FR2459040A1 - KINESITHERAPY APPARATUS, IN PARTICULAR FOR REHABILITATION TREATMENTS - Google Patents

Abstract

KINESITHERAPY DEVICE, ESPECIALLY FOR REHABILITATION TREATMENTS. THE APPARATUS INCLUDES, MOUNTED ON A DIRECTABLE SUPPORT 16, A PLATE 5 WITH A CONTROL ARM 6 DRIVEN BY THE MOVEMENT OF A MEMBER OR SEGMENT OF A MEMBER AND SUITABLE TO COOPERATE WITH A PLURALITY OF MEANS DELIVERING SIGNALS IMAGE OF THE CHARACTERISTICS OF THE MOVEMENT AND OPERATED IN A CENTRAL CABINET 3 FOR THE PURPOSES OF VISUALIZATION AND INTERVENTION ON THE CHARACTERISTICS OF THE MOVEMENT.

Description

The present invention relates to a physiotherapy apparatus

  rapie, especially for the treatment of rehabilitation of a limb

  or limb segment and to control the characteristics

  kinematics and dynamics of the movements executed by the

  holds as well as those static muscle contractions or

  related dynamics with a view to intervening on those characteristics.

  according to the results obtained.

  The problem of accidental rehabilitation of a limb or

  segment or, in a much more general way, the

  the dynamism of the dynamic muscular contraction generating movement

  led to consider a number of parameters among-

  which: - the force opposed to the movement or exercised in the direction of the latter, - the amplitude of the movement, - the frequency of the movement,

- work time.

  The intrinsic, separated or combined medical or physiological interest of these parameters which are well known to those skilled in the art will not be studied here, but any practitioner is convinced

  of interest, with a view to optimizing the processes

  to be able to control them closely in real time or

  by means of recordings or signals, but still

  the interest that would be shown in terms of a psycho-

  the possibility for the patient to follow his efforts, to appreciate the results, to correct himself and to

  competitive spirit, to a certain perfection.

  This is precisely the problem that the invention aims to solve.

  tion by posing as an additional imperative, that one

  relatively simple and only involving the devices

  proven or easily assembled modules.

  For the solution of the problem thus posed, the invention proposes a physiotherapy apparatus for controlling and modifying the

  least one of the kinematic, dynamic or static characteristics

  of a repetitive movement, in particular alternative movement, of a limb or

  limb segment performed by a patient between set positions

  one of the rest and the other set downstream of the first in the direction of movement, which is characterized in that

  mounted on a steerable support, a stage on which is

  with one of its ends, around an axis, an arm of

  control adapted to be entralné by said member or segment of mem-

  during its movement and to cooperate with a variety of

  capable of delivering image signals of said characteristics

  movement, to record said signals and, in response to certain preselected ones of said signals, to modify at least

one of said characteristics.

  According to a first of these features, there is further provided at least one intermediate position between said positions

  of rest and instructions and electrical contacts

  placed at said resting positions, intermediate and

  sign, on a sector with calibrated graduations, rotatably mounted

  controlled on said platen and about said axis, contacts likely to

  tible to be activated when crossed by said arm

  control and emit signals image of his departure from the po-

  rest and return to it as well as from the

  intermediate and set positions.

  It will be appreciated at this stage that the invention

  firstly, the control of the characteristics of an angular movement carried out by a patient in the course of the reeducation of a limb or segment of limb and, moreover, thanks to the signals caused, a visualization by luminous display,

  digital and / or sound for this patient.

  Advantageously, activation is provided at the crossing

  said setpoint position, a means adapted to angularly offset

  downstream or upstream of a predetermined value said graduated sector and at least one of its associated contacts; said means is constituted by a stepping motor acting by

  through a mechanism known per se on the said grading sector.

  dué. Here we find the advantage of stimulation in some way

  the patient's sport, prompting him, in a well-defined setting, to

improve its results.

  The device has many other features,

  particular from the claims which all tend to

  purpose of the control of the work and the motivation of the patient.

  These features and the benefits of them

  are also reflected in the following description of a mode

  embodiment of the invention, with reference to the accompanying drawings in which:

  Figure t is an overview of the physiotherapy apparatus

  according to the invention making it possible to define the essential elements

tial;

  FIG. 2 is a more detailed view of the platinum con-

  trhe angular characteristics of movement; Figure 3 is a view of an accessory for attaching auxiliary devices and equipped with such devices; FIG. 4 is a more detailed view and partly in section

  of one of the auxiliary devices of Figure 3.

  In the following description and in the figures

  referred to, the physiotherapy apparatus according to the

  vention is supposed to be used for the rehabilitation of the legs

  (knee). It goes without saying that the apparatus is easily adaptable to

  problems of rehabilitation and for this purpose has the means to

  mechanical and electrical controls which involve

  positive in themselves and therefore will not be described in

detail here.

  It will be specified here that the notion of movement mentioned hereinafter defines both the displacement of a limb or segment of limb

  than a simple muscle contraction without apparent displacement.

  Referring first to Figure 1, we will find

  as a whole by 1 a care table on which is reported the physiotherapy apparatus according to the invention designated by

2 as a whole.

  The apparatus can essentially be broken down into a control, signal processing and recording cabinet as well as

  visualization and signaling 3, a linkage linkage

  port 4, a deck 5, a control crew 6.

  This control unit 6, articulated as a whole around an axis 7, is itself constituted by an arm 8 that extends a rod 9, which is pivotable relative to the arm 8, carrying a stirrup 10 to

  two flexible branches 11 and 12, mounted adjustable on a tread

pays 13.

  Although we will come back to some details of the operation of the physiotherapy apparatus according to the invention,

  it seems useful at this stage to explain succinctly, in

  in Figure 2, the principle of its action.

  The aim is to control the reciprocating movement of

  lifting and lowering of one leg, crew 6 is adjusted

  In order for the patient's calf 14 to cooperate with the cross-member 13 in the "up" direction (arrow M), the return contact (arrow R) is ensured by a very smooth action return spring 15. At the level of FIG. the platinum 5, the possibility is offered to control the angular characteristics (stroke, speed, frequency, etc ...) of the movement while the "linearity" of the movement (trajectory

  maintained in a median plane between the branches 11, 12) is

  monitored by means associated with the stirrup 10.

  Thanks to the processing in the control cabinet 3 signals whose emission is caused at different stages of movement, the latter can be followed and corrected, the patient being able to

  to be warned visually or acoustically about the outcome of their

  strong. FIG. 3 shows some details of the plate 5 whose essential function is the control of the characteristics

  angular motion. This stage is, as a whole,

  steerable end at the end of the rod 16 of the superstring linkage.

  port 4. It has a semicircle plate 17 mounted in a stirrup 18 in which is journalled the axis 7 (around which oscillates

  the arm 8), a mobile sector 19 and a motor assembly

  step type reducer 22 associated with said sector 19. The plate

  17 and sector 19 are provided with graduations 21 making it possible to

  finish the range of motion of the patient. At the lower part of the plate 5 is arranged the stepping motor unit 22 acting via a mechanism 23 (of the worm type and

  gear wheels for example) on sector 19 which is adapted to

  vote around the axis 7. The sector 19 is equipped with a plurality of contacts that can be activated at the passage of the arm 8, and

  which are represented only the contacts 24 and 25 defining

  especially the so-called intermediate and deposit positions. thus

  a rest position in which the patient's leg rests-

  on the table 1, the movement of the latter brings the arm 8 to ac-

  successively switch off a normally closed contact

  presented), then the contact 24 which may correspond to a minimum required stroke or is intended to control the speed of movement at a given angle and finally the contact 25 which defines the value

  set to be achieved in a time and possibly after a

  pre-determined warm-up return trip.

  The signal transmitted at the passage of the contact 24 is operated by the devices of the cabinet 3 for various control purposes but that

  transmitted by the activation of the contact 25 is specially intended to

2459040

  after validation by the control cabinet, the progress

  of an angular "step" prefixed, in one direction or the other, with the

  contact carrier 19. In other words, subject to validation,

  activation of the setpoint contact 25 automatically leads to

  stimulation to a progressive effort in

predetermined limits.

  In the case of a movement of the leg according to Figure 2, it is conceivable that the displacement can be done, ideally, in a vertical plane parallel to the arm 8 and median to the

  branches 11, 12 of the stirrup 10. For the control of this characteristic

  "linearity", the mounts 26, 27, sliding on the

  13, branches 11, 12 are provided with microswitches ac-

  when one of these two branches is slightly deformed,

  in flexion, by the impact of the deviating leg of its

  diane. The corresponding signals are processed in the control cabinet 3 and result in the corresponding visualizations and, in particular, by the temporary inhibition of the stepper motor control 22; this is the process referred to above for the validation of the activation of the contact of

set point 25.

  It will be noted that the stirrup 10 is pivotably mounted at the end of the rod 9 that can itself be oriented relative to the arm 8, which in turn can pivot with the plate 5. All the possibilities of directional adjustment (arrows F, G, H) are thus offered for

  define the characteristics of the movement and its median plane.

  It is also possible that the branches 11, 12 comprise means (electrodes, heating resistors, etc.) preactivated and

  likely to intervene correctively in the trajectory of the mem-

  member's segment or segment at its predetermined approach to one of the

two branches.

  Figure 4 gives an overview of some additional devices

  in the case of a movement according to Figure 2 by

  example, to intervene on the characteristics of the movement. The Your-

  lon of the patient being caught between two half-shells 28 maintained

  by elastic tightenings 29, these shells carry a square

  support 30 on which are mounted a directional stimulator 31, an additional weight 32 and a coupling frame 33 with movable roller

  34 of a counterweight (not shown).

  The directional stimulator And aims to print to the mem-

  or a limb segment in motion a directional pulse calling on the patient for a muscular reaction (twisting, flexing or combination of the two) determined to oppose said pulse. The stimulator 31 comprises a tube, preferentially

  transparent, 35 closed at its ends by screwed ends 36.

  On these tips 36 are reported electromagnets 37 whose spring plungers terminate externally by a collar

  38 and internally by an excitation contact of the electro-

  magnet 37. Inside the tube is placed a heavy ball 39.

  Any inclination of the tube 35 (by twisting of the foot or inclination of the leg during its movement) results in an impact of the ball on one of the flanges 38, and eventual activation of one of the electromagnets 37 with, the where appropriate, return of the ball

  towards the other end of the tube. By setting the positions of

  ends (by screwing), the force of the springs of the plungers, the weight of the ball, one can predetermine the conditions of triggering

  the movement of the ball (single or back-and-forth) and its

  invest-. The tube 35 is normally mounted pivoting and sliding on the bracket 30 to work the target muscles in well-defined conditions, forcing the patient to react to avoid going out of the median plane that is imposed between the branches of

the stirrup 10.

  The attachment frame 33, also mounted pivoting and sliding

  health, aims at a goal of the same nature. With the roller 34 movable on a rail 40 between adjustable stops 41, a counterweight coupled to

  the sling 42 can solicit different muscles (rotator

dull or external, for example).

  Of course,. the devices 31 and 33 may be arranged at any other location of the bracket 30 and in particular inverts

between them.

  It will be recalled finally that the control cabinet 3 comprises

  a plurality of means, all known in themselves, for accounting for

  "all signals emitted during the movement and to trigger,

  in response to some of these signals, the activation of means of

  various types of visualization and / or visualization, including

  directional optical signaling.

  It goes without saying that the physiotherapy apparatus according to the invention

  tion lends itself to many different variants of

  the controlled movement and the member or segment of the mem-

  the subject of rehabilitation, all of which are part of

of the present application.

Claims (13)

R E V E N D I C A T IO N S   1. Physiotherapy apparatus for controlling and modifying   Prove at least one of the kinematic, dynamic or static characteristics of a repetitive motion, in particular an alternative movement, of a member or segment of limb executed by a patient between adjustable positions, one of rest and the other of downstream of the   first in the direction of movement, characterized in that it   te, mounted on an orientable support, a plate on which is articulated by one of its ends, around an axis, an arm of   control adapted to be entralné by said member or segment of mem-   during its movement and to cooperate with a variety of   capable of delivering image signals of said characteristics   movement, to record said signals and, in response to certain preselected ones of said signals, to modify at least said characteristics.   2. Physiotherapy apparatus according to claim 1, characterized   provided that at least one international position is provided for   mediate between said rest positions and instructions and   electrical contacts respectively arranged at the level of said positions.   rest periods, intermediate and deposit, on a sector with   calibrated, mounted rotationally controlled on said plate and about said axis, contacts that can be activated during their crossing by said control arm and transmit image signals from its departure from the rest position and its return to this one as well as the crossing of the positions intermediate and deposit.   3. Physiotherapy apparatus according to claim 2, characterized   activated by the activation, at the crossing of the said con-   sign, means adapted to angularly offset downstream or upstream of a predetermined value said graduated sector and at   least one of his associated contacts.   4. Physiotherapy apparatus according to claim 3, characterized   characterized in that said means is constituted by a stepping motor acting via a mechanism known on said graduated sector.   5. Physiotherapy apparatus according to any one of the   1 to 4, characterized in that said control arm comprises   appropriate means, on the one hand, to control the trans-   the movement of said member or limb segment relative to a predetermined median angular displacement plane and, on the other hand, to emit a signal when said deviation reaches, in one direction or the other, by inclination or torsion of said member   or member segment, a preset value.   6. Physiotherapy apparatus according to claim 5, characterized   characterized in that said means is constituted by a stirrup with two flexible branches of adjustable spacing, articulated by its apex at the free end of said control arm which it accompanies in its stroke and positioned so that the two branches are located symmetrically on both sides of the plane of movement   median prefixed to said arm, and in that said branches are   electrical contacts that are activated by the impact of the member or limb segment when its movement deviates from   preset value of said median plane.   7. Physiotherapy apparatus according to claim 6, characterized   in that the transmission of the signal corresponding to the impact on   one of the contacts of the branches of said stirrup inhibits the im-   mediate the means adapted to shift said graduated sector.   8. Physiotherapy apparatus according to any one of the   1 to 7, characterized in that said member or segment of   limb is caught between two rigid half-shells shaped   removable mantle, and in that it is provided on said enve-   loppe a means adapted to impart to him directional impulses tional.   9. Physiotherapy apparatus according to claim 8, characterized   characterized in that said means consists of a ball of weight   mobile property in a tube of substantially horizontal axis, mounted axially sliding and orientable about a vertical axis by   ratio to the median plane of the angular displacement, between two bu-   adjustable heads defining the stroke of said ball and of which each   this is provided with a contact which, in response to its activation by the ball, prints to the latter, by the play of an electromagnet,   an adjustable intensity return pulse.   Physiotherapy apparatus according to claim 8 or 9,   characterized in that said envelope further comprises a provision   hitch, slidably and pivotally mounted, from one of the   of a sling, the other of which is secured to a counterweight, a device consisting of a substantially horizontal rail on which moves between adjustable stops a wheel to which is coupled said sling.   Physiotherapy apparatus according to any one of claims 1 to 10, characterized in that said arm comprises a   mating positive, of a type known per se, which is incor-   a load limiter which intervenes to allow the sliding   ment of said coupling in the event that the stress is applied   arm exceeds a prefixed value.   12. Physiotherapy apparatus according to any one of claims 1 to 11, characterized in that a central unit is provided.   order and processing adapted to the chrono-   and the counting of the different signals emitted during the movement   repetitive operation of said member or limb segment, to activate, in response to some of said signals or at their frequency, optical signaling means, including directional, and acoustic, and to control certain predefined interactions of said signals.   13. Physiotherapy apparatus according to claim 6,   characterized in that said branches are provided with sus-   able to act, for a directional effect, on said member or limb segment at its predetermined approach to one of the two: said branches.