WO2007044264A2 - Dispositif et procede pour amortir des tremblements - Google Patents

Dispositif et procede pour amortir des tremblements Download PDF

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Publication number
WO2007044264A2
WO2007044264A2 PCT/US2006/038251 US2006038251W WO2007044264A2 WO 2007044264 A2 WO2007044264 A2 WO 2007044264A2 US 2006038251 W US2006038251 W US 2006038251W WO 2007044264 A2 WO2007044264 A2 WO 2007044264A2
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WO
WIPO (PCT)
Prior art keywords
brace
joint
malleable
malleable elements
cumulative
Prior art date
Application number
PCT/US2006/038251
Other languages
English (en)
Other versions
WO2007044264A3 (fr
Inventor
Eric Sorenson Hansen
Original Assignee
Eric Sorenson Hansen
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 Eric Sorenson Hansen filed Critical Eric Sorenson Hansen
Publication of WO2007044264A2 publication Critical patent/WO2007044264A2/fr
Publication of WO2007044264A3 publication Critical patent/WO2007044264A3/fr

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Classifications

    • 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
    • A61F5/0104—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 without articulation
    • A61F5/0118—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 without articulation 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
    • A61F5/37—Restraining devices for the body or for body parts, e.g. slings; Restraining shirts
    • A61F5/3715—Restraining devices for the body or for body parts, e.g. slings; Restraining shirts for attaching the limbs to other parts of the body
    • A61F5/3723—Restraining devices for the body or for body parts, e.g. slings; Restraining shirts for attaching the limbs to other parts of the body for the arms

Definitions

  • Tremors in humans are associated with several medically defined disorders. These disorders include Essential tremor and Parkinson's disease. Sufferers of these diseases often experience excessive and involuntary oscillation of their limbs, which results in loss of control of attempted performance of an action or attempted maintenance of a postural position. Tremors can severely impair a person's ability to engage in everyday tasks such as walking, writing, driving, etc.
  • U.S. Patent Number 6,361 ,549 describes methods of treating such tremors. These include medications such as Propranolol, Primidone, and Benzodiazepines. However, such medications are often poorly tolerated and/or become less effective with continued treatment. Other treatment methods described include "deep brain stimulation" - which involves drilling a hole through a patient's skull into his or her brain. This procedure has the disadvantages of high expense and the risk of intracerebral hemorrhage or stroke.
  • Active electromechanical damping systems attempt to detect tremors and apply force to counteract them.
  • Current research in this area is focusing on differentiating tremors from voluntary movements.
  • Approaches to this problem include using bioelectrical sensors to identify tremor-producing signals and using mechanical sensors to detect and predict tremor movements. This sensor data is then sent to a local processing unit and commands are sent to electromotive devices that counter class of treatments suffers from several potential flaws. First, it is likely that such systems will have difficulty in differentiating between a tremor and the beginning of a voluntary movement.
  • the primary wearable passive tremor damping system utilizes a viscous fluid held between two plates, with each plate fixed on one side of the joint to be controlled. Motion between the plates causes the pressure of the fluid to increase or decrease, pushing or pulling the fluid through small holes connecting the parallel plates to adjacent fluid reservoirs.
  • This technology does not provide control of fine tremors, such as those that might interfere with a person's ability to write, and it does not differentiate tremors from rapid voluntary movements. Because most tremors are short and rapid movements, in practice this approach would likely substantially allow tremors to continue while impairing voluntary movement.
  • the invention provides braces for use in suppressing tremors and other unintentional movement such as shaking, and other perturbations.
  • the invention provides a brace for a human joint such as a knee, elbow, wrist, shoulder, knuckle or finger joint having an upper bone and a lower bone attached thereto.
  • the brace includes (a) an upper portion configured to overlie at least a portion of said upper bone, (b) a lower portion configured to overlie at least a portion of said lower bone, and (c) one or more •riillei&SH ;: yeri ⁇ lft ⁇ li ⁇ lOverlie the joint and run longitudinally from said upper portion to said lower portion and is attached to said brace.
  • the middle portion is configured to be disposed over said joint, said middle portion connecting said upper portion and said lower portion.
  • the upper portion is securable around said upper bone; and said lower portion is securable around said lower bone.
  • the one or more malleable elements include a metal wire.
  • the upper portion and said lower portion comprise a substantially non-extensible material.
  • the joint is a finger, wrist or elbow, and the one or more malleable elements is associated with the brace such that one or more malleable elements run substantially on the posterior side of the user's body during use. In other embodiments, the one or more malleable elements may be associated with the brace such that they also (or exclusively) run on the anterior side of the body when in use.
  • the joint is the wrist, and the one or more malleable elements are associated with the brace such that they run on the anterior side of the user's body when in use.
  • one or more malleable elements may also (or exclusively) be associated with the brace such that they also (or exclusively) run on the posterior side of the body when in use.
  • the brace includes a fastener.
  • the brace is used to control a user's tremors or other unintentional movement in the joint, and the one or more malleable elements are together plastically deformable only in response to a cumulative force greater than the force of the tremor or other unintentional movement in the joint.
  • the one or more malleable elements for a particular joint have a cumulative malleability threshold that is between about 5% and about 50% of the user's maximum strength in the joint.
  • the one or more malleable elements hinder movement of the joint when the one or more malleable elements are not plastically deformed.
  • the malleable element(s) are configured to overlie a user's wrist and have a cumulative malleability threshold between about 0.4N to about 4ON. ⁇ i ipi
  • the brace has malleable element(s) that are configured to overlie a user's shoulder, and the one or more malleable elements have cumulative malleability threshold between about 9N to about 900N.
  • the invention provides a shoulder brace for the purpose of decreasing tremors or other unintentional movement.
  • This brace includes one or more malleable elements associated with the brace and running along at least a part of the brace that is shaped to be worn over the user's shoulder.
  • the one or more malleable elements include a metal wire.
  • the brace further includes a horizontal belt attached or attachable to a diagonal strap wherein said one or more malleable elements is associated with the diagonal strap.
  • the shoulder brace further includes an arm cuff attached to the diagonal strap and one or more malleable elements is associated with the arm cuff.
  • the one or more malleable elements yield only in response to a cumulative force greater than the force of a tremor or other unintentional movement in the shoulder joint.
  • the one or more malleable elements that are configured to overlie a particular joint have a cumulative malleability threshold that is between about 5% and about 50% of the user's maximum strength in the particular joint.
  • the one or more malleable elements hinder movement of the joint when the one or more malleable elements are not plastically deformed.
  • the one or more malleable elements have a cumulative malleability threshold that is between about 0.125N and about 900N. • lM& Inverftion further provides a method of decreasing the severity of tremors or other unintentional movement in a human being, wherein said human being has multiple joints each connecting an upper bone and a lower bone.
  • the method includes the step of securing one or more malleable elements across a joint from the upper bone longitudinally to the lower bone.
  • the one or more malleable elements together undergo plastic deformation when subjected to a cumulative force greater than the force of the tremor or other unintentional movement.
  • the one or more malleable elements that overlie the particular joint have a cumulative malleability threshold that is between about 5% and about 50% of the user's maximum strength in the joint.
  • the invention provides a brace for decreasing a user's tremors or other unintentional movements in a joint.
  • the brace has one or more malleable elements attached to the brace, wherein the one or more malleable element undergo plastic deformation when subjected to a cumulative force greater than the strength of the tremor or other unintentional movement in the joint and wherein they further hinder movement of the joint when not plastically deformed.
  • the one or more malleable elements that overlie a particular joint have a cumulative malleability threshold between about 5% to about 50% of the user's maximum force in the joint.
  • FIG. 1 illustrates the anterior and posterior view of a human being. In each drawing, the human being is standing with arms straight down and palms facing forward.
  • lnd 2b illustrate one embodiment of device 10.
  • FIG. 3a and 3b illustrates an anterior and posterior view of a second embodiment of device 10 in use on a human hand and wrist.
  • FIG. 4 illustrates an anterior and posterior view of a third embodiment of device 10 in use on a human elbow.
  • FIGS. 5a, 5b, 5c and 5d illustrate a front, back, side and top view of another embodiment of device 10.
  • FIG. 6 shows a prior art device.
  • FIG. 7 illustrates an ideal force displacement curve.
  • Fig. 8 illustrates a modified hinge assembly 17.
  • dotted lines indicate the shape of a user (or body part(s) of the user) wearing the device 10.
  • the same reference numbers are used to refer to similar parts of the invention in the different embodiments.
  • the term “cumulative”, as used herein in the term “cumulative malleability threshold”, refers to the sum of the forces applied to the one or more malleable elements used for a particular joint in the direction that the user would need to apply force to the malleable elements to plastically deform them while wearing brace 10 as further described below. Forces applied to malleable elements should only be added together if they are applied to malleable elements that are used on the same joint.
  • a brace has a first malleable element for a wrist that plastically deforms with a minimum of 10N of force, and a second malleable element for a shoulder joint that plastically deforms with a minimum of 9ON of force
  • the cumulative force required to deform the wrist malleable element is 10N
  • the cumulative the shoulder malleable element is 9ON.
  • overlie means to cover part of the skin area that is over, under or otherwise around the joint.
  • a conventional wrist watch overlies the wrist joint on all sides
  • a conventional sweater overlies an elbow joint on all sides.
  • the overlying malleable element may be but is not necessarily in direct contact with the user's body
  • overlying point refers to the portions of the user's one or more joints or bones associated therewith over which the malleable element(s) overlie.
  • the term refers to portions of one or more malleable elements that are configured to overlie a joint or upper and lower bones associated therewith when the brace is in use.
  • the overlying point may include an area of any size.
  • the user's motion is restricted at the overlying point by the malleable element(s).
  • the malleable elements are preferably attached to the user's body (either directly or indirectly) at some or all of the overlying point(s) as further described below.
  • the terms “treat”, “treatment”, and “treating” refer to a decrease in severity of the individual's tremors or other unintentional movement rather than a full recovery.
  • yield means to plastically deform.
  • malleability threshold refers to the minimum force that a user wearing a brace 10 of the invention will need to exert in order to plastically deform the one or more malleable element that overlie a particular joint.
  • the particular malleability threshold will depend on a number of factors including the material from which the one or malleable elements are constructed / formed and also on how/ where the malleable on the user's body when the user is wearing the brace.
  • the "malleability threshold" of a malleable element is the minimum force required to cause plastic deformation of the malleable element. Preferably, this term refers to the minimum force required to be applied at an overlying point to cause plastic deformation.
  • the current invention provides devices and methods for decreasing the severity of an individual's tremors or other unintentional movements.
  • the devices control or decrease tremors (or other unintentional movement) by imposing a load on one or more joints affected by the unintentional movement.
  • the additional work required to move limbs or bones attached to the joint is small and easily manageable by the human being wearing the device without substantially effecting rate of motion.
  • the human being wearing one or more of these devices can quickly learn to compensate for the extra work required by the devices for voluntary movements. Imposing a load on the joints affected by the unintentional movements substantially reduces the range of motion of the unintentional movements.
  • joints are each connected to at least one bone that is above the joint (i.e., closer to the person's head than the joint when the person is standing straight with arms and fingers down), and at least another that is below the joint (i.e., closer to the ground).
  • Each joint allows articulation or movement of the bones that connect to it.
  • the higher bone is referred to herein as “upper bone” and the lower bone is referred to herein as “lower bone”.
  • the skilled artisan will understand that a lower bone for one joint can be the upper bone for another joint and vice versa.
  • device 10 includes a brace 12.
  • the brace 12 may be configured to fit over any of a number of joints in the body (for example, a finger joint, a wrist, an elbow, a knee, etc.).
  • Upper portion 13 of brace 12 is configured to overlie at least a portion of the upper bone connected to the joint
  • lower portion 14 is configured to overlie at least a portion of the lower bone that is associated with the joint.
  • a malleable element 11 runs longitudinally from the upper portion 13 to the lower portion 14 along at least one face of brace 12.
  • malleable element 11 is attached to the brace 12.
  • it can be attached by insertion into sleeve(s) 22.
  • middle portion 28 is also part of brace 12.
  • Middle portion 28 connects upper portion 13 to lower portion 14. It is shaped to fit over the joint.
  • Middle portion 28 may include padding to fit over the joint, between the joint and the malleable element(s) 11.
  • one or more malleable elements 11 extends over the wrist and palm.
  • Brace 12 has an upper portion 13 and a lower portion 14.
  • Lower portion 13 is shaped to fit over at least a part of the forearm and upper portion 14 is shaped to fit over at least a part of the hand.
  • the illustrated brace is in fact a glove except that it has a first cavity through which four fingers are placed and a second cavity through which the thumb is inserted). The fingers are not inside the glove, and the glove extends to the forearm.
  • Malleable element 11 runs longitudinally from upper portion 13 to l ⁇ Mfpferf Sl ⁇ iS"fe"lttached to each portion.
  • Malleable element 11 is attached to brace 12, for example by insertion into sleeves 22.
  • only one malleable element 11 is used. It is attached to the portion of brace 11 that is designed to fit over the anterior part of the wrist / hand. In some embodiments, multiple malleable elements 11 are used. For example, one or more may be attached to the portion of brace
  • brace 12 designed to fit over the posterior portion of the wrist and hand, and multiple malleable elements 11 may also be attached to the portion of brace 12 designed to fit over the anterior portion of the body.
  • the brace 12 extends over one or more fingers along with one or more malleable elements 11 being positioned to overlie one or more finger joints.
  • brace 12 includes one or more fasteners 20. These fasteners fasten the malleable element 11 and/or brace 10.
  • fastener(s) 20 may be one or more conventional securing straps attached through conventional methods like buckles, Velcro closures, etc. over brace 12 and/or malleable element 11.
  • Fastener(s) 20 may further include a D ring or similar device to help the user adjust the length of the fastener(s) 20.
  • device 10 can be used to reduce tremors or other unintentional movements in the elbow. The skilled artisan understands that the human elbow connects the ulna ("lower bone”) to the humerus ("upper bone”).
  • the elbow connects the forearm to the upper arm.
  • device 10 includes a brace 12.
  • Brace 12 includes an upper portion 13 that is shaped to fit over at least a part of the upper arm, and lower portion 14 that is shaped to fit over at least a part of the forearm.
  • Malleable element 11 runs longitudinally from upper portion
  • upper portion 13 and lower portion 14 are each a cuff that fits tightly over the appropriate limb.
  • a middle portion 28 is preferably part of the brace 12 and surrounds the joint.
  • malleable element 11 is used in device 10.
  • Malleable element 11 is attached to brace 12, so that it fuW ; ICl/fR across the elbow, and down the forearm on the posterior side when in use.
  • Additional malleable elements 11 may be attached to the anterior and posterior of the device (as viewed when in use).
  • the elbow is controlled by more powerful muscles than the wrist and hand, so it will generally require more or thicker malleable elements 11 than when device 10 is used to dampen tremors or other unintentional movements in less powerful joints such as finger joints.
  • brace 12 is shaped to fit over the shoulder area of a person in need of tremor suppression therein.
  • brace 12 must be shaped to overlie at least one malleable element 11 over a joint (such as the acromioclavicular joint or the glenohumeral joint).
  • brace 12 includes a cuff 1 that is configured to surround the upper arm (i.e., above the elbow) and extend up to a shoulder portion 3 configured to extend over at least a portion of the user's shoulder.
  • a horizontal belt 2 is designed to extend around the trunk of the wearer. For example, it may be a single strap that is wrapped around the trunk and closed with Velcro or other conventionally used attachments or any other conventional way of securing a belt around a human torso.
  • Diagonal straps 23 (which extends from the user's posterior (back) to the user's shoulder and down his/her anterior (front)) and 24a and 24b (which extend from the user's shoulder to posterior and from the user's shoulder to anterior, respectively) extend from the shoulder segment 3 and are secured to horizontal belt 2 with conventional Velcro attachments both in the anterior and posterior of the horizontal belt.
  • the Velcro mechanism on the horizontal belt 2 and the horizontal straps 23 and 24a and 24b are not shown.
  • diagonal straps 23, 24a, and 24b may be fed through a D ring to allow the user to adjust the length of the horizontal straps, and hence to maintain the desired tension.
  • the cuff 1 , shoulder portion 3, horizontal belt 2 and diagonal straps 23, 24a and 24b are substantially made from a non-extensible material as further described below. Other methods for attaching the diagonal straps(s) and horizontal belt will be obvious to the skilled artisan.
  • a second malleable element 11b extends from the upper arm cuff 1 to the shoulder and down the diagonal strap 24a.
  • a third malleable element 11c extends from diagonal strap 22 to the shoulder portion 3 and down diagonal strap 24b.
  • one or more fastener(s) 20 may be attached to or attachable around upper arm cuff 1 and /or horizontal belt 2.
  • malleable element(s) 11 , 11 a-11 c (hereinafter “malleable element”) [57]
  • the invention derives from the inventor's realization that malleable damping reinforcements (malleable eler ⁇ ent(s)) provide superior tremor control properties for a human being under certain conditions.
  • a malleable damping mechanism i.e., malleable element
  • the first range is elastic with a very high modulus. This large modulus has the effect of completely or almost completely arresting tremors from rest.
  • a malleable element in a brace of the invention yields elastically to wearer-applied loads up to a threshold beyond which it deforms plastically.
  • the brace is designed to have a plastic threshold that is achievable by the wearers to which it may be marketed. For example, some braces may be marketed only to women while others may be marketed to men. Alternately, some braces of the invention may be marketed to individuals having heights and/or weights within a certain range. In other embodiments, braces of the invention may be prescribed or chosen by the physician or other medical practitioner for each individual.
  • the current invention accomplishes this effect by fixing a malleable element across a user's joint(s).
  • the malleable element used is a metal wire.
  • the metal wire is ttitiJl ' tP& ⁇ ' iHi/iiiStiel.
  • the metal wire can be made from a silicon-based polymer such as Silly Putty (sold by Binney & Smith in Easton, PA).
  • Silly Putty sold by Binney & Smith in Easton, PA
  • it can be made as a composite using the silicon polymer as a matrix component with copper or steel wires as reinforcement.
  • any material that exhibits the desired properties discussed herein can be used.
  • the malleable element is chosen based on the user's strength and the severity of the user's tremors or other unintentional movements.
  • the inventor made a prototype of the invention for the hand that has malleable wire elements of 1/8 th inch diameter.
  • the malleable element provides sufficient resistance to dampen the user's tremors or other unintentional movements at one or more joints, but not so much that a user cannot move the joint by exerting force.
  • a malleable element that plastically deforms in response to at least 10% of the user's maximum strength in the applicable joint may be used for the joint.
  • a malleable element may be used if it plastically deforms in response to a force that is between about 5% and about 50% of the user's maximum strength in the joint .
  • malleable elements of varying hardness i.e., requiring different force to bend
  • the malleable element should preferably be chosen based on the user's strength in the joint on which the malleable element 11 will be attached. Generally, malleable materials plastically deform when sufficient force is applied to them. They stay in the deformed conformation until another force is applied to them. In other embodiments, the malleable element(s) may not be chosen for a particular user (i.e., the brace may be mass produced).
  • a device may have malleable element(s) that overlie a particular finger joint.
  • the malleable element(s) are preferably chosen and the device is preferably configured so that the malleable element(s) that overlie a particular finger joint can be plastically deformed by the user exerting between about 0.125N and about 16N of force on the malleable elements that overlie the particular finger joint.
  • the cumulative malleability threshold of the malleable element(s) ⁇ fs ⁇ e ⁇ w ⁇ sl?i ⁇ bofif B 1 IiIS 1 N and about 1.6N and in another embodiment, it is between about 1.6N and about 16N.
  • the invention further provides a brace having malleable element(s) designed to overlie the wrist joint of a user.
  • a suitable cumulative malleability threshold for the malleable element(s) that overlie a wrist range from about 0.4N to about 4ON, in other embodiments from about 0.4N to about 4N, and in yet other embodiments from about 4N to about 4ON.
  • the invention provides a brace having malleable element(s) configured to overlie an elbow joint. Suitable cumulative malleability thresholds for malleable element(s) that overlie an elbow joint of a brace range from about 8N to about 900N.
  • the range is from about 8N to about 9ON, between about 8N and about 240N in yet another embodiment, and between about 9ON and about 900N in another embodiment.
  • the invention provides a brace having malleable element(s) that are configured to overlie a user's shoulder when in use.
  • a suitable cumulative malleability threshold of the one or more malleable elements that overlie the shoulder is between about 9N and about 900N in one embodiment, between about 16N and about 480N in another embodiment, between about 9N and about 9ON in another embodiment, and between about 9ON and about 900N in another embodiment.
  • multiple malleable elements may overlie the same joint.
  • the malleable elements should be chosen so that the cumulative force required to plastically deform the malleable elements for voluntary motion falls into one or more of the above ranges as appropriate for the particular embodiment.
  • device 10 may be used to suppress tremors in the wrist.
  • a single malleable element may be used if it can be plastically deformed with a force between about 0.4N and about 4ON.
  • two malleable elements may be used.
  • the first malleable element may require 2ON of force to plastically deform and the second malleable element may require 10N of force to plastically deform.
  • the multiple malleable elements may be on the same or from each other.
  • three malleable elements may be used for the wrist, each requiring, for example, 10N to deform.
  • the force required to deform a malleable element can be measured by a cantilever beam deflection test or other test well known to the skilled artisan.
  • the force required to deform a malleable element can be measured by a cantilever beam deflection test or other test well known to the skilled artisan.
  • the force measured is in the direction that the user would apply force if she or he were wearing the brace with the malleable element..
  • malleable element reduces or dampens the tremor while offering relatively little resistance to voluntary movement. What resistance there is to voluntary movement is predictable and easily adjusted for, allowing for better control over the joint.
  • Malleable elements are preferably substantially linear. If the malleable element is attached by insertion into sleeve(s) 22 in brace 12, the malleable element is preferably bent at each end for insertion into the sleeves 22 as shown in certain figures herein. The skilled artisan will understand that malleable elements may be any shape, e.g., straight, curved, triangular etc. within the scope of the invention.
  • Malleable elements can be attached by insertion into sleeves (e.g., sleeve 22) made from a nylon "ribbon" woven using large-gauge nylon thread, such as, webbing item number 530-T2 sold by National Webbing Products Co. (Garden City Park, NY).
  • the sleeves are sewn or glued to ⁇ bVyBi' IMP Alt ' elSMiipi 4 sleeve can be formed by sewing an approximately rectangular piece of webbing to brace 12 so that the sleeve material is attached along two of its approximately parallel sides.
  • the malleable element can be inserted underneath the rectangular piece in and out of the two sides that are not sewn shut.
  • Alternately malleable element may be sewn into the brace with a conventional needle and thread, glued into place, or attached in other ways obvious to the skilled artisan.
  • the malleable element(s) should be connected such that they are deformed only when the user voluntarily moves the joint to which they are applied, and so that they do not slip from their position vis a vis the joint and bones connected thereto.
  • the exact length of the one or more malleable element(s) is not important for the various embodiments of the invention so long as the one or more malleable elements meet the other requirements herein.
  • the malleable element(s) of the invention can take on a variety of shapes. For example, as described above, it may be a wire (i.e., a single, usually cylindrical, elongated strand of drawn metal). In other embodiments, the element may be generally rectangular in shape. Yet other shapes that will work within the requirements of the invention will be obvious to the skilled artisan.
  • malleable elements having different malleability thresholds may be used on the same brace.
  • the malleable element chosen to overlie a particular joint will depend on the likely force of the unintentional movement in that joint and, in some embodiments, the strength of the actual or potential user's joint.
  • a human being may be able to bend his thumb with more force than his middle finger, and hence the malleable element that may be chosen to overlie a thumb joint may be chosen to require more force to deform than a malleable element chosen to overlie a middle finger.
  • Each of these portions must be made of a substantially non- extensible material.
  • Non-extensible materials are commonly used in orthotics to be sufficiently non-extensible so that the malleable element(s) 11 do not move from their position over the relevant joint and bones, except when the user is wearing the brace and intending to move the joint (i.e., bend the malleable element(s)).
  • the substantially non-extensible material could be leather but could not be spandex.
  • the brace 12 includes a middle portion 28 that is configured and shaped to fit over a particular joint.
  • the malleable element will run down the surface of middle portion 28.
  • Middle portion 28 can include padding to protect the user from skin irritation or discomfort that might result from the malleable element coming into contact with the human being's skin.
  • middle portion 28 must be sufficiently extensible to allow the human wearer of the device to move the joint to which the middle portion 28 is applied. Thus, if the device is for an elbow, middle portion 28 should have sufficient "give" or room to allow the user to bend and unbend his elbow.
  • middle portion 28 includes a metal shaped to fit over the upper and lower bones (that are attached to a particular joint) with an artificial joint attached to the metal and shaped to fit over the user's joint.
  • the artificial joint allows the user to bend / unbend or otherwise move the limbs attached to the joint consistent with normal use.
  • the braces of the invention are reinforced.
  • they can have double stitching, be made of several layers of a material, or combine extensible materials with non-extensible materials.
  • the goal of using such reinforcements is to provide a sturdy brace while allowing the use of softer materials which may be more comfortable to a user.
  • Reinforcements can also be used to minimize the stretching of the brace.
  • braces are rigidly linked.
  • a lace, strap, plastic toothed fasteners such as are used for ski boots
  • any other similar device can be attached to the lower portion of one brace and upper portion of the next brace.
  • multiple devices are worn simultaneously but not physically linked.
  • the invention provides methods of controlling or decreasing the severity of tremors or other unintentional movement in a human being.
  • These methods includes the step of attaching a malleable element over at least one joint of the human being.
  • the malleable element is attached to at least one of the posterior side of a finger, the anterior side of a wrist or hand, the posterior side of an elbow or to a shoulder.
  • the malleable element is preferably attached so that it does not move in relation to the relevant joint, and so that it yields only when the human being voluntarily moves the bones attached to the joint.
  • the malleable element can be applied using any embodiment of device 10 or any other similar device.
  • the method may further include the step of measuring the force of the unintentional movement in one or more joints experienced by the human being, and choosing the malleable element based on the force of the unintentional movement.
  • the malleable element must not plastically deform in response to a force less than or equal to the force of the unintentional movement. Yet, it must plastically deform in response to a force greater than the force of the unintentional movement that is also within the ability of the user.
  • a malleable element is chosen that deforms in response to one of the ranges taught herein.
  • brace 10 can be used by people who do not suffer from abnormal tremors.
  • the skilled artisan understands that some or all people experience tremors.
  • hunters may wear hand brace 10 to help them hold their rifles steady while shooting.
  • the skilled artisan will understand that the same properties as of the malleable element as described above can be achieved through other mechanisms.
  • BREG, Inc. sells a functional elbow brace (product numbers C1048X (Functional Elbow Brace, S-XL), C10475 (Functional Elbow Brace Sports Cover (Universal)), and C10530 (Functional Elbow Brace Post-Op Kit).
  • Fig. 6 shows an example of such a device.
  • Such a brace includes an upper portion, a lower portion and a middle portion including a hinge which limits the user's movement. This device as it is currently sold has a near-frictionless hinge with stops to control range of motion.
  • a device of the invention could be made or adapted to be similar to the BREG device except that the hinge can be configured to act as a malleable element.
  • a hinge can be configured to so that friction between the hinge and the washer produce the force/displacement characteristic previously described in relation to other embodiments of the invention.
  • the hinge would exhibit only elastic deformation up until the hinge slipped and then move freely (under constant force) to a final position.
  • This is exemplified in Fig. 7.
  • This graph shows the hinge moving freely under constant pressure at a force, e.g., a force equivalent to about the 95 th percentile of the tremor. This is only illustrative (i.e., a value other than the 95 th percentile of the force of the tremor may be chosen).
  • the user would release the force and the device would once again resist movement.
  • FIG. 8 illustrates schematically the make-up of the hinge assembly 17:
  • hinge assembly 17 The parts of hinge assembly 17 are:
  • Tyjeid -5*(Routside "Rinside )*(L'-l_o)*k*C
  • This hinge as part of a brace for a human joint, such as an elbow, provides adjustable resistance. This has useful application in the mitigation of tremors where the magnitude of the mean tremor controlling that joint is significantly below the user's maximum strength in articulating the joint.
  • d of 300 newton-meters would approximate a 900 N malleable element.
  • Multiple resistive hinges can be used for one joint and the ⁇ y j e i d 's of the hinges are cumulative.
  • the hinge will be configured to exhibit the approximate same properties as described for the malleable elements in the elbow brace embodiments as described above.

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  • Health & Medical Sciences (AREA)
  • Nursing (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Orthopedics, Nursing, And Contraception (AREA)
  • Prostheses (AREA)

Abstract

L'invention propose des procédés et des dispositifs pour diminuer la sévérité de tremblements et d'autres mouvements non intentionnels. Dans un mode de réalisation, les dispositifs sont destinés à l'utilisation sur une articulation humaine telle qu'un genou, un coude, un poignet, une épaule ou une articulation de la main ou des doigts ayant un os supérieur et un os inférieur articulés suivant un certain axe l'un par rapport à l'autre. Il comprend une portion supérieure dimensionnée de manière à recouvrir au moins une portion dudit os supérieur à proximité de ladite articulation, une portion inférieure dimensionnée pour recouvrir au moins une portion dudit os inférieur à proximité de ladite articulation et un premier élément malléable s'étendant longitudinalement depuis ladite portion supérieure jusqu'à ladite portion inférieure et attaché audit support.
PCT/US2006/038251 2005-09-29 2006-09-29 Dispositif et procede pour amortir des tremblements WO2007044264A2 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
US72179105P 2005-09-29 2005-09-29
US60/721,791 2005-09-29
US72351205P 2005-10-04 2005-10-04
US60/723,512 2005-10-04

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Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2018053624A1 (fr) * 2016-09-22 2018-03-29 Steadiwear Inc. Appareil pour amortir des mouvements involontaires de la main
WO2020206126A1 (fr) * 2019-04-05 2020-10-08 Narula Maanav Dispositif portable pour traiter des tremblements
KR20220063402A (ko) * 2020-11-10 2022-05-17 안현찬 손가락 떨림 보정기기
WO2022221731A1 (fr) * 2021-04-16 2022-10-20 Children's Hospital Of Orange County Dispositif d'atténuation de mouvement involontaire
US11660222B2 (en) 2020-12-07 2023-05-30 Robert Lee Bullock Methods and systems for treating hand tremors

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3938509A (en) * 1974-12-09 1976-02-17 Barber Lois M Hand splint
US5520620A (en) * 1993-04-26 1996-05-28 Johnson; Lanny L. Shoulder brace

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3938509A (en) * 1974-12-09 1976-02-17 Barber Lois M Hand splint
US5520620A (en) * 1993-04-26 1996-05-28 Johnson; Lanny L. Shoulder brace

Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2018053624A1 (fr) * 2016-09-22 2018-03-29 Steadiwear Inc. Appareil pour amortir des mouvements involontaires de la main
WO2020206126A1 (fr) * 2019-04-05 2020-10-08 Narula Maanav Dispositif portable pour traiter des tremblements
KR20220063402A (ko) * 2020-11-10 2022-05-17 안현찬 손가락 떨림 보정기기
KR102463021B1 (ko) * 2020-11-10 2022-11-03 안현찬 손가락 떨림 보정기기
US11660222B2 (en) 2020-12-07 2023-05-30 Robert Lee Bullock Methods and systems for treating hand tremors
WO2022221731A1 (fr) * 2021-04-16 2022-10-20 Children's Hospital Of Orange County Dispositif d'atténuation de mouvement involontaire

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