DEVICE FOR CONTROLLING THE TRAINING AND THE THERAPEUTIC TREATMENT AND/OR FOR SUPPORTING THE LOWER EXTREMITIES OF A HUMAN

Abstract

A device for the therapeutic treatment and/or training of the lower extremities of a human having driven and controlled movement devices which are connected to a stationary frame and comprise holding members for fastening of one extremity. The holding members can be moved independently of one another along walking trajectories, wherein the movement devices each comprise a pivot arm pivotable into different elevations, the pivot arm being rotatably connected to one single sled on a linear track. A first rotational drive is attached to a single sled and is connected to the pivot arm for changing the elevation of the respective holding member. The pivot arm comprises a second rotational drive for changing the inclination of the respective holding member and the sled is connected to a linear drive for changing the longitudinal position of the respective holding member.

Claims

1. Device for training and therapeutic treatment and/or supporting the lower extremities of a human including driven, controllable movement devices which are connected to a stationary frame and which comprise holding members for fastening one respective extremity, which are movable independently of one another along a predetermined movement pattern, wherein the movement devices each comprise a pivot arm which can be oriented in different elevations, the pivot arm being rotatably connected on one hand to a sled moveable along a linear track on the other hand to a holding member, wherein a linear drive for changing the lengthwise position of the respective holding member, a first rotational drive for changing the elevation of the respective holding member, and a second rotational drive for changing the inclination of the respective holding member are provided, wherein the movement sled together with the first rotational drive is movable relative to the stationary frame by the linear drive, wherein the first rotational drive thereby acts as a carrier for the pivot arm, which transfers the driving force of the linear drive to the pivot arm; and further the first rotational drive acts as a drive for the elevational movement of the pivot arm.

2. The device according to claim 1, characterized in that the linear track comprises several guiding rails, along which the movement sled is movably arranged.

3. The device according to claim 1, characterized in that the first rotational drive comprises a force transmission element attached to the movement sled and rotatably connects the movement sled to the pivot arm, wherein the orientation of the pivot arm is changeable by operation of the force transmission element.

4. The device according to claim 1, characterized in that the first rotational drive comprises a force transmission element which is connected to a pivot arm and which rotatably connects the pivot arm, wherein the orientation of the pivot arm is changeable by operating the force transmission element.

5. The device according to claim 1, characterized in that the pivot arm is connected to a force storage device for supporting the first rotational drive.

6. The device according to claim 5, characterized in that the force storage device comprises at least one spring which is attached on one hand to the moving sled and on the other hand to the pivot arm.

7. The device according to claim 6, characterized in that the spring acts along a guiding element which is moveably connected on one hand to the pivot arm and on the other hand to the moving sled.

8. The device according to claim 1, characterized in that the linear drive comprises a force transmission element which couples the movement sled to the stationary frame.

9. The device according to claim 1, characterized in that the linear drive comprises a driven toothed belt which is connected to the movement sled.

10. The device according to claim 1, characterized in that the second rotational drive is fastened to the pivot arm or to the holding member and couples the holding member to the pivot arm.

11. The device according to claim 1, characterized in that the second rotational drive comprises a force transmission element which couples the pivot arm to the holding member.

12. The device according to claim 1, characterized in that the holding member is arranged moveably along its own axis via a guide and wherein the distance to the pivot arm is adjustable through a closure.

13. The device according to claim 1, characterized in that an adjustment device is arranged above the movement device, which is adapted to change the center of gravity of a body of a human connected to one of the holding members.

Description

[0037] The invention is explained below in further detail with reference to the attached schematic drawings by means of embodiments. In these is shown:

[0038] FIG. 1 a perspective view of the device of an embodiment according to the invention;

[0039] FIG. 2 side view of the device according to FIG. 1;

[0040] FIG. 3 a front view of the device according to FIG. 1; and

[0041] FIG. 4 a top view onto the device according to FIG. 1; and

[0042] FIG. 5 a perspective view of the closing device for positioning the holding members.

[0043] In FIG. 1, a device is shown which can be used for therapeutic treatment and/or for training the lower extremities of a human during any and movement pattern of the human movement in everyday situations or under specific training conditions. This device is particularly suitable for training the lower extremities of neurological patients and comprises two driven, controllable movement units 11a, 11b. These two movements units 11a, 11b are each connected to a stationary frame 12. The movement units 11a, 11b comprise holding members 13a, 13b, for instance foot-plates with binding in which the patient's feet are held. The movement devices 11a, 11b and thus the holding members 13a, 13b can be moved independently of one another along calculated movement patterns. This renders asynchronous or synchronous movements possible.

[0044] The invention can be described with respect to coordinate system which includes a first horizontal direction or horizontal lengthwise direction H which can also be described as a walking direction or antero-posterior-direction. Perpendicular to the first horizontal direction H but still in the horizontal plane defined preferably by the stationary frame 12 lies in a second horizontal direction L or lateral horizontal direction which can also be described as a medio-lateral direction. A vertical direction V extends perpendicular to the plane defined by the horizontal directions H, L; that is perpendicular to the stationary frame 12 or the floor on which it sits. A sagittal plane would in this case be defined with respect to the patient by the first horizontal (walking) direction H and the vertical direction V and a coronal plane would be defined by the lateral horizontal direction L and the vertical direction V. The leg movement of the patient occurs mainly in the sagittal plane. To this end, the leg movement of the patient attached with the lower extremities to one of a holding member 13a, 13b occurs essentially in the sagittal plane, or in other words in vertical direction V and the first horizontal direction H.

[0045] The device comprises a rack 34 via which the patient is connected to the adjusting device for changing the center of gravity of the body and which is rigidly connected to the stationary frame 12. The rack 34 comprises two arms 35a, 35b extending in vertical direction from the floor upwards, wherein the arms 35a, 35b are rigidly coupled to the stationary frame 12 approximately the height of the movement devices 11a, 11b._At the top end of the arms 35a, 35b, a horizontally arranged connection element 36 is provided which connects the arms 35a, 35b. Two side rails 37a, 37b can be arranged and can be vertically adjustable on the arms 35a, 35b approximately in the height of the lower arms of the respective patient. The side rails 37a, 37b serve as handles for patients, which can hold onto the side rails 37a, 37b.

[0046] The movement devices 11a, 11b each comprise a pivot arm 14 which is pivotable to different elevations. Therefore, the pivot arm is pivotably attached to one single sled 15 which is guided by a linear track 16. The linear track 16 is firmly connected to the stationary frame 12 and forms a rail in which the sled 15 is moveably arranged. As can be seen in FIGS. 1, 2 and 4, the pivot arm 14 is at its end connected to the sled 15 by means of the first rotational drive 17 in a movable manner.

[0047] The pivot arm 14 preferably consists of one single piece with extends from the axis of rotation around which the pivot arm is movable with respect to the sled by means of the first rotational drive 17 to the second axis of rotation around which the holding member 13 is rotatable with respect to the pivot arm 14 by means of a second rotational drive 19. It shall be clear that the pivot arm 14 can comprise several structurally integrally coupled pieces.

[0048] The pivot arms 14 are each connected rotationally movable to one of the holding members 13a, 13b. The connection junction between the holding member 13a, 13b and the pivot arm 14 is arranged at the other, second lengthwise end of the pivot arm 14.

[0049] The connection junction is preferably determined by the force transmission element; in that the first connection junction between the sled 15 and the pivot arm 14 is determined by the first transmission member whereas the second connection junction is determined by the force transmission member coupling the pivot arm 14 to the holding member 13.

[0050] The pivot arms 14a, 14b extend in lengthwise direction of the respective linear track 16. The pivot arms 14a, 14b are each movable on a circular path which runs along the lengthwise direction of the respective linear track 16. The pivot arms 14a, 14b are each rotatably connected to the sled 15 via the first rotational drive 17. The position of the center of rotation of the respective pivot arm can thereby be arranged in any desired position.

[0051] The pivot arms 14a, 14b can each be supported by a force storage system 20 that is attached on one end thereof to the sled 15 and on the other end thereof to the pivot arm and which is able to store power and to return the power to the movement mechanics. Such a system comprises for instance a tension spring or compression spring 21 guided along a guiding element 22 which is movably attached on the pivot arm 14 and the sled 15 and which acts upon the pivot arm 14 of the sled 15. Other embodiments are possible.

[0052] In the device shown in the figures, the force storage device 20 is realized by a compression spring 21 pretensioned in the least favorable position of the pivot arm. In other words, the pressure spring 21 is pretension or biased when the respective pivot arm 14a, 14 b is arranged in the lowermost horizontal position. When the pivot arm 14a, 14b is pivoted upwards by means of the first rotational drive 17, this movement is supported by the compression the spring 21 which is thereby relaxed.

[0053] As indicated in the figures, the spring or generally the force storage device 20 is on the one hand attached to the sled 15, specifically to a L-shaped holding arm 22a thereof. Thereby, the first shank of the holding arm 22a extends in the lengthwise direction of the linear track 16. The shorter second shank of the holding arm 22a extends perpendicular thereto and is connected to a first end of the force storage device 20, specifically to the spring 21. The second end of the spring 21 is connected to one end of the pivot arm 14a, 14b. The connection between the pivot arm 14a, 14b and the spring 21 is defined such that the spring exerts a torsional moment onto the pivot arm 14a, 14b. To this end, the spring is rigidly connected to a lever (not shown) on the spring arm 14a, 14b.

[0054] The spring 21 is guided by a guiding rod 22. The guiding rod 22 is arranged within the spring 21. The guiding is on the one hand attached to the holding arm 22a and on the other hand to the pivot arm 14a, 14b. For length adjustment, the guiding rod 22 is telescopic. Other guiding possibilities are imaginable.

[0055] Instead of the compression spring 21, a tension spring can be used. This would then have to be attached on the opposite side and to be attached to the sled or the pivot arm, respectively.

[0056] Generally, the pivot point of the pivot arm 14 is mounted in an area or a position which is arranged between the connection of the respective pivot arm 14a, 14b to the sled 15 and the connection of the pivot arm 15 and the holding members 13a, 13b.

[0057] Through the rotational movement of the pivot arm 14, the angle between the pivot arm 14 and the sled 15 is changed. As illustrated in FIGS. 1, 2 and 4 with both pivot arms 14a, 14b, by increasing the angle of the pivot arm 14 it is moved upwards, wherein the holding member 13a, 13b describes a circular path around the connection point or junction of the pivot arm 14 and the sled 15, or generally with respect to a horizontal axis across the walking direction. Thereby, the elevation of the second lengthwise end of the pivot arm 14 and thus of the of the holding member 13a, 13b attached to the second lengthwise end is changed.

[0058] Due to the mounting of the pivot arm 14 to the sled 15, the pivot arm 14 is taken along by the movement of the sled 12, such that the horizontal movement of the entire movement device 11a, 11b is achieved.

[0059] As can be seen in FIGS. 1, 2 and 4, the sled 15 comprises a linear drive 18 which is provided for changing the lengthwise position or horizontal position of the respective holding member 13a, 13b. The first linear drive 18 comprises a first force transmission member 23a connecting the sled 15 to the stationary frame 12 for force transmission. The first force transmission member 23a can comprise a driven toothed belt 24 connected on the one hand to the movable sled 15 and on the other hand to the stationary frame 12. One respective electric motor is provided for driving the toothed belt 24. The linear drive 18 can also be realized by other means, for example a driven chain, by a tooth rack or by hydraulic or pneumatic cylinders.

[0060] The first rotational drive 17 is associated to the sled 15 and couples the sled 15 to the pivot arm 14. Therefore, a second force transmission element 23b is provided which engages_on the one hand the first sled 15 and on the other hand the pivot_arm 14. The second force transmission element has the function to take along the pivot arm 14 in case of the movement of the sled 15. Thereby, the second force transmission element 23b acts as a pushing element or pulling element. Additionally, the second force transmission element 23b transfers a force from the pivot arm 14 to the sled 15 or vice versa, when the second force transmission element 23b is operated. Thereby, the angle between the sled 15 of the pivot arm 14 and thus the elevation of the respective pivot arm 14a, 14b is changed.

[0061] The linear drive 18 provides a main drive which moves the sled 15 together with the first rotational drive 17 relative to the stationary frame 12. The first rotational drive 17, particularly the second force transmission element 23b thereby acts as a carrier which transfers the driving force of the linear drive 18 to the pivot arm 14. Additionally, the first rotational drive 17 acts as an elevation drive for the vertical or elevating movement of the pivot arm 14, as described above.

[0062] The second force transmission member 23b, for example in the form of a gear box, is rotatably connected to the sled 15 and provides for taking along or carrying and height-adjustment of the pivot arm 14.

[0063] In the embodiment according to FIG. 1, the first rotational drive 17 is fastened to the sled 15 and coupled to the force transmission member 23b. Other force transmission elements, for instance a toothed rack, or hydraulic/pneumatic operating elements are possible. Generally, the force transmission element 23b has a dual function and acts both as a carrier as well as for height-adjustment of the pivot arm 14.

[0064] The sled 15 is arranged at the movement device 11a on the right in the forward direction, wherein the pivot arm 14 extends in the forward direction towards the frame 12. An orientation of the pivot arms 14a, 14b towards the frame 12 is possible in each direction. Thereby, other orientations of the pivot, possibly extending perpendicular downwards are covered.

[0065] For setting the inclination of the holding member 13a, 13b, a second rotational drive 19 is provided which cooperates with the respective rotatably connected holding member 13a, 13b. The rotational drive 19 is arranged in the area of the forward end of the pivot arm 14a, 14b. The connection of the rotational drive 19 to the respective holding member 13a, 13b is provided by a third force transmission element 23c, for example in the form of a gear box. Other force transmission elements, such as a toothed rack or hydraulic/pneumatic operating elements are possible. The force transmission element 23c acts both as a carrier as well as a inclination adjustment for the holding element 13.

[0066] The rotational drive 19 can also be arranged in the area of the respective rear end of a pivot arm 14a, 14b. The connection of the rotational drive 19 to the respective holding member 13a, 13b in this case occurs via the third force transmission element 23c via a belt which is on one hand attached on the drive pulley on the pivot arm 14 and on the other hand on a drive pulley connected to the holding member 13a, 13b. Through the rotational drive 19 the inclination of the holding member 13a, 13b is adjusted and adapted to the respective position of the pivot arm 14. Thereby, all possible inclinational positions are variably adjustable which are required for the simulation of training situations and everyday situations.

[0067] The movement of the holding members 13a, 13b occurs in a working plane extending in sagittal direction, wherein a working range has been shown to be suitable which allows forward movements in a range of 0 mm to 800 mm, particularly 650 mm, the height movement in the range of 0 mm to 400 mm, particularly about 250 mm, and the inclination movement of the holding member 13a, 13b in a range of 80 to 30.

[0068] The movements described above can be defined with respect to a zero-position of the patient in which the movement devices are arranged such that the movement sleds 15 are arranged next to each other in the lengthwise horizontal direction L and in which the pivot arms 14a, 14b and the holding members 13a, 13b extend in the horizontal lengthwise direction so that an upright standing position of the patient is realized. From this zero-position or initial position, the movement devices can then be moved independently from one another according to the respective movement pattern to simulate or follow walking movement of the patient. Preferably, the movement range of each movement device is restricted to the ranges described above.

[0069] The inclination movement of the holding member 13a, 13b occurs around a horizontally extending axis. This horizontally extending axis is moved horizontally by operating the linear drive 18 and moved vertically by operating the first rotational drive 17.

[0070] The holding members 13a, 13b can be positioned along the horizontally extending axis 25 via a guide 26 and the closure 27 such that the distance between the holding members 13a, 13b corresponds to the physiological step width of the respective patient. This ascertains that the patient correctly loads weight onto his or her joints in order to maximize the training efficiency since no compensatory movements or adaptions if the patient is required during the performance of the movement pattern predetermined by the device according to the invention. Such a closure device is illustrated in FIG. 5, wherein the horizontally extending axis 25 is determined by a toothed rod on which the guide 26, when through operation of the closure 27 in form of a screw, is firmly canted so that thereby a displacement along the horizontal axis 25 is no longer possible.

[0071] For simulating everyday situations of human locomotion, holding members 13a, 13b for the lower extremities can be simulated through programmed predeterminations of the control as well as by foot plates yielding to the patient, with the patient standing on the holding member and being fastened thereto. Thereby, the control can be varied between a programmed movement and movement led by the patient. Alternatively, one holding member 13a can be controlled by the patient and the other holding member 13b can be controlled by programmed predeterminations.

[0072] In the embodiment according to FIG. 1, an adjusting device 28 is provided which is arranged adjacent to the movement device 11a, 1 b. The adjusting device 28 is arranged above the linear guiding track 16 so that the movement device 11a, 11b, in particular the holding members 13a, 13b, are movable below the adjusting device 31. The adjusting device 28 is adapted for controlling the center of gravity of the body or for adjusting the center of gravity of the body of a human connected to the holding members 13a, 13b. The adjusting device 28 allows for a change of the center of gravity of the body both in vertical direction, as well as in transversal direction. To this end, the adjusting device 28 includes a vertical drive 29 which cooperates with a belt 30. The belt 30 is connected to a patient carrier belt (not illustrated). The vertical drive allows for a change of the length of the vertical section of the belt 30 so that the center of gravity of the patient can be moved in vertical direction. The working area of this mechanism, or of the adjusting device 31 for changing the center of gravity, amounts to +/10 cm with respect to a zero-position. Other ranges are possible. One example for an embodiment of an adjusting device 28 is shown FIGS. 1, 2 and 3 and can comprise a further rotational drive for lifting the belt 30 via a roll-system 31 and thus vertically controls the center of gravity of the patient. Lowering the patient or lengthening of the belt 30 is also possible.

[0073] Other devices for lifting and lowering the belt 30 are possible.

[0074] For controlling the transversal component of the center of gravity, a transversal drive 32 is provided, which comprises another, further rotational drive connected to a disk 33. A rope (not illustrated) is fastened to the disk 33, the end of which rope reaches to the patient. The rope is looped around a roll system (not illustrated) and engages with both of its ends, for example through a carabiner, to lateral eyes on the patient belt. By rotating the disk 33, the patient is pulled in a transversal direction by shortening of one of either rope ends. A possible working space for the movement of the center of gravity by means of the transversal drive 32 for example amounts to +/15 cm to a zero-position. Other ranges are possible.

[0075] The control of the center of gravity in forward- or backward direction is achieved through the relative movement of the holding members 13a, 13b or the foot plates with respect to the attachment point of the adjusting device 28. The position of the sled 15 can be freely controlled on the linear track 16. Thereby, the attachment point of the patient is stationary in one direction parallel to the linear track 16, such that a corresponding displacement of the center of gravity is possible. The possible working space with respect to the step-length amounts to +/10 cm with respect to a zero-position. Other ranges are possible.

[0076] The device allows for a particularly variable and flexible therapy or training of the lower extremities, wherein the device is simple and compact in its design and therefore allows for an easy access to the patient.

LIST OF REFERENCE NUMERALS

[0077] 11a, 11b movement device [0078] 12 frame [0079] 13a,13b holding member [0080] 14a,14b pivot arm [0081] 15 sled [0082] 16 linear track [0083] 17 first rotational drive [0084] 18 linear drive [0085] 19 second rotational drive [0086] 20 force storage device [0087] 21 spring [0088] 22 guide [0089] 22a lever arm [0090] 23a, 23,b, 23c force transmission elements [0091] 24 toothed belt [0092] 25 axis [0093] 26 guide [0094] 27 closures [0095] 28 adjusting device [0096] 29 vertical drive [0097] 30 belt [0098] 31 roll system [0099] 32 transversal drive [0100] 33 disk [0101] 34 frame [0102] 35a, 35b arms [0103] 36 connecting element [0104] 37a, 37b side rail