JP4686717B2 - Bending joint contracture treatment device - Google Patents

Description

  The present invention relates to a bendable joint contracture treatment apparatus used for treating joint contracture by applying a bending / extension force to a joint portion of a human body.

  Conventionally, when contracture occurs in a joint part of a human body due to, for example, trauma, surgery, fixation or disuse syndrome, manual treatment has been mainly performed. In addition, a CPM device (continuous passive motion device) that flexes and extends a joint portion by a driving force of an electric motor may be used (for example, see Patent Document 1).

JP-A-8-687

In order to expand the range of motion of the joint part where contracture has occurred, “continue applying a certain weak external force for a long time without feeling pain” to the target joint part, “once every 1 to 2 hours It has been found that it is effective to carry out a treatment method of “extracting external force and performing joint motion to promote synovial fluid lubrication” over several weeks, and there is less burden on patients such as pain. However, with conventional manual bending / extension, it is possible to adjust the force, but it has been difficult to stably apply the force over a long period of time.
In addition, with the conventional CPM device, it is possible to maintain the range of motion of the joint, but there is no contracture improvement effect, weak bending / extension force cannot be applied for a long time, and force adjustment is not easy It was.

  The present invention has been made to solve the above-described problems, and an object of the present invention is to provide a bending joint contracture treatment apparatus that can apply a stable external force to a joint for a long time.

  The bending joint contracture treatment device according to the present invention includes a base mounted on the proximal portion and a main rotation shaft among the proximal portion and the distal portion of the human body located on both sides of the joint portion to be treated. A movable body connected to a base so as to be pivotable at the center and attached to a distal portion, a hydraulic cylinder mounted on the base and generating a driving force for rotating the movable body relative to the base, and the base It is connected to the fluid pressure type cylinder and the movable body, and is provided with a transmission member that converts the linear motion of the fluid pressure type cylinder into a rotational motion of the movable body and transmits it.

  According to the bending type joint contracture treatment device of the present invention, the linear motion of the hydraulic cylinder is converted into the rotational motion of the movable body by the transmission member and transmitted, so that a stable external force is applied to the joint for a long time. be able to.

The best mode for carrying out the present invention will be described below with reference to the drawings.
Embodiment 1 FIG.
FIG. 1 is a system configuration diagram showing a bending joint contracture treatment apparatus according to Embodiment 1 of the present invention. In this example, an apparatus for treating a finger joint portion of a human body as a treatment target is shown.

  In the figure, a finger mounting portion 1 mounted on a finger portion of a human body is provided with a plurality of balloons 2a and 2b, an air cylinder 3 that is a fluid pressure cylinder, and a displacement sensor 4. The balloons 2a and 2b are inflated by being supplied with air, thereby securing a tightening force (binding force) to the finger portion. The air cylinder 3 generates a driving force for bending and extending a finger joint that is a joint portion. The displacement sensor 4 detects the amount of movement of the inner rod of the air cylinder 3 corresponding to the bending angle of the finger joint.

  The pressure of the air supplied to the air cylinder 3 is controlled by the electropneumatic regulator 5. The electropneumatic regulator 5 is controlled by the control computer 6. A detection signal from the displacement sensor 4 is input to the control computer 6. A personal computer 7 for confirming input / output of the control computer 6 and changing a control program can be connected to the control computer 6.

  The control computer 6 controls the electropneumatic regulator 5 based on the control program input from the personal computer 7 and the feedback signal from the displacement sensor 4. Further, the control computer 6 controls the electropneumatic regulator 5 by the control program so that the air cylinder 3 applies a constant torque to the finger part while the finger joint is bent from 0 degrees to 120 degrees. Specifically, as the bending angle of the finger joint increases, the pressing force by the air cylinder 3 is gradually increased.

  Air is supplied from the cylinder 8 to the electropneumatic regulator 5. Air is supplied to the balloons 2a and 2b from the cylinder 8 via the pressure regulator 9 with a pressure gauge. Between the electropneumatic regulator 5 and the pressure-reducing regulator 9 with a pressure gauge, and the cylinder 8, a plurality of electromagnetic valves 10 for determining an air output port are provided. The opening and closing of the electromagnetic valve 10 is controlled by the control computer 6.

  2 is a side view showing the finger mounting portion 1 of FIG. 1 in a partial cross section, FIG. 3 is a side view showing a state where the finger joint of FIG. 2 is bent by about 45 degrees, and FIG. 4 is a view showing the finger joint of FIG. FIG. 5 is a side view showing a state where the finger joint of FIG. 2 is bent about 120 degrees.

  In the figure, the finger portions adjacent to each other with the finger joint 11 to be treated as the target are referred to as a proximal portion 12 and a distal portion 13. A base 14 is attached to the proximal portion 12. A movable body 15 that is rotatable with respect to the base 14 in a direction in which the finger joint 11 is bent is attached to the distal portion 13.

  The base 14 includes a cylindrical base side holding portion (strap portion) 16 into which the proximal portion 12 is inserted, and a support member 17 fixed to the base side holding portion 16. The base side holding part 16 has a balloon 2a built therein. The air cylinder 3 is supported on the support member 17. A cover 18 that covers the air cylinder 3 is attached to the support member 17.

  The movable body 15 is fixed to a cylindrical movable body side holding portion (strap portion) 19 into which the distal portion 13 is inserted, and the movable body side holding portion 19, and rotates around the main rotation shaft 21 around the support member 17. It has the rotation member 20 connected so that it was possible. The main rotating shaft 21 is located in the vicinity of the rotation center of the finger joint portion 11 when in use. The movable body side holding part 19 contains a balloon 2b. The rotating member 20 is provided with a linear first guide hole 20 a substantially parallel to the distal portion 13.

  At least one of the support member 17 and the rotation member 20 is provided with a long hole 22 through which the main rotation shaft 21 is inserted. Thereby, the rotation member 20 can slide in a slight range in a direction of about 45 degrees with respect to the support member 17.

  A transmission member 23 is connected to the support member 17 so as to be rotatable about a shaft 24. The transmission member 23 converts the linear motion of the air cylinder 3 into a rotational motion of the movable body 15 and transmits it. Further, the transmission member 23 is rotated about the shaft 24 as the finger joint 11 is bent and stretched. A first guide pin 23 a inserted into the first guide hole 20 a is provided at the distal end portion of the transmission member 23. The first guide pin 23 a is slid and moved in the first guide hole 20 a as the finger joint 11 bends and stretches.

  A second guide hole 23 b for connecting the transmission member 23 to the air cylinder 3 is provided in the vicinity of the shaft 24 of the transmission member 23. The second guide hole 23 b is a straight line extending in the radial direction of the arc centered on the shaft 24. Further, the angle of the second guide hole 23 b is changed as the finger joint 11 bends and stretches.

  The air cylinder 3 and the transmission member 23 are connected via a second guide pin 25 inserted into the second guide hole 23b. The second guide pin 25 is slid and moved in the second guide hole 23b as the finger joint 11 bends and stretches.

  Next, the operation will be described. After attaching the base side holding part 16 to the proximal part 12 and attaching the movable body side holding part 19 to the distal part 13, by starting the control program of the control computer 6, air is first supplied to the balloons 2a and 2b. As a result, the restraining force on the proximal portion 12 and the distal portion 13 is strengthened, and displacement of the base side holding portion 16 and the movable body side holding portion 19 with respect to the fingers is prevented. When the restraining force by the balloons 2a and 2b reaches a preset magnitude, the supply of air to the balloons 2a and 2b is stopped, and thereafter the restraining force is maintained.

  Thereafter, air is supplied into the outer pipe of the air cylinder 3. As a result, the inner rod of the air cylinder 3 is pushed out in a direction protruding from the outer pipe, and the transmission member 23 is centered around the shaft 24 by the force acting on the second guide pin 25 coupled to the inner rod of the air cylinder 3. It is rotated. Then, the rotational force of the transmission member 23 is transmitted to the movable body 15 via the first guide pin 23a, and the movable body 15 moves the main rotation shaft 21 to the angle defined by the position of the first guide pin 23a. The finger joint 11 is bent by being pivoted to the center. When the finger joint 11 is bent to one of the preset angles shown in FIGS. 3, 4, and 5 by the detection value of the displacement sensor 4 that detects the amount of movement of the inner rod of the air cylinder 3, the control computer 6 Is determined, the air supply to the air cylinder 3 is stopped, and the bending state of the finger joint 11 is maintained.

  Further, by retracting the inner rod of the air cylinder 3, the transmission member 23 and the movable body 15 operate in the reverse direction to the bending operation, and the bending of the finger joint 11 is released (the finger joint 11 extends).

  Supply / discharge of air to / from the air cylinder 3 is performed according to a control program. For example, after the bending force is continuously applied to the finger joint 11 for 1 hour, the operation of releasing the bending force for 5 minutes is repeatedly performed. During the rest period when the bending force is released, the air in the balloons 2a and 2b is also discharged, and the restraining force is released. That is, it is possible to intermittently apply at least one of a bending force and an extension force while sandwiching a predetermined pause time.

  According to such a bending type joint contracture treatment device, the linear motion of the air cylinder 3 is converted into the rotational motion of the movable body 15 by the transmission member 23 and transmitted, so that it is stable with respect to the finger joint 11. The applied external force can be applied for a long time. Therefore, it is possible to “continue to apply a constant weak external force that does not feel pain for a long time” to the finger joint 11. It is also possible to “remove the external force once every 1-2 hours to move the joint”. For this reason, the treatment which expands the range of motion of the finger joint 11 can be performed while preventing secondary damage of the articular cartilage of the finger joint 11.

In addition, since a fluid pressure type cylinder is used as an actuator, it is possible to easily apply a certain weak bending force for a long time. Further, it is easy to periodically release the bending force by reducing the pressure of the fluid.
Furthermore, since the air cylinder 3 is used as the fluid pressure type cylinder, the structure can be simplified and the weight can be reduced. Furthermore, it has high durability against impact force, is lightweight, easily secures water resistance, and is easy to use in daily life.

Furthermore, since the movable body 15 is slidably connected to the transmission member 23, the movable body 15 can be smoothly rotated.
In addition, since at least one of the base 14 and the movable body 15 is provided with a long hole 22 into which the main rotation shaft 21 is inserted, even if the mounting position of the support member 17 with respect to the finger joint is slightly shifted, The finger joint 11 can bend and stretch smoothly.
Furthermore, since the transmission member 23 is connected to the air cylinder 3 so as to be slidable in the radial direction of the arc centering on the rotation shaft 24 of the transmission member 23, the finger joint 11 can bend and stretch smoothly. it can.

Furthermore, since the control computer 6 is adapted to intermittently apply flexion / extension force to the finger joint 11 while sandwiching a pause state for a predetermined time, it is possible to effectively treat the contracture of the finger joint 11. it can.
In addition, the air is supplied to the inside of the base side holding part 16 and the movable body side holding part 19 so as to expand and strengthen the restraining force on the proximal part 12 and the distal part 13, and the air is discharged. Since the balloons 2a and 2b that are contracted and weaken the restraining force are arranged, the base side holding part 16 and the movable body side holding part 19 are prevented from being displaced during use by a simple and lightweight configuration, and the finger joint The force can be applied to 11 efficiently.

Furthermore, the treatment can be continued while sleeping, and the treatment period until the necessary range of motion can be secured can be shortened.
Furthermore, since the main components such as the air cylinder 3, the support member 17, the rotation member 20, and the transmission member 23 are arranged not on the palm side but on the back side of the fingers, Operation can be performed without any problem.

Embodiment 2. FIG.
Next, FIG. 6 is a side view showing a part of the finger attachment portion of the bending joint contracture treatment apparatus according to Embodiment 2 of the present invention. In the figure, the bone of the proximal portion 12 is provided with a plurality of first fixing pins 31 for fixing the support member 17. A plurality of second fixing pins 32 are provided on the bone of the distal portion 13 in order to fix the rotating member 20. Intermediate portions of these fixing pins 31 and 32 are inserted through a plurality of minute holes formed in the bone. Then, both end portions of the fixing pins 31 and 32 protruding from the side portions of the proximal portion 12 and the distal portion 13 are bent substantially at right angles to the support member 17 and the rotating member 20 side, respectively. That is, the fixing pins 31 and 32 are bent into a U-shape.

  On both sides in the width direction of the support member 17 and the rotation member 20, first and second pressing plates 33 and 34 that sandwich both end portions of the fixing pins 31 and 32 are attached. A plurality of grooves (not shown) into which the fixing pins 31 and 32 are inserted are provided on at least one of the side surfaces of the support member 17 and the rotation member 20 and the pressing plates 33 and 34. These grooves prevent displacement of the base 14 and the movable body 15 with respect to the fixed pins 31 and 32. Other configurations are the same as those in the first embodiment.

  In such a flexion type joint contracture treatment device, the positions of the base 14 and the movable body 15 with respect to the proximal portion 12 and the distal portion 13 are fixed by the fixing pins 31 and 32. Misalignment can be prevented, and stable treatment can be continued even when worn for a long time. Moreover, depending on the case, the base side holding | maintenance part 16 and the movable body side holding | maintenance part 19 can also be abbreviate | omitted.

In the above example, the balloons 2a and 2b are arranged in the base side holding part 16 and the movable body side holding part 19, but an elastic member such as silicon rubber may be simply arranged.
In the above example, the application / release of the bending force is automatically performed using the control program. However, the user may perform it manually. Thereby, the system configuration can be further simplified, and the cost can be reduced.
Furthermore, a cylinder utilizing the pressure of a liquid other than air, such as a gas or oil, may be used as the fluid pressure cylinder.
Furthermore, in the above-described example, the bending joint contracture treatment device for treating the proximal phalangeal joint of the finger is shown. However, for example, another joint of the finger, a wrist joint, an elbow joint, a shoulder joint, or a knee joint The present invention can also be applied to the treatment of other joints in the human body.

BRIEF DESCRIPTION OF THE DRAWINGS It is a system block diagram which shows the bending type joint contracture treatment apparatus by Embodiment 1 of this invention. It is a side view which shows the finger mounting part of FIG. 1 in a partial cross section. FIG. 3 is a side view showing a state where the finger joint of FIG. 2 is bent about 45 degrees. It is a side view which shows the state which bent the finger joint of FIG. 2 about 90 degree | times. FIG. 3 is a side view showing a state where the finger joint of FIG. 2 is bent about 120 degrees. It is a side view which shows the finger mounting part of the bending type joint contracture treatment apparatus by Embodiment 2 of this invention in a partial cross section.

Explanation of symbols

  3 Air cylinder (hydraulic pressure cylinder), 11 finger joint, 12 proximal portion, 13 distal portion, 14 base, 15 movable body, 21 main rotation shaft, 22 long hole, 23 transmission member.

Claims (3)

Of the proximal part and the distal part of the human body located on both sides of the joint part to be treated, the base attached to the proximal part,
A movable body connected to the base so as to be rotatable about a main rotation axis, and mounted on the distal portion;
A hydraulic cylinder mounted on the base and generating a driving force for rotating the movable body with respect to the base; and the hydraulic cylinder and the movable cylinder that are rotatably connected to the base. A transmission member connected to the body for converting the linear motion of the fluid pressure cylinder into a rotational movement of the movable body and transmitting the movement ;
The bending joint contracture treatment apparatus , wherein the transmission member is slidably connected to the movable body as the movable body rotates . Of the proximal part and the distal part of the human body located on both sides of the joint part to be treated, the base attached to the proximal part,
A movable body connected to the base so as to be rotatable about a main rotation axis, and mounted on the distal portion;
A hydraulic cylinder mounted on the base and generating a driving force for rotating the movable body relative to the base; and
A transmission member that is rotatably connected to the base, and that is connected to the fluid pressure cylinder and the movable body, and converts linear motion of the fluid pressure cylinder into a rotation operation of the movable body and transmits the same.
With
The base and on at least one of said movable body is bending music type arthrogryposis treatment device you wherein the long hole the main rotating shaft is inserted. Of the proximal part and the distal part of the human body located on both sides of the joint part to be treated, the base attached to the proximal part,
A movable body connected to the base so as to be rotatable about a main rotation axis, and mounted on the distal portion;
A hydraulic cylinder mounted on the base and generating a driving force for rotating the movable body relative to the base; and
A transmission member that is rotatably connected to the base, and that is connected to the fluid pressure cylinder and the movable body, and converts linear motion of the fluid pressure cylinder into a rotation operation of the movable body and transmits the same.
With
The transmission member, the transmission member arc slidably that bending music type arthrogryposis treatment device you characterized which is connected to the hydraulic cylinder to the radial direction around the rotation axis of the.

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