Stationary automated device for lower limb rehabilitation

Abstract

Two vertical front posts and two vertical rear posts are mounted on a flat platform of the automated device. The front posts mounted in the horizontal guide are symmetrically moved by the spacing adjustment mechanism within the range between the position of the joined front posts to a dimension between their inner surfaces equal to the width of the wheelchair, and the moved apart position to a dimension where the width dimension of the wheelchair is located between the mechanical legs suspended on the front posts. On the inner surfaces of the front posts, there are vertical guides with a screw drive mechanism for pelvic height adjustment. The mechanical legs girdle the patient's lower limbs from the outside by pelvic control units that induce a symmetrically alternating movement of the hip joint hinges in both mechanical legs with ellipsoid trajectories, and by adjustable thigh and shin connectors and foot connectors.

Claims

1. A stationary automated device for lower limb rehabilitation, comprising a tripod with two vertical guides “1” (2.2.1) of the mechanical legs (2.3a, 2.3b), which girdle the patient's lower limbs from the outside by: pelvic control units (2.4) that induce in both mechanical legs (2.3a, 2.3b) a symmetrically alternating movement of the hip joint hinges (2.3.1) with spatial trajectories that are ellipsoidal in the sagittal plane (y-z) view with the longitudinal axis being horizontal, and by adjustable thigh (2.3.4) and shank (2.3.5) connectors and foot connectors (2.3.6) actuated by tilt units (2.5), further provided with a back hold (3.2) whose position is adjustable in the sagittal plane (y-z) and tiltably relative to the vertical (y) and horizontal (x) axes of the Cartesian spatial coordinate system (x, y, z), wherein all drives of the moving parts of the automated device are controlled by signals from a software-equipped computer with the monitoring of the position and of the forces present by measuring sensors (2.5.3), characterised in that the tripod is in the form of a flat platform (1) with two vertical front posts (2a, 2b) and two vertical rear posts (3a, 3b) located symmetrically relative to the sagittal plane (y-z), wherein the front posts (2a, 2b) are slidably mounted in a horizontal guide “1” (2.1.1) provided inside the platform (1) in the frontal plane (x-y) and are symmetrically moved by the spacing adjustment mechanism (2.1.2) within the range between the position of the joined front posts (2a, 2b) to a dimension (c) between their inner surfaces equal to the width of the wheelchair and the moved apart position to a dimension (d) where the width dimension of the wheelchair is located between the mechanical legs (2.3a, 2.3b) suspended on the front posts (2a, 2b), wherein further each front post (2a, 2b) has integrated vertical guides “1” (2.2.1) on the inner face parallel to the sagittal plane (y-z) with a screw drive (2.2.4, 2.2.2, 2.2.3) of the pelvic height adjustment mechanism (2.2) which is connected to the hip joint hinge (2.3.1) of the mechanical leg (2.3a, 2.3b) coupled to the patient by the thigh (2.3.7), shank (2.3.8) and foot (2.3.9) holders, wherein the rear posts (3a, 3b) are fixedly mounted to the platform (1) with the inner faces spaced apart by a distance equal to the dimension (c) between joined front posts (2a, 2b), and, moreover, they have integrated vertical guides “2” (3.1.1) for two symmetrically actuated lift brackets (3.1.2), connected at their upper ends by supporting members “2” (3.1.3) with the lifter “1” (3.1.6) positioned forward in the sagittal plane (y-z) and ending in a crossbar (3.1.8) with two handles “2” (3.1.9) for the patient's (PA) hands, and that the back hold (3.2) with the elastic cushion (3.2.6) is mounted at the end of the tiltable supporting member “3’ (3.2.3) connected by the other end, through a hinge (3.2.2) with a vertical rotation axis, to the slide (3.2.1) embedded in a vertical guide “2” (3.1.1) of one of the lift brackets (3.1.2).

2. The automated device according to claim 1, characterised in that the spacing adjustment mechanism (2.1) of the front posts (2a, 2b) comprises a servomotor “1” (2.1.2) actuating, by a pulley transmission belt (2.1.3) with a double-toothed belt (2.1.4) two screw transmissions “1” (2.1.5), whose screws (2.1.6), positioned perpendicularly and extending to opposite sides from the sagittal plane (y-z), are connected to the nuts “1” (2.1.7) mounted to both front posts (2a, 2b).

3. The automated device according to the claim 1, characterised in that the pelvic control unit (2.4) has a spacer plate (2.4.1) connected by a screw drive (2.2.4, 2.2.2, 2.2.3) integrated in the front post (2a, 2b), and it has a support (2.4.1) mounted to the spacer plate (2.4.2) with a horizontal drive consisting of a servomotor “3” (2.4.3), belt transmission “1” (2.4.4) and screw transmission “2” (2.4.5) and horizontal guides “2” (2.4.6), which are located in a plane parallel to the sagittal plane (y-z), wherein an elliptical movement plate (2.4.2) attached to the support (2.4.7), which is connected by supporting members “1” to the hip joint hinge brackets (2.4.9) and by the tilt unit (2.5) to the hip joint hinge (2.3.1) of the mechanical leg (2.3a, 2.3b).

4. The automated device according to the claim 1, characterised in that to the lift brackets (3.1.2) there are supporting members “2” (3.1.3) fixedly attached that extend towards the front posts (2a, 2b) and are connected at their ends by two parallel front (3.1.4) and rear (3.1.5) bars, wherein on the front bar (3.1.4), there is mounted on a bearing a lifter “1” (3.1.6), composed of two parallel brackets (3.1.7) which at the ends above the front posts (2a, 2b) are connected by a crossbar (3.1.8) to the handles “2” (3.1.9) for the patient's hands, and at the ends located at the rear bar (3.1.5) are connected to a patient weight sensor (3.1.10) with a display that is mounted on said bar (3.1.5).

5. The automated device according to the claim 1, characterised in that the back hold (3.2) has horizontal guides “3” (3.2.4) of the lifter “2” (3.2.5) ending with an elastic cushion (3.2.12), which is mounted on a bearing plate 3.2.11, yieldingly connected to the lifter “2” 3.2.5 by a vertical tilt axis 3.2.10, supporting member 3.2.15 and nut 3.2.16 with a lifting screw 3.2.9, actuated by a servomotor “6” 3.2.17 by a belt transmission “3” 3.2.18, and that it is provided with a hold handle 3.2.13 and a controller for locking the support position on the casing 3.2.14.

6. The automated device according to the claim 1, characterised in that the brackets (2.5.1) of the tilt units (2.5) actuating the hip (2.3.1), knee (2.3.2) and ankle (2.3.3) joints are provided with cut-outs (2.5.2) increasing their susceptibility to elastic strain, and that resistance strain gauges (2.5.3) are attached with an adhesive to the front and side faces of said brackets (2.5.1), whose signals are transmitted to the controller of the automated device.

Description

[0018] The solution according to the invention is illustrated by the description of an embodiment of the automated device shown in the drawing, wherein the figures illustrate the following:

[0019] FIG. 1, FIG. 2 and FIG. 3—a top perspective view of the automated device, in the following order: with the front posts joined and with the lift lowered, with the front posts moved apart, and with the front posts joined and the lift raised,

[0020] FIG. 4 and FIG. 5—front and side views of the automated device with the front posts moved apart and the lift raised,

[0021] FIG. 6—a top view with the front posts moved apart and the platform cover removed,

[0022] FIG. 7—a cross-section view of the front post movement drive through A-A line of FIG. 6,

[0023] FIG. 8—a perspective view of the components of the spacing drive,

[0024] FIG. 9—a side view of the components of the spacing drive,

[0025] FIG. 10—a front view of the pelvic control unit system with the tilt unit removed,

[0026] FIG. 11—a perspective exploded view of the pelvic control unit,

[0027] FIG. 12—a vertical cross-section view of the pelvic control unit,

[0028] FIG. 12—a vertical cross-section view of the front post and pelvic control unit

[0029] FIG. 14 to FIG. 16—a front, side and top views, respectively, of the tilt unit, with the indication of where the resistance strain gauges are attached with an adhesive,

[0030] FIG. 17—a perspective view of the upper part of the lift,

[0031] FIG. 18 and FIG. 19—perspective views of the back hold with the indication of tilts and shifts,

[0032] FIG. 20—a perspective exploded view of the back hold,

[0033] FIG. 21 and FIG. 22—a vertical cross-section of the back hold and an enlarged view of the section with the elastic cushion mounted on the lifter,

[0034] FIG. 23—a front view of the automated device with the following indicated by the dotted line: patient's silhouette during lifting and weighing, suspended by rehabilitation harness and strap ropes on the crossbar of the lift and during the performance of exercises, with hands on the handles of the pelvic control unit,

[0035] FIG. 24 and FIG. 25—a view of the pelvic control unit shown from the centre of the automated device, successively in the extreme positions of the pelvic joint height, selected for a tall and short patient, with the elliptical movement trajectory indicated,

[0036] FIG. 26 and FIG. 27—schematic side views of the automated device in the positions of the pelvis and lift adjusted for a tall and short patient, respectively,

[0037] FIG. 28 and FIG. 29—side and front views of the mechanical legs with the directions of measuring forces with resistance strain gauges indicated.

[0038] In the following description of an exemplary embodiment of the automated device, due to the repeated names of technical means, such as servomotor, screw, guide, belt transmission, their instances in different units has been differentiated by adding a number inside quotation marks to the name, for example “screw “2””.

[0039] FIGS. 1 to 5 of the drawing provide a comprehensive picture of the external structure of the rehabilitation automated device having the inventive characteristics. Symmetrically to the sagittal plane of the automated device, defined by the y-z Cartesian system axes, two vertical front posts 2a and 2b and two vertical rear posts 3a and 3b are integrated on the flat platform 1.

[0040] The front posts 2a and 2b are slidably mounted in the frontal plane x-y and inside platform 1 of the horizontal guide “1” 2.1.1. Said posts are moved symmetrically by the spacing adjustment mechanism 2.1.2 within the range between the position of the joined front posts 2a and 2b to a dimension “c” between their inner faces equal to the width of the wheelchair, and the moved apart position to a dimension “d”, where the width dimension of the wheelchair is located between the mechanical legs 2.3a and 2.3b suspended in vertical guides “1” 2.2.1 on the inner faces of front posts 2a and 2b. The front post spacing adjustment mechanism 2.1, with the design shown in FIG. 6 to FIG. 9, comprises a servomotor “1” 2.1.2 which actuates, by pulley transmission belt 2.1.3 with a double-toothed belt 2.1.4 two screw transmissions “1” 2.1.5, whose screws 2.1.6, positioned perpendicularly and to opposite sides of the sagittal plane y-z are connected with nuts “1” 2.1.7 mounted to both front posts 2a and 2b. On the inner faces of both front posts 2a and 2b there are vertical guides “1” 2.2.1 of the pelvic height adjustment mechanism 2.2, each of which is composed of a servomotor 2.2.4 that actuates by the screw “2” 2.2.2 the nut “2” 2.2.3 mounted to the spacer plate 2.4.1 of the pelvic control unit 2.4 (FIG. 10 to FIG. 13). On the spacer plate 2.4.1 a support 2.4.2 is mounted with horizontal drive composed of: servomotor “3” 2.4.3, belt transmission “1” 2.4.4 and screw transmission “2” 2.4.5 and horizontal guides “2” 2.4.6 located in a plane parallel to the sagittal plane y-z. An elliptical movement plate 2.4.7 is attached to the support 2.4.2, which is connected by supporting members “1” 2.4.8 to the hip joint hinge brackets 2.4.9 and by the tilt unit 2.5 to the hip joint hinge 2.3.1 of the mechanical leg 2.3a and 2.3b. The mechanical legs 2.3a and 2.3b girdle the patient's PA lower limbs from the outside by: pelvic control units 2.4 that induce a symmetrically alternating movement of the hip joint hinges 2.3.1 and by adjustable thigh 2.3.4 and shin 2.3.5 connectors and foot connectors 2.3.6 actuated by tilt units 2.5. The movement of the hip joint hinge brackets 2.4.9 has spatial trajectories t that are ellipsoid in the sagittal plane view y-z with the longitudinal axis being horizontal. The trajectories t are defined by integrating the controlled movements: vertical, by the pelvic height adjustment 2.2 and horizontal, by the support 2.4.2 of the pelvic control unit 2.4. The tilt units 2.5 are mounted in the mechanical legs 2.3a and 2.3b, successively: between hip joint hinge brackets 2.3.1, adjustable thigh 2.3.4 and shank 2.3.5 connectors and the foot connector 2.3.6, giving each of them, by a servomotor “4” 2.5.4 and a screw actuator 2.5.5 a relative tilt angle, determined by the software of the controller. The brackets 2.5.1 of all of the tilt units 2.5 are provided with cut-outs 2.5.2 that increase their susceptibility to elastic strain. On the front and side faces of said brackets 2.5.1, there are resistance strain gauges 2.5.3 attached with an adhesive, whose signals are transmitted to the controller of the automated device, where, analysed by the control system software in terms of values and direction, they provide an image of the forces present in individual joints and braces of the mechanical legs 2.3a and 2.3b both in the sagittal plane y-z and in the frontal plane x-y, which allows for introducing the required parameter adjustments to a safe extent.

[0041] Rear posts 3a and 3b are fixedly attached to platform 1, allowing for the patient PA to be lifted into the exercising position without their feet contacting the platform 1, and for the patient PA to be weighed. On the inner faces, rear posts 3a and 3b have vertical guides “2” 3.1.1 for the two symmetrically actuated lift brackets 3.1.2, which at their upper ends are connected by supporting members “2” 3.1.3 extending towards front posts 2a and 2b (FIG. 17). Supporting members “2” 3.1.3 at their ends are connected by two parallel front 3.1.4 and rear 3.1.5 rods. On the front bar 3.1.4 there is mounted on a bearing a lifter “1” 3.1.6 composed of two parallel brackets 3.1.7, which at their ends above front posts 2a and 2b are connected by a crossbar 3.1.8 with two handles “2” 3.1.9 for the patient's PA hands. Rear ends of the lifter “1” 3.1.6 connected to a patient weight sensor 3.1.10 with a value display mounted on the rear bar 3.1.5.

[0042] In the vertical guide “2” 3.1.1 of one of lift brackets 3.1.2 there is mounted a slide 3.2.1 with a hinge 3.2.2 having a vertical rotation axis, connected by tiltable supporting member 3.2.3 to the back hold 3.2 (FIG. 18), which serves as an additional support point and, optionally, upholding a patient PA in conditions of advanced illness. During the introduction of the patient PA into the exercise area of the automated device, the back hold 3.2 is moved to the side beyond the lift bracket 3.1.2 on which it is suspended and locked in this position, which provides full bilateral access to the exercise area and to the patient PA. The position of the back hold 3.2 is adjustable (FIG. 19) in the sagittal plane y-z and tiltable relative to the vertical y and horizontal x axes of the spatial Cartesian coordinate system x,y,z. In the casing 3.2.14 of the back hold 3.2 there are mounted horizontal guides “3” 3.2.4 of the lifter “2” 3.2.5, which ends with a bearing plate 3.2.11 and a elastic cushion 3.2.12. The extension of the lifter “2” 3.2.5 is performed by the servomotor “5” 3.2.6, belt transmission “2” 3.2.7 and screw transmission 3.2.8 (FIG. 20, 21, 22). The bearing plate 3.2.11 is connected to the lifter “2” 3.2.5 by a vertical tilt axis 3.2.10, which is fixed in the supporting member “4” 3.2.15 on rubber yielding parts. A nut 3.2.16, which interacts with the vertical lifting screw 3.2.9, actuated by the servomotor “6” 3.2.17 connected to the supporting member “4” 3.2.15 is attached to the supporting member “4” 3.2.15. The ends of the lifting screw 3.2.9 are mounted on a bearing on the lifter “2” 3.2.5. The yielding parts of the tilt axis 3.2.10 and nut 3.2.16 allow movement of the body of the patient PA adjacent to the back hold 3.2 according to the controlled elliptical movement of the pelvis during walking, and the support depth is coupled with the pelvic height adjustment. The solution allows for rotation of the elastic cushion 3.2.12 relative to the vertical axis y in the sagittal plane y-z between −10° and +10° and vertical translation between −2 and +2 cm, which corresponds to vertical oscillations of the patient's PA centre of gravity during walking. At the back, a control panel with control buttons is mounted to the hold 3.2.14 casing, and at the side, a handle with a controller for locking the position, which is implemented as a gas spring.

[0043] The following figures of the drawing present utility characteristics of using the automated device during rehabilitation exercises. In the front view of FIG. 23, the positions of the patient's PA hands are indicated with a dotted line in the following situations: [0044] p1—during lifting, putting on the rehabilitation harness u, thigh 2.3.7, shin 2.3.8 and foot 2.3.9 holders, and weighing, when the patient PA, depending on the severity of paresis, is using their hands to grasp the handles “2” 3.2.9 of the crossbar 3.1.8 of the lift 3.1 or is lifted in the rehabilitation harness attached by strap ropes u1 and eyelets u2 on the handles “2” 3.2.9 of the crossbar 3.1.8, [0045] p2—while performing the exercises, when the patient PA is brought into a standing position by the thigh 2.3.7, shank 2.3.8 and feet 2.3.9 holders and the back hold 3.2, optionally, suspended in the rehabilitation harness u, is holding with their hands the handles “1” 2.4.10 of the pelvic control unit 2.4.

[0046] FIGS. 24 and 25 and FIGS. 26 and 27 show the extreme heights of the hip joint hinge 2.3.1 height adjustment and of the handle “2” 3.2.9 of the lift 3.1, adjusted for a tall l1 and h1 and short l2 and h2 patient PA, respectively. FIGS. 24 and 25 further show an elliptical trajectory t of hip joint hinge bracket 2.4.9 movement. The automated device changes the exercising height of the patient PA in an automated manner, based on the inference mechanism, and is mechanically and electronically coupled with the back hold 3.2 and the pelvic height adjustment mechanism 2.2. Once the patient PA is introduced into the exercise area, they are lifted by the lift 3.1 so that in the upright position their feet are a short distance above platform 1, with the length of adjustable thigh 2.3.4 and shank i 2.3.5 connectors being adjusted accordingly. The settings require that the asymmetry of the patient's PA lower limbs be taken into account, even if part or all of the limb is missing.

[0047] In the last figures FIGS. 28 and 29, arrows indicate places and directions of forces measured by resistance strain gauges 2.5.3 on mechanical legs 2.3a and 2.3b. All movements of the automated device are controlled by computer software and monitored using sensors. During the first exercises of the patient PA, their dimensions are entered into the database, which allows for setting the required parameters of the automated device at the beginning of each subsequent exercise.

FIGURE REFERENCE LIST

[0048] 1. Platform [0049] 2. Front post, 2a—left, 2b—right [0050] 2.1 Front post spacing adjustment mechanism [0051] 2.1.1 Horizontal guide “1” [0052] 2.1.2 Servomotor “1” [0053] 2.1.3 Pulley transmission belt [0054] 2.1.4 Double-toothed belt [0055] 2.1.5 Screw transmission “1” [0056] 2.1.6 Screw “1” [0057] 2.1.7 Nut “1” [0058] 2.2 Pelvic height adjustment mechanism [0059] 2.2.1 Vertical guide “1” [0060] 2.2.2 Screw “2” [0061] 2.2.3 Nut “2” [0062] 2.2.4 Servomotor “2” [0063] 2.3 Mechanical leg 2.3a—left, 2.3b—right [0064] 2.3.1 Hip joint hinge [0065] 2.3.2 Knee joint hinge [0066] 2.3.3 Ankle joint hinge [0067] 2.3.4 Adjustable thigh connector [0068] 2.3.5 Adjustable shank connector [0069] 2.3.6 Foot connector [0070] 2.3.7 Thigh holder [0071] 2.3.8 Shank holder [0072] 2.3.9 Foot holder [0073] 2.4 Pelvic control unit [0074] 2.4.1 Spacer plate [0075] 2.4.2 Support [0076] 2.4.3 Servomotor “3” [0077] 2.4.4 Belt transmission “1” [0078] 2.4.5 Screw transmission “2” [0079] 2.4.6 Horizontal guide “2” [0080] 2.4.7 Elliptical movement plate [0081] 2.4.8 Supporting member “1” [0082] 2.4.9 Hip joint hinge bracket [0083] 2.4.10 Handle “1” [0084] 2.5 Tilt unit [0085] 2.5.1 Bracket [0086] 2.5.2 Cut-out [0087] 2.5.3 Resistance strain gauge [0088] 2.5.4 Servomotor “4” [0089] 2.5.5 Screw actuator [0090] 3. Rear post, 3a—left, 3b—right [0091] 3.1 Lift [0092] 3.1.1 Vertical guide “2” [0093] 3.1.2 Lift bracket [0094] 3.1.3 Supporting member “2” [0095] 3.1.4 Front bar [0096] 3.1.5 Front bar [0097] 3.1.6 Lifter “1” [0098] 3.1.7 Lifter bracket [0099] 3.1.8 Crossbar [0100] 3.1.9 Handle “2” [0101] 3.1.10 Patient weight sensor [0102] 3.2 Back hold [0103] 3.2.1 Slider [0104] 3.2.2 Hinge [0105] 3.2.3 Supporting member “3” [0106] 3.2.4 Horizontal guide “3” [0107] 3.2.5 Lifter “2” [0108] 3.2.6 Servomotor “5” [0109] 3.2.7 Belt transmission “2” [0110] 3.2.8 Screw transmission “3” [0111] 3.2.9 Lifting screw [0112] 3.2.10 Tilt axis [0113] 3.2.11 Bearing plate [0114] 3.2.12 Elastic cushion [0115] 3.2.13 Hold handle [0116] 3.2.14 Hold casing [0117] 3.2.15 Supporting member “4” [0118] 3.2.16 Nut “3” [0119] 3.2.17 Servomotor “6” [0120] 3.2.18 Belt transmission “3” [0121] x, y, z Cartesian coordinate system axes [0122] y-z Sagittal plane [0123] x-y Frontal plane [0124] x-z Transverse plane [0125] c. Internal dimension between front posts joined [0126] d. Internal dimension between front posts moved apart [0127] t. Elliptical movement plate trajectory [0128] l1. Maximum length of the mechanical leg [0129] l2. Minimum length of the mechanical leg [0130] h1. Maximum extension height of lift handles [0131] h2. Minimum extension height of lift handles [0132] PA. Patient [0133] p1. Position of hands on handles “2” of the lift crossbar during lifting, weighing of the patient [0134] p2. Position of hands on the handles “1” extending from the pelvic control units, [0135] u. Rehabilitation harness [0136] u1. Strap rope [0137] u2. Strap rope attachment eyelet