RU2029535C1 - Device for active and passive exercises for humeral articulation - Google Patents

Abstract

FIELD: medical engineering. SUBSTANCE: this device includes base 1, upright 2 connected to base 1 and made adjustable for height, and curved rod 4 provided with handgrips 4 and 5. Upright 2 is T-shaped. Rotation mechanism is disposed in horizontal portion of T-shaped upright 2. Rod 4 is U-shaped. EFFECT: more sophisticated design. 4 dwg

Description

 The invention relates to medicine, namely to bending devices for therapeutic exercises.

 A device for the development of the shoulder joint (ed. St. N 923543, class A 61 H 1/02), which contains a housing articulated with a lever connected to the handle. The lever is made in the form of a gear rack turning into a threaded rod, on which a counterweight with a lock nut is mounted. At the junction of the handle with the lever, a slider and a sleeve with grooves are installed, a gear with a shaft, which is in mesh with the gear rack, is placed in the slider, and the shaft is equipped with a lock made in the form of a button with a spring and a finger in contact with the grooves and the sleeve.

 The disadvantage of this device is that rotation in the shoulder joint occurs with a straightened arm. This does not allow rotation at full amplitude, since rotation mainly occurs due to the wrist and elbow joints. The movement can only be carried out actively, which with muscle pain syndrome significantly reduces the amplitude of movement and the effectiveness of the training.

 The closest in technical essence to the proposed device is a device that includes a base with a coaxial seat mounted on it, a stand mounted on the base with the possibility of rotation around the vertical axis of the seat, an I-shaped bar pivotally mounted on the stand with the possibility of rotation, and a rotation angle indicator connected to a rack flexible connection.

 The disadvantage of this device is that the movements in the shoulder joint are carried out in a horizontal plane around a vertical axis. In this case, the physical load on all the muscles of the joint is dispersed and is not achieved by targeted training of the shoulder rotator muscles. Meanwhile, the training of these particular muscles is of paramount importance in the development of contractures of the shoulder joint.

 The aim of the invention is to increase the development efficiency by training shoulder rotator muscles.

 The goal is achieved by the fact that in the apparatus for active-passive development of the shoulder joint, containing a base associated with it with the possibility of height adjustment of the rack, a curved rod with handles installed in the upper part of the rack, and a rotation mechanism including a bearing, the rack has T- shaped, the rotation mechanism is located in its horizontal part and provides the ability to rotate a curved rod around its horizontal axis, and the rod has a U-shape and is configured to resize.

 Figure 1 shows a General view of the apparatus; figure 2 is a section aa in figure 1; figure 3 - section bb in figure 1; figure 4 is a section through a locking device.

 The proposed apparatus consists of a base 1, height-adjustable rack 2, a telescopic cross member 3, a rod 4 rigidly connected to it, a handle 5 for a brush (Fig. 3) and set screws 6 and 7.

 The height adjustment of the rack 2 is carried out by means of the set screw 6 (Fig. 4), and to prevent rotation, a guide key 9 is installed. A similar design of stepless length adjustment is also provided in the cross-member 3. The cross-member rotates in the pillar sliding bearing 8 (Fig. 2).

 The proposed device operates as follows.

 The patient sits on a chair with his back to the device. Stand 2, cross member 3 and handle 5 are set to the position according to the anthropometric dimensions of the patient and are secured with screws 6 and 7. The patient places the hand on the handle 5, while the forearm is installed along the rod 4 rigidly connected to the cross member 3, the patient begins to rotate. With this position of the forearm brushes, the elbow joint is excluded from rotational motion and targeted training of the shoulder rotator muscles is achieved. The pace and amplitude of movements are set by a healthy hand. The first phase of the movement - the maximum active movement is carried out with the affected hand, the healthy hand moves passively. The second phase of movement is passive movement in the affected joint with a healthy arm.

 Clinical example 1. Patient D., 43 years old (medical history N 239), was admitted for treatment to the interdistrict rehabilitation center on 02/01/90 with a diagnosis of osteochondrosis of the cervical spine, syndrome of bilateral humeroscapular periarthrosis, II st. Pain and restriction of movement in the shoulder joints bothered the patient for six months. From 12/30/89 to 01/27/90, the patient was treated in hospital No. 13 of the GAS medical unit (DAT, PHC, butadione) without effect.

On admission to rehabilitation center amplitude active movement in the shoulder joints was as follows: in the right shoulder joint - bending ^60, retraction 55 ^of, external rotation 10 ^a, internal rotation 15 ^a, the left shoulder joint - bending ^150, retraction of ^120, outer rotation 50 ^about , internal 60 ^about .

 The patient received treatment: electrophoresis of analginum, phonophoresis of hydrocortisone, massage, acupuncture, mechanotherapy, exercise therapy.

 Mechanotherapy included a lesson on the apparatus for active-passive development of the shoulder joint. Training was carried out at a slow pace, to pain. In the process of developing rotational movements, as the pain syndrome decreases, both the amplitude of the rotational movements and the number of exercises performed in one approach increased.

As a result of the treatment the time of discharge from ambulatory motion of the center in the left shoulder joint were normalized, and the right of the active bending amplitude was ^140, exhaust ^130, external rotation ^of 50, 70 ^of internal rotation.

 03.03.90, the treatment in the rehabilitation center was completed. The length of stay in the center was 31 days.

 Clinical example 2. Patient G., 30 years old (case history No. 526), was admitted for treatment to an inter-district rehabilitation center with a diagnosis of post-traumatic humeroscapular periarthrosis on the left, III tbsp. 01/26/90, the patient had an accident. From January 27 to February 20, 1990, he was treated at Hospital No. 13 with a diagnosis of concussion, a bruise of the chest on the left.

On admission to a rehabilitation center active movement in the left shoulder joint were moderately limited - bending ^115, 140 ^{of the} abduction, external rotation ^of 50, 35 ^{of the} inner. In addition, they limited and passive rotary motion of the shoulder joint: external rotation ^to 65 °, internal - up to ⁵⁰ °.

 The patient received treatment: dipyrone electrophoresis, electrical stimulation, novocaine blockade of the suprascapular and axillary nerves, exercise therapy, mechanotherapy. Classes on the apparatus of the active-passive development of the shoulder joint were initially performed for 2-3 minutes and included 2-3 exercises. Subsequently, the duration of classes increased to 15 minutes, and the number of exercises increased to 30.

As a result of the treatment the time of discharge from the amplitude center outpatient active bending was ^about 160, exhaust ^180, rotation of the outer ^80, inner - ^60. The amplitude of the passive internal rotation of the left shoulder joint was 75 ^about .

 03/17/90, the treatment in the rehabilitation center was completed. The length of stay in the center was 18 days.

 Using the apparatus for active and passive development of rotational movements in the shoulder joint in the treatment of shoulder-shoulder periarthritis allows gradually increasing the load and amplitude of movements, while pain is more easily overcome, shoulder rotator muscles are trained, shoulder joint contracture is developed, which allows to reduce the treatment time for patients 20-30%. The device was used in the rehabilitation treatment of 200 patients with humeroscapular periarthritis, injuries of the shoulder joint in the conditions of the interdistrict center for the rehabilitation of the medical unit of the PA GAZ automobile plant.

Claims (1)

 DEVICE FOR ACTIVE-PASSIVE DEVELOPMENT OF THE SHOULDER JOINT, containing a base, a stand connected with it with the possibility of height adjustment, a curved rod with handles mounted in the upper part of the stand, and a rotation mechanism including a bearing, characterized in that, in order to increase the development efficiency by training rotator muscles, the stand has a T-shape, the rotation mechanism is located in the horizontal part of the T-shaped stand and provides the ability to rotate a curved bar around its horizontal si, and the rod has a U-shape and is configured to resize.

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