WO2017039550A1 - Mécanisme de traitement de troubles du mouvement survenant aux extrémités en conséquence de lésions du système nerveux - Google Patents

Mécanisme de traitement de troubles du mouvement survenant aux extrémités en conséquence de lésions du système nerveux Download PDF

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WO2017039550A1
WO2017039550A1 PCT/TR2015/000310 TR2015000310W WO2017039550A1 WO 2017039550 A1 WO2017039550 A1 WO 2017039550A1 TR 2015000310 W TR2015000310 W TR 2015000310W WO 2017039550 A1 WO2017039550 A1 WO 2017039550A1
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movement
motor
target organ
muscles
string
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PCT/TR2015/000310
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Özcan KALKAN
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Kalkan Özcan
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    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H1/00—Apparatus for passive exercising; Vibrating apparatus; Chiropractic devices, e.g. body impacting devices, external devices for briefly extending or aligning unbroken bones
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    • A61B5/0033—Features or image-related aspects of imaging apparatus classified in A61B5/00, e.g. for MRI, optical tomography or impedance tomography apparatus; arrangements of imaging apparatus in a room
    • A61B5/0036—Features or image-related aspects of imaging apparatus classified in A61B5/00, e.g. for MRI, optical tomography or impedance tomography apparatus; arrangements of imaging apparatus in a room including treatment, e.g., using an implantable medical device, ablating, ventilating
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Definitions

  • This invention is about a mechanism developed in direction with the use of technological opportunities for the purpose of speeding up the neurological improvement of the movement disorders occurring due to damages in the nervous system by exercising hand, arm, leg, foot joints so that the target organ gains locomotion, thus treating movement disorders occurring on extremities due to nervous system damages in order to provide individuals gain their independency in performing their daily activities.
  • the nervous system providing the movement is separated into two parts; the I s and 2" Motor neurons. While the 1 st Motor neuron is composed of brain and spinal cord, the 2 nd Motor neuron contains the nerves coming out of the spinal cord and spreading all around the body. In the brain, the movements to be performed are planned. The order for the movements planned is transmitted from the spinal cord to the nerves in the body. As the muscle receiving the movement order contracts, the movement occurs.
  • Cerebral palsy (Spastic child) disease occurs due to any damage on the brain being developed during prenatal, intranatal and postnatal period. This disease can occur due to a developmental impairment, trauma, infection or anoxia (lack of oxygen in the brain) in the brain in the early years of life.
  • cerebral palsy is not a progressive disease, life expectancy of such children or individuals is normal. This disease arises in the first years of life and it is permanent. However the damage level in the brain does not change or get worse in general terms. Only an increase in contractions is seen depending on growth of the child. Development of the brain starts in early pregnancy and continues during childhood. Any incident damaging the brain within the first 3 years of life leads to cerebral palsy. Depending on the function of the brain part damaged, a variety of contractions and involuntary movements are seen in children suffering from cerebral palsy;
  • Spasticity It is characterized by the resistance against passive movement. It increases with voluntary movement.
  • Dystonia It is characterized by involuntary muscle contractions that cause bending or twisting movements
  • Athetoid It is characterized by involuntary, slow, snake-like movements.
  • Ataxia It is characterized by balance and coordination problems.
  • hypotonia It is the term defining children, who do not have any contraction but whose bodies are in state of a "sack of jelly”.
  • Purpose of the cerebral palsy rehabilitation is initially to forestall the structural problems arising from the contractions and involuntary movements, then to increase the functional capacity.
  • the movements considered as functional capacity are standing on front arms, standing on hands, turning, grovelling, sitting, crawling, standing on knees, standing up and walking.
  • the main problem of a child with cerebral palsy is not the physical contractions, but the damage in the central nervous system (brain). Treatment of the damaged part in the brain is not possible with the present systems. What should be done is to try to use the brain's plasticity and to teach the sound parts of the body how to perform some of the tasks of the damaged parts. The learning process proceeds from easy to hard. The more we simplify these movements, the sooner the child can start performing them. As the movements are exercised more often, the solid parts in the brain eventually learn these movements and the child will start using these movements also during daily life. The best example proving the effectiveness of this treatment is the rehabilitation in water.
  • Vojta technique is a treatment method developed based on the consideration of that there are neurologically over-structured points in the body and performed as applying a certain amount of pressure on these points for a certain period of time. In this treatment method, the child feels pain and this is not a preferable situation.
  • the spasticity determined in the child should be inhibited in the first phase. Then, the muscular tonus is normalized and normal tonus is stimulated to be used in the function.
  • Spina bifida is caused when the development of spine and spinal cord is not properly completed . due to folic acid deficiency in the first months of pregnancy. It has two types: Open spina bifida and closed spina bifida. In closed spina bifida cases, the spine development is completed. The membrane around the fluid, in which the spinal cord is found, is called dura. Dura extends from the brain all the way down to coccyx area. Due to the structural problems in dura, there may be pressure on the roots coming out of the spinal cord.
  • C cervical-neck-, T-thoracic-chest area.
  • These extending nerves first unite with each other in an area close to armpit then separate again. They form a node.
  • This node is called brachial plexus.
  • the nerves extending from this node provide the movement of the arm muscles. In cases, where the labour is hard and the child is pulled from the neck, these nerves get stretched due to the rotation in the neck. Sometimes stretching can be so much that these nerves break at the points where they extend from the spine.
  • EMG EMG is used as a diagnostics tool.
  • a positioning time of 21 days is given.
  • opposite T position of the shoulder like how police signals to stop traffic
  • stomach the arm is kept in opposite T position for a long time after the initial 21 -day period is over. This is the wrongest treatment method. Because the muscles that require the most training are the ones bringing the hand to the opposite T position.
  • the electrotherapy methods used for treatment of spina bifida are applicable in the same way for treatment of brachial plexus.
  • One of the most effective treatment methods of brachial plexus is vojta therapy.
  • the purpose is activating the reflex movement by applying pressure on the neutrally sensitive points on the arm.
  • the same pressure applications are done also on the healthy arm. When the pressure is applied on the healthy arm, the child suffers from pain.
  • a contracted arm has a typical paralyzed posture.
  • Brunsstrom technique is the most common method used in treatment of stroke patients. Its purpose is to elicit movement by using contractions. In this approach, the paralyzed arm position is divided into three stages. After the 3 rd stage, the contraction is considered as activated. After being activated, the contraction initiates a synergy, an associated movement occurs. The purpose is to elicit isolated movements by using this synergy. In this method of paralysis treatment, what we assert is that any contraction would be prevented. After a treatment, where contraction is prevented, independency is much more easily gained. PNF is another method used to treat paralysis. Here, a better use of activated movement elicited is targeted.
  • the intention here is to bring a movement that has been elicited by a variety of techniques up to a more active level.
  • Bobath concept is also one of the methods used in stroke rehabilitation. Treatment of stroke patients is based on the similar principles of the abovementioned treatments applied on children. Stretching method is used more commonly. After a certain time, by using a variety of tools, it is intended to elicit movements on the non-functional side based upon the movements performed by the other side. However, we are totally against the stretching principle applied in this treatment. Because stretching causes the muscle to lose its quality, thus leads to contraction again, when it obtains a new movement order from the brain.
  • Lokomat system is also used in treatment of stroke patients. Since there is no function in this system for activating movement in arms and legs, it is inadequate to achieve any success.
  • This invention which is about a mechanism developed in direction with the technological opportunities for the purpose of speeding up the neurological improvement of the movement disorders occurring due to damages in the nervous system by exercising hand, arm, leg, foot joints so that the target organ gains locomotion thus treating movement disorders occurring on extremities due to nervous system damages in order to provide individuals gain their independency in performing their daily activities, overcomes all the disadvantages mentioned above and its main feature is, in respect to teaching the brain arm and leg movements, applying a physiotherapy to the patient, by enabling the controlled movement of hands, fingers, arms and legs with the help of sensors like encoder and electrical motors being operated under the surveillance of cameras as well as ultraviolet cameras.
  • Cerebral palsy refers to all the movement and posture disorders that occur depending on any kind of damage in the brain developing during prenatal, intranatal and postnatal period. Treatment of the damaged brain part is not possible with any of the present treatment systems.
  • the only treatment to be applied should be teaching the healthy parts of the brain to take over the tasks of the damaged part by using neuroplasticity (the brain's ability to change shape). This can only be achieved by teaching these movements to the brain.
  • the learning process proceeds from easy to hard. This process should be executed by simplifying these movements and providing the child the oppbrtunity of performing them. While teaching a movement to a new brain part, there are few matters, which require attention. First of all, it should be ensured that the movement is performed slowly.
  • the upwards-lifting muscle's movement is taught and the downwards-lowering muscle controlling the speed is activated.
  • the communication of every muscle is provided through different nerves.
  • movement of both upward and downward ways of the relevant muscle can be taught.
  • the functioning mechanism of the brain is based on the cooperative work of the first and the second muscle. There is no possibility to achieve teaching any movement to the brain if we only stimulate the first muscle. This way of training is against the functioning mechanism of the brain. It is also required that an impulse is sent to the brain through both ways of the second muscle. In order to stimulate the ways to and from the brain of both first and second muscle; the movement is paused, then oriented to the reverse direction for a while and proceeded again in the desired direction.
  • a splint is put on the arm in a way to prevent the elbow from bending.
  • the splint is provided with a flexible mechanism on it.
  • This flexible mechanism is attached to the motor with inflexible strings.
  • Two strings are attached to the motors, one being placed at foot level, the other one at head level.
  • the control lever attached to the strings By pulling upwards and pushing downwards the control lever attached to the strings, the arm is brought right beside the body.
  • the motor at the head level pulls the shoulder up in a way to stimulate the movement.
  • the motor at the foot level pulls down in a way to control the movement. But the motor below does not provide enough power to prevent the movement.
  • the motors ensure that the movement is performed under control and with a certain speed from the starting point to the end point.
  • the sensors become activated, sense the movement and allow the child to perform the entire movement.
  • the sensors sense this and activate the motors to proceed the movement.
  • the power of the motor which provides the upwards-lifting movement
  • the power of the downwards-lowering motor exceeds a little more than the power of the motor performing the upwards-lifting movement.
  • the motor performing the downwards-lowering movement does not ever elicit the movement. In this process, only a pause takes place. The arm is lifted upwards in this way when the pause occurs. Timing of the pause changes according to the requirement.
  • the sensors detect arm contraction arising within different intervals during occurrence of the movement and allow execution of the movement in arm's contraction direction so as not to prevent occurrence of the movement. In addition to this, they allow execution of the movement by granting maximum resistance without preventing the movement. In this way, the contracted muscle is taught the movement by granting resistance to it. This operation continues until the contracted muscle allows full execution of the movement in the space of the joint.
  • all actions on the arms and legs are activated by splints ensuring execution of the movement when arm contraction is seen in different intervals during occurrence
  • These sensors are force meter, tension meter, encoder angle gauge, infrared camera, EMG and sound wave module.
  • Force meter and tension meter can be placed on the engine, string or flexible mechanism. The force arising during execution of the movement is measured on the string.
  • Encoder angle gauge is placed onto the area of joint during functioning of the target organ. It can instantly track the angle arising during movement of the joint via the camera across it.
  • Infrared camera tracks the muscle functions on the target organ according to changes in temperature. Temperature increase during functioning of muscles and movement execution status may be tracked.
  • Electrodes are attached to the muscles on the target organ via EMG. Electrophysiological changes arising on muscles during movements can be followed-up via electrodes. Functioning level of the muscles can be identified.
  • Sound wave module may be placed on the muscles functioning on the target organ. Mass change in the muscle during execution of movements may be folio wed-up via sound waves.
  • the splint is put on the palm.
  • the splint is connected to the flexible mechanism.
  • the flexible mechanism is connected to front and rear motor by the string. Shoulder and elbow joints are fixed. It is ensured that shoulder and elbow joints do not move. While the front motor is pushing up the wrist, the motor on the opposite side creates resistance in reply to the movement.
  • the splint is put on the ankle.
  • the flexible mechanism is connected to front and rear motor by the string. While the front motor is pushing up the leg through the ankle, the rriotor on the opposite side creates resistance in reply to the movement.
  • the splint is put on the wrist.
  • the splint is connected to the flexible mechanism.
  • the flexible mechanism is connected to front and rear motor by the string.
  • Elbow joints may/may not be fixed. In case of fixing, it is ensured that elbow joints do not move.
  • the front motor is pushing up the arm through the shoulder, the motor on the opposite side creates resistance in reply to the movement.
  • the splint is put on the wrist.
  • the splint is connected to the flexible mechanism.
  • the flexible mechanism is connected to front and rear motor by the string.
  • the shoulder is positioned so as to be vertical to the body. While the front motor is pushing up the forearm through the shoulder, the motor on the opposite side creates resistance in reply to the movement.
  • Hand finger flexion/extension During practicing the hand fingers, the splint is put on every finger other than the thumb. The splint is Connected to the flexible mechanism. The flexible mechanism is connected to front and rear motor by the string. While the front motor is bending and pushing the hand lingers, the motor on the opposite side creates resistance in reply to the movement.
  • the splint When the patient is put to the bed vertically during practicing the hip, the splint is put on the ankle.
  • the splint is connected to the flexible mechanism.
  • the flexible mechanism is connected to front and rear motor by the string. While the motor on the side is opening the single leg and foot of the patient laying on his back laterally and closing them inward, the motor on the opposite side creates resistance in reply to the movement.
  • connection accessories and rollers reach out from front and rear motors to the sides. In this way, functioning of motors at different axes can be ensured.
  • the splint is put on the upper part of the heel.
  • the splint is connected to the flexible mechanism.
  • the flexible mechanism is connected to front and rear motor by the string. The patient is put on the mechanism horizontally. While the front motor is pushing and drawing the ankle, the motor on the opposite side creates resistance in reply to the movement Thumb abduction/adduction:
  • the splint is put on the thumb.
  • the patient is put on the mechanism horizontally.
  • the splint is connected to the flexible mechanism.
  • the flexible mechanism is connected to front and rear motor by the string. Wrist, shoulder and elbow joints are fixed. While the front motor is executing inside-outside movement of the thumb, the motor on the opposite side creates resistance in reply to the movement.
  • Elbow flexion/extension
  • the splint is put on just under the wrist.
  • the splint (9) is connected to the flexible mechanism.
  • the flexible mechanism is connected to front and rear motor by the string. The patient is put on the mechanism horizontally. While the front motor is pushing and drawing the elbow, the motor on the opposite side creates resistance in reply to the movement.
  • the splint is put on a just under the ankle.
  • the splint is connected to the flexible mechanism.
  • the flexible mechanism is connected to front and rear motor by the string.
  • the patient is put on the mechanism face-down. While the front motor is pushing and drawing the ankle, the motor on the opposite side creates resistance in reply to the movement. It is possible for the splint used in the mechanism that its location may be changed if deemed necessary by the operator or physiotherapists depending on the treatment method applied to the target organ.
  • Figure 1 is the general view of the mechanism.
  • Figure 2 is the detailed general view of the mechanism.
  • Figure 3 is the general view showing how finger flexion extension movement works in the mechanism.
  • Figure 4 is the general view showing how thumb abduction adduction movement works in the mechanism.
  • Figure 5 is the general view showing how wrist flexion extension movement works in the mechanism.
  • Figure 6 is the general view showing how front arm pronation supination movement works in the mechanism.
  • Figure 7 is the general view showing how elbow flexion extension movement works in the mechanism.
  • Figure 8 is the general view showing how shoulder flexion extension movement works in the mechanism.
  • Figure 9 is the general view showing how shoulder abduction adduction movement works in the mechanism.
  • Figure 10 is the general view showing how shoulder external rotation internal rotation movements work in the mechanism.
  • Figure 11 is the general view showing how horizontal shoulder abduction adduction movement works in the mechanism.
  • Figure 12 is the general view showing how hip flexion extension movement works in the mechanism.
  • Figure 13 is the general view showing how shoulder flexion extension movement works in the mechanism when a side roller is used.
  • Figure 14 is the general view showing how hip abduction adduction movement works in the mechanism.
  • Figure 15 is the general view showing how it works in the mechanism when a side roller is used.
  • Figure 16 is the general view showing how it works in the mechanism when a side roller is used.
  • Figure 17 is the general view showing how knee flexion extension movement works in the mechanism.
  • Figure 18 is the general view showing how ankle plantarflexion dorsiflexion movement works in the mechanism.
  • Figure 19 is the general view showing how hip flexion extension movement works when four way motors are used.
  • This invention -related to the mechanism about treating movement disorders arising in extremities as a result of nervous system damages bringing movement capability to the target organ by activating hand, arm, leg and foot joints developed to grant freedom of movement for people in their daily lives by accelerating neurologic recovery in movement disorders caused by nervous system damages- is essentially formed of 1 st Motor (1), 2 nd Motor (2), 3 rd Motor (3), 4 th Motor (4), motor box (5), covering motors, pressure gauge (6) measuring the arising pressure, inflexible string (7), flexible mechanism (8) linked on the string (7), splint (9) linked to the target organ of the patient, encoder angle gauge (10) measuring the angle during the movement towards joint of the target organ, camera (11), infrared camera (12) tracking temperature of muscles running on the target organ, EMG (13) tracking electrophysiology in the muscles of the target organ, electrotherapy (14) activating the muscles in the target organ by transmitting electric current, sound wave module (15) tracking mass changes in muscles of the target organ by sound waves, marker and camera (16)
  • 1 st Motor (1), 2 nd Motor (2), 3 rd Motor (3) and 4 th Motor (4) of the mechanism may be technically known and used as well as power generating motors.
  • electric powered step motor or servomotors are preferred.
  • 3 rd Motor (3) is located at the side in a vertical axis to the mechanism.
  • 4 th Motor (4) faces the 3 rd Motor.
  • 3 rd Motor (3) and 4 th Motor (4) may march on the rails. Their locations may be adjusted according to height of the patient or direction of movement as desired.
  • the motor box (5) protects the engines (1, 2, 3 and 4).
  • the string (7) developed by the invention may be technically known and used fixed inflexible materials and products establishing connection between engines (1, 2, 3 and 4) and flexible mechanism (8).
  • the flexible mechanism (8) developed by the invention can connect the inflexible string (7) and splint (9). In return of inflexibility of the string (7), the flexible mechanism (8) is used to make data collection of sensors more efficient. In the mechanism, needed flexibility of the string (7) is compensated by the flexible mechanism (8). Therefore, more efficient data can be collected via sensors despite fixed and inflexible structure of the string (7).
  • Pressure gauges (6) are placed on the 1 st Motor (1), 2 nd Motor (2), 3 rd Motor (3) and 4 th Motor or connected string (7) as sensors.
  • the pressure gauge (6) adjusted response of the motors (1, 2, 3 and 4) to the patient according to tension arising on the string (7).
  • the pressure gauge (6) detects responses of the user to the movement during the period of reducing assistance for assisted movements requested in treatment and it also adjusts power applied by the motors (1 , 2, 3 and 4).
  • the string (7) going the 1 st Motor (1), 2 nd Motor (2), 3 rd Motor (3) and 4 th Motor is connected with splint(9) on the user.
  • the splint (9) is put on the target organ or limb of the user which is required to be activated.
  • the splint (9) is put on the target organ or limb of the user and connected to the motor or roller used in treatment by the string (7) through front and back of the user.
  • control mechanism (18) enabling operator to control and track the entire mechanism.
  • the control mechanism (18) ensures operation of the entire mechanism and enables operator to command.
  • the motors (1, 2, 3 and 4) developed by the invention area used on opposite sides. While commanding a movement to the user, a motor draws and the motor on the opposite side moves in the reverse direction with less power. Therefore, the movement is transmitted to the user in a way most resembling to functioning mechanisms of his muscles and this movement is taught to him.
  • Pressure gauge (6) as force meter, gravity meter and tension meter may be placed on the motors (1, 2, 3 and 4), string (7) or flexible mechanism (8). It measures the force or tension arising on the strain while the patient is executing the movement.
  • the pressure gauge (6) developed by the invention may measure the change in torque force arising in the motors (1, 2, 3 and 4) in addition to measuring activities in the mechanism. The change in torque force arising in the motors (1, 2, 3 and 4) indicates movement execution efficiency of the patient. When the patient starts to execute the movements by himself, the decrease in torque force of the motors (1, 2, 3 and 4) indicates that the movement can be executed.
  • Encoder angle gauge (10) is placed onto the area of joint during functioning of the target organ. It can instantly track the angle arising during movement of the joint via the camera (11) across it.
  • Infrared camera (12) tracks the muscle functions on the target organ according to changes in temperature. Temperature increase during functioning of muscles and movement execution status may be tracked. Electrodes are attached to the muscles on the target organ via EMG (13). Electrophysiological changes arising on muscles during movements can be followed-up via electrodes. In this way, functioning level of the muscles can be identified.
  • Sound wave module (15) may be placed on the muscles functioning on the target organ. Mass change in the muscle during execution of movements may be followed-up via sound waves.
  • whether the user executes the determined movements or not may be tracked by placing markers on the user via marker and camera system (16).
  • Treatment efficiency in terms of execution of the movements, may be tracked during the treatment.
  • the markers on the user may be tracked via cameras located around the mechanism. Movement of markers can be recorded via camera and whether the movements are executed or not can be checked.
  • biofeedback control mechanism (17) can be used during activation of the mechanism and treatment of the user.
  • audio and visual alert can be received when the movement is properly executed by the user. This audio and visual alert indicates proper execution of the movement by the user and conditions him.
  • the audio and visual alert also gives instant information to the physician or operator about movement analysis of the user. It can instantly indicate movement analysis and efficiency of the user to the physician or operator.
  • the biofeedback .control mechanism (17) developed by the invention can be used by technically known and used televisions placed out of the mechanism.
  • the television should be placed in a way that can be seen by both the user and practicing physician or operator.
  • the user's movement is analyzed and his efficiency is brought into open.
  • electrical stimulation is transmitted to his target muscles if his movement execution efficiency is considerably low.
  • electrotherapy 14
  • electrodes are connected to the areas of target muscles depending on the applied treatment and executed movements. Electrodes enable functioning of the target muscles by transmitting electrical stimulation to them.
  • the marker and camera system the muscles that cannot be activated by the user are detected according to the results of the movement efficiency analysis. Electrical stimulation is transmitted to the detected unused muscles via electrotherapy (14) mechanism.
  • Movement analysis results obtained during use of the mechanism by the user can be transferred to a central evaluation unit via wireless communication networks so as to be used for treatment of disorders related to nervous system damages.
  • the date transferred to the evaluation unit can be externally tracked by the physician or operator administering the treatment.
  • the data of first and following stages of the treatment may be compared by the physician or operator.
  • the flexible mechanism (8) may be located on any point on the string (7).
  • the splint (9) is put on the target organ or limb desired to be treated.
  • the splint (9) is connected to the flexible mechanism (8).
  • the string is connected to the front and rear connection points of the flexible mechanism (8).
  • the string (7) connected to the flexible mechanism (8) is linked to the motor executing the movements determined for treatment of the selected target organ or limb. The movements required by treatment are ensured via motors under control of the sensors on the string (7) or motors (1, 2, 3 and 4).
  • the movements applied to the target organs or limbs for treatment method of aforesaid disorders are as following:
  • a splint (9) is put on the arm so as to prevent bending of elbow.
  • the flexible mechanism (8) is on the splint (9).
  • the flexible mechanism (8) is connected to the motors by inflexible strings (7).
  • One of the strings (7) is connected to 2 Motor (2) on leg part and other string (7) is connected to the 1 st Motor (1) on the head part.
  • the arm comes next to the body by pushing up and down the arm thanks to the strings (7).
  • the arm rises at head level by push up.
  • the sensors connected to the motors and force or tension measuring pressure gauge (6) pulls the shoulder to push it up so as to create 1 st Motor (1) movement at head part.
  • 2 nd Motor (2) on the leg part pushes the movement down so as to control it.
  • the 2 nd Motor (2) on the lower part does not apply power as near as to prevent execution of the movement.
  • the motors ensure execution of the movement under control and at a certain sp$ed frOrii the starting to finishing point of the
  • the sensors detects the movement by stepping in and allows the kid to execute the movement.
  • the sensors detect it arid motors continue to command the movement. While power of the motor ensuring push up in every second remains stable, the power of the motor ensuring push down exceeds the power of former engine by a slight difference for a very short period of time. The engine ensuring push down movement never generates the movements. Only cessation occurs in this action. The movement of pushing up arm occurs in standstill as explained. The timing of movement of cessation differs depending on the needs.
  • the sensors detect arm contraction arising within different intervals during occurrence of the movement and allow execution of the movement in arm's contraction direction so as not to prevent occurrence of the movement. In addition to this, they allow execution of the movement by granting maximum resistance without preventing the movement. In this way, the contracted muscle is taught the movement by granting resistance to it. This operation continues until the contracted muscle allows full execution of the movement in the space of the joint. Thus, all actions on the arms and legs are activated by splints (9) ensuring execution of the movement. Wrist flexion/extension:
  • the splint (9) is put on the palm.
  • the splint is connected to the flexible mechanism (8).
  • the flexible mechanism is connected to front and rear motor by the string. Shoulder and elbow joints are fixed. It is ensured that shoulder and elbow joints do not move. While the front motor is pushing up the wrist, the motor on the opposite side creates resistance in reply to the movement.
  • the splint (9) is put on the ankle.
  • the flexible mechanism (8) is connected to front and rear motor by the string. While the front motor is pushing up the leg through the ankle, the motor on the opposite side creates resistance in reply to the movement.
  • the splint (9) is put on the wrist.
  • the splint (9) is connected to the flexible mechanism (8).
  • the flexible mechanism (8) is connected to front and rear motor by the string.
  • Elbow joints may/may not be fixed. In case of fixing, it is ensured that elbow joints do not move.
  • the front motor is pushing up the arm through the shoulder, the motor on the opposite side creates resistance in reply to the movement.
  • the splint (9) is put on the wrist.
  • the splint (9) is connected to the flexible mechanism (8).
  • the flexible mechanism (8) is connected to front and rear motor by the string.
  • the shoulder is positioned so as to be vertical to the body. While the front motor is pushing up the forearm through the shoulder, the motor on the opposite side creates resistance in reply to the movement.
  • Hand fi ger flexion/extension! ⁇ I ⁇ ⁇ i ⁇ ⁇ : ' j I ' ' : ⁇
  • the splint (9) is put on every finger other than the thumb.
  • the splint (9) is connected to the flexible mechanism (8).
  • the flexible mechanism (8) is connected to front and rear motor by the string. While the front motor is bending and pushing the hand fingers, the motor on the opposite side creates resistance in reply to the movement.
  • the splint (9) When the patient is put to the bed vertically during practicing the hip, the splint (9) is put on the ankle.
  • the splint (9) is connected to the flexible mechanism (8).
  • the flexible mechanism (8) is connected to front and rear motor by the string. While the motor on the side, is opening the single leg and foqt of the patient laying on his back laterally and closing them inward, the motor on the opposite side creates resistance in reply to the movement.
  • connection accessories and rollers reach out from front and rear motors to the sides. In this way, functioning of motors at different axes can be ensured.
  • the splint (9) is put on the upper part of the heel.
  • the splint (9) is connected to the flexible mechanism (8).
  • the flexible mechanism (8) is connected to front and rear motor by the string. The patient is put on the mechanism horizontally. While the front motor is pushing and drawing the ankle, the motor on the opposite side creates resistance in reply to the movement. Thumb abduction/adduction:
  • the splint (9) is put on the thumb.
  • the patient is put on the mechanism horizontally.
  • the splint (9) is connected to the flexible mechanism (8).
  • the flexible mechanism (8) is connected to front and rear motor by the string. Wrist, shoulder and elbow joints are fixed. While the front motor is executing inside-outside movement of the thumb, the motor on the opposite side creates resistance in reply to the movement.
  • the splint (9) is put on just under the wrist.
  • the splint (9) is connected to the flexible mechanism (8).
  • the flexible mechanism (8) is connected to front and rear motor by the string. The patient is put on the mechanism horizontally. While the front motor is pushing and drawing the elbow, the motor on the opposite side creates resistance in reply to the movement.
  • the splint (9) is put on a just under the ankle.
  • the splint (9) is connected to the flexible mechanism (8).
  • the flexible mechanism (8) is connected to front and rear motor by the string. The patient is put on the mechanism face-down. While the front motor is pushing and drawing the ankle, the motor on the opposite side creates resistance in reply to the movement.
  • the splint (9) is put on the wrist.
  • the splint (9) is connected to the flexible mechanism (8).
  • the string (7) is fastened to the flexible mechanism (8) so as to cover around the wrist.
  • the flexible mechanism (8) is connected to front and rear motor by the string. Shoulder and elbow joints are fixed. It is ensured that shoulder and elbow joints do not move.
  • the front motor is turning the ankle in its axis, the motor on the opposite side creates resistance in reply to the movement. Practicing the movement from different axes simultaneously during the treatment applied to the target organ ensures that the movement is taught so as to be used in daily life.
  • Motor 3 (3) and Motor 4(4) In order to cause the muscles providing the stability to function, it is also necessary to cause Motor 3 (3) and Motor 4(4) to function so that it is necessary to teach the determined movement.
  • the contribution of Motor 3 (3) and Motor 4(4) to the movement may also be used in other movement groups.
  • the invention, mechanism to treat movement disorders arising in extremities due to nervous system damages can be integrated to where the patient is located or the bed on which he lays. It can be integrated personal bed of the patient, sickbed or examination bed. By the mechanism developed to be used for treatment of nervous system damages, the users are allowed to simultaneously execute the treatment movements indicated above.
  • the splints (9) connected to relevant limbs may be connected to the motors (1, 2, 3 and 4) by use of more than one string (7). Execution of more than one movement simultaneously can also be ensured by increasing number of motors in the sections where the motors (1 , 2, 3 and 4) are located.

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Abstract

La présente invention concerne un mécanisme pour le traitement de troubles du mouvement survenant aux extrémités en conséquence de lésions du système nerveux, amenant la capacité de mouvement de l'organe cible par activation d'articulations développées de main, de bras, de jambe et de pied à autoriser une liberté de mouvement pour les personnes dans leur vie quotidienne par accélération du rétablissement neurologique de troubles du mouvement provoqués par des lésions du système nerveux, qui est essentiellement formé d'un 1er moteur (1), d'un 2ième moteur (2), d'un 3ième moteur (3), d'un 4ième moteur (4), d'une boîte de moteur (5), de moteurs de recouvrement, d'un manomètre (6) mesurant la pression résultant, d'une chaîne rigide (7), d'un mécanisme souple (8) relié sur la chaîne (7), d'une attelle (9) reliée à l'organe cible du patient, d'un indicateur d'angle de codeur (10) mesurant l'angle pendant le mouvement vers une articulation de l'organe cible, d'une caméra (11), d'une caméra infrarouge (12) suivant la température de muscles fonctionnant sur l'organe cible, d'EMG (13) suivant l'électrophysiologie dans les muscles de l'organe cible, d'électrothérapie (14) activant les muscles dans l'organe cible par transmission de courant électrique, d'un module d'ondes sonores (15) suivant des changements de masse dans des muscles de l'organe cible par des ondes sonores, d'un marqueur et d'une caméra (16) reliant des marqueurs sur le patient et réalisant des analyses d'efficacité de mouvement par suivi des marqueurs de manière électronique, d'un mécanisme de commande de rétroaction biologique (17) par lequel des niveaux d'exécution et d'apprentissage de mouvement des patients peuvent être suivis pendant le traitement, et d'un mécanisme de commande (18) permettant à l'opérateur de démarrer et de commander le mécanisme.
PCT/TR2015/000310 2015-09-04 2015-09-04 Mécanisme de traitement de troubles du mouvement survenant aux extrémités en conséquence de lésions du système nerveux WO2017039550A1 (fr)

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Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN109568082A (zh) * 2018-12-11 2019-04-05 上海大学 一种上肢康复训练机器人及上肢康复训练方法
US20210045957A1 (en) * 2018-01-28 2021-02-18 Papoyama LTD. Device for reduction of vibrations
EP3915535A1 (fr) * 2020-05-27 2021-12-01 Fizio Tech d.o.o. Appareil pour la traction et la vibration de l'articulation de la hanche

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6685605B1 (en) * 2000-10-30 2004-02-03 Mark A Klossner Exercise apparatus for the limbs and joints
CN103263338A (zh) * 2013-06-06 2013-08-28 中山大学 一种上肢康复机器人

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6685605B1 (en) * 2000-10-30 2004-02-03 Mark A Klossner Exercise apparatus for the limbs and joints
CN103263338A (zh) * 2013-06-06 2013-08-28 中山大学 一种上肢康复机器人

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20210045957A1 (en) * 2018-01-28 2021-02-18 Papoyama LTD. Device for reduction of vibrations
CN109568082A (zh) * 2018-12-11 2019-04-05 上海大学 一种上肢康复训练机器人及上肢康复训练方法
EP3915535A1 (fr) * 2020-05-27 2021-12-01 Fizio Tech d.o.o. Appareil pour la traction et la vibration de l'articulation de la hanche

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