WO2004043307A1 - Appareil orthopedique pour la marche et la reeducation de personnes handicapees - Google Patents

Appareil orthopedique pour la marche et la reeducation de personnes handicapees Download PDF

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Publication number
WO2004043307A1
WO2004043307A1 PCT/EP2002/012283 EP0212283W WO2004043307A1 WO 2004043307 A1 WO2004043307 A1 WO 2004043307A1 EP 0212283 W EP0212283 W EP 0212283W WO 2004043307 A1 WO2004043307 A1 WO 2004043307A1
Authority
WO
WIPO (PCT)
Prior art keywords
patient
exoskeleton
rods
positioned beside
bust
Prior art date
Application number
PCT/EP2002/012283
Other languages
English (en)
Inventor
Benito Ferrati
Original Assignee
Benito Ferrati
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Benito Ferrati filed Critical Benito Ferrati
Priority to PCT/EP2002/012283 priority Critical patent/WO2004043307A1/fr
Publication of WO2004043307A1 publication Critical patent/WO2004043307A1/fr

Links

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
    • A61H3/00—Appliances for aiding patients or disabled persons to walk about
    • A61H3/008—Appliances for aiding patients or disabled persons to walk about using suspension devices for supporting the body in an upright walking or standing position, e.g. harnesses
    • 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
    • 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
    • A61H1/024—Knee
    • 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
    • A61H3/00—Appliances for aiding patients or disabled persons to walk about
    • 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
    • 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
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/01—Constructive details
    • A61H2201/0192—Specific means for adjusting dimensions
    • 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
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/12—Driving means
    • A61H2201/1238—Driving means with hydraulic or pneumatic drive
    • 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
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/16—Physical interface with patient
    • A61H2201/1602—Physical interface with patient kind of interface, e.g. head rest, knee support or lumbar support
    • A61H2201/1619—Thorax
    • A61H2201/1621—Holding means therefor
    • 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
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/16—Physical interface with patient
    • A61H2201/1602—Physical interface with patient kind of interface, e.g. head rest, knee support or lumbar support
    • A61H2201/165—Wearable interfaces

Definitions

  • the present invention relates to an orthopedic apparatus for the walking and rehabilitation of disabled persons.
  • Orthopedic apparatuses of this type designed to stimulate and exercise movement of the lower limbs and allow walking have been invented by the author of the present invention and been the subject of Italian patents nos. 1,153,225, 1,178,548, 1,281,584 and 1,298,080, Italian utility model no. 226,083 and U.S. patent no. 5,961,541.
  • Italian patent no. 1,298,080 dealt with and solved the problem of allowing patients to wear an exoskeleton even when seated and to change from an erect position to a seated position and vice versa while continuing to wear the exoskeleton and on command of the actuators which control movement of the exoskele- ton. Further details on the apparatus of said patent are given below with reference to FIGS 1 to 3.
  • the orthopedic apparatus in accordance with the present invention provides an exoskeleton for support of the patient's body comprising the below listed parts:
  • the exoskeleton has a corset formed in accordance with the patient's bust with an at least partly rigid structure
  • the rods of the exoskeleton positioned beside the patient's bust are connected rigidly together by the corset, - the corset of the exoskeleton is provided with means designed to hook and fasten to its sides in a removable manner the rods of the exoskeleton positioned beside the patient's bust at the time the exoskeleton is donned by the patient,
  • the rods positioned beside the thighs and the legs have adjustable length so as to be adaptable to the measurements of the patient's body
  • each of the above mentioned plates displays a plurality of holes designed to allow adjustment of the anchor points of the above mentioned actuators according to the lengths adopted for the rods positioned beside the thighs and legs.
  • FIGS 1 and 2 show views of the exoskeleton which is the subject of Italian patent no. 1,298,080 corresponding respectively to FIGS 2 and 5 of the same patent,
  • FIG 3 shows a diagrammatic front view of the metal reinforcement of the exoskeleton of FIG 1
  • FIG 3a shows a hinge jointing the upper ends of the rods of FIG 3 positioned beside the interior of the thighs
  • FIG 4 shows a side view of the metal reinforcement of the exoskeleton in accordance with the present invention (right-hand side)
  • FIG 5 shows a perspective view of the corset and the right-hand side of the exoskeleton example in accordance with the present invention with omission of the microcylinders and the circular plate for the sake of simplicity
  • FIGS 6a and 6b show the perfected walker in accordance with the present invention.
  • FIGS 1 and 2 illustrate respectively to FIGS 2 an 5 of Italian patent no. 1,298,080
  • 3 and 3a illustrate embodiments of the known exoskeleton of which the present invention is an improvement.
  • FIG 1 shows in particular an exoskeleton worn by a pa- tient standing in erect position and with his hands grasping the two handles of a 4-legged walker (not shown in the FIG) the front legs of which have rollers.
  • the figure shows a harness or exoskeleton comprising the following: - metal rods 1,2,3 positioned respectively beside the bust, the thighs and the legs and connected together by pins 4 and 5 positioned opposite the articulations of the hip and knee and fastened to the patient's body by bands 6 (other rods, not shown in the FIGS, are positioned inside the legs and thighs),
  • first, second and third actuators 8, 9, 10 (each consisting of for example a microcylinder fed with compressed air) hinged with one end to said plate and the other to bracket extensions fastened respectively to the rods 1, 3 and 2,
  • a distribution box 11 for housing the solenoid valves which power and operate the microcylinders,
  • the plate 7 is firmly anchored to the rod 2 by a small hooking pin engaged in a hole 12 of the plate and to accomplish each step the patient presses a pushbutton of the remote control.
  • the microcylnders 8 and 9 (and as an alternative the corresponding microcylinders not visible in the FIGS placed on the patient's left side) move the rods 2 and 3 so as to cause the leg to take a step.
  • FIG 3 shows diagrammatically a front view of the exoskeleton of FIG 1 in which for the sake of simplicity the cylinders and the plate 7 are omitted. It shows that the exoskeleton requires insertion of a hinge 18 uniting the upper ends of the rods positioned at the inside of the thighs (FIG 3a shows an enlarged side view of the hinge).
  • FIGS 4 to 6 show an example of an embodiment of the orthopedic apparatus in accordance with the present invention.
  • FIG 4 shows the metal reinforcement of the exoskeleton with its associated actuators viewed from the right- hand side thereof while
  • FIG 5 shows a perspective view of the right- hand side of the exoskeleton with its associated corset and artificial legs while in FIG 5 for the sake of simplicity the actuators are omitted.
  • FIG 4 shows some of the improvements made to the exoskeleton of FIG 1. These improvements call mainly for the following: - the possibility of regulation of the length of the rods 2 and 3 according to the length of the legs and thighs of the patient for whom the exoskeleton is intended, and
  • each rod not in a single piece but in two superimposed pieces bearing holes uniformly spaced, pieces held together by a pair of bolts inserted in two pairs of said superimposed holes. In this manner the adjustability takes place with a pitch equal to the distance between two contiguous holes.
  • FIG 5 shows other improvements made to the exoskeleton. These additional improvements call mainly for the following:
  • the corset is realized preferably in a single piece of rigid material covered on the inside with a layer of soft elastic material such as for example rubber latex.
  • the means designed to hook and fasten the upper rods of the exoskeleton to the sides of the corset in a removable manner can be provided for example by two rectilinear grooves 21 on the side of the corset with each designed to receive the upper part of the rods of the exoskeleton positioned beside the patient's bust and traversed transversely by two pins 22 running in holes perpendicular to the axis of the grooves and engaging in a removable manner in two holes 23 of said rods.
  • the possibility of easily engaging with and disengaging from said rods can be achieved by providing a spring (not shown in the drawings) in each pin stressing the pin to insert it in the groove and an external head designed to allow partial manual withdrawal of the pin.
  • the exoskeleton When the exoskeleton is not worn by the patient it is separated in three separate parts consisting of the corset 20, the right-hand part 30 of the exoskeleton and the corresponding left- hand part (not shown in the FIGS because specular to the right- hand part with respect to a vertical median plane). This allows the following:
  • the presence of the corset shaped according to the patient's bust ensures well defined positioning of the corset on the patient and consequently always ensures correct positioning of the right-hand and left-hand parts of the exoskeleton on the patient with the hinges of the exoskeleton located correctly beside the hip and knee articulations.
  • the possibility of adjusting the length of the rods 2 and 3 according to the length of the patient's legs and thighs and the possibility of changing the anchoring points of the microcylinders 8, 9 and 10 to the plate 7 in accordance with the length adopted for the rods 2 and 3 allow reduction to the minimum of parts of the apparatus constructed to measure for a certain patient and thus reduction of said parts to only the corset 20 and the artificial legs 24 and 25 (FIG 5 shows only the right-hand artificial legs).
  • FIGS 6a and 6b show the improvements which in accordance with the present invention have been made to the orthopedic apparatus walker which serves both as a support for the patient and for support and transportation of the exoskeleton control and power supply unit 29.
  • the legs of the walker are adjustable in length and the sides are foldable along two vertical axes so as to allow reduction to approximately half of the space occupied by the walker under rest condition (in frontal direction).
  • the parts 26 designate four hinges while the parts 27 designate two rods hinged at the points 28 and designed to keep the walker in open or closed position.
  • the possibility of adjusting the length of the legs serves both to reduce the space occupied by the walker during transportation and to adapt the height of the walker handgrips to the patient's height when the apparatus is in use.
  • a provision in addition to those above mentioned could be to provide as shown in FIG 4 a plurality of holes also on the plate 9 which acts as a connection between the rod 1 positioned beside the bust and the associated actuator (microcylinder) so as to allow greater possibility of adjustment of the anchor points of said actuator.
  • this rod is composed of two sections having planes perpendicular to each other, i.e. sections which FIGS 4 and 5 show joined together for welding but which could be provided by a single flat rod bent to a 90° angle along the rod axis. — oOo —

Landscapes

  • Health & Medical Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Rehabilitation Therapy (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Pain & Pain Management (AREA)
  • Epidemiology (AREA)
  • Nursing (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Rehabilitation Tools (AREA)

Abstract

La présente invention a trait à un appareil orthopédique du type utilisant un exosquelette mû par des actionneurs, caractérisé en ce que : l'exosquelette est équipé d'un corset (20) conformé selon le buste du patient avec une structure au moins partiellement rigide ; les tiges (1) de l'exosquelette positionnées à côté du buste du patient sont reliées ensemble de manière rigide par le corset ; le corset de l'exosquelette est muni de moyens destinés à accrocher et attacher à ses côtés de manière amovible les tiges de l'exosquelette positionnées à côté du buste du patient lorsque le patient se prépare à porter l'exosquelette ; les tiges positionnées à côté des cuisses et des jambes sont de longueur réglables de manière à s'adapter aux dimensions de la corpulence du patient ; et il est prévu des plaques (7) dont chacun est articulée à un axe (5) positionnées à côté et à l'extérieur de l'articulation du genou et présentant une pluralité de trous destinés à permettre le réglage des points d'ancrage desdits actionneurs selon la longueur adoptée pour les tiges positionnées à côté des cuisses et des jambes.
PCT/EP2002/012283 2002-11-01 2002-11-01 Appareil orthopedique pour la marche et la reeducation de personnes handicapees WO2004043307A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/EP2002/012283 WO2004043307A1 (fr) 2002-11-01 2002-11-01 Appareil orthopedique pour la marche et la reeducation de personnes handicapees

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/EP2002/012283 WO2004043307A1 (fr) 2002-11-01 2002-11-01 Appareil orthopedique pour la marche et la reeducation de personnes handicapees

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Cited By (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2007088044A1 (fr) * 2006-02-03 2007-08-09 Cantoni, Luciana Appareil orthopedique pour faire marcher et rehabiliter des personnes accidentees
EP2193774A1 (fr) * 2007-10-02 2010-06-09 Tokyo University of Science, Educational Foundation Équipement auxiliaire pour la marche
CN103445932A (zh) * 2013-09-13 2013-12-18 南京理工大学 仿人步态下肢康复助行器械
CN103720081A (zh) * 2014-01-16 2014-04-16 岳彤 一种病人防护护理服
CN104983542A (zh) * 2015-07-24 2015-10-21 天津科技大学 外骨骼式康复辅助装置
WO2016039608A1 (fr) * 2014-09-10 2016-03-17 Uprobots S. De R.L. De C.V. Exosqueoette mécanique ajustable pour animal bipède présentant une déficience osseuse et musculaire
CN106038177A (zh) * 2016-08-01 2016-10-26 江苏怡龙医疗科技有限公司 一种用于病人行走的辅助机构
JP2020523051A (ja) * 2017-06-12 2020-08-06 オットー・ボック・ヘルスケア・プロダクツ・ゲーエムベーハー 継手装置
RU206583U1 (ru) * 2021-03-09 2021-09-16 Общество с ограниченной ответственностью "Экзомед" Устройство для снижения нагрузки и повышения безопасности при подъеме грузов
US11191653B2 (en) * 2016-11-03 2021-12-07 University Of New Brunswick Powered lower limb devices and methods of control thereof

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
IT1153225B (it) 1982-10-12 1987-01-14 Benito Ferrati Armatura ortopedica per sostenere e mobilizzare gli arti di motulesi
IT1178548B (it) 1984-10-03 1987-09-09 Benito Ferrati Perfezionamento ad un apparecchio ortopedico per sostenere e mobilizzare gli arti di motulesi
US5961541A (en) 1996-01-02 1999-10-05 Ferrati; Benito Orthopedic apparatus for walking and rehabilitating disabled persons including tetraplegic persons and for facilitating and stimulating the revival of comatose patients through the use of electronic and virtual reality units
WO2000028927A1 (fr) * 1998-11-13 2000-05-25 Hocoma Ag Dispositif et procede d'automatisation de la reeducation a la marche sur tapis roulant

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
IT1153225B (it) 1982-10-12 1987-01-14 Benito Ferrati Armatura ortopedica per sostenere e mobilizzare gli arti di motulesi
IT1178548B (it) 1984-10-03 1987-09-09 Benito Ferrati Perfezionamento ad un apparecchio ortopedico per sostenere e mobilizzare gli arti di motulesi
US5961541A (en) 1996-01-02 1999-10-05 Ferrati; Benito Orthopedic apparatus for walking and rehabilitating disabled persons including tetraplegic persons and for facilitating and stimulating the revival of comatose patients through the use of electronic and virtual reality units
WO2000028927A1 (fr) * 1998-11-13 2000-05-25 Hocoma Ag Dispositif et procede d'automatisation de la reeducation a la marche sur tapis roulant

Cited By (13)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2007088044A1 (fr) * 2006-02-03 2007-08-09 Cantoni, Luciana Appareil orthopedique pour faire marcher et rehabiliter des personnes accidentees
EP2193774A1 (fr) * 2007-10-02 2010-06-09 Tokyo University of Science, Educational Foundation Équipement auxiliaire pour la marche
EP2193774A4 (fr) * 2007-10-02 2013-05-01 Univ Tokyo Sci Educ Found Équipement auxiliaire pour la marche
CN103445932A (zh) * 2013-09-13 2013-12-18 南京理工大学 仿人步态下肢康复助行器械
CN103720081A (zh) * 2014-01-16 2014-04-16 岳彤 一种病人防护护理服
CN103720081B (zh) * 2014-01-16 2015-05-13 岳彤 一种病人防护护理服
WO2016039608A1 (fr) * 2014-09-10 2016-03-17 Uprobots S. De R.L. De C.V. Exosqueoette mécanique ajustable pour animal bipède présentant une déficience osseuse et musculaire
CN104983542A (zh) * 2015-07-24 2015-10-21 天津科技大学 外骨骼式康复辅助装置
CN106038177A (zh) * 2016-08-01 2016-10-26 江苏怡龙医疗科技有限公司 一种用于病人行走的辅助机构
US11191653B2 (en) * 2016-11-03 2021-12-07 University Of New Brunswick Powered lower limb devices and methods of control thereof
JP2020523051A (ja) * 2017-06-12 2020-08-06 オットー・ボック・ヘルスケア・プロダクツ・ゲーエムベーハー 継手装置
US11786382B2 (en) 2017-06-12 2023-10-17 Otto Bock Healthcare Products Gmbh Joint device
RU206583U1 (ru) * 2021-03-09 2021-09-16 Общество с ограниченной ответственностью "Экзомед" Устройство для снижения нагрузки и повышения безопасности при подъеме грузов

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