FR3133540A1 - Portable active shoulder rehabilitation device - Google Patents

Abstract

Portable device for the active exercise of a patient's upper limb, comprising: - a platform (1) capable of being placed on a work surface, - a plate (2) adopting an elongated rectangular shape along a longitudinal axis and having an upper face (20) surrounded by two short sides (21) and two long sides (22), the plate (2) being mounted articulated to the platform (1) by one of its short sides, called the proximal side (211). ), and comprising retractable means for holding in at least one inclined position relative to the plane of the platform (1) in which the other short side, called the distal side (212), is raised, and - a carriage (3) movable in longitudinal translation on the plate (2), shaped to receive the patient's forearm and hand in fixed support, respectively on a rear part (311) and on a front part (312) of said cart.

Description

Portable active shoulder rehabilitation device

The present invention belongs to the field of equipment used for rehabilitation or exercise of the upper limbs and more particularly relates to a device intended to improve shoulder mobility.

Its subject is a device formed of a mobile cart intended to be moved by a user back and forth on a plate, which can be inclined at will to offer diversity in the orientation of the movement and in the effort to apply.

Many patients are disabled by motor deficiencies in the upper limbs due to neurological diseases or musculoskeletal damage, particularly after surgery or a personal accident. Deficiencies are often also attributable to the aging of the body through a natural process, often accentuated by the repetition of traumatic actions. They manifest as a loss of mobility in the joints, particularly the elbow and shoulder, accompanied by muscle atrophy. Whatever the cause of the deficiencies, they must be taken care of to relieve the patient and allow him to return to normal activity.

Functional rehabilitation aims to recover mobility through muscle strengthening and/or mobilization of the joints of the upper limb concerned, generally the elbow and/or shoulder. Different techniques can be used, including passive rehabilitation methods consisting of subjecting the limb to a device which imposes a repeated movement involving a joint to be treated. This type of exercise essentially aims to reduce stiffness and increase the angular range of the mobilized joint, without voluntarily involving the patient's muscles. Passive shoulder rehabilitation requires the use of complex and motorized equipment, adaptable in its dimensions to the patient's anatomy. For passive rehabilitation of the elbow, there are medical devices called arthromotors allowing anatomically correct passive movement of the elbow and its joint.

Passive rehabilitation can be a prerequisite for active rehabilitation in which the patient must initiate a movement himself, which will stress both the joints and the competent muscular chain.

Active functional rehabilitation is generally implemented by a physiotherapist who establishes the exercises adapted to each pathology to be treated based on the diagnosis and recommendations of a therapist. It is usually carried out over a series of sessions and involves progressive exercises in order to avoid any muscle or joint damage during treatment. In all cases, rehabilitation methods that cause pain should be avoided, which could aggravate the underlying pathology.

Various devices for active muscle strengthening and/or rehabilitation of the shoulder and upper limb have been designed and are known to professionals. These are, for example, devices with push elements which are equipped with resistant members such as elastic bands, pulleys, weights, or the like. This rehabilitation technique gives good results, but its implementation has drawbacks, particularly due to the fact that it requires the acquisition of complex and bulky equipment.

We also know all kinds of gymnastic machines or free weights offering a certain resistance. However, the accessories must be handled with care under the supervision of a specialist who checks that the patient has good positioning and correctly orients the machine. Rehabilitation must in all cases be carried out gently and gradually to avoid the appearance of inflammatory phenomena which can hinder the recovery of joint range of motion through the appearance of painful phenomena.

There is therefore a need to have a device allowing active arm exercises to be performed, in which the movement is guided while allowing the patient to provide a voluntary effort adapted to their capacity. We want to offer practitioners a device that is easy to implement, scalable and can easily adapt to the anatomy and level of effort required of each patient. The progression in the exercises should be perceptible and objectified by both the practitioner and the patient. Such a device must be compact and portable. Its low cost is also sought after. The portable device which is the subject of the present application was developed to meet these needs.

More specifically, the present invention relates to a portable device for the active exercise of a patient's upper limb, comprising:
- a platform suitable for being placed on a work surface,
- a plate adopting an elongated rectangular shape along a longitudinal axis and having an upper face surrounded by two short sides and two long sides, the plate being mounted articulated to the platform by one of its short sides, called the proximal side, and comprising means retractable holding devices in at least one inclined position relative to the plane of the platform in which the other short side, called the distal side, is raised, and
- a trolley movable in longitudinal translation on the plate, shaped to receive the patient's forearm and hand in fixed support, respectively on a rear part and on a front part of said trolley.

In the description which follows, we will consider the device as it appears during its use, namely placed on a work surface, which is commonly horizontal, although strict horizontality is not necessary for the proper functioning of the device. . Such a work surface may be a table or any other support allowing the exercise device to be placed at the desired height and in a stable position with regard to the forces to which it will be subjected during its use. This support can rest on one or more legs and be fitted with casters making it easier to move. In the latter case, care will be taken to equip the casters with a locking-unlocking system.

In fact, the user will place his forearm and his hand in the cart and exert a push to move it in translation along the plate, then a pull to bring it back to its initial position. The forearm and the hand are thus in fixed support, immobile in relation to the cart, the movement of which is accompanied on the other hand by a movement of the elbow and shoulder of said user. By convention, we will designate "rear part", the part of the cart supporting the forearm, and "front part", the part of the cart supporting the hand.

The plate acts as a track for the cart. Depending on the movement to be performed by the patient and the level of difficulty sought, it can be in a horizontal or almost horizontal position, or more or less inclined relative to the plane of the platform, the lower part being articulated to the platform, while the opposite part is raised. The carriage circulating on the upper face of the plate is therefore inclined in the same way and it will, in principle, be pushed up and held down, or simply pushed and pulled when it is flat. The user's hand thus corresponds to the raised part of the plate, called the "distal part", while the forearm close to the elbow corresponds to the lower part, called the "proximal part". It is indicated that in the remainder of this description, the adjectives "proximal" and "distal" will be used in accordance with this orientation for all the parts of the device.

The plate is conveniently formed from a thin rigid board which adopts a rectangular shape significantly longer than it is wide, or to be more precise, the upper face of which is a rectangle, as is the lower face. The side faces corresponding to the thickness of the plate form the sides of said plate, distributed into two long sides and two short sides, one distal, the other proximal. A longitudinal axis of the plate is an axis extending parallel to the long edges.

The plate is designed so that its upper face provides a track for longitudinal movement of the carriage of sufficient amplitude. The amplitude is considered sufficient when the user can perform a complete extension-flexion movement of the arm. Thus, the plate is advantageously sized to suit everyone, with a length making it usable even by tall people. However, it can be manufactured in any size, in particular with a shorter length so that children in particular can use it conveniently. For example, it could have a length of between 30 cm and 60 cm.

The plate is associated with a platform which will play a supporting role for the entire device which is the subject of the invention of which it is an integral part. It is this platform, generally made from a rigid plate, which is intended to be placed on a work surface. Its shape and dimensions can match the plate, although these characteristics are not critical (except for a particular aspect explained in detail later) and different embodiments can be implemented without harming the essential functionalities of the inventive device. . When the plate is lowered, its underside is located facing the platform. On the other hand, when it is in the inclined position, the platform supports it on the one hand at the level of the proximal side and on the other hand at the level of the holding means with which it is equipped and which will be described later.

According to a characteristic of the device which is the subject of the present invention, the plate is provided with longitudinal sliding and guiding means cooperating with complementary means with which the carriage is fitted. Indeed, the cart which is mobile in longitudinal translation on the plate, must allow the user to perform a controlled gesture using a specific joint and group of muscles, and to repeat it regularly. The movement of the carriage must therefore be done smoothly, by gentle and guided sliding in its orientation, which can be achieved either by sliding, by rolling, or by a combination of these two modes.

Furthermore, the user's forearm and hand must remain in a fixed position in the cart during the exercises, so as to exercise the shoulder joint. This is why, according to a preferred characteristic of the device which is the subject of the invention, the cart is shaped like a gutter of a defined length to allow support for the forearm and the hand of said patient, comprising a bottom with from which rise side walls and a handle intended to be grasped by the patient. The bottom of the cart is conveniently flat. In the present description, the term "handle" designates any manual gripping organ that the patient can grasp to perform the exercises, whether by grasping it with the whole hand or by holding it with one or more fingers. For example, said handle can be a vertical pin fixed to the bottom of the cart or a lever fixed horizontally between the walls of the cart.

For a user to be able to support themselves in the cart and hold said handle, the distance separating it from the edge of the cart must correspond to the anatomy of this user, it being understood that the elbow is normally placed at the level of the proximal edge of the cart. cart. It is therefore useful to be able to place the handle adequately in each case. This is why, according to an interesting characteristic of the present invention, the cart comprises a plurality of sites capable of receiving said handle, arranged in different longitudinal positions, the handle being removably mounted in one of said sites.

According to a preferred embodiment of the invention, the bottom of the cart comprises a plurality of holes made at intervals along a longitudinal axis, and the handle is formed of a pin provided at its base with an axial tenon capable of being insert into one of said holes in free sliding. The holes can be blind or through, and are conveniently aligned with the median longitudinal axis of the carriage, although there is nothing to prevent choosing an alignment offset laterally towards one of the walls. The tenon has a diameter slightly smaller than the internal diameter of the holes so that it can enter by sliding and be removed effortlessly when it is desired to place the tenon in another hole.

As indicated previously, the device which is the subject of the present invention may comprise one or more means allowing guidance and/or facilitating the sliding of the carriage on the plate.

According to one embodiment of the intention, the plate comprises a longitudinal groove in which is engaged at least one guide pin projecting under the carriage. This groove can either be made in the middle position or be offset laterally towards one of the long sides of the plate. One or more lugs can be provided under the underside of the plate, taking the shape of a stud or a rod collinear with the groove.

According to a particular variant, the guide pin can be formed by the tenon of the pin which is inserted through one of the holes in the bottom of the carriage, an end segment of which projects under the carriage. In this case, we ensure that the relative positions of the groove and the holes coincide to allow insertion of the end of the tenon.

The amplitude of the back and forth movement of the carriage can be limited by a stop system preventing the carriage from disengaging from the plate. A cleat can be inserted at one or each of the ends of the furrow, in a fixed or removable manner. In addition, it may be necessary in certain cases to restrict the movement carried out by the user. We can then place a cleat in a chosen location in the furrow to limit the amplitude of the carriage's movement. The cleats can be placed in the furrow in a fixed or removable manner. Thus, according to an interesting characteristic of the invention, the furrow is obstructed by at least one stop acting as a stop.

According to a preferred characteristic of the present intention, the plate comprises two lateral grooves extending longitudinally each near a long side and cooperating with rolling means fixed to the carriage, which comprise four rolling units, including two units fixed in the front part of the cart and two units fixed in the rear part of the cart, arranged symmetrically on either side of the longitudinal axis of said cart, directly above the lateral grooves with which they cooperate, respectively. In said rolling means, the rolling units can be coupled with accessories whose movement is essentially sliding, so that the rolling means combine the two modes of movement. It goes without saying that the rolling means and the grooves of the plate are positioned to face each other, taking into account the particular method of assembly, so as to be able to effectively cooperate. In particular, the transverse spacing of the grooves corresponds to that of the rolling means.

Preferably, according to the invention, each lateral groove is fitted with a rail comprising a groove which matches the shape of said groove and two lateral wings extending on either side of said rail on the surface of the plate. Such a rail can be made of a synthetic material with a low coefficient of friction, for example silicone rubber, promoting the sliding of the accessories with which the rolling means may be fitted.

The grooves coated with their rail will impose a rectilinear movement on the cart. According to one embodiment, the rolling units may comprise a roller circulating in the groove of a rail. A small caster can be contained entirely in the groove of the rail, while a caster of larger diameter can be guided without completely engaging in the groove of the rail. According to another embodiment, the rolling can be done along a side wing of each rail, with optionally guided by an accessory sliding in the adjacent groove. It is also interesting that the rail is shaped to retain in the groove either the caster or the accessory, so that the carriage and the plate remain united. The rail can for example include a groove (or two grooves, symmetrically) running longitudinally in the upper part of the groove, which is therefore tightened and forms an entry slot narrower than the groove itself, with a section Omega-shaped. More simply, the section of the rail can adopt a dovetail shape.

Thus, according to a first embodiment of the invention, each rolling unit comprises a roller engaged entirely or partially in the groove of the rail directly above which said rolling unit is located.

According to a second embodiment of the invention, each rolling unit comprises a wheel whose tread rests on a lateral wing of the rail directly above which said rolling unit is located.

Optionally, each rail has an omega or dovetail shaped section, so as to have an entry slot narrower than the groove and each bearing unit has a guide blade which is engaged vertically in the groove of said rail, said blade being flared in its end part with a thickness greater than the width of the slot.

We have seen that the plate is mounted articulated to the platform, which is fixed by nature. In other words, the plate is associated with the platform so that it can pivot in a vertical plane around an axis located at the proximal side. This articulation is conveniently materialized by a hinge fixed on the one hand to the plate, and on the other hand to the platform. Concerning the plate, the hinge can be mounted on the proximal side of said plate or at its adjacent proximal end. Concerning the platform, the hinge can be fixed directly on its upper face, in which case, the axis of rotation coincides with the edge joining the proximal side and the lower face of the plate. It can also, advantageously, be attached to a strip itself fixed to the end of the platform on its upper face, making it possible to raise the axis of rotation. This arrangement is preferred for reasons of space requirements which will be explained later.

Thus, according to the invention, the plate can be mounted articulated to the platform by a hinge fixed on the one hand to the platform and on the other hand to the proximal side of said plate or to its adjacent proximal end.

The articulation can also be carried out by any other means known to those skilled in the art, for example by a support element without fixing, such as a molding or a strip fixed on the platform, sufficiently protruding or deep to block the plate in the desired position.

This articulated assembly makes it possible to tilt the plate above the platform, by raising the distal part and the adjacent distal side of said plate. To maintain it in the chosen position in relation to the plane of the platform, retractable holding means are used, in the form of shoring pieces which are deployed for this purpose and rest on the platform, at the locations provided. for this purpose, commonly on the upper face of said platform. These locations are distributed on the upper face of said platform, at different distances relative to the articulation with the plate, in other words at an increasing longitudinal distance relative to the proximal side of the plate. The inclination of the plate then corresponds to a non-zero angle relative to the plane of the platform, whereas when the holding means are retracted, that is to say not deployed, the plate has an inclination of zero angle (or almost zero) on the platform. The slope of the plate can thus go from 0° to values close to the vertical, of the order of 80°, or even 85° of angle. The angular adjustment of the plate is predefined, that is to say it is chosen and implemented before carrying out a sequence of movements. It can be easily modified to vary the exercises during a work session.

Thus, according to a preferred characteristic of the device which is the subject of the invention, the plate is provided with at least one longitudinally deployable shoring piece, one end of which is pivotally fixed to said plate, the other end being free and able to take support on a dedicated location of the platform, chosen from a series of locations located at an increasing longitudinal distance relative to the proximal side of the plate, so that the plate is raised at its distal end with an angle of inclination predetermined by in relation to the platform plan. The shoring piece(s) are preferably fixed in the distal half of the plate, to create a solid buttress when they are in the deployed position.

According to a variant embodiment of the device which is the subject of the present invention, the plate can be provided with a shoring part comprising a plate pivotally fixed under the plate, by a hinge perpendicular to the longitudinal axis of said plate. The plate can then rest on locations arranged in a strip extending longitudinally over a middle zone of the platform.

According to another alternative embodiment of the invention, the plate is provided with a first pair of props arranged symmetrically with respect to the longitudinal axis of the plate, each having one end pivotally fixed against an opposite long edge of the plate . In this way, the props can be retracted on either side of each of the long edges when they are not in use. In this configuration, support locations are conveniently arranged in two strips extending longitudinally directly above each of the props.

In a particularly interesting embodiment of the invention, the plate is provided with at least a second pair of props fixed symmetrically and pivoting against the opposite long edges of the plate, the first pair and said at least one second pair of props having different lengths and being mounted at different distances relative to the proximal side of said plate. For example, we can provide two or three pairs of retractable props on a device. Optionally a spacer can join the two props of a pair, like an easel. This embodiment offers numerous possibilities for adjusting the angle between the plate and the platform. It also ensures optimal support of the plate whatever the angle chosen.

One or more dedicated locations are provided on the platform (in general, on its upper face), the shape and position of which depend on the shape given to said at least one shoring piece and to its end which must bear on the platform.

To the extent that an objective is to adjust the inclination of the plate as desired, the platform will advantageously include a plurality of dedicated locations capable of receiving the shoring piece in support, or one of the shoring pieces if the device has several. The locations are then organized in at least one continuous or discrete series, and are placed aligned in the longitudinal direction at an increasing distance relative to the proximal side of the plate. In addition, each series can occupy a wide strip, even the entire width of the platform or only a narrow strip located opposite the shoring piece(s).

A series of dedicated locations is described as continuous when it forms a continuous strip and the end of a shoring piece can be placed in support at any point of said strip. This method can be achieved using a gripping material, such as silicone rubber or a grainy coating, with which the platform and possibly also the ends of the support parts can be coated. In contrast, a series of dedicated locations is described as discrete when it is made up of successive delimited support zones, arranged in a discontinuous strip. This method is notably achieved by a series of notches provided in relief or hollow on the platform, allowing stable wedging of the ends of the shoring parts. The position of a shoring piece can then be modified with an increment depending on the proximity of the notches to each other. The notches can be sculpted on the surface of the platform or added using a rack. They can also be indexed, for example marked by numbers, in order to allow the therapist or the user to objectively control the inclination given to the plate and to follow the progress made during the exercises.

Thus, according to a preferred embodiment of the invention, the platform comprises at least one series of dedicated locations, organized in at least one continuous or discrete strip, placed aligned in the longitudinal direction at an increasing distance relative to the proximal side of the plate.

In addition to the inclination of the plate which will direct the movement to be carried out and require a thrust that is all the greater the steeper the slope, it is possible, according to the invention, to generate a graduated effort and to increase the resistance to the movement of the cart. This resistance can be exerted in a conventional manner when pushing, but also when pulling the cart by the user.

To do this, according to an interesting characteristic of the invention, the device can be provided with means for exerting a compressive or tensile resistance opposing the movement of the carriage on the plate. These means should preferably be adjustable and conveniently installed and removed. One embodiment consists of using an elastic member in traction, such as a spring or an elastic ring, connecting the proximal parts of the plate and the carriage, to create resistance when the carriage is pushed. An elastic traction member can also be used to create resistance when pulling the cart towards its initial position. In this case, it connects the distal parts of the plate and the carriage. If the choice falls on compressible members, such as a compression spring, they will be placed inversely with regard to the desired braking effect.

An elastic member can be fixed in different locations, chosen so as not to bother the user. It can for example be linked on the one hand to one of the long sides of the plate and on the other hand to a side wall of the carriage. The means for attaching the elastic member may comprise at least one rod projecting perpendicularly from said long side of the plate and at least one rod projecting perpendicularly from the side wall of said carriage.

Different elastic members of calibrated force can be made available to the user, one of them being used depending on the recommended exercise. Also, several rods can be fitted to the side wall of the carriage at increasing distances from the rod mounted on the plate to increase resistance. The plate can also be equipped with several rods. Optionally, an elastic member can be provided on each side of the carriage, which makes it possible to further increase the resistance to movement, if desired.

The device which is the subject of the present invention as described above is light and compact, while offering the robustness necessary for its use. It can easily be moved, installed on any work surface, and then stored in a space-saving manner. It can be used without intervention from a practitioner except at the start of the exercise for the establishment and control of the initial position. It allows repeated and/or progressive work, programmed and carried out in a quantifiable manner. Such a device can be used, not only in the context of functional rehabilitation, to practice exercises recommended by a specialist, but also for preventive purposes, or even for bodybuilding and fitness exercises. It finds its place both in individuals and in physiotherapy practices or rehabilitation services.

The present invention will be better understood and details relating to it will appear, in the light of the description which will be made of different embodiments, in relation to the appended figures.

is a general view of a first embodiment of the device according to the invention.

is a general view of the same device, after translation of the carriage.

represents a second embodiment of the device according to the invention, in the lowered position.

shows the same device in intermediate position.

shows the same device in the raised position.

represents a device with a single shoring piece.

is a cross-sectional view showing a mode of arrangement of the handle of the device according to the invention.

is a cross-sectional view showing another mode of arrangement of the handle of the device according to the invention.

is a cross-sectional view showing the rolling units of the device according to a first embodiment of the invention.

is a cross-sectional view showing the rolling units of the device according to a second embodiment of the invention.

EXAMPLE 1: General presentation of an exercise device

The exercise device as shown in figures And consists of a platform 1 intended to be placed on a work table, a tilting plate 2 and a cart 3 movable on the plate by the voluntary action of a user. It is essentially made of wood, but other materials can be used for its manufacture (for example metal, plastics, etc.).

Platform 1 here takes the form of a rectangular plate, a little wider than plate 2. It can be fitted on its underside with anti-slip pads improving its grip on the work surface on which it is placed. The plate 2 is composed of a rigid rectangular board, having an upper face 20 and a lower face 20' which are surrounded by two opposite short sides 21 and two opposite long sides 22, the latter defining the longitudinal direction of the plate 2 and of the entire device. The proximal short side 211 is adjacent to the platform 1, while the distal short side 212 can be raised or lowered, as shown in the figures.

Plate 2 is associated with platform 1 via a hinge 12. As shown in the figures And , this is fixed on the one hand to the lower face 20' of the plate 2, near its short proximal side 211, and on the other hand to the platform 1. The pivot axis of the plate 2 is thus merged with the pin of the hinge running along the edge at the junction of the lower face 20' and the proximal edge 211. In the figures has , the plate 2 is fixed on a cleat 111 running along the proximal end of the platform 1. The hinge is here fixed on the one hand on the lower face 20' of the plate 2 near its proximal short side 211, and d on the other hand at the top of the cleat 111. The height of the cleat 111 being similar to that of the racks 12 (described later), the plate can rest on said racks in a horizontal position.

To maintain the plate 2 in an inclined position, it comprises at least one shoring piece 6, in this case two props 64 each pivotally fixed to a long edge 22 of the plate. The props 64 are fixed by an end 61 comprising a bore through which a pivot screw 67 is inserted into the lateral thickness of the plate 2, symmetrically. The props 64 can thus rotate in the vertical plane, to be retracted under the plate 2 or at the front of it as shown on the . They can be deployed in variable orientations, in which case they rest with their free end 62 each on a location on the platform provided for this purpose. A particular location 10 is chosen for a given exercise from a series 101 of dedicated locations. For each prop 64, such a series 101 of locations is offered by a rack 12 placed on the longitudinal edge of the platform 1. For the robustness of the assembly, the two racks 12 are fixed in the distal half 112 of the platform 1 In addition, the props 64 are joined by a spacer 66.

The cart 3, shaped like a gutter, has a bottom 30 located in a plane parallel to that of the plate 2 and two side walls 32 which rise vertically on either side of the bottom 30. The cart 3 has a handle 33 , here in the form of a pin 35 comprising an axial tenon 37 inserted into one of the holes 34 made at regular intervals in the bottom 30. The tenon 37 is inserted in free sliding into one or other of the holes 34 of so that it is easy to place the pin 35 at the appropriate distance, depending on the anatomy of the user's arm. The user can thus conveniently grasp the pin 35 by its rounded knob 38 to maneuver the carriage 3.

The carriage 3 is movable in longitudinal translation on the plate 2. This mobility is favored by complementary sliding and guiding means with which the plate 2 and the carriage 3 are fitted.

The plate has two lateral grooves 5 which each extend longitudinally near an opposite long side 22. Each groove 5 is fitted with a rail 51 comprising a groove 52 which matches the shape of the groove 5, and two lateral wings 53 deploying on the surface of the plate 2, on either side of the groove 52. These grooves 5 cooperate with rolling means fixed to the carriage 3. These here take the form of four rolling units 4 arranged symmetrically, including two units fixed in the front part 312 of the carriage 3 and two units fixed in the rear part 311 of the carriage 3. Of course, the rolling units 4 are each located directly above the lateral groove 5 with which they cooperate. They are fixed here in recesses provided for this purpose in the side walls 32 of the cart and are hidden by a cover 46. This protects both the mechanism and the user, while improving the overall aesthetics.

In a first embodiment shown in the figure , each rolling unit 4 comprises a caster 41 partly engaged in the groove 52 of the rail 51 directly above which it is located. The caster 41 is mounted on an axis 47 fixed to the cover 46. It comprises a cylindrical part ensuring rolling on the external lateral wing 53 of the rail 51, and is extended by a flange 45 of larger diameter than the cylindrical part. The collar 45 is engaged in the groove 52 and ensures the guidance of the carriage 3 along the rail 51.

In a second embodiment shown in the figure , each rolling unit 4 comprises a wheel 42 whose tread 43 rests entirely on the external lateral wing 53 of the rail 51 directly above which it is located. The wheel 41 is carried by an axle 47 fixed to the cover 46. In addition, the axle 47 carries a guide blade 44 which is engaged vertically in the groove 52 of the rail 51. The rail 51 here has a tail-shaped section dovetail, so as to present an entry slot 54 narrower than the groove 52, and moreover, the blade 44 is flared in its end part with a thickness greater than the width of the entry slot 54 This arrangement ensures that the carriage 3 is held together with the plate 2 at the same time as the carriage 3 is guided along the rail 51.

EXAMPLE 2: Presentation of a variant with guide furrow

The exercise device is provided with means for guiding the carriage 3, and in particular, the plate 2 may comprise a longitudinal groove 23 in which is engaged at least one guiding lug 37 projecting under the carriage 3. As shown in the figures, the groove 23 is made longitudinally on the upper face of the plate 2 over its entire length. It can be dug in the middle position ( ) or be offset laterally towards one of the long sides 22 of the plate 2 ( ). It is obstructed by two tabs 24 placed at its ends, which limits the travel of the carriage 3 when the lug 37 abuts.

According to a first form illustrated in , the lug 37 consists of a rod oriented longitudinally and offset laterally like the groove 23 in which it circulates. The rod and the groove 23 have a straight dovetail section, this conformation making it possible to keep the carriage 3 secured to the plate 2 in addition to ensuring its guidance.

According to a second form illustrated in , the lug 37 is formed by the tenon 36 of the pin 35 which is inserted into the bottom 30 of the carriage 3. The holes 34 provided for inserting the pin 35 are in this case through and the tenon 36 is sufficiently long so that its segment end protrudes under the carriage 3 in order to penetrate into the groove 23. The end of the tenon 36 can be reinforced by a metal sleeve or other. In addition, the holes 34 being generally provided only in the front part 312 of the carriage, it is possible to add in addition a fixed lug 37, in the form of a stud or rod, under the rear part of the carriage.

EXAMPLE 3: Presentation of a variant with one prop

In the execution variant illustrated in , the plate 2 is supported at a chosen inclination, by a single shoring piece 6. It is shaped like a plate 6a fixed under the plate 2 by its end 61 using the hinge 63. This is mounted perpendicular to the longitudinal axis of the plate 2 which allows the pivoting of the plate 6a d 'a retracted position to one of the deployed positions. The plate 6a can then be supported on a rack 12 offering a series of locations 10, installed on a middle zone of the platform 1.

EXAMPLE 4: Presentation of a variant with several props

In the execution variant illustrated in the figures , And , the plate 2 can be supported in a given inclination, by a pair of shoring parts 6, chosen from three pairs fitted to the exercise device according to the invention. In addition to the first pair of props 64 described in Example 1, the device comprises a second and a third pair of props 65, 66, one of the three pairs being able to be implemented according to the user's choice or of the therapist. They have different positions and lengths, which will allow robust shoring, whatever the inclination of the plate. In practice, we seek to ensure that the angle formed between the props and the plate 2 on the one hand, and between the props and the carriage 3 on the other hand, approaches a right angle, so that during use, the forces are applied with an orientation deviating moderately from the perpendicular, for example by at most 20°. In doing so, each pair of props 6 must be able to be deployed and folded without disturbing the others. The positions and lengths of the props 6 were defined to also meet this constraint.

Each of the pairs of props 64, 65, 66 is pivotally mounted on the long edges 22 of the plate 2, and can rest on the dedicated locations 10 of the rack 12, in the same manner as described in Example 1. The first pair of props 64 is the longest (with a length L1) and closest to the distal end 212 of the plate 2. Then, moving away from this end, we find the second pair of props 65 which is the shortest of the three (with a length L2), and finally the third pair 66 of intermediate length L3. The first pair of props 64 will be conveniently retracted towards the distal end 212, as will the second pair 65. The attachment points of these two pairs of props 64, 65 are spaced apart by a length slightly greater than L2 , thus leaving the necessary space to retract the props 65 of the second pair. The third pair of props 66 will be retracted towards the proximal end 211 of the plate 2, being fixed near the fixing point of the second pair 65, which does not raise any size problems. To meet all the desired configurations, the two racks 12 advantageously extend over almost the entire platform 1.

EXAMPLE 5: Presentation of a variant with braking

Whatever the embodiment chosen, a braking system can be installed on the exercise device, to increase as desired the effort that the user must provide to move the cart 3. As a non-limiting example illustrated to the figures And , an elastic ring 71 is used to increase the resistance when pushing the carriage 3. A rod 72 is mounted perpendicular on the long side 22 of the plate 2, at its proximal end 211, and four rods 73 are inserted protruding perpendicularly on the side wall of said cart. The elastic ring 71 is simply slipped onto the rod 72 and onto one of the rods 73, so that a forward push of the carriage 3 causes it to stretch. To increase the resistance, we will pass the ring 71 on a more distant rod 73, and/or use a harder elastic band.

Claims (20)

Portable device for active exercise of a patient's upper limb, characterized in that it comprises:
- a platform (1) capable of being placed on a work surface,
- a plate (2) adopting a rectangular shape elongated along a longitudinal axis and having an upper face (20) surrounded by two short sides (21) and two long sides (22), the plate (2) being mounted articulated to the platform (1) by one of its short sides, called the proximal side (211), and comprising retractable means for holding in at least one inclined position relative to the plane of the platform (1) in which the other short side, called the side distal (212), is raised, and
- a carriage (3) movable in longitudinal translation on the plate (2), shaped to receive the patient's forearm and hand in fixed support, respectively on a rear part (311) and on a front part (312) of said cart. Device according to claim 1, characterized in that the plate (2) is provided with longitudinal sliding and guiding means cooperating with complementary means with which the carriage (3) is provided. Device according to claim 1 or 2, characterized in that the cart (3) is shaped like a gutter of a defined length to allow support for the forearm and hand of said patient, comprising a bottom (30) from which rise side walls (32) and a handle (33) intended to be grasped by the patient. Device according to the preceding claim, characterized in that the carriage (3) comprises a plurality of sites capable of receiving said handle, arranged in different longitudinal positions, said handle being removably mounted in one of said sites. Device according to one of claims 3 or 4, characterized in that the bottom (30) of the cart (3) comprises a plurality of holes (34) made at intervals along a longitudinal axis, and the handle (33) is formed of a pin (35) provided at its base with an axial tenon (36) capable of being inserted into one of said holes in free sliding. Device according to one of the preceding claims, characterized in that the plate (2) comprises a longitudinal groove (23) in which is engaged at least one guide lug (37) projecting under the carriage (3). Device according to claims 5 and 6 taken together, characterized in that the guide lug (37) is formed by the tenon (36) of the pin (35) which is inserted through one of the holes (34) of the bottom (30). ) of the carriage (3), and of which an end segment projects under said carriage. Device according to claim 6 or 7, characterized in that the groove (23) is obstructed by at least one stop (24) acting as a stop. Device according to any one of the preceding claims, characterized in that the plate (2) comprises two lateral grooves (5) each extending longitudinally near a long side (22) and cooperating with rolling means fixed to the cart (3), which comprise four rolling units (4), including two units fixed in the front part (312) of the cart and two units fixed in the rear part (311) of the cart, arranged symmetrically on either side of the longitudinal axis of said carriage, directly above the lateral grooves (5) with which they cooperate, respectively. Device according to the preceding claim, characterized in that each lateral groove (5) is fitted with a rail (51) comprising a groove (52) which matches the shape of said groove and two lateral wings (53) extending on either side. other side of the rail (51) to the surface of the plate (2). Device according to claim 10, characterized in that each rolling unit (4) comprises a roller (41) engaged entirely or partially in the groove (52) of the rail (51) plumb with which said rolling unit is located. rolling. Device according to claim 10, characterized in that each rolling unit (4) comprises a wheel (42) whose tread (43) rests on a lateral wing (53) of the rail (51) plumb with which is finds said rolling unit. Device according to the preceding claim, characterized in that each rail (51) has an omega-shaped or dovetail section so as to present an entry slot (54) narrower than the groove (52), and each rolling unit (4) comprises a guide blade (44) which is engaged vertically in the groove (52) of said rail, said blade being flared in its end part with a thickness greater than the width of the slot (54 ). Device according to any one of the preceding claims, characterized in that the plate (2) is mounted articulated to the platform (1) by a hinge (12) fixed on the one hand to the platform (1) and on the other hand at the proximal side (211) of said plate or at its adjacent proximal end. Device according to any one of the preceding claims, characterized in that the plate (2) is provided with at least one shoring piece (6) deployable longitudinally, one end (61) of which is pivotally fixed to said plate, the other end (62) being free and capable of bearing on a dedicated location (10) of the platform (1), chosen from a series (101) of locations located at an increasing longitudinal distance relative to the proximal side (211). ) of the plate, so that the plate (2) is raised at its distal end (212) with a predetermined angle of inclination relative to the plane of the platform (1). Device according to claim 15, characterized in that the plate (2) is provided with a supporting part (6) comprising a plate (6a) pivotally fixed under the plate (2), by a hinge (63) perpendicular to the longitudinal axis of said plate. Device according to claim 15, characterized in that the plate (2) is provided with a first pair of props (64) arranged symmetrically with respect to the longitudinal axis of said plate, each having one end (61) fixed pivotally against an opposite long edge (22) of the plate. Device according to the preceding claim, characterized in that the plate (2) is provided with at least a second pair of props (65, 66) fixed symmetrically and pivoting against the opposite long edges (22) of the plate, the first pair of props (64) and said at least one second pair of props (65, 66) having different lengths and being mounted at different distances relative to the proximal side (211) of said plate. Device according to one of claims 15 to 18, characterized in that the platform (1) comprises at least one series of dedicated locations (10) placed aligned in the longitudinal direction in at least one continuous or discrete strip, at an increasing distance relative to the proximal side (111) of said platform. Device according to any one of the preceding claims, characterized in that it is provided with means for exerting a compressive or tensile resistance opposing the movement of the carriage (3) on the plate (2).