WO2019135081A1 - Dispositif de rééducation de patient - Google Patents

Dispositif de rééducation de patient Download PDF

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Publication number
WO2019135081A1
WO2019135081A1 PCT/GB2019/050016 GB2019050016W WO2019135081A1 WO 2019135081 A1 WO2019135081 A1 WO 2019135081A1 GB 2019050016 W GB2019050016 W GB 2019050016W WO 2019135081 A1 WO2019135081 A1 WO 2019135081A1
Authority
WO
WIPO (PCT)
Prior art keywords
support
foot
leg
limb
rehabilitation apparatus
Prior art date
Application number
PCT/GB2019/050016
Other languages
English (en)
Inventor
Oliver William Allonby WILEMAN
Samuel James HUGHES
Lucas BENSON
Anna Beth SINGLETON
Dylan CUNNAH
Jordan HUDDART
Original Assignee
Bae Systems Plc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Bae Systems Plc filed Critical Bae Systems Plc
Publication of WO2019135081A1 publication Critical patent/WO2019135081A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H1/00—Apparatus for passive exercising; Vibrating apparatus; Chiropractic devices, e.g. body impacting devices, external devices for briefly extending or aligning unbroken bones
    • A61H1/02—Stretching or bending or torsioning apparatus for exercising
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H1/00—Apparatus for passive exercising; Vibrating apparatus; Chiropractic devices, e.g. body impacting devices, external devices for briefly extending or aligning unbroken bones
    • A61H1/005—Moveable platforms, e.g. vibrating or oscillating platforms for standing, sitting, laying or leaning
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H1/00—Apparatus for passive exercising; Vibrating apparatus; Chiropractic devices, e.g. body impacting devices, external devices for briefly extending or aligning unbroken bones
    • A61H1/02—Stretching or bending or torsioning apparatus for exercising
    • A61H1/0237—Stretching or bending or torsioning apparatus for exercising for the lower limbs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H1/00—Apparatus for passive exercising; Vibrating apparatus; Chiropractic devices, e.g. body impacting devices, external devices for briefly extending or aligning unbroken bones
    • A61H1/02—Stretching or bending or torsioning apparatus for exercising
    • A61H1/0237—Stretching or bending or torsioning apparatus for exercising for the lower limbs
    • A61H1/0266—Foot
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B33—ADDITIVE MANUFACTURING TECHNOLOGY
    • B33Y—ADDITIVE MANUFACTURING, i.e. MANUFACTURING OF THREE-DIMENSIONAL [3-D] OBJECTS BY ADDITIVE DEPOSITION, ADDITIVE AGGLOMERATION OR ADDITIVE LAYERING, e.g. BY 3-D PRINTING, STEREOLITHOGRAPHY OR SELECTIVE LASER SINTERING
    • B33Y80/00—Products made by additive manufacturing
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/01—Constructive details
    • A61H2201/0173—Means for preventing injuries
    • A61H2201/0176—By stopping operation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/01—Constructive details
    • A61H2201/0192—Specific means for adjusting dimensions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/12—Driving means
    • A61H2201/1207—Driving means with electric or magnetic drive
    • A61H2201/1215—Rotary drive
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/16—Physical interface with patient
    • A61H2201/1602—Physical interface with patient kind of interface, e.g. head rest, knee support or lumbar support
    • A61H2201/164—Feet or leg, e.g. pedal
    • A61H2201/1642—Holding means therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/16—Physical interface with patient
    • A61H2201/1657—Movement of interface, i.e. force application means
    • A61H2201/1664—Movement of interface, i.e. force application means linear
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/16—Physical interface with patient
    • A61H2201/1657—Movement of interface, i.e. force application means
    • A61H2201/1676—Pivoting

Definitions

  • the invention relates to a joint support and manipulation device for use in the medical rehabilitation industry. More particularly, the invention relates to rehabilitation apparatus for use in the rehabilitation of ankle joints. The invention is particularly useful for the rehabilitation of ankle joints in medical patients fitted with Taylor Spatial Frame (TSF) or lllizarov frames, or for medical patients who have previously been fitted with a cast.
  • TSF Taylor Spatial Frame
  • lllizarov frames or for medical patients who have previously been fitted with a cast.
  • patients may be fitted with various medical supports such as casts or frames to prevent undue movement of the injured limb or joint. Isolating the limb or joint can allow a degree of structural repair to occur as well as prevent further injury as a result of sudden or strenuous movement. Devices such as frames or casts may cause the patient to suffer stiff joints as the prevention of movement can cause the associated tendons or ligaments to tighten. Though the joint or limb may repair structurally, patients may, as a result of limb isolation, be left with reduced movement of the joint and in some severe cases, they may be unable to move the limb and/or or joint.
  • various medical supports such as casts or frames
  • physiotherapists In order to rehabilitate the limb and regain movement of the joint, physiotherapists are employed to manipulate the joint to loosen the tendons and ligaments and increase flexibility and range of movement. This can be very time consuming, often requiring multiple sessions of physiotherapy over many weeks or months.
  • an apparatus for joint motion control between at least a first limb and a second limb, comprising a first limb support and a second limb support, a moveable plate, said moveable plate being mounted on the first limb support, wherein the first limb support is pivotally mounted, about a pivot joint, to a support structure, which is attached to the second limb support, and a resilient bias, used to control the degree of pivotal motion of the first limb support; in relation to the second limb support such that the first limb support coincides with the first limb to be motioned controlled in relation to the second limb.
  • the arrangement allows the joint between said first and second limbs to be isolated, controlled and moved by securing a first limb in its natural plane in relation to a second limb.
  • the joint to be exercised is an ankle
  • the lower leg may be secured against the second limb support in its natural plane, with the foot being secured against a first limb support in its corresponding natural plane, thereby isolating the two limbs. This allows the ankle joint motion to be controlled by the action of the device.
  • the limb may be a large limb, such as the upper leg with the lower leg being secured and the knee joint isolated or a smaller limb pair such as either side of a knuckle joint on a patient’s hand.
  • the apparatus moves a limb about a pivot point in the natural plane of movement, either partially through the limb range or entirely through the limb range depending on the limitations of the joint and the stage of the patient’s therapy.
  • the range of movement of limb may be controlled to be limited and increased as therapy progresses as well as the speed through which the limb is moved through the range.
  • the movement of a first limb in relation to a second limb requires the joint to be moved to be positioned relative to the pivot point; the pivot point of the rehabilitation device may be mounted on a support structure located on the second limb support.
  • the support structure may be an apex support structure.
  • the first limb support may comprise a further apex support.
  • the apex support structure and further apex support structures may be joined at the pivot point.
  • the first limb support may be attached to the support structure, about the pivot joint, utilising a pivotal mechanical fixing using a self-lubricating metal.
  • the pivot joint may be passive, such that it moves freely; it may comprise a resilient bias to provide resistance to the user.
  • the first limb may be moved to adjust the pivot point in relation to the joint to be exercised. This point may change as the size of limbs the invention is to accommodate changes, whether due to the size of the patient or the joint to be exercised.
  • the moveable plate may be either slideably or mechanically adjustable to move the joint, which connects the first and second limb, into alignment with the pivot point.
  • the moveable plate may be slideably adjusted with respect to the first limb support as this allows the limb to find the joint’s point of rotation naturally to the patients comfort and so prevents unnecessary intervention by a professional to mechanically adjust the plate.
  • the support structure may further comprise a swing stop to engage with the first limb support to prevent pivoting, such as, for example to prevent the first support structure from either impacting the control panel of the rehabilitation device or over-extending the joint to be exercised.
  • the swing stop may be rigidly fixed or mechanically adjustable in order that it may be moved to accommodate differing ranges of joint motion.
  • a prop may be tailored to fit differing limb types, for example where the first limb is a foot (where the ankle is the joint to be exercised) the moveable plate may further include a raised portion at the end of the moveable plate to provide support for the first limb and to aid in its retention.
  • the first limb support may comprise a retention strap.
  • the first limb support may comprise at least one slot for the insertion of the retention strap which may hold the first limb against the first limb support, once the first limb is in place.
  • the retention strap may be permanently attached to the first support and in use, placed over the first limb and reversibly inserted into the slot, however alternatively at least two slots may be included as part of the first support to allow the restraint strap to be completely removed from the rehabilitation device or installed on the rehabilitation device by insertion into both slots.
  • the first limb support and/or moveable plate may further comprise a support cushion constructed from plastic, foam or gel to add to the patient comfort and the limb support.
  • the second limb support may be constructed with a curved recessed portion to allow the limb to sit in the second limb support.
  • the second limb support may also comprise a support cushion constructed from plastic, foam or gel.
  • the second limb support may further comprise retention straps, such as, for example the second limb support may comprise at least one slot, running through its length for the connection of a limb retention strap to secure the limb to the second limb support and prevent undue movement to the second limb in relation to the first, whilst allowing a full range in joint motion.
  • the restraint strap(s) may be permanently mechanically fastened or reversibly fastened by inclusion of an additional slot on the second limb support for the insertion of an additional end of the restraint strap.
  • the resilient biased means may be located within the pivot joint, or may be located such that it provides resilience between the first and second limb support.
  • the motion of the first limb support in relation to the second limb support may be patient controlled through the use of a resilient biased means, for example non-mechanical resistance devices, such elastic straps, springs, rubber mounts, thereby utilising the patient’s own efforts to move against the resistance of the elastic, thereby strengthening the joint.
  • the non-mechanical resistance devices may be affixed to the first and second limb supports, and the resistance changed by changing the resilience of the elastic or spring.
  • the motion of the first limb support in relation to the second limb support may be a mechanically controlled means, for example a motor such as a stepped motor, which is programmable to allow for a specific selection of range of movement and force to be applied, thereby creating a number of different training programmes.
  • the motor may cause either the first limb support and/or second limb support to move through a range of different programmed angles of pivot, about said pivot joint, in order to move the first limb, in relation to the second limb, and thereby cause the joint between the first limb and second limb to work through a controlled motion and range.
  • the motor may be located within the pivot joint or located in a housing and drive the first limb support or second limb support, about said pivot joint.
  • the motor is intended to control the motion of the first limb and second limb it is a requirement of the motor that it is capable of delivering a range of force in order for it to move the first limb support or second limb support as required.
  • the stepped motor may deliver from 0kg or 0 N to 500kg or 490.5N, of force over the range of movement traversed by the first or second limb supports, more preferably from 50kg to 240kg or 235.4N of force over the range of movement traversed by the first limb support.
  • the rehabilitation device may include a control panel to input programs to control the operation of the resilient means.
  • the control panel may be fixed to the device or be detachable to allow remote operation.
  • the control panel may be used to enable the selection of an exercise program, after which it will cause the motor to move the first limb support, second limb support or both, through a range of motions, varying the angle between the first limb support and second limb support, the speed or both speed and the angle.
  • the control panel may include a display to allow the operator to select training programs, a means to manually adjust the resistance to movement of the first limb support or second limb support or various status indicators to inform the operator of the device as to how it is functioning.
  • the control panel comprises an emergency stop to immediately halt the movement motor and therefore the motion of the first limb support, second limb support or both.
  • a method of joint motion control with a device as discussed herein wherein: a second limb (e.g. a leg) is placed on the limb support with a first limb (e.g. a foot) placed on the moveable plate of the first limb support and the first limb and first limb support is pivoted in relation to the second limb support in order that the angle between the second limb and first limb is increased and decreased under control of the resilient bias.
  • a second limb e.g. a leg
  • a first limb e.g. a foot
  • a rehabilitation apparatus (also referred herein as an ankle rehabilitation apparatus, device or system) comprising: a foot support and a leg support; wherein the foot support is pivotally attached, by way of at least one pivot joint, to the leg support; and wherein the rehabilitation apparatus further comprises: a moveable foot plate mounted on the foot support; and a motor adapted/configured to control the degree of pivotal motion of the foot support in relation to the leg support about the at least one pivot joint.
  • a rehabilitation apparatus comprising: a foot support and a leg support; wherein the foot support is pivotally attached, by way of at least one pivot joint, to the leg support; and wherein the rehabilitation apparatus further comprises: a moveable foot plate mounted on the foot support; and means for controlling the degree of pivotal motion of the foot support in relation to the leg support about the at least one pivot joint.
  • the foot support may comprise a base, which is preferably flat, and the foot support may further comprise at least one side wall (preferably two opposing side walls) extending (at approximately 90 degrees) from the base, e.g. extending upwards from the base.
  • the at least one side wall may comprise at least one attaching structure.
  • the at least one attaching structure (e.g. an apex structure) may extend from, for example up from and parallel to, the at least one side wall.
  • the second attaching structure is the attaching structure nearest the motor.
  • the foot support may further comprise a back wall, preferably extending between the two side walls. This back wall may function to stop the moveable plate from sliding off the foot support.
  • the leg support may have two side walls, a front wall and a back wall.
  • the front wall i.e. the wall nearest to the patient’s knee in use
  • the back wall i.e. the wall opposite the front wall
  • the leg support extends into a control panel.
  • the leg support may comprise at least one support structure and the foot support may be pivotally attached, by way of the at least one pivot joint, to the at least one support structure of the leg support.
  • the support structure may be joined to the attaching structure at a pivot joint.
  • the at least one support structure of the leg support acts to support/hold the foot support (and associated moveable foot plate).
  • the at least one support structure is rigid and does not move during operation of the rehabilitation device.
  • the leg support has two support structures and the foot support is pivotally attached to the leg support by way of two pivot joints.
  • first attaching structure is pivotally attached, by way of a pivot joint to the first supporting structure and the second attaching structure is pivotally attached, by way of a (different) pivot joint to the second supporting structure.
  • the rehabilitation apparatus comprises a foot support comprising first and second attaching structures; a leg support comprising first and second supporting structures; wherein the first attaching structure is pivotally attached, by way of a first pivot joint, to the first support structure; and the second attaching structure is pivotally attached, by way of a second pivot joint, to the second support structure; and wherein the rehabilitation apparatus further comprises a moveable foot plate mounted on the foot support; and a motor adapted to control the degree of pivotal motion of the foot support in relation to the leg support by way of the first and second pivot joints.
  • the motor may be adapted or configured to control the degree of pivotal motion of the foot support by any suitable means known in the art.
  • the motor may, for example, drive mechanical means of rotating the foot support about the pivot point(s).
  • a suitable example includes the use of a motor to control gears which rotate the foot support.
  • the motor may turn a first gear that engages with a second gear, which second gear rotates the foot support.
  • the first gear rotates by the action of the motor by way of a drive shaft.
  • the cogs of the first gear engage with the cogs of the second gear, thus turning the second gear.
  • the second gear may rotate the foot support about the pivot joints(s) by either being attached (e.g. bonded) to the foot support or by being integral to the foot support (e.g. made from the same additive manufactured piece).
  • the pivot joint(s) may be any suitable pivot joint known in the art, for example a bush and pin receptacle, made from any suitable material known in the art.
  • the pin is aluminium thus providing a lightweight and strong pivot joint.
  • the pivot joint(s) may be a self-lubricating pivot joint.
  • the at least one pivot joint comprises a self-lubricating metal.
  • self-lubrication provides a smooth pivoting motion and also reduces wear.
  • Any suitable, medical grade self-lubrication method known in the art may be used, for example Oilite ® (porous bronze).
  • the motor is adapted or configured to control the degree of pivotal motion of the foot support by way of a pinion (first gear) and half-moon gear (second gear) mechanism.
  • the half-moon gear extends down from the attaching structure of the foot support (i.e. extends away from the pivot joint and past the base of the foot support).
  • the half-moon gear (the second gear) is integral to the attaching structure of the foot support.
  • the base, side walls of the foot support, the attaching structure and the half-moon gear may be made in the same additive layer manufacturing process.
  • the motor powers the rotary movement of the pinion, causing the cogs of the pinion to engage with the cogs of the half-moon gear.
  • This causes the attaching structure of the foot support to pivot about the pivot point (e.g. the second pivot joint), thus pivoting the foot support about the pivot points (e.g. the first and second pivot points).
  • At least one of the support structures also comprises a guard piece.
  • the guard piece functions to stop entrapment of, for example, fingers in the gear mechanism, e.g. the half-moon gear and pinion arrangement.
  • the guard piece can be of any suitable shape that functions to encapsulate the half-moon gear of the attaching structure.
  • a guard piece may also be included on the first support structure (the support structure opposite the motor) so as to cover the gap created by the rotation of the foot support.
  • the guard piece(s) may be permanently fixed or removable.
  • the support structure(s) may be attached to the leg support by any suitable method or attachment device known in the art, for example by way of one or more dove joints.
  • the support structure(s) is rigidly attached to the sides/side walls of the leg support.
  • the attachment device may be reinforced.
  • the dove joint(s) may have a threaded insert, such a grub screw, which acts to brace the support structure against the walls of the leg support.
  • this reduces gear wear by reducing deleterious movement.
  • the support structure may be of any shape or design.
  • the support structures are triangular in shape - that is they are apex structures. This advantageously provides optimum structural strength whilst minimising the weight and thus costs of manufacture. This is particularly advantageous in helping to provide a lightweight, cheap rehabilitation device that can be easily used by bed-ridden patients.
  • the support structure may further comprise a safety device called a swing stop.
  • the swing stop may be considered an extension to the guard piece.
  • the swing stop functions to engage with the foot support and prevent further pivoting of the foot support past the programmed extreme limit of dorsiflexion and extreme limit of plantar flexion. In other words, the swing stop acts to prevent the foot support from pivoting to a point where the control panel is impacted.
  • infilling of certain cogs in the half moon gear at certain determined points in the half moon gear can be utilised as a safety mechanism. This infilling acts as a physical way of stopping over travel of the gear and thus over extension of the foot.
  • the rehabilitation apparatus of the present invention also may comprise at least one“soft stop”, for example one or more limit switches. These are preferably located proximate to or touching the half-moon gear. When the“soft stop” is inadvertently hit, the motor is programmed to stop and most preferably reverse back, thus moving the foot support away from the impinging article (e.g. a finger).
  • the“soft stop” is inadvertently hit, the motor is programmed to stop and most preferably reverse back, thus moving the foot support away from the impinging article (e.g. a finger).
  • the moveable foot plate is preferably adapted or configured to move (e.g. slide) parallel to the base of the foot support.
  • moveable foot plate is mounted on the foot support by way of at least one slot recessed into the at least one side wall.
  • the moveable plate could be considered to sit within the volume defined by the back wall of the foot support and the two side walls of the foot support.
  • the slots in the side walls hold the moveable foot plate above the base of the foot support and allow the moveable foot plate to move/slide parallel to the base of the foot support, towards and away from the back wall.
  • the moveable foot plate“hovers” or“floats” above the base of the foot support it does not contact the base of the foot support.
  • the slots/grooves may be tapered and preferably are U-shaped channels. This type of tapering advantageously aids in the sliding motion of the moveable foot plate.
  • the moveable foot plate is preferably a solid plate with side edges that are tapered so that they fit within the tapered slot of the side walls of the foot support.
  • the patient’s foot i.e. the sole of the foot
  • the moveable foot plate held in place by way of retention straps
  • the patient’s heal rests against the back wall of the moveable foot plate.
  • the back wall of the moveable foot plate could be considered a heal support, a limb cradle or an ankle rest.
  • the back wall may be ergonomically designed to support an ankle e.g. it may be curved.
  • the end of the foot support opposite to the foot support back wall is open so as to allow movement of the moveable plate away from the foot support back wall (and out of the volume defined by the foot support back wall and the two side walls of the foot support).
  • the rehabilitation device of the present invention is able to accommodate different foot sizes through means of the“floating” pivot point and moveable plate.
  • the leg support preferably has an upper surface that is either flat or comprises a curved recessed portion (i.e. concave - the leg support could be considered to have a trough).
  • the upper surface of the leg support is the surface that supports the leg (more specifically the calf of the leg) or leg with frame, when in use.
  • the rehabilitation device is particularly useful for the rehabilitation of patients who have suffered complex fractures. In this instance, it is preferable that no cushioning is used on top of the upper surface of the leg support.
  • the device When the upper surface of the leg support is flat, patients without a frame attached to their leg may use the device.
  • the device can also be used on patients that have suffered non-complex fractures (for example ones that previously required a cast).
  • cushioning it is preferable that cushioning is provided on top of the flat, upper surface of the leg support.
  • the moveable foot plate and/or the leg support may comprise at least one retention strap.
  • the retention strap may be a toe strap, a heel strap or a leg strap.
  • the moveable foot plate has one toe strap and one ankle strap.
  • the ankle strap acts to stop or reduce natural ankle lift thus enabling most efficient manipulation of the ankle.
  • the retention strap(s) are slideable.
  • the slideable retention strap(s) e.g. the toe and/or heel strap(s)
  • the leg support has two leg retention straps.
  • the strap(s) ensure that the leg or leg with fixture device/frame does not move freely when the device is running - the leg retention straps act to clamp the leg, or leg with frame, in place.
  • the retention strap(s) are attached to the leg support by way of slots in the side walls of the leg support. This allows the retention straps to reach over the patient’s leg, or leg with cage, and hold the leg (leg and cage) to the leg support.
  • the combination of a trough with retention strap(s) allows varying heights, widths, and orientations of cages to be used in conjunction with the device.
  • the retention straps are flexible, that is they allow a degree of movement so that patient doesn’t feel discomfort.
  • the retention straps may be cushioned.
  • the retention straps are covered with an outer coating, for example a plastic coating.
  • the plastic coating is preferably Dartex ® or any other medically approved coating material. This type of coating is easily cleaned, and helps in infection control within hospitals.
  • the moveable plate and/or leg support may also further comprise a support cushion constructed from plastic, foam or gel.
  • the support cushion may be made from a foam e.g. a silicone foam, for example HT800 flame retardant foam Silex.
  • the support cushion(s) may be attached to the moveable foot plate and/or leg support by way of Velcro or any other suitable medically approved temporary fixing material.
  • the support cushion is preferably covered by Dartex ® polyurethane or any medically approved covering material.
  • a support cushion is particularly preferred when the upper surface of the leg support is flat and the device is being used on patients with simple fractures (without a frame). Such a covered support cushion may also be used over the retention straps.
  • a further advantage of the present invention is the use of a motor configured to control the degree of pivotal motion of the foot support.
  • the motor may be configured as such by further comprising at least one gear. Further, preferably the motor is a programmable stepper motor.
  • the stepper motor is able to be programmed to automate the exercising of the patient’s ankle.
  • the stepper motor powers the gears (in for example the half-moon gear and pinion) which rotate the foot support about the pivot joints thus placing the foot in dorsiflexion and plantar flexion.
  • the motor can be programmed to vary the level of intensity and by limiting or expanding the range of movement or speed at which the foot support rotates.
  • the stepper motor may be programmed with PC code allowing, for example, identification of the extreme parameters (e.g.
  • extreme limit of dorsiflexion and extreme limit of plantar flexion the limit of the patient’s range of movement
  • rehabilitation programs which move within a percentage of the patient’s range of movement
  • programs at various speeds as well as warm-up routines and full speed and range of movement programs.
  • a physiotherapist By automating in such a manner, a physiotherapist is not required to manually manipulate the ankle joint and is free to undertake other tasks. Further, the stepped intensity allows the rehabilitation device to accommodate patients with varying levels of required rehabilitation. Different programs can be created to suit different patients and requirements. The use of programmed extreme limits of dorsiflexion and plantar flexion also advantageously provide safety to the patient - they can undertake their own physiotherapy in the knowledge that their ankle will not be overextended past that considered necessary or safe by the physiotherapist.
  • the motor preferably has a rotary encoder which measures the angular position of the foot plate.
  • the rotary encoder is attached to the back of the motor, however any other suitable locations are also envisaged.
  • the use of a rotary encoder advantageously allows accurate control and measurement of the rotation of the foot support.
  • the motor and rotary encoder are proximate to the half-moon gear so as to provide the most accurate positioning data.
  • the motor may be powered by any suitable source, for example by a mains source or battery source.
  • a transformer may be used in addition to these sources to supply the device with voltages up to 90V, for example mains to 12V, mains to 24V, mains to 48V or mains to 62V.
  • the rehabilitation apparatus may include a control panel which functions to control the operation of the motor and thus the movement of the foot support.
  • the control panel may be fixed to the device or may be detachable to allow remote operation.
  • the control panel is preferably located proximate to the back wall of the leg support (i.e. nearest the patient’s foot in use).
  • the control panel may be any suitable type of method of controlling the rehabilitation device.
  • the control panel may have a means of starting the motor and thus the motion of the pinion and half-moon gear (e.g. a start button).
  • the means for starting the motor e.g. the start button
  • the means for starting the motor is a delayed means - in other words it requires the user to deploy/hold the button for a minimum of, for example, 2 seconds.
  • the control panel may also have a means of immediately halting the movement of the motor and thus the foot support (e.g. an emergency stop button).
  • the control panel may also include a display to allow the operator to select training programs, a means to manually adjust the resistance to movement of the foot support or various status indicators to inform the operator of the device as to how it is functioning.
  • the control panel may be used to enable the selection of an exercise program, which controls the ankle’s rehabilitation by, for example, varying the angle between the foot support and the leg support, the speed of rotation of the foot support about the pivot point(s) or both.
  • the control panel may also have a plurality of mode buttons, with pre-programmed modes of operation (for example a warm up mode, an intermediate mode and a full running mode), a means for varying the speed and/or time of physiotherapy (e.g. a speed and time setting button) and a means of resetting any programs currently in progress (e.g. a reset button).
  • pre-programmed modes of operation for example a warm up mode, an intermediate mode and a full running mode
  • a means for varying the speed and/or time of physiotherapy e.g. a speed and time setting button
  • a means of resetting any programs currently in progress e.g. a reset button
  • the rehabilitation apparatus may also further comprise a means for the patient to halt the physiotherapy e.g. a hand held emergency stop for the patient, for when, for example, the physiotherapy gets too painful.
  • a means for the patient to halt the physiotherapy e.g. a hand held emergency stop for the patient, for when, for example, the physiotherapy gets too painful.
  • the foot support (base, back wall and side walls), leg support (base, back wall, front wall and side walls), moveable plate, support structure, attaching structure (and associated half-moon gear) and/or control panel (“these parts”) are made from any suitable method or material known in the art.
  • these parts can be any suitable metal or plastic.
  • Preferably these parts are solid but could, however, be hollow or honeycombed to reduce the weight of the rehabilitation device.
  • the metal parts may be cast.
  • the plastic parts may be injection moulded.
  • these parts are manufactured by additive layer manufacturing, for example by fused deposition modelling.
  • they are made from any suitable printable plastic, for example Acrylonitrile Styrene Acrylate (ASA).
  • ASA Acrylonitrile Styrene Acrylate
  • This provides parts with good wear and UV resistance.
  • these parts are manufactured by additive layer manufacturing and then are post-processed to reduce or eliminate microcavities/pores. This can be achieved by any suitable method known in the art, for example sintering.
  • the cogs of the half-moon gear may alternatively be formed from a metal such as titanium (by way of additive layer manufacturing, for example). This would advantageously provide good wear resistance for the cogs. These metal printed cogs may then be fused to the plastic attaching structure.
  • Figure 1 shows an example rehabilitation device as viewed from the top of the device.
  • Figure 2 shows an example rehabilitation device as viewed from the bottom of the device.
  • Figure 3 shows an example rehabilitation device when in use with a leg and foot.
  • Figure 4 shows an example rehabilitation device as viewed from the side of the device.
  • Figure 5 shows an example rehabilitation device as viewed from the back of the device.
  • Figure 6 shows an example rehabilitation device illustrating the half- moon pinion gear system.
  • Figure 7 shows an example rehabilitation device with an lllizarov or TSF frame.
  • a rehabilitation device/apparatus 10 comprising a foot support 12 and a leg support 14, and wherein the foot support 12 has a slideably adjustable moveable plate 12a.
  • the slideably adjustable moveable plate 12a has a limb cradle 15 (a heel support) at a first end, which may act as an ankle/heel rest.
  • the foot support 12 also has an attaching apex structure 12b, which is attached to a support apex structure 13 at the pivot joint 13a.
  • the foot support 12 is able to move pivotally around the pivot joint 13a in order to provide controlled movement to the ankle connecting the foot and leg (not shown).
  • a control panel 16 is also provided to allow movement routines to be selected or entered into the rehabilitation device 10 therein allowing for various treatment routines to be selected as required by individual patients.
  • the leg support 14 has a concave shape/surface (a trough) to provide a degree of additional comfort to the leg, allowing the leg support 14 to support the leg on contact.
  • the leg support 14 further comprises a leg support recess 18, allowing a leg restraint strap (not shown) to be fitted if desired.
  • the leg restraint strap may be a permanent attachment or may be reversibly fixed, as is the case in Fig 1 , wherein the leg support recess 18 extends to the top of the leg support 14 to allow a leg restraint strap to be slideably inserted into the leg support recess 18. While in use the leg restraint strap may be tightened to draw the leg close to the leg support 14 thereby reducing or preventing leg movement and in turn reducing or preventing unintended movement of the ankle.
  • a rehabilitation device/apparatus 20 comprising a foot support 22, shown from below, and pivotally attached, via pivot joint 23a, to an apex support structure 23.
  • the apex support structure 23 further comprises a swing stop 22b, which acts to prevent the foot support 22 from pivoting to a point where the control panel 26 is impacted. Further the swing stop 22b, acts to prevent the ankle (not shown) from being overstretched.
  • the swing stop position on the apex support structure 23 may be fixed as shown in Fig 2 or adjustable to fit a different range of joint motion.
  • the leg support 24 is shaped to include a concave portion (e.g. a trough) and is fitted with a leg support recess 28 for the inclusion of a leg restraint strap (not shown).
  • a rehabilitation device/apparatus 30 in use, comprising a foot support 32 which is attached to a support apex structure 33 of a leg support 34.
  • a first limb 37a in this example a foot, is sat on the slideably adjustable plate 32a, allowing the foot to naturally slide to suit its pivot point, the foot 37a being secured in place by a foot restraint strap 31 a.
  • the second limb 37b in this case a leg (the range of diameters of the leg being denoted by the black ring 40), rests on the leg support 34 and is secured in place with a leg restraint strap 31 b.
  • the foot 37a and leg 37b are placed on the rehabilitation device 30 and utilising the adjustable plate 32a the foot 37a is moved to locate the ankle joint’s 37 natural pivot point in relation to the pivot joint 33a.
  • the rehabilitation device 30 exercise program may then be entered via the control panel 36, following which the foot support 32 moves pivotally, in a controlled fashion, to exercise the ankle joint 37.
  • a rehabilitation device/apparatus 40 which has a foot support 42, with slideably adjustable moveable foot plate 42a, and a leg support 44.
  • the foot support 42 has a flat base 42d (with upper and lower surfaces) and, extending upwards at 90 degrees to the base 42d (the upper surface of the base), two side walls - a first side wall 42c(1 ) and a second side wall 42c(2).
  • a first attaching structure 42b(1 ) extends up from, and parallel to, the first side wall 42c(1 ) and a second attaching structure 42b(2) extends up from, and parallel to, the second side wall 42c(2).
  • the leg support 44 has a first supporting apex structure 43(1 ) and a second supporting apex structure 43(2).
  • the first attaching apex structure 42b(1 ) is attached to the first supporting apex structure 43(1 ) at a first pivot joint 43a(1 ) (a first bush and pin receptacle).
  • the second attaching apex structure 42b(2) is attached to the second supporting apex structure 43(2) at the second pivot joint 43a(2) (a second bush and pin receptacle). This allows the foot support 42 to move pivotally around the pivot joints 43a(1 ) and 43a(2) in order to provide controlled movement to the ankle (not shown).
  • the slideably adjustable moveable plate 42a has a heel support 45, which may act as an ankle/heel rest.
  • the leg support 44 has a trough 44a (e.g. a concave upper surface of the leg support) to support the leg (not shown) in use.
  • a trough 44a e.g. a concave upper surface of the leg support
  • a control panel 46 is also provided to control the movement of the rehabilitation device.
  • a rehabilitation device/apparatus 50 which has a foot support 52, with slideably adjustable moveable foot plate 52a, and a leg support 54 (with a cushioned flat upper surface 54b).
  • the foot support 52 has a flat base 52d (with lower surface shown) and extending upwards at 90 degrees to the base 52d, two opposing side walls - a first side wall 52c(1 ) and a second side wall 52c(2).
  • the moveable foot plate 52a is mounted on the foot support 52 by way of a first u-shaped slot 52e(1 ) in the first side wall 52c(1 ) and a second u-shaped slot 52e(2) in the second side wall 52c(2).
  • the leg support 54 has a first supporting apex structure 53(1 ) and a second supporting apex structure 53(2).
  • a first attaching apex structure (not visible) is attached to the first supporting apex structure 53(1 ) at a first pivot joint (not visible)
  • the second attaching apex structure 52b(2) is attached to the second supporting apex structure 53(2) at the second pivot joint 53a(2) (a bush and pin receptacle).
  • the second support structure 53(2) (the support structure nearest the motor) also has a guard piece 53b encapsulating a half-moon gear (not shown) of the second attaching structure 52b(2).
  • the second support structure 53(2) is attached to the side wall of the leg support 54 by two dove joints 53c.
  • a control panel 56 is also provided to control the movement of the rehabilitation device.
  • FIG. 6 there is shown a side view of a rehabilitation device/apparatus 60 which has a foot support 62, with slideably adjustable moveable foot plate (not visible), and a leg support 64 (with a trough 64a).
  • the figure shows a foot support 62 with flat base 62d and a side wall 62c(2) extending upwards at 90 degrees to the flat base 62d.
  • a first attaching apex structure (not visible) is attached to the first supporting apex structure 63(1 ) at a first pivot joint (not visible).
  • a second attaching apex structure 62b(2) is attached to the second supporting apex structure (not shown) at a second pivot joint 63a(2) (a bush and pin receptacle). Integral to the second attaching structure 62b(2) is a half-moon gear 62f.
  • a motor 69 powers the rotary movement of a pinion 69a, causing the cogs of the pinion 69a to engage with the cogs of the half-moon gear 62f.
  • a rehabilitation device/apparatus 70 which has a foot support 72, with a slideably adjustable moveable foot plate 72a and a leg support 74.
  • the foot support 72 has a flat base 72d and extending upwards at 90 degrees to the base 72d, two side walls - a first side wall 72c(1 ) and a second side wall 72c(2).
  • a first attaching structure 72b(1 ) extends up from, and parallel to, the first side wall 72c(1 ) and a second attaching structure 72b(2) extends up from, and parallel to, the second side wall 72c(2).
  • the leg support 74 has a first supporting apex structure 73(1 ) and a second supporting apex structure 73(2).
  • the first attaching apex structure 72b(1 ) is attached to the first supporting apex structure 73(1 ) at a first pivot joint 73a(1 ) (a first bush and pin receptacle).
  • the second attaching apex structure 72b(2) is attached to the second supporting apex structure 73(2) at the second pivot joint 73a(2) (a second bush and pin receptacle). This allows the foot support 72 to move pivotally around the pivot joints 73a(1 ) and 73a(2) in order to provide controlled movement to the ankle (not shown).
  • the slideably adjustable moveable plate 72a has a heel support 75, which may act as an ankle/heel rest.
  • leg support 74 has a trough 74a (e.g. a concave upper surface of the leg support) to support the TSF frame 80 in use.
  • a trough 74a e.g. a concave upper surface of the leg support
  • a control panel 76 is also provided to control the movement of the rehabilitation device.
  • the device is firstly fitted to the patient. This involves placing the lower leg in the leg support and the foot on the moveable plate.
  • the retention straps are used to firmly attach the foot to the moveable plate and the lower leg to the upper surface of the leg support.
  • the device/apparatus of the present invention can be fitted to a patient while they are standing, sitting or while they are in bed (e.g. sitting up in bed or lying in bed).
  • the device is then turned on and a mode selected using one of the mode buttons (warm up, intermediate or full running cycle). Which mode is selected depends on variables such as whether this is the patient’s first time on the device and how far through their physiotherapy session they are.
  • the time for the treatment is then selected (between for example 1 minute to 60 minutes).
  • the speed of the rotation of the foot support about the pivot point is then selected (e.g. the rotational speed, for example from about 0.5 degrees per second up to about 20 degrees per second).
  • the maximum dorsiflexion and plantar flexion is then set. These extreme limits of dorsiflexion and plantar flexion are individual to each patient and are dependent on multiple factors such as severity of injury, and how far through the physiotherapy program the patient is. Advantageously the setting of these maximum limits ensures that the patient’s ankle is not over rotated.
  • the start button is pushed for a minimum of, for example, 2 seconds to initiate the program. The treatment will then run between the maximum dorsiflexion and the maximum plantar flexion at the specified speed and for the specified time.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Rehabilitation Therapy (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Epidemiology (AREA)
  • Pain & Pain Management (AREA)
  • Physical Education & Sports Medicine (AREA)
  • General Health & Medical Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Chemical & Material Sciences (AREA)
  • Manufacturing & Machinery (AREA)
  • Engineering & Computer Science (AREA)
  • Materials Engineering (AREA)
  • Rehabilitation Tools (AREA)

Abstract

L'invention concerne un appareil de rééducation comprenant un support de pied (42) et un support de jambe (44); le support de pied (42) étant fixé de manière pivotante, au moyen d'au moins une articulation rotoïde (43a), au support de jambe (44); et l'appareil de rééducation comprenant en outre : une plaque mobile (42a) montée sur le support de pied; et un moteur conçu pour commander le degré de mouvement pivotant du support de pied (42) par rapport au support de jambe (44) au moyen de l'au moins une articulation rotoïde (43a).
PCT/GB2019/050016 2018-01-08 2019-01-03 Dispositif de rééducation de patient WO2019135081A1 (fr)

Applications Claiming Priority (2)

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GBGB1800267.5A GB201800267D0 (en) 2018-01-08 2018-01-08 Patient rehabilitation device
GB1800267.5 2018-01-08

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WO2019135081A1 true WO2019135081A1 (fr) 2019-07-11

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WO (1) WO2019135081A1 (fr)

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CN111529318A (zh) * 2020-06-11 2020-08-14 山东省肿瘤防治研究院（山东省肿瘤医院） 一种用于卧床患者下肢及脚踝活动的辅助治疗仪
CN112168551A (zh) * 2020-11-06 2021-01-05 宁波奥达智能家居有限公司 一种腿部康复装置及护理床
CN113018099A (zh) * 2021-03-04 2021-06-25 邵欠欠 一种基于腿部康复医疗设备对腿部进行康复的方法
CN115068899A (zh) * 2022-06-22 2022-09-20 齐齐哈尔大学 一种用于腿部肌肉拉伤用的定向力量训练设备

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CN108433912B (zh) * 2018-04-19 2023-11-21 中国科学院沈阳自动化研究所 一种可实现多运动模式的病床用踝关节康复系统
CN111904791B (zh) * 2020-08-12 2023-08-22 威海经济技术开发区天智创新技术研究院 下肢康复器械皮肤变形补偿结构

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DE8913308U1 (fr) * 1989-11-10 1990-03-22 Gerhard Hug Gmbh, 7801 Umkirch, De
US5738636A (en) * 1995-11-20 1998-04-14 Orthologic Corporation Continuous passive motion devices for joints

Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN111529318A (zh) * 2020-06-11 2020-08-14 山东省肿瘤防治研究院（山东省肿瘤医院） 一种用于卧床患者下肢及脚踝活动的辅助治疗仪
CN111529318B (zh) * 2020-06-11 2022-05-03 山东省肿瘤防治研究院（山东省肿瘤医院） 一种用于卧床患者下肢及脚踝活动的辅助治疗仪
CN112168551A (zh) * 2020-11-06 2021-01-05 宁波奥达智能家居有限公司 一种腿部康复装置及护理床
CN113018099A (zh) * 2021-03-04 2021-06-25 邵欠欠 一种基于腿部康复医疗设备对腿部进行康复的方法
CN115068899A (zh) * 2022-06-22 2022-09-20 齐齐哈尔大学 一种用于腿部肌肉拉伤用的定向力量训练设备
CN115068899B (zh) * 2022-06-22 2023-10-24 齐齐哈尔大学 一种用于腿部肌肉拉伤用的定向力量训练设备

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GB201800267D0 (en) 2018-02-21
GB2571433A (en) 2019-08-28

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