WO2016041964A1

WO2016041964A1 - Orthosis, in particular foot drop orthosis

Info

Publication number: WO2016041964A1
Application number: PCT/EP2015/071101
Authority: WO
Inventors: Ulf Michael Grimmer; Felix STARKER
Original assignee: Meyer-Clasen, Petra
Priority date: 2014-09-17
Filing date: 2015-09-15
Publication date: 2016-03-24
Also published as: DE102014113363A1

Abstract

The invention relates to an orthosis, in particular foot drop orthosis, comprising a sole (12) from which web-like supporting elements (14), which are opposite each other, extend away in the vertical direction and transition into a support region (17) which partially surrounds a lower leg while leaving a shinbone region open. A tab (19) is provided on the sole (12) in the region of the forefoot and extends at least in the direction of an upper side of the forefoot and forms a first point of application (31) for connection of at least one tie strap (25). A second and third point of application (32, 33) for connection of the at least one tie strap (25) and a cuff strap (26) is provided in each support section (16) facing the shinbone. A fastener (27), which can be operated by hand, has at least one first and second fastening point (28, 29) for the at least one tie strap (25) and the cuff strap (26) and is detachably fastened to the second or third point of application (32, 33). In a closed position (14) of the fastener (27), a tension force is applied to the at least one tie strap (25) between the first, second and third point of application (31, 32, 33).

Description

Orthese, insbesondere FußhebeortheseOrthosis, in particular Fußhebeorthese

The invention relates to an orthosis, in particular Fußhebeorthese, with a sole from which two opposing web-like support elements extend in the vertical direction laterally of the ankle and pass into a support region which surrounds a lower leg at least partially.

From DE 43 18 588 C1 a Sprungelenksorthese with U-shaped joint sleeve is known. This ankle orthosis has two crosswise associated fastener straps extending from the outer forefoot to the inner ankle or from the inner forefoot to the outer ankle joint. In addition, two further fastening straps are provided which extend transversely to the tibia in order to fix the ankle orthosis, which comprises a cuff fixedly arranged in the area of the Achilles tendon. For the tightening of such an ankle orthosis it requires the fourfold attachment of Velcro tabs.

Furthermore, an ankle orthosis is known from US Pat. No. 5,944,678 A, in which a very complex attachment of a large number of fastening straps is provided in an analogous manner in order to enable a precisely fitting arrangement on the foot.

Furthermore, from DE 20 2008 001 405 A1 an ankle brace made of a flexible shell by textile material known. After lateral positioning of the ankle abutment abutments on the ankle, cross-tab positioning of attachment tabs over the forefoot is required to subsequently close a brace guided along the tibia.

From US 6,793,640 B1 a Fußhebeorthese is known in which the sole is mounted relatively soft against the support elements extending in the vertical direction. For fixing an angle between the lower leg and the foot or for lifting the foot lateral flexible bands are provided, which attack on the one hand in the ankle area of the support elements and on the other hand on the sole in the area of the forefoot.

From DE 91 00 531 U1 further a Fußhebeorthese is known. This has in the upper region of the support elements on a cuff, through which the Fußhebeorthese is firmly attached to a lower leg. Between this cuff and the sole, a non-elastic band is provided, through which a fixed angular position of the foot is set to the lower leg of 90 °.

A variety of disorders, such as multiple sclerosis, polyneuropathy, amyotrophic lateral sclerosis, traumatic peroneal lesion, nerve root symptoms, or apoplexy, can result in foot-lift weakness requiring the use of such foot-lifting orthotics. These foot lifting orthoses serve to raise the toe so that when walking, the tip of the foot is prevented from getting caught on the ground or the foot does not drag across the ground. In addition, tripping over bumps or falling can at least be reduced. In addition, the signs of a so-called stork passage should at least be reduced.

In many affected individuals, however, not only a motor disorder, ie the voluntary movement of the lower extremities, is limited, but also the arm of the affected side of the body, which is partly more or less or completely paralyzed. Such hemiparesis means for those affected that the above-described Fußhebeorthesen can not be attracted without additional support from third parties. In addition, the prior art Fußhebeorthesen also can not be used for therapeutic purposes to allow a weakening of the Fußhebefunktion a therapeutic support and thus to achieve a partial or total regeneration of damaged muscles.

The invention has for its object to provide an orthosis, in particular a Fußhebeorthese, by which not only easy handling when donning such Fußorthese is possible, but also allows a simple and flexible adaptation to personal circumstances and in particular for therapeutic support can be used.

This object is achieved by the features of claim 1. Further advantageous embodiments and further developments are specified in the appended claims.

The Fußhebeorthese invention has on an outer side of the sole in the region of the forefoot on a tab which extends at least partially in the direction of an upper side of the forefoot and forms a first point of attack. Furthermore, a second and third point of application for at least one cuff strap is provided on the support region of the orthosis in the respective support sections facing the tibia. Furthermore, the orthosis comprises a manually operable closure, which has a first attachment point for the at least one cuff strap and a second attachment point for at least one tension belt, wherein the closure is releasably attached to the second or third engagement point. This embodiment of the orthosis has the advantage that the at least one cuff strap and the at least one tension belt can be transferred simultaneously and together in a simple manner from an opening or entry position into a closing or carrying position by the one hand-operable closure so that the person concerned can enter the orthosis without additional aids or tighten the orthosis and close it. The closure can be transferred with one hand in a locking position, so that the foot orthosis is ready for use immediately. At the same time, due to a presettable length of the at least one cuff belt engaging therewith, this closure can always be given the same wearing conditions, so that a resulting risk of injury can be prevented due to a possible incorrect adjustment of the tension straps. Such an orthosis is preferably used in light impairments.

A further advantageous embodiment of the orthosis provides that at the upper end of the support elements or on two half-shell-shaped support portions of the support region extending between a tibial region and an Achilles tendon region on the inside and outside of the lower leg, for fixing the two support sections a fourth and fifth engagement point is provided for at least one Achilles tension belt. This can for example be fixedly attached to the two fourth and fifth points of attack, so that in this example case an entry from the front is possible. Alternatively, this Achilles tension belt can be detachable at least at a fourth and / or fifth point of attack by a closure, thereby enabling a so-called rear entry.

The third engagement point provided in the support region and / or the fourth or fifth engagement point provided on the support element are preferably designed as a releasable latching receptacle which releasably receives the one-hand operable closure. An arranged on the closure latching element can advantageously engage in the closure element, thereby for example a detachable connection by hooking, insertion, insertion, snapping or clipping can be provided.

Preferably, the closure is held rotatably in a latching position about the latching element.

Advantageously, holding magnets are provided on the closure element and / or latching element of the closure. As a result, unintentional release of the closure can additionally be secured in a simple manner.

It is preferably provided that in a closed position of the closure, at least between the first and second as well as between the first and third point of application in the at least one tension belt, a tensile stress is applied. As a result, the range of motion within the ankle can be adjusted so that an increased tensile force is set in the case of severe paralysis phenomena and only slight tension can be set in the case of muscle weakness.

This arrangement allows a vector steering, that is, due to the deflection of the Zuggurts in the first point of an adjustment and alignment of the Zuggurts takes place with respect to the second and third attack point. At the same time, a supination or pronation tendency can be counteracted by a setting in this regard.

A further preferred embodiment provides that the third point of application, on which the closure element is arranged for receiving the catch element provided on the closure, is attached to an adjusting device with a slide which is adjustable at a distance from the second point of application, in particular by a releasable detent , As a result, a change in the pulling direction, and thus incoming tension, can be adjusted in a simple manner.

Preferably, the tensile stress of the at least one tension belt is adjustable. As a result, in particular, the tensile stress acting between the first and second point of application and between the first and third point of application can be adjusted, as a result of which the degree of compliance between the support area and the sole can also be adjusted.

Furthermore, it can be provided that also the cuff belt is adjustable in its length in order to apply a corresponding tensile stress. Preferably, the cuff belt engages in the second point separately to the tension belt.

Due to the triangular application of the tension, a high stability of the orthosis on the one hand and a dynamic in biomechanical unwinding on the other hand can be achieved. In addition, not only an individual setting, but with a therapeutic accompaniment is also possible to reduce the tension gradually, provided that a rehabilitation or a muscle builds up in the ankle.

A further advantageous embodiment of this orthosis provides a three-point belt for fixing the foot in the orthosis through the closure and the at least one tension belt and the cuff belt engaging thereon. Thus, after the transfer of the closure into a closed position, a fast and secure fixation of the orthosis on the foot can be provided. As a result, on the one hand a secure enclosing the support area on the lower leg is given, and at the same time a lifting of the forefoot is made possible by the predetermined angular position of the sole to the support area.

The tab of the orthosis, on which the first point of application is provided, is advantageously located on a sole outside and in particular is arcuate, so that it at least partially surrounds the forefoot. As a result, a joint gentle increase of the forefoot can be made possible.

A further preferred embodiment of the invention provides that the support elements or stabilizers extending between the sole and the support section have a curved course, so that they extend on the inside and outside of the foot in each case in a region between the Achilles tendon and the ankle , As a result, the foot orthosis can cling to the foot, without the ankle is impaired as a center of rotation for the joint. In addition, the support elements additionally form a support adjacent to the Achilles tendon. Advantageously, stiffening elements are provided in the support elements. As a result, an interaction of tension and pressure on the lower limb is exerted on the occurrence of the heel on this orthosis, that is, over the support area and the rigid support elements a kind of pressure is exerted in the direction of the sole and in the forefoot thereby a train can be achieved above for lifting the foot. Through this interaction, a dynamic movement between the lower leg and the foot can be achieved, whereby the bands are loaded and also activated.

Preferably, the sole of the orthosis extends only in the region of the metatarsus. This means that at least the toes as well as the heel protrude freely against the sole. The toe and / or heel can only be supported by a lightweight customizable insole with appropriate cushioning and cushioning properties. As a result, the freedom of movement can be further optimized, so that the natural rolling of the foot can be almost maintained. Furthermore, this may be the support of therapeutic options.

A further embodiment of the invention provides that the sole is reinforced at least in the transition region to the support element and tapers to the forefoot or heel. As a result, the biomechanical unwinding can be supported.

Furthermore, the sole preferably has a U-shaped recess extending from the forefoot to the midfoot, which is provided in the region between the second and third beam of the foot. This allows the natural rolling movement of the foot to continue to be allowed.

Furthermore, the at least one point of application and / or the at least one attachment point are preferably formed by slot-shaped recesses or eyelets through which the at least one tension belt and / or cuff belt and / or Achilles tension belt can be carried. As a result, a simple attachment may be possible. In addition, in the passage of a tension belt and / or cuff belt and / or Achilles tension belt by several attack and / or attachment points an independent compensation in the position of the tension belt can be created, so that a uniform tension between the attack and / or attachment points can be built. This is particularly advantageous for the tension belt, which is firmly connected to the second point of attack and extends through an eyelet in the tab to the second attachment portion of the closure.

Advantageously, a deflection ring for the tension belt can be provided on the tab. As a result, the vector steering can be favored. The deflection ring may be an oval or round ring element, through whose opening the tension belt runs. The deflection ring can be rotatably mounted in the tab according to the tongue and groove principle. The deflector ring can turn clockwise and counterclockwise from the center position by between 10 degrees. Through the opening of the
Zuggurt led by the closure at the third point of attack, in particular central closure, and the support element at the outer foot, guided in its direction according to a vector setting.

According to an alternative embodiment of the orthosis it is provided that the tab, which extends on an upper side of the forefoot and forms a first point of application, is designed as a loop extending from the sole. This loop can be formed by a flexible band or rope, whereby at the same time given by the design of the tab as a loop and the recess for the tension belt. This embodiment by means of the flexible tab has the advantage that the tension belt can slide along better and thus can adapt to the current situation and position. This also creates an improvement in wearing comfort.

The invention and further advantageous embodiments and developments thereof are described in more detail below with reference to the examples shown in the drawings and explained. The features to be taken from the description and the drawings can be applied individually according to the invention individually or in combination in any combination. Show it:

FIG. 1 shows a perspective view of the foot lifting orthosis according to the invention,

FIG. 2 shows a schematic view from the rear of the foot lifting orthosis according to FIG. 1,

FIG. 3 shows a schematic side view of the foot lifting orthosis according to FIG. 1,

FIG. 4 shows a further schematic side view of the foot lifting orthosis according to FIG. 1,

FIG. 5 shows a schematic sectional view along the line IV-IV in FIG. 2,

FIG. 6 shows a schematic view from above of the foot lifting orthosis according to FIG. 1,

7a and 7b is a schematic front view of the Fußhebeorthese according to Figure 1 with a closure in a closed and open position,

FIG. 7c shows a schematically enlarged view of a latching element for receiving a closure,

FIGS. 8a to 8d show schematic views of a footrest orthosis which is attached to a foot;

9a and 9b are schematic views of an alternative embodiment of an Achilles drawstring,

FIG. 10 shows a schematic view from below of an alternative embodiment of a sole of a foot lifting orthosis,

FIG. 11 shows a schematic sectional view along the line X-X in FIG. 10,

FIG. 12 shows a schematic view of a snap spring according to FIG. 10,

13a and 13b perspective view of the orthosis in an entry position and a carrying position,

14a to 14d are schematic views of a closure of the Fußhebeorthese according to Figure 1,

Figure 15 is a schematic view of an open closure according to Figure 14a to d and

16 is a schematic view of a loading and / or data transfer device for the closure with a connection device for the closure of the orthosis.

FIGS. 1 to 6 show various views of an orthosis 11, in particular the foot lifting orthosis, to which reference will be made below.

This Fußhebeorthese 11 includes a sole 12, which merges at an inner and an outer side in a support member 14, wherein the support members 14 extend in the vertical direction. At the upper end of the support members 14, a half-shell-shaped support portion 16 is provided in each case, which is designed to rest on a lower leg and cooperatively forms a support region 17 for the lower leg.

The sole 12 is shortened with respect to the length of the foot, that is, the sole 12 extends to the footpad of the foot and opposite to the heel, so that the heel remains free with respect to the sole 12. In the rear region of the sole 12, the support elements 14 are attached to the inside and outside, which, viewed from the side, arcuately extend in the direction of lower leg, so that the support elements 14 along a region between the ankle and the Achilles tendon of the foot run. The support area 16 surrounds the lower leg above the ankle.

The Fußhebeorthese 11 has on an outer side of the sole 12 further in the area of the forefoot a tab 19 which extends arcuately upwards and pointing towards the middle of the sole, so that it at least partially covers or overlaps the instep-instep area of the instep and thus fixed the foot to the sole 12.

For improved rolling of the foot is provided that the sole 12 can be greatly tapered in the direction of the heel or slightly curved to be tapered, or has a rounding 20, so that a simplified unrolling is given. Pointing towards the ball of the foot in the front region, the thickness of the sole is increasingly reduced, so that a bend-soft region 23 is formed, which on the one hand enables a virtually imperceptible transition at the front end of the sole to the ball of the foot and on the other hand allows flexibility in rolling the foot , In addition, in the sole 12, a U-shaped recess 21 may be introduced, which extends from the front end of the sole 12, starting in the direction of the heel. This recess 21 is preferably provided between the second and third beam of the foot, to promote the natural rolling of the foot.

Such Fußhebeorthese 11 may for example be made of a thermoplastic material, in particular a fiber-reinforced plastic. For example, in the case of a paroneus disease-that is to say a muscle weakness-such a foot-lifting orthosis can be formed from a thermoplastic polyurethane, so that a sufficient support of the ankle and the raising of the forefoot is already made possible by the foot-lifting orthosis shown in FIGS. Alternatively, a fiber-reinforced thermoplastic, in particular a polyamide or polypropylene, may be provided in order to be used preferably for more severe illnesses or in persons who have an increased weight. Alternatively, such a Fußhebeorthese be made by plastic injection molding.

A first embodiment of the Fußhebeorthese is shown in Figures 1 to 6, that is, the transitions from the sole 12 in the support members 14 and of the respective support member 14 in the support portion 16 are sufficiently rigid, so that the support portions 16 on the lower leg abutment and when putting on the heel at the beginning of a step and the initiation of a rolling action act and the forefoot is raised. Due to the connection between the tab 19 acting on the forefoot over the sole 12 and the support elements 14 to the support portion 16, a sufficient alignment and fixation of the foot to the lower leg can already be made possible. By the tab 19, a first point of attack 31 is formed, which is as follows, can also be used to receive a tension belt 25.

Preferably, reinforcing elements 22 are introduced into the support elements 14, which may also extend partially into the sole 12. These stiffening elements 22 are preferably arranged in each case on the outer side of the support sections 16, so that the inner areas of the support sections 16 can pass over into the support section 16 as well as into the sole 12 both paragraph-free and thus form a high wearing comfort.

Due to the formation of a two-part support portion 17 by the two half-shell-shaped support portions 16, which are each received by the support members 14, a facilitated entry into the Fußhebeorthese 11 may be possible. The support portions 16 can be pressed apart during insertion of the foot in a simple manner, so that the forefoot can reach independently to the sole 12 and between the tab 19 and the sole 12. As a result, the tightening of this orthosis 11 is possible with only one hand.

It is understood that the foot-facing portions and inner sides of this orthosis 11 is provided with a padding or a soft material, so that a high level of comfort is given. This padding is not shown for clarity.

The orthosis 11 has on a support portion 16 a second attack point 32, which is shown in Figure 3. On the opposite side of the support portion 17, a third point of application 31 is formed, to which a closure 27 is releasably attached. The point 32 has, for example slot-shaped recesses 38 to receive and fix a cuff belt 26 which engages at the opposite end to a first attachment point 28 of the closure 27. This cuff belt 26 is preferably adjustable in its length. It can be used both an elastic tension band and an inelastic band.

The closure 27 can be actuated with one hand. Advantageously, a pull tab 75 is fastened thereto at the third attachment point 30, by means of which the closure 27 is transferred in a simple form from an open position 40, as shown in FIG. 7a, into a closed position 39, for example according to FIG. 7b. As a result, the orthosis 11 can already be converted into a carrying function, since the upper support sections 16 rest sufficiently firmly on the lower leg through the cuff belt 26 and the forefoot is sufficiently fixed in the orthosis 11 by means of the tab 19 and allows lifting.

For simple and variable adjustment of the lower leg engaging support portion 17 of the third point 33 is changed by an adjusting device 44 (Figure 1) in the radial direction. The adjusting device 44 comprises, for example, a slide element 45 on which a latching tongue 46 is provided, which is releasably held by a latching pawl 47 (see FIG. 1). The slider element 45 preferably has the latching receptacle 41 with an undercut 49, so that a mushroom-type latching element 42 can engage in it in a simple manner and can be locked. This locking element 42 is shown by way of example in Figure 7a closer. To secure the closure 27 against inadvertent release from the third point 33, for example, a magnet may be provided both in the latching element 42 and in the latching receptacle 41 in order to apply an increased holding force.

FIGS. 7a and 7b show a preferred embodiment of the foot orthosis 11 according to the invention. This Fußorthese 11 corresponds to the embodiment of Figures 1 to 6, wherein additionally the tension straps 25 engages a second attachment portion 29 of 27 closures. The closure 27 can be operated with one hand in order to transfer it from an opening position 40 or entry position according to FIG. 7b into a closed position 39 or carrying position according to FIG. 7a and to release it again after use.

The tension belt 25 extends from the second engagement point 29 via the first engagement point 31 provided on the lug 19 to the second attachment portion 29 of the closure 27. Furthermore, as described above, the cuff belt 26 also engages the closure 27. Due to the configuration of the first engagement point 31 as an eyelet, which is traversed by the tension belt 25 or advantageously by a deflecting ring, which is rotatably provided on the tab 19 and the tension belt 25 is deflected, a vector adjustment between the first point of attack 31 and second point of attack 32 on the one hand and between the first point of attack 31 and third point 33 and the closure 27 on the other hand be enabled. In particular, when the brace 11 is worn in a closed shoe, this can be given a particularly good fit and at the same time the lifting function of the forefoot done by the brace 11.

The engagement points 31, 32, 33 may advantageously be formed by slot-shaped recesses 38. The attachment points 28, 29, 30 of the closure 27 may preferably be formed as

eyelets

51, 54. The second engagement point 29 preferably has two separate recesses 38, so that the tension straps 25 can engage and be attached to the protection area separately from the cuff straps 26.

The tension belt 25 is preferably formed of elastic material so that they can be arranged by applying a tensile stress through the closure 27 in a closed position 39 (FIG. 7b). As a result of the arrangement and design of the tension straps 25, a tensile force can be achieved starting from the first engagement point 31 in the direction of the second and third engagement points 32, 33. Depending on the setting of the tension, an increased tensile force for lifting the forefoot can thereby be set independently of the cuff belt 26, which is set to abut the two half-shell-shaped support sections 16 on the lower leg. The tension belt 25 may alternatively be formed of an inelastic or tensile material.

Due to the arrangement of the tension straps 25 and the cuff belt 26 according to FIG. 7a, a secured lifting of the forefoot due to the tension straps 25 and the cuff belt 26 is possible in connection with the geometry of the orthosis, starting from the support section 16 through the support elements 14 to the sole 12, on the one hand Placing the heel over the support portion 16 and / or the support members 14 a pressure is generated, which supports the train up in the front region of the sole. At the same time a dynamic walking behavior is achieved by the arrangement and design of the tension straps 25 and the cuff belt 26 on the other hand, that is, the ankle is not held firmly without a range of motion in the Fußorthese 11, but allows a dynamic rolling without the foot lift is impaired ,

The arrangement of the first, second and third points of

application

31, 32, 33 and the connection by the tension belt 25 and the cuff belt 26, which both act on a closure 27, a three-point belt can be created. This three-point belt allows for easy putting on and taking off the foot orthosis 11 with one hand. By a provided in the third point locking recess 41, a provided on the closure 27 locking element 42 can be easily attached and released. If the shutter 27 is removed from the third point 33, the cuff belt 26 and a first portion of the tension belt 25 can be pivoted outwardly, so that easy accessibility from above for tightening the brace 11 is given. Subsequently, when transferring the closure 27 into a closed position 39 according to FIG. 7b, both a secure abutment of the support sections 16 on the lower leg and a tension between the first point of application 31 on the lug 19 to the second and third attachment points 32, 33 on the support region 17 can be achieved.

Due to the arrangement of the tension belt 25 and the cuff belt 26 on the closure 27, a tension once set, which is applied by the tension belt 25 and the cuff 26 in a closed position 39, be taken again and again, that is, one of a specialist and adapted adjusted setting can be maintained without additional action by the user. This facilitates the handling of such Fußhebeorthese 11 and ensures the proper use.

In this embodiment, according to Figure 7a and Figure 7b, the tab 19 is formed differently from the above-described embodiments. In this embodiment, it is provided that the tab 19 is formed as a loop, in particular flexible loop, which extends from the sole 12 from. This loop can be formed by a thread or a cord and / or a band which is limp. Due to the formation of the loop, the recess 38 for receiving the tension straps 25 is formed at the same time. This can increase the wearing comfort.

FIG. 7 c shows a schematically enlarged view of the latching receptacle 41, which can be provided, for example, on the slide element 45 or directly on a section of the orthosis 11. Starting from a contact surface, this latching receptacle 41 has an insertion bevel 48 and / or an increasing taper, below which an undercut 49 is formed. As a result, the mushroom-shaped latching element 42, as shown for example in FIG. 14 c, can engage or hook into the taper and the corresponding undercut 49 and be fixed. At the same time, the closure 27 remains rotatable by the latching element 42 in the locking position relative to the latching receptacle 41 and can align itself as a function of the tensile stress acting through the tension belt 25 and maintain the locking position.

Different views of the foot orthosis 11 applied to the foot are shown in FIGS. 8a to 8d. Figure 8a shows a view on an inside of the foot, Figure 8b shows the view on an outside of the foot, Figure 8c shows a view from the rear, and Figure 8d shows a view from below. From Figures 8a and 8b it can be seen that the support member 14 extends laterally along the foot from the sole 12 upwardly, initially provided a diagonal portion extending to the ankle, before this diagonally extending portion in a vertical Section passes to receive the support portions 16. The pointing to the Achilles tendon end portions of the diagonal and vertical portion of the support member 14 are adapted to the contour of the foot, so that these support members 14 rest in a region between the Achilles tendon and the ankle on the foot and also support the foot against lateral tilting. At the same time a rotational movement about the ankle for the Fußhebeorthese 11 can be initiated while walking, so that the dynamics of the foot is maintained. The tab 19 is preferably provided on the inside in the area of the front football, which supports a straight lifting of the foot and is favored. The half-shell-shaped support sections 16 preferably each have at the rear end or a Achilles tendon associated portion a fourth and fifth point of attack 35, 36 (Figures 3 and 4) on which an Achilles pull straps 37 (Figure 8a and 8c) can be fastened. This can be permanently attached to the fourth and fifth point of

application

35, 36 or be attached to one of the two points of

engagement

35, 36 by a closure 43 releasably attached thereto. This closure 43 may advantageously have the same design features and advantages as the closure 27. Likewise, the above-described locking receptacle 41 may be provided at the fourth or fifth point of

application

35, 36. Through the interaction of the cuff belt 26 and the Achilles tension belt 37, the fixation of the orthosis is achieved with respect to the lower leg. The Achilles tension belt 37 may, as shown for example in Figure 7c, be aligned diagonally from the one support member 14 to the adjacent support member. Likewise, the Achilles pull straps can be aligned horizontally. The Achilles tension belt 37 may also be formed of a same or similar material as the tension belt 25.

FIGS. 9a and b show a schematic view of an alternative Achilles tension belt 37. This is a band made of spring steel, which is fastened with one end 71, for example, in the fourth point of application 35 and can be fastened to the opposite end in the fifth point of action 36. It can also be provided on the inside of this alternative Achilles tension belt 37, a magnet 73 which can engage the locking element 42 in the fifth point 36 and remains fixed to it for security. Furthermore, a pull tab 75 may be provided at this front end 74, whereby the handling of this Achilles tension belt 37 may be simplified. Since this embodiment can be formed, for example, from a spring steel, it is possible that for easy adjustment of this Achilles tension belt 37 is released from its closed position, but remains close to the locking element 42 in the fifth point 36, so that subsequently a simple fixation is given. Preferably, this Achilles tension belt 37 is formed as a simple stamped part.

FIG. 10 shows an embodiment of a foot orthosis 11 with a sole 12, which can occupy both an entry position 79 according to FIG. 13a and a use position 80 according to FIG. 13b. In this regard, the sole 12 has an inner and outer

sole portion

86, 87, in particular an inner and outer sole half, which are interconnected by a hinge 88. Also provided in the sole 12 is a spring member 77 which extends transversely of the hinge 88 and whose respective end portions are provided in the inner and outer

sole portions

86, 87. This spring element 77 is self-holding at least in one end position. Advantageously, this is self-retaining in two end positions, so that both the entry position shown in FIG. 13a and the use position 80 shown in FIG. 13b each represent a self-holding end position.

The joint 88 is formed, for example, by a taper 82 with respect to the sole thickness, in particular the inner and outer

sole portions

86, 87, so that in a simple manner, an easy taking of the angular arrangement of the two

sole portions

86, 87 to each other. Alternatively it can be provided that instead of the taper, an elastic material or elastic thermoplastic is provided, which connects the outer and inner

sole portion

86, 87 with each other and also has the joint function. The joint 88 is advantageous meadow in the U-shaped recess 21, so that the biodynamic rolling behavior of this orthosis is favored.

The spring element 77 is completely integrated into the sole 12, as shown in FIG. 11 according to the sectional view along the line X-X in FIG. The spring element 77 is preferably designed as a snap spring and consists for example of a pair of strip-shaped band members 81 made of spring steel, which are joined together at a front end 83, whereby they set up against a base portion 84 and thereby a snap movement between two self-retaining end positions is possible. The number of paired band elements 81 may be a function of the sole length 12 as well as the applied force.

When comparing the use position 80 of the orthosis 11 according to Figure 13b and the entry position 79 of Figure 13a is apparent that the support portions 16 in the entry position 79 of the orthosis 11 are further spaced from each other. This makes it easier to get in from the top or from the top to the rear. Subsequently, when applying a force through the sole of the user on the sole 12 of the orthosis 11, this is converted into the use position 80, so that the support portions 16 rest at least with little force on the lower leg.

Various views of the closure 27 are shown in FIGS. 14a to 14d. This closure 27 comprises a housing 51, which comprises two opposing eyelets 53 and an intermediate eyelet 54 for receiving a tension belt 25 and cuff 26, which are arranged in an overall U-shaped to each other. In a receiving space 56 of the housing 57, an electronic module 57 and accumulators 58 are provided.

According to FIG. 15, the electronic module 57 is connected to at least one sensor element 55, which extends at least partially into the eyelets 54. By way of example, this sensor element 55 comprises a bending beam 60 and a measuring element 59. The bending beam 60 preferably has an elevated area for engaging the tension belt 25 in the central region of the loop 54. This bending beam 60 is for example L-shaped, so that it extends at least partially with a leg within the eyelet 54 and with a second leg between the receiving space 56 and an adjacent eyelet 53. In the region of the L-shaped bending beam 60 is the measuring element 59 is provided, which is designed for example as a strain gauge. The occurrence of a tensile stress F _z over the tension belt 25, which stresses the bending beam 60 in bending, can be detected by the measuring element 59 and corresponding signals are delivered to the electronic module 57, which at least detects and stores these signals.

Furthermore, the electronics module 57 can detect the application and release of the closure 27 from the third point 33, so that the period of time and the period of time within which the Fußhebeorthese 11 was worn.

Within the electronic module 57, a controller may be provided to evaluate the acquired measurement data. Likewise, this can be done via an energy management. Furthermore, components for wireless data transmission may be provided in the electronic module 57 in order to transmit and provide the acquired measurement data for a personal computer, a tablet, a smartphone or the like. Alternatively and / or additionally, an interface, such as a USB micro-port, may be provided to allow data transmission. Furthermore, connection contacts 62 may be provided, which are contacted with complementary connection elements 63 when attaching the closure 27 to a loading and / or data transfer device 61 or a connection housing 68 (FIG. 16), in order to charge on the one hand and / or on the other hand for data transfer enable.

FIG. 16 shows a perspective view of an exemplary embodiment of a loading and / or data transfer device 61 with a connection housing 68. This charging and / or data transfer device 61 can be connected via the plug 64 in a socket to a power supply network. In the housing 65, for example, a display 66, such as a display or at least one or more LEDs, be provided to the on and off state or other operating conditions, such as charging, state of charge of the accumulators in the shutter 27 and / or the closure 27 to the loading and / or data transfer device 61 transmitted data and measurement signals to display. Furthermore, a USB interface 67 or other interface is provided on the housing 65 of the loading and / or data transfer device 61 in order to connect a connection cable 70 to an interface 69, in particular a micro socket, on a connection housing 68. This connection housing 68 has a latching receptacle 41, which receives the latching element 42 of the shutter 27 and thus positioned for a loading operation and / or data transfer operation to the loading and / or data transfer device 61. In this case, the connection contacts 62 of the closure 27 can come into contact with complementary connection contacts 63, so that both a charging process and a data transfer or only one of both is possible. Alternatively, a contactless data transfer between the shutter and the loading and / or data transfer device 61 can take place. Preferably, one or more LEDs are arranged in the housing 27, which can output to the user at least one status display. In this case, the LEDs can be directly adjacent to the surface of the closure or be provided lying behind it and shine through a closed wall of the closure. The same applies to the closure 43, provided that this is constructed in analogy to the closure 27 with an electronics. It is understood that the shutter 27 can be used in its function as a three-point belt by means of a one-hand operation without any electronics.

If the closure 27 is designed without a data transmission device, this may be contained in the loading and / or data transfer device 61, that is to say that during the loading of the closure, first a transfer of the data from the closure into the loading and / or data transfer device 61 through the

connection contacts

62, 63 takes place and is transmitted from there to an evaluation.

By capturing the data by means of the closure 27, a therapeutic treatment can be supported. In addition, it can also be checked and monitored whether this Fußhebeorthese 11 is worn regularly and for a sufficient period of time. Because of this closure 27, for example, a step cadence, a step intensity, a trip, a fall or an overload as well as the range of motion in the course of the day / week as well as a fatigue and wearing period can be detected and evaluated accordingly. As a result, a conclusion can be drawn at the same time as to whether and to what extent the preset length of the tension belt 25 and / or the position of the slider element 45 must be adapted and / or changed to produce the required tension or the vector setting, for example to avoid tripping or at one Increasing muscle growth or a muscle reaction to adjust a corresponding reduction in traction to further promote muscle growth.

Furthermore, in the closure 27 in an emergency an emergency call signal can be issued. This can be triggered by the user or in the case of an unknown situation or unknown occurring load, which is detected by the electronic module 57, automatically deducted by a corresponding signal and transmitted, for example, to a smartphone or to a call center.

By this closure 27 is thus an evaluation of the use of Fußorthese 11 over a certain period of use allows to constructively based on an evaluation and adjustment in the setting of the tension straps 25 and the adjustment device 44 to ensure application-specific.

Claims

Orthosis, in particular Fußhebeorthese, with a sole (12) from which two opposing web-like support elements (14) extend in the vertical direction and in a support area (17), which surrounds a lower leg at least partially and spars a tibia area, characterized in

- That on an outer side of the sole (12) in the region of the forefoot a tab (19) is provided, which extends at least in the direction of an upper side of the forefoot and a first point (31) for attaching at least one tension belt (25) .

a second and third point of engagement (32, 33) for binding the at least one cuff belt (26) is provided on the respective tibia support sections (16) of the support area (17),

in that a manually operable closure (27) is provided which has at least one first attachment point (28) on which at least one collar strap (26) engages, and which has a second attachment point (29) on which at least one tension strap (28) 25) engages, wherein the closure (27) at the second or third point (32, 33) is releasably attached.
Orthosis according to one of the preceding claims, characterized in that at the upper end of the support elements (14) and / or on the two half-shell-shaped support sections (16) forming the support region (17) and extending between a tibial region and an Achilles tendon region at the inner a fourth and fifth engagement point (35, 36) is provided for at least one Achilles tension belt (37) releasably connected to a manually operable closure (43) at the fourth or fifth engagement point (35, 36). is attached.
Orthosis according to claim 1, characterized in that the third and fifth engagement point (33, 36) as a releasable locking receptacle (41) for the closure (27, 43) is formed, on which the closure (27, 43) arranged thereon Detent element (42) releasably secured and the latching element (42) is preferably fastened by hooking, insertion, insertion, snapping or clipping.
Orthosis according to claim 3, characterized in that the closure (27, 43) is rotatably received in its locking position in the locking element (42).
Orthosis according to claim 3, characterized in that on the latching element (42) and / or the latching receptacle (41) is provided a holding magnet.
Orthosis according to one of the preceding claims, characterized in that the third engagement point (33) is provided on an adjusting device (44) arranged on the support section (16) of the support region (17), which preferably has a slide element (45) which is relatively spaced to the second point of attack (32), in particular by a releasable latching (46, 47), is adjustable.
Orthosis according to claim 1, characterized in that between a second attachment point (29) of the closure (27), which is provided in a closed position at the third point of application (30), the first point of application (31) and the second point of application (32), the at least one tension belt (25) and between the second engagement point (32) and the first attachment point (28) of the closure (27) extend the cuff belt (26).
Orthosis according to one of the preceding claims, characterized in that in a closed position of the closure (27) between the first and second engagement point (31, 32) and between the first and third engagement point (31, 33) of the at least one tension belt (25 ) and applies a tensile stress.
Orthosis according to claim 7, characterized in that the tension of the at least one Zuggurts (25) and / or the cuff belt (26) and / or the Achilles tension belt (37) is adjustable.
Orthosis according to one of claims 7 to 9, characterized in that by the closure (27), which engages the at least one tension belt (25) and cuff belt (26), a 3-point belt for fixing the foot in the orthosis ( 11) is provided.
Orthosis according to one of the preceding claims, characterized in that the tab (19) is arranged on an outer side of the sole (12) and preferably has an arcuate contour, so that it at least partially overlaps the at least fourth and fifth strand of the foot.
Orthosis according to one of the preceding claims, characterized in that between the sole (12) and the support portions (18) extending support elements (14) have a curved course, so that these on the inside and outside of the foot in each case Extend region between the ankle and the Achilles tendon and preferably have stiffening elements (22).
Orthosis according to one of the preceding claims, characterized in that the sole (12) extends only in the region of the metatarsus.
Orthosis according to one of the preceding claims, characterized in that the sole (12) is reinforced at least in the transition region of the support elements (14) and tapers towards the forefoot and / or the heel.
Orthosis according to one of the preceding claims, characterized in that the sole (12) has a U-shaped recess (21) extending from a front end to the midfoot, which in the sole (12) in the region between the second and third beam of the foot is provided.
Orthosis according to one of the preceding claims, characterized in that at least the first and second engagement point (31, 32) and the first and second attachment point (28, 29) by slot-shaped recesses (38) or eyelets (53, 54) are formed through which the at least one tension belt (25) and the cuff belt (26) can be passed.
Orthosis according to one of claims 1 to 15, characterized in that the tab (19) as a to the sole (12) attached to the loop, in particular flexible loop, is formed, which simultaneously forms the recess (38).