Rehabilitation device is tempered with treatment of old hip fracture
Technical Field
The invention relates to the technical field of medical care, in particular to an exercise rehabilitation device for treating hip fracture of old people.
Background
The senile hip fracture refers to the fracture of hip bones (including the femoral neck, the femoral trochanter and the like) of the elderly aged 65 years old and older due to falling, trauma or other reasons. Such fractures are common in the elderly population, particularly those suffering from osteoporosis. The consequences of senile hip fractures can be very severe, including long-term bedridden, increased risk of complications, reduced quality of life, and even increased mortality.
Treatment of senile hip fractures generally involves both surgical and non-surgical methods. Surgical treatment including internal fixation, artificial joint replacement, etc., aims to restore the mobility of the patient as soon as possible, reducing complications. Non-surgical treatments may include traction, medication, etc., as appropriate for certain circumstances. Preventive measures for senile hip fracture comprise improving home environment, increasing physical activity, reasonable diet, and treating osteoporosis with medicine. By these measures, the risk of hip fracture in elderly people can be reduced.
In the prior art, if the patent with the publication number CN118807170A is granted, a quick rehabilitation auxiliary training device for hip fracture treatment is disclosed, including the back connecting plate, the both sides of back connecting plate are provided with the installation connecting plate, the free end of installation connecting plate is connected with waist fixed band, the outside rotation of installation connecting plate is connected with the rolling disc that can vertical rotation, the outside of installation connecting plate is provided with many L type elastic resistance strips downwards, the inboard of rolling disc is provided with the bar slot, the bar slot inserts and is equipped with U type cutting, the outside of rolling disc is provided with the spacing ring, the spacing ring rotates and is connected with the linking collar, the linking collar outwards is provided with the linking arm, the free end of linking arm is provided with the arc thigh cover that can entangle the thigh front side, the rolling disc outwards is provided with the back shaft in the middle part of spacing ring, the free end rotation of back shaft is connected with the knob, the spacing intra-annular is provided with the resistance torsion spring, the device can satisfy the training demand at multiple hip joint position, its simple structure is with low costs, but safety limit when to the motion is less.
In the rehabilitation of senile hip fracture, prevention of hip adduction (Adduction) and internal rotation (InternalRotation) are core targets in early postoperative period (especially after artificial joint replacement), and improper actions can easily cause dislocation of prosthesis or re-displacement of fracture. In the prior art and the device, no corresponding protective measures exist, and when the old people perform rehabilitation exercise, the hip joint exercise of the old people is correspondingly limited, so that the hip joint adduction or internal rotation degree is reduced, and the exercise amplitude is kept in a proper range.
Accordingly, the present invention proposes an exercise rehabilitation device for the treatment of hip fracture in elderly people to solve the above problems.
Disclosure of Invention
In order to solve the problems, the invention provides an exercise rehabilitation device for treating senile hip fracture, which is used for limiting the movement angle of the hip joint of a patient when the patient performs rehabilitation training and providing reverse thrust for the patient based on leg movement during internal rotation of the patient, so that the internal rotation action of the hip joint of the patient is limited within a reasonable range, and the problem of dislocation of a prosthesis or re-displacement of the fracture caused by improper action is avoided.
In order to achieve the aim, the technical scheme is that the training rehabilitation device for treating the hip fracture of the elderly comprises two rear waist fixing plates and a plurality of waist fixing belts, wherein one ends of the waist fixing belts are fixedly connected to one rear waist fixing plate, the other ends of the waist fixing belts are detachably connected to the other rear waist fixing plate, the device also comprises an adjusting component for adjusting the distance between the two rear waist fixing plates, one side of each rear waist fixing plate is fixedly connected with a connecting component, and the connecting components are respectively provided with an auxiliary component for limiting the bending amplitude of thighs of a patient;
The resistance component comprises a plurality of arc-shaped sliding grooves, wherein moving blocks are slidably matched in the arc-shaped sliding grooves, push rods are fixedly connected to one ends of the moving blocks, a plurality of extrusion cavities corresponding to the arc-shaped sliding grooves one by one are formed in the connecting component, one ends, far away from the moving blocks, of the push rods are all extended into the extrusion cavities and are fixedly connected with pistons, springs are fixedly connected to one ends of the pistons, one ends of the springs are fixedly connected to the inner wall of the extrusion cavity, and one ends of the extrusion cavities are all communicated with gas pipes.
The basic scheme principle is that when a patient performs rehabilitation training, the auxiliary component is used for limiting the movement angle of the hip joint of the patient and limiting the adduction action of the hip joint of the patient, and when the patient performs internal rotation action, the resistance component provides reverse thrust for the patient based on leg movement during internal rotation, so that the internal rotation action of the hip joint of the patient is limited within a reasonable range, and the problem of dislocation of a prosthesis or fracture re-displacement caused by improper action is avoided.
The rehabilitation device has the beneficial effects that the comprehensive dynamic protection of rehabilitation training of the elderly hip fracture patient is realized through the multi-component linkage mechanism, and the core advantages of the rehabilitation device are three aspects. Firstly, the device forms a bidirectional dynamic constraint mechanism when a patient performs hip joint movement through the synergistic effect of the auxiliary component and the resistance component, wherein the auxiliary component precisely controls the hip joint buckling angle in a rigid limiting mode to avoid prosthesis load unbalance caused by excessive forward tilting, and the resistance component automatically generates progressive reverse acting force when the internal rotation movement of the patient exceeds a preset threshold value through sliding fit mechanical feedback, so that the patient is allowed to actively train in a safety range, abnormal internal rotation torque can be timely restrained, and the secondary damage risk of the joint capsule is effectively reduced. Secondly, the adjustable waist fixing system and the modularized design obviously improve the suitability, the space adjusting function of the two rear waist fixing plates can be compatible with lumbar vertebra physiological curvatures of patients with different body types, and the flexible fixing belts distributed at multiple points are matched, so that the trunk stability is ensured, local compression is avoided, and the waist fixing system is particularly suitable for long-term wearing of osteoporosis patients. In addition, the device realizes the hierarchical control of the multiaxial activities of the hip joint through the combined application of the hinge structure and the sliding component, and the bending and stretching training of the patient on the sagittal plane and the rotation training on the horizontal plane can respectively receive differential limiting protection. The overall design gives consideration to the dual requirements of medical protection and functional recovery, and provides reliable guarantee for early postoperative recovery.
Further, the adjusting component comprises a plurality of main connecting rods and a plurality of auxiliary connecting rods which are in sliding fit with the main connecting rods, and two rear waist fixing plates are fixedly connected with the main connecting rods and the auxiliary connecting rods respectively on one sides close to each other.
The adjustable waist belt has the beneficial effects that the sliding main and auxiliary rod structure of the adjusting assembly enables the interval between the two rear waist fixing plates to be flexibly adapted to waistline sizes of different patients through bidirectional telescopic adjustment. The main connecting rod provides rigid support to maintain the overall stability of the device, and the sliding clamping groove of the auxiliary connecting rod is designed to realize stepless adjustment, so that the waist curve of a lean patient can be tightly attached, and the physical characteristics of an obese patient can be expanded.
Further, the connecting assembly comprises first connecting rods fixedly connected with the rear waist fixing plates, the first connecting rods are hinged with second connecting rods, arc plates are fixedly connected to one ends, far away from the first connecting rods, of the second connecting rods, arc sliding grooves are formed in an array along the length direction of the arc plates, and extrusion cavities are formed in the arc plates.
The double-connecting-rod hinge structure of the connecting assembly has the beneficial effects that the dynamic angle adaptation in hip joint rehabilitation training is realized through the multi-degree-of-freedom motion design. The first connecting rod and the second connecting rod are hinged and matched to form an adjustable transmission mechanism, so that the adjustable transmission mechanism can follow the natural movement track of the hip of a patient during flexion and extension, and uniform supporting force distribution is provided through the fit of the curved plate and the curved surface on the outer side of the thigh. The structure reduces rigid collision during joint movement through a flexible buffer mechanism while guaranteeing the movement precision of the auxiliary assembly, and is particularly suitable for limb swing deviation of old patients caused by muscle atrophy. The streamline cladding design of the arc plate can synchronously disperse the concentrated pressure of the traditional brace on the femoral trochanter, and reduce the abrasion risk of soft tissues caused by long-term training.
Further, the auxiliary assembly comprises an adjusting knob for adjusting the rotation angle range of the first connecting rod and the second connecting rod, and the adjusting knob is arranged at the hinge joint of the first connecting rod and the second connecting rod.
The hip joint bending and stretching angle control device has the beneficial effects that the accurate dynamic control of the hip joint bending and stretching angle is realized by the adjusting knob. The step locking function can set the activity threshold value step by step according to the rehabilitation stage of the patient, so that the prosthesis impact caused by sudden overflexion can be prevented in training, and the joint activity degree can be gradually enlarged in a safety range.
Further, the angle adjustment range of the first connecting rod and the second connecting rod is 0-60 degrees.
The hip joint rehabilitation device has the beneficial effects that the angle adjusting range is accurately matched with the staged requirement of the hip joint postoperative rehabilitation, through gradually expanding the movable angle, the safety protection of the early bedridden stage can be maintained, and the functional requirement of the mid-stage sitting and standing training can be met. In the adjusting process, the limiting mechanism and the tension of the joint capsule form dynamic balance, so that the prosthesis collision risk caused by excessive buckling is prevented, meanwhile, a patient is ensured to obtain a coherent biomechanical support during transition from passive activity to active training, and the controllability of the rehabilitation process is obviously improved.
Furthermore, the resistance assemblies also comprise two air bag assemblies for applying resistance to the inner sides of thighs of the patient, the air bag assemblies are respectively communicated with corresponding air delivery pipes, one sides of the moving blocks, which are far away from the arc-shaped sliding grooves, are fixedly connected with fixing supports, and the fixing supports are provided with binding bands.
The dynamic resistance control system has the beneficial effects that the fluid dynamic feedback system of the resistance component forms a self-adaptive dynamic resistance control mechanism through the real-time conversion of mechanical energy and air pressure. When the leg of the patient rotates inwards, the displacement of the moving block along the arc chute drives the piston to compress the spring, and gas in the extrusion cavity is synchronously injected into the corresponding side air bag through the gas pipe, so that gradient pressure feedback positively related to the internal rotation angle is generated. The design converts mechanical sliding quantity into biocompatible air pressure resistance in a breakthrough way, and realizes flexible buffering of contact pressure through soft tissue deformation characteristics of the air bag layer while limiting abnormal internal rotation angles. The antagonistic layout of the double air sac layers can intelligently balance tension difference of bilateral muscle groups, is particularly suitable for the problem of internal rotation muscle force unbalance existing after femoral neck fracture operation, and has the rehabilitation value of promoting proprioception reconstruction besides the core function of preventing dislocation of the prosthesis.
Further, the airbag components comprise supporting plates which are connected to one side of the rear waist fixing plate in a sliding mode, arc-shaped baffle plates are fixedly connected to one ends, close to each other, of the supporting plates, airbag layers are arranged on one sides, away from each other, of the arc-shaped baffle plates, when the airbag layers are in an inflated state, the upper end width of the airbag layers is always larger than the lower end width, and the difference value of the upper end width and the lower end width is increased along with the inflation degree of the airbag layers.
The three-dimensional dynamic adaptation of the thigh inner muscle group is realized through the special-shaped expansion design of the air bag component and the bionic fluid pressure distribution. The wedge-shaped expansion structure with the upper part wide and the lower part narrow of the air sac layer can synchronously bond the anatomical trend of the gracilis muscle and adductor muscle group when in inflation, the upper wide section covers the proximal myoabdomen to provide a main resistance surface, and the lower narrowing part avoids the popliteal nerve blood vessel bundle. The sliding rail adjusting mechanism of the supporting plate enables the arc-shaped baffle plate to slide and position along the axis from the ischial tuberosity of the patient to the middle section of the femur, and ensures that the air bag pressure precisely acts on the mechanical fulcrum of the internal rotation moment. The structure breaks through the two-dimensional compression mode of the traditional annular binding belt, reduces the circulating compression risk of perineum and femoral artery areas through gradient decompression design while limiting abnormal internal rotation, and is particularly suitable for the long-term wearing requirement of elderly patients accompanied with peripheral vascular lesions.
Further, the back waist fixing plate also comprises a sponge layer, wherein two ends of the sponge layer are respectively and fixedly connected with two opposite sides of the back waist fixing plate.
The elastic buffer structure of the sponge layer has the beneficial effects that the elastic buffer structure of the sponge layer is optimized through precompression distribution, so that the self-adaptive fitting of the physiological curvature of the waist is formed while the fixing stability is ensured. The open porous base material generates gradient deformation when being longitudinally stretched, can absorb the shearing stress when lumbar vertebra is laterally bent, reduces the accumulation of damp and heat through the pore breathing effect, and effectively prevents the pressure injury caused by long-term wearing.
Further, the springs are all nonlinear springs.
The variable stiffness characteristic of the nonlinear spring realizes intelligent gradient response of resistance, and the progressive compression curve of the variable stiffness characteristic is accurately matched with the biomechanical characteristic of the internal rotator muscle group of the human body. The lower elastic modulus at the initial stage allows the patient to start training with smaller muscle force to avoid micro injury of the joint capsule caused by sudden load, and the spring stiffness increases in a nonlinear way along with the increase of the internal rotation angle to form an exponentially increasing dynamic barrier when approaching a safety threshold.
Further, the surface of the air bag layer is provided with anti-skid patterns.
The anti-skid pattern surface of the air bag layer remarkably improves the dynamic reaction force transmission efficiency during the internal rotation action through a directional friction enhancing mechanism.
Additional aspects and advantages of the invention will be set forth in part in the description which follows, and in part will be obvious from the description, or may be learned by practice of the invention.
Drawings
FIG. 1 is an overall front isometric view of an embodiment of an exercise rehabilitation device for the treatment of senile hip fracture according to the present invention;
FIG. 2 is a top view of the entire bottom of an embodiment of the exercise rehabilitation device for the treatment of senile hip fracture according to the present invention;
FIG. 3 is a front isometric view of the entirety of an embodiment of an exercise rehabilitation device for the treatment of senile hip fracture according to the present invention;
FIG. 4 is an enlarged view of portion A of an embodiment of an exercise rehabilitation device for the treatment of senile hip fracture according to the present invention;
fig. 5 is a front cross-sectional view of an inflatable module of an embodiment of an exercise rehabilitation device for the treatment of senile hip fracture according to the present invention.
The reference numerals in the attached drawings of the specification comprise a rear waist fixing plate 1, a first connecting rod 2, a second connecting rod 3, an arc chute 4, an arc-shaped plate 5, an arc-shaped plate 6, a fixing bracket 7, a binding belt 8, an adjusting knob 9, a sponge layer 10, a supporting plate 11, a main connecting rod 12, an auxiliary connecting rod 13, a moving block 14, a push rod 15, a spring 16, an extrusion cavity 17, an arc-shaped baffle 18, an air bag layer 19 and an air pipe.
Detailed Description
The following description of the embodiments of the present invention will be made apparent and fully in view of the accompanying drawings, in which some, but not all embodiments of the invention are shown. All other embodiments, which can be made by those skilled in the art based on the embodiments of the invention without making any inventive effort, are intended to be within the scope of the invention.
In the description of the present invention, it should be noted that the directions or positional relationships indicated by the terms "center", "upper", "lower", "left", "right", "vertical", "horizontal", "inner", "outer", etc. are based on the directions or positional relationships shown in the drawings, are merely for convenience of describing the present invention and simplifying the description, and do not indicate or imply that the devices or elements referred to must have a specific orientation, be configured and operated in a specific orientation, and thus should not be construed as limiting the present invention. Furthermore, the terms "first," "second," and "third" are used for descriptive purposes only and are not to be construed as indicating or implying relative importance.
In the description of the present invention, unless explicitly stated or limited otherwise, the terms "mounted," "connected," and "connected" are to be construed broadly, and may be, for example, fixedly connected, detachably connected, or integrally connected, mechanically connected, electrically connected, directly connected, indirectly connected via an intervening medium, or in communication between two elements. The specific meaning of the above terms in the present invention will be understood in specific cases by those of ordinary skill in the art.
The following is a further detailed description of the embodiments:
Example 1:
As shown in figures 1, 2, 3, 4 and 5, the exercise rehabilitation device for treating senile hip fracture comprises two rear waist fixing plates 1 and a plurality of waist fixing belts, wherein one end of each waist fixing belt is fixedly connected to one rear waist fixing plate 1, the other end of each waist fixing belt is connected to the other rear waist fixing plate 1 in a ring-buckling manner, and the two rear waist fixing plates 1 are fixed on the waist of a patient through the waist fixing belts when the device is used.
Because the patient (waistline is different) that needs to adapt to different sizes, so still include the adjusting part that is used for adjusting the interval of two back waist fixed plates 1, concretely, adjusting part includes a plurality of main connecting rods 11 and a plurality of vice connecting rods 12 with main connecting rod 11 sliding fit, two back waist fixed plates 1 be close to one side each other respectively with main connecting rod 11 and vice connecting rod 12 fixed connection, secondly main connecting rod 11 and vice connecting rod 12 slide the back and screw fixedly (as shown in fig. 2) through corresponding lock nut to adjust the interval of two back waist fixed plates 1 through the relative slip of main connecting rod 11 and vice connecting rod 12, with the majority crowd of adaptation.
For the old patient during the rehabilitation of hip fracture, doctors can make the old patient perform proper simple leg movements, such as ankle pump movements, pendulum leg exercises, walking of a supporting device and the like, the movement difficulty is increased step by step according to the rehabilitation time (according to the postoperative time), when the old patient is trained, in order to prevent accidents from happening and causing the hip joint to violently move and influence the subsequent rehabilitation, a connecting component is fixedly connected to one side of a rear waist fixing plate 1, specifically, the connecting components comprise a first connecting rod 2 integrally formed with the rear waist fixing plate 1, the first connecting rod 2 is hinged with a second connecting rod 3, one end of the second connecting rod 3 far away from the first connecting rod 2 is fixedly connected with an arc plate 5 (shown in fig. 1 and 2), meanwhile, the hinge joint of the second connecting rod 3 and the first connecting rod 2 is provided with an auxiliary component for limiting the bending amplitude of the thigh of the patient, specifically, the auxiliary component comprises an adjusting knob 8 for adjusting the rotation angle range of the first connecting rod 2 and the second connecting rod 3, the adjusting knob 8 is arranged at the hinge joint of the first connecting rod 2 and the second connecting rod 3, and the first connecting rod 2 and the second connecting rod 2 are fixedly connected with the first connecting rod 2, and the second connecting rod 3 and the adjusting rod 3 are fixedly connected with the connecting rod and the connecting rod.
In the rehabilitation of senile hip fracture (early postoperative), excessive adduction and internal rotation of the hip joint easily cause dislocation of the prosthesis or re-displacement of fracture, soft tissues around the hip joint are not healed within 6 weeks after operation, adduction (crossing of two legs) or internal rotation (oversteering of the toes) can cause abnormal stress of the joint capsule or the prosthesis, the dislocation risk is increased, and meanwhile, the senile patient has difficulty in actively controlling the joint movement range due to pain or muscle strength deficiency, so that resistance components for limiting the adduction and internal rotation of the hip joint of the patient are slidingly matched on one side of the arc-shaped plate 5, which is close to each other.
The resistance assembly comprises a plurality of arc-shaped sliding grooves 4 which are arranged along the length direction of an arc-shaped plate 5 in an array manner, wherein a moving block 13 is slidably matched in each arc-shaped sliding groove 4, one end of each moving block 13 is fixedly connected with a push rod 14, a plurality of extrusion cavities 16 which are in one-to-one correspondence with the arc-shaped sliding grooves 4 are respectively arranged in each arc-shaped plate 5, one end of each push rod 14, far away from each moving block 13, extends into each extrusion cavity 16 and is fixedly connected with a piston, one end of each piston is fixedly connected with a spring 15, each spring 15 is a nonlinear spring 15, one end of each spring 15 is fixedly connected with the inner wall of each extrusion cavity 16, and one end of each extrusion cavity 16 is communicated with a gas pipe 19;
The inflatable waist fixing plate comprises a rear waist fixing plate 1, and is characterized by further comprising two air bag assemblies for applying resistance to the inner sides of thighs of a patient, wherein the air bag assemblies are respectively communicated with corresponding air delivery pipes 19, each air bag assembly comprises a supporting plate 10 which is connected to one side of the rear waist fixing plate 1 in a sliding mode, one end, close to each other, of each supporting plate 10 is fixedly connected with an arc baffle 17, each arc baffle 17 is provided with an air bag layer 18 on one side, far away from each other, of each arc baffle 17, the surface of each air bag layer 18 is provided with anti-skid patterns, when the air bag layers 18 are in an inflated state, the width of the upper ends of the air bag layers 18 is always larger than the width of the lower ends of the air bag layers 18, the difference value of the air bag layers is increased along with the inflation degree of the air bag layers 18, one side, far away from the arc chute 4, of each moving block 13 is fixedly connected with a fixing bracket 6, and each fixing bracket 6 is provided with a binding belt 7.
For the prevention of excessive adduction of the hip joint, the patient's legs can be fixed to the fixing bracket 6 by the straps 7 so that the patient's legs are temporarily integrated with the two arc plates 5, and the lateral movement of the arc plates 5 is limited due to the structural design, as shown in fig. 1, thereby limiting the adduction movement of the hip joint of the elderly patient.
For the internal rotation limitation of the hip joint of the elderly patient, the device can realize intelligent regulation and control through a dual mechanism of dynamic fluid resistance and mechanical linkage. When a patient attempts to pronate (e.g., toe oversteered medial), their leg movements will trigger the following chain reaction:
When the legs of the patient rotate inwards, the binding belt 7 fixed on the outer side of the thighs drives the moving block 13 to slide along the arc-shaped chute 4 towards the center of the hip joint. The displacement of the moving block 13 pushes the piston to stretch the nonlinear spring 15 in the extrusion cavity 16 through the push rod 14, and meanwhile, gas in the cavity is pressed into the corresponding side air bag layer 18 through the gas pipe 19. The progressive stiffness characteristic of the spring 15 in this process makes the initial phase resistance gentle, avoiding sudden braking induced muscle strain.
The inflated balloon layer 18 takes on a wedge-shaped inflated form with a wide upper area and a narrow lower area, wherein the upper area precisely covers the joint of the gracilis and adductor muscle groups, the pressure of the balloon layer 18 is converted into tangential resistance opposite to the internal rotation direction through the directional friction between the surface of the anti-skid pattern and the skin, and the lower narrowing structure avoids the popliteal nerve vascular area and only applies moderate constraint to distal tendons. The balloon layer 18 pressure increases exponentially with increasing pronation angle, reaching peak pressures near a safety threshold (e.g., pronation exceeding 6 °), creating a physical action blockage.
When the patient continues to apply force to try to break the limit, the stiffness of the nonlinear spring 15 increases suddenly the resistance to movement of the piston, and the expansion rate of the air bag is synchronously enhanced. At this time, the support plate 10 is adaptively adjusted along the sliding track of the rear waist fixing plate 1, so that the pressure of the air bag acts on the anatomical fulcrum (the connecting line area of the ischial tuberosity and the femur lesser trochanter) of the internal rotation moment in a concentrated manner, and the braking effect of the resistance is amplified through the biomechanical lever effect. The process forms closed-loop regulation and control of mechanical compression, pneumatic conduction and soft tissue impedance, and ensures that abnormal internal rotation is inhibited within a deviation range of 3-5 degrees.
Example 2:
The difference with the above embodiment is that, as shown in fig. 1 and 2, the device further comprises a sponge layer 9, two ends of the sponge layer 9 are respectively and fixedly connected to two opposite sides of the rear waist fixing plate 1, and the bidirectional stretching characteristic of the sponge layer enables the sponge layer 9 to synchronously generate elastic deformation (0.5-15 cm) when the distance between the two rear waist fixing plates 1 is adjusted, so that the device not only keeps continuous fit with the waist of a patient, but also avoids stress concentration caused by excessive stretching of the traditional elastic belt. Meanwhile, when a patient performs antegrade training, the sponge layer 9 can absorb 40% -60% of shearing force through a hysteresis compression effect, so that abnormal load of the intervertebral disc is obviously reduced.
It is apparent that the above examples are given by way of illustration only and are not limiting of the embodiments. Other variations or modifications of the above teachings will be apparent to those of ordinary skill in the art. It is not necessary here nor is it exhaustive of all embodiments. While still being apparent from variations or modifications that may be made by those skilled in the art are within the scope of the invention.