RU2325895C2 - Device for thoracic limb motor function restoration - Google Patents

Abstract

FIELD: medicine; neurology.

SUBSTANCE: device contains supporting elements designed as collars that can be fixed on thoracic limbs, and fixing elements. Fixing elements are designed as flexible rods than can be placed on patient's body from the front, side and back, rigidly connected to related supporting elements through tension regulator. Besides, device is furnished with jacket as supporting element. Collars are designed in number of two pairs that can be fixed around shoulder and forearm from right and left sides of patient's body. Flexible rods are divided into five groups, in pairs for left and right parts of patient's body. The first three groups including front, back and lateral rods are fixed on shoulder collars and by means of tension regulators are fixed with fixing locks on contra-lateral jacket parts and in upper part of forearm from the front and back. Two other groups of rods are mounted between collars of shoulder and forearm from the front and back. Invention enables to reduce arm paresis intensity, increase number of active movements of shoulder and elbow joint due to dosed load on proximal parts of shoulder and forearm and differential relief and complication of voluntary movements in all planes of shoulder and elbow joints.

EFFECT: possible more rapid arm motor function restoration.

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Description

The invention relates to medicine, namely to neurology, to the means of restoring motor functions in the upper limb with central paresis syndrome.

Known methods for the restoration of motor functions in the syndrome of central paresis, based on the provision of active and passive resistance to movement, which are carried out by increasing the friction force by the instructor’s hand, weights, elastic traction [OG Kogan, V.L. Naidin. Medical rehabilitation in neurology and neurosurgery. M., Medicine, 1988].

The disadvantage of this solution is the low effect of restoration of motor functions in the upper limb with central paresis syndrome.

The closest in technical essence to the proposed solution is a device for the treatment of patients with impaired posture and motor activity (RU 2054907 C1, A61F 5/00 of January 31, 1992), containing supporting elements located in the shoulders, elbows, hands, waist, knees and feet, which are connected in series with the help of elastic rods located relative to the human body in the longitudinal, transverse, oblique directions, while each elastic rod is rigidly connected at one end to the corresponding support, and the other through its tension regulator eniya.

A disadvantage of the known device is its selective purpose, it is aimed at correcting the pathological stereotype of posture and movements (mainly the walking function in patients with cerebral palsy and strokes). In addition, in the known device it is not possible to provide a metered load on the proximal parts of the upper limb due to the lack of elastic traction on the shoulder with impaired motor functions in the upper limbs, which leads to insufficiently effective restoration of motor functions in the hand.

The objective of the invention is to provide a device that provides an effective increase in motor capabilities of the upper limbs with central paresis syndrome.

The problem is solved in that the device for the restoration of motor functions in the upper limb, containing supporting elements made in the form of cuffs, with the possibility of their fastening on the upper limbs, and fixing elements made in the form of elastic rods located on the front, side and rear surfaces parts of the patient’s body and rigidly connected to the corresponding supports through the tension regulator, additionally contains a vest as a supporting element, cuffs are made in the amount of 2 pairs, with possibly Tew their fastening around the shoulder and forearm on both sides, elastic drafts, which are divided into five groups, pairwise on the left and right parts of the patient’s body, the first three groups of drafts, including front, rear and lateral drafts, are fixed on the cuff of the shoulder and using the adjusters the tension is fixed by the fastening locks on the vest, while the front and rear groups are fixed on the contralateral half of the vest, the lateral group is fixed in the upper part of the armhole, two other groups of rods are located between the cuffs of the shoulder and forearm whose front and rear.

Each group of elastic rods can be made of six tensioning elements.

A device for restoring motor functions in the upper limb is illustrated in the drawing, where figure 1 shows a General view of the device from the front; figure 2 is a rear view; figure 3 is a side view.

The device consists of support elements made in the form of a vest 1 and two pairs of cuffs 2, 3, located around the shoulder and forearm, five groups of elastic rods 4, sequentially connecting the support elements, tension regulators 5, which are tapes, one end connected to elastic rods, and others - passed through the fastening locks 6.

The device operates as follows.

A vest 1 of the appropriate size is worn on the patient, cuffs 2, 3 are fixed respectively around the shoulder, forearm on both sides. The first three groups of elastic rods 4 are pulled from the cuffs of the shoulder front and rear by adjusting tapes, the achieved position is fixed using fastening locks 6 located on the opposite half of the vest front and rear, the lateral group of elastic rods is fixed to the fastening locks on the vest armhole. The tension of elastic rods is controlled until a load sensation occurs when the movements of raising the arm up and sideways in the shoulder joint are performed. Two groups of elastic rods are tensioned from the cuff of the forearm to the cuff of the shoulder using the appropriate tension adjusters and the achieved position is fixed with locks on the cuff of the shoulder in such a way as to create a load or facilitate the movement of flexion and extension of the forearm in the elbow joint.

The patient in the proposed device performs traditional exercises for the upper limb: flexion and abduction of the arm in the shoulder joint, flexion and extension of the forearm in the elbow joint. The duration of the exercises is 20 minutes, the exercises are performed at a slow pace, classes are carried out twice a day, the course of treatment is 1 month.

When performing exercises with elastic rods, they facilitate or create a significant increased load on the muscles of the upper limb.

The device was used for the rehabilitation of patients with impaired motor functions in the upper limb. The following is an example of using the inventive device.

Patient M., 56 years old. Man. Diagnosis: Consequences of acute ischemic cerebrovascular accident (August 2003), in the pool of the right middle cerebral artery with a syndrome of moderate central left-side hemiparesis, a late recovery period, a low rate of recovery of impaired functions in the upper limb, a mild sensitivity violation in left limbs. The average level of domestic and social activity. Hypertension III, risk IV.

After a stroke for 1.5 years, the patient underwent a course of motor rehabilitation three times in a hospital for 1 month. The rest of the time I attended classes on an outpatient basis. The work was carried out according to the classical method. The effect of the treatment was low. Upon examination of January 2004, it was found:

Arbitrary movements in the hand are limited in the shoulder joint: 1 point (moderate paresis), raising the arm up to 40 °, lateral abduction - 30 °, in the elbow joint the extension of the forearm to 1 point (moderate paresis). Muscle tone in the left hand 2 points (moderately elevated).

The patient underwent treatment with the proposed device for 1 month. A metered load was created on the proximal parts of the shoulder and forearm, when performing arbitrary movements (raising the arm up and sideways, bending and unbending the forearm) for 20 minutes 2 times a day. After completing the exercises, the patient had the opportunity to move his arm up and take it sideways 10-15 ° above the original, active voluntary extension in the elbow joint. In the first 5 days, the effect was unstable, after a night's rest the range of movements returned to the original. On the 10-15th day of treatment, a steady result appeared in the form of an increase in the range of motion in the shoulder joint to 90 °, a decrease in the severity of paresis by 1 point in the distal sections.

As a result of treatment, at the end of the rehabilitation course, which lasted 30 days, the severity of paresis in the patient's arm decreased by 1 point to the degree of mild paresis, movements in the shoulder and elbow joints were fully restored. In the follow-up history after 3 months, the effect of rehabilitation was maintained.

Using this device, 23 patients were treated: 16 - with central left-side hemiparesis syndrome, 7 - with right-side hemiparesis, aged 36 to 74 years, having a motor defect in the upper limb as a consequence of an acute cerebrovascular accident.

Rehabilitation classes were held for a month.

A good effect from the use of the proposed device was observed in 20 patients (15 - with left-sided hemiparesis syndrome, 5 - with right-sided hemiparesis): the severity of paresis decreased significantly, the angle of raising and extending the arm, as well as extension of the forearm, increased. A satisfactory treatment effect was observed in 2 patients with severe right-sided hemiparesis syndrome.

In one observation, the effect of treatment was low due to the presence of pain in the shoulder joint, increased muscle tone in the elbow joint.

Using this device to restore motor functions in the upper limb with central paresis syndrome has the following advantages:

- the severity of paresis in the arm decreases, the volume of active movements in the shoulder and elbow joints increases, due to the possibility of a metered load on the proximal parts of the shoulder and forearm and differentiated relief or difficulty in performing arbitrary movements in all planes in the shoulder and elbow joints, which ultimately , provides higher rehabilitation efficiency in patients with central paresis syndrome.

Claims (2)

1. A device for restoring motor functions in the upper limbs, containing support elements made in the form of cuffs, with the possibility of their fastening on the upper limbs, and fixing elements made in the form of elastic rods with the possibility of location on the patient’s body front, side and back, rigidly associated with the respective supporting elements through a tension regulator, characterized in that it further comprises a vest as a supporting element, the cuffs are made in the amount of two pairs with the possibility of closing arches around the shoulder and forearm on the left and right sides of the patient’s body, elastic rods are divided into five groups, pairwise for the left and right parts of the patient’s body, the first three groups of rods, including the front, rear and lateral rods, are fixed on the cuffs of the shoulder and using the adjusters the tension is fixed by fastening locks on the contralateral halves of the vest and in the upper part of the armhole of the vest, and two other groups of rods are located between the cuffs of the shoulder and forearm in front and behind. 2. The device according to claim 1, characterized in that each group of elastic rods is made of six tensioning elements.

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