SI26009A - Medical device for replacing lost or weakened muscle function that allows limb flexion or extension in the joint - Google Patents

Abstract

The present invention is included in the field of medicine and medical devices in the field of orthopedic devices for non-surgical treatment of bones and joints. The invention relates to a medical device for the replacement of lost or weakened muscle function, which allows flexion or extension of the limb in the joint. The essence of the medical device according to the invention is that to replace the lost or weakened muscle function that allows flexion or extension of the limb in the joint, use a torsion spring that is properly prestressed, so that: - in case of missing active muscle activity (agonist) bending (flexion), extension of the limb causes tension of the torsion spring, in which energy is stored, which automatically releases the joint when the antagonist is released, thus replacing the function of the agonist; or - in the case of missing limb antagonist activity, limb flexion causes torsion spring tension to store energy that automatically stretches the limb when the agonist is released, thereby replacing antagonist function.

Description

A medical device to replace lost or impaired muscle function that allows flexion or extension of a limb in the joint

Field of technology

The present invention is included in the field of medicine and medical devices in the field of orthopedic devices for non-surgical treatment of bones and joints. The invention relates to a medical device for the replacement of lost or weakened muscle function, which allows flexion or extension of the limb in the joint.

Background of the invention and technical problem

In anatomy, movement is a term that includes the movement of organs, joints, limbs and certain parts of the body. The terminology of movement depends on the direction according to the anatomical position of the joints. In general, flexion and extension are cases of angular motion in which two axes of the joint approach (flexion or flexion) or move away (extension or extension), thus changing the angle between two parts of the body. Rotational movement, for example, occurs in the shoulder joint, and can be internal or external. The movement of the body allows the muscle tissue of the human body, which is generally divided into skeletal muscle, smooth muscle and heart muscle, with skeletal muscle being attached to the bone through tendons and allowing movement of bone and consequently body parts. At the same time, skeletal muscles provide an upright posture.

Muscles are often paired, one being an antagonist and the other an agonist, with agonists causing movement and antagonists restricting it. The agonist is a muscle that contracts (shorter) in the observed movement, the antagonist is a muscle that relaxes (longer) in the observed movement and performs the reverse movement of the agonist. Examples of antagonistic pairs are biceps and triceps. The biceps muscle lies on the front of the upper arm and is revitalized by the musculocutaneous nerve (C5 and C6). Is t.i. elbow flexor and main forearm supinator in strength. The triceps is a three-headed muscle that takes care of the extension of the elbow joint. It is revitalized by the radial nerve (C7 to C8). To bend or flex the arm, the triceps are relaxed, while the biceps contract to lift the forearm.

However, if any of the nerves or parts of the muscle are damaged, the function of the muscle is lost, making it impossible for the person to contract or stretch the limb on their own, in the case of the biceps and triceps of the arm at the elbow. This means limited mobility and the ability to perform completely everyday movements. As muscle function is lost, it is consequently not possible to strengthen it with conventional physiotherapy devices. The technical problem solved by the present invention is therefore to design a medical device to replace lost muscle function that allows flexion or extension of the limb in the joint, the device must be adapted to perform a movement that a person cannot perform independently using muscles. The device must be as easy to install and use as possible, allowing reliable limb contraction or extension, such as the arms at the elbow.

State of the art

In the field of medicine, kinesiology and physiotherapy, quite a few devices are known to improve the condition of muscles and their functions in bending and stretching limbs, but they are fully adapted to improve muscle strength or restore their function after prolonged immobilization due to injury treatment. Such devices are unsuitable for people with damaged nerves that revitalize muscles, as they cannot replace lost muscle function. Examples of said devices are available on the Dynasplint manufacturer's website and are also described in patent applications US 4485808, US 4508111, US 4538600 and US4947835.

U.S. Pat. No. 4,370,977 describes an improved knee and elbow splint. The knee brace includes thigh and sword mounting cuffs, identical side links with a hinge that allows for a predetermined degree of movement in the knee. A torsion spring can be used to inhibit the quadriceps femoris or to adjust tension during rehabilitation exercises. The torsion spring can be equipped with a special screw that immobilizes the knee and flexion and extension are not possible. The elbow brace described above also works in a similar way to the knee brace described above, with the hinge allowing movement in the elbow and the spring inhibiting the biceps or providing the desired tension during rehabilitation exercises. The described spring does not allow to replace muscle function, for example, it can not by itself bend or extend the patient's elbow.

Patent application JP2008272312 describes a knee brace to help improve leg strength. It includes support for the upper leg, support for the lower leg, a pair of torsion springs to connect the two supports, and appropriate mounting cuffs. When the knee bends and the weight is transferred to the support for the upper leg, the elastic energy is stored in the torsion springs and returns through the rear part to support the thigh and the rear part to support the sword. As a result, during running or similar activity, elastic energy is used to push the thigh from the back, which improves muscle strength.

Patent application JP2009279130 is the only one of the listed documents relating to assistance in bending and stretching the limb in the elbow, knee or wrist, using an air cylinder mounted on the upper bone support above the joint and on the lower bone support below the joint. . This solution is different in design from the present invention.

Description of the solution to the technical problem

The essence of the medical device according to the invention is that to replace the lost ah weakened muscle function, which allows flexion or extension of the limb in the joint, uses a torsion spring that is properly shaped and / or pre-tensioned, so that:

- in case of missing activity of the active muscle (agonist) for bending (flexion), stretching the limb causes tension of the torsion spring, which stores energy that automatically releases the joint when the antagonist is released and thus replaces the function of the agonist; but

- in case of missing activity of the antagonist for extension (extension) of the limb, bending of the limb causes tension of the torsion spring, which stores energy, which automatically releases the limb when the agonist is released and thus replaces the function of the antagonist.

In the case of a bending device, the torsion spring is designed so that the outgoing arms of the springs face in the same direction or are approximately at right angles or up to about 135 ° between them. In the case of an extension device, the torsion spring is designed so that the outgoing arms are in opposite directions and practically horizontal (or in the same axis).

The medical device can be adapted for the elbow, knee, wrist or any other joint that requires a functioning antagonistic muscle pair for its movement.

Preferably, the medical device is designed as an elbow support having at least: - an upper cuff for attachment to the upper arm, - a lower cuff for attachment to the forearm, - a torsion spring connecting:

o at least one lower support rod on the other side attached to the upper cuff, and o at least one upper support rod on the other side attached to the lower cuff, with one torsion spring arm attached to the upper support rod and the other torsion spring arm to the lower support rod stick.

The torsion spring can be made of any suitable material, preferably stainless wire for springs, with an Rmr of 5 Nmm / ° or more. This constant means what torque is needed to bend or move the spring by one degree. Preferably, the R _mr is higher than 10 Nmm / ° in order to be able to perform the return movement in an adult. Depending on the selected spring strength, the device according to the invention can be adapted to the needs and physical characteristics of the user, with children and those with lower weight or muscle strength springs with lower Rmr constant and adults and stronger springs with higher Rmr constant.

The torsion spring is activated by stretching or bending the arm so that energy is stored in it, allowing the arm to return. Muscle function, the action of which is replaced by the device, is defined by choosing the shape of the torsion spring as described above. Torsion springs can be two, one on each side of the elbow, and consequently the support bars at the upper arm and forearm are two (left and right)

Additionally, the device can have two springs, each on one side of the elbow, but it can also be optionally equipped with a suitable motion limiter to prevent stretching or bending at predetermined angles. The spring may also have a lock that allows the spring to be activated or deactivated. The lock can be designed in any suitable way, and some possible and preferred embodiments are described below.

In the first embodiment of the lock, the lower arm of the spring, which is connected to the lower support rod, can be connected to it in a flexible way via a locking element, which firmly connects it to the support rod or moves away from it so that the spring does not pull with itself upwards, making the arm not bend. The element can be controlled via a trigger / button and either pressed on the element to maintain the connection or to release the spring arm and consequently move away from the support rod.

In another embodiment of the lock, a pair of strong magnets may be used instead of the locking element, one mounted on the spring arm and the other on the lower support rod. With the button on the outside of the device, a spacer shaped like an elongated element with increasing height can be moved, which with its higher part can be inserted between the two magnets, thus breaking the connection between the spring and the lower support rod. With the connection between the spring and the lower support rod, the spacer is only with its low (flat) part between the magnets, which does not affect their mutual attraction.

Cuffs can be of any type, and their attachment can be done using straps with loops and hooks, using buttons or any other way to place medical devices on a part of the patient's body. The cuff for attachment can also be more. Preferably, the device also extends beyond the shoulder joint, being designed in the shoulder area in any manner suitable for shoulder braces or other devices, as this improves the stability of the arm.

Support rods can be one-piece or telescopic, so that the device can be adjusted to the hands of different lengths. They are preferably made of plastic, aluminum, fiberglass, carbon fiber or any other suitable material for skin contact, and are fastened with a torsion spring by means of a detachable connection, such as fastening by means of a specially designed fastener as described above for lockable variants or by welding or any other inseparable connection, if the device does not have a lock and the operation of the spring cannot be interrupted. The spring can also be fastened by means of a nut screw, the screw having a hole through which the spring arm is threaded. cuffs of the device according to the invention.

The described elbow solution is also useful for performing a medical device for bending or stretching the leg in the knee or also the ankle, where the device is designed as a knee support at least:

- upper thigh cuff,

- lower cuff attachment cuff,

- torsion spring connecting:

o the upper support rod on the other side attached to the upper cuff, and o the lower support rod on the other side attached to the lower cuff, with one torsion spring arm attached to the upper support rod and the other torsion spring arm attached to the lower support rod.

The torsion spring can be made of any suitable material, preferably stainless wire for springs, and R _mr is at least 15 Nmm / ° to be able to perform a return movement. There can also be two torsion springs, one on each side of the knee.

The torsion spring is activated by stretching or bending the leg, so that energy is stored in it, which allows the leg to move back. In the case of a bending device, the torsion spring is designed so that the outgoing arms of the springs face in the same direction or are approximately at right angles or up to about 135 ° between them. In the case of an extension device, the torsion spring is designed so that the outgoing arms are in opposite directions and practically horizontal (or in the same axis).

The use of a medical device according to the invention is suitable for persons who have lost the function of one of the muscles in the antagonist pair due to illness or injury, for example:

- Loss of biceps function due to C5 and / or C6 nerve damage

- Loss of triceps function due to C7 and / or C8 nerve damage

- Loss of function of one of the muscles in any antagonistic pair.

When using the device according to the invention in the case of damage to the C5 and / or C6 nerve, energy is stored in the torsion spring when the arm is extended, which pulls the arm to the bent position when the triceps is released.

Furthermore, the described device can be upgraded so that it can replace any other muscle function. In the case of a hand device, missing, limited or impaired muscle function that allows pronation or supination of the arm can also be replaced. Pronation is a movement when the palm of the hand is turned down, and supination is a movement when the palm is turned up if the hand is in front of the body. For such an upgrade, the device has at least the following components:

- upper cuff for attachment to the upper arm,

- lower cuff for attachment to the forearm,

- torsion spring connecting:

o the upper support rod on the other side attached to the upper cuff, and o the lower support rod on the other side attached to the lower cuff, with one torsion spring arm attached to the upper support rod and the other torsion spring arm to the lower support rod,

- elbow hinge with said torsion spring,

- at least one reversing element, preferably an elastic band which can be placed around the thumb of the hand in one part, and at least two stabilization rings mounted on each of the two lower support rods, the ring having a suitably shaped opening for the wrist installation of the second part of the elastic.

To ensure pronation (the user can therefore turn the palm upwards, but not with the palm down), the elastic is preferably placed on the guide on the outside of the forearm and guided along the wrist on the underside of the palm to the root of the thumb.

To ensure supination (the user can therefore turn the palm downwards rather than upwards), the elastic is preferably placed on the inner guide on the forearm and is guided along the wrist on the upper side of the palm to the root of the thumb on the hand.

The elastic can be additionally threaded via a suitable roller or similar element, which is clamped on the opposite side of the ring as the elastic, as this reduces the point loads of the elastic. For a more even distribution of forces, in both devices, the elastic is preferably placed on the thumb with the help of a glove similar to a cycling glove. This has a positive effect on the blood circulation of the thumb during long-term active use of the device, which can be weakened in the gloveless version.

Instead of an elastic, a suitably shaped bearing in the form of a ring around the arm, which has suitable springs or weights inside the arm to return the arm to the desired position, can be used as a return element. One version of the bearing is preferably an oiled roller bearing, which would always gravitate to a stable state instead of free rotation. Complete rotation with this bearing is impossible. The roller bearing has an adequate number of free leaf springs inside, and two rollers are attached one to the inner and the other to the outer circumference. In the case of the bearing version, it is necessary to place the inner bearing ring on the arm without slipping, and in the case of bearing rings, the rings slide along the skin.

Said rings are preferably two-part or open, so that the hand can be placed in the device, the rings preferably not touching the hand or being in light contact with the hand. It is only important that the rings do not squeeze your hands. The rings are mounted on the support bars in any known manner, preferably fastened to the support bars by means of lugs or screws.

The upper cuff can be adjusted to run over the shoulder like previously known devices that are placed over one shoulder to the other armpit around the torso. This part of the cuff can be made of any suitable material and is preferably fitted with Velcro straps with hooks and loops.

The described upgrade of a medical device according to the invention, which can replace more than one missing muscle function, can be performed in various combinations, namely the device can replace:

- bending functions,

- extension functions,

- bending and pronation functions,

- bending and supination functions,

extraction and pronation functions, or

- extension and supination functions.

During the development of the invention, it was also found that the medical device is also suitable for persons with markedly impaired muscle function, whose nerves are not damaged, but the muscle tissues are so weakened that they cannot bend or stretch on their own.

The medical device for the replacement of lost or weakened muscle function, which allows flexion or extension of the limb in the joint according to the invention, will be described in more detail below with the help of embodiments and figures showing:

Picture la

Figure 1b

Figure 1c

Figure 2

Figure 3

Figure 4

Figure 5

Figure 6

Torsion spring shape for bending aid

Torsion spring shape for extension device

Possible embodiment of the torsion spring shape shown in Figures 1a and 1b

Scheme of the principle of operation of a medical device according to the invention Embodiment of a medical device according to the invention for the elbow Embodiment of a medical device according to the invention for the knee

An embodiment of a medical device for the elbow, which also allows the replacement of muscle function for pronation

The medical device according to the invention can be adapted for the elbow, knee, wrist or any other joint that requires a functioning antagonistic pair of muscles for its movement. Preferably, the medical device is designed as an elbow support having at least: - an upper cuff for attachment to the upper arm,

- lower cuff for attachment to the forearm,

- torsion spring connecting:

o the upper support rod on the other side attached to the upper cuff, and o the lower support rod on the other side attached to the lower cuff, with one torsion spring arm attached to the upper support rod and the other torsion spring arm attached to the lower support rod.

The torsion spring is activated by stretching or bending the arm so that energy is stored in it, allowing the arm to return. Muscle function, the action of which is replaced by the device, is defined by the choice of the shape of the torsion spring. In the case of the bending device, the torsion spring is designed as shown in Figure 1a so that the outgoing springs of the spring are turned in the same direction or are approximately at right angles or up to about 135 ° between them. In the case of the extension device, the torsion spring is designed as shown in Figure 1b, so that the outgoing arms are in opposite directions and practically horizontal (or in the same axis). Figure 1c shows a preferred embodiment of the torsion spring shape, where both outgoing arms are perpendicular to each other.

Figure 2 shows a diagram of the principle of operation of a medical device according to the invention. The device therefore has a suitably shaped torsion spring so that it allows one of the following functions:

a) in case of missing activity of the active muscle (agonist) for flexion, flexion of the limb causes tension of the torsion spring, which stores energy, which automatically releases the joint when the antagonist is released and thus replaces the function of the agonist; but

b) in case of missing antagonist activity for limb extension, limb flexion causes torsion spring tension, which stores energy that automatically stretches the limb when the agonist is released, thus replacing the function of the antagonist.

Thus, in case a) the torsion spring is designed so that the outgoing arms of the springs face in the same direction or are approximately right angles or angles up to about 135 ° between them. The user extends the arm, thus overcoming the force of the spring by means of a working triceps of the arm. When he wants to bend the arm, he then just releases the triceps, which means that the force of the spring prevails and moves the lower part of the arm towards the upper. If the spring is equipped with a motion limiter, the arm bend ends at an angle pre-set with the limiter.

In the case of the extension device (b), the torsion spring is designed so that the outgoing arms are in opposite directions and practically horizontal (or in the same axis). The user therefore overcomes the force of the spring when bending the arm at the elbow, and when the biceps is released, the force of the spring prevails and causes the arm to extend. If the spring is equipped with a motion limiter, the arm bend ends at an angle pre-set with the limiter.

Figure 3 shows an embodiment of a medical device 1 according to the invention for the elbow, wherein the device 1 has:

- upper cuff 1a for attachment to the upper arm,

- lower cuff 1b for attachment to the forearm,

- torsion spring 3 connecting:

o the upper support rod 2a on the other side attached to the upper sleeve 1a, and o the lower support rod 2b on the other side attached to the lower cuff 1b, one torsion spring arm 3a being attached to the upper support rod 2a, the other torsion arm 3b springs 3 on the lower support rod 2b.

Figure 4 shows an embodiment of a medical device 21 according to the invention for the knee, the device 21 having:

- upper cuff 21 a for attachment to the thigh,

- lower cuff 21 b for attachment to the sword,

- torsion spring 23 connecting:

o the upper support rod 22a on the other side attached to the upper sleeve 21a, and o the lower support rod 22b on the other side attached to the lower sleeve 21b, one torsion spring arm 23a 23 being attached to the upper support rod 22a, the other torsion spring arm 23b 23 on the lower support rod 22b.

Figure 5 shows an embodiment of a medical device 10 for the elbow, which also allows the replacement of muscle function for supination, where the device 10 consists of the following components:

- upper cuffs 10a for attachment to the upper arm,

- lower cuffs 10b for attachment to the forearm,

- torsion springs 13 connecting:

o the upper support rod 12a on the other side attached to the upper sleeve 10a, and o the lower support rod 12b on the other side attached to the lower cuff 10b, one torsion spring arm 13 being attached to the upper support rod 12a and the other torsion spring arm 13 to the lower support rod 12b;

- at least two rings 14 which do not squeeze the hand and allow it to move and the elastic 15, the elastic being mounted preferably on the inner guide on the forearm and guided along the wrist on the upper palm to the root of the thumb.

Figure 6 shows an embodiment of a medical device 100 for the elbow, which also allows the replacement of muscle function for pronation, where the device 100 consists of the following components:

- upper cuffs 100a for attachment to the upper arm,

- lower cuffs 100b for attachment to the forearm,

- torsion springs 103 connecting:

o the upper support rod 102a on the other hand attached to the upper sleeve 100a, and o the lower support rod 102b on the other side attached to the lower sleeve 100b, one torsion spring arm 103 being attached to the upper support rod 102a and the other torsion spring arm 103 to the lower support rod 102b;

- at least two rings 104 which do not squeeze the hand and allow it to move and the elastic 105, the elastic preferably being placed on the guide on the outside of the forearm and guided along the wrist on the underside of the palm to the root of the thumb.

Claims (16)

1. A medical device for the replacement of lost or impaired muscle function that allows flexion or extension of a limb in the joint, characterized in that: - in case of missing muscle agonist muscle activity, stretching the limb causes torsion spring tension, which stores energy that automatically bends the joint when the antagonist is released, thus replacing the agonist function; but - in case of missing activity of the limb extension antagonist, limb flexion causes torsion spring tension, which stores energy that automatically stretches the limb when the agonist is released, thus replacing the function of the antagonist. that the outgoing arms of the spring are turned in the same direction or that there is approximately a right angle or angle of about 135 ° between them, in the case of an extension device the torsion spring is designed so that the outgoing arms are in opposite directions and practically horizontal or in the same axis . Medical device according to Claim 1, characterized in that it can be adapted to the elbow, knee, wrist or any other joint which requires a functioning antagonistic muscle pair for its movement. A medical device according to claim 1 or claim 2, which is designed as an elbow support having at least: - upper cuff for attachment to the upper arm, - lower cuff for attachment to the forearm, - torsion spring connecting: o at least one lower support rod on the other side attached to the upper cuff, and o at least one upper support rod on the other side attached to the lower cuff, with one torsion spring arm attached to the upper support rod and the other torsion spring arm to the lower support rod stick. A medical device according to claim 1 or claim 2, which is designed as a knee brace having at least: - upper thigh cuff, - lower cuff attachment cuff, - torsion spring connecting: o the upper support rod on the other side attached to the upper cuff, and o the lower support rod on the other side attached to the lower cuff, with one torsion spring arm attached to the upper support rod and the other torsion spring arm attached to the lower support rod. Medical device according to any one of claims 3 to 4, characterized in that the torsion springs are two, one on each side of the elbow, the support rods at the upper arm and forearm being also two, on the left and right side. Medical device according to any one of claims 3 to 5, characterized in that the torsion spring is made of any suitable material, preferably stainless steel spring wire, and its Rmr is greater than 5 Nmm / °, preferably greater than 15 Nmm / ° to be able to perform movement in an adult, with the spring Rmr constant being selected according to the needs and physical characteristics of the user, so that for children and users with lower weight or muscle strength, the spring Rmr is lower. Medical device according to any one of claims 3 to 6, characterized in that at least one spring is equipped with a suitable motion limiter which prevents stretching or bending at predetermined angles and / or has a spring lock which enables spring activation or deactivation . Medical device according to Claim 7, characterized in that the lock is mounted on the lower arm of the spring, which is connected to the lower support rod, connected to it in a flexible manner via a locking element which is firmly connected to the support rod or it moves away from it just enough so that the spring does not pull it upwards, which prevents the arm from bending, the lock can be controlled via a trigger / button and either pressed on the element to maintain the connection or to release the spring arm and consequently move away from the support rod. Medical device according to claim 7, characterized in that the lock is a pair of strong magnets, one mounted on the spring arm and the other on the lower support rod, and a spacer shaped as an elongate element can be moved by a button on the outside of the device with increasing height, which with its higher part can be inserted between the two magnets, thus breaking the connection between the spring and the lower support rod. Medical device according to any one of claims 3 to 9, characterized in that the cuff is of any type, and their attachment can be made by means of straps with loops and hooks, by means of buttons or any other means of placing medical devices on a body part the patient, with the device also extending preferentially over the shoulder joint. Medical device according to any one of claims 3 to 10, characterized in that the support rods are: - inserted into appropriate fasteners or pockets in the mounting cuffs; - may be one-piece or telescopic, - are made of plastic, aluminum, fiberglass, carbon fiber or any other suitable material for skin contact, and - are connected to the torsion spring by means of a detachable connection in the case of a lock present or by welding or any other inseparable connection if the device does not have a lock and the operation of the spring cannot be interrupted. Medical device according to any one of the preceding claims, characterized in that it can replace any other muscle function, for example muscles that enable pronation or supination of the arm, the device having at least one element for return movement, preferably an elastic it can be mounted on one part around the thumb, and at least two stabilization rings mounted on each of the two lower support rods, the ring having a suitably shaped opening closer to the wrist to accommodate the other part of the elastic. Medical device according to the preceding claim, characterized in that, in order to ensure pronation, the elastic is preferably mounted on a guide on the outside of the forearm and is guided along the wrist on the underside of the palm to the root of the thumb; to ensure supination, however, the elastic is preferably placed on the inner guide on the forearm and is guided along the wrist on the upper side of the palm to the root of the thumb on the hand. Medical device according to any one of claims 12 to 13, characterized in that the elastic is passed through a suitable roller or similar element mounted on the opposite side of the ring as an elastic, thus reducing the point loads of the elastic and / or the elastic apply to the thumb with the help of a glove similar to a cycling glove. Medical device according to any one of claims 12 to 14, characterized in that it replaces the muscle functions selected from the group consisting of: - flexion function, - extension function, - bending and pronation function, - bending and supination function, - extension and pronation function, and - extension and supination function. A medical device according to any one of the preceding claims for use in persons who have lost function of one of the muscles in the antagonist pair due to illness or injury, for example: - Loss of biceps function due to C5 and / or C6 nerve damage - Loss of triceps function due to damage to the C7 and / or C8 nerve, - Loss of function of one of the muscles in any antagonistic pair.