RU2639794C1 - Device for restoration of motor activity of patients with spinal cord and brain damage - Google Patents

Abstract

FIELD: medicine.SUBSTANCE: device for restoration of the motor activity of patients with spinal cord and brain damage consists of a metal frame on a rack, a stationary metal u-shaped rod fixed at its top with a rotating roller block of a hand winch, where a suspension system is located. The suspension system consists of a seat, executed as a parachute suspension and connected by straps with a wide belt, to which four metal cables are attached, connected with the ends of a transverse transition bar from the center of which one metal cable extends via two roller blocks through the pad to winch rack and further to the mechanical reduction gear with a rotating handle. Two movable metal bars are secured on the frame by rotating anchor mechanisms on ball bearings, with the top parts made as handles, where the patient's hands are fixed by straps, and splints for knee joint fixation are secured in the middle and feet platforms (pedals) are secured in the bottom, as well as a mechanical reduction gear for patient establishment in an upright position, a dynamometer to control the degree of load on the limbs. The metal frame basis also contains a gear-eccentric system engine, coupled by handles with two moving metal thrust transfer bars secured to the pedals. The electronic converter and the computer provide a programmable algorithm for reciprocating movements of limbs in the horizontal plane. Six-channel electrostimulator, by means of which the three groups of muscles on each limb are stimulated, participates in the simulated motion. Three channels on one limb work in antiphase with the three channels of the other limb. Piezosensors are installed on the feet platforms, they synchronize the work of the engine and the electrostimulator by means of software.EFFECT: invention allows to provide the earliest possible physiological verticalization of the patient with fine dosage of orthostatic load on the lower limbs, to improve results and reduce the time of rehabilitation of patients with spinal cord and brain damages, and prepare a patient for independent walking on two legs.1 dwg

Description

The invention relates to medical equipment and can be used in institutions of practical health care, sanatorium-resort institutions, rehabilitation medical centers.

The relevance of the invention lies in the widespread trauma and diseases of the neuromuscular and musculoskeletal systems, especially with damage to the spinal cord and brain, leading to impaired bipedal locomotion (bipedal walking), for the restoration of which its use is effective.

The relevance of the invention also lies in the high social significance of the restoration of bipedal locomotion of the disabled, neurological, neurosurgical and trauma-orthopedic profiles.

A device is known (Patent No. 203836 dated 10/09/1967) for teaching walking patients with a sharp violation of the motor functions of the lower extremities with determining the degree of patient load on the limbs during walking, consisting of a base rigidly connected to curved racks on which handrails are mounted, it is also equipped a crossbeam with a mobile carriage in the form of a suspension system, a cord and a block with a hook. In order to determine the degree of load on the limbs during walking, medical scales are mounted in the base. The disadvantage of this device is the use of an outdated system for determining the degree of patient load on the limbs by means of mounted medical scales and a rigidly fixed flooring for walking.

The closest in technical essence to the proposed device is a treadmill simulator (Patent No. 2131283 dated 06/10/1999), containing a movable tape and holding means for the user, with the help of which his body weight can be partially balanced. The disadvantages of this simulator include the fact that it is impossible to perform passive movements with paralyzed limbs when the patient is vertical, which makes it impossible to rehabilitate patients with damage to the spinal cord and brain, and it is also impossible to perform rhythmic translational-recurrent movements with simultaneous muscle stimulation by paralyzed limbs.

The technical result of the proposed device for restoring the motor activity of patients with damage to the spinal cord and brain is to improve the results and shorten the rehabilitation of patients with injuries of the spinal cord and brain, early adaptation to orthostatic status and loads due to the use of gear-eccentric system, which ensures consistency in progressive-return movements of metal rods, as well as six-channel electric elements fixed to a metal frame a stimulator, which allows synchronizing with the operation of the engine electrical stimulation of three muscle groups on each limb involved in the act of simulated movement.

The indicated technical result is achieved in that the device for restoring the motor activity of patients with spinal cord and brain damage consists of a fixed metal frame on which two movable metal rods are mounted on ball bearings by rotating knot mechanisms, in the upper part are made in the form of handles, and in the lower part parts of them are fixed with splints that fix knee joints and platforms for feet; a mechanical gearbox is used to set the patient upright; the degree of load on the limbs is controlled by a dynamometer mounted on a cable; on a metal frame there is also an engine connected to two movable metal rods in their lower part through a gear-eccentric system; a programmable algorithm for translational-reciprocal limb movements in the horizontal plane is provided by an electronic converter and a computer; with the help of a six-channel electrical stimulator, three muscle groups are stimulated on each limb involved in the act of simulated movement; three channels on one limb work in antiphase with three channels of another limb; piezosensors installed on the platforms for feet, programmatically synchronize the operation of the engine and electrical stimulator.

Description of a device for restoring motor activity of patients with damage to the spinal cord and brain.

The device consists of a fixed metal frame, including a base (1), stabilizing bars (5) and a vertical strut (4), in the middle third of which two movable metal rods (6) are attached on ball bearings by rotating knots, while the lower part of the rods there are platforms for feet in the form of pedals (7) with built-in piezoelectric sensors, on which the patient's feet are mounted and secured with straps for fixing; removable fixing knee joints of the splint are fixed in the middle part of the rods (6), stops in the form of handles are built into the upper parts of the rods, where they are fixed with straps of the patient's hand; on a metal frame (1) on the basis of (13) there is a gear-eccentric system engine (12) connected by handles (10) with two movable metal rods of the transmission rod (8), attached to the pedals (7); in the upper part of the metal frame, on the stand (4), a fixed metal U-shaped rod (3) is fixed with a rotating roller block of a manual winch (2), on which there is a suspension system consisting of a seat made in the form of a parachute suspension and connected by belts with a wide belt, to which four metal cables are attached, connected to the ends of the transverse cross bar (3), from the center of which one metal cable passes through two roller blocks through the platform (9) to the winch post (11) and then to the mechanical eduktoru (12) with rotary knob (10), which ensures smooth movement of the dosing suspension system in the vertical plane, which is controlled by means of the dynamometer fixed on the cable; in turn, a six-channel electrical stimulator is also installed on the metal frame (4), from which electrical stimulation of three muscle groups on each limb participating in the act of simulated movement is supplied through the electrodes, while three channels on one limb work in antiphase with three channels of the other limb , and the synchronization of the engine and electrical stimulator is carried out by piezoelectric sensors. The essence of the proposed device is illustrated in FIG. one.

Description of the operation of the device for restoring the motor activity of patients with damage to the spinal cord and brain.

The device is used as follows. The patient is fixed in the suspension system. The patient's feet are located on the platforms for the feet and are fixed with straps. By rotating the handle of the mechanical gearbox, the tension of the metal cable and four cables is ensured, as a result of which the patient is set in a vertical position. Then the patient's knee joints are fixed with tutors and brushes to the handles using belts. Then, under the control of the dynamometer, by rotating the gear knob, the necessary amount of lightening the body weight (the amount of load on the legs) is set. Depending on the patient's capabilities, the degree of cable tension, which allows you to adjust the load of the body weight on the foot, can vary from 0 to 100%. The cutaneous electrodes are superimposed on the gluteus muscle (1-channel), on the quadriceps muscle (2-channel), on the calf muscle (3-channel) of the right lower limb and are fixed with elastic bands and similarly on the left lower limb, the electrodes are connected by wires to a six-channel electrical stimulator and further with the computer. The computer sets the algorithm for the synchronous action of electrical stimulators (the duration of the electrical stimulation of the muscles of each leg is 1 s, and the operation of the three channels is configured to work in antiphase mode with respect to the other three channels on the opposite lower limb) and the back and forth movement of the rods (with frequent movements of 60 translational movements in 1 min of each bar) in three combinations: full mode (using an electric stimulator and passive back and forth movements); incomplete mode (passive movements are provided only by the electric drive system without electrical stimulation); simple mode (active movements are carried out without electrical stimulation when the electric motor is off due to the own muscular effort of the limbs). The duration of the procedures is 40 minutes (every 10 minutes the patient rested for 5 minutes) twice a day.

The proposed device for restoring the motor activity of patients with damage to the spinal cord and brain, used in the rehabilitation of patients with damage to the spinal cord and brain, provides the earliest physiological verticalization of the patient with a thin dosage of orthostatic (gravitational) load on the lower extremities. Mechanical movements and simultaneous electromyostimulation are capable of producing a powerful afferent flow from proprioceptors of muscles and joints, which activates the regeneration of cells in the damaged part of the spinal cord and can help restore the lost stereotype of bipedal walking. A dosed change in the orthostatic force of gravity and a combination of mechanical movements of the limbs with electromyostimulation of the main antigravity muscle groups on the proposed device can significantly reduce the rehabilitation time and prepare the patient for independent movement.

Claims (1)

A device for restoring the motor activity of patients with spinal cord and brain damage, consisting of a metal frame on a rack fixed in its upper part of a fixed U-shaped metal rod with a rotating roller block of a manual winch, on which there is a suspension system consisting of a seat, made as parachute suspension and connected by belts with a wide belt, to which four metal cables are attached, connected to the ends of the transverse cross bar, from the center of which two metal blocks cut one metal cable through the platform to the winch stand and then to a mechanical gearbox with a rotating handle, characterized in that on the frame by means of rotating knot mechanisms on the ball bearings are fixed two movable metal rods made in the upper part in the form of handles, where they are fixed patient's hand straps, and in the middle part they are fixed with splints that fix the knee joints and at the bottom of the platform for the feet (pedals); mechanical gearbox to set the patient in a vertical position; dynamometer to control the degree of load on the limbs; on a metal frame on the base there is also a gear-eccentric system engine connected by handles to two movable metal transmission rod rods attached to the pedals; an electronic converter and a computer that provide a programmable algorithm for translational-reciprocal limb movements in the horizontal plane; a six-channel electrical stimulator, with the help of which three muscle groups are stimulated on each limb participating in the act of simulated movement; three channels on one limb work in antiphase with three channels of another limb; piezosensors installed on the platforms for feet, programmatically synchronize the operation of the engine and electrical stimulator.

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