WO2024090649A1 - Dispositif de marche pour renforcer un côté affecté chez un patient ayant une hémiplégie - Google Patents

Dispositif de marche pour renforcer un côté affecté chez un patient ayant une hémiplégie Download PDF

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Publication number
WO2024090649A1
WO2024090649A1 PCT/KR2022/018173 KR2022018173W WO2024090649A1 WO 2024090649 A1 WO2024090649 A1 WO 2024090649A1 KR 2022018173 W KR2022018173 W KR 2022018173W WO 2024090649 A1 WO2024090649 A1 WO 2024090649A1
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WO
WIPO (PCT)
Prior art keywords
footrest
rod
affected side
user
external force
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Application number
PCT/KR2022/018173
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English (en)
Korean (ko)
Inventor
이정후
Original Assignee
(재)예수병원유지재단
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Publication of WO2024090649A1 publication Critical patent/WO2024090649A1/fr

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    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B21/00—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices
    • A63B21/00181—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices comprising additional means assisting the user to overcome part of the resisting force, i.e. assisted-active exercising
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B21/00—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B21/00—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices
    • A63B21/008—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices using hydraulic or pneumatic force-resisters
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B21/00—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices
    • A63B21/008—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices using hydraulic or pneumatic force-resisters
    • A63B21/0083—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices using hydraulic or pneumatic force-resisters of the piston-cylinder type
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B21/00—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices
    • A63B21/15—Arrangements for force transmissions
    • A63B21/151—Using flexible elements for reciprocating movements, e.g. ropes or chains
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B21/00—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices
    • A63B21/40—Interfaces with the user related to strength training; Details thereof
    • A63B21/4001—Arrangements for attaching the exercising apparatus to the user's body, e.g. belts, shoes or gloves specially adapted therefor
    • A63B21/4007—Arrangements for attaching the exercising apparatus to the user's body, e.g. belts, shoes or gloves specially adapted therefor to the chest region, e.g. to the back chest
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B21/00—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices
    • A63B21/40—Interfaces with the user related to strength training; Details thereof
    • A63B21/4001—Arrangements for attaching the exercising apparatus to the user's body, e.g. belts, shoes or gloves specially adapted therefor
    • A63B21/4011—Arrangements for attaching the exercising apparatus to the user's body, e.g. belts, shoes or gloves specially adapted therefor to the lower limbs
    • A63B21/4015—Arrangements for attaching the exercising apparatus to the user's body, e.g. belts, shoes or gloves specially adapted therefor to the lower limbs to the foot
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B22/00—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B22/00—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements
    • A63B22/0048—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements with cantilevered support elements pivoting about an axis
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B24/00—Electric or electronic controls for exercising apparatus of preceding groups; Controlling or monitoring of exercises, sportive games, training or athletic performances
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B24/00—Electric or electronic controls for exercising apparatus of preceding groups; Controlling or monitoring of exercises, sportive games, training or athletic performances
    • A63B24/0087—Electric or electronic controls for exercising apparatus of groups A63B21/00 - A63B23/00, e.g. controlling load
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B2220/00—Measuring of physical parameters relating to sporting activity
    • A63B2220/50—Force related parameters
    • A63B2220/56—Pressure

Definitions

  • This technology relates to a stepper device for patients with lower extremity hemiplegia that is used by adjusting different resistance values to suit the different muscle strength of the healthy side and the affected side, but allows the user to stably perform rehabilitation exercises in a standing state. .
  • rehabilitation exercise equipment that can be used by users with symptoms of hemiplegia of the lower extremities largely takes the form of a bicycle or a stepper.
  • a stepper-type rehabilitation exercise equipment allows users to walk in place in a limited indoor or outdoor space. It refers to exercise equipment to improve the strength of the lower extremities, and has the advantage of being able to exercise even in narrow places.
  • the pair of footstools Rehabilitation exercises are performed while being alternately raised and lowered by wires and cylinders.
  • the conventional stepper device is used based on the resistance value of the same applied wire without considering the difference in muscle strength between the healthy side and the affected side for users with lower extremity hemiplegia, and has the problem of not being able to move the center of gravity to the affected side well. and 3) Because the problem of difficulty in maintaining initial muscle strength on the affected side is overlooked, proper push down of the foot on the affected side cannot occur due to the weakened motor ability of the affected side, and even if a low resistance value is initially set, the weakened muscle strength on the affected side prevents the foot from being pushed down properly. As it does not reflect the weakening of endurance that occurs, fatigue increases and causes people to stop exercising.
  • the present invention measures different muscle strength values on the healthy side and the affected side using a pressure sensor and applies different resistance values to the stepper based on the measurement information to induce optimal weight transfer.
  • the purpose is to provide a stepper that can reduce fatigue and increase the effectiveness of rehabilitation exercise.
  • Another purpose is to provide a stepper that can stably perform rehabilitation while maintaining balance even in a standing state when performing rehabilitation exercise using a stepper.
  • the stepper device for strengthening the affected side of a hemiplegic patient includes a footrest fixing unit 100 whose lower part is supported on the ground, and both feet of a user with lower extremity hemiplegia are seated to generate the external force necessary for rotation.
  • a pair of footrest parts 200 installed on the footrest fixing part 100 so that they can rotate by the external force provided, and a load ( 320) expands and contracts, but the end of the body 310 is rotatably coupled to the footrest fixing part 100, and the end of the rod 320 is rotatably coupled to the footrest part 200.
  • a control unit 400 that measures and displays the strength of the external force applied through the footrest unit 200 and the strength of the rod 320 for expansion and contraction in the body 310, wherein the cylinder 300 Is either an electric cylinder further provided with an adjustment switch 330 for controlling the intensity of expansion and contraction of the rod 320 or an electric cylinder capable of adjusting the intensity of the rod 320 by an electrical signal controlled by the control unit 400 It is characterized by being.
  • the footrest fixing unit 100 further includes a fixture 110 and a detachable armrest member 120, wherein the lower portion of the armrest member 120 is inserted into the footrest fixing unit 100. It includes a vertical bar 121 inserted perpendicularly into the ball 111 and an arm support bar 123 installed in a ' ⁇ ' or 'U' shape on the upper part of the vertical bar 121, and the control unit 400 It is preferable to be installed in the form of a monitor on the insertion hole 111 or the arm support bar 123.
  • the armrest member 120 further includes a harness 125 made of an elastic material to support the user's buttocks or back, and both sides of the harness 125 are detachable from both ends of the arm support bar 123. It is desirable to have it provided.
  • the footrest unit 200 includes a lower stand 210 rotatably installed with the footrest fixing part 100, an upper stand 220 rotatably coupled to one side of the lower stand 210, and A plantar pressure sensor 230 is provided on the upper support 220 and measures the external force applied by the user, and the lower part is rotatably installed with the lower support 210, and the upper part is supported on the bottom of the upper support 220 or It includes a rotating piece 240 that is installed to be rotatably coupled, and the upper support 220 is a fixed band that can wrap and secure the instep of the user who is seated so as to pressurize the plantar pressure sensor 230. 223) is preferably further included.
  • the rotating piece 240 is installed to have an inclination angle between the lower support 210 and the upper support 220 and can be parallel to the lower support 210 by the pressing force of the upper support 220. After rotation, it is desirable to be able to return to its original state by the elastic force of the elastic body.
  • the power auxiliary means 250 for assisting the force of lifting the foot with respect to the footrest 200 on which the user's affected side rests
  • the power auxiliary means 250 includes the footrest 200 and It is preferable that the wire is in the form of a grippable wire that is connected to have a predetermined length.
  • the resistance value of the cylinder that is, the strength at which the rod can expand and contract, is determined according to the confirmed results.
  • the user can easily perform rehabilitation exercises while taking steps even in a standing state, which can be expected to improve safety.
  • Figure 1 is a perspective view showing a stepper device for strengthening the affected side of a hemiplegic patient according to the present invention.
  • Figure 2 is a side view of Figure 1.
  • Figure 3 is a view showing the cylinder of Figure 1.
  • Figure 4 is a diagram showing a cylinder with different resistance values adjusted on the sound side and the affected side of the stepper device for strengthening the affected side of a hemiplegic patient according to the present invention.
  • Figure 5 is a diagram illustrating the operational relationship of the footrest portion of the stepper device for strengthening the affected side of a hemiplegic patient according to the present invention.
  • Figure 6 is another embodiment of a stepper device for strengthening the affected side of a hemiplegic patient according to the present invention.
  • Figure 7 is a diagram showing a power assistance means for a stepper device for strengthening the affected side of a hemiplegic patient according to the present invention.
  • stepper device for strengthening the affected side of a hemiplegic patient according to the present invention (hereinafter, simply referred to as 'stepper device') will be described in detail.
  • control unit 400 described below has a display capable of displaying numerically the respective external force on the user's affected side and unaffected side, which is applied downward by the applied power in the form of a monitor, which will be described later.
  • This refers to a typical controller composed of a plurality of switches to control the ON/OFF operation of the control unit 400, and a detailed description thereof will be omitted.
  • control unit 400 in the present invention can be configured with models of different sizes depending on the installed part, such as the fixture 110 or the armrest member 120.
  • the stepper device 1 largely includes a footrest fixing part 100, a footrest part 200, a cylinder 300, and a control part 400.
  • the control unit 400 as well as the footrest unit 200 and cylinder 300, which will be described later, are rotatably installed so that they can be mounted on the floor or ground indoors or outdoors. It is fixedly installed so as to be movable, so that a user with hemiplegia can easily perform rehabilitation exercises, and includes a fixture 110 and an armrest member 120.
  • the fixture 110 is provided with a detachable sliding pad at the bottom so that it stably sits on the ground, but on the outer surface, a pair of footrest parts 200 and a cylinder 300 are rotatable. Ensure that it can be installed symmetrically.
  • a pillar protrusion is formed on the outer surface of the fixture 110 and protrudes upward, and an insertion hole 111 is formed on the upper surface of the pillar protrusion so that the control unit 400 can be detachably mounted.
  • control unit 400 mounted on the insertion hole 111 is electrically connected to the plantar pressure sensor 230 and calculates numerical values for the different external forces on the affected side and the sound side detected through the plantar pressure sensor 230. , it is desirable to be able to display it.
  • control unit 400 may be used with the cylinder 300 consisting of a servo cylinder in addition to the plantar pressure sensor 230 when the cylinder 300, which will be described later, is used as a servo cylinder that does not require the control switch 330. It can be electrically connected, and through this, the rod of the servo cylinder can be controlled electrically to adjust the strength of the extension and contraction of the rod 320.
  • the above mechanical The cylinder 300 equipped with the control switch 330 capable of adjusting the strength of the rod 320 will be described as an example.
  • the armrest member 120 is configured to provide convenience for rehabilitation exercise in consideration of the user's physical characteristics and safety, and includes a vertical bar 121, an arm support bar 123, and a harness 125. ), and if necessary, the armrest member 120 can be omitted and used.
  • the vertical bar 121 has a length in the vertical direction so that the lower part can be inserted into the insertion hole 111, and the upper part is formed to be detachable or integrated with the arm support bar 123.
  • the arm support bar 123 is overall formed into a ' ⁇ ' or 'U' shape and is placed on the upper part of the vertical bar 121, and a control unit 400 is provided on the upper part of the arm support bar 123.
  • both ends of the arm support bar 123 may be further provided with anti-slip pads so that the user can easily grip and perform rehabilitation exercises.
  • the harness 125 can be molded to have a predetermined length and area using an elastic material, and is preferably molded into a mesh shape to provide a breathable function.
  • the harness 125 can be formed with a wider central area so that the user's buttocks or back (waist area) can be stably supported, and if necessary, rehabilitation exercise can be performed in the form of sitting astride through the relatively large central area. Make it executable.
  • both sides of the harness 125 are detachably fastened to both ends of the arm support bar 123.
  • the armrest member 120 in the present invention is further provided with a cushion pad 127 formed of a cushion material on the inner surface of the arm support bar 123 as needed to further improve the user's safety during rehabilitation exercise. It is also possible to use the above-described armrest member 120, if necessary, separated from the insertion hole 111. In this case, the insertion hole 111 may be provided with a control unit 400. You can.
  • the footrest unit 200 measures different external forces applied downward to the sound side and the affected side while the user's both feet are seated, and sends the measurement information to the control unit 400.
  • the device is designed to enable rehabilitation of walking motion while simultaneously transmitting the device and includes a lower support 210, an upper support 220, a plantar pressure sensor 230, and a rotating piece 240.
  • a pair of lower supports 210 is arranged symmetrically on both sides of the fixture 110 so that both feet on the healthy side and the affected side can be used, and one side of each is rotatably coupled to the fixture 110.
  • the lower part is rotatably coupled to the rod 320 of the cylinder 300.
  • the upper stand 220 is arranged to be located above each lower stand 210, and as shown, one side is rotatably coupled to the upper part of the lower stand 210 so that the user can stand on it using both feet. It satisfies the structure that can be achieved.
  • the outer surface of the upper support 220 is provided with a detachable fixing band 223 that can be fixed to the upper support 220 by pressing the instep of the user being interviewed, so that when the user performs rehabilitation exercise in a walking exercise method, the lower part is provided. Of course, this prevents unwanted separation from the upper support 220 during the process of lifting the foot upward.
  • control unit 400 is provided with a plantar pressure sensor ( 230) may be provided.
  • the plantar pressure sensors 230 may be used in a form in which a plurality of plantar pressure sensors 230 are evenly distributed over the area of the upper support 220, and a plurality of muscle strength values transmitted to the control unit 400 through the plurality of plantar pressure sensors 230 It is also possible for the control unit 400 to calculate and display the average value.
  • a user who performs rehabilitation exercise through a pair of footrest units 200 experiences a difference in muscle strength between the healthy side and the affected side, and the control unit 400 bases the strength value transmitted from the footrest unit 200 on the user.
  • the control unit 400 bases the strength value transmitted from the footrest unit 200 on the user.
  • the rotation piece 240 is configured to compensate for stiffness or contracture of the ankle portion on the affected side through rotation when an external force is applied downward to the footrest portion 200.
  • the lower part of the rotary piece 240 is rotatably coupled to the upper part of the lower support 210, and the upper part is installed so that it can be supported and rotated on the lower surface of the upper support 220.
  • the rotating piece 240 is installed to have an inclination angle so that it can be easily rotated against the external force applied downward to the upper support 220 and placed parallel to the lower support 210, and the upper support 220 It is desirable to install it so that it can be returned to its original position by the elastic force of an elastic body such as a coil spring or torsion spring so that it can be returned to its original position after the external force is relieved.
  • an elastic body such as a coil spring or torsion spring
  • a power auxiliary means 250 may be further provided to assist the lifting force with respect to the footrest 200 used for rehabilitation exercise of the affected side
  • the power auxiliary means is an example. It may be in the form of a wire that is individually connected to a pair of footrest parts 200 so that the user can hold it and then lift the footrest part 200 belonging to the affected side by force (see FIG. 7).
  • the cylinder 300 applies resistance to the external force in the process of applying downward external force to the footrest unit 200 described above by the user to enable rehabilitation exercise. It includes a body 310, a rod 320, and an adjustment switch 330.
  • one side of the body 310 is rotatably coupled to the fixture 110, and a column-shaped rod 320 is inserted into the other opened side so that it can expand and contract, thereby causing piston movement by hydraulic pressure. Satisfies the normal cylinder structure as much as possible.
  • the end of the rod 320 is rotatably coupled to the lower surface of the lower support 210, so that resistance is generated through the rod 320, which contracts when an external force is generated downward, to enable rehabilitation exercises to improve muscle strength, etc. It is desirable to do so.
  • control switch 330 is configured to gradually apply the strength of the resistance value to the expanding and contracting rod 320 through a rotatable switch and a printed unit on the outer surface of the body 310. It is used by adjusting the resistance value of the rod 320.
  • the control unit 400 adjusts the resistance of the cylinder 300 according to the muscle strength value.
  • a method of displaying the value so that the user can recognize it can be used.
  • the pressure on the rod 320 of the cylinder 300 can be adjusted through electrical control of the control unit 400.
  • An electric cylinder with a deceleration function can be used, and through the use of such an electric cylinder, the pressure of the rod 320 is manually adjusted in real time according to the pressure value (pressing force) of the footrest 200 on the affected side. This can enable rapid adjustment.
  • control unit 400 be remotely operated by the user or a guardian assisting the user for smooth control of the electric cylinder.
  • the stepper device 1 is different from the conventional one in that it confirms different muscle force values for the healthy side and the affected side through the plantar pressure sensor 230 and the control unit 400, and the confirmed results Accordingly, the resistance value of the cylinder 300, that is, the strength at which the rod 320 can expand and contract, is adjusted in stages to provide different optimal weight transfers, thereby maximizing the effect of rehabilitation exercise.
  • the user can easily perform rehabilitation exercises while taking steps even in a standing state, which can be expected to improve safety.

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  • Health & Medical Sciences (AREA)
  • General Health & Medical Sciences (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biophysics (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Cardiology (AREA)
  • Vascular Medicine (AREA)
  • Pulmonology (AREA)
  • Rehabilitation Tools (AREA)

Abstract

La présente technologie concerne un dispositif de marche pour un patient souffrant d'hémiplégie des membres inférieurs qui peut être utilisé en ajustant différentes valeurs de résistance pour s'adapter à la force musculaire différente du côté non affecté et du côté affecté d'un utilisateur, et qui permet à l'utilisateur d'effectuer de manière stable un exercice de rééducation en position debout. En particulier, le dispositif de marche comprend : une unité de fixation de repose-pieds dont une partie inférieure est soutenue par le sol ; une paire d'unités repose-pieds installées sur l'unité de fixation de repose-pieds de sorte que les deux pieds d'un utilisateur souffrant d'hémiplégie des membres inférieurs peuvent être placés dessus, ce qui permet de fournir une force externe nécessaire pour la rotation de sorte que les pieds placés peuvent tourner au moyen de la force externe fournie ; un cylindre dans lequel une tige se dilate et se rétracte à l'intérieur et à l'extérieur de son corps par réception de la force externe provenant de l'unité de repose-pieds, une extrémité du corps étant couplée de manière rotative à l'unité de fixation de repose-pieds, et une extrémité de la tige étant couplée de manière rotative à l'unité de repose-pieds ; et une unité de commande qui mesure et affiche l'intensité de la force externe appliquée au moyen de l'unité de repose-pied et l'intensité de la tige pour l'expansion et la rétraction dans le corps, le cylindre étant soit équipé d'un commutateur de réglage pour régler l'intensité d'expansion et de rétraction de la tige, soit un cylindre électrique capable d'ajuster l'intensité de la tige au moyen d'un signal électrique commandé par l'unité de commande.
PCT/KR2022/018173 2022-10-24 2022-11-17 Dispositif de marche pour renforcer un côté affecté chez un patient ayant une hémiplégie WO2024090649A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
KR1020220137617A KR20240057183A (ko) 2022-10-24 2022-10-24 편마비 환자의 환측 강화를 위한 스탭퍼장치
KR10-2022-0137617 2022-10-24

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KR20110079039A (ko) * 2009-12-31 2011-07-07 (주)써프림 머천트 허리 운동이 가능한 스텝퍼
KR20110136981A (ko) * 2010-06-16 2011-12-22 박영식 다목적 운동기구
KR200472204Y1 (ko) * 2012-09-01 2014-04-14 (주)웰텍 유압식운동기구의 자동부하조절장치
KR20210107423A (ko) * 2020-02-24 2021-09-01 서강대학교산학협력단 중족지관절 보조장치
KR102395512B1 (ko) * 2020-07-16 2022-05-09 제이엔티(주) 자체 안전제동 전동기 구동 노약자 보행보조장치

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