ORTHOTIC OR PROSTHETIC JOINT DEVICE, AND METHOD FOR CONTROLLING SAME
20240358530 ยท 2024-10-31
Inventors
- Christian WILL (Gottingen, DE)
- Matthias PREIS (Gernrode, DE)
- Sven Zarling (Duderstadt, DE)
- Cornelia HARTMANN (Duderstadt, DE)
Cpc classification
A61F2/741
HUMAN NECESSITIES
A61F2002/7635
HUMAN NECESSITIES
A61F2002/7645
HUMAN NECESSITIES
A61H3/00
HUMAN NECESSITIES
International classification
A61H1/02
HUMAN NECESSITIES
A61H3/00
HUMAN NECESSITIES
Abstract
The invention relates to an orthotic or prosthetic joint device with an upper part and a lower part arranged in a hinged manner on the latter, and fastening means for securing the joint device on a user, with at least one hydraulics unit between the upper part and the lower part, which hydraulics unit has a piston that is movable in a housing with an extension chamber and a flexion chamber and that is coupled to the upper part or the lower part, and which hydraulics unit is assigned a pressure supply device with a pump and a pressure accumulator via which the piston, controlled by a control device, is subjected to a pressure, wherein the pump can be operated in generator mode, the pressure accumulator can be coupled drivingly to the pump, and the hydraulic fluid can be conveyed by the pressure accumulator through the pump to the hydraulics unit.
Claims
1-22. (canceled)
23. A method for controlling an orthotic or prosthetic knee joint device with an upper part and a lower part arranged in an articulated manner thereon, fastening devices to secure the knee joint device on a user, a drive device to apply a moment to the knee joint device, and a control device communicatively coupled to at least one sensor and configured to control the drive device, the method comprising: applying a supporting moment to the orthotic or prosthetic knee joint device with the drive device during operation of the orthotic or prosthetic knee joint device when mounted to the user, where the supporting moment is a supporting flexion moment or a supporting extension moment, and where the supporting flexion moment or the supporting extension moment is sufficient to support a flexion movement or an extension movement and is applied in a same direction as a flexion movement or an extension movement, respectively, of the lower part relative to the upper part; applying a passive dampening of a swing phase flexion movement using a drive device; and applying an activation moment to the knee joint device in the swing phase, wherein the applied activation moment causes flexion movement or extension movement of the lower part relative to the upper part.
24. The method of claim 23, wherein applying the support moment to the orthotic or prosthetic knee joint device includes applying the supporting flexion moment, the supporting flexion moment being applied prior to the knee joint device being flexed and reduced when the knee joint device begins to flex.
25. The method of claim 23, wherein applying the supporting moment to the orthotic or prosthetic knee joint device includes applying the supporting flexion moment, the supporting flexion moment being provided in a varying degree in dependence on a walking situation selected from walking on level ground, walking up an incline, or walking up stairs.
26. The method of claim 23, wherein applying the supporting moment to the orthotic or prosthetic knee joint device includes applying the supporting flexion moment, the supporting flexion moment including a first supporting flexion moment that is applied after activation of supporting flexion movement of the lower part relative to the upper part, and a second supporting flexion moment that is greater than the first supporting flexion moment and is applied before activation of supporting flexion movement of the lower part relative to the upper part.
27. The method of claim 23, wherein applying the supporting moment to the orthotic or prosthetic knee joint device includes applying the supporting flexion moment, the supporting flexion moment being applied during supporting flexion movement up to a predetermined, ascertained flexion angle of the lower part relative to the upper part.
28. The method of claim 23, wherein the supporting moment is applied up to a predetermined, ascertained bending angle.
29. The method of claim 23, wherein the supporting moment is applied in a time period before the knee joint device is flexed that is between 5% and 40% of a duration of a gait cycle.
30. The method of claim 23, wherein applying a passive dampening of a swing phase flexion movement using a drive device comprises applying a passive dampening of a mid-swing phase flexion movement of a swing phase flexion movement using a drive device.
31. A method for controlling an orthotic or prosthetic knee joint device with an upper part and a lower part arranged in an articulated manner thereon, fastening devices to secure the knee joint device on a user, a drive device to apply a moment to the knee joint device, and a control device communicatively coupled to at least one sensor and configured to control the drive device, the method comprising: applying a supporting moment to the orthotic or prosthetic knee joint device with the drive device during operation of the orthotic or prosthetic knee joint device when mounted to the user, the applied supporting moment being a supporting flexion moment or a supporting extension moment, the supporting flexion moment or the supporting extension moment being sufficient to support a flexion movement or an extension movement and that is applied in the same direction as a flexion movement or an extension movement, respectively, of the lower part relative to the upper part; wherein applying the supporting moment to the orthotic or prosthetic knee joint device includes applying the supporting flexion moment, the supporting flexion moment being applied in a time period before a swing phase flexion movement during a gait cycle; and applying an activation moment to the knee joint device in the swing phase during the gait cycle, the applied activation moment causes flexion movement or extension movement of the lower part relative to the upper part.
32. The method of claim 31, wherein applying the support moment to the orthotic or prosthetic knee joint device includes applying the supporting flexion moment, the supporting flexion moment being applied prior to the knee joint device being flexed and reduced when the knee joint device begins to flex.
33. The method of claim 31, wherein applying the supporting moment to the orthotic or prosthetic knee joint device includes applying the supporting flexion moment, the supporting flexion moment being provided in a varying degree in dependence on a walking situation, the walking situation including walking on level ground, walking up an incline, or walking up stairs.
34. The method of claim 31, wherein applying the supporting moment to the orthotic or prosthetic knee joint device includes applying the supporting flexion moment, the supporting flexion moment including a first supporting flexion moment that is applied after activation of supporting flexion movement of the lower part relative to the upper part, and a second supporting flexion moment that is greater than the first supporting flexion moment and is applied before activation of supporting flexion movement of the lower part relative to the upper part.
35. The method of claim 31, wherein applying the supporting moment to the orthotic or prosthetic knee joint device includes applying the supporting flexion moment, the supporting flexion moment being applied during supporting flexion movement up to a predetermined, ascertained flexion angle of the lower part relative to the upper part.
36. The method of claim 31, wherein the supporting moment is applied up to a predetermined, ascertained bending angle.
37. The method of claim 31, wherein the supporting moment is applied in a time period before the knee joint device is flexed that is between 5% and 40% of the duration of a gait cycle.
38. A method for controlling an orthotic or prosthetic knee joint device with an upper part and a lower part arranged in an articulated manner thereon, fastening devices to secure the knee joint device on a user, a drive device to apply a moment to the knee joint device, and a control device communicatively coupled to at least one sensor and configured to control the drive device, the method comprising: applying a supporting moment to the orthotic or prosthetic knee joint device with the drive device during operation of the orthotic or prosthetic knee joint device when mounted to the user, the applied supporting moment being a supporting flexion moment or a supporting extension moment, the supporting flexion moment or the supporting extension moment being sufficient to support a flexion movement or an extension movement and that is applied in the same direction as a flexion movement or an extension movement, respectively, of the lower part relative to the upper part; wherein a supporting flexion moment or a supporting extension moment of a varying degree is provided in dependence on a walking situation; and applying an activation moment to the knee joint device in a swing phase during a gait cycle, the applied activation moment causes flexion movement or extension movement of the lower part relative to the upper part.
39. The method of claim 38, wherein applying the support moment to the orthotic or prosthetic knee joint device includes applying the supporting flexion moment, the supporting flexion moment being applied prior to the knee joint device being flexed and reduced when the knee joint device begins to flex.
40. The method of claim 38, wherein applying the supporting moment to the orthotic or prosthetic knee joint device includes applying the supporting flexion moment, the supporting flexion moment being provided in a varying degree in dependence on a walking situation, the walking situation including walking on level ground, walking up an incline, or walking up stairs.
41. The method of claim 38, wherein applying the supporting moment to the orthotic or prosthetic knee joint device includes applying the supporting flexion moment, the supporting flexion moment including a first supporting flexion moment that is applied after activation of supporting flexion movement of the lower part relative to the upper part, and a second supporting flexion moment that is greater than the first supporting flexion moment and is applied before activation of supporting flexion movement of the lower part relative to the upper part.
42. The method of claim 38, wherein applying the supporting moment to the orthotic or prosthetic knee joint device includes applying the supporting flexion moment, the supporting flexion moment being applied during supporting flexion movement up to a predetermined, ascertained flexion angle of the lower part relative to the upper part.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0038] Exemplary embodiments of the invention are explained in more detail below on the basis of the accompanying figures, in which:
[0039]
[0040]
[0041]
[0042]
[0043]
[0044]
[0045]
[0046]
[0047]
[0048]
[0049]
DETAILED DESCRIPTION
[0050] In
[0051] To assist the respective movement, that is to say the bending and stretching movement, a drive by way of which the respective movement is executed, initiated or assisted is provided in the hydraulic unit.
[0052] In
[0053] The hydraulic unit 10 is assigned a pressure providing device 20, by which the hydraulic system of the hydraulic unit 10 is supplied with hydraulic fluid. A hydraulic pump 21, which is driven by a motor 22, supplies the hydraulic unit 10 with pressurized hydraulic fluid. Likewise provided is a pressure accumulator 23, which likewise introduces pressurized hydraulic fluid into the hydraulic system.
[0054] The pressure providing device 20 is connected to the hydraulic unit 10 by way of a switching device 60 in the form of a switching valve. The switching device 60 of the embodiment shown can be switched into three positions, so that three different flow progressions can be realized, explained in more detail later.
[0055] Arranged between the switching device 60 and the hydraulic unit 10 are adjustable valves 40, 50, by way of which the extension damping and the flexion damping can be set. In order to drive the hydraulic unit 10, it is advisable to keep the respective dampings as small as possible, in order that less flow losses occur. The extension damping is set by way of the extension valve 40; the flexion damping is set by way of the flexion valve 50. It is possible by way of motors either to variably restrict the fluid flow or to shut it off entirely.
[0056] Pressure sensors 71, 72, 73 are provided, in order to set the valves 40, 50 in dependence on the existing pressures and the desired movements or dampings.
[0057] The switching position C shown is intended for passive movement damping, in which the pressure providing device 20 is separated from the hydraulic device 10. Extension damping and flexion damping take place by way of a setting of the respective valves 40, 50; the position of the switching device is chosen such that driving by the pressure providing device 20 is not possible. If a flexion movement is carried out, the piston 12 is forced downward. The hydraulic fluid flows through the flexion valve 50. The fluid flows out of the extension chamber 14 through the flexion valve 50 by way of the reservoir 16 back into the flexion chamber 15. On account of the reduction in the volume that can flow back, occurring due to the piston rod 13, the level in the oil reservoir 16 increases; since there is no assistance by the pump 21 or the pressure accumulator 23, this is a case of passive flexion.
[0058] Passive extension takes place in the event of a reversal of the movement, when the piston 12 moves upward and the hydraulic fluid out of the flexion chamber 15 through the extension valve 40 in the flow circuit through the switching device 60, hydraulic fluid additionally flowing into the extension chamber 14 out of the reservoir 16 of the hydraulic device 10.
[0059] In
[0060] In order to ensure precise control of the hydraulic unit 10 with the valves 40, 50 and the switching device 60, sensors which monitor the individual components are provided. Apart from a knee angle sensor and an ankle moment sensor, axial force sensors may also be provided. The control may take place for example by observing the knee angle velocity. At a point of inflection of the knee angle velocity, active flexion assistance with the valve position A is activated for a certain time period. The flexion valve 50 is set to a low value and, when a defined joint angle is exceeded, the assistance is switched off and the switching device is displaced into the position C.
[0061] A variant of the control in which the assistance is constituted by active extension assistance is shown in
[0062] In
[0063] As from a defined target angle of the knee angle KA, the flexion assistance is switched off and the switching device 60 returns to the position C. The flexion damping FD and the extension damping ED remain unchanged. Shortly before reaching the maximum knee angle, the flexion damping is increased, in order to limit the maximum knee angle KA. After reaching the maximum flexion angle and the setting down of the foot, the extension assistance is activated and the switching device 60 is moved into the valve position B. At the same time, the extension damping ED is reduced, in order to ensure full assistance for the lifting movement. The flexion damping is left at a high level, for example in order to prevent the patient from falling back. When raising up the patient, the extension damping ED is slowly increased in dependence on the knee angle KA, in order to reduce the assisting moment by the pump 21 or the pressure accumulator 23 and avoid a hard abutment against the extension limit stop. After reaching the maximum stretching angle, the assistance is switched off and the valve position B is switched on.
[0064] In
[0065] In addition, it is possible with the circuit according to
[0066] As a further option, be provided, one pressures, accumulator may be provided, one that is designed for very high pressures, higher than those pressures that the pressure accumulator 23 requires for normal operation of the joint device. The additional accumulator can be charged to a very high level by going down an incline or going down stairs, so that the energy storage potential increases. There is the possibility that the pump 21 is thereby operated as a pneumatic motor, so that electrical energy can be generated in generator mode. The additional accumulator could also be discharged into the pressure accumulator 23 in a controlled manner, in order to create pressure reserves.
[0067] In
[0068] In
[0069] In
[0070] Subsequently, the extension is completed. These are the mid and terminal standing phases in the sixth time period. There is subsequently a passive flexion of the knee joint, in what is known as the forward swinging phase 7. At the end of the forward swinging phase 7, what is known as the toe off takes place, that is to say the lifting of the foot off the ground, in order that the leg can swing forward. In the initial swinging phase, the maximum flexion is then subsequently reached; in the mid swinging phase 9, the swinging 20 forward of the leg is reached and, in the terminal swinging phase, the extension of the knee joint is pursued, in order to reach the maximum knee angle and carry out the preparation for the standing phase.
[0071] In the table presented below this sequence of movements, the individual elements of the hydraulic circuit of the joint device are shown for the situation with active extension assistance and without active extension assistance. Up until the terminal standing 30 phase, the switching device 60 is arranged in the middle position C; for the terminal standing phase up to the maximum flexion, it is brought into the valve position A, in order to make assistance possible during the initiation of bending. After reaching the maximum flexion, without the extension-assisting function, that is to say extension assistance, assistance by a pressure accumulator 23 or the pump 21 is switched off again. In the case of extension assistance, after reaching the maximum flexion switching into the valve position B takes place, in order to achieve extension assistance.
[0072] The extension valve 40 remains predominantly closed during the standing phase. The extension valve only opens at the beginning of the terminal standing phase, remains substantially open during the entire flexion phase and the extension valve is only closed again during the terminal swinging phase, in order to avoid a hard strike against the extension limit stop. The high extension damping during the standing phase prevents a hard strike in the extension during the standing phase extension.
[0073] The flexion valve 50 is initially predominantly closed, in order to dampen standing phase bending. After the standing phase extension, the flexion damping is reduced, in order to make bending possible. Before the initiation of bending, the flexion damping is reduced to the maximum extent, since here the knee joint is kept up against the limit stop by the ground reaction forces. Without extension assistance, the flexion damping is increased in the swinging phase in order to avoid over-swinging of the prosthetic foot and what is known as heel rising. The flexion damping remains at a high level to allow stumbling to be averted. The flexion valve with the extension-assisting function does not provide any increase in the damping during the flexion phase because heel rising does not have to be avoided here, since this is brought about by the activation of the extension assistance. The damping in the direction of flexion remains low for longer in comparison with the damping without an extension-assisting function in order to make extension assistance possible. Subsequently, the flexion damping is increased again, in order to allow stumbling to be averted.
[0074] For the variant according to
[0075]
[0076] In
[0077] The flexion valve 50 has increased flexion resistance during the standing phase, in order to dampen the bending during the downward movement. Subsequently, the flexion valve 50 is slowly opened, in order to make a flexion movement possible. In the swinging phase, the damping remains low, in order to make extension assistance possible, if so desired; alternatively, the flexion damping may also be increased, as is provided in the region of the mid swinging phase. In the region of the terminal swinging phase, maximum flexion damping is again provided.
[0078] Shown in
[0079] As a departure from
[0080] Shown in
[0081]
[0082] After the toe off, that is to say at about t=1.2 s, there is no longer an assisting bending moment; rather, an extension moment EM is applied, acting as flexion damping and preventing excessive bending of the knee joint. Instead of active application of an extension moment EM, purely passive damping may also take place; it is likewise possible that energy is drawn from the system by conversion for the damping, so that the energy required for the application of a bending moment can be at least partially returned. If a stretching moment EM is applied, the phase in which a stretching moment EM is applied is ended before complete stretching of the knee joint.
[0083] It is possible and intended that the energy remains applied even beyond the initiation of the movement, either at the same level or at a reduced level, in order to assist the user in the movement. The relatively low level of supplied energy prolongs the possible times of use without maintenance.
[0084] In the diagram according to
[0085] Control such as that described on the basis of