CA3033098A1 - Systeme d'ajustement pour therapie de la marche naturelle a assistance simulee - Google Patents
Systeme d'ajustement pour therapie de la marche naturelle a assistance simulee Download PDFInfo
- Publication number
- CA3033098A1 CA3033098A1 CA3033098A CA3033098A CA3033098A1 CA 3033098 A1 CA3033098 A1 CA 3033098A1 CA 3033098 A CA3033098 A CA 3033098A CA 3033098 A CA3033098 A CA 3033098A CA 3033098 A1 CA3033098 A1 CA 3033098A1
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- Prior art keywords
- seat
- link
- coupled
- base
- gait
- 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.)
- Abandoned
Links
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- 238000002560 therapeutic procedure Methods 0.000 title claims abstract description 49
- 210000003127 knee Anatomy 0.000 claims abstract description 12
- 230000033001 locomotion Effects 0.000 claims description 35
- 230000008878 coupling Effects 0.000 claims description 21
- 238000010168 coupling process Methods 0.000 claims description 21
- 238000005859 coupling reaction Methods 0.000 claims description 21
- 230000004044 response Effects 0.000 claims description 15
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- 238000000034 method Methods 0.000 abstract description 7
- 238000004088 simulation Methods 0.000 abstract description 4
- 210000002414 leg Anatomy 0.000 description 22
- 238000004891 communication Methods 0.000 description 6
- 238000004590 computer program Methods 0.000 description 5
- 230000015654 memory Effects 0.000 description 5
- 208000020431 spinal cord injury Diseases 0.000 description 5
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- 206010033799 Paralysis Diseases 0.000 description 1
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Classifications
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- 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
- A61H1/0274—Stretching or bending or torsioning apparatus for exercising for the upper limbs
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- 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
- A61H1/0262—Walking movement; Appliances for aiding disabled persons to walk
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- A—HUMAN NECESSITIES
- A63—SPORTS; GAMES; AMUSEMENTS
- A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
- A63B21/00—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices
- A63B21/00178—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices for active exercising, the apparatus being also usable for passive exercising
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- A—HUMAN NECESSITIES
- A63—SPORTS; GAMES; AMUSEMENTS
- A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
- A63B21/00—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices
- A63B21/00185—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices using resistance provided by the user, e.g. exercising one body part against a resistance provided by another body part
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- A—HUMAN NECESSITIES
- A63—SPORTS; GAMES; AMUSEMENTS
- A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
- A63B22/00—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements
- A63B22/0002—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements involving an exercising of arms
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- 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
- A61H2201/1253—Driving means driven by a human being, e.g. hand driven
- A61H2201/1261—Driving means driven by a human being, e.g. hand driven combined with active exercising of the patient
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- 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
- A61H2201/14—Special force transmission means, i.e. between the driving means and the interface with the user
- A61H2201/1481—Special movement conversion means
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- A—HUMAN NECESSITIES
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- 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
- A61H2201/1628—Pelvis
- A61H2201/1633—Seat
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- A—HUMAN NECESSITIES
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- 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
- A61H2201/1635—Hand or arm, e.g. handle
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- A—HUMAN NECESSITIES
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- 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
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- 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
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- A—HUMAN NECESSITIES
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- A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
- A61H2201/50—Control means thereof
- A61H2201/5007—Control means thereof computer controlled
- A61H2201/501—Control means thereof computer controlled connected to external computer devices or networks
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- 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
- A61H2201/50—Control means thereof
- A61H2201/5023—Interfaces to the user
- A61H2201/5043—Displays
- A61H2201/5046—Touch screens
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- A—HUMAN NECESSITIES
- A63—SPORTS; GAMES; AMUSEMENTS
- A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
- A63B22/00—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements
- A63B22/0048—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements with cantilevered support elements pivoting about an axis
- A63B2022/0051—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements with cantilevered support elements pivoting about an axis the support elements being supported at a substantial distance below their axis, e.g. the axis for the foot support elements are arranged at hip height
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- A—HUMAN NECESSITIES
- A63—SPORTS; GAMES; AMUSEMENTS
- A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
- A63B22/00—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements
- A63B22/06—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements with support elements performing a rotating cycling movement, i.e. a closed path movement
- A63B22/0664—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements with support elements performing a rotating cycling movement, i.e. a closed path movement performing an elliptic movement
- A63B2022/0688—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements with support elements performing a rotating cycling movement, i.e. a closed path movement performing an elliptic movement with cranks being substantially within the horizontal moving range of the support elements, e.g. by using planetary gearings
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- A—HUMAN NECESSITIES
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- A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
- A63B21/00—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices
- A63B21/00181—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices comprising additional means assisting the user to overcome part of the resisting force, i.e. assisted-active exercising
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- A—HUMAN NECESSITIES
- A63—SPORTS; GAMES; AMUSEMENTS
- A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
- A63B21/00—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices
- A63B21/005—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices using electromagnetic or electric force-resisters
- A63B21/0058—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices using electromagnetic or electric force-resisters using motors
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- A—HUMAN NECESSITIES
- A63—SPORTS; GAMES; AMUSEMENTS
- A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
- A63B22/00—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements
- A63B22/0002—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements involving an exercising of arms
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- A63B22/00—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements
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- A63B22/0056—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements with cantilevered support elements pivoting about an axis the pivoting movement being in a vertical plane, e.g. steppers with a horizontal axis
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- A—HUMAN NECESSITIES
- A63—SPORTS; GAMES; AMUSEMENTS
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- A63B2208/00—Characteristics or parameters related to the user or player
- A63B2208/02—Characteristics or parameters related to the user or player posture
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- A63B2208/00—Characteristics or parameters related to the user or player
- A63B2208/02—Characteristics or parameters related to the user or player posture
- A63B2208/0228—Sitting on the buttocks
- A63B2208/0233—Sitting on the buttocks in 90/90 position, like on a chair
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- A63—SPORTS; GAMES; AMUSEMENTS
- A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
- A63B2220/00—Measuring of physical parameters relating to sporting activity
- A63B2220/80—Special sensors, transducers or devices therefor
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- A—HUMAN NECESSITIES
- A63—SPORTS; GAMES; AMUSEMENTS
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- A63B2220/00—Measuring of physical parameters relating to sporting activity
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- A63B2220/00—Measuring of physical parameters relating to sporting activity
- A63B2220/80—Special sensors, transducers or devices therefor
- A63B2220/83—Special sensors, transducers or devices therefor characterised by the position of the sensor
- A63B2220/833—Sensors arranged on the exercise apparatus or sports implement
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- A—HUMAN NECESSITIES
- A63—SPORTS; GAMES; AMUSEMENTS
- A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
- A63B2225/00—Miscellaneous features of sport apparatus, devices or equipment
- A63B2225/09—Adjustable dimensions
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- A—HUMAN NECESSITIES
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- A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
- A63B2225/00—Miscellaneous features of sport apparatus, devices or equipment
- A63B2225/20—Miscellaneous features of sport apparatus, devices or equipment with means for remote communication, e.g. internet or the like
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- A—HUMAN NECESSITIES
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- A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
- A63B2225/00—Miscellaneous features of sport apparatus, devices or equipment
- A63B2225/50—Wireless data transmission, e.g. by radio transmitters or telemetry
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- A—HUMAN NECESSITIES
- A63—SPORTS; GAMES; AMUSEMENTS
- A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
- A63B2230/00—Measuring physiological parameters of the user
- A63B2230/04—Measuring physiological parameters of the user heartbeat characteristics, e.g. ECG, blood pressure modulations
- A63B2230/06—Measuring physiological parameters of the user heartbeat characteristics, e.g. ECG, blood pressure modulations heartbeat rate only
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- A63B24/00—Electric or electronic controls for exercising apparatus of preceding groups; Controlling or monitoring of exercises, sportive games, training or athletic performances
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- A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
- A63B71/00—Games or sports accessories not covered in groups A63B1/00 - A63B69/00
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- A—HUMAN NECESSITIES
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- A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
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- A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
- A63B71/00—Games or sports accessories not covered in groups A63B1/00 - A63B69/00
- A63B71/06—Indicating or scoring devices for games or players, or for other sports activities
- A63B71/0619—Displays, user interfaces and indicating devices, specially adapted for sport equipment, e.g. display mounted on treadmills
- A63B71/0622—Visual, audio or audio-visual systems for entertaining, instructing or motivating the user
Landscapes
- Health & Medical Sciences (AREA)
- General Health & Medical Sciences (AREA)
- Physical Education & Sports Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Biophysics (AREA)
- Epidemiology (AREA)
- Pain & Pain Management (AREA)
- Rehabilitation Therapy (AREA)
- Animal Behavior & Ethology (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Vascular Medicine (AREA)
- Cardiology (AREA)
- Rehabilitation Tools (AREA)
Abstract
L'appareil et les procédés associés concernent un dispositif de thérapie pour la marche naturelle pourvu d'un ensemble de liaison de synchronisation de la marche réglable conçu pour actionner un ensemble de support des genoux réglable et un ensemble de support des pieds à hauteur réglable pour simuler un modèle de marche normale pour un utilisateur sur la base des caractéristiques de l'utilisateur. Dans un exemple illustratif, l'ensemble de liaison de synchronisation de la marche réglable comprend un pignon de chaîne conçu pour ajuster un degré de soulèvement du talon et une longueur jusqu'au point de soulèvement du talon pendant une simulation de marche normale. Dans certains modes de réalisation, un ensemble de réglage de pas peut ajuster une longueur de pas en vue d'une adaptation à des utilisateurs de différentes tailles. L'ensemble de réglage de pas peut avantageusement contribuer à la simulation de modèle de marche naturelle.
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US201662374383P | 2016-08-12 | 2016-08-12 | |
| US62/374,383 | 2016-08-12 | ||
| PCT/US2017/046788 WO2018032007A1 (fr) | 2016-08-12 | 2017-08-14 | Système d'ajustement pour thérapie de la marche naturelle à assistance simulée |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA3033098A1 true CA3033098A1 (fr) | 2018-02-15 |
Family
ID=61163346
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA3033098A Abandoned CA3033098A1 (fr) | 2016-08-12 | 2017-08-14 | Systeme d'ajustement pour therapie de la marche naturelle a assistance simulee |
Country Status (5)
| Country | Link |
|---|---|
| EP (1) | EP3496825A4 (fr) |
| JP (1) | JP2019530548A (fr) |
| AU (1) | AU2017308230A1 (fr) |
| CA (1) | CA3033098A1 (fr) |
| WO (1) | WO2018032007A1 (fr) |
Families Citing this family (7)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US10881572B2 (en) | 2013-12-13 | 2021-01-05 | ALT Innovations LLC | Natural assist simulated gait therapy adjustment system |
| US10758774B2 (en) | 2017-10-06 | 2020-09-01 | ALT Innovations LLC | Walk therapy station |
| US11883714B2 (en) | 2020-12-24 | 2024-01-30 | ALT Innovations LLC | Upper body gait ergometer and gait trainer |
| JP7721083B2 (ja) * | 2021-10-22 | 2025-08-12 | トヨタ紡織株式会社 | 血液循環機能評価装置及び血液循環機能トレーニング装置 |
| IT202200013162A1 (it) * | 2022-06-22 | 2023-12-22 | Rodolfo Castaldini | Dispositivo di movimentazione degli arti inferiori in una persona a limitata mobilita’ |
| CN115969673A (zh) * | 2023-02-15 | 2023-04-18 | 安徽中医药大学第二附属医院(安徽省针灸医院) | 软瘫患者步态训练设备 |
| WO2025038653A1 (fr) * | 2023-08-14 | 2025-02-20 | Life Enabled Inc. | Appareil d'entraînement à la marche |
Family Cites Families (8)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5242179A (en) * | 1991-10-11 | 1993-09-07 | Research Foundation Of The State University Of New York | Four-line exercising attachment for wheelchairs |
| US6830538B2 (en) * | 2002-11-26 | 2004-12-14 | Paul William Eschenbach | Cyclodial drive for exercise apparatus |
| US7614639B2 (en) * | 2004-10-12 | 2009-11-10 | Invacare Corporation | Modular standing frame |
| US7938756B2 (en) * | 2007-02-10 | 2011-05-10 | Roy Rodetsky | Powered mobile lifting, gait training and omnidirectional rolling apparatus and method |
| CH712922B1 (de) * | 2007-07-13 | 2018-03-15 | Levo Ag Wohlen | Aufrichteinheit für Aufrichtrollstühle und Therapiegeräte. |
| JP2010154929A (ja) * | 2008-12-26 | 2010-07-15 | Gifu Univ | 起立補助椅子 |
| GB2484463A (en) * | 2010-10-11 | 2012-04-18 | Jonathan Butters | Apparatus to assist the rehabilitation of disabled persons |
| AU2014361932B2 (en) * | 2013-12-13 | 2019-01-31 | ALT Innovations LLC | Multi-modal gait-based non-invasive therapy platform |
-
2017
- 2017-08-14 CA CA3033098A patent/CA3033098A1/fr not_active Abandoned
- 2017-08-14 WO PCT/US2017/046788 patent/WO2018032007A1/fr not_active Ceased
- 2017-08-14 JP JP2019529470A patent/JP2019530548A/ja active Pending
- 2017-08-14 AU AU2017308230A patent/AU2017308230A1/en not_active Abandoned
- 2017-08-14 EP EP17840410.9A patent/EP3496825A4/fr not_active Withdrawn
Also Published As
| Publication number | Publication date |
|---|---|
| WO2018032007A1 (fr) | 2018-02-15 |
| EP3496825A1 (fr) | 2019-06-19 |
| EP3496825A4 (fr) | 2020-03-25 |
| AU2017308230A1 (en) | 2019-02-21 |
| JP2019530548A (ja) | 2019-10-24 |
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| Date | Code | Title | Description |
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| FZDE | Discontinued |
Effective date: 20231114 |