US20220175567A1 - Elbow Orthosis - Google Patents
Elbow Orthosis Download PDFInfo
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- US20220175567A1 US20220175567A1 US17/412,011 US202117412011A US2022175567A1 US 20220175567 A1 US20220175567 A1 US 20220175567A1 US 202117412011 A US202117412011 A US 202117412011A US 2022175567 A1 US2022175567 A1 US 2022175567A1
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- arm member
- orthosis
- joint
- arm
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Images
Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
- A61F5/01—Orthopaedic devices, e.g. splints, casts or braces
- A61F5/0102—Orthopaedic devices, e.g. splints, casts or braces specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations
- A61F5/013—Orthopaedic devices, e.g. splints, casts or braces specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations for the arms, hands or fingers
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
- A61F5/01—Orthopaedic devices, e.g. splints, casts or braces
- A61F5/0102—Orthopaedic devices, e.g. splints, casts or braces specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
- A61F5/01—Orthopaedic devices, e.g. splints, casts or braces
- A61F5/0102—Orthopaedic devices, e.g. splints, casts or braces specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations
- A61F2005/0132—Additional features of the articulation
- A61F2005/0137—Additional features of the articulation with two parallel pivots
- A61F2005/0139—Additional features of the articulation with two parallel pivots geared
Definitions
- the present invention relates to an adjustable orthosis for stretching tissue in the human body.
- the present invention relates to an adjustable orthosis which can be used for stretching tissue such as ligaments, tendons or muscles around a joint during flexion or extension of the joint.
- joints move in two directions, flexion and extension. Flexion is to bend the joint and extension is to straighten the joint; however, in the orthopedic convention some joints only flex.
- the ankle has dorsiflexion and plantarflexion.
- Other joints not only flex and extend, they rotate.
- the elbow joint has supination and pronation, which is rotation of the hand about the longitudinal axis of the forearm placing the palm up or the palm down.
- ROM orthoses are devices commonly used during physical rehabilitative therapy to increase the range-of-motion over which the patient can flex or extend the joint.
- Commercially available ROM orthoses are typically attached on opposite members of the joint and apply a torque to rotate the joint in opposition to the contraction. The force is gradually increased to increase the working range or angle of joint motion.
- Exemplary orthoses include U.S. Pat. No. 6,599,263, entitled “Shoulder Orthosis;” U.S. Pat. No. 6,113,562, entitled “Shoulder Orthosis;” U.S. Pat. No. 5,848,979, entitled “Orthosis;” U.S. Pat. No.
- the present invention provides an orthosis for stretching tissue around a joint of a patient between first and second relatively pivotable body portions.
- the joint and the first and second body portions define on one side of the joint an inner sector which decreases in angle as the joint is flexed and define on the opposite side of the joint an outer sector which decreases in angle as the joint is extended.
- the orthosis includes a first arm member affixable to the first body portion.
- the first arm member has a first extension member extending therefrom.
- a second arm member affixable to the second body portion is also included.
- the second arm member has a second extension member having an arcuate shape extending therefrom.
- a third arm member including a third extension member, having an arcuate shape extending therefrom, is interposed between the first and second arm members.
- the second and third arm members are operatively connected, such that the third arm member travels along an arcuate path defined by the second extension member when the third arm member is moved from a first position to a second position relative to the second arm member.
- the first arm member is slidingly connected to the third extension member, such that the first arm member slides along an arcuate path defined by the third extension member when the third arm member is moved from the first position to the second position relative to the second arm member.
- the orthosis further includes a drive assembly for selectively moving the third arm member relative to the second extension member.
- the drive assembly is mounted onto the third arm member, engaging the second extension member.
- the drive assembly can be manually or automatically actuated to selectively move the third arm member relative to the second extension member.
- FIG. 1 is a schematic diagram of the orthosis of the present invention in a flexed position
- FIG. 2 is a schematic diagram of the orthosis of the present invention in an extended position
- FIG. 3 is a second schematic diagram of the orthosis of the present invention in a flexed position
- FIG. 4 shows an adjustable first extension member of the orthosis of the present invention
- FIG. 5 shows the adjustable first extension member of FIG. 4 in a second position
- FIG. 6 shows a segmented first extension member of the present invention
- FIG. 7 shows an arcuate first extension member of the present invention
- FIG. 8 shows an orthosis of the present invention
- FIG. 9 shows a non-circular arcuate shaped second extension member of the present invention.
- FIG. 10 shows an alternative arcuate shaped second extension member of the present invention
- FIG. 11 shows a linear shaped second extension member of the present invention
- FIG. 12 shows an exemplary drive assembly of the present invention
- FIG. 13 depicts a first side view of another orthosis of the present invention for flexing and extending a joint in a patient
- FIG. 14 depicts an opposite side view of the orthosis of FIG. 13 ;
- FIG. 15 depicts a first arm member of the orthosis of FIG. 13 ;
- FIG. 16 depicts a second arm member of the orthosis of FIG. 13 ;
- FIG. 17 depicts a third arm member of the orthosis of FIG. 13 ;
- FIG. 18 depicts the drive assembly of the orthosis of FIG. 13 ;
- FIG. 19 depicts the connectivity of the first, second, and third arm members of the orthosis of FIG. 13 ;
- FIG. 20 depicts the orthosis of FIG. 13 in a middle flexed position
- FIG. 21 depicts the orthosis of FIG. 13 in a fully flexed position.
- the present invention relates to an orthosis for moving a joint between first and second relatively pivotable body portions.
- the joint and the first and second body portions define on one side (the flexor side) of the joint an inner sector which decreases in angle as the joint is flexed (bent) and on the opposite side (the extensor side) of the joint an outer sector which decreases in angle as the joint is extended (straightened).
- the orthosis of the present invention is affixable to either the flexor or extensor side of the joint for treatment of flexion or extension contractures.
- FIG. 1 a schematic of the orthosis 10 of the present invention.
- the orthosis 10 includes a first arm member 12 attachable to the first body portion and a second arm member 14 attachable to the second body portion, wherein a joint axis of rotation 16 is interposed between and offset from the first and second arm members 12 and 14 .
- the first and second arm members 12 and 14 are operatively connected to each other offset from the joint axis 16 .
- the first arm member 12 of the orthosis 10 includes a First extension member 18 , which extends at angle ⁇ from the first arm member 12 .
- the second arm member 14 of the orthosis 10 includes a second extension member 20 extending therefrom and having an arcuate shape.
- the first and second extension members 18 and 20 are operatively connected at point “P,” such that in operation the second extension member 20 travels along an arcuate path about and substantially through point “P.”
- the arcuate shape of the second extension member 20 results in the second body portion rotating about the joint axis 16 , when the second arm member 14 is moved from a first position to a second position relative to the first arm member 12 .
- the angle ⁇ between the first extension member 18 and the first arm member 12 and the radius of curvature of the second extension member 20 are a function of the joint to be treated and the degree of flexion or extension contractures.
- the orthosis further includes a drive assembly 22 at point “P.”
- the drive assembly connects the first and second extension members 18 and 20 for applying force to the first and second arm members 12 and 14 to pivot the first and second body portions relative to each other about the joint.
- the orthosis 10 of the present invention is shown having an angle ⁇ such that the operative connection, at point “P.” of the first and second extensions 18 and 20 is located in a plane “A” passing through the joint axis 16 , wherein plane “A” is substantially orthogonal to a longitudinal axis of the first arm member 12 .
- This position of point “P” provides an angle ⁇ 1 between the second arm member 14 and the joint axis 16 , wherein ⁇ 1 is the maximum angle of flexion.
- the second extension member includes a stop 24 .
- the stop 24 acts to limit the angle of maximum extension ⁇ between the second arm member 14 and the joint axis 16 .
- An increase in the length of the stop 24 will decrease the angle of maximum extension ⁇ .
- a decrease in the length of the stop 24 will increase the angle of maximum extension ⁇ .
- the maximum flexion angle can be increased by increasing the angle ⁇ .
- An increase in the angle ⁇ will move the point “P” to a location “in front of” the plane “A.”
- This position of point “P” provides an angle ⁇ 2 between the second arm member 14 and the joint axis 16 in maximum flexion, wherein ⁇ 2 is greater than ⁇ 1 .
- the greater the angle ⁇ the greater the angle of maximum flexion.
- a decrease in the angle ⁇ will move the point “P” to a location “behind” the plane “A.”
- This position of point “P” provides an angle ⁇ 3 between the second arm member 14 and the joint axis 16 in maximum flexion, wherein ⁇ 3 is less than ⁇ 1 .
- the first extension member 18 is selectively, pivotally connected at location 26 to the first arm member 12 .
- the pivotal connection 26 of the first extension member 18 permits the angle ⁇ between the first extension member 18 and the first arm member 12 to be selectively increased and decreased, increasing and decreasing the range of motion.
- a first position 28 the first extension member 18 is positioned at an angle ⁇ 1 , wherein the operative connection, at point “P,” of the first and second extension members 18 and 20 is located in a plane “A” passing through the joint axis 16 , wherein plane “A” is substantially orthogonal to a longitudinal axis of the first arm member 12 .
- the first position 28 of point “P” provides a maximum angle of flexion of ⁇ 1 .
- the second extension member stop 24 acts to limit the angle of maximum extension ⁇ 1 between the second arm member 14 and the joint axis 16 .
- a second position 30 the angle ⁇ is increased to an angle ⁇ 2 , positioning the point “P” to a location “in front of” the plane “A.”
- the second position 30 of point “P” provides a maximum angle of flexion of ⁇ 2 , wherein ⁇ 2 is greater than ⁇ 1 .
- the second extension member stop 24 acts to limit the angle of maximum extension ⁇ 2 between the second arm member 14 and the joint axis, wherein ⁇ 2 is less the ⁇ 1 .
- the selective pivotal connection 26 of the first extension member 18 to the first arm member 12 can have a plurality of selectable positions.
- the angle ⁇ between the first arm member 12 and the first extension 18 can be selectively increased to move the point “P”, on, “in front of” or “behind” the plane “A.” It is also envisioned that a positioned can be selected to increase the angle ⁇ between the first arm member 12 and the first extension 18 sufficiently to move the point “P” “in front of” plane “A” and “above” the longitudinal axis of the first arm member 12 , maximizing the maximum angle of flexion ⁇ .
- the orthosis 10 of the present invention can be connected to the flexor side of the first and second body portions of the joint, which results in a decrease in angle as the joint is flexed (bent) and an increase in angle and the joint is extended (straightened).
- orthosis 10 of the present invention can be connected to the extensor side of the joint, which results in a decrease in angle as the joint is extended straightened and an increase in angle as the joint is flexed (bent).
- first arm member 12 depicts a first extension 18 having a substantially linear shape, extending at an angle ⁇ from the first arm member 12 .
- first extension member 18 can be any shape extending from the first arm member 12 which positions the point “P” in the desired relationship to the plane “A.”
- a segmented first extension member is shown, including a first extension member segment 18 a and a second extension member segment 18 b .
- the first and second extension member segments 18 a and 18 b extend from the first arm member 12 , positioning the point “P” at an angle ⁇ from the first arm member 12 .
- an arcuate first extension member 18 c is shown.
- the arcuate extension member 18 c extends from the first arm member 12 , positioning the point “P” at an angle ⁇ from the first arm member 12 .
- the orthosis 10 of the present invention includes a first arm member 12 attachable to the first body portion and a second arm member 14 attachable to the second body portion, wherein the joint axis 16 is interposed between and offset from the first and second arm members 12 and 14 .
- the first and second arm members 12 and 14 are connected with each other offset from the joint axis 16 .
- the first arm member 12 of the orthosis 10 includes a first extension member 18 , which extends at angle ⁇ from the first arm member 12 .
- the second arm member 14 of the orthosis 10 includes a second extension member 20 , having an arcuate shape.
- the first and second extension members 18 and 20 are operatively connected a point “P,” such that in operation the second extension member 20 travels along an arcuate path about and substantially through point “P.”
- the arcuate shape of the second extension member 20 results in the second body portion rotating about the joint axis 16 , when the second arm member 14 is moved from a first position to a second position relative to the first arm member 12 .
- the angle ⁇ between the first extension member 18 and the first arm member 12 and the radius of curvature of the second extension member 20 are a function of the joint to be treated and the degree of flexion or extension contractures.
- a first cuff 32 is attached to the first arm member 12 , wherein the first cuff 32 is positionable about the first body portion.
- the first cuff 32 is attached to the first body portion by cuff straps.
- the first cuff 32 secures the first body portion to the first arm member 12 .
- a second cuff 34 is attached to the second arm member 14 , wherein the second cuff 34 is positionable about the second body portion.
- the second cuff 34 is attached to the second body portion by cuff straps.
- the second cuff 34 secures the second body portion to the second arm member 14 .
- the orthosis 10 is operated to extend a joint in the following manner.
- the first cuff 32 is fastened about the first body portion tightly enough that the first arm member 12 may apply torque to the first body portion without having the first cuff 32 slide along the first body portion.
- the second cuff 34 is fastened securely around the second body portion so that the second arm member 14 may apply torque to the second body portion without the second cuff 34 sliding along the second body portion.
- the orthosis 10 is attached to the first and second body portions in a first position.
- the second arm member 14 is rotated from the first position to a second position, relative to the first arm member 12 , rotating the second body portion about the joint axis 16 stretching the joint.
- the second extension member 20 travels along an arcuate path about and substantially through point “P.”
- the orthosis 10 is maintained in the second position for a predetermined treatment time providing a constant stretch to the joint.
- the orthosis 10 may alternatively be configured to impart a constant force or load on the joint or may utilize the techniques of Static Progressive Stretch as described in co-pending application Ser. No. 11/203,516, entitled “Range of Motion System and Method”, and filed on Aug. 12, 2005, the entirety of which is incorporated by reference.
- the second extension member 12 can be made of a substantially rigid but flexible material, such that while the second extension member 12 is in the second position, the second extension member 12 acts like a spring, providing dynamic stretch to the connective tissue of the joint.
- the second arm member 14 After the expiration of the treatment time, the second arm member 14 is moved back to the first position, relieving the joint.
- the second arm member 14 can be rotated to a third position, increasing the stretch on the joint.
- the second arm member 14 can be rotated at discrete time intervals to incrementally increase the stretch of the joint through the treatment cycle.
- the second arm member After completion of the treatment cycle, the second arm member is returned to the first position for removal of the orthosis 10 .
- the first and second arm members 12 and 14 are rigid members made of, for example, aluminum. stainless steel, polymeric, or composite materials.
- the arms are rigid so as to be able to transmit the necessary forces. It should be understood that any material of sufficient rigidity can be used.
- the components of the orthosis 10 of the present invention are made by injection molding.
- tool and die metal molds of the orthosis 10 components are prepared. Hot, melted plastic material is injected into the molds. The plastic is allowed to cool, forming components. The components are removed from the molds and assembled.
- the cuff portions 32 or 34 can be individual molded and attached to the arm members 12 or 14 . Alternatively, the cuff portions can be molded as an integrated part of the arm members 12 or 14 .
- the orthosis 10 can be connected to the flexor side of the first and second body portions of the joint, which results in a decrease in angle as the joint is flexed (bent) and an increase in angle as the joint is extended (straightened).
- orthosis 10 of the present invention can be connected to the extensor side of the joint, which results in a decrease in angle as the joint is extended straightened and an increase in angle as the joint is flexed (bent).
- the orthosis 10 includes a first cuff 32 for attachment to a first body portion, and a second cuff 34 for attachment to a second body portion.
- the first body portion is joined to the second body portion at a joint, around which is located, as is well known, soft tissue.
- Each of the first and second cuffs 32 and 34 includes loop connectors for receiving straps extending around the body portions to clamp the cuffs 32 and 34 to the body portions.
- the first cuff 32 is mounted for sliding movement on the first arm member 12 and is slidable along the first arm member 12 in a manner as described below.
- the second cuff 34 is mounted for sliding movement on a second arm member 14 and is slidable along the second arm member 12 in a manner as described below.
- the orthosis 10 starts at a more flexed position.
- the first and second cuffs 32 and 34 are clamped onto the first and second body portions, respectively, by straps, tightly enough so that the cuffs 32 and 34 can apply torque to the body portions to extend the joint.
- the second arm member 14 is rotated from the first position to a second position, relative to the first arm member 12 , rotating the second body portion about the joint axis 16 stretching the joint.
- the second extension member 20 travels along an arcuate path about and substantially through point “P.”
- the orthosis 10 is maintained in the second position for a predetermined treatment time providing a constant stretch to the joint.
- the first and second cuffs 32 and 34 move along the first and second arm members 12 and 14 .
- the first cuff 32 moves inwardly along the first arm member 12 .
- the second cuff 34 moves inwardly along the second arm member 14 . Because the cuffs 32 and 34 are clamped onto the first and second body portions as described above, the outward pivoting movement of the first and second arm members 12 and 14 and the cuffs 32 and 34 causes the joint to be extended as desired. However, this extension of the joint can place strong distractive forces on the soft tissues around the joint.
- the cuffs 32 and 34 slide inwardly along the first and second arm members 12 and 14 a distance far enough so that the joint is only slightly distracted during extension. Thus, the detrimental effects of strong distractive forces normally generated in forced extension of a joint are avoided, being replaced with the beneficial effects of limited and controlled distraction.
- the orthosis 10 starts at a more extended position.
- the first and second cuffs 32 and 34 are clamped onto the first and second body portions, respectively, by straps, tightly enough so that the cuffs 32 and 34 can apply torque to the body portions to extend the joint.
- the second arm member 14 is rotated from the first position to a second position, relative to the first arm member 12 , rotating the second body portion about the joint axis 16 stretching the joint.
- the second extension member 20 travels about and substantially though point “P,” along an arcuate path.
- the orthosis 10 is maintained in the second position for a predetermined treatment time providing a constant stretch to the joint.
- the first and second cuffs 32 and 34 move along the first and second arm members 12 and 14 .
- the first cuff 32 moves outwardly along the first arm member 12 .
- the second cuff 34 moves outwardly along the second arm member 14 . Because the cuffs 32 and 34 are clamped onto the first and second body portions the inward pivoting movement of the first and second arm members 12 and 14 and the cuffs 32 and 34 causes the joint to be flexed as desired. However, this flexion of the joint can place strong compressive forces on the soft tissues around the joint.
- the cuffs 32 and 34 slide outwardly along the first and second arm members 12 and 14 a distance Far enough so that the joint is only slightly compressed during flexion. Thus, the detrimental effects of strong compressive forces normally generated in forced flexion of a joint are avoided, being replaced with the beneficial effects of limited and controlled compression.
- the second arm member 14 is shown having a non-circular arcuate shaped second extension member 44 .
- the non-circular arcuate shaped second extension member 44 provide an axis of rotation which changes as the second arm member 14 is moved from the first position to the second portion. As such, as the second arm member 14 is moved from the first position to the second portion the second body portion will exhibit both a rotational motion, about the joint axis 16 , and a translational motion, distracting or compressing the joint.
- the arcuate shape of the second extension member 20 or 44 as shown have concave radius of curvature relative to the joint 16 .
- the second extension member 20 or 44 can have a convex radius of curvature relative to the joint 16 . Similar to the concave radius of curvature, the convex arcuate shape of the second extension member 20 or 44 results in the second body portion rotating about the joint axis 16 , when the second arm member 14 is moved from a first position to a second position relative to the first arm member 12 .
- the second arm member 14 of the orthosis 10 includes a second extension member 46 extending therefrom and having a linear shape.
- the first and second extension members 18 and 46 are operatively connected at point “P,” such that in operation the second extension member 46 travels along a linear path through point “P.”
- the linear shape of the second extension member 46 results in the second body portion being translated with respect to the first body portion.
- the translational movement of the second arm member 14 results in a distraction or compression of the joint when the second arm member 14 is moved from a first position to a second position relative to the first arm member 12 .
- the hand pad can be mounted for translational and rotational movement on the base member.
- the drive assembly 22 of the orthosis includes a gear system.
- the components of the orthosis, including the drive assembly 22 can be made by injection molding a polymer.
- the drive assembly 22 is supported in the first extension member 18 , including a gear 50 rotatable about point “P.”
- a shaft 52 attached to the gear 50 , extends from first extension member 18 .
- a knob 54 is connected to the shaft 52 , opposite the gear 50 , for manually rotating the gear 50 .
- the second extension member 20 includes a series of teeth 56 along an inner surface 58 .
- the second extension member 20 is threaded through the first extension member 18 , such that the teeth 56 on the second extension member 20 engage the gear 50 .
- the rotation of the knob 56 causes the gear 50 to rotate, pushing or pulling the second extension member 20 through the first extension member 18 .
- the drive assembly 22 includes a locking or breaking mechanism which prevents the gear 50 from rotating absent any applied Force rotation of the knob 56 .
- a lock or breaking mechanism can include a compression washer or other known gear locking or breaking mechanisms.
- the drive assembly 22 is described as utilizing a gear system. However, it is contemplated that other known drive systems can be used to move the second extension member 20 through the first extension member 18 , for example a friction type drive system. Regardless of the drive system used, the joint orthosis of the present invention can act as a brace, restricting the relative movement of the first and second body portions to one degree of freedom (e.g. flexion and extension about the joint). Thus, drive assembly 22 can be configured to allow free motion in one degree of freedom. This can be achieved in a number of different ways. For example, gear 50 can be positioned such that it does not engage teeth 56 .
- the drive assembly 22 of orthosis 10 in accordance with the present invention can be actuated by a motor instead of by a manually actuatable member.
- the motor may be configured an adapted with gearing that causes the orthosis to cycle through a range of motion in a predetermined manner, or alternatively maybe controlled by a programmable logic controller (PLC).
- PLC programmable logic controller
- an electric motor is mounted to the shalt 52 for rotation of the gear 50 .
- a battery provides electric power to the motor.
- the motor can be supplied with external power.
- a microprocessor controls the operation of the motor. The microprocessor and motor together can be used to cycle the first and second arm members 12 and 14 through extension and flexion; to move the first and second arm members 12 and 14 in one pivotal direction a certain amount, hold there while tissue stretches, then move further in that direction; or in any other manner.
- the orthosis can be set to cycle to one end of the joint's range of motion and hold there for a predetermined period of time, then cycle to the other end of the joints range of motion and hold there.
- the programming and control of the microprocessor is within the skill of the art as it relates to driving the motor to control the first and second arm members 12 and 14 to move in known manners.
- This embodiment is ideally suited for continuous passive motion exercise, because the orthosis is portable and because the motor can be programmed with the desired sequence of movements.
- an orthosis 80 of the present invention includes a first arm member 82 attachable to the first body portion and a second arm member 84 attachable to the second body portion, wherein the joint axis 86 is interposed between and offset from the first and second arm members 82 and 84 .
- a third arm member 88 is interposed between the first and second arm members 82 and 84 , where the first and second arm members 82 and 84 are connected to the third arm member 88 , offset from the joint axis 86 .
- the first arm member 82 of the orthosis 80 includes a first extension member 90 , which extends from the first arm member 82 .
- the second arm member 84 of the orthosis 80 includes a second extension member 92 having an arcuate shape.
- the first and second extension members 90 and 92 are operatively connected to the third arm member 88 , where the second extension member 92 is operably connected to the third arm member 88 at a point “P,” such that in operation the third member 88 travels along an arcuate path of the second extension member 92 .
- the arcuate shape of the second extension member 92 results in the first body portion rotating about the joint axis 86 , when the first and third arm members 82 and 88 are moved from a first position to a second position relative to the second arm member 84 .
- the radius of curvature of the second extension member 92 is a function of the joint to be treated and the degree of flexion or extension contractures.
- a first cuff 94 is attached to the first arm member 82 , wherein the first cuff 94 is positionable about the first body portion.
- the first cuff 94 is attached to the first body portion by cuff straps.
- the first cuff 94 secures the first body portion to the first arm member 82 .
- a second cuff 96 is attached to the second arm member 84 , wherein the second cuff 96 is positionable about the second body portion.
- the second cuff 96 is attached to the second body portion by a cuff strap(s) 98 .
- the second cuff 96 secures the second body portion to the second arm member 84 .
- the cuffs 94 and 96 can be provided in a variety of sizes or have adjustable sizes to fit about the body portions. (The term “cuff” as used herein means any suitable structure for transmitting the force of the orthosis 80 to the limb portion it engages.).
- the first cuff 94 can be slidingly connected to the first arm member 82 .
- a sliding bar 100 is affixed to the first cuff 94 .
- the sliding bar 100 includes channels 102 positioned on opposite sides of the sliding bar 110 .
- the first arm member 82 includes a main channel 106 configured to slidingly receive the sliding bar 100 .
- Pins 108 are positioned though opposite sides of the main channel 106 of the first arm member 82 and into the channels 102 to slidingly secured the sliding bar 100 in the main channel 106 .
- An adjustable member 110 can be threaded though the first arm member 82 , into a channel 102 to adjustably secure the position of the sliding bar 102 in the main channel 106 .
- the position of the first cuff 94 can be adjusted with respected the first arm member 82 , the position being secured with the adjustable member 110 .
- the first cuff 94 can be free to slide with respect to the first arm member 82 , thereby allowing the position of the first cuff 94 to self adjust during operation of the orthosis 80 .
- the second cuff 96 can be slidingly connected to the second arm member 84 .
- the second extension member 92 has an arcuate shape, where the radius of curvature of the second extension member 92 is a function of the joint to be treated and the degree of flexion or extension contractures.
- the second extension member 92 includes an inner surface 112 have a plurality of teeth 114 thereon.
- the second extension member 92 can include channels 115 disposed on opposite sides thereof.
- the third arm member 88 includes a third extension member 116 has an arcuate shape, where the radius of curvature of the third extension member 116 is a function of the joint to be treated and the degree of flexion or extension contractures.
- the third extension member 116 includes channels 118 disposed on opposite sides thereof.
- a drive housing 120 is positioned proximal to a guide channel 122 .
- a drive assembly 124 is positioned in the drive housing 120 of the third arm member 88 .
- the drive assembly 124 includes a drive gear 126 and a main gear 128 , where the teeth of the drive gear 126 engage the teeth 130 of the main gear 128 .
- a drive shaft 132 is connected to the drive gear 126 , extending through the cover plate 134 .
- a knob 133 can be affixed to the drive shaft 132 to facilitate rotation thereof.
- a rotation of the drive shaft 132 rotates the drive gear 126 , which in turn rotates the main gear 128 .
- the main gear 128 is sized such that a portion of the gear teeth 130 protrudes into the guide channel 122 of the third arm member 88 .
- the second extension member 92 is positioned in the guide channel 122 , such that the gear teeth 132 of the main gear 128 engage the teeth 114 on the inner surface 112 of the second extension member 92 .
- a rotation of the dive shaft 132 rotates the drive gear 126 , which in turn rotates the main gear 128 , driving the second extension member 92 through the guide channel 122 .
- the cover plate 134 is positioned over the guide channel 122 , securing the second extension member 92 in the guide channel 122 and defining a passage through which it travels.
- Guide pins 135 can be positioned in the channels 115 of the second extension member 92 , engaging on one side the third arm member 88 and on an opposite side the cover plate 134 .
- the guide pins 135 can be used to secure the second extension member 92 in the passage and control the tacking of the third arm member 88 along the second extension member 92 .
- the drive mechanism 22 can further include a locking mechanism.
- the locking mechanism can be used to secure the position of the second arm member 84 with respect to the third arm member 88 .
- the locking mechanism can prevent the actuation of the drive assembly 124 , securing the position of second and third arm members 84 and 88 .
- the locking mechanism can secure the second and third arm members 84 and 88 , preventing an actuation of the drive mechanism 124 from moving the second and third arm members 84 and 88 .
- the locking mechanism can be utilized such that the orthosis 80 can be used as a static splint.
- the first arm member 82 can be sliding affixed to the third arm member 88 .
- the first extension member 90 is positioned about the third extension member 88 , where an end portion 136 of the first extension member 90 is slidingly connected about the third extension member 118 .
- Pins 140 are positioned through pin holes 142 , provided on opposite sides of the end portion 136 of the first extension member 90 , into the channels 118 of the third extension member 88 , thereby allowing the end portion 136 of the first extension member 90 to slide along the arcuate path defined by the channels 118 , rotating the first arm member 82 about the joint axis 86 .
- the first arm member 82 can slide freely with respect to the third extension member 116 .
- a push pin 144 can be positioned through the end portion 136 of the first extension member 92 into push pin hole 146 in the channels 118 of the third extension member 116 . (See also FIG. 14 ). The push pin 144 prevents relative movement of the first arm member 82 with respect to the third arm member 88 .
- the orthosis 80 is operated to extend a joint in the following manner.
- the first cuff 94 is fastened about the first body portion tightly enough that the first arm member 82 may apply torque to the first body portion without having the first cuff 94 slide along the first body portion.
- the second cuff 96 is fastened securely around the second body portion so that the second arm member 84 may apply torque to the second body portion without the second cuff 96 sliding along the second body portion.
- the orthosis 80 is attached to the first and second body portions in a first position.
- the first and second arm members 82 and 84 are rotated from the first position to a second position, relative to the second arm member 84 , rotating the first body portion about the joint axis 86 stretching the joint.
- the third arm member 88 travels along an arcuate path along the second extension member 92 .
- the orthosis 80 is maintained in the second position for a predetermined treatment time providing a constant stretch to the joint.
- the second extension member 92 can be made of a substantially rigid but flexible material, such that while the first arm member 82 is in the second position the second extension member 92 acts like a spring, providing dynamic stretch to the connective tissue of the joint.
- the first arm member 82 After the expiration of the treatment time, the first arm member 82 is moved back to the first position, relieving the joint.
- the first arm member 82 can be rotated to a third position, increasing the stretch on the joint.
- the first arm member 82 can be rotated at discrete time intervals to incrementally increase the stretch of the joint through the treatment cycle.
- the first arm member 82 After completion of the treatment cycle, the first arm member 82 is returned to the first position for removal of the orthosis 80 .
- the push pin 144 is removed from the first and third arm members 82 and 88 , such that as the first and third arm members 82 and 88 are moved from a first position to a second position, with respected to the second arm member 84 , the first arm member 82 can slide along the arcuate path of the third extension 116 of the third arm member 88 .
- This can be utilized to increase the range on motion of the orthosis 80 . It is contemplated that the orthosis 80 can have a range of motion from around 15 degrees to around 145 degrees.
- the first, second, and third arm members 82 , 84 , and 88 are rigid members made oft for example, aluminum, stainless steel, polymeric, or composite materials.
- the arms are rigid so as to be able to transmit the necessary forces. It should be understood that any material of sufficient rigidity can be used.
- the components of the orthosis 80 of the present invention are made by injection molding.
- tool and die metal molds of the orthosis 80 components are prepared. Hot, melted plastic material is injected into the molds. The plastic is allowed to cool, forming components. The components are removed from the molds and assembled.
- the cuff portions 92 or 96 can be individual molded and attached to the arm members 82 or 84 . Alternatively, the cuff portions can be molded as an integrated pant of the arm members 82 or 84 .
- the gears 132 and 134 are rigid members made of, for example, aluminum, stainless steel, polymeric, or composite materials.
- the gears 132 and 134 are rigid so as to be able to transmit the necessary forces.
- the orthosis 80 In operation of the orthosis 80 to flex an elbow joint, the orthosis 80 starts at a more extended position.
- the first and second cuffs 94 and 96 are clamped onto the forearm and bicep portions of the arm, respectively, by straps, tightly enough so that the cuffs 94 and 96 can apply torque to the body portions to flex the joint.
- the first and second arm members 82 and 84 are rotated from the first position to a second position, relative to the second arm member 84 , rotating the forearm about the elbow joint axis 86 stretching the joint.
- the third arm member 88 travels along the arcuate path of the second extension member 92 .
- the orthosis 80 is maintained in the second position for a predetermined treatment time providing a constant stretch to the joint.
- the first and second arm members 82 and 884 are moved back to the first position, relieving the joint.
- the first and second arm members 82 and 84 can be rotated to a third position, increasing the stretch on the joint.
- the first and second arm members 82 and 84 can be rotated at discrete time intervals to incrementally increase the stretch of the joint through the treatment cycle. Referring to FIG. 20 , the treatment cycle can continue until the third arm member 88 traverses the second extension member 82 .
- the first and second arm members 82 and 84 are returned to the first position for removal of the orthosis 80 .
- the first arm member 82 can be released to move along the third arm member 88 .
- the first and third arm members 82 and 88 are rotated from the first position to a second position, relative to the second arm member 84 , rotating the forearm about the joint axis 86 stretching the joint.
- the third arm member 88 is rotated to the second position, the first arm member 82 can travel along an arcuate path of the third extension member 116 , thereby increasing the range of motion.
- the first cuff 94 is connected with the forearm and the second cuff 96 is connected to the bicep.
- the first and second cuffs 94 and 96 are clamped onto the forearm and biceps respectively, by straps, tightly enough so that they can apply torque to flex the joint.
- the first and third arm members 82 and 88 are rotated from the first position to a second position, relative to the second arm member 84 , rotating the forearm about the elbow joint axis 86 stretching the joint.
- the third arm member 88 travels along the arcuate path of the second extension member 92 .
- the orthosis 80 is maintained in the second position for a predetermined treatment time providing a constant stretch to the joint.
- the first and second arm members 82 and 84 are moved back to the first position, relieving the joint.
- the first and second arm members 82 and 84 can be rotated to a third position, increasing the stretch on the joint.
- the first and second arm members 82 and 84 can be rotated at discrete time intervals to incrementally increase the stretch of the joint through the treatment cycle.
- the first and second arm members 82 and 84 are returned to the first position for removal of the orthosis 80 .
- the first arm member 82 can be released to move along the third arm member 88 .
- the first and third arm members 82 and 88 are rotated from the first position to a second position, relative to the second arm member 84 , rotating the second body portion about the joint axis 86 stretching the joint.
- the third arm member 88 is rotated to the second position, the first arm member 82 can travel along an arcuate path of the third extension member 116 , thereby increasing the range of motion.
- the second and/or third extension members 92 and 116 are shown and described as having a substantially circular arcuate shape, positioning the axis of rotation at the joint axis 86 . However, it is contemplated that the second and/or third extension members 92 and 116 can have alternative shapes.
- the drive assembly 124 is described as utilizing a gear system. However, it is contemplated that other known drive systems can be used to move the first extension member 90 with respect to the second extension member 92 for example a friction type drive system. Regardless of the drive system used, the joint orthosis of the present invention can act as a brace, restricting the relative movement of the first and second body portions to one degree of freedom (e.g. flexion and extension about the joint). Thus, drive assembly 124 can be configured to allow free motion in one degree of freedom. This can be achieved in a number of different ways. For example, gear 128 can be positioned such that it does not engage teeth 130 .
- the drive assembly 124 of orthosis 80 in accordance with the present invention can be actuated by a motor instead of by a manually actuatable member, such as the knob 133 .
- the motor may be configured and adapted with gearing that causes the orthosis to cycle through a range of motion in a predetermined manner, or alternatively maybe controlled by a programmable logic controller (PLC).
- PLC programmable logic controller
- an electric motor is mounted to the shaft 132 for rotation of the gear 128 .
- a battery provides electric power to the motor.
- the motor can be supplied with external power.
- a microprocessor controls the operation of the motor. The microprocessor and motor together can be used to cycle the second and third arm members 84 and 88 through extension and flexion; to move the first and second arm members 82 and 84 in one pivotal direction a certain amount, hold there while tissue stretches, then move further in that direction; or in any other manner.
- the orthosis can be set to cycle to one end of the joint's range of motion and hold there for a predetermined period of time, then cycle to the other end of the joints range of motion and hold there.
- the programming and control of the microprocessor is within the skill of the art as it relates to driving the motor to control the second and third arm members 84 and 88 to move in known manners.
- This embodiment is ideally suited for continuous passive motion exercise, because the orthosis is portable and because the motor can be programmed with the desired sequence of movements.
- the present invention can further include a monitor for use with the orthosis 10 , 80 , which provides assurances the patient is properly using the orthosis 10 , 80 during his/her exercise period.
- the monitor can have a position sensor, a temperature sensor, a force sensor, a clock or timer, or a device type sensor for monitoring the patient's implementation of a protocol.
- the information obtained from these monitoring devices may be stored for later analysis or confirmation of proper use or may be transmitted in real-time during use of the device.
- the data obtained from the monitor can be analyzed by a healthcare professional or technician and the protocol can be adjusted accordingly.
- the components of the present invention are rigid members made of, for example, aluminum, stainless steel, polymeric, or composite materials.
- the member and extensions are sufficiently rigid to transmit the necessary forces. It should be understood that any material of sufficient rigidity might be used,
- some components can be made by injection molding. Generally, for injection molding, tool and die metal molds of the components are prepared. Hot, melted plastic material is injected into the molds. The plastic is allowed to cool, forming components. The components are removed from the molds and assembled.
- the components can be made of polymeric or composite materials such that the device can be disposable.
- the components can be made of a biodegradable material such as a biodegradable polymer.
- a biodegradable material such as a biodegradable polymer.
- PHA's poly (hydroxyacids)
- PLA polyactic acid
- PGA polyglycolic acid
- the device can be made of a nonmagnetic material.
- the device can be used as a positioning device for use in imaging devices, such as a MRI device. It is also contemplated that the device can be used as a positioning device for use during surgical procedures, where it may be necessary to adjust and hold the position of the joint.
- imaging devices such as a MRI device.
- the device can be used as a positioning device for use during surgical procedures, where it may be necessary to adjust and hold the position of the joint.
Abstract
Description
- The present application claims priority to U.S. Provisional Patent Application No. 60/783,895 filed Mar. 20, 2006, entitle ELBOW ORTHOSIS, the contents of which are herein incorporated by references in its entirety.
- The present invention relates to an adjustable orthosis for stretching tissue in the human body. In particular, the present invention relates to an adjustable orthosis which can be used for stretching tissue such as ligaments, tendons or muscles around a joint during flexion or extension of the joint.
- In a joint, the range of motion depends upon the anatomy of that joint and on the particular genetics of each individual. Typically, joints move in two directions, flexion and extension. Flexion is to bend the joint and extension is to straighten the joint; however, in the orthopedic convention some joints only flex. For example, the ankle has dorsiflexion and plantarflexion. Other joints not only flex and extend, they rotate. For example, the elbow joint has supination and pronation, which is rotation of the hand about the longitudinal axis of the forearm placing the palm up or the palm down.
- When a joint is injured either by trauma or by surgery, scar tissue can form, often resulting in flexion or extension contractures. Such conditions can limit the range of motion of the joint, limiting flexion (in the case of an extension contracture) or extension (in the case of a flexion contracture) of the injured joint. It is often possible to correct this condition by use of a range-of-motion (ROM) orthosis.
- ROM orthoses are devices commonly used during physical rehabilitative therapy to increase the range-of-motion over which the patient can flex or extend the joint. Commercially available ROM orthoses are typically attached on opposite members of the joint and apply a torque to rotate the joint in opposition to the contraction. The force is gradually increased to increase the working range or angle of joint motion. Exemplary orthoses include U.S. Pat. No. 6,599,263, entitled “Shoulder Orthosis;” U.S. Pat. No. 6,113,562, entitled “Shoulder Orthosis;” U.S. Pat. No. 5,848,979, entitled “Orthosis;” U.S. Pat. No. 5,685,830, entitled “Adjustable Orthosis Having One-Piece Connector Section For Flexing;” U.S. Pat. No. 5,611,764, entitled “Method of Increasing Range of Motion;” U.S. Pat. No. 5,503,619, entitled “Orthosis for Bending Wrists;” U.S. Pat. No. 5,456,268, entitled “Adjustable Orthosis;” U.S. Pat. No. 5,453,075, entitled “Orthosis with Distraction through Range of Motion;” U.S. Pat. No. 5,395,303, entitled “Orthosis with Distraction through Range of Motion;” U.S. Pat. No. 5,365,947, entitled “Adjustable Orthosis;” U.S. Pat. No. 5,285,773 entitled “Orthosis with Distraction through Range of Motion;” U.S. Pat. No. 5,213,095, entitled “Orthosis with Joint Distraction;” and U.S. Pat. No. 5,167,612, entitled “Adjustable Orthosis,” all to Bonutti and herein are expressly incorporated by reference in their entirety.
- The present invention provides an orthosis for stretching tissue around a joint of a patient between first and second relatively pivotable body portions. The joint and the first and second body portions define on one side of the joint an inner sector which decreases in angle as the joint is flexed and define on the opposite side of the joint an outer sector which decreases in angle as the joint is extended.
- The orthosis includes a first arm member affixable to the first body portion. The first arm member has a first extension member extending therefrom. A second arm member affixable to the second body portion is also included. The second arm member has a second extension member having an arcuate shape extending therefrom. A third arm member including a third extension member, having an arcuate shape extending therefrom, is interposed between the first and second arm members. The second and third arm members are operatively connected, such that the third arm member travels along an arcuate path defined by the second extension member when the third arm member is moved from a first position to a second position relative to the second arm member. The first arm member is slidingly connected to the third extension member, such that the first arm member slides along an arcuate path defined by the third extension member when the third arm member is moved from the first position to the second position relative to the second arm member.
- The orthosis further includes a drive assembly for selectively moving the third arm member relative to the second extension member. The drive assembly is mounted onto the third arm member, engaging the second extension member. The drive assembly can be manually or automatically actuated to selectively move the third arm member relative to the second extension member.
- A more complete understanding of the present invention, and the attendant advantages and features thereof, will be more readily understood by reference to the following detailed description when considered in conjunction with the accompanying drawings wherein:
-
FIG. 1 is a schematic diagram of the orthosis of the present invention in a flexed position; -
FIG. 2 is a schematic diagram of the orthosis of the present invention in an extended position; -
FIG. 3 is a second schematic diagram of the orthosis of the present invention in a flexed position; -
FIG. 4 shows an adjustable first extension member of the orthosis of the present invention; -
FIG. 5 shows the adjustable first extension member ofFIG. 4 in a second position; -
FIG. 6 shows a segmented first extension member of the present invention; -
FIG. 7 shows an arcuate first extension member of the present invention; -
FIG. 8 shows an orthosis of the present invention; -
FIG. 9 shows a non-circular arcuate shaped second extension member of the present invention; -
FIG. 10 shows an alternative arcuate shaped second extension member of the present invention; -
FIG. 11 shows a linear shaped second extension member of the present invention; -
FIG. 12 shows an exemplary drive assembly of the present invention; -
FIG. 13 depicts a first side view of another orthosis of the present invention for flexing and extending a joint in a patient; -
FIG. 14 depicts an opposite side view of the orthosis ofFIG. 13 ; -
FIG. 15 depicts a first arm member of the orthosis ofFIG. 13 ; -
FIG. 16 depicts a second arm member of the orthosis ofFIG. 13 ; -
FIG. 17 depicts a third arm member of the orthosis ofFIG. 13 ; -
FIG. 18 depicts the drive assembly of the orthosis ofFIG. 13 ; -
FIG. 19 depicts the connectivity of the first, second, and third arm members of the orthosis ofFIG. 13 ; -
FIG. 20 depicts the orthosis ofFIG. 13 in a middle flexed position; and -
FIG. 21 depicts the orthosis ofFIG. 13 in a fully flexed position. - The present invention relates to an orthosis for moving a joint between first and second relatively pivotable body portions. The joint and the first and second body portions define on one side (the flexor side) of the joint an inner sector which decreases in angle as the joint is flexed (bent) and on the opposite side (the extensor side) of the joint an outer sector which decreases in angle as the joint is extended (straightened). The orthosis of the present invention is affixable to either the flexor or extensor side of the joint for treatment of flexion or extension contractures.
- Referring now to the drawing figures in which like reference designators refer to like elements, there is shown in
FIG. 1 , a schematic of theorthosis 10 of the present invention. Theorthosis 10 includes afirst arm member 12 attachable to the first body portion and asecond arm member 14 attachable to the second body portion, wherein a joint axis ofrotation 16 is interposed between and offset from the first andsecond arm members second arm members joint axis 16. - The
first arm member 12 of theorthosis 10 includes aFirst extension member 18, which extends at angle α from thefirst arm member 12. Thesecond arm member 14 of theorthosis 10 includes asecond extension member 20 extending therefrom and having an arcuate shape. The first andsecond extension members second extension member 20 travels along an arcuate path about and substantially through point “P.” The arcuate shape of thesecond extension member 20 results in the second body portion rotating about thejoint axis 16, when thesecond arm member 14 is moved from a first position to a second position relative to thefirst arm member 12. The angle α between thefirst extension member 18 and thefirst arm member 12 and the radius of curvature of thesecond extension member 20 are a function of the joint to be treated and the degree of flexion or extension contractures. - The orthosis further includes a
drive assembly 22 at point “P.” The drive assembly connects the first andsecond extension members second arm members - The
orthosis 10 of the present invention is shown having an angle α such that the operative connection, at point “P.” of the first andsecond extensions joint axis 16, wherein plane “A” is substantially orthogonal to a longitudinal axis of thefirst arm member 12. This position of point “P” provides an angle β1 between thesecond arm member 14 and thejoint axis 16, wherein β1 is the maximum angle of flexion. As shown inFIG. 2 , the second extension member includes astop 24. Thestop 24 acts to limit the angle of maximum extension γ between thesecond arm member 14 and thejoint axis 16. An increase in the length of thestop 24 will decrease the angle of maximum extension γ. A decrease in the length of thestop 24 will increase the angle of maximum extension γ. - Referring to
FIG. 3 , the maximum flexion angle can be increased by increasing the angle α. An increase in the angle α will move the point “P” to a location “in front of” the plane “A.” This position of point “P” provides an angle β2 between thesecond arm member 14 and thejoint axis 16 in maximum flexion, wherein β2 is greater than β1. The greater the angle α, the greater the angle of maximum flexion. - Alternatively, (not shown) a decrease in the angle α will move the point “P” to a location “behind” the plane “A.” This position of point “P” provides an angle β3 between the
second arm member 14 and thejoint axis 16 in maximum flexion, wherein β3 is less than β1. The smaller the angle α, the smaller the angle β of maximum flexion. - Referring to
FIG. 4 , thefirst extension member 18 is selectively, pivotally connected atlocation 26 to thefirst arm member 12. Thepivotal connection 26 of thefirst extension member 18 permits the angle α between thefirst extension member 18 and thefirst arm member 12 to be selectively increased and decreased, increasing and decreasing the range of motion. In afirst position 28, thefirst extension member 18 is positioned at an angle α1, wherein the operative connection, at point “P,” of the first andsecond extension members joint axis 16, wherein plane “A” is substantially orthogonal to a longitudinal axis of thefirst arm member 12. Thefirst position 28 of point “P” provides a maximum angle of flexion of β1. The second extension member stop 24 acts to limit the angle of maximum extension γ1 between thesecond arm member 14 and thejoint axis 16. - Referring to
FIG. 5 , in asecond position 30 the angle α is increased to an angle α2, positioning the point “P” to a location “in front of” the plane “A.” Thesecond position 30 of point “P” provides a maximum angle of flexion of β2, wherein β2 is greater than β1. The second extension member stop 24 acts to limit the angle of maximum extension γ2 between thesecond arm member 14 and the joint axis, wherein γ2 is less the γ1. - The selective
pivotal connection 26 of thefirst extension member 18 to thefirst arm member 12 can have a plurality of selectable positions. The angle α between thefirst arm member 12 and thefirst extension 18 can be selectively increased to move the point “P”, on, “in front of” or “behind” the plane “A.” It is also envisioned that a positioned can be selected to increase the angle α between thefirst arm member 12 and thefirst extension 18 sufficiently to move the point “P” “in front of” plane “A” and “above” the longitudinal axis of thefirst arm member 12, maximizing the maximum angle of flexion β. - The
orthosis 10 of the present invention can be connected to the flexor side of the first and second body portions of the joint, which results in a decrease in angle as the joint is flexed (bent) and an increase in angle and the joint is extended (straightened). Alternatively,orthosis 10 of the present invention can be connected to the extensor side of the joint, which results in a decrease in angle as the joint is extended straightened and an increase in angle as the joint is flexed (bent). - The previous description of the
first arm member 12 depicts afirst extension 18 having a substantially linear shape, extending at an angle α from thefirst arm member 12. However, it is within the scope of the present invention that thefirst extension member 18 can be any shape extending from thefirst arm member 12 which positions the point “P” in the desired relationship to the plane “A.” Referring toFIG. 6 , a segmented first extension member is shown, including a firstextension member segment 18 a and a second extension member segment 18 b. The first and secondextension member segments 18 a and 18 b extend from thefirst arm member 12, positioning the point “P” at an angle α from thefirst arm member 12. Referring toFIG. 7 , an arcuate first extension member 18 c is shown. The arcuate extension member 18 c extends from thefirst arm member 12, positioning the point “P” at an angle α from thefirst arm member 12. - Referring to
FIG. 8 , theorthosis 10 of the present invention includes afirst arm member 12 attachable to the first body portion and asecond arm member 14 attachable to the second body portion, wherein thejoint axis 16 is interposed between and offset from the first andsecond arm members second arm members joint axis 16. - The
first arm member 12 of theorthosis 10 includes afirst extension member 18, which extends at angle α from thefirst arm member 12. Thesecond arm member 14 of theorthosis 10 includes asecond extension member 20, having an arcuate shape. The first andsecond extension members second extension member 20 travels along an arcuate path about and substantially through point “P.” The arcuate shape of thesecond extension member 20 results in the second body portion rotating about thejoint axis 16, when thesecond arm member 14 is moved from a first position to a second position relative to thefirst arm member 12. The angle α between thefirst extension member 18 and thefirst arm member 12 and the radius of curvature of thesecond extension member 20 are a function of the joint to be treated and the degree of flexion or extension contractures. - A
first cuff 32 is attached to thefirst arm member 12, wherein thefirst cuff 32 is positionable about the first body portion. Thefirst cuff 32 is attached to the first body portion by cuff straps. Thefirst cuff 32 secures the first body portion to thefirst arm member 12. Asecond cuff 34 is attached to thesecond arm member 14, wherein thesecond cuff 34 is positionable about the second body portion. Thesecond cuff 34 is attached to the second body portion by cuff straps. Thesecond cuff 34 secures the second body portion to thesecond arm member 14. (The term “cuff” as used herein means any suitable structure for transmitting the force of theorthosis 10 to the limb portion it engages.) - In an exemplary use, the
orthosis 10 is operated to extend a joint in the following manner. Thefirst cuff 32 is fastened about the first body portion tightly enough that thefirst arm member 12 may apply torque to the first body portion without having thefirst cuff 32 slide along the first body portion. Similarly, thesecond cuff 34 is fastened securely around the second body portion so that thesecond arm member 14 may apply torque to the second body portion without thesecond cuff 34 sliding along the second body portion. Theorthosis 10 is attached to the first and second body portions in a first position. Thesecond arm member 14 is rotated from the first position to a second position, relative to thefirst arm member 12, rotating the second body portion about thejoint axis 16 stretching the joint. As thesecond arm member 14 is rotated to the second position, thesecond extension member 20 travels along an arcuate path about and substantially through point “P.” Theorthosis 10 is maintained in the second position for a predetermined treatment time providing a constant stretch to the joint. Theorthosis 10 may alternatively be configured to impart a constant force or load on the joint or may utilize the techniques of Static Progressive Stretch as described in co-pending application Ser. No. 11/203,516, entitled “Range of Motion System and Method”, and filed on Aug. 12, 2005, the entirety of which is incorporated by reference. - Additionally, the
second extension member 12 can be made of a substantially rigid but flexible material, such that while thesecond extension member 12 is in the second position, thesecond extension member 12 acts like a spring, providing dynamic stretch to the connective tissue of the joint. - After the expiration of the treatment time, the
second arm member 14 is moved back to the first position, relieving the joint. Optionally, thesecond arm member 14 can be rotated to a third position, increasing the stretch on the joint. Thesecond arm member 14 can be rotated at discrete time intervals to incrementally increase the stretch of the joint through the treatment cycle. After completion of the treatment cycle, the second arm member is returned to the first position for removal of theorthosis 10. - The first and
second arm members - In an embodiment, the components of the
orthosis 10 of the present invention are made by injection molding. Generally for injection molding, tool and die metal molds of theorthosis 10 components are prepared. Hot, melted plastic material is injected into the molds. The plastic is allowed to cool, forming components. The components are removed from the molds and assembled. Thecuff portions arm members arm members - In use, the
orthosis 10 can be connected to the flexor side of the first and second body portions of the joint, which results in a decrease in angle as the joint is flexed (bent) and an increase in angle as the joint is extended (straightened). Alternatively,orthosis 10 of the present invention can be connected to the extensor side of the joint, which results in a decrease in angle as the joint is extended straightened and an increase in angle as the joint is flexed (bent). - In an embodiment, the
orthosis 10 includes afirst cuff 32 for attachment to a first body portion, and asecond cuff 34 for attachment to a second body portion. The first body portion is joined to the second body portion at a joint, around which is located, as is well known, soft tissue. Each of the first andsecond cuffs cuffs - The
first cuff 32 is mounted for sliding movement on thefirst arm member 12 and is slidable along thefirst arm member 12 in a manner as described below. Thesecond cuff 34 is mounted for sliding movement on asecond arm member 14 and is slidable along thesecond arm member 12 in a manner as described below. - Bending a Joint in Extension:
- In operation of the
orthosis 10 to extend the joint, theorthosis 10 starts at a more flexed position. The first andsecond cuffs cuffs second arm member 14 is rotated from the first position to a second position, relative to thefirst arm member 12, rotating the second body portion about thejoint axis 16 stretching the joint. As thesecond arm member 14 is rotated to the second position thesecond extension member 20 travels along an arcuate path about and substantially through point “P.” Theorthosis 10 is maintained in the second position for a predetermined treatment time providing a constant stretch to the joint. - As the
orthosis 10 is rotated from the first position to the second position, extending the joint, the first andsecond cuffs second arm members first cuff 32 moves inwardly along thefirst arm member 12. Similarly, thesecond cuff 34 moves inwardly along thesecond arm member 14. Because thecuffs second arm members cuffs cuffs second arm members second arm members cuffs second arm members 12 and 14 a distance far enough so that the joint is only slightly distracted during extension. Thus, the detrimental effects of strong distractive forces normally generated in forced extension of a joint are avoided, being replaced with the beneficial effects of limited and controlled distraction. - Bending a Joint in Flexion:
- In operation of the
orthosis 10 to flex the joint, theorthosis 10 starts at a more extended position. The first andsecond cuffs cuffs second arm member 14 is rotated from the first position to a second position, relative to thefirst arm member 12, rotating the second body portion about thejoint axis 16 stretching the joint. As thesecond arm member 14 is rotated to the second position thesecond extension member 20 travels about and substantially though point “P,” along an arcuate path. Theorthosis 10 is maintained in the second position for a predetermined treatment time providing a constant stretch to the joint. - As the
orthosis 10 is rotated from the first position to the second position, flexing the joint the first andsecond cuffs second arm members first cuff 32 moves outwardly along thefirst arm member 12. Similarly, thesecond cuff 34 moves outwardly along thesecond arm member 14. Because thecuffs second arm members cuffs cuffs second arm members second arm members cuffs second arm members 12 and 14 a distance Far enough so that the joint is only slightly compressed during flexion. Thus, the detrimental effects of strong compressive forces normally generated in forced flexion of a joint are avoided, being replaced with the beneficial effects of limited and controlled compression. - Referring to
FIG. 9 , thesecond arm member 14 is shown having a non-circular arcuate shapedsecond extension member 44. The non-circular arcuate shapedsecond extension member 44 provide an axis of rotation which changes as thesecond arm member 14 is moved from the first position to the second portion. As such, as thesecond arm member 14 is moved from the first position to the second portion the second body portion will exhibit both a rotational motion, about thejoint axis 16, and a translational motion, distracting or compressing the joint. - In the previously described embodiments, the arcuate shape of the
second extension member FIG. 10 , it is contemplated that thesecond extension member second extension member joint axis 16, when thesecond arm member 14 is moved from a first position to a second position relative to thefirst arm member 12. - Referring to
FIG. 11 , thesecond arm member 14 of theorthosis 10 includes asecond extension member 46 extending therefrom and having a linear shape. The first andsecond extension members second extension member 46 travels along a linear path through point “P.” The linear shape of thesecond extension member 46 results in the second body portion being translated with respect to the first body portion. The translational movement of thesecond arm member 14 results in a distraction or compression of the joint when thesecond arm member 14 is moved from a first position to a second position relative to thefirst arm member 12. - As discussed further below, the hand pad can be mounted for translational and rotational movement on the base member.
- Drive Assembly:
- Referring to
FIG. 12 , thedrive assembly 22 of the orthosis includes a gear system. As previously noted, the components of the orthosis, including thedrive assembly 22, can be made by injection molding a polymer. Thedrive assembly 22 is supported in thefirst extension member 18, including agear 50 rotatable about point “P.” Ashaft 52, attached to thegear 50, extends fromfirst extension member 18. Aknob 54 is connected to theshaft 52, opposite thegear 50, for manually rotating thegear 50. Thesecond extension member 20 includes a series ofteeth 56 along aninner surface 58. Thesecond extension member 20 is threaded through thefirst extension member 18, such that theteeth 56 on thesecond extension member 20 engage thegear 50. The rotation of theknob 56 causes thegear 50 to rotate, pushing or pulling thesecond extension member 20 through thefirst extension member 18. Thedrive assembly 22 includes a locking or breaking mechanism which prevents thegear 50 from rotating absent any applied Force rotation of theknob 56. Such a lock or breaking mechanism can include a compression washer or other known gear locking or breaking mechanisms. - The
drive assembly 22 is described as utilizing a gear system. However, it is contemplated that other known drive systems can be used to move thesecond extension member 20 through thefirst extension member 18, for example a friction type drive system. Regardless of the drive system used, the joint orthosis of the present invention can act as a brace, restricting the relative movement of the first and second body portions to one degree of freedom (e.g. flexion and extension about the joint). Thus, driveassembly 22 can be configured to allow free motion in one degree of freedom. This can be achieved in a number of different ways. For example,gear 50 can be positioned such that it does not engageteeth 56. - In an alternative embodiment, the
drive assembly 22 oforthosis 10 in accordance with the present invention can be actuated by a motor instead of by a manually actuatable member. Likewise, the motor may be configured an adapted with gearing that causes the orthosis to cycle through a range of motion in a predetermined manner, or alternatively maybe controlled by a programmable logic controller (PLC). - In an embodiment, an electric motor is mounted to the
shalt 52 for rotation of thegear 50. A battery provides electric power to the motor. Alternatively, the motor can be supplied with external power. A microprocessor controls the operation of the motor. The microprocessor and motor together can be used to cycle the first andsecond arm members second arm members - In another manner of use, the orthosis can be set to cycle to one end of the joint's range of motion and hold there for a predetermined period of time, then cycle to the other end of the joints range of motion and hold there. The programming and control of the microprocessor is within the skill of the art as it relates to driving the motor to control the first and
second arm members - It should be understood that the particular physical arrangement of the motor, the battery, and the microprocessor is not the only possible arrangement of those elements. The invention contemplates that other arrangements of these or similarly functional elements are quite suitable, and thus the invention is intended to cover any such arrangement. Additionally, another type of power source, other than an electric motor, can also be used. For example, the use of a hydraulic or pneumatic motor as the drive mechanism is contemplated.
- Referring to
FIGS. 13 and 14 , anorthosis 80 of the present invention includes afirst arm member 82 attachable to the first body portion and asecond arm member 84 attachable to the second body portion, wherein thejoint axis 86 is interposed between and offset from the first andsecond arm members third arm member 88 is interposed between the first andsecond arm members second arm members third arm member 88, offset from thejoint axis 86. - The
first arm member 82 of theorthosis 80 includes afirst extension member 90, which extends from thefirst arm member 82. Thesecond arm member 84 of theorthosis 80 includes asecond extension member 92 having an arcuate shape. The first andsecond extension members third arm member 88, where thesecond extension member 92 is operably connected to thethird arm member 88 at a point “P,” such that in operation thethird member 88 travels along an arcuate path of thesecond extension member 92. The arcuate shape of thesecond extension member 92 results in the first body portion rotating about thejoint axis 86, when the first andthird arm members second arm member 84. The radius of curvature of thesecond extension member 92 is a function of the joint to be treated and the degree of flexion or extension contractures. - A
first cuff 94 is attached to thefirst arm member 82, wherein thefirst cuff 94 is positionable about the first body portion. Thefirst cuff 94 is attached to the first body portion by cuff straps. Thefirst cuff 94 secures the first body portion to thefirst arm member 82. Asecond cuff 96 is attached to thesecond arm member 84, wherein thesecond cuff 96 is positionable about the second body portion. Thesecond cuff 96 is attached to the second body portion by a cuff strap(s) 98. Thesecond cuff 96 secures the second body portion to thesecond arm member 84. Thecuffs orthosis 80 to the limb portion it engages.). - The
first cuff 94 can be slidingly connected to thefirst arm member 82. Referring toFIG. 15 , a slidingbar 100 is affixed to thefirst cuff 94. where the slidingbar 100 includeschannels 102 positioned on opposite sides of the slidingbar 110. Thefirst arm member 82 includes amain channel 106 configured to slidingly receive the slidingbar 100.Pins 108 are positioned though opposite sides of themain channel 106 of thefirst arm member 82 and into thechannels 102 to slidingly secured the slidingbar 100 in themain channel 106. Anadjustable member 110 can be threaded though thefirst arm member 82, into achannel 102 to adjustably secure the position of the slidingbar 102 in themain channel 106. As such, the position of thefirst cuff 94 can be adjusted with respected thefirst arm member 82, the position being secured with theadjustable member 110. Alternatively, thefirst cuff 94 can be free to slide with respect to thefirst arm member 82, thereby allowing the position of thefirst cuff 94 to self adjust during operation of theorthosis 80. - Similar to the
first cuff 92, thesecond cuff 96 can be slidingly connected to thesecond arm member 84. - Referring to
FIG. 16 , thesecond extension member 92 has an arcuate shape, where the radius of curvature of thesecond extension member 92 is a function of the joint to be treated and the degree of flexion or extension contractures. Thesecond extension member 92 includes aninner surface 112 have a plurality ofteeth 114 thereon. Thesecond extension member 92 can includechannels 115 disposed on opposite sides thereof. - Referring to
FIG. 17 , thethird arm member 88 includes athird extension member 116 has an arcuate shape, where the radius of curvature of thethird extension member 116 is a function of the joint to be treated and the degree of flexion or extension contractures. Thethird extension member 116 includeschannels 118 disposed on opposite sides thereof. Adrive housing 120 is positioned proximal to aguide channel 122. - Referring also to
FIGS. 18 and 19 , adrive assembly 124 is positioned in thedrive housing 120 of thethird arm member 88. Thedrive assembly 124 includes adrive gear 126 and amain gear 128, where the teeth of thedrive gear 126 engage theteeth 130 of themain gear 128. Adrive shaft 132 is connected to thedrive gear 126, extending through thecover plate 134. Aknob 133 can be affixed to thedrive shaft 132 to facilitate rotation thereof. A rotation of thedrive shaft 132 rotates thedrive gear 126, which in turn rotates themain gear 128. Themain gear 128 is sized such that a portion of thegear teeth 130 protrudes into theguide channel 122 of thethird arm member 88. - The
second extension member 92 is positioned in theguide channel 122, such that thegear teeth 132 of themain gear 128 engage theteeth 114 on theinner surface 112 of thesecond extension member 92. A rotation of thedive shaft 132 rotates thedrive gear 126, which in turn rotates themain gear 128, driving thesecond extension member 92 through theguide channel 122. Thecover plate 134 is positioned over theguide channel 122, securing thesecond extension member 92 in theguide channel 122 and defining a passage through which it travels. - Guide pins 135 can be positioned in the
channels 115 of thesecond extension member 92, engaging on one side thethird arm member 88 and on an opposite side thecover plate 134. The guide pins 135 can be used to secure thesecond extension member 92 in the passage and control the tacking of thethird arm member 88 along thesecond extension member 92. - The
drive mechanism 22 can further include a locking mechanism. The locking mechanism can be used to secure the position of thesecond arm member 84 with respect to thethird arm member 88. The locking mechanism can prevent the actuation of thedrive assembly 124, securing the position of second andthird arm members third arm members drive mechanism 124 from moving the second andthird arm members orthosis 80 can be used as a static splint. - The
first arm member 82 can be sliding affixed to thethird arm member 88. Thefirst extension member 90 is positioned about thethird extension member 88, where anend portion 136 of thefirst extension member 90 is slidingly connected about thethird extension member 118.Pins 140 are positioned through pin holes 142, provided on opposite sides of theend portion 136 of thefirst extension member 90, into thechannels 118 of thethird extension member 88, thereby allowing theend portion 136 of thefirst extension member 90 to slide along the arcuate path defined by thechannels 118, rotating thefirst arm member 82 about thejoint axis 86. Thefirst arm member 82 can slide freely with respect to thethird extension member 116. Alternatively, apush pin 144 can be positioned through theend portion 136 of thefirst extension member 92 intopush pin hole 146 in thechannels 118 of thethird extension member 116. (See alsoFIG. 14 ). Thepush pin 144 prevents relative movement of thefirst arm member 82 with respect to thethird arm member 88. - In an exemplary use, the
orthosis 80 is operated to extend a joint in the following manner. Thefirst cuff 94 is fastened about the first body portion tightly enough that thefirst arm member 82 may apply torque to the first body portion without having thefirst cuff 94 slide along the first body portion. Similarly, thesecond cuff 96 is fastened securely around the second body portion so that thesecond arm member 84 may apply torque to the second body portion without thesecond cuff 96 sliding along the second body portion. Theorthosis 80 is attached to the first and second body portions in a first position. The first andsecond arm members second arm member 84, rotating the first body portion about thejoint axis 86 stretching the joint. As the first andsecond arm members third arm member 88 travels along an arcuate path along thesecond extension member 92. Theorthosis 80 is maintained in the second position for a predetermined treatment time providing a constant stretch to the joint. Additionally, thesecond extension member 92 can be made of a substantially rigid but flexible material, such that while thefirst arm member 82 is in the second position thesecond extension member 92 acts like a spring, providing dynamic stretch to the connective tissue of the joint. - After the expiration of the treatment time, the
first arm member 82 is moved back to the first position, relieving the joint. Optionally, thefirst arm member 82 can be rotated to a third position, increasing the stretch on the joint. Thefirst arm member 82 can be rotated at discrete time intervals to incrementally increase the stretch of the joint through the treatment cycle. After completion of the treatment cycle, thefirst arm member 82 is returned to the first position for removal of theorthosis 80. - In another exemplary use, the
push pin 144 is removed from the first andthird arm members third arm members second arm member 84, thefirst arm member 82 can slide along the arcuate path of thethird extension 116 of thethird arm member 88. This can be utilized to increase the range on motion of theorthosis 80. It is contemplated that theorthosis 80 can have a range of motion from around 15 degrees to around 145 degrees. - The first, second, and
third arm members - In an embodiment, the components of the
orthosis 80 of the present invention are made by injection molding. Generally for injection molding, tool and die metal molds of theorthosis 80 components are prepared. Hot, melted plastic material is injected into the molds. The plastic is allowed to cool, forming components. The components are removed from the molds and assembled. Thecuff portions arm members arm members - Similarly, the
gears gears - Bending an Elbow Joint Flexion:
- In operation of the
orthosis 80 to flex an elbow joint, theorthosis 80 starts at a more extended position. The first andsecond cuffs cuffs second arm members second arm member 84, rotating the forearm about the elbowjoint axis 86 stretching the joint. As the first andsecond arm members third arm member 88 travels along the arcuate path of thesecond extension member 92. Theorthosis 80 is maintained in the second position for a predetermined treatment time providing a constant stretch to the joint. - After the expiration of the treatment time, the first and
second arm members 82 and 884 are moved back to the first position, relieving the joint. Optionally, the first andsecond arm members second arm members FIG. 20 , the treatment cycle can continue until thethird arm member 88 traverses thesecond extension member 82. After completion of the treatment cycle, the first andsecond arm members orthosis 80. - Alternatively, the
first arm member 82 can be released to move along thethird arm member 88. Referring toFIG. 21 , the first andthird arm members second arm member 84, rotating the forearm about thejoint axis 86 stretching the joint. As thethird arm member 88 is rotated to the second position, thefirst arm member 82 can travel along an arcuate path of thethird extension member 116, thereby increasing the range of motion. - Bending an Elbow Joint in Extension:
- When an elbow joint is to be bent in extension, the
first cuff 94 is connected with the forearm and thesecond cuff 96 is connected to the bicep. The first andsecond cuffs third arm members second arm member 84, rotating the forearm about the elbowjoint axis 86 stretching the joint. As the first andthird arm members third arm member 88 travels along the arcuate path of thesecond extension member 92. Theorthosis 80 is maintained in the second position for a predetermined treatment time providing a constant stretch to the joint. - After the expiration of the treatment time, the first and
second arm members second arm members second arm members second arm members orthosis 80. - Alternatively, the
first arm member 82 can be released to move along thethird arm member 88. The first andthird arm members second arm member 84, rotating the second body portion about thejoint axis 86 stretching the joint. As thethird arm member 88 is rotated to the second position, thefirst arm member 82 can travel along an arcuate path of thethird extension member 116, thereby increasing the range of motion. - In the above description, the second and/or
third extension members joint axis 86. However, it is contemplated that the second and/orthird extension members - The
drive assembly 124 is described as utilizing a gear system. However, it is contemplated that other known drive systems can be used to move thefirst extension member 90 with respect to thesecond extension member 92 for example a friction type drive system. Regardless of the drive system used, the joint orthosis of the present invention can act as a brace, restricting the relative movement of the first and second body portions to one degree of freedom (e.g. flexion and extension about the joint). Thus, drive assembly 124 can be configured to allow free motion in one degree of freedom. This can be achieved in a number of different ways. For example,gear 128 can be positioned such that it does not engageteeth 130. - In an alternative embodiment, the
drive assembly 124 oforthosis 80 in accordance with the present invention can be actuated by a motor instead of by a manually actuatable member, such as theknob 133. Likewise, the motor may be configured and adapted with gearing that causes the orthosis to cycle through a range of motion in a predetermined manner, or alternatively maybe controlled by a programmable logic controller (PLC). - In an embodiment, an electric motor is mounted to the
shaft 132 for rotation of thegear 128. A battery provides electric power to the motor. Alternatively, the motor can be supplied with external power. A microprocessor controls the operation of the motor. The microprocessor and motor together can be used to cycle the second andthird arm members second arm members - In another manner of use, the orthosis can be set to cycle to one end of the joint's range of motion and hold there for a predetermined period of time, then cycle to the other end of the joints range of motion and hold there. The programming and control of the microprocessor is within the skill of the art as it relates to driving the motor to control the second and
third arm members - It should be understood that the particular physical arrangement of the motor, the battery, and the microprocessor is not the only possible arrangement of those elements. The invention contemplates that other arrangements of these or similarly functional elements are quite suitable, and thus, the invention is intended to cover any such arrangement. Additionally, another type of power source, other than an electric motor, can also be used. For example, the use of a hydraulic or pneumatic motor as the drive mechanism is contemplated.
- The present invention can further include a monitor for use with the
orthosis orthosis - This analysis may be conducted remotely, thereby saving the time and expense of a home visit by a healthcare professional or technician. An exemplary monitoring system is provided in U.S. Pat. No. 7,182,738 entitled “Patient Monitoring Apparatus and Method for Orthosis and Other Devices,” to Bonutti et al., the content of which is herein expressly incorporated by reference in its entirety.
- The components of the present invention are rigid members made of, for example, aluminum, stainless steel, polymeric, or composite materials. The member and extensions are sufficiently rigid to transmit the necessary forces. It should be understood that any material of sufficient rigidity might be used, For example, some components can be made by injection molding. Generally, for injection molding, tool and die metal molds of the components are prepared. Hot, melted plastic material is injected into the molds. The plastic is allowed to cool, forming components. The components are removed from the molds and assembled.
- Furthermore, it is contemplated that the components can be made of polymeric or composite materials such that the device can be disposable. For example, at least some or all of the components can be made of a biodegradable material such as a biodegradable polymer. Among the important properties of these polymers are their tendency to depolymerize relatively easily and their ability to form environmentally benign byproducts when degraded or depolymerized. One such biodegradable material is poly (hydroxyacids) (“PHA's”) such as polyactic acid (“PLA”) and polyglycolic acid (“PGA”).
- Additionally, the device can be made of a nonmagnetic material. In such instance, the device can be used as a positioning device for use in imaging devices, such as a MRI device. It is also contemplated that the device can be used as a positioning device for use during surgical procedures, where it may be necessary to adjust and hold the position of the joint. It will be appreciated by persons skilled in the art that the present invention is not limited to what has been particularly shown and described herein above. For example, although the examples presented identify the wrist joint, the present invention can be used for any joint. In addition, unless mention was made above to the contrary, it should be noted that all of the accompanying drawings are not to scale. A variety of modifications and variations are possible in light of the above teachings without departing from the scope and spirit of the invention.
Claims (28)
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US8251935B2 (en) * | 2006-03-17 | 2012-08-28 | Bonutti Research, Inc. | Ankle orthosis |
US7955286B2 (en) | 2006-03-20 | 2011-06-07 | Bonutti Research Inc. | Elbow orthosis |
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US8273043B2 (en) | 2007-07-25 | 2012-09-25 | Bonutti Research, Inc. | Orthosis apparatus and method of using an orthosis apparatus |
US8905950B2 (en) | 2008-03-04 | 2014-12-09 | Bonutti Research, Inc. | Shoulder ROM orthosis |
US9402759B2 (en) | 2013-02-05 | 2016-08-02 | Bonutti Research, Inc. | Cervical traction systems and method |
US11826274B1 (en) | 2013-12-12 | 2023-11-28 | Ermi Llc | Devices and methods for assisting extension and/or flexion |
CN105982809A (en) * | 2015-02-10 | 2016-10-05 | 青岛尤尼科技有限公司 | Elbow joint flexion-extension trainer |
JP7141088B2 (en) * | 2018-05-11 | 2022-09-22 | 学校法人早稲田大学 | Joint structure and robot hand |
CN112690999B (en) * | 2021-01-12 | 2022-04-26 | 中国人民解放军陆军军医大学第一附属医院 | Rehabilitation device after mammary gland operation |
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US11123212B2 (en) | 2021-09-21 |
US10159591B2 (en) | 2018-12-25 |
US7955286B2 (en) | 2011-06-07 |
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US8591443B2 (en) | 2013-11-26 |
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US20160120681A1 (en) | 2016-05-05 |
US9248041B2 (en) | 2016-02-02 |
US20140142484A1 (en) | 2014-05-22 |
US20070219476A1 (en) | 2007-09-20 |
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