FR2809615A1 - Electromechanical equipment for promoting flexure and extension of the lower limbs, comprises pivoting shoes and leg supports fitted to a motor driven trolley which slides to and fro on a rail - Google Patents
Electromechanical equipment for promoting flexure and extension of the lower limbs, comprises pivoting shoes and leg supports fitted to a motor driven trolley which slides to and fro on a rail Download PDFInfo
- Publication number
- FR2809615A1 FR2809615A1 FR0007092A FR0007092A FR2809615A1 FR 2809615 A1 FR2809615 A1 FR 2809615A1 FR 0007092 A FR0007092 A FR 0007092A FR 0007092 A FR0007092 A FR 0007092A FR 2809615 A1 FR2809615 A1 FR 2809615A1
- Authority
- FR
- France
- Prior art keywords
- rail
- movement
- patient
- carriage
- servomotor
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Granted
Links
- 210000003141 lower extremity Anatomy 0.000 title claims description 8
- 230000001737 promoting effect Effects 0.000 title 1
- 244000309466 calf Species 0.000 claims description 3
- 230000003100 immobilizing effect Effects 0.000 claims description 2
- 230000003071 parasitic effect Effects 0.000 claims description 2
- 230000006978 adaptation Effects 0.000 claims 1
- 230000000630 rising effect Effects 0.000 claims 1
- 230000000694 effects Effects 0.000 description 3
- 210000002683 foot Anatomy 0.000 description 3
- 210000002414 leg Anatomy 0.000 description 3
- 230000002035 prolonged effect Effects 0.000 description 3
- 230000036626 alertness Effects 0.000 description 2
- 210000000544 articulatio talocruralis Anatomy 0.000 description 2
- 230000001771 impaired effect Effects 0.000 description 2
- 210000001503 joint Anatomy 0.000 description 2
- 210000003205 muscle Anatomy 0.000 description 2
- 208000004067 Flatfoot Diseases 0.000 description 1
- 210000003423 ankle Anatomy 0.000 description 1
- 230000000903 blocking effect Effects 0.000 description 1
- 230000017531 blood circulation Effects 0.000 description 1
- 230000006835 compression Effects 0.000 description 1
- 238000007906 compression Methods 0.000 description 1
- 230000006735 deficit Effects 0.000 description 1
- 230000001419 dependent effect Effects 0.000 description 1
- 238000001514 detection method Methods 0.000 description 1
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 1
- 210000001624 hip Anatomy 0.000 description 1
- 210000004394 hip joint Anatomy 0.000 description 1
- 210000003127 knee Anatomy 0.000 description 1
- 210000000629 knee joint Anatomy 0.000 description 1
- 239000000463 material Substances 0.000 description 1
- 230000002232 neuromuscular Effects 0.000 description 1
- 230000007935 neutral effect Effects 0.000 description 1
- 238000011084 recovery Methods 0.000 description 1
- 230000001960 triggered effect Effects 0.000 description 1
- 230000001228 trophic effect Effects 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H1/00—Apparatus for passive exercising; Vibrating apparatus; Chiropractic devices, e.g. body impacting devices, external devices for briefly extending or aligning unbroken bones
- A61H1/02—Stretching or bending or torsioning apparatus for exercising
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H1/00—Apparatus for passive exercising; Vibrating apparatus; Chiropractic devices, e.g. body impacting devices, external devices for briefly extending or aligning unbroken bones
- A61H1/02—Stretching or bending or torsioning apparatus for exercising
- A61H1/0237—Stretching or bending or torsioning apparatus for exercising for the lower limbs
- A61H1/0255—Both knee and hip of a patient, e.g. in supine or sitting position, the feet being moved together in a plane substantially parallel to the body-symmetrical plane
- A61H1/0259—Both knee and hip of a patient, e.g. in supine or sitting position, the feet being moved together in a plane substantially parallel to the body-symmetrical plane moved by translation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
- A61H2201/12—Driving means
- A61H2201/1207—Driving means with electric or magnetic drive
- A61H2201/1215—Rotary drive
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
- A61H2201/16—Physical interface with patient
- A61H2201/1602—Physical interface with patient kind of interface, e.g. head rest, knee support or lumbar support
- A61H2201/164—Feet or leg, e.g. pedal
- A61H2201/1642—Holding means therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
- A61H2201/16—Physical interface with patient
- A61H2201/1657—Movement of interface, i.e. force application means
- A61H2201/1676—Pivoting
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H2203/00—Additional characteristics concerning the patient
- A61H2203/04—Position of the patient
- A61H2203/0406—Standing on the feet
Landscapes
- Health & Medical Sciences (AREA)
- Epidemiology (AREA)
- Pain & Pain Management (AREA)
- Physical Education & Sports Medicine (AREA)
- Rehabilitation Therapy (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Rehabilitation Tools (AREA)
- Percussion Or Vibration Massage (AREA)
Abstract
Description
La présente invention concerne un dispositif motorisé d'aide à la mobilisation des membres inférieurs du corps humain adapté aux patients de réanimation et d'unité de soins intensifs présentant une diminution des fonctions supérieures (d'origine artificielle ou non: patient anesthésié et/ou présentant atteinte directe des fonctions supérieures). The present invention relates to a motorized device for assisting in the mobilization of the lower limbs of the human body suitable for resuscitation patients and intensive care units having a decrease in upper functions (whether of artificial origin or not: anesthetized patient and / or with direct impairment of higher functions).
L'invention se rattache au secteur technique des appareils luttant contre les effets indésirables de l'hospitalisation prolongée en réanimation et unité de soins intensifs chez les patients aux fonctions supérieures diminuées. The invention relates to the technical sector of devices combating the undesirable effects of prolonged hospitalization in intensive care and intensive care unit in patients with impaired superior functions.
En réanimation et unité de soins intensifs, pour les patients aux fonctions supérieures altérées l'immobilisation prolongée à l'origine d'effets secondaires invalidants: atteintes neuro musculaires, atteintes articulaires, troubles de la circulation sanguine, atteintes trophiques. Ces effets secondaires sont responsables d'un allongement des durées de séjour et du temps de récupération après le séjour en réanimation et unité de soins intensifs. La mobilisation journalière de tous les membres du corps est donc nécessaire pour prévenir ces complications. Celle ci est actuellement effectuée par un personnel spécialisé (kinésithérapeutes) quand il est en nombre suffisant. Cette mobilisation génère une grande charge de travail, mais reste tout de même limitée dans le temps. In intensive care and intensive care, for patients with impaired upper functions prolonged immobilization causing disabling side effects: neuro-muscular damage, joint damage, blood circulation disorders, trophic damage. These side effects are responsible for an extension of the length of stay and the recovery time after the stay in intensive care and intensive care unit. The daily mobilization of all members of the body is therefore necessary to prevent these complications. This is currently carried out by specialized personnel (physiotherapists) when there are enough of them. This mobilization generates a large workload, but is still limited in time.
Le dispositif selon l'invention se propose de résoudre, chez les patients aux fonctions supérieures diminuées, le problème de l'immobilisation prolongée des membres inférieurs, en accompagnant et coordonnant le mouvement de flexion - extension des membres inférieurs qui met en jeu trois articulations (la hanche, le genou, la cheville). Il comporte en effet selon une première caractéristique, un chariot motorisé pouvant effectuer un mouvement de va et vient sur un rail linéaire. Le chariot est équipé de chausses conçues pour recevoir les pieds du patient et maintenir ses jambes dans un plan vertical. La motorisation du chariot est pilotée de telle façon qu'elle permet de 'adapter au niveau de vigilance du patient: Le mouvement est entièrement pris en charge la machine si le patient est totalement passif. En revanche, le déclenchement du mouvement est directement dépendant des sollicitations du patient quand ce dernier est capable d'esquisser une ébauche de mouvement. Une auto-adaptation du système, fonction de la capacité d'effort et de coordination de chaque patient, permet ensuite d'effectuer la totalité du mouvement de flexion - extension des membres inférieurs. The device according to the invention proposes to solve, in patients with reduced upper functions, the problem of prolonged immobilization of the lower limbs, by accompanying and coordinating the flexion movement - extension of the lower limbs which involves three joints ( hip, knee, ankle). According to a first characteristic, it indeed comprises a motorized carriage capable of performing a movement back and forth on a linear rail. The trolley is fitted with casings designed to receive the patient's feet and keep his legs in a vertical plane. The motorization of the trolley is controlled in such a way that it makes it possible to adapt to the level of alertness of the patient: The movement is fully supported by the machine if the patient is completely passive. On the other hand, the triggering of the movement is directly dependent on the patient's requests when the latter is able to sketch a draft of the movement. A self-adaptation of the system, depending on the effort and coordination capacity of each patient, then makes it possible to carry out the entire flexion movement - extension of the lower limbs.
Les dessins annexés illustrent l'invention La figure 1 représente une de coté du dispositif de l'invention. La figure 2 représente une vue de face du dispositif de l'invention La figure 3 représente une vue de dessus du dispositif de l'invention. En référence à ces dessins, le dispositif constitué de quatre parties A) Un socle (1) constitué d'une plaque plane et rigide équipée d'un système de sangles permettant sa fixation stable sur tous types de lit médicalisé. Ce socle se place sous les jambes du patient. Il est donc placé sur la partie antérieure du lit médicalisé, en adéquation avec la morphologie de chaque patient. The accompanying drawings illustrate the invention. Figure 1 shows a side view of the device of the invention. Figure 2 shows a front view of the device of the invention Figure 3 shows a top view of the device of the invention. With reference to these drawings, the device consisting of four parts A) A base (1) consisting of a flat and rigid plate equipped with a system of straps allowing its stable attachment to all types of medical bed. This base is placed under the patient's legs. It is therefore placed on the front part of the medical bed, in line with the morphology of each patient.
B) Un système de translation motorise. Le système de translation en question est fixé rigidement sur le socle décrit en A). Il est composé d'un rail rectiligne (2) équipé d'un chariot (3) conçu de telle sorte que seul le mouvement de translation selon l'axe du rail est possible. Le chariot est mis en mouvement via courroie crantée et un jeu de roues dentées par un servomoteur (4) fixé rigidement au socle. B) A motorized translation system. The translation system in question is rigidly fixed to the base described in A). It is composed of a rectilinear rail (2) equipped with a carriage (3) designed so that only the translational movement along the axis of the rail is possible. The carriage is set in motion via a toothed belt and a set of toothed wheels by a servomotor (4) rigidly fixed to the base.
Le rail est équipé de capteurs dont fonction est de détecter le passage du chariot. Le positionnement de ces capteurs est réglable le long du rail de façon à ajuster l'amplitude des mouvements de va et vient du chariot ' la morphologie du patient. Par ailleurs, le moteur est équipé d'un codeur permettant de reperer précisément la vitesse et la position de l'arbre moteur. De plus, le système est équipé capots permettant d'éviter tout risque de coincement avec les parties mobiles du dispositif. The rail is equipped with sensors whose function is to detect the passage of the carriage. The positioning of these sensors is adjustable along the rail so as to adjust the amplitude of the movements back and forth of the carriage 'the morphology of the patient. In addition, the motor is equipped with an encoder making it possible to pinpoint the speed and the position of the motor shaft. In addition, the system is fitted with covers to avoid any risk of jamming with the moving parts of the device.
C) Deux chausses (5) réglables en fonction de la morphologie des pieds de chaque patient (système coulissant - bloquant à l'embase de la chausse) et fixées au niveau du talon sur un axe solidaire du chariot mobile. Les pieds du patient sont maintenus fixes dans les chausses à l'aide de sangles réglables (6). Pour maintenir l'articulation de la cheville en position neutre pendant tout le mouvement, les chausses ont la possibilité de pivoter autour de l'axe (7) qui les relie au chariot. Pour limiter mouvements des membres inférieurs au simple mouvement de flexion - extension et rendre impossible des mouvements latéraux parasites risquant d'entrainer une position non adaptée des trois articulations hanche, genou et cheville, les jambes sont maintenues à l'aide dispositif latéral (8) solidaire des chausses remontant et immobilisant le haut du mollet. Afin d'éviter les risques de compression et de frottement, tous les points de contact (talon, plat du pied et mollet) sont revêtues de matière souple. Enfin chaque chausse pourra être désolidarisée du chariot pour rendre possible le mouvement de flexion - extension d'un seul membre inférieur. C) Two bags (5) adjustable according to the morphology of the feet of each patient (sliding system - blocking at the base of the shoe) and fixed at the heel on an axis integral with the mobile carriage. The patient's feet are kept fixed in the cuffs using adjustable straps (6). To keep the ankle joint in a neutral position during the entire movement, the shoes have the possibility of pivoting around the axis (7) which connects them to the carriage. To limit movements of the lower limbs to the simple flexion - extension movement and to make it impossible for parasitic lateral movements which risk causing an unsuitable position of the three hip, knee and ankle joints, the legs are supported using the lateral device (8) attached to the breeches going up and immobilizing the top of the calf. In order to avoid the risks of compression and friction, all the contact points (heel, flat foot and calf) are coated with flexible material. Finally each shoe can be detached from the carriage to make possible the flexion movement - extension of a single lower limb.
D) Un système de pilotage et de gestion des paramètres de fonctionnement du système. Ce système de commande est composé d'un système informatique (automate programmable), du logiciel de commande, d'une carte électronique de commande du moteur, d'une carte électronique de gestion des entrées sorties logiques du système et d'une interface homme/machine. Les fonctions remplies par les systèmes de commande sont les suivantes commande de la vitesse, du couple et de l'amplitude du mouvement du chariot selon deux modes de fonctionnement dont la mise en oeuvre est paramétrable par l'intermédiaire de l'interface homme/machine . Le premier mode de commande appelé "mouvement totalement controlé" assure une prise en charge totale des mouvements du chariot. Il est adapté à un patient entièrement passif. Dans ce cas, le système effectue un nombre de cycle donné à une vitesse donnée avec une fréquence donnée. Ces trois paramètres sont saisies sur l'interface homme/machine. L'amplitude du mouvement est déterminée par la position des capteurs. Le second mode de contrôle appelé "mouvement partiellement contrôlé " assure une prise en charge du mouvement adaptée au niveau de vigilance du patient et de sa tonicité musculaire. Dans cas, le système déclenche un cycle sur sollicitation du patient par détection d'une variation angulaire significative (seuil ajustable) de la position de l'axe moteur. Une fois le cycle déclenché, le système fourni une aide au déroulement complet du cycle en fonction de la capacité d'effort et de la tonicité musculaire du patient. Le système donc adapter la vitesse et le couple fournis par le moteur afin d'effectuer le cycle à une vitesse donnée. Par ailleurs, au bout d'un certain temps de latence fonction de la fréquence cycle désirée, si aucune sollicitation du n'a été détectée, le système effectue un cycle selon le mode mouvement totalement contrôlé . D) A system for steering and managing the operating parameters of the system. This control system is composed of a computer system (programmable logic controller), control software, an electronic motor control card, an electronic card for managing the system logic inputs and outputs and a human interface. /machine. The functions fulfilled by the control systems are the following control of the speed, the torque and the amplitude of the movement of the carriage according to two modes of operation the implementation of which can be parameterized via the man / machine interface . The first control mode called "fully controlled movement" provides full support for the movements of the carriage. It is suitable for a fully passive patient. In this case, the system performs a given number of cycles at a given speed with a given frequency. These three parameters are entered on the man / machine interface. The range of motion is determined by the position of the sensors. The second control mode called "partially controlled movement" provides movement management adapted to the patient's level of alertness and muscle tone. In this case, the system triggers a cycle at the request of the patient by detection of a significant angular variation (adjustable threshold) of the position of the motor axis. Once the cycle has started, the system provides assistance with the complete course of the cycle depending on the effort capacity and muscle tone of the patient. The system therefore adapts the speed and the torque supplied by the motor in order to carry out the cycle at a given speed. Furthermore, after a certain latency period as a function of the desired cycle frequency, if no stress has been detected, the system performs a cycle according to the fully controlled movement mode.
Enfin, quel que soit le mode de fonctionnement, le système de pilotage assure un contrôle du couple fourni par le moteur en fonction de la position du chariot. Si la valeur du couple dépasse un seuil paramétrable, le mouvement s'arrête immédiatement et une alarme sonore est déclenchée.Finally, whatever the operating mode, the control system ensures control of the torque supplied by the motor depending on the position of the carriage. If the torque value exceeds a configurable threshold, the movement stops immediately and an audible alarm is triggered.
Claims (8)
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
FR0007092A FR2809615B3 (en) | 2000-06-02 | 2000-06-02 | ELECTROMECHANICAL APPARATUS FOR PROVIDING BENDING / EXTENSION MOVEMENT OF LOWER LIMBS IN PATIENTS WITH REDUCED SUPERIOR FUNCTIONS |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
FR0007092A FR2809615B3 (en) | 2000-06-02 | 2000-06-02 | ELECTROMECHANICAL APPARATUS FOR PROVIDING BENDING / EXTENSION MOVEMENT OF LOWER LIMBS IN PATIENTS WITH REDUCED SUPERIOR FUNCTIONS |
Publications (2)
Publication Number | Publication Date |
---|---|
FR2809615A1 true FR2809615A1 (en) | 2001-12-07 |
FR2809615B3 FR2809615B3 (en) | 2003-06-06 |
Family
ID=8850912
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
FR0007092A Expired - Fee Related FR2809615B3 (en) | 2000-06-02 | 2000-06-02 | ELECTROMECHANICAL APPARATUS FOR PROVIDING BENDING / EXTENSION MOVEMENT OF LOWER LIMBS IN PATIENTS WITH REDUCED SUPERIOR FUNCTIONS |
Country Status (1)
Country | Link |
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FR (1) | FR2809615B3 (en) |
Cited By (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP1729710A2 (en) * | 2004-02-05 | 2006-12-13 | Motorika Inc. | Gait rehabilitiation methods and apparatuses |
US8177732B2 (en) | 2004-02-05 | 2012-05-15 | Motorika Limited | Methods and apparatuses for rehabilitation and training |
WO2014173545A1 (en) * | 2013-04-25 | 2014-10-30 | Hans Schiessl | Apparatus for training and/or analysis of the musculoskeletal system of a user |
US8915871B2 (en) | 2004-02-05 | 2014-12-23 | Motorika Limited | Methods and apparatuses for rehabilitation exercise and training |
US10039682B2 (en) | 2004-02-05 | 2018-08-07 | Motorika Limited | Methods and apparatus for rehabilitation and training |
Families Citing this family (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
KR20070061476A (en) | 2004-02-05 | 2007-06-13 | 모토리카 리미티드 | Neuromuscular stimulation |
WO2006021952A2 (en) | 2004-08-25 | 2006-03-02 | Reability Inc. | Motor training with brain plasticity |
-
2000
- 2000-06-02 FR FR0007092A patent/FR2809615B3/en not_active Expired - Fee Related
Cited By (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP1729710A2 (en) * | 2004-02-05 | 2006-12-13 | Motorika Inc. | Gait rehabilitiation methods and apparatuses |
EP1729710A4 (en) * | 2004-02-05 | 2012-03-07 | Motorika Ltd | Gait rehabilitiation methods and apparatuses |
US8177732B2 (en) | 2004-02-05 | 2012-05-15 | Motorika Limited | Methods and apparatuses for rehabilitation and training |
US8915871B2 (en) | 2004-02-05 | 2014-12-23 | Motorika Limited | Methods and apparatuses for rehabilitation exercise and training |
US10039682B2 (en) | 2004-02-05 | 2018-08-07 | Motorika Limited | Methods and apparatus for rehabilitation and training |
WO2014173545A1 (en) * | 2013-04-25 | 2014-10-30 | Hans Schiessl | Apparatus for training and/or analysis of the musculoskeletal system of a user |
Also Published As
Publication number | Publication date |
---|---|
FR2809615B3 (en) | 2003-06-06 |
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