UA82761C2 - Device for rehabilitation of children, suffering from cerebral palsy - Google Patents

Abstract

A device for rehabilitation of children, suffering from cerebral palsy, relates to medicine and sport, in particular to equipments for adjustment and medical treatment of musculoskeletal apparatus in children by exercises of medical gymnastics. The device has a supporting tubular bed which consists of two pivotally connected parts: upper – for a body and lower – for a pelvis and legs. Both parts support on wheels and rollers. There are supports for head, hands and body, thoracic bandage with hook & loops on the upper part, and on its axis a vibrator is placed. There are supports for legs and buttocks on the beckets as the concave figured plates with fixative straps on the lower part, placed as a telescopic pipe. This part of bed supports on the rollers, which are made with possibility of providing foolproof support during motion. A process for rehabilitation is the regulated loading of body, neck and extremities muscles, stretching of them under the condition of vibrostimulation and attitudinizing of certain correcting poses on the bed supports with possibility of performing of physical exercises in water environment (in warm bath).

Description

The intended invention relates to medicine and sports, in particular, to means of correction and treatment of the musculoskeletal system of children with therapeutic gymnastics exercises.

A well-known set of devices used for the treatment and physical education of children with cerebral palsy, which includes soft rollers in the form of pelotons, stands for fixing the child's body, carts for the development of confident standing and walking, means for straightening the body, stimulation of his limbs, maintaining balance on limited support, etc. (E.M. Mastyukova, "Physical rehabilitation of children with cerebral palsy". - M., "Education", 1991.-6.28-321|.

The disadvantage of this kit is that it contains many devices, the number of which is difficult to place even in a spacious apartment, and it will take a lot of effort to adapt them to training procedures and to implement them in this direction by the child’s relatives or instructors, without whose participation therapeutic and educational work with children , patients with cerebral palsy (CP), it is impossible. The main devices recommended at the same time do not always meet the requirements of sufficiently effective corrective and rehabilitation actions.

There is a well-known gymnastic projectile, which contains the support of the patient installed on the base in the form of an unfolded bed, covered with a light cover, and a means of fixing the biolinks of his body (a.s. USSR 1628397, Ab63823/02, 21/06, Byul.

Me35, 19911.

The disadvantage of this analog is that it is not possible to lay and fix a child on it, and since many manipulations must be performed in a lying position, and in addition, appropriate means are needed to fix the biolinks of the patient's body, the analog cannot cover and provide all those positions and provisions that the child needs for effective rehabilitation.

A well-known simulator of combined therapeutic and preventive action, which contains a stand, supporting a seat with a backrest and a vibration-braking pedal means of loading, with the possibility of placing them in a bath with adjustable water temperature (item RF 25910, Ab1Н23/00, 1/00, Byul Me 44, 19891.

The disadvantage of this simulator is that although it is suitable for use in the conditions of heating the patient's body with warm water, the pedaling movement, as the only element of motor activity, is not sufficient in complexity for such patients. In addition, the range of movements and possible static postures in it are limited to achieve the rehabilitation of children with cerebral palsy. Therefore, this analog is unsuitable for rehabilitation in cerebral palsy.

The closest in terms of technical essence is the device - "Corrective toy - trainer", which looks like an animal with a saddle, the body of which is equipped with a mechanism of free movement and is made of two interconnected parts. One of the parts - the front, rests on the front axle of the freewheel mechanism, and the second rear part - on its rear axle. At the same time, the case has a frame covered with a film and a vibrator connected to the pedal-crank mechanism (item U. 38728, Ab1TN 1/00, AbITN 1/02, Ab1N 69/12, Byul. Me 4, 20011.

The shortcoming of the prototype is that although it allows you to successfully reproduce exciting and powerful efforts for the child, they are extremely limited and only the fact that the achieved extension of its spine under vibrostimulation conditions is clearly not enough for cerebral palsy rehabilitation.

The invention is based on the task, taking into account all the positive qualities and shortcomings of the prototype - "Corrective exercise toy", to create such a rehabilitation device for children with cerebral palsy, which would make it possible to implement with better effect all scientifically based devices used in practice for treatment and education of this contingent of children. This task was supposed to be solved by changing the design of the support bed and means of fixing the patient, wider in terms of the variety of their use, with the aim of expanding the range of movements and static postures in cerebral palsy, as well as by using warm water, and preserving the possibility of using vibrostimulation, which is known to help better muscle elasticity and better flexibility of the joints of the musculoskeletal system.

The task is solved by the fact that the device for the rehabilitation of children with cerebral palsy, which contains a body with a head holder and means of fixing the patient, consisting of two interconnected front and rear parts, mounted on two axles with wheels, parts, one of which carries vibrator, according to the proposed invention, the body is made with the possibility of placing it in a bath with heated water in the form of a tubular bed, both parts of which are hinged together and equipped with a retainer, and the vibrator is installed under its front part, and is made in the form of a bearing, the faceted part of the front axle, which rests on the front wheels, is inserted into the shaped hole of the inner element, while the head holder is made telescopic, and with the possibility of movement, rotation and fixation is installed on the end of the front part of the frame in the form of a shaped hoop with retractable chin and fronto-occipital supports , and with a fixing bandage with Velcro, the means of fixation is supplemented with a footrest them, chest and hand supports in the form of concave-shaped plates covered with soft material and soft straps with Velcro, located on both sides of the bed with the possibility of autonomous longitudinal movement, rotation around it and fixation in given positions.

The satisfaction of the need and the technical result achieved thanks to the use of all the distinguishing features of the proposed device is that it is possible to implement the entire complex of known devices, including elements of physical rehabilitation and education of children from DCI, in a single device, which was created in such a way that it could be transport for the implementation of various procedures aimed at the rehabilitation of children with the consequences of cerebral palsy. This circumstance determines the advantage of the proposed in comparison with the prototype.

The essence of what is proposed is explained by the drawing, where Fig. 1 shows the general view of the device for the rehabilitation of children with cerebral palsy during procedures in the bath; Fig. 2 - appearance of the bath; Fig. 3 - while walking with the help of a support; Fig. 4 - during vibrostimulation in motion; Fig. 5 - in a lying position, bent over on a support; Fig. 6b in a bent position; Fig. 7 - while sitting astride on a support of variable thickness; Fig. 8 - support of the child while sitting on the potty; Fig. 9 - general top view of the rehabilitation device, enlarged; Fig. 10 - front view, the dotted line shows the possible movement of the position of the support on the support and fixing bandages; Fig. 11 - the same, side view; Fig. 12 - a fragment of the subfemoral joint, side view, enlarged; Fig. 13 - foot support in axonometry; Fig. 14 - support of buttocks; Fig. 15 - subfemoral joint; Fig. 16 - handy support; Fig. 17 - the same, chest support; Fig. 18 - vibrating bearing of the axis of the front rollers, side view; Fig. 19 - the same, front view.

Specifically, the device for the rehabilitation of children with cerebral palsy contains a support tubular frame 1 composed of the upper 2 and lower C parts connected to each other by a hinge 4, equipped with a fixator for the specified bending angles of the frame (fig. 12, 15). The upper part 2 has a removable bandage 5 with velcro (not shown) at the ends, which is movable and fixed on the bed, and hand supports b in the form of movable and fixed brackets with sub-carpal grips 7, having straps 8 with velcro at the ends, chest a soft bandage 9 with velcro at the ends, fixed on the sides of the chest supports 10 in the form of shaped concave plates covered with soft material, and a head holder 11 is attached to the end of the upper bed by a similar hinge 4, made in the form of a rubber-covered hoop of a shaped shape with equipped with Velcro bandage 12 with soft stops: chin 13 and fronto-occipital 14, attached to a telescopic hinge 4 with the possibility of extension, rotation and fixation. On the top of the head holder, on its hoop, there is an eyelet 15 for fixing the device on the support when using it in a vertical position, for example, when extracting the spine (fig. 9, 10, 11, 12, 16, 17).

The lower 3 part of the bed is made in the form of a telescopic tube 16, in order to change its length and limited rotation, a foot support 17 fixed to the lower part of this tube with a clip 18, which has double concave-shaped plates 19 for supporting the legs and fixing straps 20, is mounted on it with velcro (fig. 9, 11, 13), as well as soft buttock support 18 installed on a similar clip, also in the form of concave shaped plates (fig. 14). The clip 18 of the footrests 17, the buttocks 21, the chest supports 10, as well as the hinged and telescopic joint of the head holder are equipped with clamping screws 22, which are not marked in all cases, as some of them are drilled from below. All of them, which have the designation of elements (5, 6, 7, 8, 9, 10, 11, 12 16, 17, 18, 19, 21, 22), are made removable, and the stop 13 is retractable (fig. 11, 13 , 14, 16, 17).

The bed rests on a support with the possibility of movement along it thanks to an axis 23 with wheels 24 installed under it. At the same time, it can also be used in a vertical position, if it is leaned against a wall or another support, and is attached to them by the eye 15 of the head holder, which is placed on a hook fixed in the support (not shown). The axis 23 of the upper 2 part of the bed is placed with the possibility of rotation and rearrangement in the bearing 25, which has a bracket 26 attached to the wall, inside which, with the possibility of rotation and lateral limitation, a disc-shaped element 27 with a shaped cross-section 28 is placed, in which the faceted section 29 places the axis 23 This axis together with the bearing 25 and the wheels 24 form a vibrator, to change the amplitude of its oscillations, its rearrangement in different sections of the cutout 28 is used (fig. 18, 19). As a changeable bed and as a covering on the supports of the device, a soft ZO blanket is used, as an improvised bed, and to ensure self-care of the child, a tool in the form of a potty 31 attached to the device is used. At the same time, elements 23, 25, 26, 30, 31 are also made variable for the possibility of disconnection from the bed.

The device is used to organize the main procedure - posture correction, under the conditions of normalization of the location of the limbs and head of the child relative to its body, to solve the following tasks: - correction of spine deformation in scoliosis, lordosis and kyphosis; - stretching of the spine in all its departments; - learning and improving walking; - learning self-care.

In all cases, static fixations of the child's body and its links are used, as well as corrective maintenance of the posture and proper mutual location of the body links during movement, in the usual mode and with the use of vibrostimulation. At the same time, the most important procedures are the formation of anatomically correct relative positions of all parts of the child's body, their statistical poses and movement exercises in the air environment, as well as in a warm water environment, in the bath, under the control and with the help of adults.

In the bath, correcting the child’s posture and correcting the location of all parts of his body is carried out by long-term stretching of his spine in all departments, in warm water, having previously placed the child on all supports (6, 10, 17, 20, 21) and in the head holder of the device, and adding the body and to all links fixed by straps 8, 20, 21 and bandages 9, 12, corrective positions. For this purpose, not only straps and bandages are used, but also appropriate supports 6, 10, 17, 20, 21, which are set in advance in the necessary position in relation to them, recommended by orthopedic specialists (E. M. Mastyukova, 1991).

The reduction of determined spine deformations is achieved by gradually and consistently increasing the pressure on the corresponding body links with the help of means of fixation (8, 9, 12, 15) on supports (6, 10, 11, 17, 20), with the aim of creating a natural anatomical position (fig. 13, 14, 16, 17). Correction procedures in the bath are used not only by gradually approaching the statically fixed positions of the child's body to the corresponding anatomical standard positions, but mainly use the device without the use of water procedures (fig. 13, 14, 16, 17). At the same time, it is recommended to perform dynamic exercises with tilts, turns and other movements of the body and its parts by the efforts of the child himself, as well as with the help of adults. For this, if necessary, the corresponding links of the body are freed from fixation, and the stretching of the spine is ensured by a gradual increase in the distance between the bandage 5 and the straps 20 on the lower part of the bed and between the supports 19 and their straps 20, on the one hand, and with the bandage 9 and chest supports 10, on the other hand, in the upper 2 part of the bed. Stretching in the cervical region is achieved by anatomically careful movements of the distance of the head holder 11 relative to the frame, which ensures its telescopic attachment under the conditions of fixation of the patient's head, the lower part of which rests on the chin rest 13 when the head is fixed with a bandage 12 (fig. 9, 10, 11). More effective extraction can be achieved by attaching the device to a support (wall, rack, etc.) with its eyelet 15 fixed to the hook of the wall in a vertical position of the bed. For prolonged procedures, cover 30 is used (Fig. 20).

Learning to walk and eliminating body movement defects in space are achieved by using wheels 24.

To do this, the frame is bent at hinge 4 and fixed by means of fixation in the form of an arch, and all supports, with the exception of manual ones, are removed. The child stands between the wheels and rides on the bed, holding on to the hand supports, tries to move, rearranging the legs independently or initially with the help of adults. If necessary, you can use the buttock support 21 (fig. 3, 4).

Increasing the efficiency of the process of learning to walk and its improvement is achieved by using vibromechanical stimulation, which, according to the school of scientists (1986), significantly intensifies this process. To do this, the front axle 23 is slightly pushed out of the bearing 25 and pushed back into the cutout 28 so that its faceted part 29 takes an eccentric position at a distance from the center, depending on the required amplitude of vibration, taking into account that the farther from the center, the more amplitude (Fig. 18, 19). For walking under vibration stimulation, this axis is fixed eccentrically in rollers. Its frequency is set by the speed of movement of the bed. If necessary, for example, during processes that lead to the contraction of the adductor muscles of the legs, the child is prepared in advance for walking, using inverted and attached at different angles in relation to the support frame of the buttocks 21 with the condition of their gradual separation and fixation. Adults seat the child on these supports and, holding it, carry it using vibration stimulation, which promotes muscle relaxation and increases the flexibility of the joints (Fig. 7). Before laying the child on the support means, they are covered with a soft blanket 30 (Fig. 20). Thus, the proposed device, with the appropriate transformation, allows to change the entire set of devices provided for the rehabilitation of children with cerebral palsy, as well as with other deviations from the norm of the structure and functions of their musculoskeletal system, and to successfully perform the task set before it.

The technical and consumer advantage of the proposed device over the rejection of the prototype is that it was possible to significantly expand its functional capabilities, and most importantly - to bring its design features closer to the solution of an important problem - physical education, treatment and rehabilitation of children with cerebral palsy, to replace with this device a whole a voluminous set of technical devices that are traditionally used in the practice of physical education and rehabilitation of cerebral palsy patients. The device simulates horse riding and realizes the possibilities of hippotherapy.

Such devices can be useful to parents and doctors who raise and treat children with cerebral palsy at home and in medical institutions.

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Claims (1)

Device for the rehabilitation of children with cerebral palsy, containing a body with a head holder and means of fixing the patient, consisting of two interconnected front and rear, mounted on two axles with wheels, parts, one of which contains a vibrator, which differs in that that the body is made with the possibility of immersion in a bath with heated water and has the form of a tubular bed, both parts of which are hinged together 1 equipped with a latch, and the vibrator is installed under the front part of the bed 1 is made in the form of a bearing, in the shaped hole of the inner element of which is inserted the faceted part is the front axle, which rests on the front wheels, while the head holder is telescopically installed on the end of the front part of the frame with the possibility of movement, rotation and fixation and is made in the form of a shaped hoop with retractable chin and fronto-occipital stops and with a fixing bandage equipped with Velcro, and means of fixing the patient are foot, subthoracic and handy supports, made in the form of shaped concave plates covered with soft material and soft straps with Velcro, located on both sides of the bed with the possibility of autonomous longitudinal movement, rotation around the bed and fixation in given positions.