Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
  • A61H1/00—Apparatus for passive exercising; Vibrating apparatus; Chiropractic devices, e.g. body impacting devices, external devices for briefly extending or aligning unbroken bones
  • A61H1/02—Stretching or bending or torsioning apparatus for exercising
  • A61H1/0237—Stretching or bending or torsioning apparatus for exercising for the lower limbs
  • A61H1/0255—Both knee and hip of a patient, e.g. in supine or sitting position, the feet being moved together in a plane substantially parallel to the body-symmetrical plane
  • A61H1/0259—Both knee and hip of a patient, e.g. in supine or sitting position, the feet being moved together in a plane substantially parallel to the body-symmetrical plane moved by translation

Definitions

• the present invention relates to the medical field and relates to the materials used for orthopedic treatments or functional rehabilitation of the lower limbs.
• the proposed equipment is generally constituted in the form of a splint comprising a base or base supporting an articulated structure composed of a segment or crural cradle connected by an articulation to a segment or cradle cradle most equipped often, like the crural cradle, a hammock for receiving and supporting the corresponding part of the lower limb to be mobilized.
• Such splints called articulated as opposed to fixed splints allowing only immobilization in determined posture of a lower limb, are intended to allow mobilization in flexion-extension at least for two of the joints of a lower limb, namely coxofemoral joint and knee.
• Such a non-coincidence has a consequence which is that the effective length of the crural segment between its articulation on the base and the axis of articulation with the leg segment, appears of length greater than that of the osseous segment of the member to be reeducated and, more in particular, the length of the femur between the coxo-femoral axis and the knee.
• any displacement in extension results in a shift between the trajectories in arcs of a circle described by these points of articulation.
• the object of the invention is to propose a constructive solution which precisely makes it possible to solve the problem thus posed.
• the means according to the invention are particularly designed to meet, in addition to the above problem, a second requirement frequently imposed on the personnel responsible for the commissioning of such splints and which is that of necessity to be able or to have to adjust the length of the leg segment according to the length of the corresponding bone segment of the member to be rehabilitated.
• the object of the invention by the means implemented to resolve the above problem, opens up the possibility of automatic adjustment of such a length.
• the object of the invention is also designed to take account of a finding frequently made in the field of rehabilitation, when the functional rehabilitation treatment, following a trauma of great importance, leaves the lower limb in a passive level of work not involving any voluntary muscular solicitation, mainly in the thigh muscles.
• the object of the invention is precisely to choose technical means which, if necessary, can be implemented to provide a first type of response to such a finding, without claiming to be able to constitute a substitute for the means of rehabilitation.
• functional and effective functional of the quadriceps muscles are therefore to propose technical means which are able to offer several rehabilitative functionalities which can be considered independently or simultaneously.
• the mobilization splint of a lower limb of the type comprising a base carrying an articulated structure composed of a crural segment or cradle articulated at one end of the base and a cradle or leg segment linked to the crural cradle by a hinge pin orthogonal to the direction of a rail defined by the base for guiding the leg cradle, a motor means interposed between the base and the articulated structure for moving the leg segment relative to the rail according to an alternative rectilinear displacement and a footrest adapted at the end of the leg cradle or segment opposite the crural cradle, is characterized in that, according to the invention, said footrest is mounted on the cradle cradle by means of at least one slide with the interposition of an elastic return means always tending to bring the footrest into a position of least extension relative to the cradle leg.
• Fig. 1 is a schematic perspective of a lower limb mobilization splint.
• Fig. 2 is an explanatory diagram highlighting the fundamental problem that the object of the invention aims to solve.
• Fig. 3 is a partial sectional elevation showing, on a larger scale, a detail of constructive embodiment of the splint according to FIG. 1.
• Fig. 4 is a sectional elevation, on a larger scale, illustrating an alternative embodiment.
• Fig. 5 is a partial sectional elevation, partially cut away, showing, on a still larger scale, another embodiment of the means according to the invention.
• Fig. 1 shows a so-called passive mobilization splint of a lower limb which can be either a right limb or a left limb, since the illustrated splint reveals a symmetrical construction.
• the splint includes a base or base 1 which is intended to rest on a support surface, such as 2, of any suitable nature and advantageously constituted by the mattress of bedding.
• the base or base 1 has a proximal part 3 with which it supports an articulated structure 4 composed of a segment or crural cradle 5 connected by an articulation 6 at the proximal part 3.
• the crural segment 5 is composed of two longitudinal members or the like 7 possibly connected together by a spacer and able to be fitted with a flexible element for supporting the thigh of a member lower, for example, a hammock 8 of any suitable material.
• the structure 4 is also composed of a leg segment 9 which is articulated in the extension of the crural segment 5 by means of trunnions or pivots 10 which define between them a pivot axis xx 'which is orthogonal to the general direction of the plinth or base 1.
• the leg segment 9 consists of two longitudinal members or the like 11 possibly connected by a transverse spacer 12 and also capable of being fitted with a flexible support mattress, such as a hammock 13.
• the end portion of the leg segment 9 opposite the pins 10 carries a footrest 14 consisting of a support 15 optionally adjustable in orientation along an axis y-y 'substantially parallel to the axis x-x'.
• the support 15 carries a soleplate 16 which can be adjusted in orientation in the double direction of the arrow fi by any suitable means known in the art involving, for example, a pivot and a tightening button.
• the plate 16 carries a sole 17 possibly adjustable in the double direction of the arrow f-> and, preferably, made in the form of an open shell to allow the establishment and support of the foot of the lower limb to be rehabilitated.
• the structure 4 is carried at the leg segment 9 by a carriage 18 supported by a guide track 19 materialized by the base or the base 1 in a rectilinear direction which is orthogonal to the axis x-x ' .
• the structure 4 is associated with motorization means, such as those designated by the general reference 20, to act on the structure so as to control a movement of the carriage 18 in alternating rectilinear travel on the track 19 to drive the structure 4 from of a complete extension in a flexion movement and vice versa, as is known to those skilled in the art.
• motorization means such as those designated by the general reference 20
• the motorization means 20 which can be controlled from a remote control unit 21, can be adapted on one of the pivots 10 or even be placed in relation to the carriage 18 by involving then an appropriate transmission.
• the choice of such motorization means does not fall directly within the scope of the invention and are accessible to those skilled in the art.
• a mobilization splint of the above type generally, or at least, frequently occurs during its installation, a situation of the type illustrated in FIG. 2, in which by sliding, inadvertence or impossibility of positioning, the articulation 6 between the crural segment and the base 1 is not coincident with the coxo-femoral articulation 22 of the member 23 to be rehabilitated.
• Such a situation also involves a length of the crural segment 4 which is different from the length of the femoral articular segment of the limb 23, so that two types of offset can occur between axes 6 and 22, namely an offset N relative to the plane of the base and an offset n in a plane perpendicular to this plane.
• the difference between the trajectories ti and t 2 can be variable but, in all cases, results in non-optimal functional conditions.
• Fig. 2 clearly shows that the offset of the trajectories ti and t 2 has the consequence that, in the extended position, the knee trajectory t 2 is located behind the trajectory ti relative to the distal end of the base and that , as a result, the footrest 17 gradually disappears forward relative to the foot which is no longer supported nor, if necessary, supported.
• the object of the invention is to propose means which make it possible to compensate for this progressive deviation during the trajectory, so as to restore, over the whole trajectory, a support between the foot and the footrest 17, whatever the difference between the trajectories ti and t 2 .
• each rod 30 is provided with an extreme collar 31 and slides in a tubular plug 32 closing the distal end of the spar 11, so as to constitute a sliding bearing for the rod 30.
• the spar 11 delimits a blind bore which defines with the rod 30, an annular interval 33 capable of receiving a elastic return member 34 constituting a means always tending to act on the rod 30, so as to urge it in the direction of the arrow f $ to give it a position of least extension relative to the spar 11.
• a position of least extension is , for example but not exclusively, determined by the bearing support of the collar 31 on the bottom of the bore of the side member 11.
• the elastic members 34 are advantageously constituted by helical springs placed under compression stress.
• the plug 32 can be formed in the form of a plain bearing, or even a ball bushing and is fitted on the end of the beam 11, advantageously removable to facilitate the mounting of the rod 30, as well as that spring 34.
• the useful length between the axis x -x 'and the axis yy' is adjusted, for example, by means of the position of the support 15 on the rods 30, so that it is less than the length of the tibial segment 25 of the lower limb 23, so that in this position, the footrest 17 is urged in partial extension stroke against the antagonistic action of the spring or springs 34 which are subjected to a stress greater than that which they undergo in the position of least extension, as mentioned above.
• the offset between the trajectories ti and t 2 shows that that t2 followed by the knee 24 tends to lag behind that ti followed by the x-x 'axis.
• Fig. 4 shows that it may be advantageous to constitute the plug 32 in the form of a smooth or ball bearing, adjustable, for example by thread-tapping, in the direction of the arrow fs relative to the spar 11.
• Such an adjustment makes it possible, when desirable, to modify the restoring force of the spring 34 and to consider, for example, using the means according to the invention to offer a possibility of active mobilization which would be voluntarily maintained by the patient to cause the footrest 17 to recede against the antagonistic action of the spring or springs 34, so as to stress the muscular function of the quadriceps.
• FIG. 4 shows that in certain cases, it may be advantageous to provide a possibility of adjusting the abutment position in lesser extension, other than by bringing the collar 31 to bear on the bottom of the bore of the spar 11.
• Such a possibility of adjustment can intervene by a nut 36, for example formed by two half-collars assembled by a deformable hoop 37 elastically forcing the half-collars to occupy a tightened state on the rod 30 in an axial immobilization position in which each half -collar is engaged by a rib 38 in notches 39 of a series presented axially by the rod 30.
• FIG. 5 An alternative embodiment of such a means is illustrated in FIG. 5 in which the tubular proximal part of the spar 11 has one or more series of holes 40 allowing the engagement of a pin 41 on which the collar 31 comes to bear.
• Fig. 1 highlights a simplified variant embodiment of the means according to the invention.
• each rod 30 - spar 11 assembly is associated with an elastic return means constituted by a spring 34 which is interposed under prior stretching constraint between an anchoring ring 42 carried by the rod 30, or even the support 15 , and a bar with holes 43 carried by the beam li near the journal 10.
• the members 34 can be springs of all suitable types and, in particular, elastic cables of the type of those known commercially under the name of SANDOW.
• a variant may also consist in replacing the helical springs of FIG. 3 by elastic cables housed inside the rods 30 which are then tubular, and so that one of the ends is integral with said rod, while the other is linked to the tube 11.
• Such simpler means and less expensive offer a possibility of adaptation to the will of the user and confer the same functional characteristics as those described above.
• the object of the invention finds a preferred application for knee rehabilitation splints

Landscapes

• Health & Medical Sciences (AREA)
• Public Health (AREA)
• Life Sciences & Earth Sciences (AREA)
• Veterinary Medicine (AREA)
• Rehabilitation Therapy (AREA)
• Epidemiology (AREA)
• Animal Behavior & Ethology (AREA)
• General Health & Medical Sciences (AREA)
• Pain & Pain Management (AREA)
• Physical Education & Sports Medicine (AREA)
• Orthopedics, Nursing, And Contraception (AREA)
• Prostheses (AREA)
• Toys (AREA)
• Walking Sticks, Umbrellas, And Fans (AREA)
• Ladders (AREA)
• Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)
• Beverage Vending Machines With Cups, And Gas Or Electricity Vending Machines (AREA)
• Pens And Brushes (AREA)

Priority Applications (6)

Applications Claiming Priority (2)

Publications (1)

Family

ID=9532052

Family Applications (1)

Country Status (8)

Families Citing this family (3)

Citations (4)

• 1998
  • 1998-10-23 FR FR9813467A patent/FR2784893B1/fr not_active Expired - Fee Related
• 1999
  • 1999-10-22 JP JP2000577967A patent/JP2002528176A/ja active Pending
  • 1999-10-22 AT AT99950808T patent/ATE261292T1/de not_active IP Right Cessation
  • 1999-10-22 CA CA002347986A patent/CA2347986A1/fr not_active Abandoned
  • 1999-10-22 EP EP99950808A patent/EP1121085B1/fr not_active Expired - Lifetime
  • 1999-10-22 AU AU63450/99A patent/AU771107B2/en not_active Ceased
  • 1999-10-22 DE DE69915503T patent/DE69915503D1/de not_active Expired - Lifetime
  • 1999-10-22 WO PCT/FR1999/002567 patent/WO2000024354A1/fr active IP Right Grant

Patent Citations (4)

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