JP6089253B2 - Tilt table for crus movement support - Google Patents

Description

  The present invention relates to a tilt table for performing standing training on a patient, and more particularly to a tilt table that can change the angle of a joint in addition to the change between a horizontal posture and a standing posture with respect to a patient.

  When lying on the bed for a long time due to long-term hospitalization, etc., blood pressure may decrease excessively when standing up, causing dizziness or fainting (orthostatic hypotension). This often interfered with diagnosis and training. Moreover, the same symptom may be caused to a person with a small blood volume or a person with impaired heart function. This is because, when standing up from lying down, a large amount of blood accumulates in the lower body veins, resulting in a decrease in blood pressure due to the difference between the amount of blood supplied from the heart and the amount of blood flowing into the heart. This happens because blood flow to the brain is reduced. Therefore, stabilization of blood pressure is performed as a kind of rehabilitation by performing exercises (standing training) for alleviating these symptoms.

  A tilt table is used for the above-mentioned standing-up training. The tilt table is used by changing the angle of the tilt table so that a person performing standing training (hereinafter referred to as a patient) lies on the tilt table and changes from a horizontal posture to a standing posture. The patient maintains the standing posture for a predetermined time to adapt to the change in blood flow in the standing state.

  A conventional tilt table fixes a mat on which a patient can be placed on a gantry, pivots one end of the gantry, and moves the other end up and down to change the surface of the mat from a horizontal state to a vertical state. Therefore, the patient is placed on the mat so that the state of the patient changes from a horizontal posture to a standing posture (see Patent Document 1).

Japanese Utility Model Publication No. 5-9536 (FIG. 9)

  Since the conventional tilt table as described above is configured to change the patient from a horizontal state to a standing state, the tilting table brings a certain result to the standing-up training. However, as described above, the cause of orthostatic hypotension is due to a decrease in blood pressure in the upper body because a large amount of blood flows into the lower body and blood returning to the heart decreases. When standing in a standing position, it may cause dizziness while staying on the tilt table, causing anxiety to the patient. In addition, when a long-term bedridden patient is in a standing posture, the patient's weight cannot be supported, and the patient may become unstable, which also causes anxiety to the patient. .

  To relieve such anxiety or relieve excessive blood flow concentration, an assistant (such as an attendant or nurse) lifts the patient's upper or lower leg, etc. Preliminary exercises such as bending and stretching joints were sometimes performed. This is because the blood pressure gradually increases as the blood flow to the lower body is gradually increased by moving the lower body in advance, and by increasing the blood pressure in advance, the blood pressure to the lower body during the standing posture is increased. The purpose is to moderate the decrease in blood pressure due to rapid blood flow.

  However, since the preliminary exercise as described above is performed by an assistant, the labor for that must be severe. Therefore, a device capable of assisting preliminary exercise has been desired.

  In addition, after surgery related to artificial knees, hip joints, femurs, etc. (eg total hip arthroplasty, total knee arthroplasty, hip fracture surgery, etc.), the risk of deep vein thrombosis is increased and severe In some cases it was foreseen to develop into pulmonary thromboembolism. Therefore, in general, the lower leg is moved to prevent thrombus by urging early leaving after surgery, etc., and elastic blood pressure is used to increase the blood flow velocity of the vein, or intermittent pneumatic compression is used. Promoting venous blood perfusion in a short time.

  However, in cases where there are many elderly people, such as proximal femoral fractures, it is difficult to prompt the elderly to get out of bed early, and when using intermittent pneumatic compression, It was necessary to confirm in advance that venous thrombosis had not occurred, and it was not possible to deal with all postoperative patients. Therefore, a device that assists the patient in training so as to enable movement similar to the state of getting out of bed to a patient who is difficult to get out of bed early is also desired.

  The present invention has been made in view of the above-described points, and the object of the present invention is to support a preliminary exercise of the lower body before a standing posture for a patient who is performing standing training, and a deep vein thrombus. To provide a tilt table that can support exercise to prevent illness.

  Therefore, the present invention provides a mat portion having a sufficient area on which the patient can be placed on the front surface side, a gantry that supports the mat portion on the back surface side, a base end side of the gantry, and the gantry. In a tilt base comprising a base having a drive part for tilting and a footrest provided on the base end side of the gantry, the mat part includes an upper mat on which a patient's upper body is placed, and a patient's upper leg The upper mat is fixed to a gantry, and the intermediate mat is positioned at an end of the upper mat at a position close to the upper mat. The lower mat is pivotably connected to the intermediate mat at a position close to the intermediate mat and is opposite to the intermediate mat. Sides are slidably supported by the gantry, and the gantry has driving means for driving the surface formed by the intermediate mat and the lower mat to bend toward the surface side of the mat portion. It is provided.

  According to the above configuration, the mat portion is separated into the upper mat, the intermediate mat, and the lower mat, but when the surface formed by the intermediate mat and the lower mat is in a flat state, Similar to the tilt table, it is possible to change the posture between the horizontal posture and the standing posture depending on the patient sitting on the mat in the supine position (sleeping on his back). In the state, by bending the surface formed by the intermediate mat and the lower mat, it can be guided to bend a joint such as a patient's knee along with the bending.

  Here, among the intermediate mats, the position close to the upper mat is rotatably supported by the gantry, so that the intermediate mat at the time of bending is inclined around the supported portion. . At this time, since the free end side of the intermediate mat (the side not supported by the gantry) is connected to the lower mat in a rotatable state, the connecting portion of the lower mat is moved away from the gantry (that is, , So that the stand is raised in a horizontal state). Further, since the side of the lower mat that is not continuous with the intermediate mat is supported in a slidable state on the gantry, the slidable portion moves during the bending, and the linear distance changes due to the bending. It can cope with. Then, by eliminating the bending state as described above (returning to a flat state again), it is possible to guide the joint such as the knee to an extended state. It is possible to repeatedly induce bending and stretching movements of joints such as knees.

  “Upper” and “lower” in the upper and lower mats are based on the patient's standing posture, and are used to mean that “upper” and “lower” are maintained even in a horizontal posture. is not.

  According to the present invention, the footrest portion in the above-described configuration is a plate-like footrest base portion fixed to the gantry, and a footrest that is slidably contacted with the surface of the footrest base portion so as to abut the patient's sole. A contact portion, and the sole contact portion may be configured to be pivotably connected to the lower mat at a position close to the lower mat.

  According to the above configuration, the entire footrest portion is not fixed, only the footrest base portion is fixed, and the sole contact portion that is in sliding contact with the surface is freely rotatable between the lower mat. Therefore, the surface of the sole contact portion is inclined with the variation of the lower mat (bending by the intermediate mat and the lower mat). As a result, the patient's foot in contact with the sole contact portion is guided to bend the ankle joint. In addition, the change of the sole contact portion due to the change of the lower mat is accompanied by the movement of the slide portion of the lower mat when the surface of the intermediate mat and the lower mat is bent, As the sliding portion of the lower mat moves, the connecting portion with the sole contact portion moves in the sliding direction, so that the portion is separated from the footrest base portion and between the portion that is in sliding contact with the footrest base portion, This is in a state of being inclined with respect to the footrest base portion. This enables guidance in the direction of extending the toes with respect to the ankle of the patient on the mat portion.

  Further, the present invention provides a servo motor for driving the drive means in the above-described configuration so as to be able to advance and retreat from the pedestal so as to rotate around the portion supported by the pedestal with respect to the intermediate mat. And a rotating body that is rotated in the forward and reverse directions by the servo motor, and a link portion having one end connected to the rotating body and the other end moving in the forward / backward direction according to the rotation of the rotating body. can do.

  According to the above configuration, the free end side (the side not supported by the gantry) of the intermediate mat is moved forward and backward (the gantry) by the rotating body that is driven to rotate in the forward and reverse directions while the speed is controlled by the servo motor. By moving the free end up and down, the intermediate mat can be rotated around the supported position, and the lower mat can also be swung.

  Further, the present invention provides a mat portion having a sufficient area on which the patient can be placed on the front surface side, a gantry that supports the mat portion on the back surface side, a base end side of the gantry, and a pedestal that is supported by the gantry. In a tilt base comprising a base having a drive part for tilting and a footrest provided on the base end side of the gantry, the mat part includes an upper mat on which the patient's upper body is placed, and left and right sides of the patient Separated into left and right intermediate mats for individually placing the upper thighs and left and right lower mats for individually placing the patient's left and right lower thighs. The upper mat is fixed to a gantry, and the left and right intermediate mats are Each of the left and right lower mats is positioned close to the intermediate mat. The intermediate mat is individually connected to the intermediate mat in a freely rotatable state, and the opposite side is supported in a slidable state on the gantry. The gantry includes the left and right intermediate mats and the Drive means for driving the respective surfaces formed by the left and right lower mats individually to bend toward the surface side of the mat portion is provided.

  According to the above configuration, since the intermediate mat and the lower mat are separated on the left and right, a patient who is placed on the mat portion in a supine position can put one leg on the left and right intermediate mat and the lower mat. . And both legs can be exercise | moved separately by act | operating (bending) both right and left separately. This individual motion can be bent and stretched alternately left and right by adjusting the timing of operation, and can also be operated in the same way so that only one side is bent or stretched. Such an operation is the same when the patient is in a standing posture.

  In addition, a belt for fixing a leg may be provided on each mat so that the patient's feet can be individually installed by being divided into left and right intermediate mats and a lower mat. By mounting the fixing belt, it is possible to prevent the movement of one leg from being influenced by the movement of the other leg (or mat) and to reliably perform the expected bending and stretching of the joint.

  According to the present invention, the footrest portion in the above configuration is in sliding contact with the plate-like footrest base portion fixed to the gantry and the surface of the footrest base portion, and the left and right soles of the patient are individually brought into contact with each other. Two sole contact portions that are connected to each other so as to be independently rotatable with the lower mat at a position close to the left and right lower mats one by one. Can be configured.

  According to the above configuration, when the left and right legs are exercised independently, the ankle joint can also be exercised separately on the left and right. Since the sole contact part is linked to the lower mat, when the left and right lower mats are operated alternately, the joints of the left and right ankles can be bent and extended alternately, and only one side is operated. When the lower mat is actuated at the same time, the left and right ankle joints are bent and extended at the same time.

  Further, the present invention is such that the drive means in the above configuration is driven so as to be able to advance and retreat from the pedestal so as to rotate about the portion supported by the pedestal with respect to the left and right intermediate mats, A single servo motor, a transmission unit that transmits the rotational drive of this servo motor to the left and right, a rotating body that rotates in the forward and reverse directions by the rotational driving force transmitted from this transmission unit, and one end connected to this rotating body And a link portion in which the other end moves in the forward / backward direction according to the rotation of the rotating body, and an electromagnetic clutch portion installed between the transmission portion and the rotating body. it can.

  According to the above configuration, the rotating body can be rotationally driven while the speed or the like is controlled by a single servo motor, and the rotational driving force to be transmitted from the transmitting unit to the rotating body is transmitted by the operation of the electromagnetic clutch unit. A non-transmission state can be selected. In this case, since the servo motor is single, the left and right electromagnetic clutches are connected together (the drive force is transmitted), and the left and right legs are induced to move simultaneously in the same manner. In addition, by intermittently connecting (repeating connection and disconnection alternately), it is possible to induce the left and right legs to move alternately.

  Furthermore, the present invention controls the rotation angle and rotation speed of the servo motor in the above configuration, and changes the stop time and the rotation in the forward and reverse directions when the surfaces of the intermediate mat and the lower mat are bent. It can be set as the structure provided with the control part which controls the stop time at the time.

  According to the said structure, the rotation angle and rotation speed by a servomotor will be controlled, and the exercise | movement according to the state of the patient who receives standing training can be performed. At this time, the rotation angle and the rotation speed can be feedback-controlled whether or not the rotation angle or the like is transmitted in a controlled state by installing an encoder in the transmission unit or the rotating body. In addition, by controlling the stop time when in the bent state, the knee joint or the like can be maintained for a predetermined time in a bent state, and the stop time when the rotational direction is converted to forward or reverse (that is, in a state where the knee joint is not bent). By controlling this, it is also possible to adjust the start timing of the flexion and extension movements of the knee joint and the like.

  Further, according to the present invention, in the direction in which the driving means having the above configuration forcibly slides the side on which the lower mat is supported by the gantry by an actuator that is driven in the advancing and retreating direction separately provided on the left and right of the gantry. It may be driven.

  In the case of the above-mentioned configuration, the distance between both ends of the intermediate mat and the lower mat is shortened by forcibly moving the slide portion of the lower mat, and as a result, the connecting portion between both is rotated and bent. Can do. Further, since the two actuators are individually installed with respect to the left and right lower mats, it is possible to individually control the bending of the intermediate mat and the lower mat which are separated into the left and right. At this time, if the driving state is the same at the same time, both legs are guided to perform the same movement, and if the driving state is different on the left and right, the legs are guided to a movement that causes the legs to move differently. At this time, in addition to simply bending and stretching both legs alternately, it is also possible to guide the legs to operate at the timing of walking, by driving them in a time difference manner.

  Furthermore, the present invention may be configured so as to include a control unit that controls the advance / retreat drive timing, advance / retreat distance, and advance / retreat speed of the actuator and that controls the stop time during forward or backward movement.

  According to the above configuration, the angle in the bent state is adjusted by controlling the driving distance by the actuator, the speed of bending and extension is adjusted by controlling the driving speed, and the stop at the time of forward movement or backward movement By controlling the time, the stop time in the bent state or the stop time in the extended state can be adjusted. Since this actuator is installed separately on the left and right, it can be guided to move at individual angles and speeds according to the state of the left and right legs of the patient (such as the degree to which the joints can be bent). It becomes.

  Further, according to the present invention, in each of the above configurations, an appropriate range in which the left and right intermediate mats are adjacent to each other is used as an intermediate region, and the intermediate mat in the intermediate region can be attached and detached. You may comprise so that it may be provided.

  According to the above configuration, the intermediate mat is a mat on which the upper thigh can be placed. Since the hip joint of the patient is located at the boundary between the left and right intermediate mats, a saddle is provided at the position of the hip joint. Thus, the seat can be configured to be seated on the saddle during the standing posture. At this time, an appropriate range at the right and left borders of the intermediate mat can be used as an intermediate region, and the intermediate mat in the region can be partially removed, and the back surface of the intermediate mat is within the range of the intermediate region from which the mat has been removed. By installing the saddle so as to be immersed in the side, and allowing the saddle to be projected and retracted to the surface side, the saddle can appear and be used on the surface side only when necessary. This saddle is for the case where a patient unfamiliar with standing training is weakened by dizziness or the like when standing, and is installed for relieving the patient's anxiety.

  In the present invention, two auxiliary armrests, which are rod-shaped and extend from both sides of the frame, are rotatably provided with the tips facing each other, and two auxiliary members supported near the tips of the respective armrests. It can be set as the structure provided with a table.

  According to the above configuration, the armrest can be arranged in front of the patient (near the chest front) by rotating the armrest when the standing posture or a state close to the standing posture is reached. Arms, elbows, wrists and the like can be placed on both the auxiliary table and the auxiliary table, and the weight in the standing posture can be supported by the arms.

  In the case of the said structure, it is good also as a structure which equips the front-end | tip of the said armrest with the grip part each bent in a corner shape.

  In such a configuration, the patient can support his / her posture by the upper body by gripping the grip portion when the patient is in the standing posture or a state close to the standing posture. The angle of bending may be an orthogonal direction, but is preferably about 60 ° with respect to the axial direction of the armrest as an angle at which the patient can easily grip.

  Further, in the present invention, the mat portion is provided in a state of being laminated on the surface of the lower layer bed fixed to the gantry, and the driving means penetrates the lower layer bed or the lower layer bed. The mat portion can be driven to bend from the side surface.

  According to the said structure, since the mat part is a structure laminated | stacked on the surface of a lower layer bed, the existing tilt stand can be utilized. In other words, the tilt table that already exists has a bed part that is wide enough to allow the patient to ride in the supine position, and the bed is configured to be tiltable together with the mount. It is possible to perform patient standing training. Therefore, by laminating the mat portion on the surface of the bed as a lower layer bed, the patient can get on the surface of the mat portion to add a function of bending and stretching the lower body joint. . Since the driving means for driving the mat portion is installed on the gantry, the driving of the intermediate mat or the lower mat by the driving means passes through the lower layer bed or outside the side surface of the lower layer bed. The driving force is transmitted using this method.

  According to the present invention, by bending the surface formed by the intermediate mat that can put the upper thigh of the patient performing the standing training and the lower mat that can put the lower thigh, The patient who is in the supine position on the mat part) can induce the flexion and extension movements of the lower body joints such as knee joints and ankle joints, and therefore can support the preliminary movement of the lower body of the patient. Is.

  This lower body joint flexion / extension movement is performed in a state where the patient is in a horizontal posture, so that the part where the intermediate mat and the lower mat are connected is raised (both mats bend in a mountain shape). As a result, the position of the knee rises, and the knee joint bends together with the hip joint, and the joint can bend and stretch. Further, in the case where the sole contact portion is connected to the lower mat, the ankle joint can be extended simultaneously with the bending of the joint, and the blood to the lower body can be bent by bending and stretching each joint of the lower body. The flow can be increased, and a sudden change in blood flow when standing can be mitigated.

  Furthermore, the lower body bending and stretching movements as described above can be performed in a standing posture. In this case, for example, when one leg is bent and stretched, the center of gravity moves to the other leg, and it is possible to apply a load to the other leg, thereby inducing an action close to real walking and a rehabilitation effect is expected. . In order to prevent deep vein thrombosis, which is a problem after surgery such as artificial knees, hip joints, and femurs, blood is applied to the lower leg veins by applying a load to one leg and bending and stretching the lower body joint. The flow velocity can be increased, which can contribute to prevention of deep vein thrombosis. In particular, for the prevention of deep vein thrombosis, it is said that contracting the triceps surae is effective. And thus the triceps surae can be contracted. Therefore, the effect of preventing deep vein thrombosis can be further exhibited.

  As described above, in the case of the preliminary exercise, since it is possible to drive the intermediate mat or the lower mat with the driving means while the patient is in the supine position on the tilt table, the assistant needs labor. There is no need to assist. In addition, when the patient is operated in a standing posture, training that approximates the walking state can be performed. Furthermore, since the mat portion can be at an arbitrary angle according to the tilting state of the gantry, it can be appropriately adjusted according to the degree of patient familiarity with walking training, the condition of the patient on the day, and the like. Further, by increasing the angle stepwise from the horizontal state, preliminary training before full-scale walking training is also possible.

  In the configuration in which the mat portion is laminated on the surface of the lower layer bed, a function for inducing bending and stretching motions of the joints of the lower body can be added while using the existing tilt table. In this case, since the existing tilt table has a function of tilting the frame and includes a bed (lower layer bed) firmly fixed to the frame, the mat portion is laminated on the surface of the bed (lower layer bed). By doing so, the mat portion is bent on the surface of the lower layer bed. In addition, the structure provided with armrests can support the elbow, wrist, etc. with a large area by supporting the auxiliary table with the tip of the two armrests extending from the side of the gantry, and in the bending and stretching movement in the standing posture It will support patient stability.

It is explanatory drawing which shows the outline of 1st embodiment of this invention. It is explanatory drawing which shows the state of the base of 1st embodiment, and a mount frame. (A) is a perspective view which shows the state which mounted | wore the mount with the mat part, (b) is a perspective view of the state which bent the intermediate mat and the lower mat. (A) is a perspective view of a state where the left intermediate mat and the lower mat are bent, and (b) is a perspective view of a state where the right intermediate mat and the lower mat are bent. (A) is explanatory drawing which shows the state made into a horizontal posture, (b) is explanatory drawing of the state made into a standing posture. It is explanatory drawing which shows the state of the action | operation of 1st embodiment. It is explanatory drawing which shows the state of the action | operation of 1st embodiment. It is explanatory drawing which shows 2nd embodiment of this invention. It is explanatory drawing which shows the state of the action | operation of 2nd embodiment. It is explanatory drawing which shows 3rd embodiment of this invention. It is explanatory drawing which shows 4th embodiment of this invention. It is explanatory drawing which shows the modification of embodiment of this invention. It is explanatory drawing which shows the usage condition concerning the modification of embodiment of this invention. It is explanatory drawing which shows the other modification of embodiment of this invention.

  Hereinafter, embodiments of the present invention will be described with reference to the drawings. FIG. 1 is a diagram showing an outline of the first embodiment of the present invention. As shown in this figure, the schematic structure of the tilt base is as follows. The base 1 is a base, the base 2 is pivotally supported with respect to the base 1, and the mat part 3 is supported by the base 2. And.

  The base 1 is provided in a substantially rectangular parallelepiped shape and is hollow inside, but includes a hydraulic device and a control device (not shown) inside, and is relatively heavy as a whole. The hydraulic device is for operating a hydraulic cylinder 11 for rotating the gantry 2, and the control device is for controlling the operation of each part described later. Operation units 12 and 13 for inputting a control signal to the control device are provided on the side surface of the base, and the operation units 12 and 13 are provided with a display unit for displaying a control state together with various switches. ing. In addition, support portions 14 and 15 for supporting the shaft are erected on the edge portion on one end side of the base portion 1 with an appropriate interval. The support portions 14 and 15 are for pivotally supporting the gantry 2 in a rotatable manner.

  The gantry 2 includes two long vertical frames 21 and 22 arranged with an appropriate interval, and a plurality of rectangular tubes or U-shaped cross-sections that are interposed between the frames 21 and 22. The frames 23, 24 and 25 form a rectangular peripheral part and are reinforced at appropriate points. In the drawing, one vertical frame 21 is drawn to be broken, but this is for easy understanding of the internal structure of the gantry 2 and is essentially continuous. Each of the frames 21 to 25 is made of metal, and each contact is firmly fixed by welding. A shaft portion 26 is provided at one end of each of the vertical frames 21 and 22 so as to be pivotally supported by the base portion 1, and both ends of the shaft portion 26 are supported by the support portions 14 and 15 of the base portion 1. Thus, the base 1 can be mounted in a rotatable state. A part of the horizontal frame 25 is provided with a connecting part 27 for connecting the tip of the hydraulic cylinder 11 of the base 1. When the connecting portion 27 receives the advance / retreat drive of the hydraulic cylinder 11, the gantry 2 can be rotated around the shaft portion 26.

  Further, as will be described later, the gantry 2 is provided with a driving means 4 near the center for driving the mat portion 3. Further, the footrests 5 and 6 are fixed to the horizontal frame 23 located in the vicinity of the shaft portion 26, and the footrest portions 5 and 6 are positioned outside the mount 2 (outside the shaft portion 26). It is installed to do. In addition, armrests 7 and 8 are rotatably provided at end portions opposite to the footrest portions 5 and 6. The armrests 7 and 8 can be arranged so that the distal end portion is disposed on the surface side of the mat portion 3 by being rotated, and the patient can be put on the arm in a standing posture. As will be described later, the armrests 7 and 8 can be configured to be provided with an auxiliary table, or can be configured to be provided with a grip portion by bending the tip.

  The mat portion 3 is roughly divided into an upper mat 31, an intermediate mat 32, and a lower mat 33. The upper mat 31 is for placing the upper body of the patient in a state where the patient is in a supine position (sleeping on his back), the intermediate mat 32 is for placing the upper thigh, and the lower mat 33 is for placing the lower thigh. Is. The intermediate mat 32 and the lower mat 33 are further separated into left and right, and are composed of left and right intermediate mats 32a and 32b and left and right lower mats 33a and 33b, respectively. Since these are separated, each is individually installed on the gantry 2, and the upper mat 31 is a fixed area, so that it is fixedly installed as a whole, but the intermediate mat 32 and the lower mat 33. Since this is a movable region, a part of it is installed on a gantry.

  Explaining in detail how the intermediate mat 32 and the lower mat 33 are installed, the intermediate mat 32 can be rotated at its end edge (sometimes referred to as the upper edge) in the vicinity of the upper mat 31. While being connected to the gantry 2 in a state, an end edge in a position close to the lower mat 33 (sometimes referred to as a lower edge) is rotatably connected to an end edge of the lower mat 33. As for the lower mat 33, an end edge in a position close to the intermediate mat 32 (which may be referred to as an upper edge) is connected to the lower edge of the intermediate mat 32 as described above, and the opposite edge thereof. (This may be referred to as a lower edge) is connected to the gantry 2 in a rotatable state. The lower edge of the lower mat 33 is connected to the vertical frames 21 and 22 of the gantry 2 and is slidable along the longitudinal direction of the vertical frames 21 and 22.

  These mats 31, 32, and 33 are called mats, but are not made of a flexible material as a whole, and are firmly fixed to the gantry 2 and support the weight of the patient. In addition, a plate-like member such as wood is provided on the back surface side, and a flexible material is laminated on the surface side of the plate-like member.

  Here, the drive means 4 for moving the intermediate mat 32 and the lower mat 33 will be described in detail. As described above, the driving means 4 is attached to the gantry 2 and is exclusively installed in a region formed between the vertical frames 21 and 22.

  FIG. 2 is a diagram showing a state in which the gantry 2 is attached to the base 1 (excluding the mat portion 3). As shown in this figure, the driving means 4 is provided at a position outside the region where the hydraulic cylinder 11 of the base 1 operates, and provides a driving force independently of the hydraulic cylinder 11. ing. The configuration of the driving means 4 generally includes a servo motor 41, a transmission unit 42, a rotating body 43, and a link unit 44. The servo motor 41 is rotationally driven in a forward and reverse direction to a predetermined rotational angle at a predetermined rotational speed based on a control signal from the control device, and the transmission unit 42 includes two types of bevel gears 45 and 46. By doing so, the rotational driving force of the servo motor 41 is transmitted while changing the rotational direction. At the time of this transmission, the number of teeth of the two types of bevel gears 45 and 46 is made different to function as a speed reducer.

  In this embodiment, the rotating body 43 is constituted by a pulley, and is rotatable by interposing a timing belt 48 between the rotating body 43 and a small-diameter pulley 47 that is rotated by the rotating force of the output bevel gear 46. Also here, the deceleration function is exhibited by making the outer diameters of the small-diameter pulley 47 and the rotating body 43 different. In this embodiment, an electromagnetic clutch 49 is interposed between the output-side bevel gear 46 and the small-diameter pulley. By interposing the electromagnetic clutch 49, the transmission state and the non-transmission state can be operated for the transmission of the rotational driving force supplied from the bevel gear 46 to the small-diameter pulley 47. That is, in the present embodiment, as shown in the figure, the two rotating bodies 43 are provided, and the driving force to the left and right sides (left and right intermediate mats 32a and 32b) can be provided. Thus, it is possible to selectively provide the driving force only to one of these. Incidentally, it is also possible to provide driving force to both the left and right simultaneously by setting both electromagnetic clutches 49 to the transmission state.

  The link portion 44 is configured by a link rod formed in a rod shape, and the base end side is connected to the vicinity of the outer peripheral edge of the rotating body 43. Accordingly, when the rotating body 43 rotates, the position of the base end of the link portion 44 changes, and the driving force is transmitted to the other end (tip). The front ends of the link portions 44 are connected to the back surfaces of the intermediate mats 32a and 32b in a rotatable state. As described above, the upper edges of the intermediate mats 32a and 32b can be rotated to the base 2. Since they are connected, a link mechanism is formed together with the intermediate mats 32a and 32b. As a result, the link portion 44 is driven in the forward / backward direction while swinging.

  Although not shown, the driving means 4 having the above-described configuration is supported by the gantry 2 at several locations, and the driving means 4 is provided integrally with the gantry 2. In addition, as a part thereof, the vertical frames 21 and 22 of the gantry 2 are provided with bearing portions 28 so that the pivot of the rotating body 43 can be supported.

  With the configuration as described above, by installing the mat portion 3 on the gantry 2, standing training can be performed while the patient is placed on the surface of the mat portion 3. FIG. 3A shows a state in which the mat portion 3 is installed on the gantry 2. As shown in this figure, the mat portion 3 is separated into five mats 31, 32a, 32b, 33a, 33b. Although a slight gap is formed between them, the single mat portion 3 as a whole is formed. As shown in FIG. When the patient rides on the surface of the mat portion 3, the upper body is supported by the upper mat 31 and the lower body is supported by the intermediate mats 32a and 32b and the lower mats 33a and 33b. The intermediate mats 32a and 32b and the lower mats 33a and 33b can be appropriately provided with a fixing belt 30 for fixing the patient's upper or lower thighs. Although the figure shows a state in which the fixing belt 30 is installed only on the right intermediate mat 32b and the lower mat 33b, it can be similarly installed on the left side. Further, the fixing belt 30 illustrated in the figure is constituted by a band-like body separated on both sides, and can be made continuous by providing a hook-and-loop fastener or the like at both ends. Further, the footrests 5 and 6 installed on the gantry 2 are positioned in the vicinity of the lower edges of the lower mats 33a and 33b in the state where the mat unit 3 is installed, The soles are positioned near the footrests 5 and 6. This prevents the patient from slipping down when the gantry 2 is tilted to assume a standing posture. In addition, you may comprise the position of this footrest part 5 and 6 so that a position can be adjusted according to a patient's height.

  Then, by operating the driving means 4 described above, the angles of the surfaces of the intermediate mats 32a and 32b and the lower mats 33a and 33b are changed. This state is shown in FIG. FIG. 3B shows a state in which the same driving force is transmitted to the left and right intermediate mats 32a and 32b. As shown in this figure, the intermediate mats 32a and 32b are rotated, and the lower edges thereof are moved away from the gantry 2 (the direction in which the mat portion 3 is raised in the horizontal state). With the rotation of the intermediate mats 32a and 32b, the upper edges of the lower mats 33a and 33b are pulled up by the lower edges of the intermediate mats 32a and 32b and the lower edges of the lower mats 33a and 33b are raised to the vertical frame 21. , 22 is slid to cope with the change in the linear distance accompanying the change in angle. By this series of operations, the surfaces of the intermediate mats 32a and 32b and the lower mats 33a and 33b are bent into chevron shapes (in a state of protruding to the surface side).

  It is also possible to rotate only one of the left and right intermediate mats 32a and 32b by operating the transmission state (electromagnetic clutch 49) by the driving means 4. This case is shown in FIG. 4A shows a state in which the driving force is transmitted only to the left intermediate mat 32a and the state is rotated, and FIG. 4B shows only the right intermediate mat 32b rotated. Indicates the state. As shown in these drawings, only the intermediate mat 32a (or 32b) on the side to which the driving force is transmitted rotates, so that the surface becomes a mountain shape together with the lower mat 33a (or 33b) associated therewith. Bends. In this way, the surfaces of the left and right 32a, 33a (or 32b, 33b) can be selectively bent into a mountain shape, so that it is also possible to operate to change the left and right periodically (periodically). .

  The rotation of the intermediate mats 32a and 32b is such that the driving force is transmitted by the rotation of the driving means 4 in the forward rotation direction. However, when restoring the original state, the driving means 4 moves in the reverse rotation direction. This is done by rotating. Therefore, in principle, the operation of the transmission state of the driving force (the electromagnetic clutch 49) is performed when the reverse rotation is restored after the normal rotation. At that time, by using the fixing belt 30 (see FIG. 3 (a)), the patient's legs (upper and lower legs) can move at a speed according to the bent state of the intermediate mats 32a and 32b and the lower mats 33a and 33b. It is induced to bend and stretch by, for example.

  Next, an overall operation mode of the tilt table will be described. The tilt table is mainly intended to maintain a standing posture for a patient who is to perform a standing training, and can naturally be changed until the surface of the mat portion 3 is in a vertical direction. is there. This state is shown in FIG. FIG. 5 (a) shows a case where the posture is horizontal, and FIG. 5 (b) shows a state where the vehicle gradually tilts and reaches a standing posture.

  The posture change (tilted state) can be performed by extending the hydraulic cylinder 11 by a driving device (hydraulic device) built in the base 1. Therefore, by retracting the hydraulic cylinder 11, the standing posture can be returned to the water posture again. That is, since the gantry 2 rotates around the shaft portion 26 supported by the support portions 14 and 15 of the base portion 1 due to the expansion and contraction of the hydraulic cylinder 11, the gantry 2 depends on the length of the hydraulic cylinder 11. The rotation angle is determined, and the tilting state can be changed as appropriate. Further, since the armrests 7 and 8 are supported by the gantry 2 via the shaft portion 70, the distal ends 71 and 81 of the armrests 7 and 8 are rotated by rotating around the shaft portion 70 of the armrests 7 and 8 in the standing posture. (FIG. 1) can be moved forward of the patient's chest. Although illustration is omitted, in order to fix the armrests 7 and 8 at predetermined positions, the shaft portion 70 and the armrests 7 and 8 can be fixed by fixing screws.

  Moreover, since the footrest parts 5 and 6 are being fixed to the mount frame 2, the position and angle change as the mount frame 2 tilts. The footrests 5 and 6 are made of a substantially plate-like member having a rectangular surface, and the surface is arranged toward the mat portion 3 side. A state in which one side (plate-like edge) of the rectangular surface protrudes greatly in the orthogonal direction from the surface of the mat portion 3, and the patient's sole riding on the mat portion in a supine position can contact the rectangular surface. It can be moved with the gantry 2 while maintaining. Since the footrests 5 and 6 are fixed in the vicinity of the shaft portion 26 and are installed outside the frame 2 with respect to the shaft portion 26, when the frame 2 is in a horizontal posture, Although it is located at the same height, when changing to the standing posture, it is rotated downward about the shaft portion 26, and in the standing posture state, it can be moved to a sufficiently low position. It can be done. In the standing posture, the patient stands on the rectangular surface of the footrests 5 and 6, so that the position is lowered to relieve the patient's anxiety.

  Next, the movable state of the intermediate mat 32 and the lower mat 33 will be described in detail with reference to FIG. Transmission of the driving force for movement is as described above, and the driving force is transmitted to the intermediate mat 32 by the driving means, and both mats 32 and 33 are bent by this driving force. Therefore, the intermediate mat 32 is connected in a rotatable state by interposing connecting means such as a hinge 91 between the back surface on the upper edge side and the upper surface of the gantry 2. Thus, by fixing the upper end side of the intermediate mat 32 to the gantry 2, the intermediate mat 32 can be rotated relative to the gantry 2. The direction of rotation is centered on the straight edge on the upper edge side when the surface of the intermediate mat 32 is rectangular, and the center line is the longitudinal direction of the gantry 2 (longitudinal direction of the vertical frame). By making the direction perpendicular to the vertical direction, the lower edge can be raised with the upper edge as a fulcrum when the gantry 2 is horizontal. In addition, when the hinge 91 is used, there is one in which the surface of the intermediate mat 32 and the surface of the upper mat 31 can be rotated in a direction in which both surfaces are angular from the state where the surfaces of the intermediate mat 32 and the surface of the upper mat 31 are substantially the same plane. used.

  Further, the lower edge side of the intermediate mat 32 and the upper edge side of the lower mat 33 are connected. This connection can be brought into a rotatable state by interposing connection means such as a hinge 92. Since the connecting means is such that only the mats 32 and 33 to be connected are connected to the gantry 2, the lower edge rises when the intermediate mat 32 rotates (when the gantry 2 is leveled). With the rise), the upper edge of the lower mat 33 is raised at the same time. On the other hand, since the lower edge of the lower mat 33 is connected to the gantry 2, the lower edge is positioned on the surface of the gantry 2 by raising the upper edge. Will incline to the opposite side of the intermediate mat 32. Further, since the lower edge side of the lower mat 33 is slidable with respect to the gantry 2, the distance from the upper edge end of the intermediate mat 32 to the lower edge edge of the lower mat when the intermediate mat 32 rotates. The lower edge of the lower mat 33 slides in response to the change in.

  A slider-type connector 93 can be interposed in the slidable connection as described above. A general slider-type connector includes a long main body having a substantially C-shaped cross section, a sliding part that can slide along the longitudinal direction inside the main body, and a part of the sliding part. And a protruding portion that protrudes from the main body portion. By connecting the main body portion of the slider-type connector and the protruding portion of the sliding portion to different members, both members can be connected in a state where the sliding portion can move only in the longitudinal direction of the main body portion. It is. In the present embodiment, the main body is fixed to the gantry 2 so that the sliding direction of the sliding portion in the slider-type connecting portion 93 is the longitudinal direction of the gantry 2 (longitudinal direction of the vertical frame). Then, by connecting the lower edge of the lower mat 33 to the projecting portion of the sliding portion, the lower edge can be slid. Since the lower edge of the lower mat 33 rotates with respect to the sliding portion when the lower mat 33 is inclined, in this embodiment, the lower mat 33 has a protruding portion and a lower mat 33 below. A rotating shaft is interposed between the edge and the edge so as to be rotatable. This rotation can also be rotated around the rotation axis of the hinge by using a hinge or the like.

  In FIG. 6, a gap is shown between the gantry 2 and the mat portion 3, but this is for easy understanding of the connected state of each portion, and the mat portion 3 is supported by the gantry 2. As can be done, a reinforcing member or the like is provided at an appropriate portion of the gap portion. In addition, when maintaining the gantry 2 in a horizontal state, in order to disperse and support the weight acting on the upper mat 31, the upper surface portion of the base portion 1 is raised, or the support portion is erected from the base portion 1. These may be configured to contact the back side of the gantry 2.

  Since the present embodiment operates as described above, the surfaces of the upper mat 31, the intermediate mat 32, and the lower mat 33 are the same when the gantry 2 is in a horizontal state (FIG. 6A). It is a horizontal plane. At this time, the distance L1 from the upper edge of the intermediate mat 32 to the lower edge of the lower mat 33 is in the most distant state. From this state, by slightly rotating the intermediate mat 32 (FIG. 6A), the lower edge of the lower mat 32 and the upper edge of the lower mat 33 rise together and become higher than the surface of the upper mat 31. The surfaces of both mats 32 and 33 are bent in a mountain shape. At this time, the lower edge of the lower mat 33 slides, and the distance H2 from the upper edge of the intermediate mat 32 to the lower edge of the lower mat 33 becomes shorter with the rotation. Further, when the intermediate mat 32 is rotated (FIG. 6C), the lower edge of the lower mat 32 and the upper edge of the lower mat 33 are further raised, and are formed by the surfaces of the mats 32 and 33. The slope of Yamagata becomes larger. Even in this case, since the lower edge of the lower mat 33 slides, the distance H3 from the upper edge of the intermediate mat 32 to the lower edge of the lower mat 33 is further shortened. By such bending of the mat portion 3, the position of the knee of the patient who rides on the mat portion 3 in the supine position is lifted high, and the hip joint and the knee joint are bent.

  In addition, as shown in FIG. 7, even when the gantry 2 is tilted, the joint of the patient's lower leg can be bent and stretched by bending the intermediate mat 32 and the lower mat 33 in a mountain shape. That is, as described above, the gantry 2 can change the surface of the mat portion 3 in a range from a horizontal state to a vertical state by driving the hydraulic cylinder 11 back and forth. It can be stably stopped in a state where the whole is inclined (FIG. 7A) or in a standing posture state (FIG. 7B). Therefore, by operating the drive device in such a tilted state or a vertical state, it is possible to induce flexion / extension motion of the lower leg. In addition, since the drive device is provided integrally with the gantry 2, even when the angle of the gantry 2 (the angle of the surface of the mat portion 3) is changed, the driving device moves with them.

  As described above, according to the first embodiment of the present invention, in the case of the operation in the horizontal posture (see FIG. 6C), before the full-scale standing training is performed (the gantry 2 is set to the standing posture). At this stage, the hip and knee joints can bend and stretch in a horizontal posture, and the preliminary movement can be carried out on the tilt table. Further, as described above, the left and right joints can be individually moved by separating the intermediate mat 32 and the lower mat 33 to the left and right and rotating them individually. Thereby, the preliminary exercise | movement of a leg on either side can be implemented alternately. In addition, when only one of the exercises is necessary, for example, when there is a need to injure only one leg and rehabilitation only for that leg, the flexion / extension exercise can be performed only for one leg.

  Further, since a servo motor is used as a drive source, the rotation speed, rotation angle, rotation direction, start timing, and the like can be controlled. By controlling the rotation speed, the bending speed of the joint can be adjusted, and by controlling the rotation angle, the size when bending the joint can be adjusted. Also, by controlling the rotation direction, the forward and reverse rotation directions can be changed, the driving force can be applied to the deformation and restoration of the mat portion, and the joint can bend and stretch smoothly with the speed adjusted. Can exercise. Then, by controlling the start timing, it is possible to adjust the stop time and stop time in a state where the joint is bent, and to enable intermittent bending and stretching movements. In order to control the rotation speed and the rotation angle to a desired state, an encoder may be provided on the output side of the rotating body 43 and the like, and feedback control may be performed so as to achieve a set speed or angle. Further, it is possible to adopt a configuration in which a counter is provided in order to control the number of bending and stretching.

  Furthermore, in a state in which the gantry 2 is tilted (see FIGS. 7A and 7B), a movement similar to walking is enabled for a patient who cannot get out of bed in order to enable the same operation as walking. Is. That is, when one leg is bent, the sole of the leg is lifted from the footrests 5 and 6, and the bottom of the other leg is stepped on the footrests 5 and 6, with the center of gravity on the leg side. Can be guided to move. FIG. 7 shows a state in which the knee joint is bent, but this shows a bent leg, and a not-illustrated leg is extended.

  In this way, since the mat portion 3 guides the legs so that each leg bends and stretches while the gantry 2 is tilted, the patient supports the weight with the left and right alternate legs. The weight will be transferred. By such a training, a load due to weight shift can be applied to the lower leg, so that the blood flow velocity of the lower leg vein can be increased and the effect of preventing deep vein thrombosis can also be obtained. Further, such training can be easily performed even by a patient before walking training (rehabilitation) by getting out of bed, and the inclination angle of the gantry 2 (mat portion 3) is gradually brought closer to a vertical state. As a result, the patient can exercise the lower leg and prevent deep vein thrombosis while gradually getting used to the standing posture.

  Next, a second embodiment of the present invention will be described with reference to FIG. In the present embodiment, the configuration of the footrests 5 and 6 of the first embodiment is modified. FIG. 8 shows a case where the gantry 2 is in a horizontal state. FIG. 8A shows a state before the intermediate mat 32 and the lower mat 33 are bent, and FIG. The lower mat 33 is slightly bent, and FIG. 8C shows a state where the lower mat 33 is bent greatly. As shown in these drawings, the footrest portion 105 of this embodiment includes a footrest base portion 151 fixed to the gantry 2 and a foot that swings while sliding on the surface of the footrest base portion 151. A bottom abutting portion 152 is provided. The footrest base portion 151 is basically the same as the footrest portion of the first embodiment, but the bottom abutment portion 152 is disposed on the surface side (the bottom abutment side). 33 is provided with an appropriate gap between the two. Further, since the sole contact portion 152 is in sliding contact with the surface, a smooth flat surface is formed.

  The sole contact portion 152 is composed of a plate-like main body portion 150 having a front surface portion 150a having a sufficient area that allows contact with the sole of the patient, and the back surface portion 150b includes a footrest base portion 151. A rolling element 153 for assisting sliding contact with the surface is provided. This rolling element 153 rolls on the surface of the footrest base portion 151, thereby smoothing the sliding contact of the sole contact portion 152. The rolling element 153 is provided in the vicinity of the tip 150c of the main body 150, and when the main body 150 is inclined with respect to the surface of the footrest base 151, at least the rolling element 153 is at the footrest base. 151 can be brought into contact.

  Further, the rear end 150 d of the main body 150 of the sole contact portion 152 is connected to the lower edge of the lower mat 33 in a rotatable state. In order to connect in a rotatable manner, a connecting member such as a hinge 154 can be interposed between them. The rear end 150d of the main body 150 is pivotally connected to the lower edge of the lower mat 33, so that when the lower mat 33 moves, the rear end 150d of the main body 150 moves accordingly. Thus, the sole contact portion 152 can be inclined with respect to the footrest base portion 151.

  That is, in a state where the mat portion 3 is not changed in the horizontal posture (FIG. 8A), the lower edge of the lower mat 33 is closest to the footrest portion 105. The main body portion 150 of the contact portion 152 is parallel to the footrest base portion 151 (the surface 150a of the main body portion 150 is parallel to the surface of the footrest base portion 151), which is the same as the footrest portion of the first embodiment. It has the same configuration. On the other hand, when the mat portion 3 is changed (FIGS. 8B and 8C), the lower edge of the lower mat 33 slides toward the center of rotation of the intermediate mat 32. The rear end 150d of the main body 150 of the portion 152 is also moved. At this time, the rolling element 153 provided on the back surface 105b close to the tip 150c rolls on the surface of the footrest base portion 151, so that the position of the tip 150c of the main body portion 150 fluctuates. This is because the contact portion 152 is inclined.

  Note that, to the extent that the lower mat 33 is slightly changed (FIG. 8B), the angle between the surface of the lower mat 33 and the surface 150a of the sole contact portion 152 does not change significantly, but the lower mat 33 changes greatly. In such a case (FIG. 8C), the angle formed by the surface of the lower mat 33 and the surface 150a of the sole contact portion 152 changes greatly so as to be an obtuse angle.

  According to the second embodiment having the above configuration, when the mat portion 3 is changed for bending and stretching of the knee joint or the like, the sole contact portion 152 is tilted with the change of the lower mat 33, so that the patient Enables bending and stretching in a state where the sole is in contact with the sole contacting portion 152, and flexing and stretching the ankle joint by changing the state of the sole according to the change in the sole contacting portion 152. It is also possible to make it. Since the ankle joint is bent and stretched, the contraction of the triceps surae muscle is induced, so that the patient can perform an effective exercise for preventing deep vein thrombosis.

  Such an operation of the sole contact portion 152 has a significant effect on the patient's movement in a standing posture or a state close thereto. That is, as shown in FIG. 9, a patient in a standing posture supports the weight by the sole, so that the angle of the sole abutting portion 152 changes, so that the ankle joint is inevitably bent. Be guided to. And by alternately bending and stretching the left and right legs, weight shift is induced alternately, so that the legs on the extended side are subjected to weight load, and the ankle joint is changed on the bent leg It is guided. By inducing the flexion and extension of each joint of the lower leg, including the ankle joint, it is possible to perform exercises that more closely resemble the actual walking state, and further increase the preventive effect of deep vein thrombosis. It becomes. 9A shows a state in which the entire mat portion 3 is inclined, and FIG. 9B shows a state in a standing posture.

  In the figure, only one footrest portion 105 is shown, but it is provided at two right and left positions as in the first embodiment, and the patient places the left and right soles on the sole contact portion 132. It can be made to contact individually. As a result, when the left and right legs are individually exercised, the ankle joint can be bent and extended during the bending and extending movement of the legs.

  Moreover, it is good also as a structure which provides a fixing belt in the sole contact part 152 so that a joint of a patient's ankle can bend and stretch in conjunction with the surface of the sole contact part 152. FIG. Further, the tip 150c of the main body 150 of the sole contact portion 152 is urged toward the footrest base so that the sole contact portion 152 can reliably slide on the surface of the footrest base portion 151. Alternatively, a rail that restricts the position of the rotating shaft that moves with the rolling of the rolling element 153 may be provided.

  Next, a third embodiment of the present invention will be described with reference to FIG. In the present embodiment, as shown in FIG. 10, a driving force for moving the mat portion 3 is obtained by an actuator 104. The actuator 104 drives the output unit 141 so that the output unit 141 can advance and retract in a linear direction. In addition, the actuator 104 is fixed to the vertical frames 21 and 22, and the advancing and retreating direction is the longitudinal direction of the vertical frames 21 and 22. Then, by connecting the tip of the output portion 141 of the actuator 104 to the lower edge of the lower mat 33, the intermediate mat 32 and the lower mat 33 can be bent by forcibly sliding the lower edge. . As described above, the bending of the intermediate mat 32 and the lower mat 33 is accompanied by the slide of the lower edge of the lower mat 33. Accordingly, the intermediate mat 32 and the lower mat 33 are bent. A bracket 142 for connecting the lower edge of the lower mat 33 is provided at the tip of the output portion 141. Since it is connected to the lower mat 33 so as to be rotatable, a connecting tool such as a hinge can be interposed between the bracket 142 and the lower edge of the lower mat 33.

  Since the actuator 104 having a general structure is used, a motor and a pinion are built in the main body, and the base of the output unit 141 is in a rack shape inside the main body. Accordingly, the rotational force of the motor advances and retracts the rack-like base portion via the pinion, and the output portion 141 is driven in the forward and backward direction by the advance and retreat. Then, by controlling the rotational speed, rotational speed, etc. of the motor built in the main body, the advance / retreat distance and the new other speed of the output unit 141 are adjusted, whereby the intermediate mat is adjusted while adjusting the speed, angle, etc. 32 and the lower mat 33 can be rotated. In addition, the control apparatus for controlling an actuator is provided in the inside of the base 1, and can be input with an operation part. Further, the conditions to be controlled are not limited to the speed and the like, and can include the timing of advance / retreat driving, stop time, and the like.

  Next, a fourth embodiment of the present invention will be described with reference to FIG. In the present embodiment, as shown in FIG. 11, the mat portion 3 is laminated on the surface of the lower layer bed 203 fixed to the surface side of the gantry 202. The driving device 4 or the actuator 104 for driving the mat portion 3 is provided on the gantry 202 as in the first or third embodiment. This embodiment is a mode in the case where an existing tilt table is exclusively used, and the lower layer bed 203 originally functions as a bed for carrying a patient, and the patient is placed in a horizontal posture by the operation of the gantry 202. The angle can be changed within a range from the standing posture to the standing posture. In the present embodiment, the upper mat 31 is fixed in a state of being laminated on the surface of the lower layer bed 203, and the intermediate mat 32 and the lower mat 33 are installed in a rotatable state. The upper edge of the intermediate mat 32 is rotatably connected to the surface of the lower layer bed 203, or is connected to the gantry 202 through the lower layer bed 203 or using the side of the lower layer bed 203. It is what is done. The lower edge of the lower mat 33 is slidably connected to the surface of the lower bed 203 or is connected to the gantry 202 using the side of the lower bed 203. is there. When the actuator 104 is used as the driving device (FIG. 10), a method of coupling with the gantry 202 is selected.

  When the intermediate mat 32 is driven by the driving device 4 using a servo motor (FIG. 2), the link portion 44 is provided so that the link portion 44 provided on the rotating body 43 can be connected to the intermediate mat 32. It can be set as the structure provided so that the lower layer bed 203 may be penetrated. In this case, a through hole is provided in the lower layer bed 203 in a range where the link portion 44 swings. In addition, when it is difficult to process the lower layer bed 203, the rotating body 43 and the link portion 44 are arranged in a state of protruding to the side of the lower layer bed 203, and are connected to the intermediate mat 32 from the side. It may be configured.

  Although the embodiments of the present invention are as described above, these are merely examples, and the present invention is not limited to the above-described embodiments. Accordingly, the second embodiment and the third embodiment are different from each other, but the configuration of the footrest 105 shown in the second embodiment is adopted in the third embodiment. It is good. Furthermore, in any case, as shown in the fourth embodiment, the mat portion 3 may be laminated on the surface of the lower layer bed 203. In addition, each configuration shown in the embodiment can be modified. That is, although the hinge was illustrated as a member for connecting in the state which can be rotated, it is not limited to this. For example, the connection between the gantry 2 and the intermediate mat 32 may be configured such that the pivot shaft of the gantry 2 is provided, and the intermediate mat 32 is provided with a cylindrical portion, and the cylindrical portion is inserted into the rotation shaft. It's good. The same applies to the connection in other rotatable states.

  Moreover, it is good also as a structure which adds another structural member to the said embodiment. FIG. 12 shows a modification thereof. In this modification, in the first embodiment, the saddle portion 310 is provided so as to be able to appear and retract from a part of the intermediate mat 32. A column 311 fixed to the horizontal frames 321 and 322 of the gantry 320 is provided, and the saddle portion 310 is provided in a rotatable state at the tip of the column 311. Further, in order to make the saddle portion 310 appear on the surface of the mat portion 303, a third intermediate mat (intermediate mat for the intermediate region) 330 is provided in a boundary region where the left and right intermediate mats 332a and 332b are adjacent to each other. It has been. The third intermediate mat 330 is separated from the left and right intermediate mats 332a and 332b, and the third intermediate mat 330 is detachable. Therefore, by removing the third intermediate mat 330, the area can be communicated with the back side of the mat portion 303. By rotating the saddle portion 310 provided on the gantry 320 in an appropriate direction from the region communicated in this manner, it can appear on the surface of the mat portion 303.

  The saddle portion 310 is used for urgent seating so that a patient in a standing posture does not fall from the tilt table due to weakness or the like. Therefore, when it is in a horizontal posture, it is kept in a state of being immersed in the pedestal 320, and the third intermediate mat 330 is mounted in a predetermined area.

  Then, as shown in FIG. 13, when the gantry 303 is rotated to the standing posture, the third intermediate mat 330 is removed and the saddle portion 310 is filed. If the patient has advanced standing training and there is no possibility of weakness in the standing posture, the saddle portion 310 can be used even in the standing posture without appearing.

  As for the armrests 7 and 8, as shown in FIG. 14A, armrests 407 and 408 having auxiliary tables 470 and 480 in the vicinity of the tip may be used. As described above, the auxiliary tables 470 and 480 having an appropriate area are installed on the armrests 407 and 408, so that arms and elbows are supported in a wide range, and the upper body of the patient in a standing posture as shown in the figure. Can be stabilized. Since the auxiliary tables 470 and 480 are for supporting the weight of the patient, it is preferable that at least the surface side be made of a flexible material in order to obtain a buffering effect on the arms and elbows. For example, the base fixed to the rest arms 407 and 408 may be made of a strong material such as a wooden plywood or a metal plate, and a flexible material such as leather or synthetic resin may be laminated thereon. it can. In the case of the laminated structure as described above, a sponge or the like may be used between the two materials for buffering effect.

  Furthermore, as shown in FIG.14 (b), the front-end | tip of armrest 407,408 may be bent and the grip parts 471,481 may be comprised. As described above, since the grip portions 471 and 481 are present at the tips of the armrests 407 and 408, the patient can hold the grip portions 471 and 481 by hand with the arms and elbows placed on the auxiliary tables 470 and 480. Therefore, even when the standing posture is relatively unstable, the body can be supported by the arm strength. In addition, the patient may feel anxious about the change in body posture when the angle changes from the horizontal posture to the standing posture, and the grip portions 471 and 481 can be gripped to obtain a psychological sense of security.

  The grip portions 471 and 481 are configured by being bent in a horned shape with respect to the axial direction of the armrests 407 and 408, but a covering member such as a synthetic resin may be provided on the surface thereof. The bending angle of the grip portions 471 and 481 may be orthogonal to the axial direction of the armrests 407 and 408, but in an acute angle direction with respect to the axial direction so that the patient can easily grasp the grip ( It is preferred to bend (for example at an angle of 60 °). Moreover, the bending in the acute angle direction may be such that the gap gradually decreases from the bent portion to the tip when the tips are opposed to each other as shown in the figure. Alternatively, the direction away from the surface of the mat portion 3 may be used. Furthermore, both of the above may be combined, and the front end portion may be bent in such a direction as to gradually reduce the gap and gradually move away from the surface of the mat portion 3. Then, if the grip portions 471 and 481 including the bent portions are formed of members different from the armrests 407 and 408, and the grip portions 471 and 481 can be rotated around the axis of the armrests 407 and 408, the bent portions are formed. It can be set as the structure which can change a direction suitably.

  In addition to the above-described modifications, various additional elements can be added. That is, since the mat portion 3 is configured to be separated into the respective mats, an appropriate gap is formed at the opposing edge, and therefore a member that closes the gap portion may be provided. Good. For example, there is a configuration in which a cushioning member made of a flexible material is inserted into the gap portion, or a configuration in which a surface between adjacent edges is continuously covered with a stretchable fabric. This is to prevent the patient's skin and the like from being pinched because the size of the gap formed between the edges changes when the intermediate mat 32 and the lower mat 33 are bent. In addition, since it is not assumed that a patient's skin is pinched | interposed by making the said gap | interval sufficiently large beforehand, the aspect which does not provide the member which should be covered may be sufficient.

DESCRIPTION OF SYMBOLS 1 Base part 2,220 Base 3,203 Mat part 4 Drive means 5,6 Footrest part 7,8,407,408 Armrest 11 Hydraulic cylinder 12,13 Operation part 14,15 Support part 21,22 Vertical frame 23,24, 25 Horizontal frame 26 Shaft portion 27 Connecting portion 30 Fixed belt 31 Upper mat 32, 32a, 32b, 332a, 332b Intermediate mat 33, 33b, 33c Lower mat 41 Servo motor 42 Transmission portion 43 Rotating body 44 Link portion 45, 46 Bevel gear 47 Small-diameter pulley 48 Timing belt 49 Electromagnetic clutch 70 Shaft portion 71, 81 Armrest tip 91, 92 Hinge 93 Slider type connector 104 Actuator 141 Output portion 142 Bracket 150 Base portion 151 of foot contact portion Foot rest base portion 152 Foot sole Abutting portion 310 Saddle portion 311 Posts 321, 32 2 Horizontal frame 330 Third intermediate mat (intermediate area intermediate mat)
470, 480 Auxiliary table 471, 481 Grip part

Claims (13)

A mat portion having a sufficient area on which the patient can be placed on the front surface side, a gantry that supports the mat portion on the back surface side, and a drive unit that pivotally supports the base end side of the gantry and tilts the gantry In a tilt base that includes a base having a base and a footrest provided on a base end side of the gantry, and the gantry is capable of posture change in a range from a horizontal posture to a standing posture .
The mat part is separated into an upper mat on which the patient's upper body is placed, an intermediate mat on which the patient's upper leg is placed, and a lower mat on which the patient's lower leg is placed,
The upper mat is fixed to a pedestal, and the intermediate mat is rotatably supported by an end of the upper mat or the pedestal at a position close to the upper mat. In a position close to the intermediate mat, it is connected to the intermediate mat in a rotatable state, and the opposite side is supported in a slidable state on the gantry,
The gantry includes driving means for driving either the intermediate mat or the lower mat so that the surface formed by the intermediate mat and the lower mat is bent toward the surface of the mat portion. Has been
The footrest portion includes a plate-like footrest base portion fixed to the gantry, and a foot contact portion that is in sliding contact with the surface of the foot rest base portion and contacts the patient's foot sole, The sole contact portion is connected to the lower mat so as to be rotatable at a position close to the lower mat, and is inclined with respect to the footrest base portion as the lower mat moves. A tilt base that is provided as possible . The sole contact portion is configured by a plate-like main body portion having a surface portion on which a patient's sole can come into contact, and a rolling element that rolls on the surface of the footrest base portion is provided on the back surface of the main body portion. The tilt table according to claim 1, wherein the tilt table is provided .   The driving means drives the intermediate mat so as to be able to advance and retreat from the pedestal so as to rotate about a portion supported by the pedestal. The rotating body according to claim 1 or 2, further comprising: a rotating body that rotates in a direction; and a link portion having one end connected to the rotating body and the other end moving in a forward / backward direction according to the rotation of the rotating body. Tilt stand. The mat portion is composed of a mat portion having a sufficient area on which the patient can be placed on the front surface side, at least two vertical frames arranged at appropriate intervals, and a plurality of horizontal frames interposed therebetween. A base that supports the base on the back side, a base that pivotally supports the base end side of the base and has a drive unit for tilting the base, and a footrest provided on the base end side of the base comprising, in tilt stand that capable posture change in the range of up to standing position the gantry from the horizontal position,
The mat part is separated into an upper mat on which the patient's upper body is placed, a left and right intermediate mat on which the patient's left and right upper legs are individually placed, and a left and right lower mat on which the patient's left and right lower legs are placed individually,
The upper mat is fixed to a pedestal, and the left and right intermediate mats are individually pivotally supported on the end of the upper mat or the pedestal at positions close to the upper mat, The left and right lower mats are individually connected to the intermediate mat at positions close to the intermediate mat so as to be individually rotatable, and opposite sides thereof are along the longitudinal direction of the vertical frame of the gantry. It is supported in a slidable state,
The gantry is provided with driving means for individually rotating the left and right intermediate mats, and can be bent so that the surface is raised by interlocking the rotation of the intermediate mat with the left and right lower mats. ,
The drive means is for driving the left and right intermediate mats in the advancing and retracting direction from the gantry, and a single servo motor, and a transmission unit for transmitting the rotational drive of the servo motor to the left and right, Two rotating bodies that are supported by bearings on the two vertical frames on the left and right sides of the transmission unit, and that rotate in the forward and reverse directions by the rotational driving force transmitted from the transmission unit on the left and right sides, and the rotation One end is connected to each of the bodies, and the other end is driven in the advancing / retreating direction with respect to the left and right sides of the intermediate mat according to the rotation of the rotating body, the transmission unit, and the rotating body And a tilt base , each having an electromagnetic clutch portion installed therebetween . The footrest portion includes a plate-like footrest base portion fixed to the gantry and two footrests that are slidably contacted with the surface of the footrest base portion and individually contact the left and right foot soles of the patient. A contact portion,
The sole contact portion is connected to the lower mat at a position close to the left and right lower mats in an independently pivotable state one by one, and as the lower mat moves, The tilt base according to claim 4, wherein the tilt base is tiltable with respect to the footrest base portion . The sole contact portion is configured by a plate-like main body portion having a surface portion on which a patient's sole can come into contact, and a rolling element that rolls on the surface of the footrest base portion is provided on the back surface of the main body portion. The tilt table according to claim 5 , wherein the tilt table is provided . Furthermore, the rotation angle and the rotation speed of the servo motor are controlled, and the stop time when the surface of the intermediate mat and the lower mat is bent and the stop time when the rotation in the forward and reverse directions is changed are controlled. The tilt base according to claim 4, further comprising a portion. The mat portion is composed of a mat portion having a sufficient area on which the patient can be placed on the front surface side, at least two vertical frames arranged at appropriate intervals, and a plurality of horizontal frames interposed therebetween. A base that supports the base on the back side, a base that pivotally supports the base end side of the base and has a drive unit for tilting the base, and a footrest provided on the base end side of the base Equipped with a tilt table that can change its posture in a range from a horizontal posture to a standing posture,
The mat part is separated into an upper mat on which the patient's upper body is placed, a left and right intermediate mat on which the patient's left and right upper legs are individually placed, and a left and right lower mat on which the patient's left and right lower legs are placed individually,
The upper mat is fixed to a pedestal, and the left and right intermediate mats are individually pivotally supported on the end of the upper mat or the pedestal at positions close to the upper mat, The left and right lower mats are individually connected to the intermediate mat at positions close to the intermediate mat so as to be individually rotatable, and opposite sides thereof are along the longitudinal direction of the vertical frame of the gantry. It is supported in a slidable state,
The gantry includes driving means for driving the slide side end portions of the left and right lower mats to advance and retreat, and can be bent so as to raise the surface in conjunction with the left and right intermediate mats.
The driving means is an actuator that is individually provided in the two vertical frames, and drives the slidable end of the lower mat so as to advance and retreat along the longitudinal direction of the vertical frame ,
The footrest portion includes a plate-like footrest base portion fixed to the gantry, and a foot contact portion that is in sliding contact with the surface of the foot rest base portion and contacts the patient's foot sole, The sole contact portion is connected to the lower mat so as to be rotatable at a position close to the lower mat, and is inclined with respect to the footrest base portion as the lower mat moves. A tilt base that is provided as possible .   9. The tilt table according to claim 8, further comprising a control unit that controls the timing of the advance / retreat drive of the actuator, the advance / retreat distance, and the advance / retreat speed, and that controls a stop time during forward or backward movement.   10. An appropriate range in which the left and right intermediate mats are adjacent to each other is defined as an intermediate region, and the intermediate mat in the intermediate region is detachable, and the intermediate region is provided with a retractable saddle portion. Tilt stand according to crab.   The frame further includes two rod-shaped armrests extending from both sides so that the armrests can be rotated with their tips facing each other, and include two auxiliary tables supported near the tips of the respective armrests. The tilt table according to any one of claims 1 to 10.   The tilt base according to claim 11, wherein the tip of the armrest is provided with a grip portion that is bent into a corner shape. The mat portion is provided in a state of being laminated on a surface of a lower layer bed fixed to the gantry, and the driving means penetrates the lower layer bed or removes the mat portion from a side surface of the lower layer bed. The tilt table according to any one of claims 1 to 12, which is driven to be bent.

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