IT201600093968A1 - BI-PODALIC MOBILIZER DEVICE FOR PASSIVE MOBILIZATION OF THE ANKLE ARTICULATION - Google Patents

Description

"BI-PODAL MOBILIZATION DEVICE FOR PASSIVE MOBILIZATION OF THE ANKLE JOINT"

The present invention relates to physiotherapy equipment, having the purpose of carrying out physical rehabilitation activities, and in particular proposes a rehabilitation device aimed at determining the passive mobilization of the lower limbs, with particular reference to the ankle joint.

By passive mobilization we mean the application of a movement to one or more joints of the body without actively intervening the muscles that, under normal conditions, would be responsible for that movement.

These are therefore treatments that are generally implemented for more or less long times to solve, or at least alleviate, the problems resulting from traumatic events, orthopedic pathologies (arthrosis, fractures, muscle and / or tendon injuries, dislocations, sprains, scoliosis , inflammation, etc.), neurological disorders (stroke, multiple sclerosis, Guillan Barrè syndrome, neuro-muscular diseases, Parkinson's disease, etc.), rheumatological diseases (rheumatoid arthritis, arthrosis, etc.), cardiovascular problems (phlebitis, coronary heart disease , varices of the lower limbs, etc.), arteriosclerosis, respiratory diseases (hypovalidity due to long immobilization), aesthetic problems (cellulite).

With passive mobilization different effects are obtained, including that of stimulating the perisynovial cells, which secrete the synovium, but also that of partially relaxing the muscles, making some tissues more elastic, in particular of the connective type (scars, tendons) and to improve the circulation of the cartilage by the synovial fluid.

In other words, what passive mobilization seeks to achieve, from one point of view, is an effect of pain relief and, from another aspect, to reach at a functional level an adequate range of movements and as close as possible. to the normal one or in any case to that determined by a predetermined functional objective.

It is known that various devices are available on the market for mobilizing the various joints of the body, devices which are more or less sophisticated and which are generally motorized, so that the patient exercises the mobilization passively.

In addition to a mere mobilization effect, which moreover, as already mentioned above, stimulates various functions on the moving parts, the known devices are however not able to reproduce other effects that the movements carried out in people able to move normally are able to determine.

For example, there are motorized mobilizers which include a sort of pedals carried by a structure to be placed on a surface, for example on the floor. The patient's feet, sitting or lying down, are fixed to the pedals, which are rotated by the motor.

Apparatuses of this type are capable of obtaining the effects described in the introduction, but cannot give rise to other effects which are determined, for example, by the walk of a person in normal conditions.

For example, it is known that walking, in addition to stimulating the articulations of the ankles, exerts a compressive action on the vascular structures on the foot.

This phenomenon, generally known as the "pump effect", constitutes one of the fundamental functional components of the lympho-venous system of the lower limbs.

The dynamic compression action on the sole of the foot facilitates the return of blood and lymph, stimulating both the venous insole of Lejars and the deeper veins of the Volta triangle.

Normally this effect is the result of walking; the tissues of the foot resting on the ground, exerting a compression action on the vascular structures, facilitate the return of blood and lymph, stimulating both the venous insole of Lejars and the deeper veins of the Volta triangle.

The blood pumped by the heart towards the distal extremities of the body, on the other hand, must rise in another way, encountering various obstacles: the distance from the heart, which cancels the initial pressure effect, and gravity, which tends to favor stagnation in the vessels farthest from the heart.

While walking, the foot exerts a compression action on the plantar vascular structures, which are therefore emptied at each step; this composite mechanism causes the sole of the foot to act as a real peripheral heart, capable of developing centripetal propulsive forces on the blood, which push the latter upwards and towards the heart.

The blood continues its ascent aided by the contraction of the calf muscles and the anterior leg muscles, during the plantar flexion-extension movement, which speeds up the blood mass and brings it into the popliteal system.

At each subsequent step, knee flexion favors emptying into the popliteal vein which is the most important drainage route to the deep venous system of the thigh, where the more proximal pump mechanisms then come into operation.

From what has been said, we understand the importance of this mechanism for the correct functioning of the vascular system and, in general, for the health of the lower limbs.

No device for passive mobilization currently available on the market is able to reproduce this very important function.

The aim of the present invention is therefore to propose a mobilization device which, in addition to stimulating the ankle joints, is able to activate the pump effect, producing a good dynamic functioning of the foot, a condition which in fact constitutes the most important operating secret of the lympho-venous system of the lower limbs, all in a comfortable way for the patient.

Another object of the invention is to propose a mobilization device able to perform the mobilization of the ankle in a variable and adjustable way, moving both legs synchronously or in phase opposition.

A further object of the invention is to propose a mobilization device in which it is possible to change the position of the fulcrum around which the foot oscillates, being able to bring it from the median area below the sole to an area corresponding to the heel. .

Finally, an object of the present invention is to provide a mobilization device made by means of an effective solution, functional but simple to produce, and therefore not prohibitive from the point of view of costs.

These and other purposes, which will become clear from the following description, are all achieved by means of a bi-podalic mobilizing device in which at least one oscillating platform is hinged to a support structure, so as to be able to be raised and lowered with suitable handling means. to determine the vertical oscillation of the platform.

The characteristics of the invention that do not emerge from the above will be made clear in the following description, to be considered with reference to the attached drawing table, in which:

Figures 1a, b, c, d illustrate the mobilizing device of the present invention in different configurations and operating steps;

Figure 2 represents the device of the invention seen from above, when it is in the operating configuration and in the rest phase illustrated in Figure 1c;

Figures 3 and 4 show details of parts of the device object of the present invention;

Figure 5 represents a detail of a foot and of the action exerted on that foot;

Figure 6 schematically illustrates a variant of the invention, which comprises a stimulating device for the ends of the toes provided in a platform of the mobilizing device;

Figure 7 illustrates a detail of the platform of Figure 6, comprising a stimulating device which affects all the toes of the foot.

With reference to the aforementioned figures 1a, b, c, d, 1 indicates the bi-podalic mobilization device object of the present invention.

The device first of all comprises a support structure 10, formed, for example, by a plate or a base frame, at one end of which two or more vertical and parallel uprights 12a, 12b are fixed, joined at the top by a fulcrum axis F which, as will be seen below, also constitutes the fulcrum of the moving parts of the equipment.

In the figures, in particular in figure 2, two uprights 12a, 12b have been illustrated by way of example, but for structural or sturdiness reasons also three uprights can be provided, placing one, for example, in a central position, or another suitable structure.

Two footrests 20a, 20b are mounted oscillating on a fulcrum axis F, so as to be able to rotate around the same axis, thus being hinged to the support structure 10.

More precisely, two bars 21a, 21b are mounted oscillating on the fulcrum axis F on which the footboards 20a, 20b are mounted slidingly. The illustrated bars 21a, 21b, if convenient from the manufacturing point of view, can in any case be replaced by as many plates, or by other suitable support for the platforms 20a, 20b.

In detail, in the embodiment illustrated in the aforementioned figures by way of example, the footrests 20a, 20b are fixed to sleeves 26 into which the bars 21a, 21b are introduced. In this way it is possible to modify the position of the footboards 20a, 20b themselves with respect to the fulcrum axis F.

It is to be understood that the mechanism for moving the footboards 20a, 20b with respect to the fulcrum axis F can also be realized differently, keeping the functionality unchanged, without however departing from the scope of the invention.

At the free end, or near the free end of the bars 21a, 21b, as illustrated in Figures 1a, b, c, d, movement means 30 are connected which are suitable for causing the vertical oscillation of the platforms 20a, 20b, moving alternatively the bars 21a, 21b upwards and downwards.

Furthermore, in the illustrated embodiment, the movement means are made in the form of an electric motor 31 connected by means of a speed reducer 34 to a disc or cam 32.

The reducer 34 could also be replaced by a speed variator or integrated by a speed variator; both of these two possibilities have not been illustrated in the figures since they are easy to implement for those skilled in the art.

The speed variator can be applied to the plate or frame 10 and can be controlled directly or remotely by means of a remote control.

Connecting rods 33a, 33b are connected to the disc or cam 32 and pivoted to the free end of the respective bars 21a, 21b.

Therefore, the activation of the motor 31 drives the disc or cam 32 in rotation and the connecting rods 33a, 33b raise and lower the bars 21a, 21b making them oscillate together with the footboards 20a, 20b.

Also as regards the transfer of motion from the motor 31 to the footboards 20a, 20b it can be carried out using other known design solutions not illustrated for simplicity. For example, the same function could be performed by mounting the disc or cam 32 eccentric with respect to its own axis of rotation, in axis with the axis of the motor 31 or connected thereto at 90 °, by means of a suitable pair of gears.

With the feet resting on the platforms 20a, 20b, possibly stopped by means of straps not shown, the patient's legs are alternately forced to raise and lower, with a movement that affects the ankle joint in particular.

As previously mentioned, the footrests 20a, 20b are movable along the bars 21a, 21b so as to vary the position of the resting areas of the feet 22a, 22b with respect to the fulcrum axis F.

For example, as illustrated in Figures 1a and 1b, when the footrests are moved and away from the fulcrum axis F, by sliding the sleeves 26 along the bars 21a, 21b, the rotation fulcrum corresponds to the heel area, and the ankle joint rotates having the heel area as the center of rotation.

If, on the other hand, the footboards 20a, 20b are moved and approached as close as possible to the fulcrum axis F, by making the sleeves 26 slide along the bars 21a, 21b in the direction of the same, the fulcrum point corresponds approximately to the median area of the plant. of the foot.

This allows you to choose the point around which the ankle joint is rotated.

On each platform 20a, 20b a layer of synthetic and elastic plastic material is applied, for example a polyurethane foam, which forms a sort of insole 24.

The surface of the insole 24 intended to come into contact with the foot is shaped so as to present an anatomical shape which adapts to the sole of the foot.

The foot is then received on the platform in a comfortable way and held in its correct position thanks to the anatomical shape, which cooperates to this end with the straps.

According to a possible advantageous characteristic, the material with which the insole 24 is made has different densities in different areas, so as to respond elastically in a differentiated manner.

This different elastic response can have positive effects in the foot massage action, as better specified below.

Another interesting feature, highlighted in figure 4, provides that on the upper surface of the insole 24, intended to come into contact with the foot, flexible pins 25 are made, suitable for practicing a sort of massage on the soles of the feet resting on the footboards 20a, 20b.

A possible advantageous variant, illustrated in Figure 3, provides that each of the insoles 24 is divided transversely so as to define sectors 24a, 24b, 24c which can be brought closer or apart to adapt the dimensions of the support area to the dimensions of the feet. which must be received on said support area 22a, 22b.

The two platforms 20a, 20b are normally actuated in phase relation to each other, in particular according to opposite phases with a 180 ° displacement.

This is obtained by positioning the connection points of the connecting rods 33a, 33b to the disc or cam 32 diametrically opposite.

However, it is possible to provide for the connection of the connecting rods 33a, 33b at the same point along the circumference of the disc or cam 32. In this way, the footboards 20a, 20b will rise and fall in unison.

Furthermore, in the embodiment illustrated here, reference has been made to two separate footrests 20a, 20b, but it is possible to realize the device also with a single footboard (not shown) of suitable dimensions, on which two orthotics 24 side by side are positioned.

This embodiment, simpler than the one described above, acts in an identical way to what is obtained by operating the two platforms in unison.

In all the variants described above, the device object of the present invention produces an oscillatory movement of raising and lowering the lower limbs, causing a passive movement from the joint of the ankles of the foot and involving both the toe and the heel of the foot in the movement. ankles and knees.

The movement of the feet can be performed both in phase and in phase opposition, in this case the platform being obviously divided into two smaller platforms 20a, 20b.

The movement can be performed by positioning the axis of rotation both on the heel and in the center of the sole of the foot, creating in this case an oscillatory movement that involves the raising and lowering not only of the toes, but also of the heels of the foot. .

In any case, the movement obtained in the ways described stimulates the soles of the feet so as to also produce a muscle pump effect.

This effect can be improved by the elastic action of the insoles and modulated by providing different elasticities (different material densities) in their extension. Basically, the pump effect just described is more effective.

The insole 24 is produced with a synthetic plastic material, for example polyurethane or polyurethane foam or the like, or an elastomer or other similar polymeric product as long as it has suitable characteristics. In particular, it must be soft, anti-allergic and non-toxic. If it is soft, it adapts more easily to all the anatomies of any foot.

Thanks to the presence of the pins 25 on the insoles 24, the proposed device can also perform a plantar proprioceptive stimulation function.

The pins 25 have a very high capacity to absorb loads, and stimulate the sole of the foot with a beneficial and pleasant massage that enhances the pump effect and improves lymphatic circulation.

Furthermore, the arched conformation of the insole 24 allows the metatarsal to resume its natural arch, while the foot rests on a large surface and the forefoot is lightened.

The support of the plantar arch can be realized, for example with a greater density in order to obtain the effect of keeping the median part of the foot raised, as clearly evident in figure 5.

In the embodiment illustrated here, the movement of the platforms is carried out with an electric motor, but this solution is for illustrative purposes only and must not be considered as limiting.

The movement of the platforms or the platform can be determined in any way, through the action of components consisting of electrical and / or mechanical and / or pneumatic and / or hydraulic parts or of any other nature.

As previously mentioned, the speed can be adjusted by means of a variator placed on the equipment itself or by means of a remote control. An emergency button, not illustrated as it is within the reach of the technician in the sector, can interrupt the power supply to the device and is positioned on the device itself and / or on the remote control, if provided.

There are various situations in which the device object of the present invention finds useful application: in particular, in addition to stimulating the articulations of the ankles, it is essential to activate the pump effect: the correct dynamic functioning of the foot is in fact the most important operating secret of the lymph system. --Venous of the lower limbs.

The passive bi-breech mobilizer, built in accordance with the present invention, performs the same function as the walk in cases in which the user has difficulty and / or inability to walk, or in cases in which he or she has needs that cannot be solved simply by walking, having to apply specific exercises.

To allow correct use of the device, the feet are secured to the footrests by means of two adjustable straps, which allow correct plantar stability during the execution of the exercise.

In use, the structure of the bipodalic mobilizer is enclosed within a protective casing, not shown in the figures for descriptive convenience, with the platforms 20a, 20b substantially aligned with the upper part of the casing itself.

A variant of the bipodalic mobilizer, schematically illustrated in Figures 6 and 7, provides that a stimulator device 50 is installed in the front part of each platform 20a, 20b, intended to stimulate by contact one or more sensitive points of the foot, and in particular of the extremities. of the fingers of the same that find correspondence in different organs of the human body, according to the theory and technique of foot reflexology.

The stimulator device 50, in the illustrated exemplary embodiment, is made by means of one or more stimulation elements 51, mounted in the front part of each of the platforms 20a, 20b. Each stimulation element 51 comprises an elastic support 52 which extends upwards and towards the inside of the platform, in the direction of the position of a toe that the platform itself is intended to accommodate. In particular, the elastic support 52 has an arched shape, or otherwise projecting towards the inside of the relative platform 20a, 20b, and is provided, near its free end, with a stem 53 which extends towards the inside of the platform, in order to press against the tip of the finger with a pressure proportional to the elastic constant of the support 52.

In figure 7 five stimulation elements 51 are provided, to effect the stimulation of all the toes of the foot. Alternatively, a single stimulation element 51 can be provided, mounted in correspondence with the big toe, to stimulate the extremity of the same which finds correspondence in the brain, and in particular in the hypothalamus, according to the theory of plantar reflexology. In the same way, two or more stimulation elements can be provided, mounted in correspondence with other toes, depending on the areas of the body to be stimulated.

The pressure exerted by the stimulation elements 51 can also be made adjustable, according to known and not illustrated methods, for example with a mechanism for adjusting the elastic constant of the support 52, or by mounting each stem 53 on a frame served by its own elastic constant. adjustable.

It is understood that what above has been described purely by way of non-limiting example. Therefore, possible modifications and variants of the invention are considered to fall within the protective scope accorded to the present technical solution, as described above and claimed hereinafter.

Claims (12)

Claims 1. Bi-podalic mobilization device comprising: a support structure (10); a pair of oscillating footrests (20a, 20b), hinged to said structure (10) around a horizontal fulcrum axis (F), so as to be able to be raised and lowered; said mobilizing device being characterized in that it comprises movement means (30) adapted to cause the vertical oscillation of said pair of oscillating platforms (20a, 20b) around said fulcrum axis (F), in phase relation to each other and according to predefined amplitudes and frequencies of oscillation. 2. Bi-podalic mobilization device according to claim 1, in which said platforms (20a, 20b) are moved in phase opposition, so that one goes up while the other goes down. 3. Bi-podalic mobilization device according to claim 1, in which said platforms (20a, 20b) are moved jointly, so that both go up or down at the same time. 4. Bi-podalic mobilization device according to one of the preceding claims, in which said platforms (20a, 20b) are slidably carried by two respective bars or plates (21a, 21b), hinged to said support structure (10) and subjected to said moving means (30), said platforms (20a, 20b) being movable along said bars or plates (21a, 21b) so as to vary the position of the resting areas of the feet (22a, 22b) with respect to the axis of fulcrum (F). 5. Bi-podalic mobilization device according to one of the preceding claims, in which said movement means (30) consist of an electric motor (31) connected by means of a speed reducer to a disc or cam (32), to which they are articulated connecting rods (33a, 33b) pivoted to the free end of the respective bars (21a, 21b). 6. Bi-podalic mobilization device according to one of the preceding claims, in which a layer of synthetic and elastic plastic material is applied to each of the platforms (20a, 20b) which constitutes an anatomically shaped insole (24). 7. Bi-podalic mobilization device according to one of the preceding claims, in which in each of said platforms (20a, 20b) said insole (24) is divided transversely so as to define sectors (24a, 24b, 24c) which can be mutually approached or moved away to adapt the aforementioned insole (24) to the dimensions of the feet which must receive on said support area (22a, 22b). A mobilizing device according to claim 7, wherein the insole (24) has different densities in different zones so as to respond elastically in a differentiated manner. 9. Mobilizing device according to claim 7 or 8, in which flexible pins (25) are made on the surface of said insole (24) intended to come into contact with the foot, suitable for practicing a sort of massage on the soles of the resting feet on the platforms (20a, 20b). 10. Mobilization device according to one of the preceding claims, characterized in that it comprises a stimulator device (50), installed in one or both of the aforementioned platforms (20a, 20b) and intended to stimulate by contact one or more sensitive points of the foot, and in particular of the extremities of the fingers of the same that find correspondence in different organs of the human body, according to the theory and technique of plantar reflexology. Mobilizing device according to claim 10, wherein said stimulating device (50) comprises one or more stimulation elements (51), mounted in the front part of each of the aforementioned platforms (20a, 20b). 12. Mobilizing device according to claim 10, wherein each aforementioned stimulation element (51) comprises an elastic support (52) which extends upwards and inwards of the relative platform (20a, 20b), in the direction of the position of a toe that the footplate itself is intended to accommodate, and a stem (53), which extends towards the inside of the footplate (20a, 20b), to press against the end of the toe with a pressure proportional to the elastic constant of the relative support (52).