Abstract
The invention relates to an orthosis comprising: a first fastening element (15) for fastening a first orthosis component (10) to a proximal body part of a user; a second orthosis component (20) having a second fastening element (21) for being fixed to a distal body part of the user; and a joint device (30) which is located at the proximal end (22) of the second orthosis component (20) and which has a joint upper part (40) and which makes it possible for the second orthosis component (20) to pivot about a joint axis (4) in the sagittal plane relative to the joint upper part (40), the joint upper part (40) being mounted or designed on the first orthosis component (10) in a fastening device (11) so as to be pivotable and/or displaceable in the frontal plane and so as to be rotationally rigid in the sagittal plane.
Claims
1. An orthosis, comprising: a first fastening element for fastening a first orthosis component on a proximal body part of a user; a second orthosis component having a second fastening element for fastening on a distal body part of the user; and a joint device arranged on a proximal end of the second orthosis component, wherein the joint device comprises an upper joint part and allows pivoting of the second orthosis component in a sagittal plane relative to the upper joint part about a joint axis, wherein the upper joint part is mounted or formed in a fastening device to be pivotable and/or displaceable in a frontal plane and to be rotationally rigid in the sagittal plane on the first orthosis component.
2. The orthosis as claimed in claim 1, wherein the upper joint part is mounted to be displaceable in a proximal-distal direction but not be displaceable in the anterior-posterior direction.
3. The orthosis as claimed in claim 1, wherein the upper joint part is configured to be flexible in the frontal plane.
4. The orthosis as claimed in claim 1 wherein the upper joint part is mounted or configured to be rotatable or rotatably rigid in a transverse plane.
5. The orthosis as claimed in claim 1 wherein the upper joint part is configured in multiple parts.
6. The orthosis as claimed in claim 5, wherein a first part and a second part of the upper joint part are fastened to one another in an articulated fashion.
7. The orthosis as claimed in claim 1 wherein the upper joint part is mounted on the fastening device on at least one pin or bolt and/or between two lateral guides.
8. The orthosis as claimed in claim 1 wherein the upper joint part is configured as a resilient element.
9. The orthosis as claimed in claim 1 wherein the upper joint part is mounted on the fastening device to be resilient in a frontal plane.
10. The orthosis as claimed in claim 1 wherein the upper joint part is guided in a link or has a link.
11. The orthosis as claimed in claim 1 further comprising a stop formed between the fastening device and the upper joint part for limiting displacement in a distal direction.
12. The orthosis as claimed in claim 1 further comprising an actuator and/or energy storage unit is arranged between the upper joint part and the second orthosis component.
13. The orthosis as claimed in claim 1 wherein the fastening device has a parallel guide in which the upper joint part is guided.
14. The orthosis as claimed in claim 1 wherein the orthosis is configured as a hip orthosis wherein the first fastening element is configured for fastening the first orthosis component on a torso of the user and the second fastening element is configured for fastening the second orthosis component on a thigh of the user.
15. The orthosis as claimed in claim 1 wherein the orthosis is configured as a shoulder orthosis wherein the first fastening element is configured for fastening the first orthosis component on an upper body of the user and the second fastening element is configured for fastening the second orthosis component on an upper arm of the user.
Description
[0020] Exemplary embodiments of the invention will be explained in more detail below with the aid of the appended figures.
[0021] FIG. 1a perspective representation of a hip orthosis;
[0022] FIG. 2a detail view of a joint device;
[0023] FIG. 3a detail view of a fastening device;
[0024] FIG. 4various views of the hip orthosis according to FIG. 1;
[0025] FIG. 5a schematic representation of the mounting of the upper joint part;
[0026] FIG. 6a variant of FIG. 5;
[0027] FIG. 7a representation of a multipart upper joint part;
[0028] FIG. 8various mounting configurations;
[0029] FIG. 9mounting of the upper joint part on a pin;
[0030] FIG. 10a variant of FIG. 9;
[0031] FIG. 11a variant of FIG. 9 with a hook-shaped upper joint part;
[0032] FIG. 12variants of FIG. 11;
[0033] FIG. 13variants of bolt mounting;
[0034] FIG. 14a variant of FIG. 11 with a deformable upper joint part;
[0035] FIG. 15a variant of FIG. 14;
[0036] FIG. 16a variant with a link in the upper joint part;
[0037] FIG. 17an individual representation of an upper joint part;
[0038] FIG. 18a side view with an upper joint part which is flexible in the frontal plane;
[0039] FIG. 19a front view of a resilient upper joint part;
[0040] FIG. 20a representation of rotatable mounting of the upper joint part;
[0041] FIG. 21a plan view of mounting according to FIG. 20;
[0042] FIG. 22a variant of FIG. 20;
[0043] FIG. 23a variant with an integrally formed resilient upper joint part;
[0044] FIG. 24a front view of FIG. 23;
[0045] FIG. 25a schematic representation of the functionality of the mounting according to FIG. 23;
[0046] FIG. 26a configuration as a shoulder orthosis;
[0047] FIG. 27a side view of FIG. 26;
[0048] FIG. 28a front view of FIG. 26 in two positions;
[0049] FIG. 29a perspective view according to FIG. 28; and
[0050] FIG. 30a variant of FIG. 26 with a resilient upper joint part.
[0051] FIG. 1 shows a schematic representation of an orthosis in the form of a hip orthosis having a first orthosis component 10 with a first fastening element 15 for fastening on the torso or pelvis of a user. The first fastening element 15 may for example be configured as a belt, cuff, shell, partial shell, or another device with which the hip orthosis can be secured removably and reappliably on the body of the user. The first orthosis component 10 has a fastening device 11, on or in which a part of a joint device 30 can be secured. The joint device 30 has an upper joint part 40, which in the exemplary embodiment represented is configured in multiple parts. The upper joint part 40 has a mounting part 41, which is connected by means of screws to an upper bearing component 42. The upper bearing component 42 is part of the joint device 30, which has a lower bearing component or joint lower part 32, arranged or formed on which there is a rod compartment in which a second orthosis component 20 is secured releasably by means of screws. The second orthosis component 20 is arranged distally with respect to the first orthosis component 10 and is mounted to be pivotable about a joint axis on the upper joint part 40. In the exemplary embodiment represented, the second orthosis component is a thigh rod 20, at the proximal end 22 of which the joint device 30 is positioned. Arranged distally with respect to the joint device 30, a second fastening element 21 in the form of a thigh cuff or a thigh shell is arranged on the second orthosis component 20 in order to secure the second orthosis component 20 on the thigh. Arranged between the upper joint part 40 and a joint lower part 32, there is an actuator 50 which is mounted with its distal end on the second orthosis component 20 and spans the joint device 30. The proximal end of the actuator 50 is secured on the upper joint part 40 on a bracket. The actuator 50 may be a damper, a drive or an energy storage unit, in particular a resilient element, or a combination thereof.
[0052] The second orthosis component 20 may further be followed distally by a third orthosis component (not represented), for example a lower leg rod, which is connected by means of an orthosis knee joint to the lower leg rod. This may likewise be followed by a foot part or a foot support.
[0053] FIG. 2 shows the joint device 30 in more detail on an enlarged scale. The mounting part 41 of the multipart upper joint part 40 is configured in the form of a rod and has a box profile, which forms a projection or a heel on its lower side facing toward the body. This projection or heel serves to increase the contact area and may also be omitted. The bearing component 42 together with the joint lower part 32 forms a joint axis 4, which in the fitted state of the hip orthosis lies at the height of the natural hip joint. The positioning of the joint device 30 on the body of the user is advantageously carried out so that the joint axis 4 runs substantially through the natural hip joint, that is to say it is mounted at the height of the natural hip joint in the frontal plane and runs with an orientation perpendicular to the sagittal plane. The joint axis 4 allows the normal forward gait of the user and pivoting of the leg in the sagittal plane in the anterior-posterior direction. FIG. 2 shows the forwardly directed bracket of the upper joint part 40 on the joint device 30 for fastening the actuator 50 (not represented).
[0054] FIG. 3 shows an enlarged representation of the first orthosis component 10 with the fastening device 11 for the upper joint part 40. The fastening device 11 has two lateral guides 110, which are aligned substantially parallel to one another and between which the mounting part 41 of the upper joint part 40 is inserted. The first fastening element 15 in the form of a belt or a cuff, on which the first orthosis component 10 is arranged, is only indicated.
[0055] FIGS. 1 to 3 show that the upper joint part 40 is not rigidly mounted in the fastening device 11 but allows pivoting and to a certain extent displacement within the frontal plane between the two lateral guides 110. A relative deflection of the upper joint part 40 and, in particular, of the mounting part 41 with respect to the fastening device 11 during abduction and adduction is thereby permitted. A deflection about a rotation axis which corresponds to the longitudinal axis 4 and is oriented substantially parallel thereto is blocked by means of the two lateral guides 110. In the fitted state, the upper joint part 40 is mounted to be rotationally rigid in the sagittal plane on the first orthosis component 10 and thereby allows supporting of the joint lower part 32, or of the second orthosis component 20, in relation to the upper joint part 40 and therefore also in relation to the first orthosis component 10 in the sagittal plane. The joint device 30 together with the actuator 50 can influence a movement of the leg in the sagittal plane and the radius of movement may likewise be restricted, for example by means of stops inside the joint device, should restriction of the hip flexion angle or the extension angle be necessary. By the laterally open configuration of the fastening device 11, it is possible initially to secure the first orthosis component 10 on the torso or the pelvis of the user as proximal body part and subsequently to fix the remaining part of the hip orthosis thereon. A reverse sequence is also possible. The upper joint part 40 is placed or hooked with the mounting part 41 in the fastening device 11 and guided with the inwardly protruding projection between the two lateral guides 110. If the joint axis 4 is positioned individually correctly for the user, the second orthosis component 20 is fixed with the second fastening element 21 on the thigh so that the hip orthosis is correctly arranged.
[0056] FIG. 4 shows six different views of movement situations of a hip orthosis. The left two representations show plan views from above in the proximal-distal direction with the joint device 30, which forms a joint axis 4 that runs while being oriented laterally outward at the height of the natural hip joint. The upper joint part 40 is mounted between the two lateral guides 110 in the fastening device 11 on the first orthosis component 10. The belt or buckle for securing on the user is represented indicatively. Besides pivoting about the joint axis 4, a rotation along the longitudinal extent of the thigh is not possible, and an inner rotation or outer rotation of the leg about the hip joint is blocked by means of the lateral guides 110.
[0057] The middle two representations of FIG. 4 show a front view of the orthosis with the joint axis 4, the lateral guides 110 and the fastening device 11. In the upper representation, the second orthosis component 20 is in an initial setting, and in the lower representation it is in a position pivoted outward in the frontal plane. The pivoting is not blocked by the mounting in the fastening device 11, which is indicated by the double arrow.
[0058] The right two representations show a side view in which it is illustrated that flexion and extension are possible only about the joint axis 4, while deflection of the upper joint part 40 about a pivot axis which is oriented perpendicularly to the sagittal plane in the frontal plane is blocked.
[0059] In the embodiment according to FIGS. 1 to 4, two rotational degrees of freedom for the mounting of the upper joint part 40 on the fastening device 11 are blocked, namely about the pivot axis in the sagittal plane and in the transverse plane; pivoting about a pivot axis perpendicular to the sagittal plane in the frontal plane is possible.
[0060] The upper joint part 40 may be guided in a longitudinally displaceable fashion in the fastening device 11, and the inwardly protruding projection or the lug on the mounting part 41 may block a displacement in the distal direction, so that in the case of abduction the mounting part 41 can be displaced upward, while in the case of an adduction beyond a standard extent the lug on the mounting part 41 becomes seated on a projection inside the fastening device 11.
[0061] FIG. 5 shows a variant of the mounting of the upper joint part 40 in a schematic sectional representation. The fastening arrangement 11 receives the upper joint part 40, for example with a lateral guide. In this embodiment as well, the upper joint part 40 is configured in multiple parts and has a mounting part 41 which is mounted on the first orthosis component 10 while being prestressed in the direction of the first fastening element 15 by means of a spring 46. The mounting part 41 is coupled in a fashion which is articulated about an additional pivot axis 47 to the bearing component 42, on which the lower part (not represented in detail) of the joint device 30 is then mounted to be pivotable. The pivot axis 47 runs orthogonally to the joint axis 4 and inside the sagittal plane, so that an abduction of the second orthosis component 20 with pivoting about the second pivot axis 47 is possible. If transverse forces that bring about a deflection of the mounting part 41 laterally or outward in the frontal plane occur, this movement is counteracted by the spring 46. The stop of the mounting part 41 or the bearing of the mounting part 41 on the side wall of the fastening device 11 prevents the upper joint part 40 from being able to rotate in the sagittal plane.
[0062] A variant of the mounting according to FIG. 5 is shown in FIG. 6, in which the mounting part 41 forms a link 43, in the exemplary embodiment as a rectilinear elongate guide hole, in which a pin 44 is guided. The pin 44 may at the same time serve as a stop and limit a deflection in the proximal direction and the distal direction. Depending on the positioning and dimensioning of the mounting part 41 relative to the fastening device 11, in particular the wall next to the body, pivoting of the mounting part 44 about the pin 44 is also possible. Resilient mounting or prestressing into an initial position, for example into a maximum stop position on the proximal end of the link 43 and/or prestressing in the medial direction, are likewise possible. The link 43 need not necessarily be configured in a straight line.
[0063] FIG. 7 shows a variant of the upper joint part 40, in which a plurality of identically shaped parts 41, 42 are connected to one another in an articulated fashion. The individual parts 41, 42 are only deflectable relative to one another about precisely one pivot axis, and make it possible that the entire upper joint part 40 can be deflected with the distal components medially and laterally inside the frontal plane, but pivoting in the sagittal plane as well as rotation in the transverse plane are prevented. The parts 41, 42 need not necessarily be identically shaped, and in particular they may have different axial spacings. In the case of two or more parts 41, 42, displacement proximally or distally is additionally possible.
[0064] Various forms of a guide or link 13 are shown in FIG. 8, in which links 13 are formed in a side wall or in a lateral guide, as denoted by the references 110 in FIGS. 1 to 4. In the upper representation, the link 13 is represented as a bore in which a pin (not represented) on the upper joint part 40 is guided. The pin may also be smaller than the bore in order to allow a limited movement. The limiting bore also need not necessarily be round. In the central representation, the link 13 is represented as an arcuate groove, and in the lower representation of FIG. 8 as a straight groove which runs with a laterodistal to medioproximal orientation.
[0065] FIG. 9 represents a further variant, in which a second orthosis component in the form of a thigh rod is arranged on an upper joint part 40, likewise by means of a joint device 30. The upper joint part 40 is configured in multiple parts, and besides the bearing component 42 has the mounting part 41, which has two laterally protruding pins 44 that bear on a mounting seat on the upper side of the fastening device 11. The fastening device 11 may be configured in the shape of an arc and comprehensively enclose the mounting part 41. For assembly, the mounting part 41 is inserted from above into the free space inside the fastening device 11 and is subsequently connected to the bearing component 42 by means of screws. The mounting part 41 is shown in the right representation of FIG. 9. The pins 44 protrude laterally from the base body of the mounting part 41 and bear on the curved mounting seat. Displaceability is provided upward or in the proximal direction, as are displaceability in the lateral direction and pivoting about the pivot axis which is formed by the pins 44. A rotation in the sagittal plane about an axis in the frontal plane is inhibited.
[0066] A variant of the embodiment according to FIG. 9 is shown in FIG. 10, in which the pins 44 no longer have a cylindrical cross section but a contour matched to the contour of the mounting seat. The lower side is rounded but not circular. An increased stability against abduction is thereby provided, and rotation about the longitudinal extent of the leg is prevented. In a similar way to FIG. 9, the fastening device may form a lateral arc next to the body part, for example the pelvis, or alternatively two flanges protruding laterally outward with upwardly curved ends may form the fastening device 11. The two flanges may also form lateral guides.
[0067] A variant of FIGS. 9 and 10 is shown in FIG. 11, in which the multipart upper joint part 40 has a hook-shaped mounting part 41 which is hooked into a bolt 14 that is part of the fastening device 11. At the same time, the bolt 14 forms a pivot axis about which the mounting part 41 can pivot during abduction. A rotation of the upper joint part 40 in the sagittal plane is prevented by the weight force of the orthosis and the thereby ensured bearing of the mounting part 41 on the bolt 14, so that reaction forces between the joint lower part 32 and the upper joint part 40 can be absorbed and transmitted via the first orthosis component 10 and the fastening device 11 onto the torso of the user.
[0068] The representations in FIG. 12 shows various configurations of the mounting part 41. In the upper representation, the free space for the bolt 14 corresponds substantially to the diameter of the bolt 14, there being a sufficiently large free space between the bent end of the mounting part 41 and the downwardly leading section in order to insert the bolt 14 into the upper, hook-shaped end.
[0069] In the lower representation, the free, upper branch extends obliquely downward, so that there is an approximately triangular free space for receiving the bolt 14. Here again, the passage is dimensioned to be sufficiently large so that the mounting part 41 can be hooked in after the first orthosis component 10 has been placed on the torso or the body of the user.
[0070] Various cross-sectional shapes of the bolt are shown in FIG. 13; besides a circular-cylindrical configuration, the bolt 14 may also be configured to be semicircular or partially matched to the contour of the mounting part 41.
[0071] A variant of the configuration of the mounting part 41 is shown in FIG. 14. Here again, the mounting part 41 is configured in the form of a hook as part of the upper joint part 40. In the upper, bent region, the mounting part 41 has a bellows structure which allows deformation, in particular resilient deformation, when the downwardly protruding inner branch bears on the bolt 14 during pivoting and the outer branch of the mounting part is moved further outward. This situation is shown in the dashed representation and indicated by the arrow. By the material weakenings and the associated bellows structure that is formed, a resilient deformation is possible in this region. In principle, it is also possible to configure the upper joint part 40 or in particular also the mounting part 41 from a plurality of components and from different materials, and to deliberately combine resilient regions with substantially rigid material sections. A controlled deformability, in particular resilient deformability, with defined restoring forces may thereby be implemented.
[0072] FIG. 15 shows a perspective view of such a configuration according to FIG. 14. The two lateral guides 110, which protrude outward from a base 12, receive between them the bolts 14 on which the mounting part 41 is placed. The mounting part 41 has a rectangular cross section, so that bearing is ensured over almost the entire length of the bolt 14, which blocks rotation in the sagittal plane. Incorporated in the apex region of the hook-shaped contour, there are material weakenings 410 or resilient components which facilitate or allow pivotability and resilient restoration.
[0073] In FIG. 16, instead of mounting which is hooked in or placed on a bolt 14, the mounting part 41 is provided with a link 43 in which the bolt 14 is guided. In order to assemble the orthosis, the bolt 14 is initially removed and the link 43 is subsequently aligned so that the bolt 14 can be reinserted and pushed through the link. The bolt 14 is then fixed on the side walls 110. This allows pivotability and displaceability about the bolt 14, although rotation of the upper joint part 40 in the sagittal plane is blocked. FIG. 16 shows two different shapes of the link 43; besides a curved groove, an overdimensioned bore may also be used as the link 13. As an alternative to reception between two side walls 110, the mounting part 41 may also form two flanges which extend on both sides next to a central body of the fastening device 11 with two pins or bolts 14 protruding laterally outward.
[0074] FIG. 17 shows a further variant, in which the mounting part 41 is configured as part of the upper joint part 40 with a plurality of resilient regions or elements 410. Deformability is thereby provided, which allows lateral displacement of the joint lower part 32 and therefore of the entire joint device 30 within the frontal plane, but still prevents rotation in the sagittal plane. Besides releasable fastening of the mounting part 41 on the fastening arrangement 11, the latter may also be formed in one piece so that a part of the upper joint part 40 is formed integrally or configured on the fastening device 11. The bearing component 42, or the joint device 30, may be fastened on the distal end of the mounting part 41.
[0075] In FIG. 18, a further variant is represented and shown in a side view. The first fastening element 15 is configured as a belt, which is applied around the pelvis and is positioned on the body, for example by means of a hook and loop fastener. Arranged on the outer side of the fastening device 15, there is a hook and loop fastening region, for example a hooked region, onto which a complementary constituent part of the hook and loop fastener, for example a fabric part, is attached. The mounting part 41 is configured to be flat and is fixed over a relatively large surface region on the hooked part on the fastening device 11. Because of the flat configuration of the mounting part 41, flexibility about pivot axes inside the main extent planes of the mounting part 41 is possible, although rotation about a pivot axis perpendicular to the sagittal plane is blocked, as is indicated by the crossed out double arrow. The bearing component 42 of the upper joint part is fastened on the mounting part 41, so that the joint device 30 is mounted to be pivotable with the joint lower part 32 and the second orthosis component 20. Arranged between the upper joint part 40 and the second orthosis component 20 in the exemplary embodiment, there is an energy storage unit 51 which is configured as a resilient element, for example a spring or an elastomer, so that energy is stored during extension and released again to assist flexion.
[0076] FIG. 19 shows a schematic representation of the attachment according to FIG. 17, with the aid of which it may be seen that a deformation about the deformation regions or resilient regions 410 on the fastening device by the mounting part 41 is possible during abduction.
[0077] FIG. 20 shows a variant in which, in a similar way to FIGS. 1 to 4, the fastening device has two lateral guides 110 between which the mounting part 41 is mounted. Rotation of the upper joint part 40 in the sagittal plane is thereby effectively avoided. In contrast to the embodiment according to FIGS. 1 to 4, the mounting part 41 is configured to be round so that a rotation about its longitudinal extent is possible, that is to say an inner rotation and an outer rotation of the limb are enabled. There are in this case a longitudinal displaceability in the proximal-distal direction as well as a displaceability in the mediolateral direction and tilting about a substantially horizontal axis running in the anterior-posterior direction.
[0078] FIG. 21 shows a plan view of a mounting situation according to FIG. 20; lateral evasion is possible outward or laterally, and facilitated assembly may therefore also be carried out by inserting the mounting part 41 between the lateral guides 110.
[0079] FIG. 22 shows a variant of the embodiment according to FIGS. 20 and 21, in which the proximal end of the mounting part 41 has a stop 45 so that deflection in the distal direction is limited, although deflection in the proximal direction inside the lateral guides 110 still remains possible.
[0080] FIG. 23 shows a variant with a resilient mounting part 41 having a rectangular cross section, which is integrally formed, materially fastened or otherwise secured on the fastening device 11. The bearing component 42 as part of the joint device 30 is fastened on the mounting part 41. FIG. 24 shows the embodiment in a front view. The upper representation of FIG. 25 shows the functionality of a deflectability of the upper joint part 40, and more precisely of the mounting part 41. Because of the configuration as a panel-like element having a relatively large main face with a relatively small thickness, a high stability may be achieved perpendicular to the main face so that deflection by applying a moment about the axis perpendicular to the sagittal plane within the frontal plane presents scarcely any or no deformation effect, which is indicated in the upper left representation of FIG. 25. Pivoting outward and a rotation in the longitudinal extent of the second orthosis component 20, as shown in the other two upper representations, are possible. The lower representation shows that an abduction movement is ensured with simultaneous blocking of a rotation in the sagittal plane.
[0081] FIG. 26 shows an embodiment in the form of a shoulder orthosis. The first orthosis component 10 is fastened on a shoulder to be treated in the form of a cuff or a supporting shell by means of a belt 15 as the first fastening element. The belt 15 is guided along the contralateral side below the armpit and, for example, fixed by means of a hook and loop fastener. There are other fastening options, for example by a plurality of geometrically stable shells, in a similar way to a suit of armor. Arranged on the first orthosis component 10, there is the fastening device 11 in which the upper joint part 40 is guided, as explained for example with the aid of FIGS. 1 to 4. The joint device 30 with a joint axis is arranged at the height of the shoulder joint and allows a pivoting movement of the arm in the sagittal plane. In the embodiment represented, an energy storage unit 51 is arranged between the second orthosis component 20, which is configured as an upper arm rod and is fixed on the upper arm by means of an upper arm cuff as the second fastening element 21, and the upper joint part 40, which facilitates a lifting movement of the arm in the sagittal plane when it is released. In the case of an angular configuration of the mounting part 41, with a corresponding lateral guide, an outer rotation of the arm is not possible. In the case of rotatable mounting of the upper joint part 40 in a similar way to FIG. 20, an outer rotation of the forearm by rotation of the upper arm about its longitudinal extent is possible.
[0082] FIG. 27 shows the shoulder orthosis according to FIG. 26 in an individual representation with rotatable mounting of the upper joint part 40 inside the fastening device 11. Here again, it may be seen that a rotation of the mounting of the upper joint part 40 inside the fastening device 11 is not possible in the sagittal plane but the other rotational degrees of freedom are not restricted. The translational degrees of freedom are limited by the two lateral guides, optionally a stop to prevent excessive deflection in the distal direction and the bearing on the body.
[0083] FIG. 28 shows the possible deflectability of the shoulder orthosis according to FIGS. 26 and 27 with the static or almost static fastening device 11 and the possibility of abduction of the upper arm.
[0084] FIG. 29 shows two possible positions of the arm in the configuration of the orthosis as a shoulder orthosis, in which the fastening device 11 is shown first in a buckle-like configuration and opening outward with an arm hanging down, and then with the opening upward with an arm extended horizontally outward.
[0085] FIG. 13 a variant of the securing and configuration of the upper joint part 40 with deformation regions or resilient regions 410 formed integrally or configured and an integrally formed fastening device 11, which is formed integrally or fastened on the first orthosis component and can be secured on the torso of the user by means of a fastening element 15 explained with the aid of FIG. 26. Here again, an energy storage unit 51 to assist a lifting movement of the arm is arranged between the upper joint part 40 and the second orthosis component 20. The fixing on the upper arm is carried out by means of the upper arm cuff as the second fastening element 21.
