JP2018064832A - Walking support orthosis - Google Patents

Walking support orthosis Download PDF

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JP2018064832A
JP2018064832A JP2016206217A JP2016206217A JP2018064832A JP 2018064832 A JP2018064832 A JP 2018064832A JP 2016206217 A JP2016206217 A JP 2016206217A JP 2016206217 A JP2016206217 A JP 2016206217A JP 2018064832 A JP2018064832 A JP 2018064832A
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knee
rotation
walking
joint
walking support
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JP6595965B2 (en
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矢野 賢一
Kenichi Yano
賢一 矢野
琢 伊丹
Taku Itami
琢 伊丹
和弘 亀田
Kazuhiro Kameda
和弘 亀田
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Mie University NUC
KEIAI ORTHOPEDIC APPLIANCE CO Ltd
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KEIAI ORTHOPEDIC APPLIANCE CO Ltd
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Abstract

PROBLEM TO BE SOLVED: To provide a novel walking support orthosis being worn from the crus to the foot part for correcting rotational movement of the crus in walking.SOLUTION: A walking support orthosis 100 according to the present invention is a lower extremity orthosis including: a sole plate 120 having a pair of support side plates 110 that are provided upward from left/right edges; lower extremity columns 140 supported by joint plates 130 formed at tip ends of the support side plates 110; and lower extremity cuff 150 to be fixed to the lower extremity columns 140. The walking support orthosis is formed by rotationally supporting connecting shafts that are fixed to connecting members provided at the lower ends of the lower extremity columns 140, by rotational shaft bearings provided at the joint plates 130, and is configured to adjust anterior limit positions and posterior limit positions of rotational ranges of the rotational shaft bearings, where the left/right rotational ranges are differed from each other, and the inner foot-side and outer foot-side rotational ranges are variable. The lower extremity cuff 150 includes a curved part 151 for enabling creep and permits that the left/right rotational shaft bearings have different rotational ranges respectively.SELECTED DRAWING: Figure 1

Description

本発明は、歩行補助器具に関するものであり詳しくは、歩容改善を目的として下肢部に装着する装具に関するものである。   The present invention relates to a walking assist device, and more particularly, to a brace attached to a lower limb for the purpose of improving gait.

現在、変形性膝関節症(以下、膝OA(Osteoarthritis of the knee)という。)患者は国内で三千万人を超えると推定されている。膝OAとは、加齢に伴う筋力低下や、肥満、遺伝的因子、靭帯の弛緩などからおこり、膝関節の骨や軟骨がすり減り膝関節が変形する退行性疾患である。膝OAの症状としては、膝の関節や軟骨がすり減ることで膝関節が変形し、膝関節の屈曲および伸展動作によって、痛みが生じる。   At present, it is estimated that there are more than 30 million patients with knee osteoarthritis (hereinafter referred to as Osteoarthritis of the knee). Knee OA is a degenerative disease that occurs due to muscular weakness associated with aging, obesity, genetic factors, ligament relaxation, etc., and bone and cartilage of the knee joint are worn and deformed. As a symptom of the knee OA, the knee joint and cartilage are worn down to deform the knee joint, and pain is caused by the flexion and extension of the knee joint.

膝OAが起こると、今まで適切であった運動が膝関節に多大な負荷を与えることになり、膝の痛みと膝関節位置の変化による歩容の変化や、行動範囲の低下が起こるため、あまり歩かなくなる。それにより筋力が衰え、さらに痛みが増すという悪循環に陥りADL(Activities of Daily Living)や、QOL(Quality of Life)が低下する。特に、膝OA患者には、正常歩行から逸脱した歩容を示す異常歩行が現れやすい。   When knee OA occurs, exercise that was appropriate until now will give a great load on the knee joint, causing changes in gait due to knee pain and knee joint position change, and a decrease in the range of action, I don't walk too much. As a result, muscular strength declines, and the vicious circle of further pain increases and ADL (Activities of Daily Living) and QOL (Quality of Life) decrease. In particular, abnormal gait indicating gait deviating from normal walking tends to appear in knee OA patients.

膝関節は、膝関節軸において屈曲、伸展、回旋運動の2自由度をもつ。この回旋運動は膝関節最終伸展30度の範囲でみられる捻じり運動であり、終末伸展回旋運動と呼ばれる。終末伸展回旋運動は、歩行中の踵接地時の衝撃吸収や全身バランスのとれた歩行、拇指での蹴りだしに役立っており、回旋運動は歩行において必須な運動の1つである。   The knee joint has two degrees of freedom of flexion, extension, and rotational movement on the knee joint axis. This rotational motion is a twisting motion that can be seen in the range of 30 degrees of the final extension of the knee joint, and is called the terminal extension rotational motion. The terminal extension rotation exercise is useful for absorbing shocks when touching the heel while walking, walking with a well-balanced body, and kicking with the thumb, and the rotation exercise is one of the essential exercises for walking.

歩行中に起こる回旋運動に関しては、足関節底屈時、具体的には踵接地から足底接地の間は下腿部が内旋し、足関節背屈時、具体的には足底接地から立脚後期の間は下腿部が外旋する。しかし、膝OA患者の多くはこの膝関節の回旋運動障害を抱えている。   Regarding the rotational movement that occurs during walking, when the ankle plantar flexion, specifically, between the heel contact and the plantar contact, the lower leg rotates internally, and when the ankle dorsiflexion, specifically from the plantar contact The lower leg rotates externally during the late stance phase. However, many patients with knee OA have this rotational disorder of the knee joint.

膝OA患者への療法としては、手術療法と保存療法があげられる。保存療法としては、装具の使用や、運動療法、薬物療法などがあげられる。装具を使用する膝OA患者の保存療法としては、3点固定タイプの膝装具、回旋運動を利用した膝装具がある。   Examples of the therapy for knee OA patients include surgical therapy and conservative therapy. Examples of conservative therapy include the use of braces, exercise therapy, and drug therapy. Conservative therapy for knee OA patients using the orthosis includes a three-point fixed type knee orthosis and a knee orthosis utilizing a rotational motion.

3点固定タイプの膝装具は、大腿部、膝および下腿部の3点を支持するものである。例えば、膝関節の変形を正常なアライメントに矯正する装具(特許文献1)がある。回旋運動を利用した膝装具は、膝が伸展するときに、装具が大腿部の回旋運動を補助するように動作するものである。例えば、内側継手と外側継手の軸の移動方向が異なり、大腿部を支持する軟性部材が変形することによって、正しい終末伸展回旋運動を誘発する装具(非特許文献1)、膝の内側に設けた回動機構の規制によって、回動機構が大腿部を内側に回旋させる捻じりモーメントとして作用する装具(特許文献2)がある。   The three-point fixed type knee orthosis supports three points of the thigh, knee and lower leg. For example, there is an orthosis (Patent Document 1) that corrects knee joint deformation to normal alignment. A knee orthosis that uses a rotational motion is one in which the orthosis operates to assist the rotational motion of the thigh when the knee extends. For example, the inner joint and the outer joint have different shaft movement directions, and a flexible member that supports the thigh is deformed to induce correct terminal extension rotation (Non-Patent Document 1). There is an orthosis (Patent Document 2) that acts as a twisting moment that causes the thigh to rotate inward due to the restriction of the turning mechanism.

特開2000−5247号公報JP 2000-5247 A 特開2016−19603号公報Japanese Patent Laid-Open No. 2006-19603

高橋一史,“OAファンタジー膝装具の機能”,日本義肢装具学会誌,2008年,Vol.24,No.1,p.16−19Kazufumi Takahashi, “Functions of OA Fantasy Knee Orthosis”, Journal of Japanese Prosthetics and Orthotics Association, 2008, Vol. 24, no. 1, p. 16-19

上記の例の膝装具は、いずれも大腿部と下腿部においての固定となるため、歩行中に固定部がずれやすい。歩行中の装具のずれは装着者にとって違和感や不快感となるだけでなく,ずれた位置で無理な回旋矯正をかけるおそれがある。また、装着者が重度のO脚である場合は、装具の適用が困難となる場合がある。さらに、回旋運動を補助する膝装具においては、下腿ローテーション障害は患者個々によって障害の度合いが異なるにもかかわらず、回旋運動の調整が困難であるという問題点がある。   Since the knee orthosis in the above example is fixed at the thigh and the lower leg, the fixing portion is easily displaced during walking. Displacement of the brace during walking not only makes the wearer feel uncomfortable and uncomfortable, but also may cause excessive rotation correction at the displaced position. In addition, when the wearer is a heavy O-leg, it may be difficult to apply the brace. Further, in the knee brace that assists in the rotation, there is a problem that the rotation of the lower leg rotation is difficult to adjust even though the degree of the disorder varies depending on each patient.

そこで、本発明は、下腿部から足部にかけて装着し、歩行時の下腿回旋運動を矯正する新たな歩行支援装具を提供することを目的とする。   Therefore, an object of the present invention is to provide a new walking support device that is worn from the lower leg part to the foot part and corrects the lower leg rotation movement during walking.

すなわち、本発明は前記した目的を達成せんとするもので、請求項1の手段は、歩行支援装具は、一対の支持側板を左右縁から上向きに設ける足底板と、前記支持側板の先端に形成される継手板部に支持される下肢支柱と、前記下肢支柱に固定される下腿カフと、を備える下肢装具であって、前記下肢支柱の下端に設けた結合部材に固着した結合軸を、前記継手板部に設けた回動軸受により回動可能に支持してなり、前記回動軸受の回動範囲の前方限界位置と後方限界位置とを調節できるよう構成したことを特徴とする。   That is, the present invention aims to achieve the above-described object, and the means of claim 1 is provided such that the walking support orthosis is formed on a bottom plate having a pair of support side plates facing upward from left and right edges, and on a tip of the support side plate. A lower limb brace that is supported by a joint plate portion to be supported and a crus cuff that is fixed to the lower limb strut, wherein a coupling shaft fixed to a coupling member provided at a lower end of the lower limb strut, The rotary plate is rotatably supported by a rotary bearing provided on the joint plate portion, and is configured to be able to adjust the front limit position and the rear limit position of the rotary range of the rotary bearing.

また、請求項2の手段は、前記回動範囲は左右で異なり、内足側と外足側の前記回動範囲は可変であることを特徴とする。   According to a second aspect of the present invention, the rotation range is different between right and left, and the rotation range on the inner foot side and the outer foot side is variable.

また、請求項3の手段は、前記下腿カフは、しなりを可能とするための湾曲部を備え、前記回動軸受の左右で異なる前記回動範囲を許容することを特徴とする。   According to a third aspect of the present invention, the crus cuff includes a curved portion for enabling bending, and allows the rotation range different on the left and right of the rotation bearing.

また、請求項4の手段は、前記前方限界位置は、左右で0度より大きくかつ30度以下の差とすることを特徴とする。   According to a fourth aspect of the present invention, the front limit position is a difference of greater than 0 degrees and less than 30 degrees on the left and right.

また、請求項5の手段は、前記足底板は、踵当接部の周囲にアッパーを設け、中足骨当接部まで形成することを特徴とする。   The means of claim 5 is characterized in that the sole plate is formed up to the metatarsal abutment portion by providing an upper around the heel abutment portion.

請求項1の構成によって、本発明の歩行支援装具は、足関節の底屈および背屈を補助することができ、膝関節の屈曲および伸展動作を制限する保存療法が可能となる。また、膝装具と比較して、足で固定することができるため、装具のずれの発生が少なく、膝OA患者が重度のO脚であるなど、膝装具の装着が困難な膝OA患者に対しても適用することができる。   According to the configuration of the first aspect, the walking support device of the present invention can assist in the plantar flexion and dorsiflexion of the ankle joint, and can perform a conservative therapy that limits the flexion and extension operations of the knee joint. Compared with knee orthosis, it can be fixed with the foot, so there is little deviation of the orthosis, and knee OA patients who are difficult to wear knee orthosis, such as knee OA patients with severe O legs Even can be applied.

請求項2の構成によって、本発明の歩行支援装具は、下腿内旋異常を有する患者の場合、内足側より外足側の回動範囲を大きくし、また、下腿外旋異常を有する患者の場合、外足側より内足側の回動範囲を大きくするように設定することができる。   According to the configuration of the second aspect, in the case of a patient having a lower leg internal rotation abnormality, the walking support device of the present invention increases the rotation range of the outer foot side from the inner foot side and In this case, the rotation range on the inner foot side can be set to be larger than that on the outer foot side.

請求項3の構成によって、本発明の歩行支援装具は、左右の下腿の回旋量を膝OA患者個々の症状にあわせて容易に調節すること、および、足関節の底背屈角度によって下腿を回旋させることが可能となり、装置のずれによる無理な矯正の心配がない。また、請求項1から3の構成を組み合わせることによって、膝OA患者に対し、下腿の正しい回旋運動に誘導しつつ、踵部中央で接地面に接し、その後、立脚中期にかけて第1、第2中足骨頭中心、外足側中央の順に重心が移動し、立脚後期において拇指で蹴りだし、踵が接地面から離れるといった、正常に近い歩容に矯正することができる。   According to the configuration of the third aspect, the walking support device of the present invention easily adjusts the amount of rotation of the left and right lower legs according to the individual symptoms of the knee OA patient, and rotates the lower legs according to the dorsiflexion angle of the ankle joint. And there is no worry of unreasonable correction due to the deviation of the device. In addition, by combining the configurations of claims 1 to 3, the knee OA patient is guided to the correct rotation of the lower leg and touches the ground contact surface at the center of the buttock. The center of gravity moves in the order of the center of the toe and the center of the outer leg, and the gait can be corrected to a normal gait such as kicking out with the thumb in the late stage of stance and leaving the heel away from the contact surface.

また、請求項4の構成によって、本発明の歩行支援装具は、膝OA患者の下腿回旋量を十分に確保し、かつ、必要以上の下腿回旋を防止することができる。   Further, according to the configuration of the fourth aspect, the walking support device of the present invention can sufficiently secure the amount of lower leg rotation of the knee OA patient and prevent the lower leg rotation more than necessary.

また、請求項5の構成によって、本発明の歩行支援装具は、踵部の支持が可能となり、踵接地の促進および足指での蹴り出しを補助し、歩容改善の効果を高めることができる。   Further, according to the configuration of the fifth aspect, the walking support device of the present invention can support the buttocks, assist the promotion of heel contact and kicking with the toes, and can enhance the effect of improving gait. .

本発明の歩行支援装具の全体の斜視図である。1 is an overall perspective view of a walking assistance device according to the present invention. 本発明の歩行支援装具の足底板の側面図である。It is a side view of the sole plate of the walking assistance device of the present invention. 本発明の歩行支援装具の継手板部を拡大した正面図である。It is the front view which expanded the joint board part of the walk assistance device of this invention. 本発明の歩行支援装具の下肢支柱の動作を説明する模式図である。It is a schematic diagram explaining operation | movement of the leg support of the walking assistance device of this invention.

以下、本発明について、実施するための形態を図面にしたがって説明する。   Hereinafter, embodiments for carrying out the present invention will be described with reference to the drawings.

図1は、歩行支援装具100の全体の斜視図である。歩行支援装具100は、一対の支持側板110を左右縁から上向きに設ける足底板120と、支持側板110の先端に形成される継手板部130に支持される下肢支柱140と、下肢支柱140に固定される下腿カフ150と、を備える下肢装具である。なお、歩行支援装具100の下肢への固定は、脛ファスナー160および甲ファスナー170によることが好ましいが、これに限定されるものではない。固定手段の例として、スリッポン型とすること、面ファスナー、バックル、レースを使用することが挙げられる。膝OA患者の半月板に近い脛ファスナー160は、柔らかい素材を用いることが好ましい。   FIG. 1 is a perspective view of the entire walking support device 100. The walking support device 100 is fixed to the leg plate 120, which is supported by a joint plate portion 130 formed at the tip of the support side plate 110, and a sole plate 120 in which a pair of support side plates 110 are provided upward from the left and right edges. And a lower leg brace 150. In addition, although it is preferable to fix to the leg of the walking assistance device 100 by the shin fastener 160 and the instep fastener 170, it is not limited to this. Examples of fixing means include a slip-on type, use of a hook-and-loop fastener, a buckle, and a race. The shin fastener 160 close to the meniscus of the knee OA patient is preferably made of a soft material.

支持側板110は、膝OA患者が歩行支援装具100を装着するときに、足底板120の左右縁から概ね膝OA患者の両踝のあたりに向かうように、一対に設ける。   The support side plates 110 are provided in a pair so that when the knee OA patient wears the walking support device 100, the left and right edges of the sole plate 120 are generally directed to both knees of the knee OA patient.

図2は、足底板120の側面図である。足底板120は、膝OA患者の足裏が当接する部材であり、踵当接部121の周囲にアッパー122を設け、中足骨当接部123まで、具体的には膝OA患者の中足骨と基節骨を繋ぐ中足指節関節に相当する部分まで形成することが好ましい。   FIG. 2 is a side view of the sole plate 120. The sole plate 120 is a member with which the sole of the knee OA patient abuts, and is provided with an upper 122 around the heel abutting portion 121, to the metatarsal abutting portion 123, specifically, the middle foot of the knee OA patient. It is preferable to form the portion corresponding to the metatarsophalangeal joint connecting the bone and the proximal phalanx.

踵当接部121の周囲にアッパー122を設けることは、膝OA患者の歩容改善において重要である。アッパー122を設けることによって、膝OA患者の踵骨のコントロールが可能となる。一般的に、踵骨の安定性は、踵骨と距骨の間にある距骨下関節の運動や変形の反映である。この距骨下関節の正常な回内可動域が阻止されるとストレスが下肢、骨盤および腰椎に加わり、病的状態をもたらす。踵部内外反の運動は足部の回内外と連動し、下腿の内外旋、膝関節の内外反にも影響する。また、アッパー122はインソールのずれの防止にも資する。インソールは、膝OA患者の左右の足の長さの調節、O脚の膝OA患者の膝関節位置の調整、アーチサポートとして膝関節への負荷の軽減のために用いることができる。   Providing the upper 122 around the heel contact portion 121 is important in improving the gait of knee OA patients. By providing the upper 122, it is possible to control the ribs of the knee OA patient. In general, the stability of the radius is a reflection of the movement and deformation of the subtalar joint between the radius and the talus. When this normal pronation range of motion of the subtalar joint is blocked, stress is applied to the lower limbs, pelvis and lumbar spine, resulting in a pathological condition. The movement of the varus and valgus is linked to the pronation and rotation of the foot, and also affects the internal and external rotation of the lower leg and the valgus of the knee joint. Further, the upper 122 contributes to prevention of insole displacement. The insole can be used for adjusting the length of the left and right feet of the knee OA patient, adjusting the position of the knee joint of the knee OA patient of the O leg, and reducing the load on the knee joint as an arch support.

また、足底板120は中足骨当接部123までとし、中足指節関節より先を自由にすることにより、膝OA患者の足部先端が靴底、地面等に直接触れることになり、足指での蹴り出しを補助する。   Further, the sole plate 120 extends to the metatarsal abutment portion 123, and by making the tip of the metatarsophalangeal joint free, the tip of the foot of the knee OA patient directly touches the shoe sole, the ground, etc. Assist kicking with toes.

足底板120の素材は、支持側板110を取付け、下肢支柱140、下腿カフ150などを支える必要があるため、強度が求められる。例えば、成形が容易かつ硬度が高い樹脂であるポリプロピレンを5mm厚として用いることが好ましいが、強度がある素材であれば、5mm厚のポリプロピレンに限定されるものではない。   The material of the sole plate 120 is required to have strength because it is necessary to attach the support side plate 110 and support the leg support 140, the lower leg cuff 150, and the like. For example, it is preferable to use 5 mm thick polypropylene which is a resin that is easy to mold and has high hardness, but it is not limited to 5 mm thick polypropylene as long as it is a strong material.

足底板120は、以上の構成とすることで、踵部の支持が可能となり、踵接地の促進および足指での蹴り出しを補助し、歩容改善の効果を高めることができる。   With the above configuration, the sole plate 120 can support the buttocks, assist the promotion of the heel contact and kicking with the toes, and enhance the effect of improving the gait.

継手板部130は、支持側板110の上端に形成され、下肢支柱140を支持する。継手板部130は、下肢支柱140の下端に設けた結合部材に固着した結合軸を、継手板部130に設けた回動軸受により回動可能に支持する。下腿と足部の間の足関節の底屈(足首を伸ばす動作)および背屈(足首を曲げる動作)は、継手板部130の回動軸受によって許容される。   The joint plate portion 130 is formed at the upper end of the support side plate 110 and supports the lower limb strut 140. The joint plate portion 130 supports the coupling shaft fixed to the coupling member provided at the lower end of the lower limb strut 140 by a rotation bearing provided on the joint plate portion 130 so as to be rotatable. Ankle joint bottom flexion (operation to stretch the ankle) and dorsiflexion (operation to bend the ankle) between the lower leg and the foot are allowed by the rotation bearing of the joint plate portion 130.

本実施例の継手板部130は、回動軸受の回動範囲の前方限界位置と後方限界位置とを調節できるよう構成されている。このような構成からなる機構をダブルクレンザックという。回動範囲を左右でほぼ均一に調節することによって、足関節の底屈および背屈を補助することができ、膝関節の屈曲および伸展動作を制限する保存療法が可能となる。   The joint plate portion 130 of the present embodiment is configured to be able to adjust the front limit position and the rear limit position of the rotation range of the rotary bearing. A mechanism having such a configuration is called a double crenzac. By adjusting the rotation range almost uniformly on the left and right, it is possible to assist the plantar flexion and dorsiflexion of the ankle joint, and it is possible to perform conservative therapy that limits the flexion and extension movements of the knee joint.

また、ダブルクレンザックの機構を有する継手板部130を備える歩行支援装具100は、膝装具と比較して、足で固定することができるため、装具のずれの発生が少なく、膝OA患者が重度のO脚であるなど、膝装具の装着が困難な膝OA患者に対しても適用することができる。   In addition, the walking support device 100 including the joint plate portion 130 having the double crenzac mechanism can be fixed with the foot as compared with the knee device, so that there is less occurrence of the device displacement, and the patient with knee OA is severe. It can also be applied to knee OA patients in which it is difficult to wear knee braces such as the O-legs.

継手板部130の回動範囲を左右で異ならしめ、内足側と外足側の回動範囲は可変とすることもできる。ここで、外足側とは足部の小指側をいい、内足側とは足部の親指側をいう。このような継手板部130を備えた歩行支援装具100は、足関節の底背屈角度によって下腿を回旋させることができる。以下、下腿の回旋について、図3および図4を用いて説明する。   The rotation range of the joint plate portion 130 may be different on the left and right, and the rotation range on the inner foot side and the outer foot side may be variable. Here, the outer foot side refers to the little finger side of the foot, and the inner foot side refers to the thumb side of the foot. The walking support device 100 provided with such a joint plate portion 130 can rotate the lower leg according to the sole dorsiflexion angle of the ankle joint. Hereinafter, rotation of the lower leg will be described with reference to FIGS. 3 and 4.

図3は、継手板部130を拡大した正面図である。継手板部130は、内蔵するロッド棒131の締め込み深さによって、回動範囲の前方限界位置と後方限界位置とを調節することが可能である。具体的には、ロッド棒131は回動のストッパーの役目を担っており、締め込みを深くすることで、回動範囲は狭くなり、逆に締め込みを浅くすることで、回動範囲は広くなる。図3は、左側の継手板部130の前方のロッド棒131の締め込みを右側の継手板部130の前方のロッド棒131の締め込みより浅くし、回動範囲の前方限界位置を右側の継手板部130の回動範囲の前方限界位置より前にしていることを示している。この場合、左側の継手板部130は、右側の継手板部130より前方に傾倒する。   FIG. 3 is an enlarged front view of the joint plate portion 130. The joint plate part 130 can adjust the front limit position and the rear limit position of the rotation range according to the tightening depth of the rod rod 131 incorporated therein. Specifically, the rod rod 131 plays the role of a stopper for rotation. By deepening the tightening, the rotation range is narrowed, and conversely, the tightening is shallow, and the rotation range is wide. Become. FIG. 3 shows that the tightening of the rod rod 131 in front of the left joint plate 130 is shallower than the tightening of the rod rod 131 in front of the right joint plate 130, and the front limit position of the rotation range is set to the right joint. It shows that it is ahead of the front limit position of the rotation range of the plate part 130. In this case, the left joint plate 130 is tilted forward from the right joint plate 130.

ロッド棒131は、継手板部130の前方および後方に設けられ、簡易な機構のため調節が容易である。本実施例においては、前方のロッド棒131にスプリングを適用して、回動時の衝撃を緩和してもよい。また、回動時の衝撃の緩和を目的として、継手板部130を油圧または電気による制御としてもよい。   The rod bar 131 is provided in front of and behind the joint plate portion 130 and is easy to adjust because of a simple mechanism. In the present embodiment, a spring may be applied to the front rod bar 131 to alleviate the impact during rotation. Further, the joint plate portion 130 may be controlled by hydraulic pressure or electricity for the purpose of mitigating impact during rotation.

図4は、右足に装着する歩行支援装具100の下肢支柱140の動作を説明する模式図である。図4においては、左支持側板210aおよび右支持側板210bは支持側板110に、平足底板220は足底板120に、左継手板部230aおよび右継手板部230bは継手板部130に、左下肢支柱240aおよび右下肢支柱240bは下肢支柱140に、それぞれ相当する。右足に装着するので、左側が内足側、右側が外足側である。また、接地面からの垂直方向に対する左下肢支柱240aおよび右下肢支柱240bの角度をそれぞれ、θおよびφとする。   FIG. 4 is a schematic diagram for explaining the operation of the lower limb strut 140 of the walking assistance device 100 attached to the right foot. In FIG. 4, the left support side plate 210a and the right support side plate 210b are on the support side plate 110, the flat sole plate 220 is on the sole plate 120, the left joint plate portion 230a and the right joint plate portion 230b are on the joint plate portion 130, and the left lower limb. The strut 240a and the right leg support 240b correspond to the leg support 140, respectively. Since it is mounted on the right foot, the left side is the inner foot side and the right side is the outer foot side. In addition, the angles of the left lower limb support column 240a and the right lower limb support column 240b with respect to the vertical direction from the ground contact surface are θ and φ, respectively.

図4(a)の模式図は、踵が接地したときの左下肢支柱240aおよび右下肢支柱240bの状態を示す。踵が接地したときとは、足底が接地していない遊脚期から足底が接地する立脚期への移行が起こるときであり、この時点の下腿と足部の間の足関節の角度αを基準とする。ここで、この時点の接地面からの垂直方向に対する左下肢支柱240aの角度をθ、同じく右下肢支柱240bの角度をφとすると、θ=φである。 The schematic diagram of Fig.4 (a) shows the state of the left leg support 240a and the right leg support 240b when a heel contacts the ground. The time when the heel touches the ground is when the transition from the swing phase where the sole does not touch the ground to the stance phase where the sole touches occurs, and the angle α of the ankle joint between the lower leg and the foot at this time Based on Here, if the angle of the left lower limb support column 240a with respect to the vertical direction from the contact surface at this time is θ 1 , and the angle of the right lower limb support column 240b is φ 1 , then θ 1 = φ 1 .

図4(b)の模式図は、足底全体が接地したときの立脚中期の左下肢支柱240aおよび右下肢支柱240bの状態を示す。このとき、足関節は底屈しており、足関節の角度βはαより大きい。健常者であれば、足関節底屈が生じる踵の接地から立脚中期の間、下腿は、内足側に回旋、いわゆる内旋する。ここで、立脚中期の時点の接地面からの垂直方向に対する左下肢支柱240aの角度をθ、同じく右下肢支柱240bの角度をφとすると、θ>φである。 The schematic diagram of FIG. 4B shows the state of the left leg strut 240a and the right leg strut 240b in the middle of the stance when the entire sole is grounded. At this time, the ankle joint is bent, and the ankle joint angle β is larger than α. In the case of a healthy person, the lower leg rotates to the inner foot side, that is, so-called internal rotation, from the ground contact of the heel where ankle plantar flexion occurs to the middle stage of stance. Here, when the angle of the left lower limb support column 240a with respect to the vertical direction from the ground contact surface at the middle stage of stance is θ 2 and the angle of the right lower limb support column 240b is φ 2 , θ 2 > φ 2 is satisfied.

膝OA患者が下腿内旋異常を有する場合は、外足側が内足側より前方に傾倒するよう、右継手板部230bの回動範囲の前方限界位置を左継手板部230aの回動範囲の前方限界位置より前にするよう調節すればよい。θ>φとなることによって、下腿の内旋が誘導される。このように調節することによって、歩行時において、足関節底屈時の内旋運動が矯正される。 When a patient with knee OA has an abnormality in internal rotation of the lower leg, the front limit position of the rotation range of the right joint plate portion 230b is set to the rotation range of the left joint plate portion 230a so that the outer foot side tilts forward from the inner foot side. It may be adjusted so that it is before the front limit position. By satisfying θ 2 > φ 2 , internal rotation of the lower leg is induced. By adjusting in this way, the internal rotation during ankle plantar flexion is corrected during walking.

図4(c)の模式図は、踵から爪先までが接地面から離れようとする立脚後期の左下肢支柱240aおよび右下肢支柱240bの状態を示す。このとき、足関節は背屈しており、足関節の角度γはαおよびβより小さい。健常者であれば、足関節背屈が生じる立脚中期から立脚後期の間、下腿は外旋する。ここで、立脚後期の時点の接地面からの垂直方向に対する左下肢支柱240aの角度を−θ、同じく右下肢支柱240bの角度をφとすると、φ>−θである。 The schematic diagram of FIG. 4C shows the state of the left lower limb strut 240a and the right lower limb strut 240b in the late stance phase from the heel to the toe to be separated from the ground contact surface. At this time, the ankle joint is bent back, and the angle γ of the ankle joint is smaller than α and β. If the subject is a healthy person, the lower leg rotates externally during the middle stance phase, when ankle dorsiflexion occurs, and during the late stance phase. Here, assuming that the angle of the left lower limb support column 240a with respect to the vertical direction from the ground contact surface at the later stage of stance is −θ 3 , and the angle of the right lower limb support column 240b is φ 3 , then φ 3 > −θ 3 .

膝OA患者が下腿外旋異常を有する場合は、内足側が外足側より前方に傾倒するよう、左継手板部230aの回動範囲の前方限界位置を右継手板部230bの回動範囲の前方限界位置より前にするよう調節すればよい。φ>−θとなることによって、下腿の外旋が誘導される。このように調節することによって、歩行時において、足関節底屈時の内旋運動の後、足関節背屈時に外旋運動が矯正される。 When the knee OA patient has an abnormality in the lower leg external rotation, the front limit position of the rotation range of the left joint plate portion 230a is set to the rotation range of the right joint plate portion 230b so that the inner foot side tilts forward from the outer foot side. It may be adjusted so that it is before the front limit position. By satisfying φ 3 > −θ 3 , external rotation of the lower leg is induced. By adjusting in this way, at the time of walking, the external rotation is corrected at the time of ankle dorsiflexion after the internal rotation at the time of ankle bottom flexion.

図1に戻って、下肢支柱140は、継手板部130に支持され、概ね膝OA患者の脛骨および腓骨に沿って、上方に伸びる。下肢支柱140には、下腿カフ150を取付けることができる。   Returning to FIG. 1, the lower limb strut 140 is supported by the joint plate 130 and extends upward generally along the tibia and ribs of the knee OA patient. A crus cuff 150 can be attached to the leg support 140.

下腿カフ150は、下肢支柱140に固定され、しなりを可能とするための略半円柱形(蒲鉾形)の湾曲部151を備える。湾曲部151は、膝OA患者の下腿に当接し、下肢支柱140の動作を伝達する。ここで、歩行支援装具100が継手板部130の回動軸受の左右で異なる回動範囲を許容するため、湾曲部151には軟性樹脂素材を用いることが好ましい。湾曲部151がしなりのない剛性素材であるならば、連動する下肢支柱140および継手板部130は、左右で異なる動作をすることが困難である。一方で、湾曲部151は、膝OA患者の下腿を支えるだけの強度も必要である。例えば、低密度ポリエチレンを3mm厚として用いることが好ましいが、しなりと強度が両立する素材であれば、3mm厚の低密度ポリエチレンに限定されるものではない。   The lower leg cuff 150 is fixed to the lower limb strut 140 and includes a substantially semi-cylindrical (saddle-shaped) curved portion 151 for enabling bending. The bending portion 151 abuts on the lower leg of the knee OA patient and transmits the movement of the lower limb strut 140. Here, it is preferable to use a soft resin material for the bending portion 151 in order that the walking support device 100 allows different rotation ranges on the left and right of the rotation bearing of the joint plate portion 130. If the bending portion 151 is a rigid material without bending, it is difficult for the lower limb struts 140 and the joint plate portion 130 to be linked to perform different operations on the left and right. On the other hand, the bending portion 151 needs to have enough strength to support the lower leg of the knee OA patient. For example, it is preferable to use low-density polyethylene with a thickness of 3 mm, but the material is not limited to a low-density polyethylene with a thickness of 3 mm as long as the material has both strength and strength.

下腿カフ150を取付けたときにおいて、継手板部130の回動軸受の回動範囲の前方限界位置は、左右で0度より大きくかつ30度以下の差とすることが好ましく、5度以上かつ30度以下とすることがより好ましい。このような構成とすることによって、本発明の歩行支援装具100は、膝OA患者の下腿回旋量を十分に確保し、かつ、必要以上の下腿回旋を防止することができる。   When the lower leg cuff 150 is attached, the front limit position of the rotation range of the rotation bearing of the joint plate 130 is preferably greater than 0 degree and less than 30 degrees on the left and right sides, and preferably greater than 5 degrees and less than 30 degrees. It is more preferable to set it to a degree or less. By adopting such a configuration, the walking support device 100 of the present invention can secure a sufficient amount of lower leg rotation of the knee OA patient and prevent excessive rotation of the lower leg.

継手板部130、下肢支柱140および下腿カフ150は、以上の構成とすることで、下腿内旋異常を有する患者の場合、内足側より外足側の回動範囲を大きくし、また、下腿外旋異常を有する患者の場合、外足側より内足側の回動範囲を大きくするように設定することができ、左右の下腿の回旋量を膝OA患者個々の症状にあわせて容易に調節すること、および、足関節の底背屈角度によって下腿を回旋させることが可能となり、装置のずれによる無理な矯正の心配がない。   The joint plate portion 130, the lower limb strut 140, and the lower leg cuff 150 are configured as described above, so that in the case of a patient having an abnormal internal rotation of the lower leg, the rotation range on the outer foot side is larger than the inner foot side. For patients with external rotation abnormalities, the rotation range of the inner foot side can be set larger than the outer foot side, and the amount of rotation of the left and right lower legs can be easily adjusted according to the individual symptoms of knee OA patients It is possible to rotate the lower leg according to the dorsal dorsiflexion angle of the ankle joint, and there is no worry of unreasonable correction due to the deviation of the device.

また、歩行支援装具100は、以上の構成とすることで、膝OA患者に対し、下腿の正しい回旋運動に誘導しつつ、踵部中央で接地面に接し、その後、立脚中期にかけて第1、第2中足骨頭中心、外足側中央の順に重心が移動し、立脚後期において拇指で蹴りだし、踵が接地面から離れるといった、正常に近い歩容に矯正することができる。   In addition, with the above-described configuration, the walking support device 100 is in contact with the ground contact surface at the center of the buttock while guiding the knee OA patient to the correct rotation of the lower leg, and thereafter, the first and first steps toward the middle of the stance. 2. The center of gravity can be corrected to a normal gait such that the center of gravity moves in the order of the metatarsal head center and the center of the outer foot side, kicks with the thumb in the late stance phase, and the heel moves away from the contact surface.

100…歩行支援装具。
110…支持側板。
120…足底板、121…踵当接部、122…アッパー、123…中足骨当接部。
130…継手板部、131…ロッド棒。
140…下肢支柱。
150…下腿カフ、151…湾曲部。
160…脛ファスナー。
170…甲ファスナー。
210a…左支持側板、210b…右支持側板。
220…平足底板。
230a…左継手板部、230b…右継手板部。
240a…左下肢支柱、240b…右下肢支柱。

100: Walking support equipment.
110: Support side plate.
120: sole plate, 121: heel contact portion, 122: upper, 123: metatarsal contact portion.
130: Joint plate part, 131: Rod rod.
140: Lower limb support.
150 ... lower leg cuff, 151 ... curved portion.
160 ... Tibial fastener.
170 ... Upper fastener.
210a ... left support side plate, 210b ... right support side plate.
220: Flat sole plate.
230a ... left joint plate part, 230b ... right joint plate part.
240a ... left lower limb support, 240b ... right lower limb support.

Claims (5)

一対の支持側板を左右縁から上向きに設ける足底板と、
前記支持側板の先端に形成される継手板部に支持される下肢支柱と、
前記下肢支柱に固定される下腿カフと、を備える下肢装具であって、
前記下肢支柱の下端に設けた結合部材に固着した結合軸を、前記継手板部に設けた回動軸受により回動可能に支持してなり、前記回動軸受の回動範囲の前方限界位置と後方限界位置とを調節できるよう構成したことを特徴とする歩行支援装具。
A sole plate providing a pair of support side plates upward from the left and right edges;
Lower limb struts supported by a joint plate formed at the tip of the support side plate;
A lower limb orthosis comprising a lower leg cuff fixed to the lower limb strut,
A coupling shaft fixed to a coupling member provided at the lower end of the lower limb support is rotatably supported by a rotation bearing provided on the joint plate portion, and a front limit position of a rotation range of the rotation bearing A walking support device characterized by being configured to adjust a rear limit position.
前記回動範囲は左右で異なり、内足側と外足側の前記回動範囲は可変であることを特徴とする請求項1に記載の歩行支援装具。   The walking support device according to claim 1, wherein the rotation range is different between right and left, and the rotation range on the inner foot side and the outer foot side is variable. 前記下腿カフは、しなりを可能とするための湾曲部を備え、前記回動軸受の左右で異なる前記回動範囲を許容することを特徴とする請求項1または2に記載の歩行支援装具。   The walking support device according to claim 1, wherein the lower leg cuff includes a bending portion for enabling bending, and allows the rotation range different on the left and right of the rotation bearing. 前記前方限界位置は、左右で0度より大きくかつ30度以下の差とすることを特徴とする請求項1から3のいずれかに記載の歩行支援装具。   The walking support device according to any one of claims 1 to 3, wherein the front limit position is a difference between 0 degrees and 30 degrees or less on the left and right. 前記足底板は、踵当接部の周囲にアッパーを設け、中足骨当接部まで形成することを特徴とする請求項1から4のいずれかに記載の歩行支援装具。

The walking support device according to any one of claims 1 to 4, wherein the sole plate is formed up to a metatarsal abutment portion by providing an upper around the heel abutment portion.

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2020103647A (en) * 2018-12-27 2020-07-09 国立大学法人三重大学 Lower leg rotation apparatus
CN117814969A (en) * 2024-03-04 2024-04-05 吉林大学 Lower limb bionic artificial limb with pneumatic balance and gravity center actively adjusted

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US11612506B2 (en) 2016-05-03 2023-03-28 Icarus Medical, LLC Unloading knee-ankle-foot orthotic apparatus with conforming and distracting hinge

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH05137742A (en) * 1991-11-14 1993-06-01 Takumi Hino Joint for human body assisting means and human body assisting means
JPH1119143A (en) * 1997-07-08 1999-01-26 Keiai Gishi Zairyo Hanbaishiyo:Kk Shoe insertion type short leg outfit
JP2008295991A (en) * 2007-05-31 2008-12-11 Nobuyuki Yoshizawa Assistant orthosis for ankle fixation
JP3155391U (en) * 2009-09-04 2009-11-12 株式会社啓愛義肢材料販売所 Lower limb orthosis for walking

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH05137742A (en) * 1991-11-14 1993-06-01 Takumi Hino Joint for human body assisting means and human body assisting means
JPH1119143A (en) * 1997-07-08 1999-01-26 Keiai Gishi Zairyo Hanbaishiyo:Kk Shoe insertion type short leg outfit
JP2008295991A (en) * 2007-05-31 2008-12-11 Nobuyuki Yoshizawa Assistant orthosis for ankle fixation
JP3155391U (en) * 2009-09-04 2009-11-12 株式会社啓愛義肢材料販売所 Lower limb orthosis for walking

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2020103647A (en) * 2018-12-27 2020-07-09 国立大学法人三重大学 Lower leg rotation apparatus
CN117814969A (en) * 2024-03-04 2024-04-05 吉林大学 Lower limb bionic artificial limb with pneumatic balance and gravity center actively adjusted
CN117814969B (en) * 2024-03-04 2024-06-07 吉林大学 Lower limb bionic artificial limb with pneumatic balance and gravity center actively adjusted

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