WO2014012961A1

WO2014012961A1 - Device for therapeutic treatment and system for device-assisted locomotion therapy with such a device

Info

Publication number: WO2014012961A1
Application number: PCT/EP2013/065065
Authority: WO
Original assignee: Reha Technology GmbH
Priority date: 2012-07-17
Filing date: 2013-07-17
Publication date: 2014-01-23
Also published as: EP2903580A1; DE102012106428A1

Abstract

The invention relates to a device for therapeutic treatment of the lower extremities of a person, the device having a frame (11) which extends during usage along one of the lower extremities, wherein a flexion means (13) for the knee joint is fixed to the frame (11). At least one retaining means for the upper leg and at least one retaining means for the lower leg are each connected by a movement element to the frame (11). The retaining means for the upper leg and the lower leg are offset in the longitudinal direction of the frame and are arranged opposite one another in such a manner that the leg can be fixed between the retaining means during usage, the flexion means (13) is arranged in the longitudinal direction of the frame between the retaining means in such a manner that the flexion means (13) is arranged during usage in the area of the hollow of the knee, the movement element is adapted for generating a force which can be transmitted during usage by the respective retaining means to the leg, and the frame (11) is connectable to a system for device-assisted locomotion therapy.

Description

THERAPEUTIC TREATMENT DEVICE AND DEVICE-BASED LOCOMOTIONAL THERAPY SYSTEM WITH ONE

SUCH DEVICE

description

The invention relates to a device for the therapeutic treatment of the lower extremities of a person with the features mentioned in the preamble of claim 1. A device of this kind is known, for example, from WO 00/61059. The invention further relates to a system for device-based locomotion therapy with such a device and to a method for controlling the device.

An acute stroke (apoplexy) is in many cases associated with hemiplegia (hemiparesis). This degenerates the muscles in the paralyzed extremities. The treatment of such, usually high-grade weakness of the lower extremities is difficult and often unsuccessful. Conventional physiotherapy is possible after the acute stage of the disease, consuming and mostly aims to solve spasticity-related muscle spasms and exercises to prepare for walking both while sitting and standing to practice, for example, the weight transfer to the affected leg to strengthen.

Modern, scientific concepts of rehabilitation after a stroke favor a repeated practice of walking. In stroke patients it has been shown that the repeated movement of the affected extremities is beneficial for the recovery of motor functions. In addition, it is common knowledge from practice that bilateral training of both the healthy and the weakened limb leads to better results. The co-movement of the non-weakened side, ie the side that is not affected by hemiplegia, positively influences the activation of the brain structures responsible for the use of the paralyzed limb in the parietal lobe.

For the treatment of the weakened side of the lower extremities of a human mechanical and electromechanical devices are known in the art. For this purpose, reference is made by way of example to DE 36 18 686 AI, DE 81 09 699 Ul, DE 20 2008 013 423 Ul and DE 195 29 764 AI. These known therapy devices include cranks that are operated by the patient. These cranks only allow asynchronous tracking of the weakened side. Asynchronously tracked movements do not reflect the variety of real movements. The desired transfer of the learning effect in connection with movement sequences from the brain lobe of the healthy to the affected side is only possible to a limited extent. Variations of the movements are excluded due to the rigid mechanical connection of the construction elements.

In addition, robotic systems for device-based locomotion therapy are known which simulate human walking via control or programmable footplates. Such robot systems are known from DE 100 28 511 AI, DE 10 2006 035 715 AI and DE 10 2009 022 560 AI. Such systems

Control the ankle joint and leave the knee flexion and extension to the patient.

Furthermore, robot systems for device-based locomotion therapy are known, which guide the walking movement through a motorized outer frame, such as AU 002002324518 AI, EP 02 408 413 AI and the aforementioned WO 00/61059. These known systems control and support knee flexion and knee extension. The problem with the guided movement by the known motorized outer scaffolding is that the

Residualkraft of the patient is not used. In addition, the movement is given in a two-dimensional plane.

Elements and orthoses for stabilizing, supporting and guiding the physiological knee movement are known, for example, from DE 10 2008 024 748 A1 and WO 00/2009139158 A2. Such devices support the knee while walking on the plane and while climbing stairs. These orthoses are not suitable for use in device-based locomotion therapy.

The invention has for its object to provide a device for the therapeutic treatment of the lower extremities of a person, which allows a facilitation of knee flexion and knee extension in the context of device-based locomotion therapy. Furthermore, with the invention, a system for the device-based locomotion therapy and a method for controlling the device for therapeutic treatment can be specified.

With regard to the therapeutic treatment device, this object is solved by the subject-matter of claim 1, with regard to the system by the subject-matter of claim 14, and with respect to the method by the subject-matter of claim 15.

The invention is based on providing a device for the therapeutic treatment of the lower extremities of a human having a frame which extends in use along one of the lower extremities, in particular of the leg. On the frame a flexion for the knee joint is attached. The device has at least one holding means for the thigh and at least one holding means for the lower leg. The thigh-holding means and the lower-thigh holding means are respectively connected to the frame and each have a moving member. The

Holding means for the thigh and the lower leg are in

Offset frame longitudinally and arranged opposite to each other such that the leg in use between the holding means is fixable or is generally receivable between the holding means. The inflectional agent is in

Frame longitudinally disposed between the holding means, in such a way that the inflection means is arranged in use in the region of the popliteal fossa. The movement element is adapted to generate a force that is transferable in use by the respective holding means on the leg. The frame can be connected to a system for device-based locomotion therapy.

The invention has the advantage that the facilitation in the implementation of a device-based locomotion therapy is made possible. Facilitation is part of the physiotherapeutic treatment method, which is enhanced by

Stimulation of the proprioceptors that promotes neuromuscular interaction. In this case, a body portion according to a predetermined physiological

Movement pattern moves repetitively, the movement against one of

Therapist is exercised resistance. It can come with each movement cycle to slight fluctuations in the facilitation time. In contrast, the facilitation in the context of device-based locomotion therapy offers the advantage that the desired facilitation movement is predetermined and is always timely for each step. The device can be connected to a system for the device-based locomotion therapy, which can be adapted in this way to perform the facilitation. The application of the resistance, against which the leg movement takes place, is made automatically by the device.

The device according to the invention, in particular the frame of the device, is adapted for connection to the system for device-based locomotion therapy in such a way that the forces occurring during the device-supported therapy can be transmitted from the system to the device and the person to be treated. For facilitation, the device has at least one

Holding means for the thigh and at least one holding means for the

Lower leg up. Several holding means for the lower leg are possible. The arrangement of the holding means on the frame is made such that one leg of the

Patients can be fixed in the device, so that the transmitted from the system for the device-based locomotion therapy forces can be introduced into the leg. Here are the predetermined by the system movement along the corresponding gear trajectories on the inventive

Transfer device and thus imprinted on the leg.

In connection with the movement patterns, the inflectional means has the

Function to assist the flexion of the knee joint. That's it

Flexionsmittel in frame longitudinal direction between the likewise in

Frame longitudinal staggered holding means arranged in such a way that the inflection means is in use in the region of the popliteal fossa.

The resistance required for the facilitation is applied according to the invention by the respective moving element on the leg. The respective

Movement element is adapted to generate a force. The force is transmitted to the leg by the holding means associated with the respective movement element. In therapy, the leg works against the through the

Movement element generated force. This simulates the strength of a therapist, for example in the facilitation of the quadriceps during knee extension. The force can preferably by the moving element mechanically, for example. As a spring force, or pneumatically, for example. By an air cushion or a

Pneumatic cylinder to be generated. Other possibilities of force generation are conceivable and are encompassed by the invention. The power generation, d. H. Resistance to leg movement is preferably passive, for example as a spring force or generally as an elastic force, and is triggered by the force with which the leg presses against the retaining means.

Preferably, the moving element connects the retaining means to the frame. This can be done in one embodiment, for example, by a

Abutment surface for the leg at the proximal, d. H. the leg facing the end of the moving element is arranged. The distal, d. H. remote from the leg end of the moving element is connected to the frame. The proximal end of the movement element is movable, in particular axially movable, and can be acted upon by a force. The arranged at the proximal end of the movement element contact surface is taken along and transmits the counterforce on the leg when it presses against the contact surface.

Alternatively or additionally, the movement element at the proximal end of the holding means, d. H. The leg facing the end of the holding means may be arranged. Preferably, the movement element itself forms the contact surface for the leg. A possible embodiment for this is an air cushion, which generates by compression the desired resistance to the leg movement.

The proximal and the distal movement element of a holding means may be provided individually or together. Generally speaking, the holding means is movable and forms a resistance to the leg, which abuts against the holding means during the therapy and presses against it.

Another advantage of the invention is that the Tibiotarsalgelenk is stabilized by the device according to the invention, specifically by the holding means. The holding means also offer the advantage that due to the fixation of the leg at different points the condition for a flexible

Adjustment of the device is created, which can be used to adjust the dorsiflexion and plantarflexion of the leg. The concrete embodiments made for this purpose are the subject of the dependent claims. Another advantage of the invention compared to movement by an orthosis or a motorized outer frame is that the device is constructed so that on the one hand the residual power of the patient can be stimulated. On the other hand, a free and natural movement is the lower one

Extremities of the patient possible. In contrast, the residual force of orthoses and known motorized external scaffolds

Patients are not used. Besides, the movement is in one

given two-dimensional level and thus severely limited.

The invention also has the advantage that the mechanism of the device is simple and compact. This facilitates the therapist's access to the patient. In summary, the inventive allows

Device a successful locomotion therapy on the one hand by the frequent repetition of exercise elements and on the other hand by transferring learning effects of the responsible for the healthy limb brain side on the responsible for the affected limb brain side or the brain area.

In the context of the invention, both the device itself, i. regardless of the system for device-based locomotion therapy, as well as

Combination of the device-based locomotion therapy system with the device of the invention is disclosed and claimed.

Preferred embodiments of the invention are in the subclaims

specified.

In a preferred embodiment, the movement element is aligned sagittal, such that the leg can be acted upon in a sagittal main direction with a force. This is particularly effective for the

Facilitation required mechanical resistance to the leg. The direction of force can be exclusively sagittal, with the

Movement element is aligned accordingly. There is also one next to it

Deviation from the sagittal direction of force possible by the

Movement element deviates from the sagittal plane accordingly. The

Deviation can take place in a range of ± 20 °, in particular ± 15 °, in particular ± 10 °, in particular ± 5 °. Below the sagittal level, one gets off your head understood to the pelvis and from the back to the abdomen extending through the leg.

The moving member may comprise a housing having a piston which is guided in the housing and actuated by a spring force, wherein the housing piston assembly movably connects the holding means and the frame. Thus, a simple and robust moving element is provided, which allows the formation of a progressively increasing force, which is transmitted from the holding means to the leg. This particularly well simulates the manual buildup of force by a therapist.

The piston may have an interior in which an elastic means, in particular a compression spring, is arranged, which is connected on the one hand to the piston and on the other hand to the housing. This embodiment is an example of a simple and effective realization of the spring force actuated movement element.

A further improvement of the functionality of the movement element is achieved in that the movement element has an actuator for adjusting the force acting on the leg and / or the movement path of the holding means. Thus, the device can be adapted to the respective patient, so that a suitable for the respective patient resistance in the facilitation is set.

A simple way of realizing the actuator is that the actuator comprises a screw which is connected to a stop for the elastic means, in particular the compression spring.

In a particularly advantageous embodiment of the invention that is

Movement element for changing the sagittal position of a holding means, in particular of the holding means for the lower leg, with the frame

adjustable, adjustable in particular by a first adjustment, connected. The adjustability of the movement means and thus the change of the sagittal position of the holding means, allows an adaptation of the device to different patients, so that an optimal holding situation for the leg is achieved. This further ensures that the force can be well adapted to the respective treatment situation. In a further preferred embodiment, the frame is designed in several parts and adjustable for positioning one or more holding means. Thus, the frame forms an adjusting means, whereby a compact construction is possible. The frame may comprise a second adjustment member having a

pivotable frame part u nd a stationary frame part hingedly connects, wherein at least one holding means, in particular the holding means for the thigh, is secured to the pivotable frame part. By the

Pivoting movement of the frame part becomes the position of the holding means,

in particular of the holding means for the thigh, changed, so that the position, in particular the distance to the staggered holding means for the

Lower leg is changed.

The movement elements are rotatably supported in the frame in all embodiments about an axis perpendicular to the frame, so that the angle of attack of the holding means, based on the leg, is variable. Thus, the position of the holding means can be adjusted by a corresponding rotational movement of the leg, for example, when the location of the holding means by the

Swiveling the frame part changes.

In a further embodiment, the frame comprises a third

Adjusting element which connects a height-adjustable frame part and a stationary frame part, wherein at least one holding means, in particular the holding means for the lower leg, is fixed to the height-adjustable frame part. This embodiment allows a vertical adjustment of the holding means, in particular of the holding means for the lower leg, for adaptation to the respective anatomy of the patient to be treated. It is further preferred that in addition to the holding means for the lower leg and the flexion means for the knee joint and the retaining means for the thigh are fixed to the height-adjustable frame part, so that the aforementioned elements are moved by an adjustment of the frame part. This can be a total of the distance of these elements or means to change the foot.

A simple and expedient embodiment is achieved in that the third adjusting element comprises a perforated plate which is fixable in different heights of the frame. The perforated plate is stable and easy to manufacture. In a particularly preferred embodiment, a single

Holding means for the thigh and two retaining means for the lower leg attached to the frame, wherein the holding means for the lower leg are arranged one above the other spaced. Thus, an optimal adaptation to the leg to be treated is achieved, with a single holding means for the thigh is sufficient to achieve the applied near the knee resistance for facilitation. In addition, it is also possible to have more than one holding means for the

Thigh, for example, two holding means to provide.

Preferably, the flexion element is adjustable to change the sagittal position with the frame, in particular adjustably connected by a fourth adjustment. By means of the adjustable flexion element, the flexibility of the device is further increased because the position of the flexion element can be adapted to the specific position of the knee in a patient-specific manner.

A further improvement of the flexibility with regard to the adjustability of the device is achieved in that the flexion element for changing the sagittal position with the frame adjustable, in particular adjustably connected by a fourth adjustment. By the fourth adjustment, the relative position between the flexion and the rest can be

Set holding elements, resulting in another way to adapt the device to different patients.

In summary, the adjustment elements explained above, taken individually and in combination, have the advantage that the position of the leg in the device can be changed, so that different facilitation treatments can be carried out. In particular, it is possible, through the flexibility of the device achieved with the adjusting elements, to achieve a desired dorsiflexion and plantarflexion during the

Set step cycle. Prerequisite for this is the separate arrangement of the individual holding elements, which are independently movable and actuated.

The invention further comprises a device-based locomotion therapy system comprising a device as claimed in claim 1, comprising powered steerable movement means movable along passage trajectories, the frame of the device being provided with one of the movement means connected, in particular releasably connected. In combination with the system for device-based locomotion therapy, the inventive

Device the advantage that the facilitation with the advantages of a

Robot system is connected. Thus, movement patterns, including different movement patterns, can be precisely repeated within one and the same therapy, so that the facilitation effect takes place repeatedly at the same time during the step cycle.

At this point, it is again pointed out that the device according to the invention is intended for supplementing or retrofitting known systems for device-based locomotion therapy. It is also possible to provide the device according to the invention integrally with one of the moving devices of a device-based locomotion therapy system, when non-facilitation operation is not required or desired.

In the method according to the invention for controlling a device according to claim 1, the position of the flexing means and / or the lower leg retaining means is changed in such a way that the plantar flexion angle or the dorsiflexion angle of the leg changes.

The invention will be explained in more detail below with reference to exemplary embodiments with reference to the attached schematic drawings. In these show:

Figure 1 is a perspective view of the device according to a

inventive embodiment;

Figure 2 is a side view of the device according to Figure 1;

Figure 3 is a plan view of the device of Figure 1;

Figure 4 is a perspective view of the device according to Figure 1, on the

Foot mechanics of a device-based system

Locomotion therapy is mounted, and

5 shows a cross section through a moving element according to FIG. 1 FIG. 1 is a perspective view of a device according to FIG

Embodiment of the invention shown, which can be used for the therapeutic treatment and / or support of the lower extremities of a human in the therapeutic simulation of walking and / or climbing stairs. The device is particularly well suited for training the lower extremities of neurological patients. For this purpose, the device has a frame 11, on which a plurality of holding means 12a, 12b, 12c, are arranged. The holding means 12a, 12b, 12c each have a padded sleeve, which provide a soft contact surface 35 for the leg. The holding means 12a, 12b, 12c are movably mounted on the frame 11 via movement elements 14. At the

Frame is also a flexion means 13 for the knee joint, such as a padded roll, provided. The flexing means 13 is fixed to the frame, i. immobile in use, connected. The position of the flexing means 13 is adjustable.

The frame 11 can be connected to a system for device-supported locomotion therapy, not shown in FIG. For this purpose, the frame has a fastening means 15, for example a metal plate, which is firmly connected to the frame 11. The frame extends in use along the lower limb or leg of a patient. Specifically, the frame extends laterally to the leg. The frame forms an outer rigid structure to which the holding means 12a, 12b, 12c and the flexion means 13 are attached. In use, the frame is stationary relative to the leg.

In use, the frame 11 is connected to a moving device of a device-based locomotion therapy system, as in FIG. 4

shown. The movement device carries the device shown in Figure 1, so that this device performs a corresponding movement together with the leg. This total movement is superimposed on the movement of the holding means 12a, 12b, 12c, which in use requires the facilities required for the facilitation

To apply resistance to the leg. The movable holding means 12a, 12b, 12c allow a relative movement of the leg relative to the fixed frame 11th

For this purpose, the holding means on the stationary frame are arranged independently movable. As shown in Figure 2, on the lower side in use of the frame, the fastening means 15, for example in the form of a horizontal metal plate, is arranged. The metal plate has various holes or general openings, with which the metal plate with the foot mechanics of

Movement device of a system for device-based locomotion therapy can be connected (see also Figure 4). At the proximal end of the

Fastener 15, the frame 11 is attached. The frame 11 forms a flat support column whose wall thickness is dimensioned so that the forces occurring during the therapy can be introduced into the leg. The support column has an arcuately curved shape, wherein the upper, spaced from the fastening means 15 end of the frame 11 terminates at about the same height or slightly before the distal end of the fastener.

Specifically, the frame 11 is constructed in several parts and has different

Sections on. The first frame portion 31 is fixedly connected to the fastening means 15 and extends obliquely backwards, so that the first

Frame section 31 protrudes at least partially beyond the fastening means 15. The second frame portion 32 is detachably connected to the first frame portion 31 and extends approximately vertically upward with respect to the attachment means 15. The third frame portion 33 is integrally connected to the second frame portion 32 and extends obliquely forward, resulting in the arcuate shape of the entire frame 11 results. A fourth

Frame portion 34 is connected to the third frame portion 33 and extends it obliquely forward.

The directions to the rear or to the front refer to the

Gear direction, which takes place in Figure 1 from right to left.

The fourth frame portion 34 forms an adjustable frame part 27 which is pivotally connected to the stationary frame part 28 corresponding to the third frame portion 33. For this purpose, a second adjusting element 16 is provided, for example in the form of a rotary joint, which is used to adjust the

adjustable frame part solved and fixed in use. For the vertical height adjustment of the frame 11, the second frame portion 32 as

Perforated plate is formed and thus forms a third adjustment member 17, the stationary first frame portion 31 with the height-adjustable frame part, comprising the third frame portion 33 and the fourth frame portion 34, adjustably connects.

In the embodiment according to Figure 2, the frame 11 is formed in three parts. It is also possible to form the frame 11 in two parts, so that the frame itself only fulfills the pivoting function. The vertical one

Adjustability of the holding means 12a, 12b can be realized otherwise. It is also possible to provide only the height adjustment of the frame 11, wherein the pivotability of the holding means 12c for the thigh is otherwise realized.

The holding means 12a, 12b, 12c are movably mounted on the frame 11. For this purpose, each holding means 12a has a movement element 14. The movement element 14 is an elongated, in particular cylindrical, component which is located in the

Extends substantially parallel to the frame. The frame 11 and the

Movement means 14 extend in parallel sagittal planes. The attachment of the movement elements 14 is effected by first adjusting elements 18 which are fixedly connected to the frame 11. The adjusting elements 18 form

Mounting clamps, in which the respective movement element 14 is releasably clamped. By loosening the clamps can

Movement elements 14 are adjusted in the sagittal direction, so that the position of the holding means 12a, 12b can be changed for the lower leg.

The movement member 14 for the upper thigh holding means 12c is rigidly connected to the frame 11. Alternatively, a sagittal adjustable connection of the movement element 14 with the frame 11 can take place.

As can be seen particularly well with reference to FIG. 2, the retaining means 12a, 12b for the lower leg and the retaining means 12c for the thigh in FIG

Longitudinal direction of the frame 11 is arranged offset. That is, the holding means 12a, 12b are attached further down the frame 11 as the thigh holding means 12c. Between the upper holding means 12b for the lower leg and the holding means 12c for the thigh, a distance is formed in the vertical direction. In addition, the thigh support means 12c faces in a rearward direction, i. in the direction of the rear. The retaining means 12a, 12b for the lower leg have in opposite

Direction. In this respect, the holding means 12a, 12b for the lower leg and the Holding means 12c for the thigh opposite each other. Here, there is a distance between the lower leg holding means 12a, 12b and the upper leg holding means 12c in the horizontal direction.

Overall, the holding means 12a, 12b, 12c arranged so that in use a leg between the holding means 12a, 12b, 12c is fixable.

The holding means 12c for the thigh is fixed to the fourth frame portion 34 and the pivotable frame part 27, namely at the free end of the frame part 27. The holding means 12a, 12b for the lower leg are in the lower region of the frame 11, fixed to the height-adjustable frame part ,

In general, the holding means 12a, 12b, 12c each have a contact surface 35 for the leg. The contact surfaces 35 of the holding means 12a, 12b for the

Lower leg and thigh abutment surface 35 are disposed at each end of the retaining means and facing in opposite directions so that the respective abutment surface contacts the front of the thigh and the back of the lower leg, respectively, as the leg moves in the device becomes.

The flexing means 13, in the region of which in use the knee joint is located, is arranged in the frame longitudinal direction between the upper retaining means 12b for the lower leg and the retaining means 12c for the thigh. The flexing means 13, in particular the padded roll, is approximately flush with the lower leg holding means 12a, 12b. Another position is possible due to the adjustability of the flexing means 13 or the holding means 12a, 12b. Concretely, the flexing means 13 is arranged in the region of the second adjusting means 16 or of the rotary joint.

The flexion means 13 has a longitudinal axis which is perpendicular to the frame 11. The curved surface of the flexing means 13 against which the knee joint abuts in use extends circumferentially about the longitudinal axis.

The flexing means 13 is attached to an angle piece, whose one leg is arranged parallel to the frame 11. On the other leg, the padded role or generally the role of the knee joint is appropriate. In the parallel leg a plurality of slots are provided, through which the inflection means 13, specifically the angle piece is adjustably secured to the frame. The Elbow has a central slot, which is in engagement with the hinge, specifically with the mounting screw of the rotary joint. Parallel to the central slot at least one, in particular two outer slots are provided, through which the fixing means 13 by means of appropriate screws on the frame 11 can be fastened.

For the facilitation the movement elements are 14, concretely all

Movement elements 14 adapted to generate a force that is transferable in use by the respective holding means 12a, 12b, 12c on the leg. For this purpose, the movement elements 14, as shown in Figure 5, constructed. Generally, each movement element 14 consists of a housing 22, in particular of an outer cylinder, which is connected by an elastic means 24, for example a compression spring, movable with a piston, concretely with an inner cylinder 23. The piston 23 is guided in the housing 22 and by a

Spring force actuated. On the piston or inner cylinder 23, the respective holding means 12a, 12b, 12c attached. For this are suitable connections,

for example, for a screw connection provided.

To adjust the force acting on the leg, an actuator 25 is provided. The actuator 25 is designed as a clamping device which is fixedly mounted on the housing 22 and the outer cylinder and as an end stop of the

Movement extent of the piston 23 and the inner cylinder 23 and / or serves as a biasing element for the elastic means 24 and the compression spring. By the bolt 26 connected to the screw can be easily adjust the bias or the path of movement of the holding means 12a, 12b, 12c.

In general, the generation of an elastic force by the

Movement element 14 achieved. The above explained in detail

Movement element is an example of the initially described distal

Frame connection of the movement element. Alternatively or additionally, a proximal arrangement of the movement element may be provided, for example.

in that the cuff is designed as a compressible air cushion.

Further details of the embodiment are shown in the plan view according to FIG. 3, from which it can be seen that the holding means 12a, 12b for the

Lower leg and the holding means 12c for the thigh in

Compared arranged with each other facing holding surfaces. Furthermore, it can be clearly seen in FIG. 3 that the first adjustment elements 18 extend perpendicular to the frame 11 and receive the movement elements 14 in a vertical position, so that they are arranged parallel to the frame 11. Furthermore, it can be seen in FIG. 3 that the retaining element 12c is tilted obliquely upwards in the rest position shown in FIG. 3, whereby the bearing of the retaining element 12c on the thigh is favored.

The precise movements of the leg in the device differ depending on the programming of the system for the device-based locomotion therapy with which the device is used. In general, the thigh support means 12c engages the thigh when the leg is stretched, with the desired counterforce being exerted on the thigh by the movement member 14 by the holding means 12c (facilitation). During flexion, the thigh is released from the thigh support 12c. The flexion of the knee is assisted by the flexing means 13, which comes into abutment with the popliteal fossa. The investment in the holding means 12c for the thigh and the inflection means 13 takes place intermittently.

The lower leg support means 12a, 12b contact it during flexion and / or extension of the leg. One function of the lower leg support means 12a, 12b is mechanical stabilization of the leg. Another feature is the improvement of muscle tension through the touch of the skin similar to stimulating the skin through physiotapes.

A position of the lower leg holding means 12a, 12b adapted to the respective patient is achieved by adjusting the lower leg holding means 12a, 12b.

In Figure 4, the device according to Figure 1 in the assembled state in

Related to a system for device-based locomotion therapy shown. For this purpose, different systems in question, for example, the system according to DE 10 2009 022 560 AI, which goes back to the applicant. In this system, driven controllable moving means are provided, one of which is shown in FIG. The movement means are connected to a stationary frame (not shown) and have holding means for fixing one foot each. The holding means for Attachment of the foot is shown in FIG. 4 and firmly connected to the base plate or fastening means 15 of the device.

The motion devices of the system are independently movable along gantry trajectories. The movement devices each comprise a pivotable at different altitudes boom, on the one hand hinged to a first carriage of a linear guide and on the other hand rotatably connected to one of the holding means. In the direction of travel in front of the first carriage and relatively movable to the first carriage, a second carriage of the linear guide is arranged, which is articulated to the boom by a connecting element. The first carriage has a first linear drive for changing the height position of the respective holding means. The boom is equipped with a rotary drive to change the inclination of the respective holding means.

Instead of the above-mentioned system, other known systems can also be used, for example the system according to DE 10 2006 035 715 A1.

LIST OF REFERENCE NUMBERS

11 frames

12a, 12b, 12c holding means

13 inflectional agent

14 movement element

15 fasteners

16 thigh adjustment element

17 vertical adjustment element lower leg

18 sagittal adjusting element lower leg

19 holding means foot plate

20 connecting means

21 foot plate

22 housing (outer cylinder)

23 pistons (inner cylinder)

24 elastic means (compression spring) 25 clamping device (actuator)

26 stop

27 frame part

28 frame part

29 adjustment element

30 moving devices

31 1st frame section

32 2nd frame section

33 3rd frame section

34 4th frame section

35 contact surface

Claims

claims

A device for the therapeutic treatment of the lower extremities of a human having a frame (11) which extends in use along one of the lower extremities, wherein a flexion means (13) for the knee joint is attached to the frame (11),

marked by

at least one thigh support means (12c) and at least one lower leg support means (12a, 12b) respectively connected to the frame (11) and each having a moving member (14), wherein

the thigh and lower leg holding means (12c, 12b, 12b, 12b) are longitudinally offset and arranged opposite one another such that, in use, the leg is interposed between the leg and the lower leg (12a, 12b)

Holding means (12a, 12b, 12c) is fixable,

the flexion means (13) is arranged in the frame longitudinal direction between the holding means (12a, 12b, 12c) such that the flexing means (13) is arranged in use in the region of the hollow of the knee,

the movement member (14) is adapted to generate a force that is transferable to the leg in use by the respective holding means (12a, 12b, 12c), and

the frame (11) is connectable to a device-based locomotion therapy system.

2. Apparatus according to claim 1,

d a d u rc h e ke n ze i c h n et that

the movement element (14) is aligned sagittally in such a way that the leg can be acted upon by a force in a sagittal main direction.

3. Apparatus according to claim 1 or 2,

d a d u rc h e ke n ze i c h n et that

the movement element (14) has a housing (22) with a piston (23) which is guided in the housing (22) and actuated by a spring force, wherein the housing piston arrangement the holding means (12a, 12b, 12c) and the frame ( 11) movably connects.

4. Apparatus according to claim 3,

d a d u rc h e ke n ze i c h n et that

the piston (23) has an interior in which a compression spring is arranged, which is connected on the one hand to the piston (23) and on the other hand to the housing (22).

5. Device according to one of the preceding claims, in particular according to claim 4,

d a d u rc h e ke n ze i c h n et that

the movement element (14) has an actuator for adjusting the force acting on the leg and / or the movement path of the holding means.

6. Apparatus according to claim 5,

d a d u rc h e ke n ze i c h n et that

the actuator (25) comprises a screw which is connected to a stop (26) for the compression spring.

7. Device according to one of the preceding claims,

d a d u rc h e ke n ze i c h n et that

the movement element (14) for changing the sagittal position of a holding means, in particular of the holding means (12a, 12b) for the

Lower leg, with the frame (11), adjustable, in particular adjustable by a first adjusting element (18) is connected.

8. Device according to one of the preceding claims,

d a d u rc h e ke n ze i c h n et that

the frame (11) is designed in several parts and is adjustable for positioning one or more holding means (12a, 12b, 12c).

9. Apparatus according to claim 8,

d a d u rc h e ke n ze i c h n et that

the frame (11) comprises a second adjusting element (16) which articulates a pivotable frame part (27) and a stationary frame part (28), wherein at least one holding means, in particular the holding means (12c) for the thigh, on the pivotable frame part (27 ) is attached.

10. Apparatus according to claim 8 or 9,

d a d u rc h e ke n ze i c h n et that

the frame (11) comprises a third adjusting element (17) which connects a height-adjustable frame part and a stationary frame part (28), wherein at least one holding means, in particular the holding means (12a, 12b) for the lower leg, on the height-adjustable frame part is attached.

11. The device according to claim 10,

d a d u rc h e ke n ze i c h n et that

the third adjusting element (17) comprises a perforated plate, which in

different heights of the frame (11) is fixable.

12. Device according to one of the preceding claims,

d a d u rc h e ke n ze i c h n et that

a single thigh support means (12c) and two lower leg support means (12a, 12b) are secured to the frame (11), the lower leg support means (12a, 12b) being superimposed on each other.

13. Device according to one of the preceding claims,

d a d u rc h e ke n ze i c h n et that

the flexion element (13) is adjustably connected to the frame (11) for changing the sagittal position, in particular adjustable by a fourth adjustment element (29).

14. A device-based locomotion therapy system comprising a device according to claim 1, comprising powered controllable movement means movable along passage trajectories, the frame (11) of the device being connected, in particular detachably connected, to one of the movement means.

15. A method of controlling one of the apparatus according to claim 1, wherein the position of the flexing means (13) and / or the holding means (12a, 12b) for the lower leg is changed such that the

Plantar flexion angle or the dorsiflexion angle of the leg changes.