ORTHOTIC OR PROSTHETIC CUSHIONED DEVICE AND METHOD OF MAKING THE SAME
20190167450 ยท 2019-06-06
Assignee
Inventors
Cpc classification
A61F2002/503
HUMAN NECESSITIES
A61F2/5046
HUMAN NECESSITIES
A61F2/7812
HUMAN NECESSITIES
A61F2002/5075
HUMAN NECESSITIES
A61F2002/5073
HUMAN NECESSITIES
A61F2002/5049
HUMAN NECESSITIES
International classification
A61F2/78
HUMAN NECESSITIES
Abstract
Orthotic and prosthetic devices having integrated features such as cushioning features are described, as well as methods for computer aided designing and making of these devices. The orthotic or prosthetic devices comprise a cushioning layer superimposed onto an orthotic or prosthetic shell, the cushioning layer comprising an array (35) of discrete solid and resilient cushioning elements (31). In one preferred embodiment, said cushioning structure is a beam, defined around a centerline of any arbitrary shape. In another preferred embodiment, said cushioning structure has the shape of a spiral.
Claims
1-20. (canceled)
21. An orthotic or prosthetic device comprising: a plurality of orthotic or prosthetic shells and a plurality of cushioning layers forming a sandwich structure, the plurality of cushioning layers comprising one or more cushioning elements that are homogenously formed with the plurality of orthotic or prosthetic shells, wherein at least one of the cushioning elements comprises a first side and a second side opposite the first side, wherein the first side is superimposed onto a first shell of the plurality of orthotic or prosthetic shells and wherein the second side is superimposed onto a second shell of the plurality of orthotic or prosthetic shells that is different from the first shell.
22. The orthotic or prosthetic device of claim 21, wherein the at least one of the cushioning elements comprises a beam.
23. The orthotic or prosthetic device of claim 22, wherein the beam is wider in a first direction than in a second direction.
24. The orthotic or prosthetic device of claim 21, wherein the one or more cushioning elements and said plurality of orthotic or prosthetic shells are formed from the same material.
25. The orthotic or prosthetic device of claim 21, wherein the at least one of the cushioning elements comprises a spiral.
26. The orthotic or prosthetic device of claim 21, wherein the at least one of the cushioning elements comprises a rectangular shape.
27. The orthotic or prosthetic device of claim 21, wherein said plurality of cushioning layers comprise a plurality of different types of cushioning elements.
28. The orthotic or prosthetic device of claim 21, wherein at least one of the plurality of cushioning layers comprises a first cushioning area having first cushioning properties and a second cushioning area having second cushioning properties different from the first cushioning properties for adapting the orthotic or prosthetic device to a patient.
29. The orthotic or prosthetic device of claim 21, wherein the at least one of the cushioning elements protrudes from at least one of the first shell or the second shell at an angle.
30. The orthotic or prosthetic device of claim 29, wherein the angle is less than 90.
31. The orthotic or prosthetic device of claim 21, wherein the at least one of the cushioning elements comprises folds configured to deform when absorbing forces.
32. The orthotic or prosthetic device of claim 21, wherein the sandwich structure forms a hollow volume with the one or more cushioning elements inside.
33. The orthotic or prosthetic device of claim 21, further comprising at least one second cushioning element having a first side that is superimposed onto at least one of the first shell, the second shell, or a third shell of the plurality of orthotic or prosthetic shells and a second side for contacting a part of at least one of a user or an item directly contacting the user.
34. A device configured to be worn by a user, comprising: a body arranged to spread pressure between a body part of the user and the device; and a plurality of orthotic or prosthetic shells and a plurality of cushioning layers forming a sandwich structure, the plurality of cushioning layers comprising one or more cushioning elements that are homogenously formed with the plurality of orthotic or prosthetic shells, wherein at least one of the cushioning elements comprises a first side and a second side opposite the first side, wherein the first side is superimposed onto a first shell of the plurality of orthotic or prosthetic shells and wherein the second side is superimposed onto a second shell of the plurality of orthotic or prosthetic shells that is different from the first shell.
35. The device of claim 34, wherein the at least one of the cushioning elements comprises a beam.
36. The device of claim 35, wherein the beam is wider in a first direction than in a second direction.
37. The device of claim 34, wherein the one or more cushioning elements and said plurality of orthotic or prosthetic shells are formed from the same material.
38. The device of claim 34, wherein the at least one of the cushioning elements comprises a spiral.
39. The device of claim 34, wherein the at least one of the cushioning elements comprises a rectangular shape.
40. The device of claim 34, wherein said plurality of cushioning layers comprise a plurality of different types of cushioning elements.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0036] Embodiments of the invention will be described, by way of example only, with reference to the accompanying drawings in which:
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DESCRIPTION OF PREFERRED EMBODIMENTS
[0049] In the following detailed description of the preferred embodiments, reference is made to the accompanying drawings, which form a part hereof, and within which are shown by way of illustration specific embodiments by which the invention may be practiced. The drawings described are only schematic and are non-limiting. In the drawings, the size of some of the elements may be exaggerated and not drawn on scale for illustrative purposes. Those skilled in the art will recognize that other embodiments may be utilized and structural changes may be made without departing from the scope of the invention.
[0050] Furthermore, the terms first, second, third and the like in the description and in the claims, are used for distinguishing between similar elements and not necessarily for describing a sequential or chronological order. It is to be understood that the terms so used are interchangeable under appropriate circumstances and that the embodiments of the invention described herein are capable of operation in other sequences than described or illustrated herein.
[0051] Moreover, the terms top, bottom, over, under and the like in the description and the claims are used for descriptive purposes and not necessarily for describing relative positions. It is to be understood that the terms so used are interchangeable under appropriate circumstances and that the embodiments of the invention described herein are capable of operation in other orientations than described or illustrated herein.
[0052] It is to be noticed that the term comprising, used in the claims, should not be interpreted as being restricted to the means listed thereafter; it does not exclude other elements or steps. Thus, the scope of the expression a device comprising means A and B should not be limited to devices consisting only of components A and B. It means that with respect to the present invention, the only relevant components of the device are A and B.
[0053] In the following and in the attached claims reference may be made to a patient. It should be understood that this term patient should be construed broadly to include not only humans but also animals in need of surgery.
[0054] In the following and in the attached claims reference may be made to an orthosis. It should be understood that an orthosis is an external insert, device, support or brace designed to support a patient in carrying the loads applied onto them by walking, running, manipulating objects and/or similar activities and/or by repositioning a limb or forcing them to move a certain way. They can also spread the pressure between the body and the shoe/ground/prosthetic over a larger surface area and provide cushioning to the loaded areas.
[0055] In the following and in the attached claims reference may be made to a prosthetic device or prosthesis. It should be understood that a prosthetic device is an artificial extension of, or addition to the human body or a replacement of a lost body part, e.g. to replace a lost limb or any other body part. A prosthetic limbupper or lower extremityusually consists of a prosthetic socket which conforms to the residual limb, the artificial limb itself, such as a hand or leg and some means of attaching the limb to the socket.
[0056] For means of explaining the invention in more detail, the following description refers to an ankle foot orthosis (AFO) that is usually a plastic brace attaching to the calf of the subject with a Velcro strap or lacing and with a sole part, fitting under the foot which in some cases can fit inside a shoe. The present invention is not limited to just such orthotic elements.
[0057] The purpose of an AFO is to control the ankle joint rotations and possibly carry some of the forces applied through the foot and ankle. Foot orthoses (FO) in the form of specially shaped inserts which fit inside the shoe, have been found to be effective for relieving pain and increasing mobility. It is believed that they work by removing pressure from painful areas and by re-aligning the foot. This is done by any of controlling abnormal or excessive subtalar-, and/or midtarsal joint motion, distributing the weight over a larger area and by offering cushioning and shock absorption, where it is needed. It should be understood however that the subject matter of this invention is also applicable to any other orthotic or prosthetic device, including, but not limited to, knee orthoses, knee-ankle-foot orthoses, hip orthoses, hip-knee-ankle-foot-orthosis, lumbar orthoses, transtibial-, transfemoral-, transradial-, transhumeral prosthesisand prosthesis sockets, sockets/adaptors for bone anchored prosthetics and cranial helmets.
[0058] Referring now to the drawings, in particular
[0059] The limb or residual limb has always a certain shape, which is to be captured accurately in order to create a well-fitting orthoses/prosthesis. The geometry can be captured non-weight bearing or weight bearing through glass or Perspex (PMMA) or such, transparent materials, which are pressed against the limb/residual limb. Alternatively, the patient can stand on the transparent plate and the weight bearing 3D shape obtained through the plate. The geometry of the limb/residual limb can be captured using the following means but not excluding other means of capturing it. In module 1 in
[0060] The geometry of the limb/residual limb determined in module 1 can be digitally imported into a computer program and may be converted using algorithms known from the field of CAD/CAM technology to produce a 3D computer model of the limb/residual limb. A computer program such as 3-matic as supplied by Materialise N.V., Leuven, Belgium, may be used for constructing this 3D model. This geometry data can be used immediately in the computer program or stored in a digital file.
[0061] Once the 3D model of the limb/residual limb is constructed, it may be manipulated manually, semi-automatically or automatically to design a 3D model of the orthotic/prosthetic device. These manipulations may include one or more of the following processes but are not limited to: [0062] 1. Scaling the geometry smaller or larger along certain axis. [0063] 2. Giving the geometry a thickness that can be varied throughout the part. [0064] 3. In creating hollow volumes inside this thickness. [0065] 4. Adding new surface shapes in certain parts, such as local elevations. [0066] 5. Adding predetermined 3D elements from a database system (E). [0067] 6. Integrating the interventions made into an optimal orthotic/prosthetic shape. [0068] 7. Adding attachment features that enable the attachment of straps or other means to fasten the orthotic/prosthetic device to the person using it. [0069] 8. Adding holes or other features for ventilation purposes.
[0070] A preferred method for performing these actions uses a computer program such a 3-matic as supplied by Materialise N.V., Leuven, Belgium.
[0071] A data base library 6 of one or more 3D models of cushioning structures comprising cushioning elements or their mathematical representations may then be used to incorporate at least one cushioning element into the 3D model of the orthotic/prosthetic device. The elements in the library may be selected manually or automatically from the database by their pre-determined properties, such as their physical dimensions, their appearance or their mechanical properties, e.g. the spring coefficient, crack formation and crack propagation. It is to be understood that the dimensions and values regarding the performance of all cushioning elements available in the library may be scaled in any dimension to obtain the preferred or expected mechanical properties and performance. Functions representing them and their performance are preferably stored in this data base so that they can be called up when required, automatically or manually by the user, and integrated into the 3D design of the orthoses/prosthesis using the design software. Specific elements may be called from the library or all elements matching certain performance parameters for the user to select for a particular location and purpose may be called. More than one element can be selected by the library system to give certain areas of cushioning structures specific properties.
[0072] In one preferred embodiment, according to
[0073] The cushioning properties of a structure refer to it being compressibly resilient. This can mean the compressibility of the material, the elastic deformation of the structure or a combination thereof. This can be measured for example with the standard ISO 7619 or ASTM D2240. The areas of the orthotic/prosthetic device that are cushioned using the embodiments described in this invention have the Shore value of 20-90 when measured using an 00 durometer using these standards. This cushioning structure is not foam. Each shape and feature in the cushioning structure is determined deliberately either by the user or the computer system. Shapes and features in the cushioning structure can be seamlessly adjusted as needed by the computer system or the user.
[0074] In
[0075] In another preferred embodiment, according to
[0076] It should be understood that any combination of the previous embodiments as described above is also within the scope of the invention.
[0077] The cushioning elements may be patterned to create areas of cushioning. The cushioning areas can consist of identical cushioning elements or have several different element types mixed up. In
[0078] The thickness of the cushioning elements 11, 21, 31, such as illustrated in
[0079] Having placed, as indicated in
[0080] Moreover, the sandwiched cushioning layers may have different properties (e.g. by using different cushioning elements, different materials for the cushioning elements, etc.). An advantage of these sandwiched layers is to make use of each of these properties.
[0081] Further, one or more of the sandwiched cushioning layers may comprise different areas that have mutually different cushioning properties, obtained e.g. by the use of cushioning elements having different shapes, materials, dimensions, by using a different number of elements per unit area, etc.
[0082] The cushioning structures may comprise a means for adjusting. Said means for adjustment may include a movable surface, beam or a plateau that modifies at least one meaningful property of the cushioning structure such as the spring coefficient, range of movement, and the like. These features accomplish a modification of at least one meaningful property by pressing against the cushioning structure and preventing motion or creating tension in the structure. This changes the deformability and compressibilit of the structure. The moveable surface can also be inserted between the deforming section of the cushioning structure and the main body of the orthoses or prosthesis modifying the properties of the deforming structure.
[0083] In one preferred embodiment, the means for adjustment may be a cylindrical surface as indicated by 51 in module A in
[0084] The surface on top of the cushioning structure as indicated by 61 in module A and B in
[0085] In another embodiment, an actuator or any other device is used to move the moveable surface or one or more beams connected to one or more cushioning structure allowing for the adjustment of several structures simultaneously.
[0086] Another means of adjusting a cushioning element is presented in
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[0089] Computer 150 includes a Central Processing Unit (CPU) 151, such as a conventional microprocessor of which a Pentium processor supplied by Intel Corp. USA is only an example, and a number of other units interconnected via bus system 154. The bus system 154 may be any suitable bus system
[0090] A CAD/CAM manufacturing unit 1516 may also be connected via a communications adapter 1517 to bus 154 connecting computer 150 to a data network such as the Internet, an Intranet a Local or Wide Area network (LAN or WAN) or a CAN. The manufacturing unit 1516 may receive an output value or support descriptor file directly from computer 150 running a computer program for support design in accordance with the present invention or a value or descriptor file derived from such an output of computer 150. Alternatively, the unit 1516 may receive the relevant design data indirectly on a suitable signal storage medium such as a diskette, a replaceable hard disc, an optical storage device such as a CD-ROM or DVD-ROM, a magnetic tape or similar.
[0091] Computer 150 also includes a graphical user interface that resides within machine-readable media to direct the operation of computer 150. Any suitable machine-readable media may retain the graphical user interface, such as a random access memory (RAM) 152, a read-only memory (ROM) 153, a magnetic diskette, magnetic tape, or optical disk (the last three being located in disk and tape drives 158). Any suitable operating system and associated graphical user interface (e.g., Microsoft Windows, Linux) may direct CPU 151. In addition, computer 150 includes a control program 1517 that resides within computer memory storage 1516. Control program 1517 contains instructions that when executed on CPU 151 allow the computer 150 to carry out the operations described with respect to any of the methods of the present invention.
[0092] Those skilled in the art will appreciate that the hardware represented in
[0093] In the example depicted in
[0094] Accordingly, the present invention also includes a software product which when executed on a suitable computing device carries out any of the methods of the present invention. Suitable software can be obtained by programming in a suitable high level language such as C and compiling on a suitable compiler for the target computer processor.
[0095] Having designed the orthotic or prosthetic device, it can be manufactured, as illustrated as module 6 in
[0096] A common feature of these techniques is that objects are typically built layer by layer. Stereo lithography, presently the most common RP&M technique, utilizes a vat of liquid photopolymer resin to build an object a layer at a time. On each layer, an electromagnetic ray, e.g. one or several laser beams which are computer-controlled, traces a specific pattern on the surface of the liquid resin that is defined by the two-dimensional cross-sections of the object to be formed. Exposure to the electromagnetic ray cures, or, solidifies the pattern traced on the resin and adheres it to the layer below. After a coat had been polymerized, the platform descends by a single layer thickness and a subsequent layer pattern is traced, adhering to the previous layer. A complete 3-D object is formed by this process.
[0097] Selective laser sintering (SLS) uses a high power laser or another focused heat source to sinter or weld small particles of plastic, metal, or ceramic powders into a mass representing the 3-dimensional object to be formed.
[0098] Fused deposition modeling (FDM) and related techniques make use of a temporary transition from a solid material to a liquid state, usually due to heating. The material is driven through an extrusion nozzle in a controlled way and deposited in the required place as described among others in U.S. Pat. No. 5,141,680.
[0099] Foil-based techniques fix coats to one another by means of gluing or photo polymerization or other techniques and cut the object from these coats or polymerize the object. Such a technique is described in U.S. Pat. No. 5,192,539.
[0100] Typically RP&M techniques start from a digital representation of the 3-D object to be formed. Generally, the digital is sliced into a series of cross-sectional layers which can be overlaid to form the object as a whole. The RP&M apparatus uses this data for building the object on a layer-by-layer basis. The cross-sectional data representing the layer data of the 3-D object may be generated using a computer system and computer aided design and manufacturing (CAD/CAM) software.
[0101] A selective laser sintering (SLS) apparatus is particularly preferred for the manufacture of the orthotic or prosthetic device from a computer model. It should be understood however, that various types of rapid manufacturing and tooling may be used for accurately fabricating these orthotic or prosthetic devices including, but not limited to, stereolithography (SLA), Fused Deposition Modeling (FDM) or milling.
[0102] The orthotic or prosthetic device may be manufactured in different materials. Preferably, only materials that are biocompatible with the human body are taken into account. In the case SLS is used as a RP&M technique, the orthotic or prosthetic device may be fabricated from a polyamide such as PA 2200 as supplied by EOS, Munich, Germany or Duraform PA from 3D Systems, South Caroline, USA, or any other material known by those skilled in the art may also be used. The orthotic/prosthetic may also be painted and/or coated using any suitable means.
[0103] The present invention may provide one or more of the following advantages: [0104] The quality of the devices is more consistent as significant manual intervention is no longer needed. [0105] Less labour is needed. The labor does not need to be as skilled in all of the manual work phases. Only in scanning, CAD design, finishing and fitting the parts. [0106] Less production equipment may be needed (one machine). [0107] The current invention may result in less waste from the manufacturing process. [0108] The current invention may result in a faster production. [0109] The current invention may result in more automated production. [0110] With the current invention, there is no longer a need to store casts as everything can be stored digitally and reproduced as needed. Also, the whole orthotic/prosthetic treatment history of the patient is available for clinicians to use when needed. [0111] Built in adjustability gives the clinician more options when the orthoses or prosthetic is fitted on the patient. Also, if there is a change in the patient's condition, and/or shape of the limb/residual limb, the adjustable device can still provide a good fit and functionality.