The present invention relates to a new device that may be employed in the medical, physical training and/or rehabilitation field and, more particularly, the invention refers to a new apparatus for rehabilitation and/or re-education of an impaired patient, preferably an individual or patient with dysfunction in the lower limbs, to induce walking movements, develop balance and train muscles, preferably in handicapped persons with gross motor impairments, wherein the apparatus is effective in helping correct the postural (stance) structure and also attaining the exact reproduction of human walking, efficiently inducing the movement of the joints of the foot, heel, ankle, knee and hips, all of them with high participation in the walking movements.
For several reasons, an important part of a community is affected by motor disorders or dysfunctions, due to accidental events or to neurological disorders. In any event, in modern communities more and more efforts are being made to incorporate disabled persons to the normal life of the community. The idea is to adopt more effective techniques in order that they may enjoy, depending on the degree of the disability, the autonomy to move among the other members of the community. It is a fact that the degree of dependence affects directly the standard of living of these citizens and, therefore, it is imperative to be socially sensitive to bring to the disabled persons the most modern solutions to cause them to be capable of joining, as long as possible, the normal persons.
The disabilities that affect the lower limbs basically hinder or limit displacement and the two-legged stance. On top of the difficulty or impossibility of walking, there is the loss of reflexes and muscle tone due to inactivity or reduced functionality, the slowdown of systemic functions such as circulation, the contraction of the abdominal cavity that hampers the respiratory and digestive functions and the proper evacuation of the bowels, progressive scoliosis, bone density loss, as well as diverse dermatological pathologies, all effects that aggravate even more the condition and quality of life of the patient.
The technical solutions available to persons with motor dysfunctions, for walking rehabilitation purposes, can be generally classified in mobile and fixed devices that have been aimed at helping patients recover their walking capabilities, without, however, efficiently achieving the right motor coordination, balance control of the limbs and torso, correction of the body posture and strengthening of the atrophic limbs. In general terms, the known mobile equipment uses the patient's own force to move, using devices commonly known as walkers.
One of such mobile devices is disclosed in Document
While the above devices may be helpful in assisting a handicapped person to walk and stimulate walking movements, the systems are based mainly on the force that the patient must exert with the upper limbs on the device that serves as a support to maintain the two-legged stance. The devices are a kind of a support or cart moving over some sort of rollers or wheels and the patient must exert the necessary force against the floor to move. It is obvious that the patient must be capable of standing up and walk, at least slightly and this is not possible for patients having strong neurological disorders with practically no muscles in conditions to support the body weight or to move the legs to get a minimal walking distance. In addition, the above systems do not provide any type of step regulation or limb movement sequence. But what is an additional limiting factor in this type of equipment is that not a single one of them provides for correction of the walking gait; they do not develop adequate motor coordination, and they do not allow for adopting the correct postural stance needed for human beings to take steps in the correct sequence to achieve full rehabilitation.
Other devices are disclosed in
In addition to the foregoing,
As it can be seen, the state of the art and existing technologies do not offer those individuals suffering from severe motor dysfunctions an integral solution for their rehabilitation, obtaining only partial results. There is no fixed or mobile device that enables these people to rehabilitate, achieve postural fitness, motion balance and good alignment of limbs and torso, with the advantage of strengthening and working out the muscle system, tendons and circulatory system, as well as all the joints involved in the walking activity, supporting the patient's body weight in an adjustable pattern, all in a single device.
It is therefore an object of the invention to provide an apparatus for rehabilitation of patients with motor disorders, particularly of patients suffering motor dysfunctions in the legs. This object is achieved by means of an apparatus with the features of claim 1.
It is still another object of the present invention to provide an apparatus for rehabilitation of patients with motor disorders, wherein the apparatus comprises a harness for supporting the patient, with the patient having their feet affixed to a couple of walking bars to really reproduce the movements of the lower limbs when walking, step by step at a constant pace, stimulating the nervous system with a mechanical movement generated from the lower limbs themselves, wherein, by systematically and repeatedly practising the exercise produced by the device, the patient, by reflex and voluntary activation, executes the movements necessary to help him/her walk and/or rehabilitate thanks to the recovery of the normal tone of his/her muscles.
It is even another object of the present invention to provide an apparatus for rehabilitation of patients with motor disorders, wherein the apparatus comprises a harness for supporting the patient, with the patient having their feet affixed to a couple of walking bars to really reproduce the movements of the lower limbs when walking, with the harness being pending from an upper part of the apparatus including height regulating means for moving the harness up and down to have the patient's body weight unloaded on the legs reduced or increased for better training of the legs.
It is a further object of the present invention to provide an apparatus for rehabilitation of patients with motor disorders affecting the legs, the apparatus comprising a couple of bars moving along a closed loop representing a walking step for the patient, with each bar including a plate to affix a foot of the patient and the plate being slidably arranged in the bar, with a motor connected to the bars to move the bars along the closed loop, the apparatus also having an harness to support the patient.
It is even a further object of the present invention to provide an apparatus for rehabilitation of patients with motor disorders, particularly patients suffering motor dysfunction in the legs, the apparatus comprising:
It is still a further object of the present invention to provide an apparatus for rehabilitation of patients with motor disorders, particularly patients suffering motor dysfunction in the legs, the apparatus comprising:
The above and other objects, features and advantages of this invention will be better understood when taken in connection with the accompanying drawings and description.
The present invention is illustrated by way of example in the following drawings wherein:
Now referring in detail to the invention, the same refers to an apparatus for use preferably in medical areas to rehabilitate patients with motor disorders, particularly patients suffering motor dysfunction in the lower limbs. However, while more specific reference will be made to rehabilitation of the lower limbs, the present apparatus has shown to be effective in a re-educating and rehabilitating a handicapped person integrally, such as correcting postural disorders, neuronal disorders, standing disorders and other physical dysfunctions. The apparatus, generally indicated by reference number 1 in
Mounted at a bottom part of the chassis 2, a left and a right walking bars 9, 10 are provided, with the walking bars 9, 10 being mounted to move along a path emulating, duplicating or copying the natural walking movement, such as up and down and back and forth along a closed movement loop, such as a seesaw movement, for example. Walking bars 9, 10 may be made of any suitable material such as steel or aluminium and preferably of a hollow metal profile to be resistant and of a light weight to support the patient's weight. The weight of the patient will be controllably unloaded, partially or totally, on the walking bars 9, 10.
To move along a desired predetermined path, such as a closed loop, copying a walking step movement, each walking bar 9, 10, has a respective rear end 11, 12 connected to motor means 13 and a respective front end 14, 15 slidably connected to respective front guide means 16, 17. The sliding connection between front ends 14, 15 of walking bars 9, 10 are preferably established by a bracket 18, 19 having, at a lower edge thereof, a rotary shaft (not shown) with end rollers of which only one roller 20 is shown in bracket 19, and only one roller 21 is shown in bracket 18, see
In addition to the movement in a longitudinal direction of the walking bars 9, 10 along front guide means 16, 17, the rear ends 11, 12 of the walking bars 9, 10 move along a circular path or closed loop, not necessarily circular as long as it copies the walking movement, under the action of said motor means 13. Motor means 13 preferably comprise a crank and connecting rod mechanism driven by an electric motor 22, or a motor and speed reducing gearbox, mounted in a base member 23, forming part of the chassis 2. Motor 22 actuates a pulley 24, a belt 25 and a pulley 26 which in turn moves a crank connecting rod comprising a couple of rods 27, 28 which are preferably extensible and regulated through a regulating assembly formed by orifices 29 and knob 30, as it is well known. Connecting rods 27, 28 are connected to ends 11, 12 of the walking bars 9, 10 by respective journalled or bearing connection with only one of them, namely connection 31, being shown. The length of connecting rods 27, 28 defines the walking step distance or path, which would be regulated according to the kind of dysfunction, age and size of the patient, by means of the regulating means 29, 30. The height of pulley 26 may be also regulated by extensible arms 32 with regulating means that can be like means 29, 30.
While ends 11, 12 are shown as cut and made of a hollow rectangular metal profile, the ends and the entire walking bars 9, 10 may be made of solid bars, and other design, with no cuts, is possible. While a crank-connecting-rod mechanism has been shown to provide a circular or looped movement, it will be apparent to any person skilled in the art that other mechanisms may be employed. For example, this mechanism may be replaced by a couple of gears, a leading gear and a rear gear, and at least one chain running around them, along an elliptical or ovoid path, with ends 11, 12 of bars 9, 10 being connected to both sides of the chain, to particular links of the chain, by respective journalled connection, in order to follow the elliptical loop of the chain. The closed path defined by the chain will be as close as possible like a walking movement.
The front guide means 16, 17, at the front end of the apparatus 1, and motor means 13, at a rear end of the apparatus, are properly covered by respective front and rear caps 33, 34 fixed at appropriate parts of the chassis 2, preferably by means of easily removable means to permit access to the corresponding mechanisms for servicing purposes. Caps 33, 34 may be made of any suitable material to protect the covered mechanisms, such as a plastic, resistant and light material.
The patient will step on the walking bars 9, 10 in a left and a right foot retaining means 35, 36 pivotally connected to left and right walking bars 9, 10 respectively. As it will be explained below, foot retaining means 35, 36 move together with the walking bars 9, 10 along the closed loop or step distance path, to copy the movement of a walking step. Left and right foot retaining means 35, 36 comprise a left and a right foot plate assemblies 37, 38 pivotally connected to left and right walking bars 9, 10 respectively. As it is better shown in
Upper foot plates 39, 40 and lower foot plates 44, 45, as mentioned above, are pivotally connected to each other and to the respective walking bar 9, 10 by double hinged means. Reference will be made first to left foot retaining means 35 as long as right foot retaining means 36 is similarly constructed. Left lower foot plate 44 has a front edge hinged, by a hinge 46, see
While upper and lower foot plates 39, 44 and 40, 45 have been disclosed as being connected to each other and to the walking bars 9, 10 by means of a double-hinge mechanism, it will be apparent to any skilled person in the art that any other tilting or oscillating mechanism may be adopted. For example, upper foot plates 39, 40 may be mounted in respective central transverse axis, placed at a distance above the walking bars 9, 10, or onto a semicircular block onto the walking bars 9, 10, to force the patient to keep the feet as horizontal as possible at least until the upper foot plate 39, 40 is tilted under the action of the front and rear guide stops 52, 53, 54, 55 reference to which is made below.
Front and rear guide stops 52, 53, 54, 55 are provided in the chassis 2 and associated to the walking bars 9, 10 to force the foot plates to tilt according to the walking movement. Thus, the apparatus 1 is provided with front guide stop 52 for the left foot and front guide stop 53 for the right foot, in each walking bar 9, 10. Front guide stops 52, 53 are adjustably placed at a front end of step distance path "SD", see
For clarity purposes only front guide stop 52 for the left foot will be described in detail as long as the front guide stop 53 for the right side is identical. Front guide stop 52 comprises a curved front guide stop plate 56, made of any resistant material, such as steel or any other suitable metal. Front guide stop plate 56 is firmly affixed to respective rear ends of a couple of extensible arms 57, 58 which have their leading ends pivotally connected at joint 59, 60, to any convenient part of the chassis 2, by any appropriate bearing means well known in the art. Arms 57, 58 may include adjusting means to regulate the length of the arms in order to move front guide stop plate 56 back and forth to a desired position to adjust the step distance according to the particular treatment or patient. Adjusting means indicated by reference 61 may be a well known mechanism of a plurality of orifices and knob to move and fix a relative position between two arm lengths 62, 63.
Front guide stop plate 56 must accompany the up and down movement of walking bar 9 while permitting the back and forth movement of the walking bar 9. Thus, a transverse roller 64, see
As to the movement of the patient's feet at the rear part of the walking movement, reference will be made to the rear guide stops 54, 55, however, for clarity purposes only rear guide stop 54 for the left foot will be described in detail as long as the rear guide stop 55 for the right side is identical. Rear guide stop 54 comprises two curved rear U-shaped guides, indicated by general references 67, 68, facing to each other by their open sides. Rear guides 67, 68 include respective horizontal guide lengths 69, 70, and curved and upwardly extending guide lengths 71, 72, see
To follow the walking movement of the walking bar 8, rear guide stop 54 is provided with a rear carriage 74 firmly affixed, by welding for example, to rear guide stop 54 and including upper rollers 75, 76 and a lower roller 77, at both upper and lower sides of walking bar 9, to keep rear guide stop 54 and walking bar 9 together during the movement of the walking bar 9. In order to prevent the leading end of rear guide stop 54, and particularly the leading end of horizontal guide length 69, 70 move upwardly during the movement of the walking bar 9, horizontal guide lengths 69, 70 are provided with a lower roller 78. Thus, rear guide stop 54 is pivotally connected to the walking bar 9, with the U-shaped guides being slidably resting onto the walking bar 9.
With the purpose of keeping the rear guide stop 54 in place, to define the rear end of the walking step distance, the rear guide stop 54, and more particularly carriage 74, is pivotally connected to respective rear ends of side arms 79, 80, see
While the leading guide stops 52, 53 and the rear guide stops 54, 55 have been illustrated and disclosed as being different of each other, it is important to remark that the leading and rear guide stops 52-55 may be identical or the leading guide stop 52, 53 may be arranged at the place of the rear guide stop 54, 55, and viceversa. For example, the leading guide stops 52, 53 may comprise, like the rear guide stops 54, 55, a couple of facing "U" shaped guides, such as guides 67, 68, within which a pair of followers or rollers may run, such as rollers 73. Thus, the use of curved leading edges 48, 49 would not be necessary. Also, instead of curved edges 48, 49, upper foot plates 39, 40 may be provided with any kind of a leading sliding means or rolling cylinder that causes the plate move upwardly onto the guide stop.
It is clear from the above description that, when the patient's feet are retained at the foot retaining means 35, 36, the feet move together with the walking bars 9, 10 along the closed loop or step distance path, to copy the movement of a walking step. The stroke/run of the step is limited by the length of connecting rods 27, 28 with the front and rear guide stops 52-55 imposing the movements to the joints of the feet at the backward and forward ends of every step. Reference to the feet movements will be made only in connection to the left foot as long as the same description is applied to the right food. When the foot reaches front guide stop 52, the front guide stop 52 impels the instep (forefoot) upwards because the front curved edge 48, with foot plate assembly 37 moving forth, enters into contact with the front guide stop plate 56 which causes upper foot plate 39 to move upwards and pivot around hinge 47, see
Considering that the patient is not in conditions to keep itself in a stand up position, the apparatus 1 may be provided with patient's supporting means for supporting and keeping the patient in a desired position. These means may comprise parallel bars, if the patient is in conditions to keep his/her body sustained by the arms, or, preferably, may comprise a supporting harness, generally indicated at 89 only in
The harness 89 is connected to harness motor means 92, which may comprise a crank handle, as illustrated or an electric motor capable of moving the harness up and down. Thus, the weight of the patient actuating on the patient's legs will be regulated as desired. According to this embodiment, upper belts 90 are connected to a rotating shaft 93, operated by the crank handle, to roll up the belts. A longitudinal and lateral adjustment of the patient position may be carried out by means of rear torso belts 94, 95 and leading torso belts 96, 97. By operating these belts the patient, depending of the disorder to be corrected, may be forced more or less to adopt a standing up, vertical position, or may be permitted to be slightly bent if the patients naturally walks with a stoop. Motor means 92 and shaft 93 also may move along guide bars 98, 99, by supports 100, 101, to further correct the position of the harness 89 longitudinally.
According to another embodiment of the invention, the apparatus 1, in addition to chassis 2, has a side chassis or side portion 102 for receiving patients in wheel chairs. Side portion 102 also is comprised of columns 103, 104 and a base 105 open to define an entrance 106 for a wheelchair, stretcher and the like. The upper end 4 of the apparatus 1 has a pair of guide beams 107, 108 and a frame 109 which is capable of moving along the guide beams 107, 108 to be placed in a position to receive a patient, shown in
In
Each intermediate walking bar 112, 113 has a respective rear end 114, 115 connected to motor means 116 that may be like the one shown in
The connection between walking bars 9, 10 to their respective intermediate walking bars 112, 113 is through pivoting connections 126, 127 including respective brackets 128, 129 provided with respective adjusting means 130, 131 to permit the movement of the brackets 128, 129 along intermediate walking bars 112, 113 to adjust the relative position between walking bars 9, 10 and intermediate walking bars 112, 113 with the result that the closed movement loop to copy a natural step movement is adapted to the patient biometric parameters. Finally, front ends 132, 133 of intermediate bars 112, 113, respectively, are provided with rolling means, such as rollers 134, 135, shown in phantom lines in
The apparatus of the invention provides a range of services in treating patients suffering motor dysfunctions, neurological disorders, standing disorders and the like that is superlative as compared to other devices of the prior art. The new design and combination of components provides a wider range of movements and adjustments to different patients, also stimulating the standing equilibrium. No rods or complex retaining means are necessary to affix to the legs of the patient but only simple straps for example, are necessary to brace the patient's feet to firmly retain the same in the walking bars.
Since only the feet are affixed to the walking bars, the feet follow the movement of the walking bars along the closed loop copying the natural walking movement thus causing the feet, with all their joints, to move accordingly. Thus, the movement to the legs is imposed at the feet and not to the entire extension of the legs. As a result, the patient, after some treatment sessions, feels that he/she can move the legs to accompany the feet movement.
While preferred embodiments of the present invention have been illustrated and described, it will be obvious to those skilled in the art that various changes and modifications may be made therein without departing from the scope of the invention as defined in the appended claims.
This list of references cited by the applicant is for the reader's convenience only. It does not form part of the European patent document. Even though great care has been taken in compiling the references, errors or omissions cannot be excluded and the EPO disclaims all liability in this regard.