DE102016104879B4 - orthosis - Google Patents

Abstract

Orthosis (1) with - a support element (2) which, when the orthosis (1) is in place, rests against a torso (8) of the wearer (4) of the orthosis (1), - a guide element (12) with an extension direction, - an arm support element (10) which, when in place, supports an arm of the wearer (4), and - a joint (14) by means of which the guide element (12) can be moved relative to the support element (2), characterized in that, when in place, - the joint (14) is arranged above, i.e. cranially, a shoulder of the wearer (4) and is designed to enable an upper arm (16) of the wearer (4) to be raised and lowered in a sagittal plane, i.e. forwards and backwards, and - the arm support element (10) is displaced relative to the guide element (12) along the extension direction or a length of the guide element (12) is changed in the extension direction when the guide element (12) is moved by the joint (14) relative to the contact element (2).

Description

The invention relates to an orthosis with a contact element which, when the orthosis is worn, rests against a torso of a wearer of the orthosis, a guide element with an extension direction, an arm support element which, when worn, supports an arm of the wearer, and a joint by means of which the guide element is movable relative to the contact element.

Such an orthosis is available, for example, in the form of an arm support orthosis from the US 2011 / 0 164 949 A1 known. In the document mentioned, the orthosis supports the wearer's forearm in order to, for example, compensate for the influence of gravity and the force required to overcome gravity. Different joints can be moved using different actuators so that the movements of the arm can be followed.

From the WO 2012 / 099 995 A2 Another arm support orthosis is known in which a force is permanently exerted on the upper arm of the wearer in order to compensate for the influence of gravity and thus, for example, to facilitate work overhead.

An orthosis for a similar task is available from JP 2014 - 113 317 A Here, too, a force is to be exerted on the wearer's upper arm in order to compensate for the influence of gravity.

From the US 2014 / 0 158 839 A1 Another arm support orthosis with several joints is known, which is also intended to compensate for the influence of gravity on the wearer's arm and at the same time allow the wearer as much freedom of movement as possible.

Another arm support orthosis to compensate for the force of gravity on the arm of a wearer while allowing the wearer as much freedom of movement as possible is known from the US 2012 / 0 184 880 A1 known

In the unpublished WO 2016 / 065 350 A1 An arm support device is described, e.g. for use in an arm support orthosis, which should allow the wearer as much freedom of movement as possible.

The US 2014 / 0 212 243 A1 describes a robotic device for assisting a wearer in lifting heavy objects, while simultaneously allowing the wearer to walk.

From the DE 20 2013 009 698 U1 Parallel kinematics is known for an exoskeleton or an orthosis, which is intended to enable, for example, the complete movement of an arm including the upper arm and forearm. It is important that the rotational axes of the joints of the orthosis or exoskeleton do not coincide coaxially with the joint axes of the natural human joint.

For this purpose, the orthoses mentioned have at least one joint through which movements of the shoulder can be simulated. However, the disadvantage is that these joints and/or the at least one guide element are arranged to the side of the shoulder joint when the orthosis is in place. This has the advantage that a joint axis can be positioned so that it coincides as well as possible with the natural joint axis of the shoulder joint, around which the upper arm can be pivoted relative to the shoulder in the sagittal plane, i.e. forwards and backwards. However, the disadvantage is that this can restrict freedom of movement in other directions and the orthosis is also built laterally onto the wearer's body. The total width of the wearer with the orthosis is therefore greater than the width of the wearer without the orthosis.

The wearer of the orthosis must therefore get used to having a larger width when the orthosis is on and thus not being able to fit through narrow doors or gaps, or only being able to do so in certain orientations and directions. This can have significant disadvantages, particularly if the orthosis is used as a work support, for example to facilitate work that has to be carried out overhead, as this work often has to be carried out in cramped situations, for example under a motor vehicle.

The invention is therefore based on the object of further developing an orthosis according to the preamble of claim 1 in such a way that the freedom of movement of the shoulder joint is not or only slightly restricted and the orthosis can experience greater acceptance, in particular as work support.

The invention solves the problem by an orthosis according to the preamble of claim 1, which is characterized in that, when applied, the joint is arranged above, i.e. cranially, a shoulder of the wearer and is designed to enable an upper arm (16) of the wearer (4) to be raised and lowered forwards or backwards, wherein the arm support element is movable relative to the guide element along the first direction of cover or a length of the guide element is changed in the direction of extension when the guide element is moved relative to the contact element.

According to the present invention, the at least one joint is therefore not arranged next to, i.e. lateral to, the shoulder joint of the wearer, but above, i.e. in a cranial direction. This reduces the required width of the orthosis and the wearer of the orthosis fits through the same gaps with the orthosis on as without the orthosis on. This significantly reduces the adjustment phase and greatly reduces the risk of accidents. This significantly increases the acceptance of the orthosis. In addition, the guide element is advantageously arranged above the arm, in particular above the upper arm, of a wearer of the orthosis. This means that the orthosis does not add bulk to the side of the arm, so that the width of the wearer without the orthosis is just as large as the width of the wearer with the orthosis.

However, this arrangement of the joint above the wearer's shoulder can lead to incongruities during certain movements of the upper arm relative to the shoulder. This particularly applies to raising and lowering the upper arm in a sagittal plane, i.e. forwards or backwards. With this type of movement, the axis of rotation of at least one joint no longer coincides with the axis of rotation of the shoulder joint. To compensate for this, the distance of the arm support element from the rest of the orthosis, i.e. in particular from the joint, can be changed by moving the support element relative to the guide element along the direction of extension or by changing the length of the guide element in this direction. This is preferably done without additional actuators by raising or lowering the wearer's arm. Detection of a corresponding movement, for example via sensors, and active actuation of the arm support element or the guide element is possible, but not necessary.

In an orthosis according to the invention, the support element is therefore designed to be placed on the torso of the wearer of the orthosis. This is advantageously done in an area of the back or shoulder, so that a safe and yet comfortable application and support is possible. The arm support element is designed to support the wearer's arm. The special positioning of the joint prevents the device from tipping over when loaded, which leads to incorrect loading and possibly uncomfortable positioning. In contrast to the prior art, the joint is advantageously located in the same sagittal plane in which the upper arm is located when not loaded and hanging down from the shoulder. The upward and downward movement already described also takes place in this sagittal plane.

The application element, the guide element, the arm support element and the joint are therefore arranged relative to one another in such a way that the joint is positioned cranial to the shoulder when applied and, in addition, the desired movements of the arm support element or the guide element are achieved.

Advantageously, the arm support element is designed to support the upper arm of the wearer. In this way, the orthosis does not have to take into account movements that the forearm performs relative to the upper arm of the wearer and a complicated joint design, as is partly known from the prior art, is not required.

It has proven to be advantageous if the guide element is a rail on which the arm support element is arranged so that it can move. In a preferred embodiment of this rail, the rail has a recess in which a correspondingly designed projection of the arm support element or a slide on which the arm support element is arranged can move. The recess can be dovetail-shaped, for example, or have a different shape. The slide can also be equipped with a corresponding projection that engages in the recess. Alternatively or additionally, the slide can also have a fastening element that partially or completely surrounds the rail and is arranged so that it can move along the rail. The bearing is preferably carried out using bearing devices that are known in principle from the prior art, such as plain or ball bearings.

Alternatively or additionally, the guide element can also consist of or have several rods or bars connected to one another via at least one joint. These are connected in an articulated manner to the joint and the arm support element, so that a movement of the arm support element relative to the joint can take place via a deformation of the guide element, which is designed in this way, whereby the distance of the arm support element from the joint and thus the length of the guide element can change.

In a preferred embodiment, the arm support element or the carriage has more than one contact element with which the carriage or the arm support element rests on the rail. For example, the arm support element can have two slides, both of which engage in the same recess in the rail or surround the same rail. The same naturally also applies to a projection that the arm support element has. Here, too, there can be two projections arranged one behind the other in the direction of extension, as is also the case with the slides. Of course, there can also be a projection or slide that extends in the direction of extension. In this way, when the upper arm moves relative to the shoulder, which leads to a movement of the joint and thus to a change in the position of the arm support element relative to the joint, the arm support element is prevented from tilting on or in the rail and thus blocking further movement and possibly making it impossible. This also further increases the manageability, comfort and acceptance of the device.

Alternatively or additionally, the guide element and the arm support element can each have at least one slide element, which are arranged so that they can slide along each other. Air cushion or gel bearings can preferably be used here.

Alternatively or in addition, the guide element is designed as a telescopic rod. In this case, a movement of the joint, i.e. a displacement of the upper arm of the wearer of the orthosis relative to the shoulder, leads to the telescopic rod being pulled out or pushed in, so that the effective length of the telescopic rod changes up to the point at which the arm support element is arranged on the guide element. This can also compensate for the incongruity between the pivot points of the joint and the shoulder joint of the wearer.

The joint is preferably a ball joint. In this way, other movements of the shoulder that do not exclusively result in a movement of the upper arm in the aforementioned sagittal plane can also be carried out. Of course, several separate joints can also be present for this purpose, one of which is used to enable movement of the arm support element in the respective pivoting direction. The advantage of a ball joint, however, is that movement in all directions is possible with a joint whose axes of rotation for the respective movement all run through the same point, namely the center of the ball joint.

In a preferred embodiment, a resistance that opposes movement of the joint can be adjusted and the joint can in particular be blocked. Of course, the resistance can also be designed differently for different directions of movement of the joint. Variable adaptation, for example to a state of movement of the joint, for example a joint angle enclosed between the legs of the joint, is also advantageous for certain applications. For example, it can be useful to prevent a movement of the joint that leads to the upper arm being lowered relative to the shoulder as long as the wearer of the orthosis is carrying out work overhead. A movement in the opposite direction, which corresponds to a further raising of the upper arm relative to the shoulder, should, however, be freely possible.

Alternatively or additionally, a resistance that prevents the arm support element from moving relative to the guide element and/or a resistance that prevents the length of the guide element from changing can also be set. The arm support element can in particular be designed to be blockable relative to the guide element and/or the length of the guide element can be fixed. Here too, different directions of movement or changes in length can of course be subjected to different resistances. A change in the respective resistance depending on the position of the two components relative to one another or the currently set length of the guide element is also conceivable.

In a preferred embodiment, the orthosis has an electrical or electronic control system that is designed to adjust this resistance depending on the position of the wearer's head. If the wearer of the orthosis tilts their head back to look upwards, for example, this can be detected by a sensor or a positioning element that rests on the head. The signal achieved in this way, which can also be transmitted mechanically, is then preferably used to prevent or at least make it more difficult for the joint to move in the direction that corresponds to lowering the upper arm. This also makes it possible to simply compensate for the influence of gravity on the respective arm of the wearer of the orthosis.

Especially when using the orthosis as work support for otherwise healthy wearers, it is advantageous if the orthosis can be put on as quickly and as easily as possible. For this purpose, the arm support element advantageously has a shell device that can be brought into a closed position by placing the arm of the wearer of the orthosis in the shell device. is inserted. The shell device can be closed by simply inserting the arm using an actuating element, for example a belt running inside the shell device, so that the orthosis can be put on without using another hand. The easier it is to put on the orthosis, especially when used as a work aid, the greater the acceptance by the wearer.

Additional locking elements for the shell device are of course possible.

The orthosis is advantageously suitable for supporting both arms of the wearer. It has two arm support elements, two guide elements and two joints. Of course, the respective elements can be designed differently for the different arms, so that, for example, the resistance of the individual joints can be controlled independently of one another.

• 1 - die schematische Darstellung einer Orthese im angelegten Zustand,
• 2 - einen Ausschnitt aus der in 1 gezeigten Orthese,
• 3a und 3b - die schematische Darstellung einer angelegten Orthese in zwei unterschiedlichen Positionen,
• 4 und 5 - einen schematischen Ausschnitt einer Orthese gemäß einem weiteren Ausführungsbeispiel der vorliegenden Erfindung und
• 6 und 7 - die schematische Darstellung einer angelegten Orthese gemäß einem weiteren Ausführungsbeispiel der vorliegenden Erfindung in unterschiedlichen Positionen.

An embodiment of the present invention is explained in more detail below with the help of the accompanying drawings. It shows:

• 1 - the schematic representation of an orthosis in the applied state,
• 2 - an excerpt from the 1 shown orthosis,
• 3a and 3b - the schematic representation of an orthosis in two different positions,
• 4 and 5 - a schematic section of an orthosis according to a further embodiment of the present invention and
• 6 and 7 - the schematic representation of an orthosis according to a further embodiment of the present invention in different positions.

1 shows an orthosis 1 according to a first embodiment of the present invention in the applied state. It has several contact elements 2, which in the embodiment shown rest in the shoulder area and in the hip area of a wearer 4 of the orthosis 1. The various contact elements 2 are connected to one another via an adjustable rod 6. In this way, the orthosis 1 can be adapted to the respective physique of the wearer 4. The distribution of the contact elements 2 in the form shown, in particular at different heights on a torso 8 of the wearer 4, allows in particular stable storage in the loaded state.

The in 1 The orthosis 1 shown also has an arm support element 10, which in the embodiment shown is attached to a guide element 12. The guide element 12 is coupled to the rest of the orthosis via a joint 14. An upper arm 16 of the wearer 4 of the orthosis 1 can be inserted into the arm support element 10 and attached to it. The joint 14 enables a movement of the upper arm 16 relative to the shoulder of the wearer 4, which extends in the sagittal plane, i.e. forwards or backwards. However, the pivot points of the joint 14 and the shoulder joint of the wearer 4 of the orthosis 1 are not on the same line, so that an incongruity occurs. If the guide element 12 is pivoted relative to the rest of the orthosis by the joint 14, for example by the wearer 4 inserting his upper arm 16 into the arm support element 10 and lifting it, the arm support element 10 moves along the guide element 12 to compensate for this incongruity.

A further joint 18 enables the arm support element 10 to move relative to the support elements 2 in a pivoting direction in the transverse plane that is perpendicular to the sagittal plane described. It has proven advantageous if the joint 14 and the further joint 18 are arranged as close to one another as possible in order to keep the incongruences of the different movements as small as possible.

2 shows an enlarged section of the 1 The orthosis 1 shown in Fig. 1 is shown. A part of the rod 6 as well as the further joint 18 and the joint 14 are shown. The guide element 12 is located on these, which in the embodiment shown includes a rail 20 to which a slide element 22 is slidably attached. The arm support element 10 is arranged on this slide element 22. In order to allow movement of the upper arm, which is in 2 not shown, which do not occur exclusively in the sagittal plane, an additional joint 24 is provided between the slide element 22 and the arm support element 10.

In the advantageous embodiments shown in the figures, the joint 14 is designed to be lockable. It has a locking mechanism 26 by means of which movement in at least one direction of the joint can be restricted, made more difficult or completely prevented. For example, it is possible to enable the guide element 12 to move upwards in the embodiment shown, i.e. pivot clockwise, while pivoting in the opposite direction is not possible or is more difficult. This is particularly useful when the orthosis 1 is worn by a wearer 4 who has to carry out work overhead. This relieves the strain on the arms.

3a shows the wearer 4 of the orthosis 1 with the upper arm 16 lowered. The rod 6 connects the support elements 2, which are located in the area of the shoulder and the waist or hip. In this way, a secure mounting of the orthosis 1 on the torso 8 of the wearer 4 is ensured. The arm support element 10 is attached to the guide element 12 via a rod 27 and can be moved in the longitudinal direction of the guide element 12, i.e. along the longitudinal direction of the upper arm 16.

In the 3a In the situation shown, the upper arm 16 is lowered and therefore the rod 27 is displaced further in the distal direction, i.e. in the direction of the elbow 30. 3b shows the same orthosis 1 with the difference that the wearer 4 has raised the upper arm 16. The arm support element 10 is still in the same position on the upper arm 16, but is now mounted on the guide element 12 much more proximally, i.e. towards the shoulder, via the rod 27. There is no displacement of the arm support element 10 relative to the upper arm 16. This displacement of the arm support element 10 relative to the guide element 12 is caused solely by the wearer 4 moving his upper arm 16.

4 shows a part of the orthosis 1. One can see the joint 14 as well as the further joint 18 and the guide element 12 arranged on the joint 14. This is in comparison for example to 2 designed differently and comprises several sliding elements 28 which can be moved relative to one another. At the front end there is a fastening element 30 on which an arm support element can be arranged.

5 shows that in 4 split component, whereby the individual displacement elements 28 are now displaced relative to one another, so that the distance between the fastening element 30 and the joint 14 has increased significantly. In this way, an arm support element 10, which is fastened to the fastening element 30, can therefore be displaced relative to the joint 14 and thus also relative to the contact elements 2, which are in 4 and 5 not shown.

The representation in 6 shows the orthosis 1 applied by a wearer 4, whereby the representation of the 6 from the in 3b shown embodiment differs only by the guide element 12. In 6 the guide element 12 has two rods 32 which are connected to each other and to the rod 27 and the joint 14 by connecting joints 34.

7 shows the 6 shown orthosis in a situation in which the wearer 4 lowers the upper arm 16. It can be seen that the angles assumed by the respective connecting joints 34 change and thus the length of the guide element 12, which is guided by the 6 and 7 two shown rods 32. The direction of extension of this guide element 12 always extends from the joint 14 to the rod 27. The distance between these two components changes depending on the arm position of the carrier 4, so that this length, as shown in the 6 and 7 shown, changed.

list of reference symbols

1

orthosis

2

investment element

4

carrier

6

rods

8

hull

10

armrest element

12

guide element

14

joint

16

upper arm

18

another joint

20

rail

22

slide element

24

additional joint

26

locking mechanism

27

rod

28

sliding element

30

fastener

32

rod

34

connecting joint

Claims (10)

Orthosis (1) with - a contact element (2) which, when the orthosis (1) is in place, rests against a torso (8) of the wearer (4) of the orthosis (1), - a guide element (12) with an extension direction, - an arm support element (10) which, when in place, supports an arm of the wearer (4), and - a joint (14) by means of which the guide element (12) is movable relative to the contact element (2), characterized in that, when in place, - the joint (14) is arranged above, i.e. cranially, a shoulder of the wearer (4) and is designed to allow raising and lowering of an upper arms (16) of the wearer (4) in a sagittal plane, i.e. forwards and backwards, and - the arm support element (10) is displaced relative to the guide element (12) along the direction of extension or a length of the guide element (12) is changed in the direction of extension when the guide element (12) is moved by the joint (14) relative to the support element (2). Orthosis (1) after claim 1 , characterized in that the arm support element (10) is arranged to support the upper arm (16) of the wearer (4). Orthosis (1) after claim 1 or 2 , characterized in that the guide element (12) has a rail (20). Orthosis (1) after claim 3 , characterized in that the rail (20) has a recess in which a correspondingly formed projection of the arm support element (10) or a carriage on which the arm support element (10) is arranged can be displaced. Orthosis (1) according to one of the preceding claims, characterized in that the guide element (12) and the arm support element (10) each have at least one slide element (22) which are arranged on one another in such a way that they can slide along one another. Orthosis (1) according to one of the preceding claims, characterized in that the guide element (12) has a telescopic rod. Orthosis (1) according to one of the preceding claims, characterized in that the joint (14) is a ball joint. Orthosis (1) according to one of the preceding claims, characterized in that a resistance which opposes a movement of the joint (14) and/or a displacement of the arm support element (10) relative to the guide element (12) and/or a change in the length of the guide element (12) is adjustable and the joint (14) and/or the arm support element (10) relative to the guide element (12) is in particular blockable and/or the length of the guide element (12) is fixable. Orthosis (1) after claim 8 , characterized in that the orthosis (1) has an electrical control which is arranged to adjust the resistance depending on a position of a head of the wearer (4). Orthosis (1) according to one of the preceding claims, characterized in that the arm support element (10) has a shell device which can be brought into a closed position by inserting the arm into the shell device.

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