WO2021098914A1 - Vorrichtung zur durchführung einer individuellen bewegungsanalyse und -therapie eines patienten - Google Patents
Vorrichtung zur durchführung einer individuellen bewegungsanalyse und -therapie eines patienten Download PDFInfo
- Publication number
- WO2021098914A1 WO2021098914A1 PCT/DE2020/100971 DE2020100971W WO2021098914A1 WO 2021098914 A1 WO2021098914 A1 WO 2021098914A1 DE 2020100971 W DE2020100971 W DE 2020100971W WO 2021098914 A1 WO2021098914 A1 WO 2021098914A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- patient
- movement
- module
- force
- trajectory
- Prior art date
Links
- 238000002560 therapeutic procedure Methods 0.000 title claims abstract description 40
- 210000003414 extremity Anatomy 0.000 claims description 36
- 210000003127 knee Anatomy 0.000 claims description 15
- 210000000629 knee joint Anatomy 0.000 claims description 14
- 210000002414 leg Anatomy 0.000 claims description 13
- 230000007246 mechanism Effects 0.000 claims description 13
- 229940079593 drug Drugs 0.000 claims description 10
- 239000003814 drug Substances 0.000 claims description 10
- 230000000007 visual effect Effects 0.000 claims description 7
- 210000003205 muscle Anatomy 0.000 claims description 6
- 230000002441 reversible effect Effects 0.000 claims description 6
- 238000006243 chemical reaction Methods 0.000 claims description 5
- 238000002567 electromyography Methods 0.000 claims description 5
- 230000009471 action Effects 0.000 claims description 3
- 210000001503 joint Anatomy 0.000 claims description 2
- 210000002435 tendon Anatomy 0.000 claims description 2
- 238000000034 method Methods 0.000 description 11
- 238000011084 recovery Methods 0.000 description 9
- 238000009207 exercise therapy Methods 0.000 description 8
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 7
- 210000004394 hip joint Anatomy 0.000 description 7
- 230000036541 health Effects 0.000 description 6
- 230000008569 process Effects 0.000 description 6
- 238000012360 testing method Methods 0.000 description 6
- 230000000638 stimulation Effects 0.000 description 5
- 230000008859 change Effects 0.000 description 4
- VYFYYTLLBUKUHU-UHFFFAOYSA-N dopamine Chemical compound NCCC1=CC=C(O)C(O)=C1 VYFYYTLLBUKUHU-UHFFFAOYSA-N 0.000 description 4
- QZAYGJVTTNCVMB-UHFFFAOYSA-N serotonin Chemical compound C1=C(O)C=C2C(CCN)=CNC2=C1 QZAYGJVTTNCVMB-UHFFFAOYSA-N 0.000 description 4
- 208000006011 Stroke Diseases 0.000 description 3
- 230000000926 neurological effect Effects 0.000 description 3
- 230000002265 prevention Effects 0.000 description 3
- 238000011002 quantification Methods 0.000 description 3
- 230000006978 adaptation Effects 0.000 description 2
- 230000008901 benefit Effects 0.000 description 2
- 229960003638 dopamine Drugs 0.000 description 2
- 230000000694 effects Effects 0.000 description 2
- 230000006870 function Effects 0.000 description 2
- 239000002858 neurotransmitter agent Substances 0.000 description 2
- 230000000144 pharmacologic effect Effects 0.000 description 2
- 229940076279 serotonin Drugs 0.000 description 2
- SFLSHLFXELFNJZ-QMMMGPOBSA-N (-)-norepinephrine Chemical compound NC[C@H](O)C1=CC=C(O)C(O)=C1 SFLSHLFXELFNJZ-QMMMGPOBSA-N 0.000 description 1
- 208000034657 Convalescence Diseases 0.000 description 1
- 208000012902 Nervous system disease Diseases 0.000 description 1
- 206010033892 Paraplegia Diseases 0.000 description 1
- 206010039897 Sedation Diseases 0.000 description 1
- 208000003443 Unconsciousness Diseases 0.000 description 1
- 239000004480 active ingredient Substances 0.000 description 1
- 238000013459 approach Methods 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 210000004556 brain Anatomy 0.000 description 1
- 238000002651 drug therapy Methods 0.000 description 1
- 230000005021 gait Effects 0.000 description 1
- 238000003384 imaging method Methods 0.000 description 1
- 208000014674 injury Diseases 0.000 description 1
- 230000003993 interaction Effects 0.000 description 1
- 210000003141 lower extremity Anatomy 0.000 description 1
- 229960002748 norepinephrine Drugs 0.000 description 1
- SFLSHLFXELFNJZ-UHFFFAOYSA-N norepinephrine Natural products NCC(O)C1=CC=C(O)C(O)=C1 SFLSHLFXELFNJZ-UHFFFAOYSA-N 0.000 description 1
- 230000000474 nursing effect Effects 0.000 description 1
- 108090000623 proteins and genes Proteins 0.000 description 1
- 238000009420 retrofitting Methods 0.000 description 1
- 230000036280 sedation Effects 0.000 description 1
- 229940125723 sedative agent Drugs 0.000 description 1
- 239000000932 sedative agent Substances 0.000 description 1
- 210000000697 sensory organ Anatomy 0.000 description 1
- 238000010972 statistical evaluation Methods 0.000 description 1
- 230000001225 therapeutic effect Effects 0.000 description 1
- 230000008733 trauma Effects 0.000 description 1
- 210000000689 upper leg Anatomy 0.000 description 1
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
- A61H1/0237—Stretching or bending or torsioning apparatus for exercising for the lower limbs
- A61H1/0255—Both knee and hip of a patient, e.g. in supine or sitting position, the feet being moved together in a plane substantially parallel to the body-symmetrical plane
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
- A61B5/11—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb
- A61B5/1121—Determining geometric values, e.g. centre of rotation or angular range of movement
- A61B5/1122—Determining geometric values, e.g. centre of rotation or angular range of movement of movement trajectories
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/48—Other medical applications
- A61B5/4836—Diagnosis combined with treatment in closed-loop systems or methods
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6801—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be attached to or worn on the body surface
- A61B5/6802—Sensor mounted on worn items
- A61B5/6812—Orthopaedic devices
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2505/00—Evaluating, monitoring or diagnosing in the context of a particular type of medical care
- A61B2505/09—Rehabilitation or training
-
- 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
- A61H2201/10—Characteristics of apparatus not provided for in the preceding codes with further special therapeutic means, e.g. electrotherapy, magneto therapy or radiation therapy, chromo therapy, infrared or ultraviolet therapy
- A61H2201/105—Characteristics of apparatus not provided for in the preceding codes with further special therapeutic means, e.g. electrotherapy, magneto therapy or radiation therapy, chromo therapy, infrared or ultraviolet therapy with means for delivering media, e.g. drugs or cosmetics
-
- 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
- A61H2201/50—Control means thereof
- A61H2201/5058—Sensors or detectors
- A61H2201/5061—Force sensors
-
- 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
- A61H2201/50—Control means thereof
- A61H2201/5058—Sensors or detectors
- A61H2201/5069—Angle sensors
-
- 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
- A61H2230/00—Measuring physical parameters of the user
- A61H2230/60—Muscle strain, i.e. measured on the user, e.g. Electromyography [EMG]
- A61H2230/605—Muscle strain, i.e. measured on the user, e.g. Electromyography [EMG] used as a control parameter for the apparatus
Definitions
- the present invention relates to a device for carrying out an individual movement analysis and therapy of a patient with the features of the preamble of claim 1.
- Bedridden patients especially those with neurological impairments after, for example, a stroke, cranial cranial trauma and / or paraplegia, have been shown to benefit from early exercise therapy to improve their motor but also their neurological abilities.
- the success of such exercise therapy depends to a large extent on the individual circumstances of each individual patient and is very difficult to assess or evaluate, especially in patients in the early stages of their recovery process.
- two stroke patients with comparable physical limitations and comparable clinical findings e.g. in MRI imaging, can recover completely differently with a comparable intervention (e.g. 3 weeks of rehabilitation therapy for 1 hour each 5 days a week).
- Patients who do not recover are classically called “non-responders”, whereas patients who “jump” to therapy are called “responders”.
- the present invention is based on the object of providing a device for performing an individual movement analysis and therapy of a patient, which is improved compared to the prior art and which enables patients in particular in the early stages of their recovery process to see the chances of success of possible therapy interventions test, develop an individualized therapy strategy and follow the recovery process even during exercise therapy.
- the device according to the invention is distinguished from devices of the prior art in that the control and analysis unit is set up to control the first intervention means in such a way that a first trajectory of the movement of the extremity of the patient is caused by a force exerted by the movement module on the extremity of the patient Patient is disturbed; a reaction to this disturbance is measured via changed measured values of the at least one force sensor and / or the at least one angle sensor and a new, second trajectory is calculated therefrom; and from a comparison of the second trajectory with the first trajectory and / or a target trajectory or the comparison of the disturbed with the undisturbed measured values of the at least one force sensor and / or the at least one angle sensor, new control parameters for (further) control of the first intervention means are calculated become.
- Such a device advantageously makes it possible to carry out an individual gait analysis in a patient in the early phase of rehabilitation, in particular in a bedridden patient Patients, and to automatically take their results into account in a further (more advanced) exercise therapy carried out with the aid of the first intervention means, in particular with the aid of the rehabilitation mechanism.
- the success of the therapy can advantageously also be determined automatically, with even slight reactions of the patient, which cannot be visually ascertained by a therapist, to the disturbances exerted on him by the first intervention means being detected.
- the disruption occurs via the first intervention means, in particular the rehabilitation mechanism, preferably in the form of “clamp trials”, i.e. in the form of a restriction of the range of motion, an impediment to movement and / or a prevention of movement.
- the analysis is carried out by measuring the force applied by the patient and / or determining the deviation of various trajectories.
- the measured values of each individual patient can advantageously be stored and used for one's own individual therapy or the determination of one's own therapy success as well as for the generation of a database of “typical” therapy processes.
- a database of “typical” therapy processes On the basis of a statistical evaluation of this data, it is advantageous to make more and more precise prognoses about different therapy courses and this already at a point in time at which a therapist / doctor cannot (yet) visually recognize any change in the condition of the respective patient.
- the rehabilitation mechanism has at least one knee module that can be brought into operative connection with the knee joints of the patient as a movement module; wherein the knee module comprises at least one force sensor for measuring an amount of a force between the knee module and a knee joint of the patient and / or at least one angle sensor for measuring the direction of the force between the knee module and the knee joint of the patient; and / or a foot module for receiving the patient's feet; wherein the foot module comprises at least one force sensor for measuring an amount of a force between the foot module and each foot of the patient.
- a rehabilitation mechanism with at least one knee module and / or foot module as a movement module is particularly suitable for carrying out an individual movement analysis and therapy of the leg movement of a patient, with the comparatively large muscle groups of the legs being involved.
- the device comprises at least one second intervention means for interacting with the patient, the second intervention means being set up to exchange (control) data with the control and analysis unit. If at least one second intervention means is provided, the influence of different therapy components or therapy strategies and concepts - for example by adding one or more additional stimuli - can be tested and / or changed in a controlled manner on the patient, which advantageously automates the individual patient "Best", most effective therapy implementation can be determined.
- the second intervention means is set up to interact with the patient's body, in particular with the patient's leg, knee joint and / or foot.
- a second intervention means set up in this way enables before geous a direct mechanical interaction with or influence on the patient.
- the second intervention means can be arranged either directly on the first intervention means, in particular on the rehabilitation mechanism, or on the device at a distance from the first intervention means.
- the second intervention means can preferably be a means for generating a vibration and / or a means for performing electromyostimulation.
- a second intervention means configured in this way advantageously enables mechanical or electrical or other type of external muscle stimulation.
- the second intervention means can also be a means for visual stimulus generation and / or a means for acoustic stimulus generation.
- this advantageously enables visual and / or acoustic stimulation of the patient, but on the other hand also offers the possibility of giving the patient a kind of visual / acoustic feedback on his performance.
- the second intervention means is a means for the scheduled administration of a medication.
- a means for the scheduled administration of a medication advantageously enables the controlled change pharmacological intervention in the patient.
- the provision of a second intervention means designed in this way makes it possible to test which medication (or which omission of a medication) can advantageously influence the rehabilitation process, i.e. whether, for example, another sedation medication or a certain neurotransmitter such as serotonin, radrenaline or individual to increase the effectiveness of exercise therapy Dopamine should be chosen.
- control and analysis unit comprises a means for performing electromyography. If the control and analysis unit comprises a means for performing an electromyography, even small changes in the electrical muscle activity of a patient can advantageously be measured, which in particular in unconscious patients allows a test of the state of health shortly after a stroke has occurred.
- the device comprises a device for the reversible connection of the device, in particular the first intervention means, to a bed, in particular to a hospital bed that can be verticalized.
- a device for the reversible connection of the device, in particular the first intervention means, with a bed, in particular with a vertically adjustable hospital bed advantageously enables the mobile Ausgestal device of the device according to the invention or the retrofitting of ordinary beds, in particular hospital beds, with a device according to the invention and reduced to this Way, the acquisition costs for hospitals and / or nursing homes are advantageous.
- a possible device for reversible connection is disclosed, for example, in DE 102018 129 370.4 of the applicant.
- Fig. 1 shows an embodiment of a device according to the invention in a 39an view
- 2 shows a further embodiment of a device according to the invention with a device for reversibly connecting the device to a bed
- 3 shows a further embodiment of the device according to the invention while an individual movement analysis and therapy is being carried out with trajectories drawn in by way of example;
- FIG. 4a shows a further embodiment of the device according to the invention while an individual movement analysis and therapy is being carried out with step heights and flexion angles of a hip joint drawn in by way of example;
- FIG. 4b shows an exemplary plot of the step heights measured by the device from FIG. 4a before and after the disturbance has occurred for a first case in which the step height is greater before the disturbance than after the disturbance;
- FIG. 4c shows an exemplary plot of the step heights measured by the device from FIG. 4a before and after the disturbance has occurred for a second case in which the step height before the disturbance is smaller than after the disturbance;
- FIG. 5a shows a further embodiment of the device according to the invention while an individual movement analysis and therapy is being carried out, the disruption being the prevention of movement of the extremity by the device;
- FIG. 5b shows an exemplary plot of the force exerted by the patient on the device from FIG. 5a and measured by it in the case of an undisturbed movement of the extremity and in the event of a disturbed, in particular completely prevented movement of the extremity;
- FIGS. 5a and 5b shows an exemplary plot of a flexion angle as a function of time, which corresponds to the implementation of an individual movement analysis and therapy shown as an example in FIGS. 5a and 5b.
- the same reference symbols designate the same or comparable components.
- Fig. 1 shows an embodiment of an inventive device 1 in a 39an view.
- the device 1 according to the invention comprises at least one first intervention means 3 in the form of a rehabilitation mechanism 30, suitably designed for a planned, automated rehabilitation movement of the extremities 94, at least the joints, muscles and tendons of the legs 92, of a patient 90, with at least one in operative connection Movement module 5 that can be brought with the extremities 94 of the patient 90.
- the movement module 5 comprises at least one force sensor 41; 51 for measuring an amount of a force F (t) between the movement module 5 and an extremity 94 of the patient 90 (see also FIGS.
- the device 1 also comprises at least one control and analysis unit 6 for controlling the first intervention means 3 and analyzing one of the actual values of the at least one force sensor 41; 51 and / or the at least one angle sensor 52 calculated trajectory Ti; T; ... the movement of limb 94 of patient 90.
- the control and analysis unit 6 of the device 1 is designed to control the first intervention means 3 in such a way that a first trajectory Ti of the movement of the extremity 94 of the patient 90 is caused by a force exerted by the movement module 5 on the extremity 94 of the patient 90 is disturbed; a reaction to this disturbance P via changed measured values of the at least one force sensor 41; 51 and / or of the at least one angle sensor 52 is measured and a new, second trajectory T is calculated therefrom; and from a comparison of the second trajectory T with the first trajectory Ti and / or a target trajectory T so u or the comparison of the disturbed with the undisturbed measured values of the at least one force sensor 41; 51 and / or the at least one angle sensor 52, new control parameters for (further) control of the first intervention means 3 are calculated.
- the force sensor or sensors 41; 51 can in particular be arranged on an arm of the movement module 5, as shown in FIG. 1, and / or in an area near the feet 91 of the patient 90, in particular on a foot module 40 of the rehabilitation mechanism 30 (see also FIGS . 3).
- the device 1 can preferably also include at least one second intervention means 7 for interacting with the patient 90, the second intervention means 7 preferably being set up to exchange (control) data with the control and analysis unit 6 .
- the second intervention means 7 can in particular be set up to interact with the body of the patient 90, in particular with his leg 92, knee joint 93 and / or foot 91, and thereby, for example, a further mechanical disturbance P of the movement of the extremity 94 through an application of force on the limb 94 of the patient 90.
- the second intervention means 7 can in particular be a means 71 for generating a vibration (cf. FIG. 3) and / or a means 72 for performing an electromyostimulation.
- the control and analysis unit 6 can then also preferably comprise a means 61 for performing electromyography, which advantageously serves to control and evaluate electrical or other type of external muscle stimulations.
- the second intervention means 7 can also alternatively or cumulatively, as shown, be a means 73 for visual stimulus generation and / or a means 74 for acoustic stimulus generation.
- the second intervention means 7 can act on other senses - sight and / or hearing - of the patient 90 as a disorder P before geous.
- the action via various sensory organs can lead to better (brain) stimulation, which in turn can advantageously support the rehabilitation process.
- the device 1 can then advantageously measure and evaluate the influence of such, in particular acoustic and / or visual, disturbances P on the patient 90, as described above.
- the second intervention means 7 can alternatively or cumulatively also be a means 75 for the scheduled administration of a medication.
- the disorder P consists in a targeted administration and / or in the targeted omission of a medication, that is to say a pharmacological intervention.
- Such a second intervention means 7 advantageously allows for example to test which drugs are beneficial or disadvantageous for the recovery process, which doses of active ingredient are effective and whether, for. B. a change in sedatives or the administration of a certain neurotransmitter such as serotonin, norepinephrine or dopamine can influence the recovery process (preferably positively).
- the device 1 according to the invention can advantageously deviate in the behavior of the patient, in particular deviations Measure deviations in its movement sequence that are so small that a therapist would not (yet) notice them during conventional movement therapy, which advantageously increases the accuracy of the results obtained.
- FIG. 2 shows a further embodiment of a device 1 according to the invention, which comprises a device 11 for reversibly connecting the device 1, in particular the first intervention means 3, to a bed 80.
- the bed 80 can preferably be a verticalisable hospital bed.
- the device 1 can be designed mobile with the help of such a device 11 for reversible connection and connected to a bed 80 to carry out an individual movement analysis and therapy and removed again after the analysis or therapy has ended .
- a possible device 11 is disclosed, for example, in DE 102018 129 370.4 of the applicant, to which reference is made in full here with regard to the functioning of the device 11.
- the device 1 can also have a rehabilitation mechanism 30 as a movement module 5, which comprises at least one knee module 50 which can be brought into active connection with the knee joints 93 of the patient 90; where the knee module 50 preferably has at least one force sensor 51 for measuring an amount of a force F (t) between the knee module 50 and a knee joint 93 of the patient 90 and / or at least one angle sensor 52 for measuring the direction of the force F (t) between the knee module 50 and the knee joint 93 of the patient 90.
- a rehabilitation mechanism 30 as a movement module 5, which comprises at least one knee module 50 which can be brought into active connection with the knee joints 93 of the patient 90; where the knee module 50 preferably has at least one force sensor 51 for measuring an amount of a force F (t) between the knee module 50 and a knee joint 93 of the patient 90 and / or at least one angle sensor 52 for measuring the direction of the force F (t) between the knee module 50 and the knee joint 93 of the patient 90.
- the rehabilitation mechanism 30 can also comprise a foot module 40 for receiving the feet 91 of the patient 90; wherein the foot module 40 preferably comprises at least one force sensor 41 for measuring an amount of a force between the foot module 40 and each foot 91 of the patient 90.
- FIG. 3 now shows a further embodiment of the device 1 according to the invention while an individual movement analysis and therapy is being carried out with trajectories T so u, Ti, T2 drawn in by way of example.
- extremities 94 of the patient 90 shown here using the example of a leg 92, can be brought into operative connection with the movement module 5.
- FIG. 3 shows, for example, an operative connection on the thigh in the area of the knee joint 93, but the leg 92 can also and / or on the lower leg, as shown in FIGS. 1, 4a and 5a be brought into operative connection with the first intervention means 3 elsewhere.
- a force sensor 51 is shown on a boom of the movement module 5 and a force sensor 41 in the area of a réellemo module 40 - and / or the at least one angle sensor 52 can then measure an amount of a force F (t) between Movement module 5 and the extremity 94 or, by measuring the direction of the force F (t) during a movement of the extremity 94, a trajectory Ti; T2; ... are determined by means of the control and analysis unit 6 and stored for further use.
- the device 1 advantageously enables, for example, the creation of a database of undisturbed, “normal” trajectories Ti; T2; ... of healthy people, whereby the first intervention means 3, in particular the rehabilitation mechanism 30, does not exert any disturbance P on the movement of the test subject during such a recording, but only accompanies the movement.
- an actual trajectory Ti; T2; ... the movement of the extremities 94 is measured and compared with the database entries described above, that is to say with the target trajectories T so u of healthy people, in order to assess the current state of health.
- a disturbance P acting on the patient 90 and any resulting thereof induced deviation from a comparison trajectory can be measured.
- the comparison trajectory can be either a target trajectory T so u stored in the database for a healthy person or a trajectory Ti measured earlier ; T2 ; ... act the patient 90 himself and thus log the recovery progress of the respective patient 90 advantageously individually.
- the device 1 according to the invention also enables un-disturbed and disturbed measured values from the at least one force sensor 41 to be quantified; 51 and / or of the at least one angle sensor 52 to make statements about the adaptability of the patient 90 to a disorder P and thereby to be able to assess his state of health and / or the success of the rehabilitation.
- Two of these quantification methods are shown below as examples: FIG. 4a shows an embodiment of the device 1 according to the invention during the implementation of an individual movement analysis and therapy with an exemplary step height H up ; H p and diffraction angles cp uP; f ,, of a hip joint 95 can be seen.
- a disturbance P acting on the patient 90 can be generated during several successive movement cycles ("steps") controlled and / or accompanied by the device 1, be it through a force exerted by the first intervention means 3 or some other disturbance P by a second intervention means 7.
- a step height H up ; H p and / or a diffraction angle cp uP ; ep p of a hip joint 95 can be selected, the disturbance P, in particular a force acting on the extremities 94 of the patient 90, effects on the measured step height H up ; H p or the diffraction angles cp uP; ep p of a hip joint 95 may have.
- the patient 90 recovers from the respective Disturbance P, which in turn can be reflected in a change in the above-mentioned measured values.
- FIG. 4b shows an exemplary plot of the step heights H up measured by the device 1 from FIG. 4a; H p before and after the disturbance P for a first case in which the step height H up before the disturbance P is greater than the step height H p after the disturbance P.
- FIG. 4c shows an exemplary plot of the step heights H up measured by the device 1 from FIG. 4a; H p before and after the disruption P for a second case in which the step height H up before the disruption P is smaller than the step height H p after the disruption.
- H (n) denotes the step height of the respective step with the number n.
- step height H p after the onset of the disturbance P differs significantly from the undisturbed step height H up .
- FIGS. 5 a to c A second possible quantification method which enables the device 1 according to the invention is outlined in FIGS. 5 a to c.
- FIG. 5 a shows an embodiment of the device 1 according to the invention while an individual movement analysis and therapy is being carried out, the disorder P being the prevention of movement of the extremity 94 by the device 1.
- a patient 90 can be effectively connected to the device 1 according to the invention, in particular to the first intervention means 3, preferably via the movement module 5.
- the force F (t) between the movement module 5 and an extremity 94 of the patient 90 can be measured during the passage of a movement cycle, that is to say a “step”, in an undisturbed state.
- the extremity 94 in particular the leg 92, as shown here, is held firmly by the first intervention means 3, preferably the movement module 5, that is to say is almost completely prevented from moving.
- the force F (t) can now be measured which the patient 90 generates in order to fight against the hindrance caused by the first intervention means 3 and still move.
- FIG. 5b shows an exemplary plot of the force F (t) exerted by the patient 90 on the device 1 from FIG. 5a and measured by it with an undisturbed movement of the extremity 94 and with a disturbed, in particular completely prevented movement of the extremity 94;
- a wegungsanalysis 5c is an exemplary application and Fig. to that shown in Fig. perform an individual Be exemplified 5a and 5b and therapy corresponding, diffraction angle cp ® as a function of time t.
- F up (t) and cp up (t) each describe the undisturbed state and F p (t) and cp p (t) the disturbed state in which the first intervention means 3 almost completely prevents the movement.
- the force F p (t) with which the patient 90 works against the disorder P in turn depends on the current, individual state of health and can be based on the measured values of the undisturbed step F up (t) and / or with database values from healthy people or other patients be compared.
- the present invention relates to a device 1 for performing an individual movement analysis and therapy of a patient, which is characterized in that a control and analysis unit 6 is set up to control the first intervention means 3 in such a way that a first trajectory Ti of the movement of a Limb 94 of the patient 90 is disturbed by the action of a force of a movement module 5 on the limb 94 of the patient 90; a reaction to this disturbance P via changed measured values of at least one force sensor 41; 51 and / or at least one angle sensor 52 is measured and a new, second trajectory T is calculated therefrom; and from a comparison of the second trajectory T with the first trajectory Ti and / or a target trajectory T so u or the comparison of the disturbed with the undisturbed measured values, new control parameters for (further) control of the first intervention means 3 are calculated.
- the device 1 according to the invention advantageously makes it possible in particular for patients in the early stages of their recovery process to test the chances of success of possible therapy interventions, to develop an individualized therapy strategy and to follow the recovery process even during exercise therapy.
- the type of therapy intervention or therapy component to which the respective patient 90 is most likely to act as a “responder” can be inferred, in particular by specifically adding or leaving out various therapy components. , i.e. with a positive rehabilitation process, will react.
- first intervention means rehabilitation mechanism for the reversible connection of the device (1), in particular the first intervention means (3), with a bed (80), in particular with a vertically adjustable hospital bed, first intervention means rehabilitation mechanism
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Physics & Mathematics (AREA)
- General Health & Medical Sciences (AREA)
- Veterinary Medicine (AREA)
- Public Health (AREA)
- Animal Behavior & Ethology (AREA)
- Pathology (AREA)
- Heart & Thoracic Surgery (AREA)
- Surgery (AREA)
- Molecular Biology (AREA)
- Biophysics (AREA)
- Medical Informatics (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Physiology (AREA)
- Geometry (AREA)
- Dentistry (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Epidemiology (AREA)
- Pain & Pain Management (AREA)
- Physical Education & Sports Medicine (AREA)
- Rehabilitation Therapy (AREA)
- Rehabilitation Tools (AREA)
- Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)
Abstract
Description
Claims
Priority Applications (7)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
CN202080080581.8A CN114727779A (zh) | 2019-11-22 | 2020-11-13 | 用于对患者进行个体运动分析和治疗的设备 |
CA3159016A CA3159016A1 (en) | 2019-11-22 | 2020-11-13 | Device for performing individual movement analysis and therapy on a patient |
JP2022521310A JP2023504986A (ja) | 2019-11-22 | 2020-11-13 | 患者に対して個々の運動分析及び運動治療を実施するためのデバイス |
EP20829793.7A EP4061217A1 (de) | 2019-11-22 | 2020-11-13 | Vorrichtung zur durchführung einer individuellen bewegungsanalyse und -therapie eines patienten |
AU2020389287A AU2020389287A1 (en) | 2019-11-22 | 2020-11-13 | Device for performing individual movement analysis and therapy on a patient |
US17/778,108 US20220347037A1 (en) | 2019-11-22 | 2020-11-13 | Device for performing individual movement analysis and therapy on a patient |
KR1020227015176A KR20220104692A (ko) | 2019-11-22 | 2020-11-13 | 환자에 대한 개별 운동 분석 및 요법을 수행하는 장치 |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE102019131703.7A DE102019131703B4 (de) | 2019-11-22 | 2019-11-22 | Vorrichtung zur durchführung einer individuellen bewegungsanalyse und -therapie eines patienten |
DE102019131703.7 | 2019-11-22 |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2021098914A1 true WO2021098914A1 (de) | 2021-05-27 |
Family
ID=74095634
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/DE2020/100971 WO2021098914A1 (de) | 2019-11-22 | 2020-11-13 | Vorrichtung zur durchführung einer individuellen bewegungsanalyse und -therapie eines patienten |
Country Status (9)
Country | Link |
---|---|
US (1) | US20220347037A1 (de) |
EP (1) | EP4061217A1 (de) |
JP (1) | JP2023504986A (de) |
KR (1) | KR20220104692A (de) |
CN (1) | CN114727779A (de) |
AU (1) | AU2020389287A1 (de) |
CA (1) | CA3159016A1 (de) |
DE (1) | DE102019131703B4 (de) |
WO (1) | WO2021098914A1 (de) |
Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JP3582689B2 (ja) * | 1997-09-10 | 2004-10-27 | 株式会社安川電機 | 肢体駆動装置 |
DE102017114290A1 (de) | 2017-06-27 | 2018-12-27 | ReActive Robotics GmbH | Messverfahren und Vorrichtung zur Bestimmung der Längenverhältnisse, der Position und/oder des Bewegungsradius der unteren Extremitäten eines bettpflichtigen Patienten |
CN110179622A (zh) * | 2019-04-25 | 2019-08-30 | 杭州电子科技大学 | 基于虚拟现实的多功能下肢康复集成系统 |
DE102018129370A1 (de) | 2018-11-21 | 2020-05-28 | ReActive Robotics GmbH | Vorrichtung und Verfahren zur reversiblen Verbindung eines Rehabilitationsmechanismus mit einem Bett, sowie Verfahren zum Betreiben eines mit einem Bett verbundenen Rehabilitationsmechanismus |
-
2019
- 2019-11-22 DE DE102019131703.7A patent/DE102019131703B4/de active Active
-
2020
- 2020-11-13 US US17/778,108 patent/US20220347037A1/en active Pending
- 2020-11-13 KR KR1020227015176A patent/KR20220104692A/ko unknown
- 2020-11-13 AU AU2020389287A patent/AU2020389287A1/en active Pending
- 2020-11-13 EP EP20829793.7A patent/EP4061217A1/de active Pending
- 2020-11-13 JP JP2022521310A patent/JP2023504986A/ja active Pending
- 2020-11-13 CA CA3159016A patent/CA3159016A1/en active Pending
- 2020-11-13 CN CN202080080581.8A patent/CN114727779A/zh active Pending
- 2020-11-13 WO PCT/DE2020/100971 patent/WO2021098914A1/de unknown
Patent Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JP3582689B2 (ja) * | 1997-09-10 | 2004-10-27 | 株式会社安川電機 | 肢体駆動装置 |
DE102017114290A1 (de) | 2017-06-27 | 2018-12-27 | ReActive Robotics GmbH | Messverfahren und Vorrichtung zur Bestimmung der Längenverhältnisse, der Position und/oder des Bewegungsradius der unteren Extremitäten eines bettpflichtigen Patienten |
DE102018129370A1 (de) | 2018-11-21 | 2020-05-28 | ReActive Robotics GmbH | Vorrichtung und Verfahren zur reversiblen Verbindung eines Rehabilitationsmechanismus mit einem Bett, sowie Verfahren zum Betreiben eines mit einem Bett verbundenen Rehabilitationsmechanismus |
CN110179622A (zh) * | 2019-04-25 | 2019-08-30 | 杭州电子科技大学 | 基于虚拟现实的多功能下肢康复集成系统 |
Non-Patent Citations (1)
Title |
---|
PEI Y ET AL: "Trajectory planning of a robot for lower limb rehabilitation", ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY,EMBC, 2011 ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE, IEEE, 30 August 2011 (2011-08-30), pages 1259 - 1263, XP032318895, ISBN: 978-1-4244-4121-1, DOI: 10.1109/IEMBS.2011.6090296 * |
Also Published As
Publication number | Publication date |
---|---|
CN114727779A (zh) | 2022-07-08 |
DE102019131703A1 (de) | 2021-05-27 |
CA3159016A1 (en) | 2021-05-27 |
AU2020389287A1 (en) | 2022-06-16 |
JP2023504986A (ja) | 2023-02-08 |
EP4061217A1 (de) | 2022-09-28 |
KR20220104692A (ko) | 2022-07-26 |
US20220347037A1 (en) | 2022-11-03 |
DE102019131703B4 (de) | 2022-09-08 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
DE3882840T2 (de) | Vorrichtung zur analyse eines bewegungsablaufs. | |
EP0232507B1 (de) | Vorrichtung für die Untersuchung der Muskelkontraktion | |
EP0959956B1 (de) | Patientenüberwachungssystem | |
EP3644852B1 (de) | Messverfahren und vorrichtung zur bestimmung der längenverhältnisse, der position und/oder des bewegungsradius der unteren extremitäten eines bettpflichtigen patienten | |
DE20221525U1 (de) | Vorrichtung zur Untersuchung von Störungen der Blasenfunktion | |
WO2011113428A2 (de) | Verfahren zur bestimmung der aktivität des parasympathikus und/oder des sympathikus des autonomen nervensstems eines lebewesens | |
DE102012214786A1 (de) | Vorrichtung zur Bestimmung der regionalen Verteilung eines Maßes für die Lungenperfusion | |
WO2009000487A1 (de) | Vorrichtung und verfahren für ein training und/oder eine analyse des bewegungsapparats eines benutzers | |
DE102015100795A1 (de) | Einrichtung zum Vermessen eines Gelenks | |
EP1279416A2 (de) | Analysesystem zur Trainingskontrolle in der Rehabilitation | |
DE202007008887U1 (de) | Vorrichtung für ein Training und/oder eine Analyse des Bewegungsapparats eines Benutzers | |
Treede | Das somatosensorische system | |
DE102015119741B4 (de) | Vorrichtung zur individuell rückgekoppelten Regulation von Muskel- und/oder Sehnen-Oszillationen eines menschlichen und/oder tierischen Nutzers | |
DE102019131703B4 (de) | Vorrichtung zur durchführung einer individuellen bewegungsanalyse und -therapie eines patienten | |
DE102019129376B4 (de) | Vorrichtung und Verfahren zur Ansteuerung von Geräten, die externe Belastungen auf den Körper von Menschen und Tieren erzeugen | |
EP4017344A1 (de) | Vorrichtung zur einwirkung auf das körpergewebe, verfahren zur messung und auswertung eines körpergewebezustandes | |
DE19817586C1 (de) | Verwendung eines Systems zur Überwachung eines Patienten | |
AT513652B1 (de) | Vorrichtung und Verfahren zur Herstellung, Dosierung und Verpackung von Arzneimitteln | |
EP0972489A2 (de) | Verfahren zur Ermittlung des im Rahmen des Parkinson-Syndroms bzw. der Parkinson-Krankheit relevanten klinischen Zustands eines Patienten, sowie System hierfür | |
DE102008032021A1 (de) | Verfahren zum quantitativen Analysieren der Wirkung eines Effektors auf die mit Muskelkontraktion assoziierte Motilität der Haut | |
DE3642237A1 (de) | Vorrichtung fuer die untersuchung der muskelkontraktion | |
DE102009034002A1 (de) | Fingerkraft-Messvorrichtung | |
Bury et al. | A novel device to measure power grip forces in squirrel monkeys | |
Reimers et al. | Bewegungstherapie bei neurologischen Erkrankungen | |
EP1842486A1 (de) | Therapieeinrichtung und Betriebsverfahren |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
121 | Ep: the epo has been informed by wipo that ep was designated in this application |
Ref document number: 20829793 Country of ref document: EP Kind code of ref document: A1 |
|
WD | Withdrawal of designations after international publication |
Designated state(s): DE |
|
ENP | Entry into the national phase |
Ref document number: 2022521310 Country of ref document: JP Kind code of ref document: A |
|
ENP | Entry into the national phase |
Ref document number: 3159016 Country of ref document: CA |
|
ENP | Entry into the national phase |
Ref document number: 2020389287 Country of ref document: AU Date of ref document: 20201113 Kind code of ref document: A |
|
ENP | Entry into the national phase |
Ref document number: 2020829793 Country of ref document: EP Effective date: 20220622 |