FR2986402A1 - DEVICE FOR AIDING THE MARKET - Google Patents

Abstract

The invention relates to a device (10, 110) for assisting the movements of the human body, comprising: - a textile suit (11), matching part of the shoulders and lower limbs of the human body, - two straps (15); , 16) closed elastics, each connecting one shoulder (19) with the opposite lower limb (26), said straps crossing one another on the chest (30) and on the back (31) of the suit, the trajectory of each strap crossing itself above (25) and below (24) of a knee (27) of the combination, one of said crossovers being on one front face and the other on a dorsal face of said combination, the elastic straps being slidable in slides (17, 18) provided on the combination. The invention is intended for persons having partially lost the use of the muscles of at least one lower limb.

Description

The present invention relates to a device for assisting gait, intended for persons who have partially lost the use of muscles of at least one lower limb. More specifically, the present invention relates to a device adapted to initialize and / or assist movements of triple flexion hip / knee / ankle of the leg during walking. The invention is intended for persons who have partially lost the use of at least one lower limb. More specifically, these people have lost the ability to flex the hip and / or knee and / or ankle, which significantly handicaps them for walking. There are two kinds of disabilities that lead to losing the function of "lifting" of the lower limb: - Pathologies or central traumatisms: they "stiffen" the lower limb (spasticity) and prohibit more or less his triple flexion (hip / knee / ankle): Such pathologies and such traumatisms are, for example, multiple sclerosis, hemiplegia or Strumpell Lorrain disease. The "stiff" muscles hold the leg stiff and are too strongly against antagonistic muscles, causing a difficult or impossible leg to flex voluntarily. - Pathologies or peripheral traumas: they "soften" the lower limb through the "flaccid" paralysis of the muscles concerned. They thus make impossible the lifting of the leg, necessary for physiological walking. Such pathologies and such traumatisms are, for example, paralyzing sciatica, Charcot Marie Tooth disease, Guillain Barre syndrome or polyneuritis. Here, the muscles affected by the paralysis are too weak and can not raise the lower limb against weight.

Known treatments for such pathologies or traumas are conventional orthopedic rigid or semi-articulated orthoses, orthopedic shoes or anti-stepping splints. These devices make it possible to take support on this limb by blocking it completely but oppose, by this blocking, to the action of the muscles. In addition, these devices weigh down the total weight of the leg and therefore do not allow the action of dynamic survey against weight of the lower limb during walking. It is also known devices for assisting the movements of the human body, such as the device described in WO2008 / 122873.

However, the forces generated by said device form "agonist / antagonist" pairs which balance out. Such a device is therefore appropriate to assist a healthy muscular system, but not to compensate for a deficient and / or asymmetrical muscular system. On the contrary, the present invention aims to restore the motor skills of patients having partially lost the use of leg muscles, by the action of a device in the form of a garment. This garment has elastic straps reproducing the trajectory of the main muscles of the walk. More specifically, the present invention relates to a device for assisting the movements of the human body, said device comprising: a textile suit capable of marrying at least a portion of the bust and shoulders, and at least a portion of the lower limbs of the human body ; two elastic straps each forming a closed path, each of said straps connecting a shoulder with the opposite lower limb, said two straps crossing one another on the chest and on the back of the suit. Furthermore, the trajectory of each strap crosses itself above and below a knee of the suit, one of said crossovers being on one front face of the suit and the other crossing on one side dorsal of said combination. In addition, the elastic straps are able to slide in slides arranged on the combination, along the trajectories of said straps. The elastic straps are arranged to follow the anatomical path of the main muscles of the walk. The slides allow traction of the elastic straps without pulling on the suit.

The operation of the device requires the upright position of the wearer. Indeed, the device according to the invention acts by the constraint of the body weight that will stretch the elastic straps at the time of full load, that is to say when the lower member is in full support on the ground . As the foot lifts to advance the leg, the elastic straps contract. The straps therefore assist the lifting of said non-bearing leg, as well as the simultaneous flexion of the hip, knee and possibly the ankle. According to a preferred form of the invention, at the level of the lower limbs, each strap crosses itself above the knee on a front face of the combination. In addition, each strap crosses itself below the knee on a dorsal side of the suit. Thus, the action of the strap during its contraction tends to bring the heel back towards the back of the body, and the thigh towards the front of the body. It would, however, be possible to have the crossovers on the leg in reverse, that is, above the knee at the back of the suit, and below the knee at the front of the suit. This arrangement would have the effect of projecting the foot forward at the time of contraction of the strap. According to one embodiment of the invention, each strap is fixed integrally to the combination in at least one point. This fastener holds the strap in position and prevents it from turning on itself within its slide. The point of attachment of the strap is preferably located at the shoulder. More preferably, the strap is fixed integrally to the combination in at least a second point, located lower than a knee of the lower limb opposite said shoulder. According to one embodiment of the invention, the path of at least one of the two straps passes under the sole of the foot of the corresponding lower limb. Preferably, at the level of said sole, the strap 25 splits into two parallel straps, one of the straps passing under a front portion of the foot and the other under a rear portion of said foot. This arrangement tends to reproduce the action of muscles that stabilize the foot during walking, thus reducing the risk of sprains. According to another embodiment of the invention, at least one of the two straps is connected to a leg strap of a foot orthosis, said bracelet being located at a calf of the combination. Said leg strap is connected to a sole of the foot by an elastic cylinder. Such a foot orthosis is for example described in document EP1382317 or FR2953129, in the name of the Applicant. This other embodiment makes it possible to combine the dynamic action of the jack with that of the elastic straps to restore a motor function when walking. According to one embodiment of the invention, the combination is at least partially formed of an elastic textile, able to exert a compression on the body of the wearer. The combination can notably produce a compression effect of the lower limbs and / or draining massage, for a better comfort of the patient. The invention will be better understood on reading the description which follows and on examining the figures which accompany it. These are given as an indication and in no way limitative of the invention. The figures show: FIG. 1: a schematic representation of a device according to an embodiment of the invention, carried by a patient seen from the front, FIG. 2: a schematic representation of the device of FIG. 1, worn by a patient seen from behind; Figure 3 is a detailed schematic view of a device according to another embodiment of the invention. Figures 1 and 2 show a schematic representation of a device 10 according to an embodiment of the invention carried by a patient. The device 10 comprises a textile combination 11, preferably formed of an elastic material. In the embodiment shown in Figure 1, the combination 11 comprises an upper element 12 adapted to fit at least a portion of the bust and the shoulders of a human body. The element 12 has for example the shape of a jersey with straps, which can furthermore comprise sleeves. The combination 11 further comprises a lower element 13 adapted to fit at least a portion of the lower limbs of the human body. The element 13 has for example the shape of a tights. In another embodiment of the invention, the combination 11 is formed in one piece and is, for example, in the form of an academic leotard. According to one embodiment of the invention, the combination 11 comprises a liner 14.

The device 10 further comprises two elastic straps (15, 16) each forming a closed path. Each strap (15, 16) is slidable in a slide (17, 18) fixed to the surface of the combination 11. The slides (17, 18) are preferably sewn on the combination 11.

The slides (17, 18) have substantially the shape of flattened tubes, in which the straps (15, 16) pass. Said slides are preferably continuous to protect the straps, including friction against the combination 11 or against other clothing of the patient, carried over the device 10.

Alternatively, the slides may have one or more discontinuities, to give punctual access to the straps (15, 16). Preferably, each strap (15, 16) is fixed integrally to the combination 11 in at least one point. The strap is for example sewn on the combination in this point, through the slide. In this way, the strap can not turn on itself inside the slide. For example, a strap 15 is attached to the suit 11 at a point 19 located on the right shoulder. The slide 17, in which the strap 15 slides, is arranged obliquely on the chest of the suit, then bypasses the left thigh 26 above the left knee 27. The slide 17 then bypasses the left calf 28 from the back and joins the left ankle inside the foot. At the level of the medial malleolus 20, the strap 15 and the slide 17 split into two parallel branches (21, 22) which pass under the left foot 32. The anterior branch 21 passes under the forefoot relative to a vertex of the arch. The posterior branch 22 passes under the back of the foot, substantially at the heel. The branches (21, 22) meet at the level of the external malleolus 23. The strap 15 can be sewn to the combination 11 through the slide 17, at the level of the sole of the foot 32 or at the level of the malleoli (20, 23 ). However, such a seam is not essential, because the splitting of the strap 15 into two branches (21, 22) restricts the possibilities of movement of said strap inside the slide 17. The slide 17 then goes up bypassing the left calf from behind. The trajectory of said slide 17 crosses itself at a point 24 located at the back of the calf, under the left knee. However, the two parts of the strap 15 passing through the point 24 are isolated from each other by the slide 17. After the point 24, the slide 17 bypasses the left leg from the inside at the knee and passes again on the front of the thigh. The trajectory of the slide 17 crosses itself at a point 25 located in front of the left thigh. However, as in point 24, the two parts of the strap 15 passing through the point 25 are isolated from each other by the slide 17.

The trajectory of the slide 17 then bypasses the left hip and obliquely crosses the back of the combination 11, to find the point 19 at the right shoulder. Similarly, a strap 16 is attached to the combination 11 at a point 29 located on the right shoulder (Figures 1 and 2). The slideway 18, in which the strap 16 slides, follows a trajectory symmetrical to that of the slide 17. The slides (17, 18) intersect at a point 30 located on the chest of the suit 11, as well as at a point 31 located on the back of said combination. At these points (30, 31), the slides (17, 18) are simply superimposed and do not communicate with each other. Preferably, the point 30 is substantially located in the lower portion of the sternum and the point 31 is substantially located between the shoulder blades. The length of the elastic straps (15, 16) is configured so that when the patient is standing with both feet to the floor, as in Figures 1 and 2, the body weight stretches said straps. Each strap (15, 16) can be configured with a specific length and tension, depending on the disability of the corresponding lower limb. The patient is considered to raise his or her left foot 32 to advance the corresponding leg. Released from the body weight - which is then transferred to the right leg - the strap 15 contracts. This contraction exerts a traction force on the left calf 28 and the left thigh 26, through the lever arm formed by the fixed point 19 on the right shoulder. The action of the strap 15 causes the uprising of the thigh 26 forwards, the raising of the calf 28 posteriorly, as well as the simultaneous flexion of the left hip, the left knee 27 and the ankle (20, 23). When the patient rest his left foot on the ground, the body weight is again worn on the left leg. The elastic strap 15 therefore stretches again and the leg unfolds. The trajectory of the straps (15, 16) at the torso substantially reproduces the path of the psoas muscle that starts from the spine and pulls on the lower limbs to raise them during walking. The passage of the straps (15, 16) above the shoulders generates an important lever arm for the dynamic action on the legs. In addition, the connection made between a shoulder and the opposite leg allows to impose a scapulo-humeral counter-rotation during walking. In other words, the device of FIG. 1 imposes a rotation of the shoulders which opposes that of the pelvis during walking, as in an individual with normal motility. In order to obtain such a counter-rotation, it is preferable for the strap to be fixed to the combination in at least one fixed point, located for example at the level of the shoulder. The crossing of the straps at the front of the thighs reproduces the path of the muscular bundles of the vast inner and outer quadriceps. Consider the case where a strap 15 is attached to the combination 11 in at least two points, one 19 at the shoulder and the other at the foot 32 or the bottom of the calf 28. It is then possible independently adjusting the tension of two portions of the strap 15, a first portion 15a of said portions connecting the point 19 to the foot 32 passing over the chest, a second portion 15b connecting the point 19 to the foot 32 passing on the back. Thus, an appropriate adjustment of the elastic tension of the corresponding strap portion allows the leg to be rotated inwardly or outwardly, depending on the needs of the patient. The crossing 24 of the straps at the back of the calf generates a projection behind the foot during walking. The device 10 thus prevents the knee 27 from being placed in recurvatum, that is to say, to lock back when walking. Such a recurvatum disrupts the fluidity of walking and can cause knee injuries.

In addition, it is possible to fix the combination of pieces of flexible materials but not extensible, to limit the amplitude of certain joint movements. For example, such a room can be attached to the back of the knee to avoid recurvatum.

Preferably, the elastic textile forming the combination 11 is able to exert a compression on the body of the wearer. For example, the tights 13 may exert a restraining and / or massage effect on the lower limbs. Figure 3 shows a schematic representation of detail of a device 110 according to another embodiment of the invention, carried by a patient. The device 110 is similar to the device 10, with the exception of the location of the patient's left calf, represented in FIG. 3. In the description that follows, the various elements of the device 110 are identified by the same references as the elements. corresponding devices of the device 10 described above. In the device 110, below the crossover point 24 at the back of the calf, the two portions (15a, 15b) of the strap 15 of the left leg are connected to an orthosis 40 fitted to the left foot 32. The orthosis 40 comprises a 41 leg strap and a foot sole 42, connected together by a structure 43. The structure 43 comprises a resilient jack 44 offset on the back of the leg and foot. The jack is longitudinally extendable to pivot the sole 42 around the hinge of the ankle of the foot 32.

Such an orthosis is known from the prior art. It is for example described in patents EP1382317 and FR2953129, in the name of the Applicant. The parts (15a, 15b) of the strap 15 of the device 110 are preferably connected to an upper portion 45 of the strap 41. According to one embodiment of the invention, the point 24 of crossing of the parts (15a, 15b) to the back of the calf corresponds to a point of attachment of said branches with the bracelet. Preferably, on each lateral edge of the foot 32, the orthosis 40 comprises two straps (46, 47) connecting the sole 42 and the bracelet 41. A first strap 46 connects the bracelet to an anterior portion of the sole; a second strap 47 connects the bracelet to a posterior portion of the sole. A boundary between said anterior and posterior portions substantially corresponds to a crown of the foot arch 32. Thus, the orthosis 40 of the device 110 has a comparable effect at the bottom of the strap 15 of the device 10 previously described.

In addition, an orthosis 40, as described in patents EP1382317 and FR2953129, has the ability to handle all the dynamic movements of the foot and ankle during walking, preventing foot position accidents (sprains) when walking. rough terrain. In addition, an orthosis 40, by its jack system, can absorb the energy transmitted by the shock wave when the heel impacts the ground, avoiding injuries to the ankle / knee / hip and back (sciatica, cruralgie, etc.).

Claims (7)

REVENDICATIONS1. Device (10, 110) for assisting the movements of the human body, comprising: - a textile suit (11) adapted to fit at least a portion of the bust and shoulders, and at least a portion of the lower limbs of the human body, - two elastic straps (15, 16) each forming a closed trajectory, each of said straps connecting one shoulder (19) with the opposite lower limb (26), said two straps crossing one another on the chest (30) and on the back (31) of the suit, the trajectory of each strap crossing itself (15a, 15b) above (25) and below (24) of a knee (27) of the suit, one of said crossings lying on one front face of the combination and the other crossing on a dorsal side of said combination, the elastic straps being slidable in slides (17, 18) formed on the combination, along the trajectories of said straps. 2. Device according to claim 1, such as at the lower limbs, each strap crosses itself above the knee (25) on a front face, and below the knee (24) on a dorsal side, of the combination. 3. Device according to claim 1 or claim 2, such that each strap is fixed integrally to the combination at least one point located at a shoulder. 4. Device according to one of the preceding claims, such that the path of at least one of the two straps (15) passes under the sole of the foot of the corresponding lower limb. 5. Device according to claim 4, such that at said sole, the strap is split into two parallel straps (21, 22), one of the straps passing under a front portion of the foot and the other under a rear portion of said foot. 6. Device according to one of the preceding claims, such as at a calf of the combination, at least one (15) of the two straps is connected to a bracelet (41) leg of an orthosis ( 40), said leg strap being connected by an elastic jack (44) to a foot sole (42). 7. Device according to one of the preceding claims, such that the combination is at least partially formed of an elastic textile, capable of exerting compression on the body of the wearer.