RU2100995C1 - All-purpose training device for medical and social rehabilitation - Google Patents

Abstract

FIELD: medical engineering. SUBSTANCE: device has base made of two U-shaped frames rigidly connected to each other and mounted on four wheels provided with locking members. Arm rest and embracing unit are mounted on the base by means of uprights. The embracing unit is designed as corset or closed frame with soft seat. The members are interchangeable. The training unit allows some members to be detachable depending on medical and social rehabilitation method. The training unit is provided with removable tables usable for carrying out various social and domestic functions like taking meals, writing, reading, performing small-scale motility movements of hands and chair with elongated back having fixing belt and plastic vessel. EFFECT: wide range of applications. 9 cl, 12 dwg

Description

 The invention relates to medical equipment, namely to simulators for medical and social rehabilitation of disabled people, children and adult patients with impaired musculoskeletal system, as well as in the presence of cerebral pathology (cerebral palsy, multiple sclerosis, childhood encephalopathies, post-stroke conditions, consequences of craniocerebral injuries).

Known simulator for rehabilitation, containing a base in the form of a frame with four swivel wheels, vertical struts, covering mechanism, soft seat [1]
The disadvantages of the known simulator include the impossibility of solving problems of a purely social nature: the impossibility of providing self-care, which consists in eating, sending out natural needs, and learning; lack of normal conditions in the simulator for relaxation. The known simulator cannot provide a normal physiological position when sitting, standing, walking. The closest analogue of the proposed universal simulator for medical and social rehabilitation is a universal simulator containing a base made in the form of two U-shaped frames rigidly interconnected and mounted on four swivel wheels with stops, armrests and a covering mechanism mounted on guides located on base, seat and table [2]
The known simulator has disadvantages associated with the fact that it is not functional enough and does not allow for the development of the correct individual gait, balance training when standing, sitting and walking, fine motor skills.

The proposed universal simulator for medical and social rehabilitation eliminates these disadvantages due to the fact
that an additional crossbar with a soft seat is introduced into it, mounted on the base on vertical struts using a locking lock, while the covering mechanism and the table are removable with the possibility of replacing them with others, and the chair is made with an elongated back for supporting the lumbar, thoracic and cervical sections the spine;
that the enclosing mechanism is made in the form of a closed frame with a removable crossbar with a soft seat mounted on vertical racks, and the removable crossbar forms a closed frame using a connection made in the form of spring-loaded hooks installed at its ends;
that the covering mechanism is made in the form of a corset mounted on vertical racks;
that guides are fixed on the base, on which two stops are located, between which bushings with a strap are installed with the possibility of movement for fixing the lower leg tibia;
that the locking lock of the crossbar is made in the form of holes at the ends of the crossbar and the stops located on the vertical racks and works due to the elasticity of the base frame when a load is applied to the crossbar;
that all racks are removable with the possibility of removal, repositioning and fixing relative to the base;
that the table is made with the possibility of replacing for training social skills and training fine motor skills of hands and is mounted on racks using elastic clips;
that the base, pillars and closed frame are made of an alloy based on titanium;
that on racks for armrests and the enclosing mechanism installed removable handles for external application of effort;
that on the racks for the armrests, longitudinal grooves are made in which the ends of the fixing bolts are located to fix the racks from turning.

 Each structural element of the proposed universal simulator for medical and social rehabilitation has a reasonable functional purpose.

The main tasks that were solved by the proposed simulator are the creation of a simulator that can be used
for the development and training of the correct gait with full or partial fixation of the patient,
for training balance when standing, sitting and walking,
for the development and training of fine motor skills of the hands,
for the safe training of individual social skills (eating, writing, reading, serving natural needs, etc.),
for training patients with mental disabilities and physical disabilities (inability to hold the head, impaired posture, improper placement of the foot).

 The design of the simulator is made on a modular basis, it is easily reconfigured taking into account the peculiarities of violations of the musculoskeletal system of the patient and the prescribed rehabilitation technique.

 An important feature of the proposed simulator is the possibility of its use both for therapeutic medical purposes in hospitals, rehabilitation centers, clinics, and at home to ensure normal functioning of patients with disorders of the musculoskeletal system.

 The proposed simulator has a wide range of adjustments and additional accessories, ensures the safety of the patient’s activities, allows him to fix his body in an upright position due to the wide covering mechanism and a closed frame with soft sitting, armrests, ensuring normal physiological acts: standing, walking, correct movement the whole body and its parts (limbs) when walking with a dosed step length.

 In FIG. 1 shows a general view of a universal simulator for medical and social rehabilitation; figure 2 simulator with a table, chair; in FIG. 3 elastic table lock when installed on the simulator; figure 4 mount armrest; in FIG. 5 installation of the covering mechanism, made in the form of a closed frame with a removable crossbar and soft seat; Fig.6 simulator, on which a closed frame with a soft seat and armrests are installed; in FIG. 7 simulator, in which a corset is used as the covering mechanism; on Fig simulator, on which only the armrests are installed; in Fig.9 tables for food, writing and fine motoring of hands; in FIG. 10 locking lock for setting the beam on the simulator with a soft seat; in FIG. 11 spring-loaded hooks for installing a removable crossbar to form a closed frame; in FIG. 12 - longitudinal grooves in the racks for the armrests.

 A universal simulator for medical and social rehabilitation consists of a base made in the form of two U-shaped frames rigidly interconnected 1.2 and mounted on four wheels 3 with stoppers. The length of frame 1 is greater than the length of frame 2 to ensure the stability of the simulator.

 Armrests 4 and corset 5 are mounted on the base using screw connections 8, 9.

 The female mechanism is mounted on the posts 7 by means of a screw connection 10, which allows the replacement of the female mechanism, depending on the method of medical and social rehabilitation.

 Vertical racks 11 are mounted on the frame 2 by means of a screw connection 12. The ends of the vertical racks are connected by a crossbar 13 with a soft seat 14, the free end of which is connected to the armrests 4.

 The locking lock 15 allows for a rigid connection of the frame 2 and the crossbar 13 with the formation of a closed frame. The locking lock 15 is made in the form of holes 16 at the ends of the crossbar 13 and located on the vertical posts 11 of the stops 17 formed by a groove 18 (Fig. 10).

 In accordance with the prescribed rehabilitation technique, a corset 5 or a closed frame 20 can be used as a female mechanism. The closed frame 20 is made with a removable bar 21 with a soft seat 22 parallel to the bar 13. The removable bar 21 forms a closed frame with spring-loaded hooks 23 installed at its ends and grooves made at the ends of the open frame 24.

 The armrests 4 are made in the form of a hard box with a belt for fixing the forearm and armrests 25 of the armrests (Fig. 4). The removable table 26 is installed using elastic retainers 27 of the tinctures 7 with the armrests removed 4. The free ends of the table rest on the racks 6, while the female mechanism 5 can be mounted on the simulator.

 Depending on the type of patient’s activity, a food table equipped with special recesses can be installed on the simulator for placing food devices in them, a table for writing, drawing and reading, or a table for training fine motor skills of hands, on which training pyramids with rings are located etc. In this position, the simulator provides a chair 28 with an elongated back (see figure 2) with a latch 29 of the back and neck. Chair 28 is also equipped with a removable boat.

 To ensure that the armrest racks do not rotate relative to the frame 2, longitudinal grooves are made in them, in which the ends of the fixing bolts of the screw connection 8 are located. On the base there are also installed guides 31, on each of which there are two stops 32, 33 and a sleeve 34 between a belt 35 for fixing it in the lower third of the lower leg of the lower extremity in order to avoid "crossing" them when walking and dosing the step length. In the simulator, all racks 6, 7, 11, crossbars 13, 21, table 26, chair 28 are made with the possibility of removal without violating the rigidity of the structure, while the simulator can be used to perform various functions of both medical (medical) and social .

 To facilitate the design of the simulator, the base, racks 6, 7, 11, the crossbar 13.21 and the open frame 24 are made of an alloy based on titanium. On the open frame 24 and the crossbar 13, removable arms 36, 37 are installed for external application of forces.

 Universal simulator for medical and social rehabilitation works as follows.

 The simulator can be used in two modes of operation: medical and social. In accordance with the prescription of the doctor, taking into account the peculiarities of disorders of the musculoskeletal system, the simulator can have six working positions that allow performing various functions, while the removable structural elements of the simulator are easily installed on the base. When training and ensuring proper walking and standing, the simulator is used as follows.

 Patients with significant lesions of the musculoskeletal system are placed in corset 5, which is strengthened on them using straps. The middle of the forearms with the help of straps is fixed on the armrests 4. A soft seat 14 is passed between the patient’s legs and attached to the armrests 4. Using the racks 6, 7, 11, the simulator is adjusted for the patient’s growth (Fig. 1). Fixation of the lower extremities in the lower third of the leg using belts 35 mounted on the sleeve. Limiters 32 and 33 are set for dosing the stride length and eliminating the "cross" of the legs. After which the patient begins to move independently by moving the lower limbs or by moving the simulator due to outside help.

 The simulator has an active and passive effect on species-specific receptors of the musculoskeletal system (muscles, joints of the arms and legs) in order to normalize the structures of the brain (hypothalamus, cerebellum, reticular formation, motor region of the cerebral cortex, oblong and midbrain through impulse into the central nervous system) ) and the spinal cord, whose activity ensures the maintenance of the correct posture, locomotion (walking, swimming, running), communication (writing, gestures, facial expressions), manipulation) (subject de telnost).

 As a result of using the simulator, the balance and mobility of the processes of inhibition and excitation in the central nervous system are increased, new motor functions lost and developed are restored, motor-visceral reflex reactions are normalized, muscle tone is reduced, coordination and accuracy of movements are improved, hyperkinesis is reduced, and new motor skills are developed.

 The technique of using the simulator is designed in such a way that the patient acquires movement skills, while it starts with the simplest movements performed by muscles and joints, but which are inherent in movements with a normal person’s gait.

 As gait improves, the complexity of the exercises should increase, and the movement carried out by the muscles and joints should approach their real movements when walking. For this, instead of a corset 5, a closed frame 20 with a soft seat 22 is installed on the base of the simulator (Fig. 5). The patient is located inside the closed frame on the soft seat 22, while the crossbar 13 with the soft seat 14 is removed from the simulator. The upper limbs can be fixed on the armrests 4 (Fig. 6). As a result of the organization of movement in active or passive modes, they are trying to ensure the emergence of impulses that can lead to an improvement in motor functions due to the development of new centers functionally close to non-functioning.

 The use of the simulator in this position allows you to significantly increase the therapeutic effect due to the possibility of the appearance of impulses both on the periphery, i.e. at the level of individual joints, and at the level of their more complex interaction.

 In this position, the spine is in a free position, similar to the physiological position when walking. As you gain and resume walking and standing skills, individual supporting elements are removed from the simulator. In this case, the patient is provided with conditions close to the conditions in a real gait. The simulator allows you to ensure the vertical position of the patient, while it can be located either in a corset or in a closed frame. The armrests in this position are removed, and the patient's upper limbs are in a free position and can carry out movements that are inherent to movement with a normal gait. Patient safety is ensured by the patient being in the female mechanism (see FIG. 5 and FIG. 7).

 As gait is restored and stability is acquired, the simulator can be used without fixing the lower extremities with straps (Fig. 5) and without landing on a soft chair (Fig. 7).

 At the stage of final rehabilitation, the simulator is used as a simple supporting device, the covering mechanism and the crossbars with soft seats are removed from it (Fig. 8). The lower limbs are in a free position without fixing straps.

 When using the simulator for social purposes, the armrests 4 and the crossbar 13 with a soft seat 14 are removed from the simulator. A table 26 is mounted on the racks for the female mechanism, which is fastened with an elastic latch 27 (Fig. 3). The free end of the table rests on the racks for the armrests 6. In this position, the patient is placed in a corset, which is installed at a height that allows the patient to sit comfortably on the seat with the ability to perform various actions on the table. For patients with a weakened supporting function of the cervical and thoracic spine, a chair with an elongated back is used, equipped with straps to fix the patient on it.

 Depending on the type of activity the patient needs in the simulator, there are three types of tables: eating; writing, drawing and reading; for training fine motor skills of the hands. Tables are equipped with the necessary accessories to facilitate the performance of functions and patient safety. The design of the tables allows, in addition to ensuring the convenience of performing various household and educational tasks, to provide a therapeutic effect through training the central nervous system and creating and training motor centers, the function of which has been lost.

 Classes with the help of a table for the development and training of fine motor skills of the hands allow you to form ways of motor reactions, i.e. at this stage also produce the formation of individual motor programs; carry out the acquisition of motor act due to special exercises.

 If it is necessary to fulfill natural needs, the chair is equipped with a vessel, and there is a hole in the chair itself.

 This simulator allows you to bring up tonic reflexes and movements regardless of the severity of the disease due to the modular construction system.

 The design of the simulator takes into account the assumption of the presence of 4 levels of regulation of the neuromuscular system.

1) the spinal level, at which there is a tendency to extensor reflexes;
2) the level of the medulla oblongata, at this level the arcs of the tonic and tonic labyrinth reflexes end;
3) the level of the midbrain, where the arcs of vertical standing end, labyrinth reflexes, reflexes of readiness for a jump, as well as chain cognitive tonic reflexes;
4) the level of the cortex.

The simulator incorporates the principle of therapy of the musculoskeletal system, consisting of:
1. inhibition of "abnormal activity" in order to normalize muscle tone;
2. beatings of the motor excretory paths, the development of potential forms of movement and posture based on normal tone.

 The proposed universal simulator for medical and social rehabilitation can be used both in clinical conditions and at home.

 Due to the implementation of the main structural elements from an alloy based on titanium, the simulator has considerable lightness and the ability to fold in comparison with the known simulators.

 An important advantage of the proposed simulator compared to the known one is its ability to perform various functions due to the constructive implementation, which makes it easy to rebuild the simulator as the rehabilitation methodology changes and the need for social tasks is performed.

 The simulator is new because a similar design is not known from the prior art, has an inventive step, because explicitly does not follow from the prior art.

 The simulator is industrially applicable in clinics, hospitals, child care facilities, rehabilitation centers, at home.

 Thus, the proposed universal simulator for medical and social rehabilitation meets the conditions of patentability and therefore can be recognized as an invention.

Claims (9)

 1. A universal simulator for medical and social rehabilitation, containing a base made in the form of two U-shaped frames rigidly interconnected and mounted on four wheels with stoppers, armrests mounted on the base, a table and a seat, characterized in that it additionally introduced the covering mechanism and the crossbar, made with the possibility of installing a soft seat, located on the base on vertical racks using a locking lock, while the covering mechanism, table and seat are made removable us, and the chair is made with a long back and fixing belts for the thoracic and cervical spine support.  2. The simulator according to claim 1, characterized in that the enclosing mechanism is made in the form of a closed frame with a soft seat and a removable crossbar parallel to the crossbar mounted on vertical racks, and the removable crossbar forms a closed frame using spring-loaded hooks located at its ends, and a groove made at the ends of the open frame.  3. The simulator according to claim 1, characterized in that on the base there are two guides, on each of which two stops are installed, and between the stops there is a moving sleeve with fixing straps for fixing the lower extremities.  4. The simulator according to claim 1, characterized in that the fixing lock of the crossbar is made in the form of holes at the ends of the crossbar and the stop formed by a groove at the ends of the vertical struts.  5. The simulator on PP. 1 to 4, characterized in that all racks are removable with the possibility of changing position and fixing relative to the base.  6. The simulator according to claim 1, characterized in that the length of the lower U-shaped base frame is greater than the length of the U-shaped upper frame.  7. The simulator according to claim 1, characterized in that the removable table is made with the possibility of replacing it with a table for training social skills and fine motor skills of hands and is mounted on racks using elastic clips.  8. The simulator on PP. 1 to 4, characterized in that the base, racks, crossbars and closed frame are made of titanium-based alloys.  9. The simulator according to claim 1, characterized in that on the racks for the armrests there are longitudinal grooves in which the ends of the fixing bolts are located.

Images