JP4541426B2 - Walking training equipment - Google Patents

Description

The present invention relates to a walking training apparatus.

  In conventional gait training in rehabilitation for stroke patients, emphasis is placed on suppressing abnormal muscle tone in the patient's paralyzed unilateral upper and lower limbs and inducing voluntary movements, reducing the use of orthoses, etc. One of the mainstream methods was to reduce assistance as much as possible. In conventional gait training for stroke patients, increasing the stride or increasing the walking speed has been regarded as undesirable because of increased instability in walking and increased abnormal muscle tone on the disabled side. Walking training based on this concept was dependent on the healthy side, with a small stride, slow walking speed, and low exercise load for cardiopulmonary function. Therefore, training on muscle strength and physical strength was not efficient. .

  However, in recent years, for stroke patients, partial support has been provided to support the standing leg of the impaired leg and promote the use of the impaired leg, resulting in a large stride, fast walking speed, and high exercise load for cardiopulmonary function. The effectiveness of the walking training method has attracted attention (Non-Patent Document 1).

    In gait training for stroke patients, the club cusp can be corrected with a conventional general metal or plastic ankle brace. However, in order to promote the use of the lower limbs on the disabled side, and to perform walking training with a large stride, fast walking speed, and high exercise load for cardiopulmonary function, support for the limbs in the stance phase of the disabled side limbs, Assistance is required for swinging out during the swing phase and controlling the movement of the center of gravity throughout the walking cycle.

  In the leg support stage of the leg on the handicapped side, muscle weakness or abnormal muscle tone occurs in the proximal part of the lower limb due to paralysis, etc., and walking exercise with high exercise load makes it more difficult to hold the hip and knee joints in the extended position Therefore, assistance is required.

  The swinging out of the disabled hip joint during the swinging leg stage on the handicapped side has reduced muscle strength and abnormal muscle tone in the proximal part of the lower limb due to paralysis, etc.In walking training with high exercise load, the delay in swinging out is conspicuous, Since it tends to become unstable with the internal or external rotation of the hip joint when swinging out, assistance is required.

  The center of gravity movement control over the whole walking cycle is to move the center of gravity to the opposite lower limb in advance when swinging the lower limb, to move the center of gravity to the support leg when standing, and to keep the trunk stable during such center movement. However, gait training with high exercise load becomes more difficult and requires assistance.

  These walking aids are performed by pulling or pushing the patient's clothes and body with the assistant's bare hands and feet, so it is inefficient, the burden on the assistant is heavy, and human intervention is required become.

  FIG. 9 shows, as a first example of a conventional gait training device for stroke patients, a treadmill 101 on which a patient performs gait training, and an unloading device 102 that lifts the patient and unloads the body weight. Includes an arm 103, a length-adjustable patient lifting means 104, a body weight detecting means 105 for detecting the unloaded weight, and an unloading value setting device 106 for setting an unloaded value. An apparatus is shown (patent document 1).

  This brace assists the leg support of the impaired leg and promotes the use of the impaired leg, but it is a mechanism that pulls and unloads with one point from the top as a fulcrum, and obstructs the above-mentioned center of gravity movement control required during walking Therefore, there is a drawback that the difficulty in walking increases. To support walking training with a large stride, fast walking speed, and high exercise load for cardiopulmonary function, support for swinging out with controlled internal and external rotation of the impaired hip joint, and center of gravity movement control hindered by one point traction This is done by directly pushing the patient's body or pulling clothes with the assistant's bare hands and feet, and has the disadvantage of requiring a plurality of assistants while introducing such a device. In order to release part of the body weight, a strong traction force and a strong frictional force to transmit this to the body are required, so there is a drawback that free movement must be obstructed by the body wearing part. .

  As a second example of a conventional gait training device for a stroke patient in FIG. 10, a force sensor 204 that measures the joint torque of the patient 201, an angle sensor 206 that measures the joint angle of the patient, and the lower limb of the patient are driven. The lower limb drive unit 205, the ankle joint drive unit 203 that drives the patient's ankle joint, the training data storage unit 209 that stores training data, the lower limb drive unit 205, and the ankle joint drive unit 203 are both driven. In a walking training apparatus 207 that includes a training trajectory generation unit 210 that generates a training trajectory that operates in cooperation with the lower limbs, and repeatedly operates the limbs of the patient 201 along the training trajectory, the biological information of the patient is obtained. A biological information measuring means 202 for measuring, and a training result evaluating unit 208 for measuring a step or a walking cycle of the patient and presenting a display or an exercise signal. The training result evaluation unit 208 evaluates the patient's training status based on the biological information measured by the biological information measuring unit 202, and changes one or both of the patient's stride and the walking cycle. A walking training device is shown (Patent Document 2).

  This brace can adjust the stride and walking cycle of the patient's impaired leg to suit the patient's gait training situation, but assists in supporting the disabled stance stand, assists in swinging out controlling the internal and external rotation of the disabled hip joint, and the center of gravity There is a drawback of not having a control mechanism for movement control. Therefore, there is a disadvantage that a plurality of assistants are required for walking training that promotes the use of the lower limbs on the disabled side, has a large stride, a high walking speed, and a high exercise load for cardiopulmonary function.

FIG. 11 shows a third example of a conventional gait training device for stroke patients. 11A is a perspective view of the wearing state as viewed from the front of the wearer, and FIG. 11B is a perspective view of the state of wearing as viewed from the back of the wearer. It is formed of a material having elasticity as a whole, and has a strong region with a strong tightening force and a weak region with a weak tightening force. The strong region includes at least a first region corresponding to the lower abdomen of the wearer, and a spine. A second region extending from the waist to the pelvis, a belt-like third region extending from the wearer's back and waist to the outer thigh and inner thigh, extending from the inner thigh of the wearer to the outer lower thigh, and the third region at the upper part of the wearer's knee Is a tights that is used as one of the purposes of rehabilitation of a wearer who has a disability in the lower body (Patent Document 3).

  This tight has only a mechanism that assists both leg extension, and if it is worn on both legs, when it is applied to a hemiplegic stroke patient, the movement of the lower limbs during walking is hindered. is there. In addition, even if this tights is worn only on one side, it is a product originally intended for healthy subjects, and the effect of supporting the stance on the lower limbs of patients with severe paralysis is insufficient. There is a drawback of inhibiting joint flexion. Therefore, there are drawbacks in that it is difficult to perform walking training that promotes the use of the lower limbs on the disabled side, has a large step length, has a high walking speed, and has a high exercise load for cardiopulmonary function.

  As a fourth example of a conventional gait training device for stroke patients in FIG. 12, in order to promote the use of the impaired lower limb, a mounting portion 301 that is mounted only on one side of the wearer's healthy lower limb, and a foot portion 302 that contacts the ground The orthosis provided with the connection part 303 which connects the mounting part 301 and the leg part 302 is shown (patent document 4).

  This orthosis aims to promote the use of the impaired leg. Disadvantages of increasing the load on the items that should be assisted in walking, which is a high exercise load for stroke patients, such as support for the standing leg on the disabled side, swinging out to control the internal / external rotation of the disabled side hip joint, and center of gravity movement control There is.

  As described above, conventional braces, instruments, and the like cannot provide sufficient support for standing leg support, swing-out controlled inner / outer rotation of the obstacle side hip joint, and control of center of gravity movement. Even with these devices, the use of the lower limbs on the disabled side, which has been attracting attention recently, can be used for gait training with a large stride, high walking speed, and high exercise load for cardiopulmonary function. It was only a mild patient or a special patient.

Utility Model Publication 6-15658 JP-A-2005-74063 JP2004-238789 Patent Publication 2007-97768 Toshio Teranishi et al .: Walking training to see partially unloaded treads for stroke hemiplegic patients. Physiotherapy Vol. 22, No. 6, 853-858, 2005

  In view of the above-mentioned conventional drawbacks, the present invention can easily support the standing leg support of the impaired side leg, swing out the controlled internal and external rotation of the impaired side hip joint, and assist the control of the center of gravity movement throughout the walking cycle. The purpose of the present invention is to provide a walking training device so that walking training with a large stride, high walking speed, and high exercise load for cardiopulmonary function can be performed.

  The above and other objects and novel features of the present invention will become more fully apparent when the following description is read in conjunction with the accompanying drawings. However, the drawings are for explanation only and do not limit the descriptive scope of the present invention.

In order to solve the above-mentioned problems, the present invention comprises a crus facing part, a patella facing part, a thigh girth part, a buttocks facing part, a traction part, and a swing-out auxiliary band. It consists of a front part of the lower leg that extends from the knee to the front of the lower leg and a lower leg fixing part that secures the front part of the lower leg to the lower leg, and the patella facing part is connected to the upper end of the lower leg facing part and covers the front of the patella The thigh circumference part is composed of two belts and is connected to the upper end of the patella facing part, wraps the thigh from the inside and outside and extends backward to the buttocks, and the buttocks facing part is at the upper end of the thigh turning part Connected to cover the buttocks from the rear, and the towing part has a loop structure that is connected to the buttocks facing part and pulled by an assistant, and the swing-out assist band is inside and outside the leg facing part. Two bands extending forward from the loop at the tip Assisting the extension of the knee and hip joints by traction on the traction part and assisting lower limb load support during walking, and by pulling forward of the swing assist band, When the hip joint is easy to rotate inward, the inner band is pulled harder, and when the hip joint is easy to rotate outward when it is swung out, the outer band is pulled harder to keep the handed hip joint in the middle and outer rotation position. It is characterized by assisting the swinging of the lower limbs during walking in a state.

Moreover, it is a band wound around the trunk, and is characterized by assisting alternate center of gravity movement toward the left and right support legs in accordance with the walking cycle.

  The lower leg front part that extends from the top of the ankle to below the knee and covers the front of the lower leg, the lower leg facing part that consists of a fixing part that fixes the front part of the lower leg to the lower leg, and the patella that is connected to the lower leg facing part and covers the front of the patella Connected to the facing part and the patella facing part, starting from the front of the lower part of the thigh, divided into two inner and outer hands, and then moved back and connected laterally at the upper rear part of the thigh, and on the thigh turning part A buttock facing part that covers the gluteal part from the rear, and a traction part that has a mechanism that supports the knee joint and hip joint extension by connecting the buttock facing part and pulling the buttock facing part upward. And supporting the lower limbs by supporting the lower limbs by towing the traction part, which can stabilize the support on the side of the obstacle, promote the use of the leg on the side of the obstacle, increase the stride, and increase the walking speed. , Walking with high exercise load for cardiopulmonary function Training can be.

  Also, two bands that start from both the inside and outside of the crus facing part and extend forward, so that if the hip joint is easy to rotate inward when swinging on the disabled side, the inner band is stronger If the hip joint is easy to rotate when pulling out and pulling out on the obstacle side, it has a pull-out assist device that enables pull-out assistance while keeping the hand side hip joint in the intermediate and external rotation position by pulling the outer band stronger. With this feature, the speed of swinging on the disabled side is improved, the use of the lower leg on the disabled side is promoted, and walking training with a large stride, high walking speed, and high exercise load for cardiopulmonary function can be performed. .

  In addition, it is a band wound around the trunk and has a balance assist device that assists in controlling the movement of the center of gravity to the side of the supporting leg in accordance with the walking cycle over the entire walking cycle by pulling left and right. This feature improves left and right center-of-gravity movement during walking, which improves swinging of the lower limbs on both sides, promotes the use of the lower limbs on the disabled side, increases stride, increases walking speed, and prevents cardiopulmonary function. Can also be used for gait training with high exercise load.

An embodiment of the present invention will be described with reference to FIGS.
FIG. 1 is a perspective view of the wearing state as seen from the front of a patient, in which 60 is a patient's body indicated by a broken line, and 61 is an upper limb of an assistant indicated by a broken line. In FIG. 1, 1 is a walking training equipment, 2 is a crus facing part, 3 is a patella facing part, 4 is a thigh turning part, 5 is a buttocks facing part, 6 is an assistant forearm traction part as an example of a traction part, Reference numeral 7 denotes a front part of the lower leg, 8 denotes a cuff band as an example of a fixing part, 9 denotes a swing-out auxiliary band as an example of a swing-out auxiliary apparatus, and 10 denotes a trunk band as an example of a balance auxiliary apparatus.

  The crus facing part 2 includes a crus front part 7 and a cuff band 8, and serves as an anchor for fixing the brace to the crus when the brace is pulled by the assistant forearm traction part 6, and assists knee joint extension. The lower leg front part 7 extends from slightly above the ankle joint to below the knee and touches the lower leg front. The cuff band 8 is connected with a hook-and-loop fastener, a buckle, or the like, and fixes the lower leg front part 7 to the lower leg.

  The patella facing portion 3 is connected to the crus front surface portion 8 and extends upward to cover the patella front surface. When the brace is pulled by the assistant forearm puller 6, the patella facing portion 3 pushes the knee joint backward to assist the knee joint extension.

  The thigh circumference portion 4 is connected to the patella facing portion 3 and extends upward. The thigh turning portion 4 is divided into two inner and outer hands from the lower front surface of the thigh, turns around backward, is connected laterally at the rear upper surface of the thigh, and moves to the buttocks facing portion 5. Go. When the buttocks facing part is pulled by the assistant forearm pulling part 6, the force applied to the upper part of the rear face of the thigh is transmitted to the lower part of the front face of the thigh so that the knee joint extension assists.

  The buttocks facing portion 5 is connected to the thigh turning portion 4 and extends upward, widely covers the buttocks, and is configured by combining two vertical and three horizontal bands. When the brace is pulled by the assistant forearm puller 6, the buttocks facing portion 5 pushes the hip joint forward to assist the hip joint extension.

  The auxiliary forearm pulling portion 6 is connected to the buttocks facing portion 5 and extends upward, and is a portion that pulls the buttocks facing portion 5 to generate a force source for assisting joint motion. It is looped so that it can be pulled easily through the forearm. By pulling up the assistant forearm puller 6, a force for assisting the knee joint and hip joint extension is generated.

  The swing-out auxiliary band 9 is two bands attached to the upper part of the cuff band 8 and extending forward one by one from each of the inner and outer sides of the lower leg, forming a loop at the tip, and swinging out the impaired lower limb during walking of the patient by the assistant It is easy to assist. By adjusting the pulling strength of the two bands coming out from the inside and outside, the internal and external rotation of the hip joint when swinging is controlled. In other words, when the hip joint is easy to rotate inward when the lower leg of the disabled side is swung, the inner band of the swing auxiliary band 9 is pulled stronger, and when the hip joint is easily rotated outward when the lower leg is swung, the outer band of the swing assist band 9 is pulled. By pulling more strongly, it is possible to assist swinging in a state in which the impaired hip joint is maintained at the intermediate position of the internal and external rotations.

  The trunk band 10 is wound around the trunk, grasped by an assistant's hand, and pulled to the left and right to assist in controlling the movement of the center of gravity to the side of the supporting leg in accordance with the walking cycle over the entire walking cycle. Functions as a balance assist device.

  FIG. 2 is a diagram illustrating a mechanical mechanism related to walking assistance according to the present invention according to a walking cycle. The situation of assisting walking while the present invention is worn on the obstacle-side lower limb is shown as a side image and a front image. FIG. 2A shows a side view of the support side scene for supporting the lower limbs in the leg side on the obstacle side, and FIG. In FIG. 2B, the swing-out auxiliary band 9 is omitted. FIG. 2C shows a front image of the support side scene for supporting the lower limbs in the leg side on the obstacle side, and FIG. The swing-out auxiliary band 9 is omitted in FIGS. Reference numeral 62 denotes a patient's body from which the upper limb is omitted, in which the impaired lower limb is indicated by a solid line and the healthy lower limb is indicated by a broken line.

  The gait cycle is from the heel contact of the swinging lower limb to the one leg standing leg support, the stance period from kicking the ground to the end of the lower limb loading, and the swing leg period from the lower limb swinging forward off the ground and touching again And divided. The stance phase and free leg phase of both lower limbs are repeated in opposite phases, and there is some overlap in the stance phase of the left and right lower limbs.

  2A, when a force 11 for pulling up the assistant forearm traction part 6 is applied by the assistant, the force 12 pulling upward with respect to the patella facing part 3 is performed. Since the lower leg facing portion 2 is fixed to the lower leg, a force 13 that pulls downward is generated. As a result, a force 14 for assisting knee joint extension is generated in the patella facing portion 3. Similarly, when the assistant forearm towing unit 6 is pulled up, the force 15 pulling the buttocks facing portion 5 upward with respect to the buttocks facing portion 5 and the lower leg facing portion 2 are fixed to the lower leg. A force 16 that pulls the buttocks facing portion 5 downward is generated. As a result, a force 17 for assisting hip joint extension is generated in the buttocks facing portion 5.

  In the support assisting scene of the lower limb stance phase on the handicapped side, if the direction of pulling the assistant forearm traction unit 6 is increased, the extension of the hip joint works strongly, and if the direction of traction is set slightly rearward, it works strongly on the knee extension.

  Such a mechanism does not require strong traction force or frictional force as in the device (Patent Document 1) for partial unloading of the body weight, and can support the standing leg support of the impaired leg.

  In the obstacle side lower limb swing leg swing assist scene of FIG. 2-b, when a force 18 is applied by the assistant to pull the swing assist band 9 forward, this force is transmitted to the crus facing part 2 to assist swinging. The Since the swing-out auxiliary band 9 is pulled from the inside and outside of the lower limb, if the hip joint is easy to rotate internally when swinging the impaired leg, pull the inner band of the swing assist band 9 more strongly, When the hip joint is easy to rotate outwardly, by pulling the outer band of the auxiliary auxiliary band 9 more strongly, it becomes possible to assist the swinging while keeping the hand side hip joint in the intermediate / external rotation position.

  In this disabled side lower limb swing leg swing assist scene, the assistant's forearm puller 6 is loosened so that no force is applied to the buttocks facing part 5 or the patella facing part 3 to assist joint extension, It is necessary not to disturb the swing.

  In FIG. 2C, the trunk band 10 applies a force 19 to pull the patient toward the obstacle side, and promotes the movement of the center of gravity toward the patient's side of the obstacle. It facilitates support and facilitates swinging of the lower limbs.

  In the obstacle side lower limb swing leg swing assist scene of FIG. 2-d, the trunk band 10 applies a force 20 to the patient's healthy side, and moves the center of gravity to the healthy side opposite to the swing side. Facilitates easy swing-out of the lower leg.

  Next, the usage method of this invention is demonstrated along the walk cycle of a patient's impaired leg.

  In the stance phase of the impaired leg, the assistant moves along with the patient's walking, and pulls the assistant forearm traction part 6 with the upper arm forearm of the assistant located on the back side of the patient. Assist joint and hip extension. If the direction of traction is higher, it works strongly in hip extension, and if it is slightly backward, it works strongly in knee extension.

  In addition, during the stance phase of the lower limb of the disabled side, the trunk band 10 held by the assistant's hand located on the back side of the patient urges the center of gravity to move to the side of the disabled side of the standing leg side, At the same time as facilitating swinging of the lower leg on the healthy side.

  During the swing period of the lower leg of the handicapped side, the assistant moves with the patient's walking while pulling the forearm swinging auxiliary band 9 forward with the hand of the upper arm of the assistant located on the front side of the assistant and swinging the lower leg. Assist and increase the stride when swinging out.

  Further, during the swinging period of the lower leg of the obstacle side, the internal / external rotation of the hip joint at the time of swinging is controlled by adjusting the pulling strength of the inner and outer two bands of the swing assisting band 9. In other words, if the hip joint is likely to rotate inward when the obstacle side is swung, the inner band of the swing assist band 9 is pulled more strongly. If the hip joint is likely to rotate outward when the hand side is swung, the outer band of the swing assist band 9 is By pulling more strongly, it is possible to assist swinging in a state in which the impaired hip joint is maintained at the intermediate rotation position.

  Further, during the swing phase of the impaired leg, the assistant's forearm puller 6 is loosened without being pulled, so that no force is applied to the thigh buttocks 5 or the patella facing portion 3 so Do not disturb.

  Further, if the swinging width of the disabled leg in the swing leg period is too large, the leg support cannot be performed in the disabled leg standing stage after that and the knee may be bent. In this case, the assistant forearm towing unit 6 is immediately pulled to assist the support of the stance.

  Further, during the swing phase of the lower limb on the disabled side, the center of gravity is moved to the healthy side opposite to the side to be swung out by the trunk band 10 held by the assistant's hand located on the back side of the patient. Facilitates swinging of the lower leg.

Next, the effect of this invention is demonstrated based on the measurement data in a stroke patient.
FIG. 3 shows the vertical component of the impaired leg load during walking of one stroke patient in the embodiment for carrying out the present invention. The recording was performed using a lower limb load meter G-620 manufactured by Anima Co., with a sampling time of 0.01 seconds (100 Hz). It is a record of walking when the patient's one leg on the disability side is just placed on the lower limb load cell. 3A and 3B show two steps. FIG. 3A is a record when the device of the present invention is not worn, and FIG. 3-B is a record when the device of the present invention is worn. When the orthosis of the present invention was not worn, the lower limb loading time on the obstacle side was 2.19 seconds and 2.08 seconds. When the orthosis of the present invention was worn, the lower limb loading time on the obstacle side was 1.90 seconds and 1.89 seconds. The tempo of walking is faster when the device of the present invention is not worn. However, the impulse between the lower limb load amount and time is 3480 kg · sec for the two steps when the device of the present invention is not worn, and 4547 kg · sec for the two steps when the device of the present invention is worn. The case of wearing the inventive brace is larger. This can support the standing leg support and center of gravity movement control of the impaired limbs by wearing the orthosis of the present invention, promote the use of the impaired limbs, fast walking speed, high exercise load even for cardiopulmonary function It is shown that gait training is completed.

  FIG. 4 shows the total number of steps and the time taken for 10 strokes of 5 stroke patients in the embodiment for carrying out the present invention. Walking time was measured using a stopwatch, and the total number of steps was measured. FIG. 4-a shows the total number of steps, and FIG. 4-b shows a 10 m walking time. The white bar is the case where the device of the present invention is not mounted, and the black bar is the case where the device of the present invention is mounted. The average number of steps is 38.4 steps and the average time is 56.6 seconds when the brace is not worn, and the average number of steps is 32.2 steps and the brace is averaged when the brace is worn. Was 39.2 seconds. From the comparison of the total number of steps, it can be seen that the stride is increased by the wearing of the device of the present invention. In addition, it can be seen from the comparison of the time required that the walking speed is increased by the wearing of the device of the present invention. This indicates that wearing this brace improves the swinging of the lower limbs on the disabled side, promotes the use of the lower limbs on the disabled side, and enables walking training with a large stride, fast walking speed, and high exercise load for cardiopulmonary function. ing.

  FIG. 5 shows a record of oxygen consumption during a 6-minute walk of one stroke patient in the embodiment for carrying out the present invention. The anima portable oxygen consumption meter AT-1100 is used for the measurement, and the breath gas for each breath is analyzed, and the amount of oxygen absorbed and used in the body is calculated from the oxygen concentration and the breath flow rate. Are shown as standard values per minute per kg of patient body weight. Oxygen consumption is the most reliable index as an indication of how much exercise is being performed for the person, and since it is a measurement for each breath, it can follow changes every moment. FIG. 5-a is a record when the device of the present invention is not worn, and FIG. 5-b is a record when the device of the present invention is worn. The measurement was carried out during a 3-minute sitting position rest, a subsequent 6-minute walk, and then a 3-minute sitting position rest. The patient was instructed to walk as fast as possible for 6 minutes on the 37.5 m circumference of the training room. Since the pace of breathing is not constant, the time on the horizontal axis of the graph is not exactly the same in FIGS. The average oxygen uptake during 6-minute walking with no brace is 4.6 ml / kg / min, and the average oxygen uptake during 6-minute walk with brace is 5 0.9 ml / kg / min. Oxygen consumption during walking was increased by wearing the present orthosis. This indicates that the walking training with a high exercise load for the cardiopulmonary function can be performed by wearing the device of the present invention.

  FIG. 6 shows the walking distance when walking for 6 minutes in 5 stroke patients in the embodiment for carrying out the present invention. The white bar is the case where the device of the present invention is not mounted, and the black bar is the case where the device of the present invention is mounted. The average of the 6-minute walking distance when the brace was not worn was 123.1 m, and the average of the 6-minute walking distance when the brace was worn was 155.0 m. The walking distance was longer when wearing the brace. This shows that the walking training with high exercise load for cardiopulmonary function with high walking speed can be achieved by wearing the device of the present invention.

  The present invention has been described above with reference to the drawings. However, the present invention is not limited to this embodiment, and can be changed within a range that can be adapted to the above-described purpose. Another embodiment for carrying out the present invention will be described.

Other forms of materials and shapes will be described.
In the first example of the embodiment for carrying out the present invention, the gait training device 1, the swing-out auxiliary band 9, and the trunk band 10 are created by stitching together a 100% thick acrylic fiber and a 5cm wide band. For example, it can be made of other shaped bands, strings, elastic bands, rubber or appropriately cut fabric.

  The lower leg facing part 2, the patella facing part 3, the thigh girth part 4, and the buttocks facing part 5 are made by molding leather, plastic, carbon resin, or metal, and a hinge mechanism such as metal is used for connecting each part. Some joints can be used. In addition, the cuff band 9 has a structure that can fix the lower leg front portion 8 to the lower leg while wearing or not wearing a general short leg brace or long leg brace.

  In the first example of the mode for carrying out the present invention, the assistant forearm traction portion 6 is looped so that it can be easily pulled through the forearm of the assistant, but other instruments that are easy to pull are used. be able to. In addition, as a towing method, a method of grasping with a hand, extending a band and placing it on a neck or shoulder of an assistant may be considered.

  In the first example of the embodiment for carrying out the present invention, the swing-out auxiliary band 9 is of a type that is pulled forward by two bands extending forward, but depending on the situation of walking training, a rigid material connected by a hinge A method of pushing out the lower limbs from the rear and assisting the swinging out is also conceivable.

  In one example of the embodiment for carrying out the present invention, an assistant assists the center of gravity movement control in accordance with the walking cycle by the trunk band 10 wound around the trunk, but does not deviate from other trunks. In this way, it is possible to use a device that is wide to control the movement of the center of gravity, a device that is formed according to the body shape, a device that is diaper-shaped and that is less likely to slip through the crotch portion, and a device that has a grip.

  FIG. 7 shows the possibility of connecting and installing each part of the present invention to match the physique of the patient and the assistant. 21 is a connection for making the swing-out auxiliary band 2 removable when not necessary, 22 is a connection for adjusting the length of the swing-out auxiliary band 9 in accordance with the physique of the patient and the assistant, and 23 is a thigh circumference portion 4 is a connection for adjusting the length and circumference of the patient's thigh, 24 is a connection for adjusting the position of the assistant forearm traction part 6 to the physique of the patient and the assistant, and 25 is the position circumference of the trunk band with the patient. It is a connection to match the physique of the assistant. The above connection can be installed using a hook-and-loop fastener, a buckle, a button, an adhesive tape, or the like.

  The connection between the swing-out auxiliary band 9 and the walking training device 1 is not limited to the upper part of the cuff band 8, and the lower part of the lower leg of the cuff band 8 cuff band 8 can be connected to the thigh circumference part 4 depending on the situation of swinging the lower limbs during walking. You may move to the level and start from inside and outside the lower limbs. For example, when the supportability of the lower limb of the patient on the disabled side is remarkably low, the knee bending in the stance phase can be reduced by placing the connecting portion with the swing-out auxiliary band 9 at the lower part of the lower leg facing portion 2. If the patient's impaired quadriceps muscle is highly spastic or is prone to be a contralateral knee, the knee flexion at the time of swinging can be achieved by placing the connecting part with the swing-out auxiliary band 9 at the level of the patella facing part 3 Can be promoted. When the gluteal muscle is highly spastic, placing the connecting portion with the swing-out assisting band 9 at the level of the thigh circumference portion 4 makes the swing-out assist more powerful.

  When the standing leg support of the lower limb of the patient is good, the knee facing portion 3, the thigh turning portion 4, the buttocks facing portion 5, and the assistant forearm pulling portion 6 are not necessary.

  The swing-out assist band 9 is not necessary when the patient has good swing of the lower leg.

  When the patient's standing position gravity center movement control is good, the trunk band 10 is not necessary.

  In principle, there is only one assistant for walking training according to the present invention. However, if the trunk is severely damaged or the patient is large, another person is required to assist this.

Other forms of force source and control mechanism will be described.
FIG. 8 shows a second example of an embodiment for carrying out the present invention. Reference numeral 62 denotes a patient's body from which the upper limb is omitted. The patient wears the walking training device 1, the swing-out auxiliary band 9, and the trunk band 10 in the lower limb of the disabled side. Reference numeral 50 denotes a treadmill device that moves in conjunction with other devices. Reference numeral 51 denotes an actuator that is positioned above and rearward of a patient who is to undergo walking training and is connected to the upper end of the buttocks facing portion 5 of the walking training device 1 with a string. By moving the arm of the actuator 51 upward and pulling the walking training device 1 upward, the support of the stance support in the obstacle side stance phase is performed. An actuator 52 is located in front of the patient who is performing walking training and is connected to the swing-out auxiliary band 9 with a string. By moving the arm of the actuator 52 forward and pulling the swing-out assisting band 9 forward, assisting in swinging out the lower limb of the obstacle-side swing leg phase is performed. 53 is a crossbar which can adjust the site | part which connects the string connected with the extraction auxiliary | assistant band 9 to the arm front-end | tip of the actuator 52, in order to adjust the direction of extraction. Reference numeral 54 denotes an actuator that is positioned on a patient to be trained in walking and is connected to two left and right portions of the trunk band 10 with strings. By moving the arm of the actuator 54 to the left and right and pulling the trunk band 10 to the left and right, the center of gravity movement control to the side of the supporting leg is assisted in accordance with the walking cycle throughout the walking cycle. A device 55 controls the actuators 51, 52, and 53 and the treadmill 50 in accordance with the walking of the patient. According to the present embodiment, it is possible to perform walking training that promotes the use of the impaired lower limbs without human intervention, and has a large stride, a high walking speed, and a high exercise load for cardiopulmonary function.

Other forms of use of the invention will be described.
The present invention can be used to assist walking training on a treadmill with or without partial unloading.

  If the maximum oxygen uptake is evaluated by a multi-stage stress test such as a treadmill of a stroke patient who is equipped with the present invention and the number of patients who can be generally evaluated, the number of stroke patients that can be evaluated can be expanded.

  The present invention can also be used to assist standing up, standing up, and ascending / descending stairs.

  The present invention can also be used for flexible paraplegia due to multiple infarctions and paraplegia due to spinal cord injury. In this case, two inventive devices are attached to both lower limbs so that the two inventive devices can be pulled. A method is conceivable in which two assistant forearm traction portions 10 of the present invention are connected by a band, and one assistant pulls the connected portion from the shoulder to the neck. Or two assistants may be sufficient.

  Although the present invention is mainly intended for stroke hemiplegic patients, it can also be used for patients with head trauma, nervous system infection, nervous system autoimmune disease, neurodegenerative disease, leg injury, disuse syndrome, and cerebral palsy.

  The present invention may change concepts related to gait training and physical fitness of stroke patients. A new direction has also been shown for braces and computer-controlled rehabilitation assistive devices.

The perspective view which looked at a mode that wearing a form for carrying out the present invention from a patient's front The figure explaining the mechanical mechanism of the walking assistance by this invention (side view image of the supporting assistance scene of the leg side in the leg side on the obstacle side) The figure explaining the mechanical mechanism of walking assistance by the present invention (side view of the swing assisting scene during the swing phase of the leg on the obstacle side) The figure explaining the mechanical mechanism of walking assistance by the present invention (front view of support side scene of obstacle side leg stand) The figure explaining the mechanical mechanism of walking assistance by the present invention (front image of the swing-out swing assist scene on the obstacle side leg) The figure which shows the perpendicular | vertical component of the obstacle side leg load at the time of the walk of one stroke patient in the form for implementing this invention (Record when not mounting | wearing this invention orthosis) The figure which shows the perpendicular | vertical component of the obstacle side leg load at the time of the walk of one stroke patient in the form for implementing this invention (record at the time of this invention orthosis wearing) The total number of steps when walking 10 m in 5 stroke patients in the embodiment for carrying out the present invention The walking time at the time of 10m walk of 5 stroke patients in the form for carrying out the present invention The figure which shows the record of the oxygen consumption at the time of 6-minute walk of one stroke patient in the form for implementing this invention (record when not wearing this invention brace) The figure which shows the record of the oxygen consumption at the time of 6-minute walk of 1 stroke patient in the form for implementing this invention (record at the time of this invention orthosis wearing) The figure which shows the walk distance at the time of 6-minute walk of 5 stroke patients in the form for implementing this invention The figure which shows the connection of each part of an orthosis, etc. in order to match with the physique of a patient and an assistant in the form for implementing this invention The figure which shows the 2nd example of the form for implementing this invention A first example of a conventional gait training device for stroke patients A second example of conventional walking training equipment for stroke patients A third example of a conventional walking training device for stroke patients (a perspective view of the wearing device viewed from the front of the wearer) A third example of a conventional walking training device for stroke patients (perspective view of the wearing from the rear of the wearer) A fourth example of a conventional gait training device for stroke patients

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Walking training equipment 2 Lower leg facing part 3 Patella facing part 4 Thigh circumference part 5 Grow part facing part 6 Auxiliary forearm pulling part 7 Lower leg front part 8 Cuff band 9 Swinging auxiliary band 10 Trunk band 11 Auxiliary forearm pulling part 6 up Force to pull the patella facing part 3 upward 13 force to pull the patella facing part 3 downward 14 force to extend the knee joint 15 force to pull the gluteal part 5 upward 16 facing the gluteal part A force for pulling the part 5 downward 17 A force for assisting hip extension 18 A force for pulling the swing-out auxiliary band 9 forward 19 A force pulling in the patient's hand side 20 A force 21 pulling in the hand side of the patient 21 In order to make the connection possible, the connection 22 is made possible. The connection 23 is used to adjust the length of the swing-out auxiliary band 9 according to the physique of the patient and the assistant. 24. Connection 25 for adjusting the position of the auxiliary forearm puller 6 to the physique of the patient and the assistant 25 Connection 50 for adjusting the position and circumference of the trunk band 10 to the physique of the patient and the assistant 50 Treadmill device 51 Standing leg Actuator 52 for assisting support Actuator 53 for assisting swingout Crossbar 54 for adjusting the direction of swingout Actuator 55 for assisting control of center of gravity movement Control device 60 for adjusting the treadmill and each actuator in accordance with the walking cycle The patient's upper limb 62 shown by the broken line 62 The patient's body 101 without the upper limb 101 The treadmill 102 The unloading device 103 that lifts the patient and loads the weight 103 Arm 104 The patient lifting means 105 that is adjustable in length Body weight detecting means 106 for detecting the loaded body weight Unloading value setting for setting the unloaded value Device 201 Patient 202 Biological information measuring means 203 Ankle joint drive unit 204 Force sensor 205 Lower limb drive unit 206 Angle sensor 207 Walking training device 208 Training result evaluation unit 209 Training data storage unit 210 Training trajectory generation unit 301 Mounting unit 302 Foot 303 Connection Part

Claims (2)

The lower leg facing part, the patella facing part, the thigh circumference part, the buttocks facing part, the traction part, and the swing-out assisting band. It consists of a crus fixing part that has a structure to fix the front part and the front part of the crus to the crus, the patella facing part is connected to the upper end of the crus facing part and covers the front of the patella, and the thigh circumference part has two belts It consists of a body and is connected to the upper end of the patella facing part, wraps the thigh from the inside and outside and extends backward to the buttocks, and the buttocks facing part is connected to the upper end of the thigh turning part and covers the buttocks widely from the back And the towing part has a loop structure that is connected to the buttocks facing part and pulled by the assistant, and the swing-out assisting band is a two band that extends forward from the inside and outside of the facing part of the crus at the tip. A loop is formed, To assist the extension of the knee and hip joints to support the lower limb load during walking, and when the hip joint tends to rotate inward when swinging out on the disabled side, the inner band is stronger When the hip joint is easy to rotate when pulling and swinging on the disabled side, the outer band is pulled more strongly to assist the lower limb swinging during walking while maintaining the disabled hip joint in the intermediate and external rotation position. Walking training equipment. The walking training device according to claim 1, wherein the walking training device is a band wound around the trunk and assists the alternate center of gravity movement toward the left and right support legs in accordance with the walking cycle.

Images