RU2766786C1 - Device for forming motor skills of walking in children with infantial cerebral palsy and with diseases of the locomotor system - Google Patents

Abstract

FIELD: medicine.SUBSTANCE: invention relates to medicine, namely to devices for the formation of motor skills of walking in children with cerebral palsy and diseases of the musculoskeletal system. The device includes thigh pads and an adult's lumbar belt connected to the pads. The thigh guards are made with the possibility of attaching them to each leg of an adult. Each shield has handles with handles for a child's grip. The thigh pads and the lumbar belt of an adult are made rigid, repeating the anatomical relief of the corresponding part of the body of an adult. The thigh pads and the lumbar belt are interconnected by a hinge. The handles are mounted on the shields by means of a fastening made with the possibility of adjusting the handles in height and length relative to the attachment point.EFFECT: increased duration, efficiency, safety and comfort, as well as reduced labor intensity and complexity of physiotherapy for children with cerebral palsy and disorders of the musculoskeletal system.7 cl, 12 dwg

Description

FIELD OF TECHNOLOGY

The invention relates to such a field of medicine as physiotherapy, namely to devices that help patients or people with disabilities walk, and can be used, for example, for teaching walking and / or rehabilitation of children diagnosed with cerebral palsy (ICP) and diseases musculoskeletal system.

PRIOR ART

Known device [RU2131232C1, publ. 06/10/1999] for physiotherapy of cerebral palsy by forming the initial passive motor skills of walking in a child, containing a children's overall with a left and right foot, in which the child is placed in the front "overalls", hung in front on the shoulders of a physiotherapist. While walking, the physiotherapist can use his hands to carry out the child's synchronous forced movements of the arms or legs, which are characteristic of walking.

The disadvantages of the device include the fact that, firstly, when using it, it is possible to limit the functionality (unsuitability for the patient to develop active motor skills of walking and motor skills of coordinated movement between arms and legs), and secondly, stiffness of movements is possible due to the complex constructive solutions - the presence of 17 parts in the design and in the third - it is possible to use only for a specific size, height and weight (individual) of one patient.

A device for physiotherapy of cerebral palsy by forming the motor skills of walking in a child is known [RU2272609 C2, publ. March 27, 2006], which contains a children's overall with a left and right foot, as well as additionally containing an adult overall, made with feet having upper parts for the child's legs, and the adult overall on the upper part of each foot is equipped with a device for fixing the same name, left and right , feet of the children's overalls, in the region of each shin, a latch is installed for fastening the same-named shin of the children's overalls, and in the area of the shoulder girdle chest straps are placed to support the torso part of the children's overalls in a straightened state, while the sleeves of the children's overalls are equipped with external, in the wrist area, rods, with the help of which a physiotherapist in an adult overalls exercises manual control of the pendulum movement of the hands of a child in a children's overalls.

The disadvantages of this device include, firstly, a long interval for putting on and taking off the overalls (30-40 minutes), and secondly, when used, it is possible to violate the stereotype of the movement of the upper limbs, which is carried out by the pendulum movement of the child's hands by the trainer-therapist. The device consists of a system of belts made of polypropylene, which, with prolonged use, leads to chafing and, accordingly, irregular training. And with prolonged training, it can lead to an increase in the influence of the cervical tonic symmetrical reflex.

The closest technical solution is a device for the formation of motor skills of walking in children with cerebral palsy (ICP) and diseases of the musculoskeletal system, disclosed in [RU2698987 C1, 02.09.2019), including means for fixing a child to an adult and the possibility of simultaneous locomotion of an adult and a child; at the same time, said means contain shields with handles, made with the possibility of their fastening on the front surface of the thigh of each leg of an adult, and a lumbar belt of an adult, made with the possibility of its connection with the shields; moreover, perpendicular to the free ends of the handles, handles are attached towards each other by means of a detachable connection, while the ends of the handles are made with the possibility of installing a removable protective chain on them.

The disadvantages of the known above device include the fact that:

- firstly, the thigh pads and the belt are made of "soft" and non-orthopedic form (cover less than 80% of the thigh), i.e. not repeating the relief of the human body, which leads to an uneven load on the entire structure, and with prolonged use to an uncomfortable state of an adult; also, a significant part of the load falls on the handles, which leads to its rapid failure;

- secondly, the device does not provide for individual adjustment to the parameters of a particular child (according to the height of the child, the length of the child's arms and the width of the shoulder girdle);

- thirdly, the handles intended for the child are installed in only one position, excluding grip options;

- fourthly, fixation on an adult is carried out with the help of belts and does not have a rigid structure (attachment), the thigh pads constantly slide off the legs of an adult, which leads to a permanent stop of the training process;

- fifthly, when the handles are located towards each other, the main pressure on the hand falls on the elevation of the thumb, which leads to discomfort and fatigue of the child's hands; while the brush experiences significant pressure and vibration.

Thus, there is a need to create an improved device for developing active motor skills of walking and motor skills of coordinated movement of arms and legs in patients with cerebral palsy and diseases of the musculoskeletal system. apparatus with milder forms of the disease.

DISCLOSURE OF THE INVENTION

The invention is based on the task of developing an improved training device for the formation of a motor stereotype in patients with a deficiency in the locomotor functions of the lower and upper limbs.

The technical result is to increase the duration, efficiency, safety and comfort, as well as reduce the complexity and complexity of physiotherapy for children with cerebral palsy and disorders of the musculoskeletal system.

Another technical result is the ability to control organs and functions in the human body by signals from the brain, implemented in the form of motor interactions of analyzer systems and cognitive processes.

And another technical result is the ability to control the frequency, length of steps and the pace of walking by demonstrating the image on the surface of the surface on which the adult and the child walk.

This task is achieved by the fact that, like the well-known proposed device for the formation of motor skills of walking in children with cerebral palsy and diseases of the musculoskeletal system, it includes thigh pads made with the possibility of fixing them on each leg of an adult and a lumbar belt of an adult connected with shields, while on each shield there are handles with handles for the child's grip.

What is new is that the hip shields and the lumbar belt for an adult are made of orthopedic form (shapes repeating the anatomical relief of the corresponding part of the body of an adult), and the hip shields and the belt are interconnected by a special hinge, which ensures stability (stabilization) of the said handles, which are installed on the shields. with the possibility of their adjustment in height and length relative to the place of attachment.

At the same time, the thigh guards are made with the possibility of their fastening, both on the left and on the right side of the thigh of each leg of an adult.

Preferably, the thigh guards and belt are made of a thermoplastic material to stiffen them, such as PVC foam.

In addition, the mentioned handles have an ergonomic shape: they consist of two parts, each of which is made of a piece of a single pipe: one main part, parallel to the horizontal plane, is fixed at one end to the thigh guards, while its other end is made bent upwards at an angle; and the second part, fixed at the end of the first, perpendicular to it, so that the ends of the second part of one handle are directed towards the end of the second part of the other handle and parallel to the child, which makes it possible to install the said handles on them facing the child and the possibility of a comfortable grip child.

At the same time, the handles are installed at the ends of the second part of the handles with the possibility of their movement and fixation along the width of the child's shoulder girdle.

Moreover, for the formation of a motor stereotype in patients with a deficiency in the locomotor functions of the lower and upper limbs, the device contains a laser module, which is two lasers located at the ends of the handles in the direction of movement.

Additionally, to control the laser module, it contains a WiFi Bluetooth module, which is located on the back of the orthopedic belt.

Handles with a fixing ring are attached to the ergonomic handles (their second part).

One of the advantages of the proposed technical solution is the lack of fixation of a child to an adult, since when fixing a child, a violation of the stereotype of movement (walking) of the child is possible.

Special orthopedic hip shields with handles, with the possibility of fastening on the left and right side of the thigh of each leg of an adult and an orthopedic belt for an adult, with a hinged fixation system with hip shields, gives the child the possibility of precise and stable movement.

You can practice for a long time in this simulator (the device proposed in the present invention), which does not lead to fatigue of the parents and the child himself, and be constantly under the supervision of an adult. The simulator can be adapted for the most convenient and safe work based on the physical characteristics of the child.

There are no uncomfortable belts to which the child is attached in a known technical solution (prototype), which in turn will protect against chafing. And for an adult (parents), the proposed device will allow you to be in a natural position (vertical). Due to the implementation of the orthopedic belt, the load is more evenly distributed on the lower back.

Due ring fixation of the handles (the handles are attached with an eccentric (screed) and a fixing ring) on the second part of the ergonomic handles (straight pipe) at an angle of 90 degrees inward, i.e. facing the child, it is possible to change the position of the arms in width and more evenly distribute the load on the hands and forearms of the child.

The Adult Orthopedic Leg Pads and Belt are designed with a smooth, semi-circular shape to prevent abrasion of the trainer's (adult) skin during use for optimal biomechanics.

Of great importance when walking is the coordinated movement of the upper and lower extremities, the so-called "cross-coordination", in which the extension of the right leg is combined with the extension of the left arm, and vice versa. Cross-coordination reduces rotational movements of the torso.

In the proposed device for the formation of a motor stereotype in patients with a deficiency in the locomotor functions of the lower and upper extremities, it is also carried out due to the laser module, which is two lasers located on the first part of a straight pipe parallel to the horizontal plane, at the end - a curved shape.

To enhance the effect and create a control system for organs and functions in the human body with signals from the brain, implemented in the form of motor interactions of analyzer systems and cognitive processes, an image is displayed on the surface of the surface on which an adult and a child walk. The child sees this image and takes a step towards the image. Thus, we can regulate the length of the step, its speed, consolidate speech, speech therapy knowledge and train visual analyzers. The lasers are controlled by a WiFi Bluetooth module that runs an http server that can be connected to from any device, such as a phone with a browser.

The training device proposed in the present invention for the formation of a motor stereotype in patients with a deficiency in the locomotor functions of the lower and upper limbs is designed to develop step automatism in a vertical position, restore a full step, a walking reflex in children with problems of the central nervous system and multiple disorders of the musculoskeletal system (ODA) from an early age.

The method of movement on the training device is based on the exoskeleton principle.

The movement begins with the movement of the adult's leg, due to which the child's arm is carried forward and upward, and the child takes a step forward with the opposite leg, etc.

THE INVENTION IS EXPLAINED BY GRAPHIC MATERIALS

In FIG. 1 shows a drawing of a general view of the proposed device.

In FIG. 2 shows a drawing of orthopedic thigh pads: a) side view, b) front view.

In FIG. 3 shows a drawing of an orthopedic belt for an adult: a) front view, b) side view.

Figure 4 shows a drawing of the mount used to secure the ergonomic handles on the thigh guard with the possibility of adjusting their height and length.

In FIG. 5 is an external view of a possible WAKE attachment (FIG. 4) for use in the present invention.

In FIG. 6 is a drawing of a side view of a handle for a child.

In FIG. 7 shows a drawing of a general view of the handle with a fixing ring and an eccentric (screed) for moving it at the end of the handle.

In FIG. Figure 8 shows a diagram of the biomechanics of a child's movement using a laser module.

In FIG. 9 shows a general view of the location of a child and an adult when using the proposed device.

In FIG. 10 shows the view of the used laser module.

Figure 11 shows a view of the ESP32 WiFi Bluetooth module used.

In FIG. 12 shows a block diagram of the operation of the hardware for the implementation of the training process.

IMPLEMENTATION OF THE INVENTION

The proposed device (Fig. 1 - Fig. 7) contains: 1 - orthopedic belt for an adult; 2 - orthopedic thigh pads for an adult; 3, 4 - hinge (KINESIO universal hinge); 5, 6 - ergonomic handles; 7 - handles; 8 - fastening of ergonomic handles, with the function of adjusting them in height and length; 9 - textile fastener for an orthopedic belt for an adult; 10 - textile fasteners for a thigh guard for an adult; 11 - hole for attaching the hinge; 12 - D-shaped semi-ring for attaching a textile fastener 9; 13 - me with the attachment of the laser module; 14 - aluminum guide for moving in height using fastening 8 of the ergonomic handle 5 and 6; 15 - eccentric for fixing the handle to the ergonomic handle; 16 - fixing ring for adjusting handles 7.

Orthopedic thigh pads 2 for adult are made of foamed PVC plastic (164mm/190mm/5mm); guide 14 is made of aluminum pipe PN 25 mm (Fig. 2) 150 mm long; orthopedic belt 1 for an adult is made of foamed PVC plastic (110 mm / 980mm / 5mm); to fasten the belt and shields 2 on the thigh, textile fasteners (9 and 10) of the brand Velcro 50mm are used - one for the belt (Fig. 3) and two fasteners for each leg of an adult (Fig. 2); holes 11 for fastening on the belt 1 with hinges 3 and 4 make a diameter of 5 mm; D-shaped semi-ring 12 for fastener 9 is made of metal with a diameter of 3 mm, a width of 50 mm; fasteners 8 use fasteners of the WAKE type (Fig. 4 and 5); handle 7 is made of aluminum alloy (pipe) with a diameter of 25 mm, a length of 100 mm; the fixing ring is made with a diameter of 25 mm; Ergonomic handles 5 and 6 have a curved shape on the side of the handle attachment at an angle of 27 degrees.

Ergonomic handles 5, 6 and handles 7 for a child are made from a solid aluminum pipe PN 25 mm, for example, aluminum pipes in accordance with GOST 18482-79, GOST 18475-82, GOST 23697-79. Aluminum pipe has physical and chemical characteristics, namely strength, wear resistance, elasticity. The handles are made of two parts: the first part (straight pipe) with the end bent upwards at an angle of 27 degrees, and the second part (straight pipe) attached perpendicular to the end of the bent part at an angle of 90 degrees inwards.

The creation of control systems for organs and functions in the human body by signals from the brain, implemented in the form of motor interactions of analyzer systems and cognitive processes in the proposed device for the formation of a motor stereotype in patients with a deficiency in the locomotor functions of the lower and upper extremities, is carried out using a laser module with a collimating lens and current limiting resistor: (not shown): two red lasers 5 mW, 3 volts, wavelength: 650 nm (Fig. 10) [https://kulibin.su/catalog/radiodetali/svetodiody/drugoe_1/lazer-5v-650nm -5mvt-diametr-6mm-krasnyy.html?r1=yandex&r2=&ymclid=16216752856578340194700001].

The laser module consists of two lasers located at the end of the first part of each handle.

The control is carried out by the ESP32 WiFi Bluetooth module (Fig. 11), which is located on the back of the orthopedic belt in the case for electronic equipment, dimensions 80x120x56mm, case type rectangular ABS plastic material (not shown).

The block diagram of the hardware operation is shown in Fig. 12, where TL-1 is a telephone; ESP32 - low power microcontrollers, which is a system on a chip with integrated Wi-Fi and Bluetooth controllers; http server - data transfer protocol; Power Bank - external battery; timer - at a given moment of time, issuing a certain signal, or turning on / off the image on the laser modules.

The device works as follows.

Step 1. Trainer-therapist (adult) puts on a special orthopedic thigh pads 2 and belt 1 (figure 1 and 6).

Step 2. The adult fastens the belt 1 and the thigh pads 2 to the left and right legs with the help of textile fasteners (Fig. 3).

Step 3. Next, the adult fixes the ergonomic handles 5 and 6 on the left and right (adjusting them in height up to 15 cm and length forward and back up to 20 cm using fastening 8).

Step 4. Then the handles 7 are adjusted using the eccentric 15 and the fixing ring 16 on the handles along the width of the child's shoulder girdle up to 10 cm to the left and right, for a comfortable grip of the child (Fig. 9). The child is placed between the ergonomic handles 5 and 6 and the trainer-therapist (Fig. 9). Child holding hands 7.

Next, the laser module is adjusted (calibrated) to the length of the child's step. To enhance the effect and create a control system for organs and functions in the human body with signals from the brain, implemented in the form of motor interactions of analyzer systems and cognitive processes, an image is displayed on the surface of the surface on which an adult and a child walk. The child sees this image and takes a step towards the image. The laser module is controlled by ESP32, which launches an http server, to which you can connect from any device (TL-1 phone) that has a browser and select which settings to set. Thus, you can adjust the length of the step, its speed, consolidate speech, speech therapy knowledge and train visual analyzers (Fig. 8).

Next, smooth stepping movements begin with the foot of an adult (coach-therapist), to which the child gets used. The trainer-therapist gives a warning command to go forward, and begins to walk forward, taking precautions. Movements are carried out according to the law of “cross-coordination”, in which the extension of the right leg of the trainer-therapist is combined with the extension of the child’s left hand, and vice versa, and all this is accompanied by a demonstration of the image on the surface on which the child and adult are walking.

The load should always be on the orthopedic hip pads and the lumbar belt of the trainer-therapist, to which the ergonomic handles for the child are fixed. The child should not hang on the training device, but try to make stepping movements on his own, try to stand, while starting to feel safe and secure.

The proposed device allows, compared with the known device (prototype), to expand the therapeutic functionality of the device, increase efficiency, safety and comfort, as well as reduce the complexity and complexity of physical therapy for cerebral palsy and children with disorders of the musculoskeletal system. The child (patient) feels not only safer, but also more comfortable and interested, the effectiveness of training and / or rehabilitation increases. Unlike known devices, the proposed device allows you to develop motor skills of coordinated movements of the arms and legs, while ensuring the synchronism of the movement of opposite arms and legs. Engage the control systems of organs and functions in the human body with signals from the brain, implemented in the form of motor interactions of analyzer systems and cognitive processes. Training can be carried out for a long time or continuously, or cyclically, with breaks. The device allows you to adjust the frequency, length of steps and the pace of walking by displaying the image.

Claims (7)

1. A device for the formation of motor skills of walking in children with cerebral palsy and diseases of the musculoskeletal system, including thigh pads, made with the possibility of attaching them to each leg of an adult, and the lumbar belt of an adult connected to the pads, while on each the shield has handles with handles for gripping a child, characterized in that the thigh shields and the lumbar belt of an adult are made rigid, repeating the anatomical relief of the corresponding part of the body of an adult, and the hip shields and the lumbar belt are interconnected by a hinge, while the handles are mounted on the shields when with the help of a fastening made with the possibility of adjusting the handles in height and length relative to the place of fastening. 2. The device according to claim. 1, characterized in that the thigh guards are made with the possibility of their fastening both on the left and on the right side of the thigh of each leg of an adult. 3. The device according to claim 1, characterized in that the thigh guards and the belt are made of thermoplastic material, namely, foamed PVC plastic. 4. The device according to claim 1, characterized in that the handles consist of two parts, each of which is made of a piece of a single pipe, with one part having a curved shape, with one end fixed to the thigh guards, and with the other end bent upward at an angle in relation to its first end, is connected to the second part of the handle, made in the form of a straight pipe, fixed perpendicular to the first part of the handle, so that the ends of the second part of one handle are directed towards the end of the second part of the other handle and parallel to the child, which makes it possible installation of handles on them facing the child, and the possibility of the child grabbing these handles. 5. The device according to claim. 1, characterized in that the handles are installed at the ends of the handles with the possibility of moving and fixing them along the width of the child's shoulder girdle. 6. The device according to claim 1, characterized in that for the formation of a motor stereotype in patients with a deficiency in the locomotor functions of the lower and upper extremities, it contains a laser module, which is two lasers located at the ends of the handles in the direction of movement. 7. The device according to claim 6, characterized in that it contains a WiFi Bluetooth module for controlling the laser module, which is located on the back of the orthopedic belt.

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