EP3903756B1 - 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

Description

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.

However, it turns out that for some patients, it is necessary to spread both the patient's thighs and legs. Indeed, it turns out that for certain patients who have low muscle tone, a single blockage 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 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 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.

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

In addition, when the device is equipped with a toe clip, the patient has difficulty moving and encounters problems 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 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.

In particular, 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. Such a device makes it possible to adapt perfectly to the patient's morphology and 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 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.

Characteristically, according to the invention, 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.According to a particular embodiment, 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.

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.

Advantageously, said spacing means are adjustable and lockable in position according to 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 according to the length of the device and lockable in position. 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.

According to a variant combinable with any one of the embodiments of the invention, 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.

According to another embodiment of the spacing means, 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.

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

According to a particular variant, when the spacing means comprise branches, 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.

The aforementioned threaded rod prevents the branches from tightening towards the saddle support, for example due to the patient's movements. Advantageously, 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. By modifying the length of the portion of the rods inserted between the parts, they can be repositioned 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 blockade is sometimes necessary depending on the patient's pathology.

Whatever the embodiment of the means for spreading the thighs or legs, they may include 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. These 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.

Advantageously, 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.

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 allows the two ends of the movable arms to be fixed, which makes the crankset more robust and non-deformable.

According to a particular embodiment, combinable with any of the embodiments of the invention, 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.

Advantageously, 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.

When the device has two motors, 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.

According to a particular embodiment of the element for wedging the patient's foot or leg, it 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.

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

Advantageously, 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. Advantageously, 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. 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 that 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 appended drawings in which:

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

In 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 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. For the sake of clarity, the saddle is not shown on the fig. 1 . The 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.

In 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 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.

In the embodiment shown on the fig. 1 , 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. 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 translation 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 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.

In reference to the fig. 2 , a particular embodiment of the means for separating the thighs or legs of the patient 8 will now be described. According to this embodiment, 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. 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 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. By turning the wheel 855 we modify the length of the threaded rod portion 856 which separates the two parts; we thus deforms the branch 85, which has the effect of moving its end carrying the thigh or leg fixing element 94 away from the median line D. The more the threaded rod 856 is pressed into 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 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°. According to a variant not shown, 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.

On the fig. 2 , 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.

In reference to the fig. 3 , a particular embodiment of the patient's foot wedging element and the connecting part 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 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.

In reference to the fig. 3 , the toe clip 6 will now be described. 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.

According to a variant not shown, combinable with any of the embodiments 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.

In all embodiments, 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.

In 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 represented. In this second embodiment, 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. They include 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.

In reference to the fig. 5 , an embodiment which includes 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 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. 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 when walking. Indeed, when the patient moves one lower limb forward, the other lower limb will be pulled backwards by the cord and the pulley, which provides valuable assistance. 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. 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 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.

In reference to the fig. 6 , a third embodiment of the means for separating the thighs or legs 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, 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.

In a variant not shown of any 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 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. These triggering/stopping means can be, for example, a joystick, a button or a controller. These 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.

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. 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.

We first proceed to adjust the various elements of the device. We adjust the length of the central beam 3, the height of the saddle, its inclination, the distance separating the toe clips 6 from the movable arm, the position of the thigh fixing ring 9. The patient is then placed on the saddle and maintain your torso with the torso holding means which may be part of the saddle. We set the patient's thighs in the rings 94 and the feet on the toe clips 6. When the means for separating the thighs are as shown on the fig. 2 , it is possible to finely adjust the spacing of the thighs simply by operating the knobs 855. If 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.

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(s). A sensor towards the rear allows you to stop the motor(s).

If the device includes side sensors, 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.

Claims (9)

1. Walking-rehabilitation device, of the type including a base (1) equipped with wheels spaced apart along the width and length of said base, which defines the width and length of said device, a saddle support (7) optionally equipped with a saddle, which fits on top of said base (1) and extends substantially vertically, over the height of said device, said device comprising two movable arms (91, 93) forming a crankset, disposed on either side of said saddle support (7), each arm (91; 93) comprising a first end mounted for rotation on said device about an axis parallel to the width of said base (1), said device furthermore including an element (6) for wedging the foot or leg of the patient, said wedging element (6) being adjustable and lockable in position across the width of the device, characterised in that it also includes means (87, 871, 9) for separating the thighs or legs of the patient on either side of said saddle support (7), in that said separation means (87, 871, 94) make it possible to modify the separation of the thighs of the patient and are adjustable and lockable in position across the width of said device, in that said separation means are able to follow the alternating movement of the lower limbs of the patient held by said wedging elements (6) and by said separation means (87, 871, 94), when the patient is installed on said device, and in that the adjustment of the position of said wedging element across the width of the device is independent of the adjustment of the means for separating the thighs of the patient, and in that said thigh and leg separation means include two branches (85, 87) that extend on either side of the saddle support (7) across the width of the device and the free end of which can be separated from said saddle support (7) to a greater or lesser extent across the width of the device and locked in position, said free end of said branches (85, 87) including an element for securing the thigh or leg (94), mounted for rotation about an axis parallel to the width of the device.
2. Device according to claim 1, characterised in that each of said branches (85) includes two pieces (851), articulated with respect to each other on parallel axes, said pieces (851) forming a deformable parallelogram, one of said articulated pieces (851) includes a threaded rod (856) passing through a thread provided in said piece, said threaded rod making it possible to deform the parallelogram formed by said pieces (851), thus modifying the separation of said branch (85) with respect to said saddle support, across the width of said device.
3. Device according to either one of the preceding claims, characterised in that said means (87, 871, 94) for separating the thighs or legs are adjustable and lockable in position along the length and/or over the height of said device.
4. Device according to any one of the preceding claims, characterised in that it includes a central beam (3) that extends along the length of said base (1) and in that said second end of each of said movable arms (93; 91) is mounted so as to slide along said central beam (3) and so as to pivot on an axis parallel to the width of the device.
5. Device according to any one of the preceding claims, characterised in that it includes means (5; 500) for driving said arms (9) forming the crankset, said driving means (5; 500) being adapted to alternately drive said movable arms (9) in a rotation movement combined with a translation.
6. Device according to claim 5, characterised in that said driving means (5; 500) can include one or two rotary motors (5) and/or at least one wheel (500) connected to said movable arms (91), able to touch the floor and to be rotated by the movement of said device on the floor.
7. Device according to any one of the preceding claims, characterised in that it includes a foot chock (6) that includes a sole plate the bottom surface of which is equipped with at least one rotary attachment element (66), said attachment element (66) being made from an elastically deformable material and mounted for rotation about an axis passing through the plane defined by the sole plate and forming a non-zero angle with the longitudinal dimension of said sole plate.
8. Device according to any one of the preceding claims, characterised in that said element (6) for wedging the foot or leg of the patient is mounted on said movable arm (91; 93) by means of a mounting element (4) comprising damping means (42) able to damp the vertical movements of said wedging element (6).
9. Device according to any one of the preceding claims, characterised in that it furthermore includes means (120, 500) for guiding said device in direction, said guiding means being in particular selected from a handlebar secured to a wheel able to touch the floor and disposed in front of said device, a bidirectional wheel optionally coupled to motorised rear wheels equipping said base (1), and/or coupled to gripping means enabling an assistant to push said device, and/or in that it includes means for controlling said means for guiding in direction and/or means for triggering/stopping said means for driving said movable arms (91), in that said control means and said triggering/stopping means are selected independently of each other among a joystick, sensors disposed on the saddle when said device includes a saddle, sensors equipping means for holding the chest of the patient and means forming a gyroscope positioned so as to be able to be activated by said patient.

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