JP2014061106A - Lower limb training device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To perform standing and bending/stretching exercises in a stable state by displacing the left/right legs in the front/back/left/right directions by a patient's own intention and uniformly applying load to both of a paralyzed lower limb and a healthy lower limb as much as possible during the training.SOLUTION: The lower limb training device includes a pair of left/right wearing plates, the interval of which is adjustable for clampingly fixing the lumbar region of a hemiplegic patient from the left and the right. The wearing plates are connected with a pair of left/right first links and a pair of left/right second links mounted thereon via free rotation shafts respectively, the free rotation shafts being rotatable only about a horizontal shaft. This configuration allows the patient with reduced lower limb exercise function to perform the lower limb training such as standing and bending/stretching exercises in a stable state without an assistant.

Description

The present invention relates to a lower limb training apparatus capable of performing lower limb training for hemiplegic patients and patients whose lower limb motor functions are reduced.

Entering a super-aging society, the proportion of elderly and disabled people is increasing. For those patients, standing motion and walking motion are considered to be the most important motions. However, in order to acquire the movement, rehabilitation for a long time is necessary, and the physical burden on the therapist is large, so it is almost always entrusted to patient self-training. In such self-training, as shown in FIG. 1, patients tend to rely on healthy feet to stand up. For this reason, it is not a training in which both lower limbs are balanced as shown in FIG. As described above, it has been pointed out that conventional voluntary training often does not result in inconvenient foot training, and that it becomes a major obstacle to walking and daily activities at a later date. This has led to an increase in bedridden patients, a decrease in patient quality of life (QOL), and an increase in care costs associated therewith. Against this background, a lower limb training device that assists the physical fitness of the occupational therapist and can focus on the training of the inconvenient foot is eagerly desired.

Many lower limb training devices have been developed to solve this problem. However, many conventional leg training devices such as standing training and walking training perform walking training, stretching of the right or left foot, and flexion training. I cannot find a lower limb training device for training.

In the other conventional examples, all of them are related to walking training, and most of them use a load-free mechanism. Furthermore, since the devices according to these prior arts do not separate the training of the healthy foot and the handicapped foot, it is difficult to focus on the handicapped foot when using this device. It is. In still another conventional example group, all of them are a walking training apparatus using a handrail and a mobile walking training apparatus.

In other words, in all conventional examples, most of the patent applications related to lower limb training devices relate to gait training, and stable standing motions, well-balanced walking motions, etc. can be obtained by focusing on the incapacitated feet. I can't find the technology I mentioned. In addition, most of them are those that perform joint extension and flexion, and those that aim to increase the muscle strength of healthy subjects. Among these, a conventional example most relevant to the present invention is disclosed below.

As a conventional example 1, Japanese Patent Publication No. 2010-119499 discloses a training device. An object of the present invention is to provide a training apparatus that can acquire an ideal way of standing and moving, and that can efficiently restore and enhance the function of standing and sitting. In other words, the training apparatus includes a seat, a lifting mechanism that lifts and lowers the seat, a servo motor, a load cell, and a control box (control unit), and the control unit records in advance the maximum load applied to the seat. At the same time, the servo motor 5 is controlled so that an auxiliary force substantially equal to the load is generated in the push-up direction of the seat when the load applied to the seat is equal to or less than a predetermined assist force limit value smaller than the maximum load. When the assist force limit value is exceeded, the servo motor 5 is controlled to stop the seat.

However, in this Reference 1, there is no technical idea that mentions the acquisition of a stable standing motion, a well-balanced walking motion, etc. by intensively training an inconvenient foot.

Further, as prior art example 2, Japanese Patent Publication No. 11-164860 discloses. A limb drive device for a hemiplegic patient is disclosed. An object of the present invention is to arbitrarily set the trajectory of a paralyzed limb using a healthy limb to enhance the training effect and at the same time shorten the training period. That is, this hemiplegic patient's limb body drive device is provided at the base of the device to teach a motion trajectory with a healthy limb, a limb body drive device provided at the base of the device to drive a paralyzed limb, and paralysis An operation condition input unit for setting an operation condition of the limb with a position, a trajectory setting unit for inputting the angle information and load information of the motion teaching device, the operation condition information of the operation condition input unit, and outputting the paralyzed limb trajectory information, The parallax limb body control unit that receives the information, the angle information and the load information of the limb body driving device, and outputs a driving command to the limb body driving device. That is, in Reference 2, the hemiplegic patient arbitrarily sets the trajectory of the paralyzed limb through the flexion and extension of his / her normal limb, and adds the operation condition information arbitrarily input by the patient based on the set trajectory. Then, the limb body motion device for the paralyzed limbs also calculates the target trajectory using the inverse kinematics calculation method of the robot manipulator in robot engineering, and the operation of the paralyzed limbs is performed as desired by one patient.

However, in this apparatus, since the paralyzed limb is restrained by the mounting portion, the limb body cannot be delicately controlled by the paralyzed patient. Furthermore, only hip and knee joints, and limited to flexion and extension movements, hip abduction, adduction, external rotation, internal rotation, ankle valgus (varying), varus (inner) E.), Lacks the technical idea of dealing with human natural movements including abduction, adduction, etc.

JP2010-119499 JP-A-11-164860

In view of the drawbacks of the conventional leg training apparatus as described above, the leg training apparatus according to the present invention is a hip joint, knee joint, ankle flexion, extension exercise, hip abduction, internal Natural standing corresponding to the natural movements of abduction, external rotation, internal rotation, ankle valgus (varying), varus (varying), abduction, adduction, etc. An object of the present invention is to provide a device in which a paralyzed patient himself performs lower limb training in a posture. Furthermore, the lower limb training apparatus according to the present invention performs lower limb training that allows the load on each of the paralyzed lower limbs and the healthy lower limbs to be changed by displacing the left and right feet forward, backward, left and right at the patient's own will during training. An object is to provide an apparatus for performing.

From the previous research of the present invention, the therapist holds the patient up and down while standing, while controlling and adjusting the left and right blurring of the patient's center of gravity and adjusting how to apply the load to the inconvenient foot. It was possible to clarify quantitatively the training entity that encourages movement. It was also found that how to apply the center of gravity was adjusted according to the patient's symptoms. Therefore, the configuration of the lower limb training apparatus according to the present invention discloses a lower limb training apparatus having a configuration in which the assisting operation of the standing motion to the lower limb patient by a therapist is replaced with a mechanical device as much as possible. In other words, a device is disclosed that is equipped with a mechanism that can suppress or appropriately adjust the shake of the patient's trunk in the left-right direction and assists the standing motion.

In the following description of the lower limb movement support device according to the present invention, regarding the expressions relating to the position, direction, etc., the user's left-right direction is the X axis, the front-rear direction is the Y axis, and the vertical direction is the Z axis. In addition, when distinguishing between the left and right members, such as a link part, the left and right members are marked with L (left) on the left hand side and R (right) on the right hand side. If there is no distinction between left and right, the description will be made without attaching L and R.

A lower limb training apparatus capable of performing lower limb training for a patient whose lower limb motor function has decreased is a pair of left and right base portions fixed at a predetermined interval on a floor surface, and a first limb that is rotatable only about the X axis. A pair of first links whose lower ends are pivotally supported by a base portion via a free rotation shaft, and a lower end pivotally supported by the upper ends of the first links via a second free rotation shaft that is rotatable only with respect to the X axis. A U-shape that is pivotally supported on the upper end of the second link via the pair of second links and a third free rotation shaft that is rotatable only with respect to the X axis, and connects the left and right second links 50, 50. The horizontal connection link and a pair of left and right mounting plates are provided on both inner sides in the X-axis direction of the horizontal connection link, and the pair of mounting plates can be adjusted with an adjustment knob. The adjustment knob is adjusted so that the patient's waist standing between the pair of mounting plates can be clamped so that the patient can repeatedly and stably perform the bending and stretching movements and the standing movements without blurring from side to side. Yes.

By configuring in this way, it is possible to apply a load evenly and stably to the left and right legs without shaking the lumbar part from side to side, so training for lower limb exercises without the support of an assistant such as a therapist Is possible.

Further, a grid-like grid scale may be provided on the floor surface so that the shift of the standing position in the front-rear and left-right directions can be visually recognized from the center position where the patient stands. Furthermore, a pair of foot fixing parts for fixing both feet of the patient are provided on the floor surface, and a means for fixing the foot fixing parts at any position on the floor surface is provided so that the standing position can be freely set. It may be configured to be changeable.

On the floor, a pair of flat plates are provided for both feet, and there are means for detecting the load (weight balance) on both feet under these flat plates, and each load on the left and right feet of the patient. It may be configured so that the lower limbs can be exercised while confirming, and a display means for displaying information from means for detecting the load on both feet and a storage means for storing the history information may be provided.

In the lower limb training apparatus of the present invention, the load on each of the paralyzed lower limb and the healthy lower limb is equalized or changed unlike the conventional example by displacing the left and right feet back and forth and left and right at the intention of the patient himself or the therapist. Or the patient can train the lower limbs without the assistance of a therapist or the like.

FIG. 1 is a schematic diagram schematically illustrating a load state applied to left and right feet of inappropriate standing training. FIG. 2 is a schematic view schematically illustrating a load state applied to the left and right feet of proper standing training. FIG. 3 is a perspective view from the left front in the standing state in the lower limb training apparatus 1 according to the present invention. FIG. 4 is a perspective view from the right rear in the standing state in the lower limb training apparatus 1 according to the present invention. FIG. 5 is a front view of the lower limb training apparatus 1 according to the present invention in a standing state. FIG. 6 is a perspective view from the right front in the knee flexion state in the lower limb training apparatus 1 according to the present invention.

Hereinafter, the lower limb training apparatus 1 according to the present invention will be described. 3 is a perspective view from the left front in the standing state of the lower limb training apparatus 1 according to the first embodiment, FIG. 4 is a perspective view from the right rear, and FIG. 5 is a front view. First, a pair of left and right base portions 10 are fixed on the floor surface at a predetermined interval. A lower end of the first link 30 is pivotally supported on the base portion 10 via a first free rotation shaft 20 that is rotatable only with respect to the X axis. The lower end of the second link 50 is pivotally supported at the upper end of the first link 30 via a second free rotating shaft 40 that is rotatable only with respect to the X axis. Further, at the upper end of the second link 50, there is a U-shaped horizontal connecting link 70 that connects the left and right second links 50, 50 via a third free rotating shaft 60 that is rotatable only with respect to the X axis. It is pivotally supported. Furthermore, a pair of left and right mounting plates 80 are provided on both inner sides of the horizontal connection link 70 in the X-axis direction. The pair of mounting plates 80 have an adjustment knob (not shown) whose width can be adjusted in the X-axis direction. For example, the adjustment knob is rotated to adjust the gap between the pair of mounting plates 80 around the patient's hips. It has a structure that can be adjusted so that it can be clamped.

Accordingly, the first link 30, the second link 50, the horizontal connection link 70 and the pair of mounting plates 80 have the first free rotating shaft 20, the second free rotating shaft 40, and the third free rotating shaft 60 with respect to the X axis. Therefore, the waist can be moved only in the Y-axis and Z-axis directions and cannot be moved in the X-axis direction. A patient who performs lower limb training using the lower limb training apparatus 1 first lifts the pair of mounting plates 80 while standing on the floor, holds the waist, and rotates and adjusts an adjustment knob (not shown). The adjustment knob may be adjusted by the patient himself or by an assistant such as a therapist. In this state, the patient can move only in the Y-axis and Z-axis directions and cannot move in the X-axis direction because the waist is sandwiched between the pair of mounting plates 80 and 80. Therefore, the knee flexion and extension movement is possible, and when the patient bends the knee from the standing state, the mounting plate 80 is also lowered downward. That is, with the patient's knee flexion movement, the first free rotation shaft 20 corresponding to the patient's ankle joint, the second free rotation shaft 40 corresponding to the knee joint, and the third free rotation shaft 60 corresponding to the hip joint rotate simultaneously. Thus, the body can be moved only in the front-rear and up-down directions. However, since the movement is limited in the X-axis direction, if the patient stands at the center of the pair of mounting plates 80, 80, he / she can bend and stretch evenly by applying a load to the paralyzed leg and the healthy leg. While it can be performed, the lower back is stable because the waist is sandwiched between the pair of mounting plates 80, 80, and the body can be bent and extended without the support of a therapist or the like. it can. It is also possible to adjust the load applied to both feet by displacing only the left and right feet back and forth and left and right while intentionally holding the waist stably during training. FIG. 6 is a perspective view from the front right side in the knee-bending state.

As a second embodiment of the present invention, a grid-shaped grid not shown in FIG. 3 that can visually recognize the standing position of the patient may be provided on the floor on which the lower limb training apparatus 1 is fixedly installed. For example, the grid graduation may be a square graduation at a predetermined unit distance in the X direction and the Y direction with the midpoint of the pair of base portions 10 and 10 as a zero graduation. The patient usually stands up to this zero scale position and flexes and stretches. However, in the case of a hemiplegic patient, it is easy to apply an unbalanced load to the left and right legs as shown in FIG. This is for adjustment. The grid scale is also for facilitating visual recognition of the standing position of a hemiplegic patient who is determined to be more appropriate to exercise with a foot placed at a specific position.

As a third embodiment of the present invention, the foot fixing portion 90 shown in FIG. 3 may be further provided on the floor surface. For example, the foot fixing part 90 may fix a slipper-like footwear with an adhesive tape that can be attached to and detached from the floor. Thereby, the patient can perform the flexion and extension training of the lower limbs by forcibly fixing both feet to a predetermined position.

Further, as a fourth embodiment of the present invention, as shown in FIG. 7, a pair of flat plates 100 on which both feet are placed may be additionally provided. Under this flat plate 100, for example, a pressure sensor, a 6-axis or 3-axis pressure sensor is attached, and it is possible to measure the twisting force and the load load on each of both feet of the patient. Moreover, you may make it the structure which displays the sensor value in the position which a patient can visually recognize. In this configuration, the patient himself / herself and an assistant such as a therapist can perform flexion training while confirming respective loads on the left and right feet of the patient. Furthermore, means for creating and displaying an exercise history or the like using existing technology may be provided for the output data of these pressure sensors.

The lower limb training apparatus 1 according to the present invention prevents an increase in bedridden patients, a decrease in quality of life (QOL) of the patient, suppresses an increase in care costs associated with them, further assists the physical fitness of the occupational therapist, Hemiplegic patients themselves can give priority to flexing and stretching movements of the lower limbs.

1 Lower limb training apparatus 10 Base part
20 First free rotation axis
30 First link
40 Second free rotation axis
50 Second link 60 Third free rotating shaft 70 Horizontal connection link 80 Mounting plate 90 Foot fixing part 100 Flat plate

Claims (5)

In the lower limb training apparatus 1 that can perform lower limb training of a patient whose lower limb motor function has decreased,
A pair of left and right base portions 10 fixed at predetermined intervals on the floor surface;
A pair of first links 30 whose lower ends are pivotally supported by the base portion 10 via a first free rotation shaft 20 that is rotatable only with respect to the X axis;
A pair of second links 50 whose lower ends are pivotally supported on the upper ends of the first links 30 via a second free rotating shaft 40 that is rotatable only with respect to the X axis;
A U-shaped horizontal connection link that is pivotally supported on the upper end of the second link 50 via a third free rotation shaft 60 that is rotatable only with respect to the X axis and connects the left and right second links 50, 50. 70,
A pair of left and right mounting plates 80 are provided on both inner sides of the horizontal connection link 70 in the X-axis direction. The pair of mounting plates 80 can be adjusted with an adjustment knob, and stands between the pair of mounting plates 80. A lower limb training apparatus 1 that is configured so that a patient's lower back can be pinched and the patient can repeatedly and stably perform bending and stretching motions and standing motions without blurring from side to side. 2. A grid-shaped graduation scale is provided on the floor so that the shift of the standing position in the front-rear and left-right directions can be visually recognized from the center position where the patient stands up. Lower limb training apparatus 1. A pair of foot fixing portions 90 for fixing both feet of the patient are provided on the floor surface, and means for fixing the foot fixing portion 90 at an arbitrary position on the floor surface is provided, and the standing position is set. The lower limb training apparatus according to claim 1, wherein the lower limb training apparatus is configured to be freely changeable. A pair of flat plates 100 for placing both feet is provided on the floor surface, and means for detecting the load on both feet is provided below the flat plate 100 so that each load applied to the left and right feet of the patient can be detected. The lower limb training apparatus (1) according to claim 1, wherein the lower limb training apparatus (1) is configured to perform a lower limb exercise while confirming. The lower limb training apparatus (1) according to claim 4, further comprising display means for displaying information from the means for detecting the load on both feet, and storage means for storing history information.