Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
  • A61B90/06—Measuring instruments not otherwise provided for
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B5/00—Measuring for diagnostic purposes; Identification of persons
  • A61B5/103—Measuring devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
  • A61B5/11—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor or mobility of a limb
  • A61B5/1124—Determining motor skills
• • A—HUMAN NECESSITIES
  • A63—SPORTS; GAMES; AMUSEMENTS
  • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
  • A63B21/00—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices
  • A63B21/40—Interfaces with the user related to strength training; Details thereof
  • A63B21/4027—Specific exercise interfaces
  • A63B21/4033—Handles, pedals, bars or platforms
  • A63B21/4034—Handles, pedals, bars or platforms for operation by feet
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
  • A61B90/06—Measuring instruments not otherwise provided for
  • A61B2090/064—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension
• • A—HUMAN NECESSITIES
  • A63—SPORTS; GAMES; AMUSEMENTS
  • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
  • A63B2225/00—Miscellaneous features of sport apparatus, devices or equipment
  • A63B2225/09—Adjustable dimensions

Definitions

• the present invention relates to a method for neuromuscular and motor characterization of at least one lower and/or upper limb of an individual and a measurement bench for implementing this method.
• the neuromoscular characterization of an individual's lower limb is well known to those skilled in the art. Such a characterization is, for example, disclosed in the document "Isocinetisme, Clinical Guide, 2009, by M. Elio Di Palma” accessible via the following address: https://elitemedicale.fr/media/documentations/Easytech/isocinetisme/lsocinetique_ea sytech_guide_clinique.pdf.
• Isokinetic systems are used for physiotherapy diagnosis, functional assessment, rehabilitation and training in cases of neuromuscular deficits. They make it possible to collect objective information which makes it possible to carry out a rehabilitation program based on facts.
• Rehabilitation based on performance monitoring with dosed muscle work is not only a highly effective treatment for correcting muscle deficits, but it is also a method that allows you to increase coordination skills, which are difficult to improve with conventional training methods.
• An isokinetic exercise consists of a movement at a constant speed in which the resistance automatically adapts to the force applied, provided that the speed of the movement is maintained. This type of movement guarantees maximum muscle contraction during the entire exercise, and for each degree of joint movement.
• suitable instruments allows exercises to be personalized according to age, sex and pathology and to define the best method of training/rehabilitation of the muscular structures in each phase of the training or rehabilitation project. .
• To perform these isokinetic exercises the individual sits on a static chair and pushes, using the front part of one of his shins, a robotic force arm.
• the present invention aims to remedy at least in part to this need.
• the present invention aims to improve the detection of musculo-osteo-articular risks on individuals with a functional imbalance such as a muscular, proprioceptive, psychological or other imbalance.
• a first object of the invention relates to a method for neuromuscular characterization of at least one lower and/or upper limb of an individual by means of a measuring bench.
• This characterization method includes:
• the characterization method uses a movement of the individual. This is attracted towards the platform by the predetermined load. The measurement of neuromuscular imbalances is then more precise because it respects the so-called "ballistic" human movement by making it possible to produce a first phase maximum deceleration for a given load. Indeed, the effort generated by the individual on the platform is an eccentric effort similar to landing or descending a staircase. A second thrust phase, also ballistic, produces a maximum acceleration phase. During this second phase, a concentric effort is made similar to a "drop jump" type jump.
• the characterization method comprises a step of cushioning the seat after the step of pushing by the individual.
• the seat is brought back, after the step of pushing by the individual, into the test position or into an evacuation position to evacuate the individual from the measuring bench.
• the seat may thus be blocked at the end of its travel after the pushing stage. It is then gently brought back to the test position or to the evacuation position. This allows the individual to push without apprehension and without having to question the cushioning or the return of the carriage, this being done automatically. The individual is therefore concentrated on his push task.
• the speed of movement of the seat towards the test position and/or towards the evacuation position is controlled.
• the speed of movement of the seat is controlled by a carriage secured to said seat.
• the mobile carriage is unstuck from the seat when said seat is locked in the test position.
• the positioning of the force platform is adjusted on a part of a frame of the measuring bench according to the individual.
• the signal acquisition step includes digitizing said signals.
• the data processing step is carried out in deferred time.
• Another object of the invention relates to a measurement bench for neuromuscular characterization of at least one lower and/or upper limb of an individual.
• the measuring bench includes:
• a seat intended to receive the individual, said seat being adapted to be movable relative to the frame up to a test position, said test position being moved back relative to a standard position in which the individual is in contact with the force platform by the at least one member of the individual;
• a locking/unlocking device suitable for locking/unlocking the seat in the test position, said seat being driven towards the force platform by a predetermined load during unlocking;
• said acquisition device comprising software signal acquisition
• the measuring bench is intended to allow the measurement of the forces generated, in one, two or three dimensions, by the lower limbs such as legs and/or upper limbs such as arms, as well as the speed reached by the human body propelled by these forces.
• This system is an integrated system allowing the management of the measurements, the positioning of the subject, the sensors, the safeties of movement, in an automatic and integrated way.
• Both pneumatic and electrical automatisms are managed by an industrial digital automaton adapted to interact with the actuators of the measuring bench and with the data acquisition system.
• the measuring bench is made in such a way as to make it possible to characterize, in all dimensions, the individual and his physical performance in complete safety, without prior learning and on all sports, non-sports, healthy, injured or recovering people. of activity.
• the force platform is suitable for measuring said force generated by the individual in three mutually perpendicular directions and for measuring three moments around said perpendicular directions.
• the force platform is in at least two parts.
• the force platform comprises sensors of the piezoelectric type adapted to generate a signal having a bandwidth at least equal to 1000 Hz.
• the measuring bench comprises a carriage and a locking bolt, said locking bolt being capable of assuming an extended position in which the locking bolt mechanically binds the carriage to the seat and a retracted position wherein the locking bolt does not bind said carriage to said seat.
• the measuring bench comprises a toothed belt adapted to move the carriage and a three-phase motor capable of actuating said toothed belt, the speed of movement of the carriage being controlled by a speed sensor.
• the charging device comprises an indexer and a stack of a plurality of weights, said indexer being adapted to house a pin in the stack in order to select the predetermined load.
• the measuring bench comprises a damping device to dampen the seat after a push from the individual.
• the processing software operates in deferred time.
• Figure 1 is a partial perspective view of a measuring bench according to the invention.
• Figure 2 is a side view of the measuring bench of Figure 1;
• Figure 3 is a rear view of part of the frame of the measuring bench of Figures 1 and 2;
• Figure 4 is a rear view of another part of the frame of the measuring bench of Figures 1 and 2;
• Figure 5 is a front perspective view of a seat of the measuring bench of Figures 1 to 4;
• Figure 6 is a rear perspective view of the seat of the measuring bench of Figures 1 to 4;
• Figure 7 is an enlarged view of part of the frame of the measuring bench of Figures 1 and 2 centered on a device for moving said measuring bench;
• Figure 8 is a partial perspective view of a charging device of the measuring bench of Figures 1 and 2;
• Figure 9 is a partial perspective view of part of the frame of the measuring bench of Figures 1 and 2 located under the seat of Figures 5 and 6;
• Figure 10 is a rear view of the measuring bench of Figures 1 and 2 centered on a mobile mass management system of said bench;
• Figure 11 is an enlarged view of part of the mobile mass management system of Figure 10;
• Figure 12 illustrates the different steps of a neuromuscular characterization method of at least one limb of an individual from the measurement bench of Figures 1 to 11.
• FIG. 1 and Figure 2 schematically represent a partial perspective view of a measuring bench 100 according to the invention.
• This measuring bench 100 includes:
• a force platform 400A, 400B intended to measure a force generated by the at least one member of the individual; - A device 500 for moving the seat 300 towards the force platform 400A, 400B, said device for moving the seat 300 being capable of bringing the seat 300 at a predetermined speed towards a test position;
• the frame 200 comprises:
• the first frame part 210 rests horizontally on the ground. As illustrated in Figure 7, this first frame part 210 comprises:
• the first rail 211 is adapted to guide the seat 300 (not shown in Figure 7) along the Z axis.
• the second rail 212 is adapted to guide a carriage 510 of the moving device 500.
• the seat 300 is secured to the carriage 510 using a locking bolt 520.
• This locking bolt 520 is more particularly shown in Figure 8.
• the second frame part 220 extends vertically perpendicular to the first frame part 210, along the Z axis. This second frame part 220 is positioned at one end travel of the mobile carriage 300.
• the third frame part 230 is carried by the second frame part 220. This third part 230 forms a partial cage comprising a vertical base 231 and two perforated triangular parts 232A, 232B extending laterally from of the vertical base 231 .
• the third part 230 rests on the first frame part 210.
• the fourth frame part 240 is carried by the third frame part 230.
• the first frame part, the second frame part 210, the third frame part 230 and the fourth frame part 240 are metal parts.
• the force platform here comprises two parts 400A, 400B which make it possible to measure the pushing forces of the individual.
• a first part 400A is adapted to measure the thrust forces on the right side of the individual.
• a second part 400B is adapted to measure the pushing forces on the left side of the individual.
• the force platform 400A, 400B allows the measurement of the forces generated by the individual when pushing and/or landing.
• This force platform 400A, 400B is called "six degrees of freedom”. It thus makes it possible to measure the forces in three independent spatial directions (in the direction perpendicular to the movement, but also in the plane perpendicular to the movement) as well as three moments inducing rotations around three independent axes.
• the platform uses piezoelectric type sensors adapted to generate a signal having a bandwidth at least equal to 1000Hz.
• the platform can be automatically repositioned in the direction of the individual, but also in the plane perpendicular to the movement (height and width) in order to guarantee optimal quality of the measurement. These movements are carried out by a set of automatisms controlled by the user according to recorded data or on demand.
• the first part 400A and the second part 400B of the platform are positioned on the fourth part of the frame 240.
• the spacing, that is to say the distance along X between the first part 400A and the second part 400B of the force platform is adjusted by means of a first DC motor 2401 and a first incremental encoder 2402, illustrated in Figure 3.
• the first DC motor 2401 is adapted to move between them the first part 400A and the second part 400B.
• the first incremental encoder 2402 is adapted to deliver pulses allowing the definition of a direction and a count.
• an incremental encoder comprises a disk comprising opaque zones and transparent zones.
• An LED diode emits light radiation arriving on photodiodes as it passes through each transparent area of the disc.
• the force platform also includes:
• the plate supports 2403A, 2403B are respectively adapted to support the first part 400A and the second part 400B of the platform. These plate supports are guided by rails (not visible in FIG. 3) fixed to the fourth chassis part 240. Blockers (not visible in FIG. 3) make it possible to limit mechanical play during tests.
• the spacing of plate supports 2403A, 2403B is done symmetrically.
• the first ball screw 2404A and the second ball screw 2404B with pitch reversed relative to each other are integral. They are driven in rotation by the DC motor 2401 via a first gear 2407.
• the first torque limiter 2406 is here a friction torque limiter. It guarantees safety during the movement of plate supports 2403A, 2403B.
• the first incremental encoder 2402 makes it possible to know the position of the plate supports 2403A, 2403B. On power-up or after an emergency stop, an initialization of this first incremental encoder 2402 is necessary.
• the "zero" encoder will be determined by separating the plate supports 2403A, 2403B.
• the two inductive detectors 2405A, 2405B serve as software stops to stop the movement of the plate supports 2403A, 4203B as soon as one of the two inductive detectors 2405A, 2405B is activated.
• An operator will manually control the spacing of the plate supports 2403A, 2043B via a Man-Machine interface and/or by a wired remote control. This control can be done in an adjustment phase to adapt the center distance to the morphology of the individual. This control can also be done in manual mode or in maintenance mode.
• the fourth frame part 240 is movably mounted on the third frame part 230. As shown in Figure 4, the fourth frame part 240 is moved in height by means of a ball screw 2301 which is driven in rotation by a DC motor 2302 via a gear system 2303. A torque limiter 2304 by friction guarantees safety during the movement of the fourth frame part 240. Blockers (not shown) make it possible to limit the mechanical play during the tests.
• An incremental encoder 2305 also makes it possible to know the position of the plates along the Y axis. On power-up or after an emergency stop, an initialization of this incremental encoder 2305 is necessary. The “zero” encoder is determined by raising the plate supports 2403A, 2403B to the maximum.
• the two inductive limit switches 2406 and 2407 serve as software stops to stop the movement of the plates 2403A, 2403B as soon as one of the two limit switches is activated.
• the operator can manually control the height of the plates 2403A, 2403B via a Human Machine Interface and/or a wired remote control during the adjustment phase to adapt the height of these plates to the morphology of the patient.
• the height of these plates can also be adapted in manual mode or in maintenance mode.
• the third frame part 230 is adapted to move on the first frame part 210 in order to adjust its position.
• the third frame part 230 thus moves along the Z axis by means of a toothed belt driven in rotation by a three-phase motor controlled by a variable speed drive.
• a friction torque limiter guarantees safety during movement of the frame. Blockers make it possible to limit mechanical play during the tests.
• An incremental encoder makes it possible to know the position of the first part 400A and of the second part 400B of the platform along the Z axis. On power-up or after an emergency stop, an initialization of the encoder is necessary. The "zero" encoder is determined by moving the first part 400A and the second part 400B back to the maximum.
• the third frame part 230 is adapted to assume an initial position, called the maximum retracted position, in which this third frame part 230 is moved back to the maximum.
• the blockers block the third frame part 230 in this position.
• This third frame part 230 is adapted to also take an intermediate position shifted along the Z axis with respect to the initial position.
• the third frame part 230 is adapted to assume a final position, called the maximum forward position, offset along the Z axis with respect to the intermediate position.
• This seat 300 is adjustable and it allows the individual to be seated or lying down.
• the seat 300 more particularly comprises:
• the patient sits on the seat 300.
• This seat 300 can move freely along the Z axis via the rail 211.
• the seat 300 is blocked by a suitable locking/unlocking device 3108, more particularly visible in Figure 6.
• An inductive limit switch in an access zone allows the seat 300 to be positioned precisely.
• Another inductive limit switch in the test area also allows the seat to be positioned precisely.
• a second incremental encoder (not visible in FIG. 7) makes it possible to know the position of the seat 300.
• This second incremental encoder is an incremental wire encoder.
• the blocking of the seat 300 in the predetermined test position allows the reproducibility of the measurements. For safety reasons, the blocking of this seat 300 is done without energy.
• the seat 300 in its outermost position has been organized to be able to accommodate individuals with disabilities, in particular individuals in wheelchairs.
• the seat 300 includes a knocker 301 1 , as illustrated in FIG. 6. This knocker 3011 promotes the damping of the seat 300 at the end of its travel.
• the seat 300 is adapted to be moved on the first rail 211 of the first frame part 210 via the moving device 500, more particularly illustrated in FIG. set in motion 500 comprises a carriage 510 and a locking bolt 520.
• the set in motion device 500 also comprises:
• the carriage 510 is adapted to move on the second rail 212 via the toothed belt 540.
• This toothed belt 540 is driven by the three-phase motor 530.
• the position of the carriage 510 is determined from the sensor of position 550.
• This position sensor 550 is a laser position sensor.
• the speed of the carriage 510 is also determined from a speed sensor 560 such as an inductive sensor. Alternatively, the speed detector is of the potentiometric type and it covers the entire travel range of the carriage. Its precision is, for example, of the order of a millimeter.
• the speed of the carriage 510 is variable depending on the distance separating it from the seat 300, when the latter is immobilized in the test phase.
• the speed of the carriage 510 is controlled by a variable speed drive.
• the drive allows rapid movement of the carriage 510 when the latter is not secured to the seat 300.
• the drive also limits the speed of the carriage 510 when the latter is very close to the seat 300.
• the movement of the carriage 510 is then stopped. when it is positioned in line with the seat 300.
• the carriage 510 is secured to the seat 300 by means of the locking bolt 520.
• This locking bolt 520 is capable of assuming an extended position in which the locking bolt 520 mechanically binds the carriage 510 to the seat 300 and a retracted position in which the locking bolt 520 does not secure the carriage 510 to the seat 300.
• the position of the locking bolt is detected by the position detector 570.
• This position detector 570 is, for example, an inductive type detector.
• Such a device 600 comprises:
• the strap 610 is arranged between a lock 620 positioned under the seat 300 and the mobile mass management system 630.
• This management system is adapted to automatically generate a load in order to tension the strap 610 and consequently prestress the seat 300.
• This load is variable and depends on the conditions under which the individual is to be solicited. The load can thus take a value between 0 kg and 207.5 kg with a step of 2.5 kg.
• the 630 mobile mass management system thus includes:
• FIG 11 more particularly illustrates the operation of the mobile mass management system 630.
• the stack 6301 is lifted from the lifting device 6305.
• a roller 63051 is shown.
• This roller 63051 supports the stack 6301 via the lower weight of said stack.
• the indexer 6303 is adapted to move along the Y axis in order to take N positions, N being a function of the number of weights constituting the stack 6301 .
• Each weight comprises a vertical channel 63011 extending along the Y direction and a horizontal channel 63012 extending along the X axis.
• the vertical channels 63011 of the different weights form a well in which the bar 6302 is adapted to slide.
• This bar 6302 also comprises a plurality of horizontal channels 63021 coaxial with the horizontal channels 63012 of the different weights.
• the indexer 6303 is positioned along the Y axis with respect to the stack 6301 .
• the pin 6304 is moved by the indexer 6303 in the direction X' towards the weight facing it. By this displacement, the pin 6304 will penetrate the horizontal channel 63012 of the weight and cross the bar 6302 at the level of the horizontal channel 63021 .
• the pin 6304 is then released from the indexer 6303 and the bar 6302 is thus mechanically linked to all the weights of the stack 6301 which are arranged above the pin 6304.
• This set of weights constitutes the predetermined load which will be applied to the seat 300 of the measuring bench 100 via the strap 610. It will be noted that the weights which are located below the pin 6304 are not linked to the bar 6302 which slides inside them when the device lifting device 6305 lowers the pile 6301 .
• additional weights to the stack 6301 by the additional charging device 6306. It is then possible to add a 5 kg load and/or a 2.5 kg load, for example in the form of two weights. of 1.25 kg. These additional weights are positioned by a cylinder of the device 6306 on the upper weight of the stack 6301 .
• the damping device 700 comprises a cylinder 710 comprising:
• the damper rod 7101 is adapted to dampen the seat 300 following an impulse phase of the individual. It is the knocker 3011 of the seat 300 which will come into contact with the rod 7101 in order to stop the seat 300.
• the damper 710 is of the oleopneumatic type and a fluid circulates between the body of shock absorber 7101 and reservoir 7103.
• the damping device 700 makes it possible to brake the entire seat in complete safety, at the end of its travel. Subsequently, the moving device 500 returns the seat 300 to the test position at reduced speed.
• the damping device thus makes it possible to be able to measure poly-articular movements in complete safety and without apprehension on the part of the individual.
• the measurement bench 100 also includes a signal acquisition device.
• This device allows the digitization of signals from sensors, such as the piezoelectric sensors of the force platform 400A, 400B or the speed sensor 560 and/or the position sensor 570 of the carriage 510.
• the digitization frequency is programmable. For example, this frequency is fixed at 1000 Hz.
• the data from the various sensors are acquired synchronously.
• the signal acquisition device is equipped with a synchronization input allowing the use of ancillary devices such as electromyography known under the name surface EMG, or segment positioners. This synchronization input thus makes it possible to carry out specific measurements.
• Acquisition software is used to pre-process the raw data in order to obtain force/velocity profiles. This acquisition software thus has the function of recording the raw data concerning the measurement in a specified format with a description by keywords.
• the acquisition software interacts via a computer network with the seat functions management automaton to control positioning and save the parameters.
• the data is recorded anonymously by digital indicator. The dating of the measurements and the incrementation of the recorded data are automatic.
• Offline processing software allows the interpretation and use of the results.
• FIG. 12 illustrates the steps of a method for the neuromuscular characterization of at least one member of the individual from the measurement bench 100.
• This method comprises a first step E1 in which the individual settles on the seat 300 of the measuring bench 100 with the help of an operator in the access area.
• the operator informs a central system via the Man-Machine interface that the individual can be brought into the test position.
• the carriage 510 is secured to the seat 300 by the locking bolt 520 and brings the patient into the test position in a step E2.
• This test position is in a retracted position compared to a standard position in which the individual would be in contact with the force plate by the limb(s) that the operator seeks to solicit.
• the seat 300 is locked in the test position by the locking/unlocking device 3108 in a step E3. Trolley 510 undocks from seat 300 and returns to a parking area.
• the damping device 700 is positioned. It will also be noted that the seat 300 is designed to limit the resistance forces as much as possible and to have a minimum inertia.
• the plate supports 2403A, 2403B will move on the frame 200 to reach the known positions with the authorization of the operator. When the positions are reached, the operator confirms that they are compliant. In the second case, the operator moves the plate supports 2403A, 2403B to position them properly on the frame 200. When the positions of the plate supports 2403A, 2403B are correct, the operator validates them on the Man-Machine interface and the machine informs a “Client” IT that it is ready and makes the morphological data available. A communication of the “WebServer” type allows the exchange between this Man-Machine Interface and this “Client” IT.
• the "Client" computer informs the loading device 600 of the predetermined load to be submitted to the seat 300 in a step E4. If this load is zero, the strap 610 is unsecured from the seat 300. Otherwise, the load can vary from 10 kg to 207.5 kg in steps of 2.5 kg and the strap 610 is secured to the seat 300.
• the machine informs the "Client" IT that the test can begin. To avoid tiring the individual, the seat is always locked during step E4 of loading.
• the "Client" computer authorizes the test and the seat 300 is released in a step E5. The individual is then driven towards the force platform 400A, 400B by the predetermined load. In the test position the individual does not touch the force plate. The distance that separates the individual from this platform combined with the predetermined load thus makes it possible to generate an acceleration when the seat 300 is unlocked.
• a step E6 the individual receives himself on the force platform 400A, 400B. The latter can then propel itself into a stage E7 from this platform of force 400A, 400B via his legs or arms.
• signals are acquired. These signals relate to the force generated by the individual on the force platform 400A, 400B during the reception step E6 and/or the push step E7.
• the seat 300 is damped in a damping step E9 by the damping device 700. Once stopped, the seat 300 is blocked and again secured to the mobile carriage 510 The individual is then brought back at a slow speed either to the test position for another test or to the access zone to allow him to leave the measurement bench 100. The measurement bench 100 is then ready to receive a new individual.
• the signal acquisition step E8 includes a digitization of said signals.
• step E10 is carried out in deferred time.
• the characterization method that is the subject of the invention and the associated measurement bench 100 provide the following advantages:
• the measuring bench also makes it possible to take static measurements when the test position coincides with the standard position.
• the individual is in contact with the force plate 400A, 400B from the start of the test.
• the measuring bench can be used for applications in muscoskeletal, osteo-articular, rehabilitation or reathletization.
• the measurement bench can use technologies for the force platform other than piezoelectric sensors.

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• 2020
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