WO2023186955A1 - Orthèse pour allonger un membre inférieur - Google Patents

Orthèse pour allonger un membre inférieur Download PDF

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Publication number
WO2023186955A1
WO2023186955A1 PCT/EP2023/058088 EP2023058088W WO2023186955A1 WO 2023186955 A1 WO2023186955 A1 WO 2023186955A1 EP 2023058088 W EP2023058088 W EP 2023058088W WO 2023186955 A1 WO2023186955 A1 WO 2023186955A1
Authority
WO
WIPO (PCT)
Prior art keywords
foot
limb
lower leg
detection device
orthosis
Prior art date
Application number
PCT/EP2023/058088
Other languages
German (de)
English (en)
Inventor
Konstantin Warneke
Original Assignee
LOHMANN, Lars
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 LOHMANN, Lars filed Critical LOHMANN, Lars
Publication of WO2023186955A1 publication Critical patent/WO2023186955A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
    • A61F5/01—Orthopaedic devices, e.g. splints, casts or braces
    • A61F5/0102—Orthopaedic devices, e.g. splints, casts or braces specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations
    • A61F5/0104—Orthopaedic devices, e.g. splints, casts or braces specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations without articulation
    • A61F5/0111—Orthopaedic devices, e.g. splints, casts or braces specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations without articulation for the feet or ankles
    • A61F5/0113—Drop-foot appliances

Definitions

  • the invention relates to an orthosis for stretching a lower limb of a human being, in which a foot of the limb is pulled at a certain angle to a lower leg of the limb, muscles, ligaments and tendons involved in a movement of the foot relative to the lower leg are stretched and the for the stretching of the muscles, ligaments and tendons involved is maintained for a certain period of time, comprising at least one foot contact molding that can be assigned to a foot of the limb, and a lower leg contact molding that can be assigned to a lower leg of the limb, the foot contact molding and the lower leg
  • the molded part is connected to one another in a hinged manner via a joint, at least fixing means assigned to the foot molded part for the limb to be stretched, and at least one tensioning device which engages the foot molded part and the lower leg molded part at opposite ends to the joint.
  • Orthoses for treating individual of these symptoms are known from the prior art.
  • the DE 20 2019 000 742 U1 shows such an orthosis with which a lower limb of a human can be subjected to static stretching.
  • the parts of the orthosis should therefore be fixed at a certain angle to one another using a clamping arrangement.
  • creeping effects, relaxation effects or relaxation effects that occur over time mean that less counterforce is applied by the muscles and the tension within the limb decreases after a short time.
  • such an orthosis is proposed which is a manually operated one Has an adjusting device so that medical personnel can adjust the orthosis and the tension in the limb can be maintained over a longer period of time.
  • the object of the invention is therefore to further develop the existing orthoses so that they can be used in a more varied way, can also be handled by patients without help and are more effective.
  • the tension force recorded at a specific point in time corresponds to the tension force recorded immediately before adjustment, so that the orthosis is always adjusted based on the current tension force and counterforce.
  • the existing tension force is directly dependent on the counterforce applied, with a maximum expansion tension being achieved over the entire period in which the orthosis is applied.
  • the clamping force is automatically adjusted until the predetermined value for the clamping force is reached.
  • a patient or medical staff only has to place the orthosis once on the lower extremity to be treated and no longer has to adjust it in order to counteract the creeping effects that occur.
  • the automatic adjustment means that, on the one hand, greater user safety is achieved and, on the other hand, a reduction in the amount of care required for the patient and an optimized effect is achieved.
  • the foot is held in a dorsiflexed position during stretching, i.e. with the back of the foot in towards the lower leg is tightened. This then primarily stretches the muscles, ligaments and tendons of the calf of the limb, especially the calf muscles.
  • This data can then be used, for example, to create stress-strain curves, which can be used to track the course of therapy and evaluate the success of the therapy. This data can also be used to combine the application of the procedure with other therapeutic measures.
  • a recorded angle value is then determined according to the position of the foot in relation to the remaining limb and assigned to the respective tension force.
  • the position of the foot can also be recorded via the muscle length of the limb to be stretched or a tensioning device for stretching.
  • the method can also be supplemented by remote access, which makes the stored data accessible to a doctor or medical staff regardless of the patient's location.
  • the tensioning device has a force detection device and a tensioning drive, the tensioning drive being connected to the force detection device in such a way that the tensioning drive can be actuated as a function of the force detection device.
  • the clamping device can thus be adjusted depending on a current clamping force, which is measured by the force detection device at the time at which the clamping force is to be readjusted.
  • a lower limb of a patient wearing the orthosis is therefore exposed to maximum stretching tension for the entire duration that the patient is wearing the orthosis, which results in a particularly effective therapy.
  • a particularly favorable arrangement of the force detection device and the tensioning drive is achieved by arranging the force detection device, the tensioning drive or the force detection device and the tensioning drive on or between webbing sections of the tensioning device.
  • the tensioning drive can be a winding device or another mechanism with the same effect, with which the length of the webbing sections or the webbing section can be changed or its length can be changed.
  • at least two webbing sections are provided, one of which engages on the inside and the other on the outside on the foot contact molding and the lower leg contact molding, so that a uniform force distribution is ensured.
  • a continuous webbing section can also attach to the foot support molding on both the inside and outside and only on the lower leg support molding be deflected, in conjunction with the webbing section deflected on the lower leg abutment molding, a pulling mechanism can then be arranged on the calf side on the lower leg molding, with which the webbing section is pulled from a proximal region of the lower leg in the directions of its distal end.
  • a corresponding webbing section can be divided into several strands, which then lead towards the foot rest molding or away from the foot rest molding.
  • the force detection device can be a weighing cell which is arranged between two webbing sections.
  • the clamping force applied to the clamping device is thus mechanically recorded in a particularly simple manner by determining how far the weighing cell is pulled apart.
  • the force detection device and the tension drive are connected to one another in a communicating manner via an electrical control unit. The readjustment of the tensioning device can therefore also be carried out automatically, with the necessary values then being stored in the control unit, based on which the tensioning drive is set depending on the value determined with the force detection unit.
  • the values required for automated operation can be manually adapted to the patient and/or the course of therapy.
  • the values can be easily adjusted if the control unit is combined with a remote access device. Data relating to the course of therapy can then also be retrieved via the remote access device.
  • At least one angle detection device is assigned to the joint, with which an angle of attack of the two molded parts relative to one another is determined and which is connected to the control unit in an electrically communicating manner.
  • electro-myo-stimulation elements are assigned to the lower leg application molding.
  • the electro-myo-stimulation elements are electrodes that send out electrical impulses and can therefore act as directly as possible on the muscles to be stretched.
  • the electrical impulses emitted by the electro-myo-stimulation elements lead to additional stimulation of the muscles, ligaments and tendons to be treated, which further improves the course of therapy.
  • the electro-myo-stimulation elements are also easily triggered via the electrical control unit.
  • the electro-myo-stimulation elements are advantageously incorporated into a stocking or a cuff, which is brought into contact with the lower leg application molding on the inside, also ensures that the electro-myo-stimulation elements are always on the limb, in particular the skin of the limb , issue.
  • an insert in particular a proprioceptive insert, is assigned to the foot rest molding. The angle of attack of the foot of the limb can then be increased via the insert.
  • the remote control can advantageously be carried out via an app, in which all other settings can then be made.
  • the orthosis can also have an emergency stop function. This is either integrated into the app or can be operated completely independently of other electronic components of the orthosis.
  • control unit For communication with a remote control, the app or remote access, the control unit can contain suitable communication electronics, such as WLAN, radio, Bluetooth and so on.
  • the tensioning drive adjusts the tensioning device to maintain the tension.
  • a high tension can be maintained over a longer period of time with the orthosis with the tensioning device.
  • a high mechanical load is placed on the muscle loaded with the orthosis. If there is a loss of muscle strength, the tensioning device is adjusted using the tensioning drive.
  • the clamping device has locking positions in which it can be fixed. These locking positions make it possible for the tensioning device to be fixed in a state in which it maintains the tension on the muscle. It is then advantageous not to constantly apply force to the clamping device through the clamping drive. These positions can be continuously lured at any point. The drive is thereby relieved and is only needed to pull further towards dorsiflexion.
  • Figure 1 a schematic side view of a first
  • Figure 2 and Figure 3 perspective views of a second
  • FIG. 1 shows a side view of an orthosis according to the invention applied to a lower limb 1.
  • This orthosis is composed of a lower leg abutment molding part 2 resting on a calf T of a patient and a foot abutment molding part 3 resting plantarly on a foot 1" of the patient, the lower leg abutment molding part 2 and the foot abutment molding part 3 being connected to one another via a joint 4.
  • This joint 4 forms a vertex in which a distal end of the lower leg support molding 2 and a heel end of the foot support molding 3 are brought together and pivotable towards one another.
  • An angle detection device 5 is formed on the joint 4, via which an angle of attack of the two molded parts, that is to say the lower leg abutment molded part 2 and the foot abutment molded part 3, is measured.
  • a tensioning device 6 is assigned to the lower leg contact molding part 2 and the foot contact molding part 3, which engages with webbing sections 7, 7" on the lower leg contact molding part 2 and the foot contact molding part 3.
  • a tensioning drive 8 for automatically re-tensioning the tensioning device 6 and a force detection device 9 are integrated into the tensioning device 6 between the webbing sections 7, 7 ', 7.
  • Both those Force detection device 9 as well as the clamping drive 8 and the angle detection device 5 are connected to one another in a communicating manner via an electronic control unit 10, so that the clamping drive 8 can be readjusted based on the values determined with the force detection device 9 and the angle detection device 5.
  • electro-myo-stimulation elements 11 can be seen from the figure, which are assigned to the lower leg application molding part 2.
  • the foot rest molding 3 is further assigned fixing means 12, with which the foot rest molding 2 can be strapped after it has been placed on the foot 1".
  • a proprioceptive insert 13 is also integrated into the foot rest molding 3.
  • the fixing means 12 has a high resilience that keeps the foot in position. High forces can therefore be applied during stretching.
  • the material is soft and supple so that it does not limit wearing comfort.
  • FIG 2 shows an alternative embodiment which has a clamping device 6a which is modified compared to Figure 1.
  • This tensioning device 6a is attached to the lower leg contact molding part 2 on the calf side.
  • the tensioning device 6a is designed as a pulling mechanism, with a single webbing section 7a engaging on the foot rest molding part 3 on the inside and outside.
  • the webbing section 7a is held with its two ends on a webbing guide element 16 of the tensioning device 6a, with the webbing section 7a extending from its two ends on the inside to the foot rest molding part 3 and on the outside to the foot rest molding part 3, and deflected on the foot rest molding part 3 and is guided back to the webbing guide element 16.
  • the strands of the webbing section 7a which are directed back to the webbing guide element 16, meet at a spindle attachment 15 and are held on a spindle 14 of the tensioning device 6a via the spindle attachment 15, with the soindle attachment 15 running along via a spindle drive 17 the spindle 14 is movable, that is to say can be moved between a distal and proximal end of the clamping device 6a or the spindle 14.
  • Figure 3 shows that the webbing section 7a is extended beyond the proximal end of the tensioning device 6a and is equipped with a handle 18.
  • the orthosis can be pretensioned with this handle 18. With this orthosis, too, a fixation means 12 secures the foot.
  • the webbing in this exemplary embodiment forms a pulley mechanism, through which the force that the tensioning drive 8a has to apply is halved.

Abstract

La présente invention concerne une orthèse pour allonger un membre inférieur (1) d'un être humain, dans laquelle un pied (1") du membre (1) est tiré selon un angle spécifique par rapport à une partie inférieure de la jambe (T) du membre (1), des muscles, des ligaments et des tendons impliqués dans un mouvement du pied (1") par rapport à la partie inférieure de la jambe (T) sont étirés, et la force de serrage provoquant l'étirement des muscles, ligaments et tendons impliqués est maintenue pendant une période de temps spécifique, l'orthèse présentant au moins une partie moulée de positionnement de pied (3), qui peut être attribuée à un pied (1") du membre (1), et une partie moulée de positionnement de partie inférieure de la jambe (2), qui peut être attribuée à une partie inférieure de la jambe (T) du membre (1), la partie moulée de positionnement de pied (3) et la partie moulée de positionnement de partie inférieure de la jambe (2) étant reliées de manière pliable l'une à l'autre par l'intermédiaire d'une articulation (4), et également des moyens de fixation (12) attribués au moins à la partie de positionnement de pied (3) pour le membre (1) à allonger, et au moins un dispositif de serrage (6), qui agit sur la partie moulée de positionnement de pied (3) et la partie moulée de positionnement de partie inférieure de la jambe (2) dans chaque cas à une extrémité opposée à l'articulation (4). L'orthèse selon l'invention est caractérisée en ce que le dispositif de serrage (6, 6a) présente un dispositif de détection de force (9) et un entraînement de serrage (8, 8a), l'entraînement de serrage (8, 8a) étant relié au dispositif de détection de force (9) de façon que l'entraînement de serrage (8, 8a) puisse être actionné en fonction du dispositif de détection de force (9).
PCT/EP2023/058088 2022-03-30 2023-03-29 Orthèse pour allonger un membre inférieur WO2023186955A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102022107519.2A DE102022107519A1 (de) 2022-03-30 2022-03-30 Verfahren und Orthese zum Dehnen einer unteren Gliedmaße
DE102022107519.2 2022-03-30

Publications (1)

Publication Number Publication Date
WO2023186955A1 true WO2023186955A1 (fr) 2023-10-05

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PCT/EP2023/058088 WO2023186955A1 (fr) 2022-03-30 2023-03-29 Orthèse pour allonger un membre inférieur

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WO (1) WO2023186955A1 (fr)

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20110172578A1 (en) * 2010-01-08 2011-07-14 China Medical University Plantar fasciitis rehabilitation controlling device
US20170135841A1 (en) 2015-11-13 2017-05-18 Bonutti Research, Inc. Orthosis for range of motion
US9707118B1 (en) * 2010-02-05 2017-07-18 Grant C. Meyer Rooster boot ankle foot orthosis
DE202019000742U1 (de) 2019-02-15 2019-03-21 Lars Hubertus Lohmann Orthese zur statischen Dehnung der Wadenmuskulatur
US20190159728A1 (en) * 2017-11-15 2019-05-30 The Florida State University Research Foundation, Inc. Diagnostic and therapeutic splints
CN110575303A (zh) * 2019-09-30 2019-12-17 郝峻巍 一种基于运动疗法的下肢痉挛模式综合康复装置

Family Cites Families (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
AT522226B1 (de) 2019-03-05 2020-12-15 Sepin Orthopaedietechnik Sanitaetshaus Ges M B H Fremdkraftbetriebene Bewegungseinheit
DE102019118402A1 (de) 2019-07-08 2021-01-14 Markus Bresser Gezielte Elektromyostimulation

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20110172578A1 (en) * 2010-01-08 2011-07-14 China Medical University Plantar fasciitis rehabilitation controlling device
US9707118B1 (en) * 2010-02-05 2017-07-18 Grant C. Meyer Rooster boot ankle foot orthosis
US20170135841A1 (en) 2015-11-13 2017-05-18 Bonutti Research, Inc. Orthosis for range of motion
US20190159728A1 (en) * 2017-11-15 2019-05-30 The Florida State University Research Foundation, Inc. Diagnostic and therapeutic splints
DE202019000742U1 (de) 2019-02-15 2019-03-21 Lars Hubertus Lohmann Orthese zur statischen Dehnung der Wadenmuskulatur
CN110575303A (zh) * 2019-09-30 2019-12-17 郝峻巍 一种基于运动疗法的下肢痉挛模式综合康复装置

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DE102022107519A1 (de) 2023-10-05

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