these means for setting in motion.
  • triggering/stopping means can be, for example, a joystick, a button or a controller.
  • control means can also include a touch sensor placed on the saddle, at the level of the patient's thorax and/or a touch sensor placed at the level of the patient's back. The patient can thus, by leaning forward or backward, trigger or stop the means of movement.
  • the device When the device includes means for changing the direction of its movement, the device includes means for controlling these means.
  • These control means may include, for example, tactile sensors placed on the lateral sides 711 of the saddle 710. These sensors are coupled to motorized rear casters which go due to their opposite rotation (one moving forward, the other moving backwards) modify the trajectory/direction of movement of the device.
  • tactile sensors placed on the lateral sides 711 of the saddle 710. These sensors are coupled to motorized rear casters which go due to their opposite rotation (one moving forward, the other moving backwards) modify the trajectory/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.
  • the device includes one or more wheels 500, a caregiver can push the device to drive the movable arms and therefore simulate walking.
  • the wheel 500 is in a bidirectional state, the caregiver can change the direction of movement of the device of the invention.
  • 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(s).
  • a sensor towards the rear allows you to stop the motor(s).
  • the patient can direct the device of the invention by swinging his torso to the right or left.
  • Motorized rear casters and 500 wheels allow change of direction.

Landscapes

  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (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)
  • Rehabilitation Tools (AREA)
  • Orthopedics, Nursing, And Contraception (AREA)

Claims (9)

  1. Vorrichtung zur Rehabilitation beim Gehen, vom Typ, umfassend eine Basis (1), die mit Rollen ausgestattet ist, die entlang der Breite und der Länge der Basis beabstandet sind, wobei diese die Breite und die Länge der Vorrichtung definiert, eine gegebenenfalls mit einem Sattel ausgestattete Sattelstütze (7), die die Basis (1) überragt und sich entlang der Höhe der Vorrichtung im Wesentlichen vertikal erstreckt, wobei die Vorrichtung zwei bewegliche Arme (91, 93) enthält, die Pedalanordnung bilden und auf beiden Seiten der Sattelstütze (7) angeordnet sind, wobei jeder Arm (91; 93) ein erstes Ende enthält, das so an der Vorrichtung montiert ist, dass es sich um eine Achse dreht, die parallel zur Breite der Basis (1) verläuft, wobei die Vorrichtung ferner ein Element zum Verkeilen des Fußes oder Beins des Patienten (6) umfasst, wobei das Keilelement (6) in seiner Position entlang der Breite der Vorrichtung einstellbar und arretierbar ist, dadurch gekennzeichnet, dass es außerdem Beabstandungsmittel für die Oberschenkel oder Beine (87, 871, 9) des Patienten auf beiden Seiten des Stützsattels (7) umfasst, dass die Beabstandungsmittel (87, 871, 94) es ermöglichen, die Beabstandung der Oberschenkel des Patienten zu verändern und in ihrer Position entlang der Breite der Vorrichtung einstellbar und arretierbar sind, dass die Beabstandungsmittel dazu ausgelegt sind, der Hin- und Herbewegung der unteren Gliedmaßen des Patienten zu folgen, die von den Keilelementen (6) und den Beabstandungsmitteln (87, 871, 94) gehalten werden, wenn der Patient auf die Vorrichtung gesetzt wurde, und dass die Einstellung der Position des Keilelements entlang der Breite der Vorrichtung unabhängig von der Einstellung der Beabstandungsmittel für die Oberschenkel des Patienten ist und dass die Beabstandungsmittel für die Oberschenkel oder Beine zwei Schenkel (85, 87) umfassen, die sich entlang der Breite der Vorrichtung auf beiden Seiten der Sattelstütze (7) erstrecken und deren freies Ende möglicherweise mehr oder weniger von der Sattelstütze (7) entlang der Breite der Vorrichtung getrennt und in seiner Position arretiert ist, wobei das freie Ende der Schenkel (85, 87) ein Element zur Fixierung des Oberschenkels oder Beins (94) umfasst, das so montiert ist, dass es sich um eine Achse dreht, die parallel zur Breite der Vorrichtung verläuft.
  2. Vorrichtung nach Anspruch 1, dadurch gekennzeichnet, dass jeder der Schwenkel (85) zwei Teile (851) umfasst, die im Verhältnis zueinander entlang paralleler Achsen gelenkig miteinander verbunden sind, wobei die Teile (851) ein verformbares Parallelogramm bilden, wobei eines der Gelenkteile (851) eine Gewindestange (856) umfasst, die durch ein in diesem Teil ausgebildetes Gewinde verläuft, wobei die Gewindestange es ermöglicht, das von den Teilen (851) gebildete Parallelogramm zu verformen und so entlang der Breite der Vorrichtung die Beabstandung des Schenkels (85) im Verhältnis zur Sattelstütze zu ändern.
  3. Vorrichtung nach einem der vorhergehenden Ansprüche, dadurch gekennzeichnet, dass die Beabstandungsmittel für die Oberschenkel oder Beine (87, 871, 94) entlang der Länge und/oder der Höhe der Vorrichtung in ihrer Position einstellbar und arretierbar sind.
  4. Vorrichtung nach einem der vorhergehenden Ansprüche, dadurch gekennzeichnet, dass sie einen Mittelträger (3) aufweist, der sich entlang der Länge der Basis (1) erstreckt, und dass das zweite Ende jedes der beweglichen Arme (93; 91) entlang des Mittelträgers (3) verschiebbar und entlang einer Achse, die parallel zur Breite der Vorrichtung verläuft, schwenkbar montiert ist.
  5. Vorrichtung nach einem der vorhergehenden Ansprüche, dadurch gekennzeichnet, dass sie Antriebsmittel (5; 500) für die Arme (9) umfasst, die die Pedalanordnung bilden, wobei die Antriebsmittel (5; 500) dazu ausgebildet sind, die beweglichen Arme (9) abwechselnd in einer Drehbewegung in Kombination mit einer Translation anzutreiben.
  6. Vorrichtung nach Anspruch 5, dadurch gekennzeichnet, dass die Antriebsmittel (5; 500) einen oder zwei rotierende Motoren (5) und/oder mindestens ein mit den beweglichen Armen (91) verbundenes Rad (500), das dazu ausgelegt ist, den Boden zu berühren und durch die Bewegung der Vorrichtung auf dem Boden drehangetrieben zu werden, umfassen.
  7. Vorrichtung nach einem der vorhergehenden Ansprüche, dadurch gekennzeichnet, dass sie eine Fußplattform (6) umfasst, die eine Sohle umfasst, deren Unterseite mit mindestens einem drehbaren Haftelement (66) ausgestattet ist, wobei das Haftelement (66) aus einem elastisch verformbaren Material hergestellt und so montiert ist, dass es sich um eine Achse dreht, die durch die durch die Sohle definierte Ebene verläuft und mit der Längsabmessung der Sohle einen Winkel ungleich Null bildet.
  8. Vorrichtung nach einem der vorhergehenden Ansprüche, dadurch gekennzeichnet, dass das Keilelement für den Fuß oder das Bein des Patienten (6) mittels eines Montageelements (4), das Dämpfungsmittel (42) enthält, die dazu ausgelegt sind, die vertikalen Bewegungen des Keilelements (6) zu dämpfen, an dem beweglichen Arm (91; 93) befestigt ist.
  9. Vorrichtung nach einem der vorhergehenden Ansprüche, dadurch gekennzeichnet, dass sie ferner Führungsmittel (120, 500) in Richtung der Vorrichtung umfasst, wobei die Führungsmittel insbesondere aus einem Lenker, der fest mit einer Laufrolle verbunden ist, die dazu ausgelegt ist, den Boden zu berühren, und an der Vorderseite der Vorrichtung angeordnet ist, und einem bidirektionalen Rad ausgewählt werden, das gegebenenfalls mit motorisierten hinteren Laufrollen gekoppelt ist, mit denen die Basis (1) ausgestattet ist, und/oder mit Greifmitteln gekoppelt ist, die es einer Pflegekraft ermöglichen, die Vorrichtung zu schieben, und/oder dass sie Mittel zum Steuern der Führungsmittel in der Richtung und/oder Mittel zum Auslösen/Anhalten der Antriebsmittel der beweglichen Arme (91) umfasst, wobei die Steuermittel und die Auslöse-/Anhaltemittel unabhängig voneinander aus einem Joystick, Sensoren, die auf dem Sattel angeordnet sind, wenn die Vorrichtung einen Sattel umfasst, Sensoren, mit denen Mittel zum Halten des Oberkörpers des Patienten ausgestattet sind, und Mitteln, die ein Gyroskop bilden und so positioniert sind, dass sie vom Patienten aktiviert werden können, ausgewählt werden.
EP21169489.8A 2020-04-27 2021-04-20 Orthopädische gehhilfevorrichtung, die zur rehabilitation des gehvermögens verwendet werden kann und mittel zum spreizen der oberschenkel des patienten umfasst Active EP3903756B1 (de)

Applications Claiming Priority (1)

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FR2004175A FR3109521A1 (fr) 2020-04-27 2020-04-27 Dispositif orthopedique d’aide a la deambulation et pouvant servir a la reeducation de la marche du type comportant des moyens d’ecartement des cuisses du patient

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EP3903756B1 true EP3903756B1 (de) 2024-05-15

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FR3128114A1 (fr) * 2021-10-18 2023-04-21 Wewalk Tech Dispositif orthopédique d’aide à la déambulation comportant des moyens de motorisatoin et des moyens d’écartement des cuisses du patient
CN115634127A (zh) * 2022-09-23 2023-01-24 吉林大学 一种可变形的失能老人行走用辅助装置

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JP4624200B2 (ja) * 2005-07-11 2011-02-02 学校法人東京理科大学 歩行補助装置
GB2484463A (en) * 2010-10-11 2012-04-18 Jonathan Butters Apparatus to assist the rehabilitation of disabled persons
WO2013142997A1 (en) * 2012-03-29 2013-10-03 Morbi Aliasgar Control system and device for patient assist
CN107874984A (zh) * 2016-09-29 2018-04-06 龙华科技大学 多功能下肢步态复健与助走机器装置结构改良
KR102334854B1 (ko) * 2017-05-10 2021-12-03 에이치엠에이치 주식회사 보행 보조 로봇
EP3598961A1 (de) 2018-07-25 2020-01-29 Rami Haidar Orthopädische gehhilfevorrichtung

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