RU2417787C1 - Method of moving patient with dysfunction of lower extrimities in self-propelled wheelchair on stairs with handrails - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to ground transport means, mainly to wheelchairs, intended for movement of patient on stairs or flat surface. Method consists in movement on stairs in sitting position in wheelchair of patient - wheelchair-user by lever pacing propelling agent with electromechanical drive. Bearing on stairs steps is realised in turn either by pair of revolving levers, or by pair of wheels. In order to surmount. Flight of stairs up patient wheelchair-user drives up to first lower step of flight of stairs by reverse moment until wheels stop in step edge, turns on or switches power of electric motor in waiting mode and fixes, if necessary, own body. Then, patient turns on drive of pacing propelling agent in mode of reverse movement and turns off after levers rest against bearing surface of step. Patient switches wheelchair in stable, double-support, on levers, position "balance" due to inertial body-movements and/or force interaction, at least, with one handrail of flight of stairs, mainly in mode of hand snatch. Then, drive of pacing propelling agent is switched on in mode of reverse movement and continues preserving "balance" position with alternating contact of levers and wheels to complete surmounting flight of stairs. Surmounting flight of stairs downward is carried out in a similar way and differs by the fact that patient-user drives up to the first step of flight of stairs by ahead movement.

EFFECT: obtaining possibility of independent movement of user in wheelchair on flights of stairs without assistant help.

9 cl, 1 dwg

Description

The invention relates to land vehicles and, at the same time, to rehabilitation (medical and rehabilitation) equipment (mainly wheelchairs), designed to move a person on stairs or a flat surface.

The most significant, urgent problem on the way of creating mobile technical rehabilitation equipment (TCP) is the problem of the movement of persons with disabilities along the stairs (flight of stairs).

Among the specialized TCPs, mobile stair-lifts (also referred to as strollers) controlled by a healthy accompanying-managing person (hereinafter referred to as the assistant) are known as vehicles with an armchair, frame, wheels, and lifting mechanisms, both foreign [GB 2290757, A61G 7/10, В62В 1/22, A61G 5/00, 7/10, 01/10/1996; SU 1607806 A1, A61G 5/06, 11/23/1990; Elektrische Treppensteiger. Hersteller / Manufacturer SANO Trasportgeraete GmbH. - Am Hoizpoldigut 22 4040 Linz / Lichtenberg. AUSTRIA. (Catalog of the Austrian company SANO. - 15 pp. - Internet product: http://www.sano-stair-climber.com; www.sano-treppensteighilfe.com): S-max - der Treppensteiger fur Ihren Rollstuhl. AAT Alber Antriebstechnik GmbH / Postfach 10 0560 D-72426 Albstadt. (S-MAX catalog of the German company AAT. - 8 pp. - Internet product: http://www.aat-online.de): S-max - der universalle Treppensteiger. AAT Alber Antriebstechnik GmbH / Postfach 10 0560 D-72426 Albstadt. (S-MAX catalog of the German company AAT. - 8 pp. - Internet product: http://www.aat-online.de)], as well as domestic (author's developments) [RU 2304952 C1, A61G 5/06, B62B 11/00, 08/27/2007; RU 2368366 C1, A61G 5/06, 02/19/2008].

The method of moving along the stairs, realized with their help, consists in the interaction of a walking propeller installed along with passive (non-driven) wheels (between wheels) with the steps of the stairs. In this case, a characteristic feature of the method is the provision (by the actions of an assistant) of the position of the stroller in the fullest possible dynamic equilibrium (including the displacement and holding of the center of mass in the transverse vertical plane passing through the centers of the spots of contact of the chassis with the ladder). Assistant functions are reduced, in general, to keep the stroller in balance, to insure the user, to adjust the course and some help in maneuvering on the landing.

At the same time, the presence of an assistant, moreover, relatively healthy physically and mentally, is far from always possible and, in some cases, impractical. Accordingly, a user like TCP should have the fundamental ability to confidently and safely move independently, without an assistant. At least subject to preliminary preparation (training) of the user and even, if necessary, certain requirements for the psychophysical state.

Closest to the claimed invention for the purpose and combination of essential features (prototype) is a method of moving a person with dysfunction of the lower extremities in a self-propelled wheelchair on the stairs with handrails (and the vehicle for its implementation), which consists in moving up the stairs in a sitting, in an armchair, position a person-user of the stroller, due to the lever walking mover with an electromechanical drive, in which the support on the steps of the stairs is carried out alternately or with a pair of rotating levers, a pair of wheels [RU 2368366 C1, A61G 5/06, 02/19/2008 - prototype]. In it, to overcome the flight of stairs, the assistant brings the stroller with the wheelchair locked (through the seat belt and the leg locks, at least in the longitudinal and transverse vertical directions) to the first lower stage of the flight of stairs in reverse to the stop with wheels to the edge of the stage, includes a walking the mover in reverse mode and immediately after the levers rest from above into the bearing surface of the step transfers the stroller, by means of the handles, to the stable, according to its sensations, two-legged, on the levers, “balance” position and continues to maintain the achieved position of dynamic equilibrium (balance in motion) with alternating contact of levers and wheels until the stairway is completely overcome in the mode, as a rule, of continuous operation of the drive of the walking propulsion or forced stop.

To overcome the flight of stairs down, the assistant takes the wheelchair to the first upper step of the flight of stairs forward to the maximum safe distance (in the case of a shorter distance, the automatic brakes will stop the wheelchair), activates the walking mechanism in forward mode and, when the wheelchair is supported, transfers the wheelchair using the handles, to the stable, according to his feelings, two-support position “balance” (similar to how the stairs move up), and continues to maintain the position “ball ns "to fully recover from a flight of stairs or emergency stop.

However, such a device is also characterized by the disadvantages described above.

The task to which the claimed invention is directed is to provide the possibility of independent (without the assistance of an assistant) movement of the user in a wheelchair along the flights of stairs.

The solution to this problem is achieved by the fact that in the method of moving a person with dysfunction of the lower extremities in a self-propelled carriage on a ladder with handrails, consisting in moving up the stairs in a sitting, in a chair, the position of the person-user of the stroller, due to the lever walking mover with an electromechanical drive, where the support on the steps of the stairs is alternately carried out either by a pair of rotating levers, or by a pair of wheels, to overcome the flight of stairs a person-user of a carriage drives up to the first lower the flight of stairs backward until it stops with the wheels to the edge of the step, it turns on or switches the power of the electric motor to standby mode, fixes its body and, if necessary, its legs relative to the stroller, at least in the longitudinal and transverse vertical directions, for example, with a seat belt and leg locks if they have not been previously fixed, turns on the drive of the walking propulsion in reverse mode and turns it off after the levers rest in the bearing surface of the stage, transfers the stroller to a stable, according to its feelings, two supporting, on the levers, the “balance” position due to inertial movements and / or force interaction with at least one staircase handrail, mainly in the brush grip mode, turns on the drive of the walking mover in reverse mode and continues to maintain the “balance” position with alternating contact of levers and wheels to complete overcoming the flight of stairs in the mode, as a rule, of continuous operation of the drive of a walking mover or forced stop, and for overcoming the flight of stairs down to a human user L wheelchairs drives up to the first upper step of the flight of stairs in forward motion to a safe distance, according to the condition of stability, turns on or switches the power of the electric motor to standby mode, fixes its body and, if necessary, its legs relative to the wheelchair, at least in longitudinal and transverse vertical directions, for example, with a seat belt and leg clamps, if they were not fixed earlier, puts the stroller in a stable, according to its sensations, two-support position “balance” due to inertial movements and / or and force interaction with at least one handrail of the stairs, mainly in the grip mode with brushes, and includes the drive of the walking propulsion in the forward mode, after which it continues to maintain the “balance” position until the flight of stairs or a forced stop is completely overcome.

The solution to this problem is also achieved due to additional significant features of the method (with the above main set of features):

- a person-user can access the first lower step of the flight of stairs by means of a walking propulsion drive, and drive the first upper step of the flight of stairs in front, on wheels, for example due to the muscular strength of the upper limbs and torso;

- a human user can drive up to the first lower step of the flight of stairs in reverse by pulling the upper limbs over the railings of the handrails;

- the human user can turn on the drive of the walking mover in forward and reverse modes by turning and / or tilting the head to a relatively large angle sufficient to avoid accidental operations, if there is a control system based on a Hall sensor or similar devices, or by voice commands in the presence of a control system based on a voice interface, or in another similar way;

- at the third additional set of signs on overcoming the first lower and / or upper stage, the human user can turn off the drive of the walking propeller by turning and / or tilting his head in the opposite direction or by submitting an alternative voice command or a disconnecting command of a different control method, to pause, if necessary for psychophysiological consolidation of the skills acquired in this way to control the balance and movement, turn on the drive of the walking propulsion again and step in such a way having at least one more step, depending on the necessary and sufficient degree of acquired skills and individual characteristics, and then turning on the drive of the walking mover in the mode of, as a rule, continuous operation until the flight of stairs or a forced stop is completely overcome;

- with the third additional set of features, the walking mover’s drive in its continuous operation, the human user can turn on, for example, using a manual toggle switch or a certain head movement, other than the movements turning the drive on and off, the control system in another mode, in which the drive is switched on by the aforementioned turning and / or tilting the head, but turns it off again by turning or tilting it, that is, in the same direction, with a preliminary return to its original position, and then turn on the drive, turn the head to its original position, and upon completion of overcoming the flight of stairs, or, if necessary, an intermediate stop, turn off the drive by the next turn of the head;

- with the third additional set of features, the walking mover’s drive in its continuous operation, the human user can turn it on by transferring, for example, a manual toggle switch or a voice command other than commands that turn the drive on and off;

- at the end of the step movement to the next step in the direction of raising or lowering the stroller, the grab of the handrail with the upper limb brush at the moment of support on the wheels with the levers of the walking propeller suspended, the user can transfer approximately the amount of the indicated step movement in the direction of movement of the stroller along the stairs, grab with both brushes of one handrail, grasp with brushes he can transfer alternately;

- to overcome the flight of stairs down, a human user can drive up to the first upper step of the flight of stairs in front of a safe distance, provided that the distance is provided by the automatic brake system.

Among the known methods of moving on the stairs on devices of this type, no methods were found whose combination of essential features would coincide with the declared one. At the same time, it is due to the latter that a new technical result is achieved in accordance with the task.

The drawing shows the process of overcoming the flight of stairs (an example with one handrail): a vehicle (with a user) at the stairs when moving up immediately after moving the stroller to the “balance” position and then turning on the walking mover, or with regular movement up or down, view bottom to side.

The stroller - a stair-lift, mainly for moving a person along the stairs, contains a chair 1 for a human user 2, a frame 3, preferably of variable height, preferably telescopic (with a lock in shortened and elongated positions), with handles 4, 5 at its upper end for the convenience of adjusting the height of the handles (telescope extension) and the principal possibility of transporting the stroller with or without person 2, if necessary, as an assistant, and non-drive (passive) wheels 8, 9 coaxial (axles 6-7) on It end thereof (the left and right sides of the carriage), at least one forward imposed additional supporting element type grand piano wheels (in these examples the two-wheel pivoting around the vertical axes 10, 11). The stroller is equipped with a two-support (simultaneously left and right across the width of the stroller) lever walking propulsor with an electromechanical drive 12 (usually an electric motor with a reducer associated with an autonomous power source) installed along with wheels 8, 9 (i.e. in addition to them ), in which the support on the steps of the stairs is carried out alternately either by the indicated pair of rotating levers 13, 14 (wheels 8, 9 spaced along the axis 6-7, i.e., on the left and right sides), or a pair of wheels 8, 9. As a rule , each of the levers 13, 14 is made of two shoulders m and is installed with an offset (eccentricity) relative to the axis 6-7 in the transverse directions within the radius of the wheels 8, 9, and the ends of the lever protrude (at least in part of their path) beyond the outer circles of the wheels 8, 9 to interact with the nearest free from wheels 8, 9 by a step of a ladder 15 (the device is described in more detail in the prototype, p. 7, Fig. 4).

Moreover, the levers 13, 14 are mounted with the possibility of reversible rotation from the electric drive 12 (the actuator 12 is made reversible) in the direction of entry to the higher step of the ladder 15 or the descent from it, around the axis 16, fixed relative to the frame 3. Thus, the levers 13, 14 are installed with the possibility of complex movement in space - at the same time a force rotation in planes parallel to the planes of rotation of the wheels 8, 9, and, due to the support on the stage, translational movement (with the whole stroller).

At the ends of the levers 13, 14 mounted supporting friction elements 17 with optimized shape and size (as with the closest analogues).

The vehicle has automatic brakes. They include levers 18, 19 with support rollers 20, 21 at their free ends, serving as sensors of the position of the wheels 8, 9 on the support step 15 relative to its edge, pivotally mounted side-to-front wheels 8, 9 with the possibility of forced transfer from the idle upper position in the working lower with the rolling of the rollers on the stage 15 next to the wheels and the subsequent breakdown under the action, along with its own gravity, the elastic force provided for this spring and hovering over the lower stage. In the lower (working) position, the hung levers 18, 19 have the ability to block the rotation of the wheels 8, 9 (as in the prototype, p. 8, figure 2). Perhaps another device for blocking the rotation of wheels 8, 9 is extremely safe, by the condition of not breaking the wheels 8, 9 from step 15, a distance s (not shown), sufficient to start the effective operation of the mechanism for moving along the steps of the stairs in the descent mode from the step.

The stroller may also include means for changing the relative position of its elements (including a number of those mentioned above), means for controlling the stroller and controlling its parameters. The strollers, as varieties of TCP, should also include a lap belt and leg restraints (preferably folding steps with or without stop holders and / or leg restraints). The presence of a "parking" mechanical brake (mechanical brakes) is also recommended.

The stairs (at the stairs) must have handrails (railings) 22, on one or both sides.

In the inventive method (in its preferred embodiment), it is especially important that the control system (device 23) based on a Hall sensor or similar devices, or variants of a voice interface, etc., are included in the side-car controls.

The described example of a specific design option (previously patented by the authors) does not exclude other possible device options for implementing the inventive method within the totality of its essential features (see the claims).

The inventive device operates as follows (in accordance with the claimed method).

The user-user 2 is in the chair 1 and, in order to overcome the flights of stairs in any direction, should, as a rule, be secured from movements of the pelvic part of the body and lower extremities by means of the aforementioned seat belt and leg clamps (footrests with or without stop holders and / or clamps lower legs).

The steps below to turn the drive 12 on and off are performed by user 2 (in this particular example) by turning the head (and, accordingly, the Hall sensor of device 23) clockwise or counterclockwise (as an option, turning it off by turning the head again clockwise, i.e. through time).

To overcome the flight of stairs upward, user 2 performs the following sequence of operations:

- drives up in the carriage to the first lower step of the flight of stairs 15 in reverse to the stop with the wheels to the edge of the stage, turns on or switches the power of the drive motor 12 into standby mode, fixes the body and, if necessary, the legs relative to the carriage, at least in the longitudinal and transverse vertical directions, for example with a seat belt and leg clamps, if they have not been previously fixed;

- turns on the drive 12 of the walking mover in reverse mode and turns it off after the levers rest in the bearing surface of the step 15 (the user can judge his levers in the step by his senses, visually, with the possible use of a mirror, etc. (in this case, the specifics unprincipled));

- translates the stroller into a stable, according to its feelings, two-legged, on the levers, “balance” position due to inertial movements and / or force interaction, with at least one handrail 22 flights of stairs, mainly in the mode of grasping with brushes;

- includes a drive 12 walking propulsion in reverse;

- continues to maintain a “balance” position with alternating contact of levers 13, 14 and wheels 8, 9 until the flight of stairs is completely overcome in the (“regular”) mode of continuous (preferably) or periodic (with “individual duty cycle for each user”) drive 12 walking mover or forced stop.

To overcome the flight of stairs down, user 2 performs the following sequence of operations:

- drives up in a stroller to the first upper step of the flight of stairs 15 in forward gear to a safe, under the condition of longitudinal stability, i.e. not stalling wheels 8. 9 from step 15, distance s, turns on or switches the power of the drive motor 12 to standby, fixes its body and, if necessary, its legs relative to the stroller, at least in the longitudinal and transverse vertical directions, for example, with a seat belt and leg clamps, if they were not fixed earlier;

- translates the stroller into a stable, according to its feelings, two-support position “balance” due to inertial body movements and / or force interaction, with at least one handrail 22 stairs, mainly in the mode of grasping with brushes;

- turns on the drive 12 of the walking propulsion in the forward mode (the last two operations the user can carry out almost simultaneously);

- continues to maintain the “balance” position (see figure) until the flight of stairs (regular or individually selected modes) is completely overcome or a forced stop.

Among the differences of the proposed method are the following optional, but recommended (preferred) operations:

- the user 2 can access the first lower step of the flight of stairs 15 by means of a drive 12, and the front entrance to the first upper step of the flight of stairs 15 by wheels 8, 9, for example due to the muscular strength of the upper limbs and the torso of user 2;

- the user 2 can drive up to the first lower step of the flight of stairs 15 in reverse by pulling the upper extremities beyond the overhangs of the handrail 22;

- the user 2 can turn on the drive 12 in the forward and reverse modes by turning the head and / or tilting the head to a relatively large angle sufficient to prevent accidental operations, if there is a control system (device 23) based on a Hall sensor or similar devices, or by giving a voice command in the presence of a control system (device) based on the voice interface, or in another similar way;

- upon overcoming the first lower and / or upper stage 15, user 2 can turn off the drive 12 by turning and / or tilting his head in the opposite direction or by applying an alternative voice command or a disconnecting command of a different control method, withstand, if necessary, a pause for psychophysiological fixation of such acquired skills to control the balance and movement, turn on the drive 12 again and step on the levers 13, 14 in this mode, at least one more step 15, depending on the necessary and sufficient ary degree of acquired skills and individual characteristics, and then start the drive 12 in continuous operation up to fully recover from a flight of stairs or emergency stop;

- the drive 12 in the continuous mode of its operation, the user 2 can be turned on by, for example, using a manual toggle switch (not shown) or a certain head movement, other than the movements turning the drive 12 on and off, of the control system (device 23) in another mode in which the drive 12 is turned on by the said turn and / or tilt of the head, and turns off by turning it again or tilting, that is, in the same direction, with a preliminary return to its original position, then turn on the drive 12, turn the head to its original position, and after to complete the flight of stairs, or if an intermediate stop is necessary, turn off the drive 12 with the next turn of the head (as briefly mentioned above);

- at the end of the step movement to the next step 15 in the direction of raising or lowering the stroller, the grab of the handrail 22 with the upper limb brush at the moment of support on the wheels 8, 9 with the levers 13, 14 of the walking propeller suspended, can transfer approximately 2 the value of the indicated step movement (the ratio of the length of the step 15 to the cosine of the angle of inclination of the handrails 22), while in case of grabbing one handrail 22 with both brushes, the gripper with the brushes should be transferred alternately.

Using the proposed method allows the user to navigate the flights of stairs independently, without the help of an assistant.

Claims (9)

1. The method of moving a person with dysfunction of the lower extremities in a self-propelled carriage on a staircase with handrails, which consists in moving up the stairs in a chair, in a sitting position of a person-user of a carriage due to a lever walking mover with an electromechanical drive, in which the support on the steps of the stairs is carried out alternately or a pair of rotating levers, or a pair of wheels, characterized in that to overcome the flight of stairs a person-user of a stroller drives up to the first lower step of the flight of stairs By moving the wheels to the edge of the stage until they stop, it turns on or switches the power of the electric motor to standby mode, fixes its body and, if necessary, its legs relative to the stroller, at least in the longitudinal and transverse vertical directions, for example, with a seat belt and leg clamps, if they are not were fixed earlier, turns on the drive of the walking propulsion in reverse mode and turns it off after the levers rest in the bearing surface of the step, puts the stroller into a two-leg position on the levers, stable in its sensations, “ allance ”due to inertial gestures and / or force interaction with at least one staircase handrail, mainly in the brush grip mode, turns on the drive of the walking propulsion in reverse mode and continues to maintain the“ balance ”position with alternating contact of levers and wheels to complete overcoming the flight of stairs in the mode, as a rule, of continuous operation of the drive of a walking propulsion unit or a forced stop, and to overcome the flight of stairs down, a person-user of a carriage drives up to the first at the top of the flight of stairs in forward motion to a safe distance under the condition of stability, it turns on or switches the power of the electric motor to standby mode, fixes its body and, if necessary, its legs relative to the stroller, at least in the longitudinal and transverse vertical directions, for example, with a seat belt and leg locks if they have not been fixed earlier, puts the stroller in a stable in its sensations two-support position “balance” due to inertial gestures and / or force interaction, at the extreme at least with one handrail of the ladder, mainly in the gripping mode with brushes and turning on the drive of the walking propulsion in the forward mode, after which it continues to maintain the “balance” position until the staircase is completely overcome or forced to stop. 2. The moving method according to claim 1, characterized in that the person-user accesses the first lower step of the flight of stairs by means of a walking propeller drive, and the wheels approach the first upper step of the flight of stairs in front, for example, due to muscular strength of the upper limbs and torso. 3. The method of movement according to claim 1, characterized in that the human user drives up to the first lower step of the flight of stairs in reverse by pulling the upper limbs over the railings of the handrails. 4. The moving method according to claim 1, characterized in that the human user engages the drive of the walking mover in forward and reverse modes by turning and / or tilting the head to a relatively large angle sufficient to exclude accidental operations in the presence of a control system based on Hall sensor or similar devices, or by issuing a voice command in the presence of a control system based on the voice interface, or in another similar way. 5. The moving method according to claim 4, characterized in that after overcoming the first lower and / or upper stage, the human user turns off the drive of the walking propeller by turning and / or tilting his head in the opposite direction or by submitting an alternative voice command or disconnecting command of another control method, if necessary, withstands a pause for psychophysiological consolidation of the skills acquired in this way to control the balance and movement, it again turns on the drive of the walking mover and steps in this mode, according to Raina least another step depending on a necessary and sufficient degree of acquired skill and the individual features, whereupon the actuator includes stepping propulsion mode, usually continuous operation to fully overcome the flight of stairs, or emergency stopping. 6. The moving method according to claim 4, characterized in that the human user engages the drive of the walking mover in continuous operation by transferring, for example, a manual toggle switch or a specific head movement other than the movements turning the drive on and off, the control system in another a mode in which the drive is turned on by the said turn and / or tilt of the head, and is turned off by turning it again or tilting, that is, in the same direction with a preliminary return to its original position, after which it turns on the drive by turning bows the head to its original position, and upon completion of the flight of stairs or, if necessary, an intermediate stop, it turns off the drive by the next turn of the head. 7. The moving method according to claim 4, characterized in that the human user engages the drive of the walking mover in its continuous operation by transferring, for example, a manual toggle switch or a voice command other than commands turning the drive on and off. 8. The method of movement according to claim 1, characterized in that at the end of the step movement to the next step in the direction of raising or lowering the stroller, the grab of the handrail with the upper limb brush at the moment of support on the wheels with the levers of the walking mover suspended, the user transfers approximately by the value of the indicated step movement, while in case of grabbing with one brush of one handrail, he transfers the grab with the brushes one by one. 9. The moving method according to claim 1, characterized in that in order to overcome the flight of stairs down, the human user drives up to the first upper step of the flight of stairs in forward motion to a condition that does not break from the distance level provided by the automatic brake system.