WO2007043379A9 - Walking training apparatus and walking training method - Google Patents

Walking training apparatus and walking training method

Info

Publication number
WO2007043379A9
WO2007043379A9 PCT/JP2006/319690 JP2006319690W WO2007043379A9 WO 2007043379 A9 WO2007043379 A9 WO 2007043379A9 JP 2006319690 W JP2006319690 W JP 2006319690W WO 2007043379 A9 WO2007043379 A9 WO 2007043379A9
Authority
WO
WIPO (PCT)
Prior art keywords
walking
walking training
lower limb
foot
training
Prior art date
Application number
PCT/JP2006/319690
Other languages
French (fr)
Japanese (ja)
Other versions
WO2007043379A1 (en
Inventor
Kimitaka Hase
Original Assignee
Univ Keio
Kimitaka Hase
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Univ Keio, Kimitaka Hase filed Critical Univ Keio
Publication of WO2007043379A1 publication Critical patent/WO2007043379A1/en
Publication of WO2007043379A9 publication Critical patent/WO2007043379A9/en

Links

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
    • A61H3/00—Appliances for aiding patients or disabled persons to walk about
    • 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
    • A61H3/00—Appliances for aiding patients or disabled persons to walk about
    • A61H2003/005—Appliances for aiding patients or disabled persons to walk about with knee, leg or stump rests
    • 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
    • A61H3/00—Appliances for aiding patients or disabled persons to walk about
    • A61H2003/007—Appliances for aiding patients or disabled persons to walk about secured to the patient, e.g. with belts

Definitions

  • the present invention relates to a walking training apparatus and a walking training method for improving walking ability.
  • gait training is generally a method of reproducing walking motion by compensating for lower limb function using a prosthetic device.
  • a method has been used that aims to improve walking ability by supporting the body with a harness, partially excluding weight, and repeatedly walking on a treadmill.
  • training using partial unloading devices and training based on auditory feedback are being conducted. These exercises have been confirmed to improve walking length and walking speed.
  • FIG. 6 shows a conventional short leg brace.
  • This short leg brace is a walking aid for patients who cannot move their ankle joints freely due to paralysis or the like.
  • the structure of the ankle foot orthosis 20 includes a foot placement body fixing member 23 fixed to the foot outer surface of the foot placement body 21, and a calf appendage fixing member 24 fixed to the foot outer surface of the calf appendage 27.
  • the connecting member 22 is connected to the base shaft via a connecting shaft 25 on the outside of the foot so as to be swingable in the direction of bottom flexion and dorsiflexion.
  • the connecting shaft 25 is provided at a position corresponding to the outer heel of the foot, and is formed in a hollow shape into which the outer heel can enter.
  • the connecting member 22 is provided with force applying means 26.
  • the force applying means 26 provides resistance when the footrest body 21 moves to the calf attachment body 27 also with a specific reference position force in the plantar flexion direction, and provides a return force in a direction to return to the reference position ( Patent literature 1).
  • FIG. 7 shows a conventional walking training apparatus.
  • This gait training device is intended for patients with impairments in motor function, brain function, etc., and is related to a gait training device that measures the state of patients undergoing rehabilitation and performs gait movement according to the patient's state. is there.
  • Its structure consists of a biological information measuring means for measuring a trainee's biological information, and a training result evaluation for measuring the stride length or walking cycle of the trainer and presenting a display or a cue for exercise.
  • the training result evaluation unit evaluates the training situation of the trainer based on the biological information measured by the biological information measuring means, and one or both of the step length and the walking cycle of the trainer (Patent Document 2).
  • Patent Document 1 JP 2004-166811 A
  • Patent Document 2 Japanese Patent Laid-Open No. 2005-74063
  • the improvement of the walking ability of the lower limbs with low support ability should be based on correcting the asymmetric performance.
  • a person walks when the muscular strength of one leg and the other leg become asymmetrical due to any force, he relies on the healthier leg and increases the asymmetry.
  • hemiplegic patients have achieved walking by supplementing the function of the unhealthy lower limbs with the healthy lower limbs, and in that sense, emphasis has been placed on the training of the healthy lower limbs.
  • it enhances the asymmetry in pedestrians with weak walking ability such as hemiplegia and cannot fully draw the patient's walking ability. Not only that, but the ability to support the body on the unhealthy side will be reduced, and the risk of falls will also increase.
  • the present invention is intended to solve the above-described problems, and is a walking training device and a walking for improving recovery of balance function and the like by actively using a lower limb on the side having low support ability in walking.
  • the purpose is to provide training methods.
  • the present invention provides a walking training device that improves walking ability, a mounting unit that is mounted only on one of the wearer's healthy lower limbs, a foot that contacts the ground, the mounting unit, and the foot. And a connecting portion for connecting the two.
  • the mounting portion includes a socket having a concave portion of a knee bent shape of the healthy lower limb of the wearer.
  • the method of the present invention is characterized in that the walking training device is attached only to the healthy lower leg of a hemiplegic patient.
  • the present invention provides a walking training device for improving walking ability, comprising: a mounting portion that is attached only to a wearer's healthy lower limb; a foot portion that contacts the ground; and the mounting portion and the foot portion. Since the connecting portion to be connected is provided, it is possible to improve the functional recovery of the lower limb having the lower support ability by actively using the lower limb of the side having a low support ability while walking.
  • the mounting portion includes a socket having a concave portion of a knee flexion shape of the healthy lower limb of the wearer.
  • the socket and the fastening member for fastening the healthy lower limb in the knee flexed state are provided, the feeling of wearing between the healthy lower limb and the walking training device is improved.
  • the walking training device is attached only to the healthy lower limb of the hemiplegic patient, so that the lower limb with the lower support ability is used actively in walking and the walking can be performed.
  • the recovery of the balance function can be improved.
  • FIG. 1 is a diagram showing a walking training apparatus according to an embodiment of the present invention.
  • FIG. 2 is a diagram showing the sway of the center of gravity according to one embodiment of the present invention.
  • FIG. 3 is a diagram showing walking speed and stability according to an embodiment of the present invention.
  • FIG. 4 is a diagram showing a vertical component of a floor reaction force according to an embodiment of the present invention.
  • FIG. 5 is a diagram showing front and rear components of a floor reaction force according to an embodiment of the present invention.
  • FIG. 6 is a view showing a conventional walking training apparatus.
  • FIG. 7 is a view showing a conventional walking training apparatus.
  • FIG. 1 shows a walking training apparatus according to this embodiment.
  • 1 is a walking training device
  • 2 is a wearing part
  • 3 is a socket
  • 4 is a cuff belt as an example of a joint part
  • 5 is a connecting part
  • 6 is a knee joint
  • 7 is a pipe
  • 8 is a foot joint
  • 10 is the forefoot
  • 11 is the buttocks.
  • the walking training device 1 has an attachment part 2, a connection part 5, and a foot part 9, and is attached to a healthy lower limb.
  • the mounting part 2 has a socket 3 and a cuff belt 4 and is a part to be mounted on a healthy lower limb.
  • the socket 3 is a portion that accommodates a healthy lower limb in a state in which the knee is bent.
  • the socket 3 has a concave portion that accepts the lower limb in a bent state of the knee. This shape takes the shape of the wearer's leg and may be created for each wearer.
  • the cuff belt 4 is a belt that joins the socket 3 and the healthy leg when the healthy leg is accommodated in the socket 3, and one of the cuff belt 4 is fixed to the socket 3 and the other is secured by a buckle or hook-and-loop fastener provided on the socket 3. It has a detachable structure.
  • the connecting portion 5 is a portion that connects the mounting portion 2 and the foot portion 9, and has a knee joint 6, a pipe 7, and an ankle joint 8 in this embodiment.
  • the knee joint 6 is for connecting the socket 3 and the pipe 7, and one is fixed to the socket 3 and the other is fixed to the pipe 7 with a screw or the like.
  • the pipe 7 connects the knee joint 6 and the foot joint 8, and one is fixed to the knee joint 6 and the other to the foot joint 8 with screws or the like.
  • the foot joint 8 is for connecting the pipe 7 and the foot 9, and one is fixed to the pipe 7 and the other is fixed to the foot 9 with screws or the like.
  • the foot portion 9 has a forefoot portion 10 and a heel portion 11, and is connected to the pipe 7 of the connecting portion 5 with a screw or the like on the upper surface, and the bottom surface is in contact with the floor or the ground.
  • the total length of the foot 9 is shorter than the total length of the wearer's foot by shortening the front foot 10, and the propulsive force from the walking training device 1 is lost, and a better effect is produced. In particular, if it is shorter than the second interval, a better effect is produced.
  • the heel part 11 has an inclined or rounded shape so that it can be grounded easily.
  • the trainee must have Put a healthy lower limb into.
  • a walking aid or a parallel bar (not shown) is held to maintain a standing posture, and the lower limbs up to the thigh force below the knee with the knee bent at a right angle are inserted into the recess of the socket 3.
  • fasten the cuff belt 4 and tighten it with a buckle fastener start walking from this state and walk repeatedly.
  • FIG. 2 shows the sway of the center of gravity during the standing control of a healthy person.
  • Fig. 2 (a) is a diagram when the walking training device 1 is worn on the left foot
  • Fig. 2 (b) is a diagram when the walking training device 1 is not worn.
  • the horizontal axis shows left and right sway
  • the vertical axis shows front and back sway
  • the right foot on the right the left foot on the left
  • the center of gravity sway in the center This center-of-gravity sway is obtained from an experimental method that measures the body sway between the left and right feet by measuring the change in the center of the pressure between the left and right feet by taking a resting position for 1 minute with two floor reaction force counts.
  • FIG. 1 a comparison of walking speed and stability before and after training when the walking training device 1 is applied to a healthy lower limb which is a non-paralyzed side of a hemiplegic patient is shown.
  • a hemiplegic patient is a person who can voluntarily exercise the ankle joint on the paralyzed side and does not have a bone joint disorder such as low back pain with severe sensory impairment.
  • Figure 3 shows the walking speed before and after training and the stability during walking. What took 6.7 seconds to walk 10m before training was shortened to 5.8 seconds after training. This indicates that walking speed has increased.
  • the support period for both lower limbs was 26.1% before training in one walking cycle, but decreased to 23.4% after training. This indicates that the stability during walking is improved.
  • FIG. 4 shows the change in the vertical component of the floor reaction force before training and after training with walking training equipment 1.
  • the vertical axis shows floor reaction force
  • the horizontal axis shows time
  • the solid line in the graph shows the paralyzed leg
  • the dotted line shows the healthy leg.
  • Fig. 4 (a) shows the floor reaction force of both lower limbs before training, and the location indicated by the arrow in the floor reaction force of the non-wearing lower limb (paralyzed lower limb) is the force of about 60 kg.
  • the part indicated by the arrow at the end is about 75kg. This is because walking exercise equipment 1 increases the vertical component of the floor reaction force in the lower limbs that are not worn. Indicates that the ability to perform has improved.
  • FIG. 5 shows changes in the front and rear components of the floor reaction force that represent the front and rear components before training and after training with the walking training device 1.
  • the vertical axis shows floor reaction force
  • the horizontal axis shows time
  • the solid line in the graph shows the paralyzed lower limb
  • the dotted line shows the healthy lower limb.
  • Fig. 5 (a) shows the front and back components of the floor reaction force of both lower limbs before training, while the driving component of the floor reaction force of the non-wearing lower limb (paralyzed lower limb) is about 12 kg, as shown in Fig. 5 (b).
  • the weight is about 18kg, and the propulsive force on the paralyzed lower limb is rather larger than that on the non-paralyzed lower limb.
  • the walking training device 1 in the present embodiment attaching the walking training device 1 in the present embodiment to a healthy lower limb, the lower limb that is not worn can be moved backward from the center of gravity of the body, and the propulsive force to the center of gravity can be increased. It becomes like this.
  • the walking training device 1 has been described with reference to the drawings, the present invention is not limited to this embodiment, and it is possible to make changes within a range that can be adapted to the above-described purpose. It is.
  • a rubber cushion or the like is attached to the lower portion of the pipe 7 of the force coupling portion 5 as a foot 9 as the foot 9 in the form in which the foot 9 has the front foot 10 and the heel 11. May be.
  • the height of the foot portion 9 may be increased and directly connected to the mounting portion 2.
  • a screw or an adhesive may be considered.
  • the length of the entire walking training device can be lengthened to further improve the ability of the paralyzed lower limb.
  • a weight support device or the like may be used in combination.

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  • 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)

Abstract

To provide a walking training apparatus and a walking training method which can improve the restoration of the functions of the lower limb of the wearer with a lower walking potency by positively using the lower limb with the lower walking potency during walking. The walking training apparatus (1) for improving walking potency comprises a fitting part (2) fitted to only one healthy lower limb of a wearer, a leg part (9) brought into contact with the ground, and a connection part (5) for connecting the fitting part (2) to a foot part (9).

Description

歩行訓練装具及び歩行訓練方法  Walking training equipment and walking training method
技術分野  Technical field
[0001] 本発明は、歩行能力を向上するための歩行訓練装具及び歩行訓練方法に関する 背景技術  TECHNICAL FIELD [0001] The present invention relates to a walking training apparatus and a walking training method for improving walking ability.
[0002] 従来、歩行訓練は、補装具を用いて下肢機能を代償することで歩行動作を再現す る方法が一般的である。近年では、身体をハーネスで支えて体重を部分的に免荷し 、トレッドミル上で歩行動作を繰り返すことで、歩行能力の改善を目指す方法も用いら れてきている。また、部分免荷装置を用いた訓練、聴覚的なフィードバックに基づく訓 練などが行われている。これらの訓練により、歩長、歩行速度などが改善することが 確かめられている。  Conventionally, gait training is generally a method of reproducing walking motion by compensating for lower limb function using a prosthetic device. In recent years, a method has been used that aims to improve walking ability by supporting the body with a harness, partially excluding weight, and repeatedly walking on a treadmill. In addition, training using partial unloading devices and training based on auditory feedback are being conducted. These exercises have been confirmed to improve walking length and walking speed.
[0003] 例えば、従来の短下肢装具を第 6図に示す。この短下肢装具は、麻痺等により足 関節を自己の意志で自由に動かすことのできない患者のための歩行の際の補助具 である。短下肢装具 20の構造は、足載置体 21の足外側面に固定される足載置体固 定部材 23と、脹脛添体 27の足外側面に固定される脹脛添体固定部材 24とを、足外 側の連結軸 25を介して底屈及び背屈方向に揺動可能に連結する連結部材 22を備 える。連結軸 25は、足の外側踝に対応する位置に設けられ、且つ外側踝が侵入可 能な中空状に形成されている。連結部材 22には力付与手段 26が設けられている。 力付与手段 26は、足載置体 21が脹脛添体 27に対して特定の基準位置力も底屈方 向へ移動する際に抗カを与え、且つ基準位置に戻す方向の復帰力を与える (特許 文献 1)。  [0003] For example, FIG. 6 shows a conventional short leg brace. This short leg brace is a walking aid for patients who cannot move their ankle joints freely due to paralysis or the like. The structure of the ankle foot orthosis 20 includes a foot placement body fixing member 23 fixed to the foot outer surface of the foot placement body 21, and a calf appendage fixing member 24 fixed to the foot outer surface of the calf appendage 27. The connecting member 22 is connected to the base shaft via a connecting shaft 25 on the outside of the foot so as to be swingable in the direction of bottom flexion and dorsiflexion. The connecting shaft 25 is provided at a position corresponding to the outer heel of the foot, and is formed in a hollow shape into which the outer heel can enter. The connecting member 22 is provided with force applying means 26. The force applying means 26 provides resistance when the footrest body 21 moves to the calf attachment body 27 also with a specific reference position force in the plantar flexion direction, and provides a return force in a direction to return to the reference position ( Patent literature 1).
[0004] また、従来の歩行訓練装置を第 7図に示す。この歩行訓練装置は、運動機能や脳 機能などに障害を持つ患者を対象とし、リハビリテーションを行っている患者の状態 を計測し、患者の状態に応じて歩行運動を行わせる歩行訓練装置に関するものであ る。その構造は、訓練者の生体情報を計測する生体情報計測手段と、前記訓練者の 歩幅あるいは歩行周期を計測して表示あるいは運動の合図を提示する訓練結果評 価部と、を備え、前記訓練結果評価部は、前記生体情報計測手段により計測された 生体情報を基に前記訓練者の訓練状況を評価し、前記訓練者の歩幅と歩行周期の 一方あるいは両方を変更するものである（特許文献 2)。 [0004] FIG. 7 shows a conventional walking training apparatus. This gait training device is intended for patients with impairments in motor function, brain function, etc., and is related to a gait training device that measures the state of patients undergoing rehabilitation and performs gait movement according to the patient's state. is there. Its structure consists of a biological information measuring means for measuring a trainee's biological information, and a training result evaluation for measuring the stride length or walking cycle of the trainer and presenting a display or a cue for exercise. The training result evaluation unit evaluates the training situation of the trainer based on the biological information measured by the biological information measuring means, and one or both of the step length and the walking cycle of the trainer (Patent Document 2).
特許文献 1 :特開 2004— 166811号公報  Patent Document 1: JP 2004-166811 A
特許文献 2：特開 2005 - 74063号公報  Patent Document 2: Japanese Patent Laid-Open No. 2005-74063
発明の開示  Disclosure of the invention
発明が解決しょうとする課題  Problems to be solved by the invention
[0005] し力しながら、支持能力の低い側の下肢の歩行能力の改善は、非対称に陥ったパ フォーマンスの是正に基づくべきである。一方の下肢と他方の下肢の筋力等が何ら 力の原因で非対称になってしまった人が歩行する際、より健常な側の下肢に頼って しまい、非対称が増強する。例えば、片麻痺患者等は、非健常側下肢の機能を健常 側下肢によって補うことで歩行を達成しており、その意味で健常側下肢の訓練に重 点が置かれて来た。しかし、それは、片麻痺等歩行能力の弱い歩行者における非対 称性を増強させ、患者の歩行能力を十分に引き出すことができない。そればかりか、 非健常側で身体を支持する能力が低下してしまうことで、転倒のリスクも大きくなると 考えられる。 [0005] However, the improvement of the walking ability of the lower limbs with low support ability should be based on correcting the asymmetric performance. When a person walks when the muscular strength of one leg and the other leg become asymmetrical due to any force, he relies on the healthier leg and increases the asymmetry. For example, hemiplegic patients have achieved walking by supplementing the function of the unhealthy lower limbs with the healthy lower limbs, and in that sense, emphasis has been placed on the training of the healthy lower limbs. However, it enhances the asymmetry in pedestrians with weak walking ability such as hemiplegia and cannot fully draw the patient's walking ability. Not only that, but the ability to support the body on the unhealthy side will be reduced, and the risk of falls will also increase.
[0006] 本発明は、上記課題を解決するためのものであって、支持能力の低い側の下肢を 歩行において積極的に使用させて、バランス機能等の回復を向上させる歩行訓練装 具及び歩行訓練方法を提供することを目的とする。  [0006] The present invention is intended to solve the above-described problems, and is a walking training device and a walking for improving recovery of balance function and the like by actively using a lower limb on the side having low support ability in walking. The purpose is to provide training methods.
課題を解決するための手段  Means for solving the problem
[0007] そのために本発明は、歩行能力を向上させる歩行訓練装具において、装着者の片 側健常下肢のみに装着する装着部と、地面に接地する足部と、前記装着部と前記足 部とを連結する連結部とを備えたことを特徴とする。 [0007] To this end, the present invention provides a walking training device that improves walking ability, a mounting unit that is mounted only on one of the wearer's healthy lower limbs, a foot that contacts the ground, the mounting unit, and the foot. And a connecting portion for connecting the two.
[0008] また、前記装着部は、前記装着者の健常下肢の膝屈曲形状の凹部をもつソケットと[0008] Further, the mounting portion includes a socket having a concave portion of a knee bent shape of the healthy lower limb of the wearer.
、前記ソケットと膝屈曲状態の健常下肢とを締結する締結部材とを有することを特徴 とする。 And a fastening member for fastening the socket and a healthy lower limb in a bent state of the knee.
[0009] また、本発明の方法は、歩行訓練装具を片麻痺患者の健常側下肢のみに装着す ることを特徴とする。 発明の効果 [0009] In addition, the method of the present invention is characterized in that the walking training device is attached only to the healthy lower leg of a hemiplegic patient. The invention's effect
[0010] 本発明は、歩行能力を向上させる歩行訓練装具において、装着者の片側健常下 肢のみに装着する装着部と、地面に接地する足部と、前記装着部と前記足部とを連 結する連結部とを備えたので、支持能力の低 、側の下肢を歩行にぉ 、て積極的に 使用させて、支持能力の低い側の下肢の機能回復を向上させることができる。  [0010] The present invention provides a walking training device for improving walking ability, comprising: a mounting portion that is attached only to a wearer's healthy lower limb; a foot portion that contacts the ground; and the mounting portion and the foot portion. Since the connecting portion to be connected is provided, it is possible to improve the functional recovery of the lower limb having the lower support ability by actively using the lower limb of the side having a low support ability while walking.
[0011] また、前記装着部は、前記装着者の健常下肢の膝屈曲形状の凹部をもつソケットと [0011] Further, the mounting portion includes a socket having a concave portion of a knee flexion shape of the healthy lower limb of the wearer.
、前記ソケットと膝屈曲状態の健常下肢とを締結する締結部材とを有するので、健常 下肢と歩行訓練装具との装着感が良くなる。 Since the socket and the fastening member for fastening the healthy lower limb in the knee flexed state are provided, the feeling of wearing between the healthy lower limb and the walking training device is improved.
[0012] また、本発明の方法は、歩行訓練装具を片麻痺患者の健常側下肢のみに装着す るので、支持能力の低い側の下肢を歩行において積極的に使用させて、歩行にお けるバランス機能の回復を向上させることができる。  [0012] Further, in the method of the present invention, the walking training device is attached only to the healthy lower limb of the hemiplegic patient, so that the lower limb with the lower support ability is used actively in walking and the walking can be performed. The recovery of the balance function can be improved.
図面の簡単な説明  Brief Description of Drawings
[0013] [図 1]本発明の一実施形態の歩行訓練装置を示す図である。  FIG. 1 is a diagram showing a walking training apparatus according to an embodiment of the present invention.
[図 2]本発明の一実施形態の重心動揺を示す図である。  FIG. 2 is a diagram showing the sway of the center of gravity according to one embodiment of the present invention.
[図 3]本発明の一実施形態の歩行速度と安定性を示す図である。  FIG. 3 is a diagram showing walking speed and stability according to an embodiment of the present invention.
[図 4]本発明の一実施形態の床反力の垂直成分を示す図である。  FIG. 4 is a diagram showing a vertical component of a floor reaction force according to an embodiment of the present invention.
[図 5]本発明の一実施形態の床反力の前後成分を示す図である。  FIG. 5 is a diagram showing front and rear components of a floor reaction force according to an embodiment of the present invention.
[図 6]従来の歩行訓練装具を示す図である。  FIG. 6 is a view showing a conventional walking training apparatus.
[図 7]従来の歩行訓練装置を示す図である。  FIG. 7 is a view showing a conventional walking training apparatus.
符号の説明  Explanation of symbols
[0014] 1 歩行訓練装具 [0014] 1 Walking training equipment
2 装着部  2 Mounting part
3 ソケット  3 socket
4 カフべノレト  4 Cuff Benoleto
5 連結部  5 Connecting part
6 膝継手  6 Knee joint
7 パイプ  7 Pipe
8 足継手 9 足部 8 foot joint 9 feet
10 前足部  10 Forefoot
11 踵部  11 Buttocks
発明を実施するための最良の形態  BEST MODE FOR CARRYING OUT THE INVENTION
[0015] 以下、本発明の実施の形態を図面に基づいて説明する。図 1は本実施形態の歩行 訓練装具を示す。図 1において、 1は歩行訓練装具、 2は装着部、 3はソケット、 4は結 合部の一例としてのカフベルト、 5は連結部、 6は膝継手、 7はパイプ、 8は足継手、 9 は足部、 10は前足部、 11は踵部である。  Hereinafter, embodiments of the present invention will be described with reference to the drawings. FIG. 1 shows a walking training apparatus according to this embodiment. In Fig. 1, 1 is a walking training device, 2 is a wearing part, 3 is a socket, 4 is a cuff belt as an example of a joint part, 5 is a connecting part, 6 is a knee joint, 7 is a pipe, 8 is a foot joint, 9 Is the foot, 10 is the forefoot, and 11 is the buttocks.
[0016] 歩行訓練装具 1は、装着部 2,連結部 5及び足部 9を有しており、健常下肢に装着 するものである。装着部 2は、ソケット 3及びカフベルト 4を有し、健常下肢に装着する 部分である。ソケット 3は、膝を折り曲げた状態の健常下肢を収容する部分であり、本 実施形態では、膝屈曲状態での下肢を受け入れる形状の凹部を有する。この形状は 装着者の下肢の型を取り、装着者ごとに作成してもよい。カフベルト 4は、ソケット 3に 健常下肢を収容した際に、ソケット 3と健常下肢とを結合するベルトであり、一方をソ ケット 3に固着し、他方はソケット 3に設けたバックル又は面ファスナ等により着脱自在 な構造となっている。  [0016] The walking training device 1 has an attachment part 2, a connection part 5, and a foot part 9, and is attached to a healthy lower limb. The mounting part 2 has a socket 3 and a cuff belt 4 and is a part to be mounted on a healthy lower limb. The socket 3 is a portion that accommodates a healthy lower limb in a state in which the knee is bent. In the present embodiment, the socket 3 has a concave portion that accepts the lower limb in a bent state of the knee. This shape takes the shape of the wearer's leg and may be created for each wearer. The cuff belt 4 is a belt that joins the socket 3 and the healthy leg when the healthy leg is accommodated in the socket 3, and one of the cuff belt 4 is fixed to the socket 3 and the other is secured by a buckle or hook-and-loop fastener provided on the socket 3. It has a detachable structure.
[0017] 連結部 5は、装着部 2と足部 9を連結する部分であり、本実施形態では膝継手 6、パ ィプ 7及び足継手 8を有する。膝継手 6は、ソケット 3とパイプ 7を連結するためのもの であり、一方をソケット 3に、他方をパイプ 7に螺子等で固着されている。パイプ 7は、 膝継手 6と足継手 8とを連結し、一方を膝継手 6に、他方を足継手 8に螺子等で固着 される。足継手 8は、パイプ 7と足部 9とを連結するためのものであり、一方をパイプ 7 に、他方を足部 9に螺子等で固着されている。  The connecting portion 5 is a portion that connects the mounting portion 2 and the foot portion 9, and has a knee joint 6, a pipe 7, and an ankle joint 8 in this embodiment. The knee joint 6 is for connecting the socket 3 and the pipe 7, and one is fixed to the socket 3 and the other is fixed to the pipe 7 with a screw or the like. The pipe 7 connects the knee joint 6 and the foot joint 8, and one is fixed to the knee joint 6 and the other to the foot joint 8 with screws or the like. The foot joint 8 is for connecting the pipe 7 and the foot 9, and one is fixed to the pipe 7 and the other is fixed to the foot 9 with screws or the like.
[0018] 足部 9は、前足部 10と踵部 11とを有し、上面で連結部 5のパイプ 7と螺子等で連結 し、底面は床又は地面等と接触する。足部 9の全長は、前足部 10を短くすることで、 装着者の足の全長よりも短くした方が、歩行訓練装具 1からの推進力が無くなり、より 良い効果が生じる。特に、第二間節より短いとなお良い効果が生じる。また、踵部 11 は、接地しやす 、ように傾斜又は丸みをおびた形状となって 、る。  [0018] The foot portion 9 has a forefoot portion 10 and a heel portion 11, and is connected to the pipe 7 of the connecting portion 5 with a screw or the like on the upper surface, and the bottom surface is in contact with the floor or the ground. The total length of the foot 9 is shorter than the total length of the wearer's foot by shortening the front foot 10, and the propulsive force from the walking training device 1 is lost, and a better effect is produced. In particular, if it is shorter than the second interval, a better effect is produced. In addition, the heel part 11 has an inclined or rounded shape so that it can be grounded easily.
[0019] 次に、この歩行訓練装具 1の使用方法を説明する。まず、訓練者はソケット 3の凹部 に健常下肢を入れる。本実施形態では、図示しない歩行補助具や平行棒等を把持 して立位姿勢を保ち、膝を約直角に折り曲げた状態の大腿部力 膝下までの下肢を ソケット 3の凹部に入れる。次に、カフベルト 4を締めバックルゃ面ファスナ等で締結 する。この状態から歩行を始め、繰り返し歩行する。 Next, a method for using the walking training device 1 will be described. First, the trainee must have Put a healthy lower limb into. In this embodiment, a walking aid or a parallel bar (not shown) is held to maintain a standing posture, and the lower limbs up to the thigh force below the knee with the knee bent at a right angle are inserted into the recess of the socket 3. Next, fasten the cuff belt 4 and tighten it with a buckle fastener. Start walking from this state and walk repeatedly.
[0020] 図 2は健常者の立位制御時の重心動揺を示す。図 2 (a)は歩行訓練装具 1を左足 に装着した場合の図、図 2 (b)は歩行訓練装具 1を装着しない場合の図である。横軸 は左右の動揺、縦軸は前後の動揺を示し、右側に右足、左側に左足、中心に全体の 重心動揺を示す。この重心動揺は、 2枚の床反力計上で安静立位を 1分間とらせて、 その間の身体の動揺を左右の足の中での圧中心の変化力 計測するという実験方 法から求める。図 2 (a)の歩行訓練装具 1を左足に装着した場合では、図 2 (b)の装 着しな 、場合に比べて右足の前後の重心動揺が大き 、ことが確認できる。前後の重 心動揺が大き 、と 、うことは歩行訓練装具 1を装着して 、な 、右足を十分に使用して 、ることを示して 、る。 FIG. 2 shows the sway of the center of gravity during the standing control of a healthy person. Fig. 2 (a) is a diagram when the walking training device 1 is worn on the left foot, and Fig. 2 (b) is a diagram when the walking training device 1 is not worn. The horizontal axis shows left and right sway, the vertical axis shows front and back sway, the right foot on the right, the left foot on the left, and the center of gravity sway in the center. This center-of-gravity sway is obtained from an experimental method that measures the body sway between the left and right feet by measuring the change in the center of the pressure between the left and right feet by taking a resting position for 1 minute with two floor reaction force counts. When the walking training device 1 shown in Fig. 2 (a) is worn on the left foot, it can be confirmed that the center of gravity swings around the right foot is larger than when the wearing device shown in Fig. 2 (b) is not worn. When the back and forth is serious, it means that wearing the walking training equipment 1 and fully using the right foot.
[0021] 次に、片麻痺患者の非麻痺側である健常側下肢に対して歩行訓練装具 1を適用し た場合の訓練する前と訓練した後の歩行速度、安定性の比較を示す。なお、片麻痺 患者とは、麻痺側足関節の随意的な運動が可能であり、重度な感覚障害がなぐ腰 痛等の骨関節の障害がない者とする。図 3は訓練前と訓練後の歩行速度及び歩行 時の安定性を示す。訓練前に 10m歩行するのに 6. 7秒かかっていたものが、訓練後 には 5. 8秒に短縮されている。このことは歩行速度が増加したことを示している。また 、両下肢支持期間が一歩行周期のうち訓練前は 26. 1%であったのに対し、訓練後 は 23. 4%に減少している。このことは歩行時の安定性が向上したことを示す。  [0021] Next, a comparison of walking speed and stability before and after training when the walking training device 1 is applied to a healthy lower limb which is a non-paralyzed side of a hemiplegic patient is shown. A hemiplegic patient is a person who can voluntarily exercise the ankle joint on the paralyzed side and does not have a bone joint disorder such as low back pain with severe sensory impairment. Figure 3 shows the walking speed before and after training and the stability during walking. What took 6.7 seconds to walk 10m before training was shortened to 5.8 seconds after training. This indicates that walking speed has increased. In addition, the support period for both lower limbs was 26.1% before training in one walking cycle, but decreased to 23.4% after training. This indicates that the stability during walking is improved.
[0022] 次に、片麻痺患者の非麻痺側である健常側下肢に対して歩行訓練装具 1を適用し た場合の訓練する前と訓練した後の床反力の比較を示す。図 4は訓練前と歩行訓練 装具 1による訓練後の床反力垂直成分の変化を示す。縦軸に床反力、横軸に時間、 グラフの実線は麻痺側下肢、点線は健常側下肢を示している。図 4 (a)は訓練前の 両下肢の床反力を表し、非装着下肢 (麻痺下肢)の床反力における矢印で示した箇 所は約 60kgである力 図 4 (b)で示す訓練後の矢印で示した箇所は約 75kgになつ ている。このことは歩行訓練装具 1により非装着下肢の床反力垂直成分が増大し、歩 行能力が向上したことを示す。 [0022] Next, a comparison of floor reaction force before and after training when the walking training device 1 is applied to the healthy lower limb which is the non-paralyzed side of a hemiplegic patient is shown. Figure 4 shows the change in the vertical component of the floor reaction force before training and after training with walking training equipment 1. The vertical axis shows floor reaction force, the horizontal axis shows time, the solid line in the graph shows the paralyzed leg, and the dotted line shows the healthy leg. Fig. 4 (a) shows the floor reaction force of both lower limbs before training, and the location indicated by the arrow in the floor reaction force of the non-wearing lower limb (paralyzed lower limb) is the force of about 60 kg. The part indicated by the arrow at the end is about 75kg. This is because walking exercise equipment 1 increases the vertical component of the floor reaction force in the lower limbs that are not worn. Indicates that the ability to perform has improved.
[0023] 図 5は訓練前と歩行訓練装具 1による訓練後の前後成分を表す床反力前後成分の 変化を示す。縦軸に床反力、横軸に時間、グラフの実線は麻痺側下肢、点線は健常 側下肢を示している。図 5 (a)は訓練前の両下肢の床反力前後成分を表し、非装着 下肢 (麻痺下肢)の床反力の駆動成分が約 12kgであるのに対し、図 5 (b)で示す訓 練後は約 18kgになっており、麻痺側下肢での推進力の方が非麻痺側下肢に比べて むしろ大きくなつている。このことは歩行訓練装具 1による歩行訓練後には、制動力を 含めて麻痺側下肢の床反力前後成分が増大し、歩行能力が向上したことを示す。  [0023] FIG. 5 shows changes in the front and rear components of the floor reaction force that represent the front and rear components before training and after training with the walking training device 1. The vertical axis shows floor reaction force, the horizontal axis shows time, the solid line in the graph shows the paralyzed lower limb, and the dotted line shows the healthy lower limb. Fig. 5 (a) shows the front and back components of the floor reaction force of both lower limbs before training, while the driving component of the floor reaction force of the non-wearing lower limb (paralyzed lower limb) is about 12 kg, as shown in Fig. 5 (b). After training, the weight is about 18kg, and the propulsive force on the paralyzed lower limb is rather larger than that on the non-paralyzed lower limb. This indicates that after walking training with walking training equipment 1, the components before and after the floor reaction force of the paralyzed lower limb, including braking force, increased, and walking ability improved.
[0024] このように、本実施形態における歩行訓練装具 1を健常下肢に装着することにより、 装着しない下肢を身体の重心より後方にもっていけることができ、重心への推進力を 増やすことができるようになる。  [0024] In this way, by attaching the walking training device 1 in the present embodiment to a healthy lower limb, the lower limb that is not worn can be moved backward from the center of gravity of the body, and the propulsive force to the center of gravity can be increased. It becomes like this.
[0025] 以上本発明に係る歩行訓練装具 1に関して、図面を参照しつつ説明したが、この実 施形態に限定されるわけではなぐ前記の趣旨に適合しうる範囲で変更を実施するこ とも可能である。例えば、本発明の一実施形態では、足部 9が前足部 10及び踵部 11 を有する形態とした力 連結部 5のパイプ 7の下部に杖のようにゴムのクッション等を 足部 9として装着してもよい。また、足部 9の高さを高くして、装着部 2に直接連結して も良い。その際の連結部 5としては、螺子又は接着剤等が考えられる。  [0025] While the walking training device 1 according to the present invention has been described with reference to the drawings, the present invention is not limited to this embodiment, and it is possible to make changes within a range that can be adapted to the above-described purpose. It is. For example, in one embodiment of the present invention, a rubber cushion or the like is attached to the lower portion of the pipe 7 of the force coupling portion 5 as a foot 9 as the foot 9 in the form in which the foot 9 has the front foot 10 and the heel 11. May be. Alternatively, the height of the foot portion 9 may be increased and directly connected to the mounting portion 2. As the connecting portion 5 at that time, a screw or an adhesive may be considered.
[0026] また、歩行能力が上がれば歩行訓練装具全体の長さを長くして麻痺側下肢の能力 をさらに向上させることもでき、逆に歩行訓練装具を用いた歩行が独力で困難であれ ば、体重支持装置等を併用してもよい。  [0026] If the walking ability improves, the length of the entire walking training device can be lengthened to further improve the ability of the paralyzed lower limb. Conversely, if walking using the walking training device is difficult on its own, A weight support device or the like may be used in combination.

Claims

請求の範囲 The scope of the claims
[1] 歩行能力を向上させる歩行訓練装具において、装着者の片側健常下肢のみに装着 する装着部と、地面に接地する足部と、前記装着部と前記足部とを連結する連結部 とを備えたことを特徴とする歩行訓練装具。  [1] In a walking training device that improves walking ability, a wearing part that is worn only on one of the wearer's healthy lower limbs, a foot part that contacts the ground, and a connecting part that connects the wearing part and the foot part. A walking training device characterized by having it.
[2] 前記装着部は、前記装着者の健常下肢の膝屈曲形状の凹部をもつソケットと、前記 ソケットと膝屈曲状態の健常下肢とを締結する締結部材とを有することを特徴とする 請求項 1に記載の歩行訓練装具。  [2] The mounting portion includes a socket having a concave portion of a knee flexion shape of the wearer's healthy lower limb, and a fastening member for fastening the socket and the healthy lower limb in a knee flexed state. The walking training apparatus according to 1.
[3] 歩行訓練装具を片麻痺患者の非麻痺側下肢に装着することを特徴とする歩行訓練 方法。  [3] A walking training method characterized by attaching a walking training device to a non-paralyzed lower limb of a hemiplegic patient.
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