DE20009353U1 - Insole for children - Google Patents

Description

DIPL.-ING. F. W. MOLL · DIPL.-ING. H.CH. BITTER

ADMISSIONS BEFORE THE EUROPEAN PATENT OFFICE

LANDAU/PFALZ 23.05.2000 BISzIFa.

Willi Vosen, 33098 Paderborn

Insole for children

CORRESPONDENCE OFFICE BANK DETAILS

P.O. BOX 20 B(J WESTRINC 17 „ BEUTSCHE BANK AG LANDAU

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Description:

The invention relates to insoles for children with a proprioceptive effect through physiodynamic influence on the misaligned child's foot according to the preamble of claim 1.

Orthopaedics recognizes a large number of foot deformities. Depending on the type and severity of the deformity, the doctor prescribes insoles or splints. These aids are generally rigid and are adjusted as needed, for example when the patient grows or the degree of the deformity changes, preferably improves.

It has been known for years that dynamic aids result in a much better and faster healing result than rigid aids. The healing success is particularly great in children whose bones are still malleable. The present invention relates to insoles with such dynamic properties that are intended for children.

The insole according to the invention is based on the knowledge that the longitudinal arch and transverse arch of the foot are formed not only by the bones of the foot, but also by the plantar ligaments and the muscles and tendons that act on the sole of the foot. The invention is also based on the knowledge that standing, and in particular walking, are dynamic processes that involve a constant alternation between acceleration and deceleration. By designing the insoles appropriately, this dynamic can be used to bring the misaligned child's foot into the correct position with good success and in a short time.

The present invention is therefore based on the object of ensuring, through physiodynamic insole design, that thanks to the proprioception of the child's foot via mechanoreceptors, a spatial perception of the position and movement of joints and limbs depending on temporal changes is possible.

This object is achieved by an insole having the features of claim 1.

The main advantage of the insole according to the invention is based on the adaptation behavior of the mechanoreceptors of the child's foot. The slowly adapting receptors are particularly important here, as they constantly generate action potentials due to the long-lasting stimuli of the insole. This is achieved by the cupped and tight heel support. In addition, the insoles according to the invention also have an effect on the quickly adapting mechanoreceptors; this is particularly due to the progressive-dynamic longitudinal arch support, which exerts a changing muscular stimulus on these receptors. Similar to the process of learning to walk in small children, a correct movement pattern is learned by practicing movement sequences with the insole according to the invention.

It goes without saying that the insole according to the invention belongs in the hands of the orthopedic specialist, who has the task of adapting the insole to the child's foot on the one hand, and fitting it into the corresponding shoe on the other. The insoles according to the invention therefore only develop their full effect in conjunction with a shoe.

It is also understood that the different misalignments of the child's foot require specially adapted types of insoles.

An insole according to the invention specifically for the muscularly flabby foot of children with poor posture and paralysis is the subject of claim 2. In addition to the shell-shaped heel support, a transverse arch support and a toe bulge provide the proprioceptive feedback. The deep-set big toe and the lateral pronation bar create additional stimuli for the mechanoreceptors and thus ensure that a physiological movement pattern is trained. This design of the insole is suitable for both flabby and spastic paralysis.

An insole according to the invention specifically for children's clubfoot is the subject of claim 3. Here, the correction is carried out according to the classic three-point correction system. The first correction point is the heel cup, which fixes the foot in the foot's longitudinal axis. The second correction point is the foamed pad under the Lisfranc joint, which serves as a lateral counterpoint for the hypomochlion. The third correction point is the soft pad formed on the medial side of the big toe joint. This runs forwards over the joint gap and

brings the foot into a corrected position. The longitudinal arch support is kept short to prevent adduction of the forefoot due to the corrective effect.

To ensure the tightest possible heel support with full contact despite the use of ready-made lasts, a base shell made of an elastic but firmer plastic foam was placed under the base layer, which consists of flexible and elastic plastic foam with high resilience. This is responsible for an increased progressive-dynamic effect of the support elements. The lateral pronation bar ensures a physiological rolling of the foot when walking.

An insole according to the invention specifically for children with flat feet is the subject of claim 4. The heel recess designed as a clamp ensures maximum heel uprightness. The apex of the longitudinal arch support is located immediately distal to the sustentaculum talare, the outer side shell serves as lateral counter support. Here too, the base shell made of an elastic but firmer plastic foam is helpful. This allows the shape of the longitudinal arch support to adapt to the position of the heel to a certain extent, and the optimal fit can also be achieved with ready-made lasts. Pressure points are eliminated by the soft padding body towards the foot.

When the position of the calcaneus is corrected in this way, the main stress point of the bony heel contact surface is in the lateral area of the heel bone. The firm heel cushioning tissue present at this point acts as natural cushioning. In all phases of the rolling process, the insole transmits information about a corrected, physiological posture pattern to the central nervous system and trains it as a movement pattern. In the landing phase, the slightly varicose heel recess, designed as a clamp, corrects the heel bone into a physiological position. In the support phase, the longitudinal arch support has a progressively dynamic effect, i.e. the support becomes firmer the more pressure is exerted on the material. To prevent the muscular structures from being lifted, the longitudinal arch support of this insole is made very steep; the plantar fascia can run freely and thus contribute to straightening the arch of the foot. During the push-off phase, the advanced lateral pronation bar and the detorsion cut of the solid base shell correct the supination position in the forefoot and thus promote the rolling over the first ray.

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To check the effect of the insoles according to the invention, the position of the patella tendon in space was measured. The so-called patella tendon angle is influenced by the hip and knee rotators and is therefore dependent on the position of the lower leg and thigh. Since valgus of the heel bone is very often associated with internal rotation of the lower leg, the patella tendon angle can be used to check the effectiveness of the insole on the entire leg axis. The insole was able to achieve a clear correction from medial to lateral, i.e. a reduction in internal rotation. Under the influence of the proprioceptive training effect, the patella tendon angle is further normalized over the course of the wearing time.

According to one embodiment of the invention, the underside of the base shell is also flat. This corresponds to the shape of the usual shoe bottoms with insoles.

Advantageously, the upholstery body and base shell are made of PUR foam.

The invention will be explained in more detail in the form of exemplary embodiments with reference to the drawing. Each of the drawings shows in perspective

Fig. 1 an insole for the child’s muscularly flabby foot,

Fig. 2 an insole for the child’s clubfoot,

Fig. 3 an insole for the child’s flat foot and

Fig. 4 the undersides of the base shell and cushion body of the insole according to Fig. 2.

Fig. 1 shows a perspective view of an insole 10 for the muscularly flabby foot, for example in the case of posture problems or paralysis. The cushion body 10 is made of PUR foam. This is soft and elastic and only develops a stronger support effect when the foot sinks more. This achieves sufficient muscle activity and a balanced proprioceptive feedback to the entire posture system, which is particularly important for children with a general posture weakness. The heel is fixed in the longitudinal direction of the sole by raised side walls 12,13 and a steep longitudinal arch support 11. A

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Transverse arch support 16, a toe bulge 15 and a depression 18 for lowering the big toe act on the mechanoreceptors, which in turn trigger corresponding muscle activity via the central nervous system.

Fig. 2 also shows a perspective view of an insole for a child's clubfoot. High side walls 12, 13 and a short longitudinal arch support 11 form a heel depression that aligns the foot in the longitudinal direction of the sole. A pad 19 under the Lisfranc joint and a soft pad 20 on the medial side of the metatarsophalangeal joint of the big toe bring the foot into a corrected position.

This insole has a base shell 30 under the cushion body 10. This is also made of PUR foam, but is firmer and more dimensionally stable than the foam of the cushion body 10. This base shell 30 ensures increased progressiveness of the cushioning with a correspondingly increased effect on the mechanoreceptors.

Fig. 3 shows a perspective view of an insole for children with flat feet. By appropriately designing the longitudinal arch support 11 and the side walls 12, 13 of the heel cup, the heel cup was designed as a clamp in order to achieve the maximum possible heel uprightness. The apex of the longitudinal arch support 11 is located immediately distal to the sustentaculum talare, the outer side cup 12 serves as a lateral counter-support. The tight heel support is also supported in this insole by a base cup 30 made of solid and dimensionally stable PUR foam.

The steep longitudinal arch support 11 prevents the muscular structures of the child's foot from being raised. The plantar fascia can run freely and contribute to straightening the arch of the foot.

The lateral pronation bar 14 is extended far forward and, in conjunction with the detorsion cut of the base shell 30, promotes the supination position in the forefoot and the rolling over the first ray.

Fig. 4 shows a perspective view of the flat undersides 29, 39 of the cushion body 10 and the base shell 30 of the insert intended for the child's clubfoot according to Fig. 2.

Claims (6)

1. Insole for children with proprioceptive effect through physio-dynamic influence on the misaligned child's foot, essentially comprehensive - a cushion body ( 10 ) made of a foamed plastic material with - Longitudinal arch support ( 11 ) - flat bottom ( 29 ) - tight heel guidance through raised side walls ( 12 , 13 ) - and lateral pronation ridge ( 14 ) characterized by the features: - the plastic material - is soft elastic, - has progressive-dynamic properties - and a high resilience. 2. Insole according to claim 1 for the muscularly flabby foot in case of poor posture and paralysis, characterized by the features: - a toe bulge ( 15 ), - a transverse arch support ( 16 ), - a steep longitudinal arch support ( 11 ) - and a recess ( 18 ) for lowering the big toe. 3. Insole according to claim 1 for the sickle foot, characterized by the features: - a pad ( 19 ) under the Lisfranc joint, - a soft pad ( 20 ) on the medial side of the metatarsophalangeal joint, - a short longitudinal arch support ( 11 ) - and a base shell ( 30 ) made of an elastic but firm plastic foam. 4. Insole according to claim 1 for the flat foot, characterized by the features: - a heel guide designed as a heel clip, - an outer lateral shell ( 21 ) which acts as a lateral counter-support, - a short longitudinal arch support ( 11 ), the apex of which is located immediately distal to the sustentaculum talare, - a pronation bar ( 14 ) - and a base shell ( 30 ) made of an elastic but firm plastic foam. 5. Insole according to claim 3 or 4, characterized by the feature: - the bottom ( 39 ) of the base shell ( 30 ) is flat. 6. Insole according to claims 1 to 5, characterized by the feature: - Upholstery body ( 10 ) and base shell ( 30 ) are made of PUR foam.