RU2683071C2 - Rehabilitation-massage device for hand and fingering - Google Patents

Abstract

FIELD: medicine.SUBSTANCE: invention refers to medical equipment and, in particular, to devices for physiological rehabilitation after a stroke in spasmodic or paresis of upper extremities, traumas, surgical and neurosurgical operations, as well as for other causes of impaired motor activity of the hand and fingers. Device can also be used as a simulator, a massager, independently or as part of a complex with a stationary or a mobile computer. Rehabilitation-massage device for hand and fingers comprises a base with a hand holding unit and a finger drive mechanism, comprising a finger tip attachment. Finger drive mechanism comprises five flat five-link hinge mechanisms installed so that their planes coincide with physiological plane of movement of each finger. One-finger drive mechanism comprises one flat five-link hinge mechanism, in the center hinged assembly of which there is a finger tip attachment, and each lower link is rigidly connected to the shaft of the electric drive of rotation fixed near it on the base and independently connected to the electronic control unit.EFFECT: invention allows combining functions of a simulator and a massager in one device.6 cl, 3 dwg

Description

The proposed device relates to the field of medical equipment and, in particular, to devices for physiological rehabilitation after a stroke (during spasm or paresis of the upper limbs), injuries, surgical and neurosurgical operations, as well as other causes of impaired motor activity of the hand and fingers. The device can also be used as a simulator, massager, independently or as part of a complex with a stationary or mobile computer.

Currently, in the general structure of diseases of the cardiovascular system, cerebrovascular disorders are characterized by the most severe medical, social and economic consequences. One of the main causes of disability is a stroke, the consequence of which is a violation of the movement of the fingers. To restore the mobility of the joints of the fingers after a stroke, the so-called method of continuous passive movements (CPM therapy) is used, which is based on mechanotherapy using special robotics. CPM therapy is as follows: due to the metered stretching of tissues under conditions of muscle relaxation, mobility in the joint is achieved. CPM therapy helps to accelerate the restoration of their own movements in the affected limb, relieve pain, relieve swelling, prevent the formation of contractures and thrombosis, and other diseases.

When recovering from an injury or surgery on the hand, it is also necessary to provide a large range of movements in the restored limb. Ensuring the mobility of the hand in the required volume and with the necessary bending angles of the fingers in the first 14 days after the operation or during the recovery period after injuries allows you to return the range of movements in the hand in full, as it was before the moment of the injury or operation. An important condition for successful recovery is working with the fingers with the maximum trajectory of the fingers moving, because with an incomplete massage amplitude, recovery may not be complete, only within the massage amplitude, and for different fingers this trajectory will be different, due to the different lengths of the fingers. To achieve the maximum effect, it is desirable to carry out both active rehabilitation - massage, and passive, when the patient himself tries to move his fingers, and the device is used as a simulator with a variable and measured resistance force. It is also important during the massage to have the most constant force exerted on the fingers, so as not to damage the bones or joints with excessive force, at the same time, the force should be sufficient to bring the fingers in motion.

A rehabilitation and massage device for the hand and fingers is known (patent DE 202016000944 (U1), IPC А61Н 1/02, publ. 2016-06-16), containing a base with a block for fixing the hand, on which the mechanism for driving the fingers into motion, made with the possibility of mounting on the middle joints of each finger, in the form of a carriage connected through levers with mounts. During operation of the device, the finger movements determined by the fastener have only one path defined by the curvature of the guide. For hands with different finger lengths, the mechanism of the guide and the carriage must be changed, since the mount must be located on the middle finger joint.

However, this device has only a limited trajectory of the finger when used for rehabilitation, requires the selection of a guide and carriage mechanism for hands of various sizes, and is limited to using only for rehabilitation movements of the hands and fingers only with the help of massage, without the possibility of using the device as a simulator.

A rehabilitation and massage device for the hand and fingers is also known (Patent application US 20130072829 A1 IPC A61H 99/00, publ. 2013-03-21), which is a base in the form of a bracket, with a mount for the hand, and 4 are installed on the base linear actuators, and the fingers are driven in motion by means of 4 flexible connections with thimbles worn on the fingertips, with intermediate fixation by loops of flexible connections on the joints, and the loops are fixed on a modular glove. The force moving the finger through the thimbles is almost equal to the force acting on the flexible rods on the drive side. For each finger, you can realize its amplitude of motion along an unchanged path.

However, the massage path in the known device is limited by the one-dimensional thimble curve, including the flexibility of the finger joints. If the joint does not bend, then other joints will bend, and the goal of the massage will not be achieved. The device is also very critical both to the length of the fingers and to the width of the palm - even with a slight difference in the length of the fingers, the device will need to be rebuilt, and the modular glove will not fit a wider or narrower palm.

Known adopted for the prototype rehabilitation and massage device for the hand and fingers, containing a base with a block for fixing the hand, on which is fixed the mechanism for driving the fingers into motion, containing a mount for the fingertips. The mechanism for driving the fingers into motion consists of an electric motor and a system of gear reducers and levers, the axis of the last lever being connected by elastic rods to the finger mount. Thus, the electric motor drives the fingertips of the patient through a system of lever reducers and elastic traction, performing only forced massage, and the movement for all fingers is immediately determined by the movement of one axis - the axis of the last lever. (Patent US 5697892 (A), IPC A61H 1/02, publ. 1997-12-16).

However, the complex kinematic scheme does not allow limiting or making the force that causes the fingers to move, which is necessary for the safe operation of the device. The use of the device is limited to using it as a massager and one-dimensional curved path of the fingers, which is not optimal for rehabilitation.

The present invention solves the problem of creating a simpler and more universal device that allows you to expand the scope of the device by combining it with various functions of a rehabilitation device - both a simulator and a massage device, to ensure work with a given force, as well as with a predetermined passive load, with an independent multidimensional path for each finger, including the thumb, providing analysis, viewing and recording session parameters, and in addition to increase its security.

The problem is solved by a rehabilitation and massage device for the wrist and fingers, containing a base with a block for fixing the hands on which the mechanism for driving the fingers is fixed, containing a mount for the tips of the fingers, the novelty of which is that the mechanism for driving the finger in motion contains at least one flat five-link hinge mechanism, in the central hinge of which there is a mount for the fingertips, each lower link is rigidly connected to the shaft of the electric drive of rotation, eplennogo near him on the ground and are independently connected to the electronic control unit, wherein the five-link hinge mechanism mounted to match its plane with the plane of physiological movements massaged finger.

To work with the fingers of the whole hand, the mechanism for driving the fingers in motion contains five five-link mechanisms installed in such a way that their planes coincide with the physiological plane of movement of each finger.

To work with both the right and left hand, the device further comprises a sixth five-link hinge mechanism, mounted in such a way that the planes of the extreme five-link mechanisms coincide with the physiological plane of the movement of the thumbs of both hands.

For safe operation of the rehabilitation and massage device, the mount for the tips of the fingers is equipped with a fuse-latch.

To work with a given force, the rehabilitation and massage device further comprises current sensors of electric rotation drives located in their power circuit.

To use the inventive device, including as a simulator, reversible electric drives are used as rotation electric drives.

For analysis, viewing and recording parameters of a session of a rehabilitation massage device, the electronic control unit is configured to connect to an indicator and / or computer.

A five-link flat hinge mechanism can be made with any rack length formed by the axes of electric rotation drives, including a rack length equal to zero.

The technical result is expressed in the implementation of rehabilitation of the upper limbs of the patient with the possibility of both active and passive rehabilitation, carried out with maximum safety, leading to its quickest recovery, restoration of joint mobility and in general the entire nervous system from the brain to muscles, leading also to accelerated treatment relieving pain, relieving edema, preventing contractures and thrombosis. The device is also suitable for recovering patients after severe injuries (fractures) and neurosurgical operations both at home and in medical hospitals.

The present invention is illustrated by drawings, an example of a rehabilitation and massage device on which, however, is not the only possible, but clearly demonstrate the possibility of achieving the claimed technical result.

In FIG. 1, a dimetric projection of a rehabilitation massage device for a hand and fingers with a mechanism for driving a finger into motion, comprising one flat five-link articulated mechanism, is shown.

In FIG. 2 shows a photo of a rehabilitation and massage device for the hand and fingers in the process of working with five fingers.

In FIG. 3 shows a view of the device in the plane of a five-link articulated mechanism (the mechanism is circled by a frame), the arm mount and control unit are not shown.

A rehabilitation and massage device for the wrist and fingers (Fig. 1, Fig. 3), contains a base 1 with a block for fixing the arm 2 and a mechanism for driving the finger into motion, containing a flat five-link articulated mechanism 3, in the central hinge of which there is a mount for the ends fingers 4, and each lower link a and d (Fig. 3), is rigidly connected to the shaft of the electric drive of rotation 5, mounted next to it on the base 1 and independently connected to the electronic control unit 6, and the five-link hinge mechanism 3 is installed with the possibility matching his plane with physiological plane motion massaged finger.

The device can be made with a mechanism for driving fingers in motion, containing five five-link flat articulated mechanisms installed in such a way that their plane coincides with the physiological plane of movement of each finger (Fig. 2), and six, with the sixth five-link articulated mechanism so that the planes of the extreme five-link mechanisms coincide with the physiological plane of the movement of the thumbs of both hands. For the safe operation of the rehabilitation and massage device, the mount 4 for the fingertips can be equipped with a fuse-latch 7 (Fig. 1, Fig. 3). To work with a given force, the rehabilitation and massage device may additionally contain current sensors of electric rotation drives located in their supply circuit (not shown in Fig.), Reversible electric drives are taken as rotation electric drives for using the inventive device including a simulator. For analysis, viewing and recording parameters of the session of the rehabilitation massage device, the electronic control unit 6 can be configured to connect to an indicator and / or computer (not shown in FIG.). The five-link flat articulated mechanism can have any length of the strut formed by the axes of electric rotation drives, including zero.

The inventive device operates as follows. The patient’s hand is secured in the wrist area with a cloth or other soft latch in the hand fixation unit 2, mounted on the base of the device 1, while the fingertips of the patient through the magnetic or mechanical fuse-latch 7 are placed in the mount 4 located in the central hinge assembly of the corresponding flat five-link hinge mechanism 3, pre-installed so that its plane coincides with the physiological plane of movement of the massed finger. The hinge mechanisms are driven by electric drives of rotation 5. In accordance with the instructions of the attending physician, the electronic control unit 6 rotates each lower link a and d independently connected to it (Fig. 3), rigidly connected to the shaft of the corresponding electric drive of rotation 5, by the given angles ϕ and ψ relative to the X axis so that the rotations of the shafts of the rotation drives 5 uniquely determine the position of the central hinge assembly of the mechanism and the fastener 4. Thus, an arbitrary 2-dimensional motion ix of the assembly. The trigonometric calculation of the mechanism shows that the force to drive the fingers into motion is practically independent of the angle of rotation of the electric drives, this is a big plus. It is possible to control the force of movement, up to zero, which allows you to use the device as partially or completely passive, as follows: having worked out a massage with a nominal force acting on the fingers, you can gradually reduce this force so that after partially restored motility the patient’s fingers will be actively participate in the movement. Such a decrease in the power of electric drives can be reduced to a complete decrease, turning the device into a completely passive simulator-patient will move his fingers, thus rotating the shafts of electric drives through 5-link mechanisms, while the electric drives should be reversible. Equipping the device with current sensors, we can measure the speed of the patient’s fingers by the voltage generated by the electric drives 5 (they will be forced to rotate).

The device allows you to turn on the massage not for all fingers, if necessary, and also to make an arbitrary movement for any finger along any path defined by the control unit 6.

Forced finger massage with fixation of the hand produces both muscle relaxation and the generation of a huge number of nerve impulses, which contributes to the regeneration of the nerve connections of the brain in case of loss of controllability of the muscles during a stroke or brain damage. Also, the device is useful in rehabilitation after surgical or neurosurgical operations as a replacement for the expensive services of a specialist massager. In passive mode, the device can be used to record the movement of fingers, current meters will give a signal, determined by the speed of movement of the fingers of the patient.

Thus, the application of the invention will allow to achieve the objectives:

- creating a simpler device by bringing the fingers into motion with a simple design of a flat 5-link mechanism;

- the universality of the device by expanding the scope, combining it with the various functions of the rehabilitation device - both the simulator and the massage device by using a reversible electric rotation drive;

- ensuring work with a given force sufficient to move the tip of the fingers and flexion of the joints, but not leading to fractures or dislocations, due to the almost unchanged force of movement of the fingers at a given moment of electric rotation, and the moment can be controlled by an electronic control unit, as well as with a predetermined the magnitude of the passive load, constant throughout the amplitude of the finger, and this constancy is especially important at the initial stage of rehabilitation.

- to obtain an independent two-dimensional trajectory for each finger, including the thumb, which is important because the fingers have different lengths and different amplitude of movement, and for the maximum therapeutic effect it is better to carry out the movement at the entire possible amplitude, different for different fingers.

- provide analysis, viewing and recording session parameters by applying current sensors of electric rotation drives

- increase the safety of the rehabilitation device by using fuses in the form of mechanical or magnetic latches for fastening the finger.

Claims (6)

1. Rehabilitation and massage device for the wrist and fingers, containing a base with a block for fixing the hands and a mechanism for driving the finger into motion, comprising a fixture for the fingertip, characterized in that the mechanism for driving the finger in motion contains five flat five-link hinge mechanisms installed in this way that their planes coincide with the physiological plane of movement of each finger, while the mechanism for driving one finger in motion contains one flat five-link hinge mechanism, in the central hinge the other node of which there is a mount for the tip of the fingers, and each lower link is rigidly connected to the shaft of the electric drive of rotation, mounted next to it on the base and independently connected to the electronic control unit. 2. The device according to p. 1, characterized in that for working with both the right and left hand, it further comprises a sixth five-link articulated mechanism, mounted in such a way that the planes of the extreme five-link articulated mechanisms coincide with the physiological plane of movement of the thumbs of both hands . 3. The device according to p. 1, characterized in that for the safe operation of the rehabilitation and massage device, the mount for the fingertips is equipped with a fuse-latch. 4. The device according to p. 1, characterized in that for working with a given force, the rehabilitation and massage device further comprises current sensors of electric rotation drives located in their power circuit. 5. The device according to claim 1, characterized in that for using it, including as a simulator, reversible electric drives are used as rotation electric drives. 6. The device according to p. 1, characterized in that for analysis, viewing and recording parameters of the session of the rehabilitation and massage device, the electronic control unit is configured to connect to an indicator and / or computer.

Images