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EP3970681B1 - Machine de rééducation motrice - Google Patents

Machine de rééducation motrice Download PDF

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Publication number
EP3970681B1
EP3970681B1 EP21183639.0A EP21183639A EP3970681B1 EP 3970681 B1 EP3970681 B1 EP 3970681B1 EP 21183639 A EP21183639 A EP 21183639A EP 3970681 B1 EP3970681 B1 EP 3970681B1
Authority
EP
European Patent Office
Prior art keywords
shaft
arm
patient
movable plate
toothed wheel
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.)
Active
Application number
EP21183639.0A
Other languages
German (de)
English (en)
Other versions
EP3970681C0 (fr
EP3970681A1 (fr
Inventor
Davide Fausti
Giovanni FUSI
Massimo Antonini
Maurizio MOR
Gianluigi Petrogalli
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Polibrixia SRL
Original Assignee
Polibrixia SRL
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Polibrixia SRL filed Critical Polibrixia SRL
Priority to EP21183639.0A priority Critical patent/EP3970681B1/fr
Publication of EP3970681A1 publication Critical patent/EP3970681A1/fr
Application granted granted Critical
Publication of EP3970681C0 publication Critical patent/EP3970681C0/fr
Publication of EP3970681B1 publication Critical patent/EP3970681B1/fr
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Anticipated expiration legal-status Critical

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Classifications

    • 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
    • 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
    • A61H2201/1207—Driving means with electric or magnetic drive
    • 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
    • A61H2201/1602—Physical interface with patient kind of interface, e.g. head rest, knee support or lumbar support
    • A61H2201/1619—Thorax
    • 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
    • A61H2201/1602—Physical interface with patient kind of interface, e.g. head rest, knee support or lumbar support
    • A61H2201/1623—Back
    • A61H2201/1626—Holding means therefor
    • 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
    • A61H2201/1602—Physical interface with patient kind of interface, e.g. head rest, knee support or lumbar support
    • A61H2201/1628—Pelvis
    • A61H2201/1633—Seat
    • 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
    • A61H2201/1602—Physical interface with patient kind of interface, e.g. head rest, knee support or lumbar support
    • A61H2201/1635—Hand or arm, e.g. handle
    • 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
    • A61H2201/1602—Physical interface with patient kind of interface, e.g. head rest, knee support or lumbar support
    • A61H2201/164—Feet or leg, e.g. pedal
    • A61H2201/1642—Holding means therefor
    • 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
    • A61H2201/1664—Movement of interface, i.e. force application means linear
    • A61H2201/1666—Movement of interface, i.e. force application means linear multidimensional
    • 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
    • A61H2203/00—Additional characteristics concerning the patient
    • A61H2203/04—Position of the patient
    • A61H2203/0406—Standing on the feet
    • 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
    • A61H2203/00—Additional characteristics concerning the patient
    • A61H2203/04—Position of the patient
    • A61H2203/0425—Sitting on the buttocks
    • A61H2203/0431—Sitting on the buttocks in 90°/90°-position, like on a chair
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • 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
    • A63B71/0009—Games or sports accessories not covered in groups A63B1/00 - A63B69/00 for handicapped persons
    • A63B2071/0018—Games or sports accessories not covered in groups A63B1/00 - A63B69/00 for handicapped persons for wheelchair users

Definitions

  • the present invention relates to a patient motor rehabilitation machine, particularly for gait rehabilitation.
  • Motor rehabilitation is necessary when events occur which inhibit or even destroy a person's ability in the physical, mental, or social contexts.
  • motor dysfunctions may be divided into two categories:
  • the typical categories of patients requiring motor rehabilitation treatment are those with:
  • the Applicant is the holder of European patent EP 2 865 363 B1 , relating to an instrument for physical exercise and rehabilitation of upper and lower limbs, usable in both passive and active therapies, comprising a differential kinematic mechanism consisting of six pulleys of equal pitch diameter: four of these, the outermost, are constrained to the frame, while the remaining two are aboard a carriage free to run along a rail, which also serves as a structural element.
  • a double-toothed belt connects all six pulleys. Two of the four outermost pulleys are actuated by electric motors, while all others are idle.
  • the system receives two angular velocities as inputs, provided by the two motors, and, as a function of their difference, returns a motion consisting of the combination of a rotation and a translation.
  • This combined law of motion of translation and rotation acts on the carriage which translates on the rail and is provided with two rotating pulleys.
  • a machine for the motor rehabilitation of a patient comprising a frame which supports movable supporting means for the patient and a gait simulation system, characterized in that the gait simulation system comprises a moving mechanism for each of the patient's leg, configured for a roto-translation movement adapted to reproduce the gait, said moving mechanism comprising:
  • the rehabilitation machine according to the invention, indicated by reference numeral 1 as a whole, comprises a frame 3 which supports movable supporting means 2 of the patient P and a gait simulation system 4.
  • the movable supporting means comprise a tilting seat 9 and a resting table 10.
  • the frame 3 comprises a base 5 on which a supporting structure 103 comprising a front post 6 and a handrail element 7 is attached.
  • the base 5 is C-shaped or horseshoe-shaped, with the open side facing the patient station.
  • the base 5 is sized to provide a stable support for the machine 1.
  • the handrail element 7 has, in top plan view, a C-shaped or horseshoe shape, substantially corresponding to that of the basement 5, and comprises front side portions 7a, which develop according to a direction substantially perpendicular to the base 5, and a curved connecting portion 7b which develops anteriorly up to correspond to the front post 6, with which it is integral.
  • the connecting portion 7b comprises inclined stretches 7c on both sides.
  • the front post 6 comprises a supporting element 8 onto which the moving system of the tilting seat 9 and of the resting table 10 are hinged, positioned above the integralization point between the handrail element 7 and the front post 6.
  • the front post 6 further supports a video screen 31, for displaying information relative to the rehabilitation or of another type.
  • the tilting seat 9 comprises an L-shaped supporting bar 11 comprising an upper end 11a and a lower end 11b corresponding to the end of the horizontal stretch of the L.
  • the upper end 11a is fixed to a connecting structure 11c, which in turn is hinged to a fixed element 12 (omitted in figure 3 , but visible in the side view in figure 6A ).
  • the fixed element 12 is integral with the front post 6 and extends in the direction of the open side of the base 5.
  • the supporting bar 11 may slide in a vertical direction relative to the connecting structure 11c (see the vertical arrow in figure 5A ) and may be fixed at different heights by means of conventional locking means to adjust the seating according to the patient's needs.
  • a first T-shaped seating element 13 comprising a mating portion 13a with the supporting bar 11 and a transverse portion 13b is fixed to the front end 11b of the supporting bar 11. Both the mating portion 13a and the transverse portion 13b preferably comprise a padded seating surface to improve the patient's comfort.
  • the first seating element 13 internally comprises a tubular bar (not shown) which constitutes the continuation of the horizontal stretch of the L-shaped supporting bar 11.
  • a second seating element 14 is slidingly associated with such a tubular bar by means of a telescopic bar 15 ( figure 5B ). In this manner, the second seating element 14 may be arranged either in a retracted position ( figure 5A ) or in an extended position ( figure 5B ).
  • the second seating element 14 further comprises an upholstered seating surface.
  • Third seating elements 16a, 16b are hinged to the transverse portion 13b of the first seating element 13 to flank the coupling portion 13a.
  • the third seating elements 16a, 16b tilt perpendicularly to the plane of the first seating element 13, in the direction opposite to the vertical stretch of the L of the supporting bar 11 ( figure 5B ).
  • the tilting seat 9 thus implements a seating which is sufficiently wide and comfortable for the patient during the step of transitioning from the wheelchair or other aid to the machine 1 of the invention ( figures 2A-2B and 6A ). Furthermore, in the step of verticalization and in the successive step of rehabilitation exercise ( figures 2C and 6B ), the tilting of the third seating elements 16a, 16b avoids the interference with the patient's gait, while the extension of the second seating element 14 provides good support for the patient's back.
  • the tilting seat can be moved and adjusted either manually or by means of appropriate actuators according to the arrows in figure 5A .
  • the resting table 10 comprises a platform 17 onto which two side bars 18a, 18b adapted to be gripped by the patient are fixed.
  • the side bars 18a, 18b comprise a first portion 19a, 19b and a second portion 20a, 20b, both of which develop substantially perpendicular to the platform 17, wherein the first portion 19a, 19b is placed proximal to the patient, and the second portion 20a, 20b is positioned distal therefrom.
  • Such first portions 19a, 19b and second portions 20a, 20b of the side bars 18a, 18b constitute a grip for the patient, respectively, in the step of approaching the rehabilitation machine 1 ( figure 8A ) and in the step of using the machine 1 during the rehabilitation exercise ( figure 8B ).
  • a pair of resting elements 21a, 21b for the patient's forearms are arranged on the platform 17 aligned with the side bars 18a, 18b and between the first portions 19a, 19b and the second portions 20a, 20b thereof.
  • the resting elements 21a, 21b preferably have an anatomical shape, e.g. a concave shape longitudinal to the patient's forearm, and are made of padded material to ensure the patient's comfort.
  • the platform 17 has a semicircular profile 22 on the side facing the patient, in which semicircular profile 22 the restraining elements 23 of the patient's torso are arranged.
  • the restraining elements 23 comprise a center cushion 24 and two side cushions 25a, 25b and are arranged to support the patient's torso both anteriorly and relative to a sidewards oscillation, such as that which may be caused by the ambulatory activity.
  • the restraining elements 23 are mounted on a semicircular element 26, which substantially corresponds to the semicircular profile 22 of the platform 17 and comprises at its ends two sleeves 27a, 27b sliding perpendicularly to the platform 17 along respective guides 28a, 28b.
  • the sleeves 27a, 27b may be moved and locked, respectively, by either loosening or tightening the locking screws 29 maneuverable by means of appropriate knobs 30. In this manner, the restraining elements 23 can be adjusted according to the patient's height.
  • the side cushions 25a, 25b are hinged onto the semicircular element 26 so that they can rock about an axis perpendicular to the platform 17. In this manner, the restraining elements 23 can be adjusted to the size of the patient's torso. In an optimal condition of use, the patient's torso must adhere to the restraining elements 23 on the front and side.
  • the adjustment of the restraining elements 23 can also be motorized.
  • the resting table 10 is mounted in a laterally rocking manner, i.e., about an axis substantially perpendicular to the patient's torso (arrow in figure 9 ), to accommodate the patient's oscillatory movement during the gait simulation, thereby improving comfort.
  • the restraining elements 23 further comprise pre-tensioned belts (not shown) which allow for improved support of the patient's torso, which is useful for patients with particularly impaired motor skills.
  • the tilting seat 9 and the resting table 10 are movably coupled to an articulated system 32, e.g. a double articulated parallelogram system, which is mounted to the fixed element 12 by means of appropriate hinges.
  • an articulated system 32 e.g. a double articulated parallelogram system
  • the articulated double parallelogram system 32 comprises a first arm 33a, a second arm 33b, a third arm 33c, and a fourth arm 33d, wherein:
  • Such a movement is enabled by a linear actuator 34 (shown in figure 6A ), hinged on the supporting element 8 and acting by means of a shaft 35 on a point near the hinge point of the first arm 33a on the second arm 33b.
  • a linear actuator 34 shown in figure 6A
  • hinged on the supporting element 8 and acting by means of a shaft 35 on a point near the hinge point of the first arm 33a on the second arm 33b.
  • the supporting structure 103 comprises a supporting element 60 for an articulated system 132 to which a tilting seat 109 and a handlebar 118 are movably coupled.
  • the tilting seat 109 may be the same as that previously described for the first embodiment, or it may consist of a simple platform 109c, preferably anatomical, fixed to a rod 109a adjustable in height by sliding in a tubular housing 109b, e.g. by screw fastening.
  • the handlebar 118 comprises one or more supporting rods 118a (in the example of the figures, two supporting rods) and a pair of grips 118b.
  • the supporting rods 118a can be adjustable in height by sliding in special tubular seats.
  • the articulated system 132 comprises a first, a second, a third, a fourth, and a fifth arm 133a, 133b, 133c, 133d, 133e, wherein:
  • a linear actuator 63 is further hinged on one side to the supporting element 60 and on the other side to the junction point between the second arm 133b and the third arm 133c.
  • the linear actuator 63 is an electric screw actuator.
  • Figures 14B and 14C show the rehabilitation machine according to this embodiment in the position that it assumes when a patient in a wheelchair approaches.
  • the tilting seat 109 is in a horizontal position and the handlebar 118 is inclined to facilitate grasping by the patient.
  • Figures 14A and 14D show the machine in an operating condition, i.e. when the patient is placed in an upright position, a condition achieved by virtue of the tilting of the tilting seat 109 (which is in a vertical position to support the rear part of the user's torso) and raising of the handlebar 118.
  • the gait simulation system 4 comprises a moving mechanism 36 for each leg of the patient, which allows a roto-translation movement adapted to reproduce the gait.
  • the movement mechanism 36 is of the type described in EP 2 865 363 B1 , to which reference is made for a better understanding of operation, which comprises a differential kinematic mechanism comprising six pulleys 37, 38 of equal pitch diameter: the four outer pulleys 37 are constrained to a casing 39, while the other two pulleys 38 are mounted on a carriage 40 free to slide along a rail (not shown in the drawings), which also performs the function of a structural element.
  • a double-toothed belt 41 connects all six pulleys 37, 38. Two of the four outer pulleys 37 are driven by electric motors, while all others are idle.
  • the system receives two angular velocities as inputs, provided by the two motors, and, as a function of their difference, returns a motion consisting of the combination of a rotation and a translation.
  • This combined law of motion for translation and rotation acts on the carriage 40 which translates on the rail, while the respective pulleys 38 are subject to rotary movement.
  • Two connecting rods 42 are hinged on the pulleys 38 mounted on the carriage 40. Instead, the opposite ends of the connecting rods 42 are hinged to a footboard 43, as will be more fully described hereafter.
  • the two moving mechanisms 36 act in an offset manner, giving each footboard 43 a substantially elliptical movement, according to a law of motion which simulates walking.
  • the carriage 40 is replaced by a linear recirculating ball bearing guide on which connecting rods 42 are mounted, one of which is idle and the other of which is motorized. In this manner, the structural strength required by the machine, which must fully support the patient's weight, is increased. In other embodiments, both connecting rods may be motorized.
  • the aforesaid moving mechanism is replaced by a system comprising a first actuator for linear translation of the carriage 40 or linear recirculating ball bearing guide and a second actuator for rotational/rocking movement of the footboard 43.
  • the first actuator may act on a worm screw associated with the carriage 40 or with the linear guide
  • the second actuator may be, for example, a linear actuator mounted on the carriage 40.
  • the footboard 43 is comprised in an articulated system 44 for the patient's leg.
  • the articulated system 44 comprises an upper rod 45 which, as shown in figure 1 , is hinged to the handrail element 7 and to a lower rod 46.
  • the lower rod 46 is, in turn, hinged to the footboard 43.
  • the upper rod 45 has a flexed shape, while the lower rod has a curved shape with the concavity facing the back of the patient's leg.
  • the articulated system is moved, through connecting rods 42, by the moving mechanism 36.
  • the movement of upper rod 45 simulates the movement of the patient's hip
  • the hinge point between upper rod 45 and lower rod 46 simulates the knee joint
  • the hinge point of lower rod 46 with footboard 43 simulates the ankle joint.
  • the lower rod 46 comprises an anteriorly extending spacer bar 47, to the distal end 48 of which a vertically arranged supporting cushion 49 is fixed at a height slightly below that of the patient's knee to provide an anterior barrier for supporting the patient's shin, avoiding the bending of the limb and thus sliding the downward slipping of the vertically arranged patient.
  • the footboard 43 comprises a heel pad 50 which prevents the patient's foot from slipping backwards.
  • the rods of the articulating system 44 are height-adjustable, either manually or in a motorized manner, to adapt them to the patient's height.
  • the moving mechanism 36 is similar to the one described in Italian patent application No. 102018000010921 filed on 10 December 2018 .
  • This mechanism 36 comprises translational-rotational members comprising:
  • the first redirecting pulley 66 is integral with the shaft 65 and the second redirecting pulley 68 is integral with the shaft 67.
  • the first redirecting pulley 66 is put in rotation, through the first transmission member 69, by the second motorization means 72
  • the second redirecting pulley 68 is put in rotation, through the second transmission element 70, by the first motorization means 71.
  • Both the first shaft 65 and the second shaft 67 comprise respective gears 65', 67', which mesh, respectively, with a lower section and an upper section of a central toothed wheel 83, located in an intermediate position between said toothings 65', 67'.
  • the central toothed wheel 83 is integral with a respective central shaft 84 which terminates, at the second side 90b of the mechanism 36, with the second toothed wheel 77' described above, which transmits motion to the first toothed wheel 77 with appropriate reduction.
  • Figures 15-18 show an embodiment in which the carriage 64 comprises a base plate 75 sliding on the track 73 by means of a pair of shoes 76.
  • the first shaft 65 meshes with the lower section of the central toothed wheel 83, which is coupled, through the second toothed wheel 77', with the first toothed wheel 77, which in turn is integral with the third shaft 82.
  • the first toothed wheel 77 has a larger diameter than the diameter of the second toothed wheel 77', to achieve a transmission ratio such that a fraction of a revolution of the third shaft 82 corresponds to a given number of revolutions of the first shaft 65.
  • the end of the third shaft 82 opposite to the first toothed wheel 77 is integral with a movable plate 79.
  • the third shaft 82 is also supported by a ball bearing system 78. The rotation of the central shaft 84 and thus the third shaft 82 causes the movable plate 79 to tilt up or down.
  • the footboard 43 is fixed in an adjustable manner on the movable plate 79.
  • the footboard 43 comprises a heel element 43a and a toe element 43b, both of which slide on a rail 80 so that the platform can be adapted to the patient's foot.
  • the heel element 43a and the toe element 43b comprise respective raised edges 43', 43" along their outer perimeter to retain the patient's foot on the footboard 43.
  • Elastic means 81 are arranged between the movable plate 79 and the base plate 75, which elastic means, by means of a rod linkage 81a, 81b, apply a force on the movable plate 79 such that the load resulting from the weight of the user is relieved, thereby contributing to relieving the torque load on the third shaft 82.
  • a support 91 for the user's shin is hinged to the movable plate 79.
  • the shin support 91 comprises a plate 92 having a C-shaped cross-section, to retain the user's shin, and a connection portion 93, preferably curvilinear in shape, with the movable plate 79, by means of a hinge 94 located at the lower end 93a of the connecting portion 93.
  • the rear face 92a of the C-shaped plate 92 preferably comprises padding or an anatomical surface to improve the resting of the user's shin.
  • the shin support 91 has the function of supporting the shin, constituting in this manner a constraint which allows the user to remain in an upright position even without exerting muscle strength.
  • An actuator 95 connects the front face 92b of the shin support 91 to the movable plate 79 by means of respective hinges 95a, 95b.
  • the actuator 95 comprises a motor 96 connected by means of a coupling to a worm screw 97.
  • the worm screw 97 is inserted into a tubular element 98 which comprises a hinge 95a connecting with the shin support 91 at one end and a scroll 99 at the opposite end.
  • a circular element 100 which has the function of a sliding shoe for the screw itself inside the tubular element 98, is constrained at the head of the worm screw 97.
  • the shin support 91 can rock relative to the movable plate 79 by virtue of the actuator 95 which, by virtue of its elongation and shortening, modifies the mutual angle between the movable plate 79 and the shin support 91.
  • the machine 1 of the invention will comprise two moving mechanisms 36 as described above, one for each leg of the patient P.
  • the machine 1 may comprise a control unit configured to command the laws of motion of the gait simulation system 4 and the adjustments of the restraining means 23, the rods 45, 46 of the articulated system 44 and of the adjustable seat 9.
  • the machine 1 of the invention achieves the intended purposes, allowing the shortening of time in the assisted step of verticalization and ensuring maximum comfort and safety for the patient.

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Epidemiology (AREA)
  • Pain & Pain Management (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Rehabilitation Therapy (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Rehabilitation Tools (AREA)

Claims (10)

  1. Machine (1) pour la rééducation motrice d'un patient (P), comprenant un cadre (3) qui supporte des moyens de support mobiles (2) pour le patient (P) et un système de simulation de marche (4), caractérisée en ce que le système de simulation de marche (4) comprend un mécanisme (36) de déplacement pour chaque jambe du patient, configuré pour reproduire un déplacement de rotation-translation adapté pour reproduire une marche, ledit mécanisme (36) de déplacement comprenant :
    - un chariot (64) comprenant une plaque de base (75) coulissant sur un rail (73),
    - une plaque mobile (79) articulée à la plaque de base (75), la plaque mobile (79) basculant avec un mouvement alternatif de haut en bas,
    - un marchepied (43) fixé de manière réglable sur la plaque mobile (79) pour pouvoir l'adapter au pied du patient (P),
    - un support de tibia (91) articulé à une extrémité inférieure (93a) à la plaque mobile (79) et connecté, sur une face avant (92b), à la plaque mobile (79) à travers un actionneur (95), de sorte que le support de tibia (91) bascule par rapport à la plaque mobile (79),
    - des moyens de motorisation (71, 72) configurés pour mettre en oeuvre la translation du chariot (64) le long du rail (73) et le basculement de la plaque mobile (79) avec ledit mouvement alternatif de haut en bas.
  2. Machine (1) selon la revendication 1, dans laquelle les moyens de support mobiles (2) sont couplés de manière mobile à un système d'articulation (32, 132) et comprennent :
    - un siège inclinable (9, 109) et
    - une table (10) dotée de barres latérales (18a, 18b) ou d'un guidon (118).
  3. Machine (1) selon la revendication 1 ou 2, dans laquelle le mécanisme (36) de déplacement comprend :
    - un premier arbre (65) passant à travers le chariot (64) ;
    - une première poulie de redirection (66) solidaire du premier arbre (65) sur un premier côté (90a) du mécanisme (36) ;
    - une deuxième poulie de redirection (68) solidaire du deuxième arbre (67) sur un deuxième côté (90b) du mécanisme (36) ;
    - une première roue dentée (77) solidaire d'un troisième arbre (82) sur le deuxième côté (90b) du mécanisme (36) ;
    - des premier et deuxième moyens de motorisation (71, 72) placés sur des supports appropriés (5', 5") aux extrémités du rail (73) ;
    - une première paire de poulies (71bis) dont l'une est située sur le deuxième côté (90b) du mécanisme, solidaire de l'arbre des premiers moyens de motorisation (71), et l'autre, au repos, est située sur le premier côté (90a) du mécanisme (36) ;
    - une deuxième paire de poulies (72bis) dont l'une est située sur le premier côté (90a) du mécanisme, solidaire de l'arbre des premiers moyens de motorisation (72), et l'autre, au repos, est située sur le deuxième côté (90b) du mécanisme (36) ;
    - un premier organe de transmission (69) agencé sur le premier côté (90a) du mécanisme (36), ledit premier organe de transmission (69) étant configuré pour connecter de manière opérationnelle les deuxièmes moyens de motorisation (72) à la première poulie de redirection (66) ;
    - un deuxième organe de transmission (70) agencé sur le deuxième côté (90b) du mécanisme (36), ledit deuxième organe de transmission (70) étant configuré pour connecter de manière opérationnelle les premiers moyens de motorisation (71) à la deuxième poulie de redirection (68) ;
    dans laquelle les première et deuxième poulies de redirection (66, 68) sont connectées de manière opérationnelle, à travers une deuxième roue dentée (77'), à la première roue dentée (77).
  4. Machine (1) selon la revendication 3, dans laquelle le premier arbre (65) et le deuxième arbre (67) comprennent tous deux des dentures (65',67') respectives qui s'engrènent respectivement, une section inférieure et une section supérieure d'une roue dentée (83) centrale étant placées dans une position intermédiaire entre lesdites dentures (65', 61'), la roue dentée (83) centrale étant solidaire d'un arbre (84) central respectif qui se termine, au deuxième côté (90b) du mécanisme (36), avec la deuxième roue dentée (77'), laquelle deuxième roue dentée (77') transmet le mouvement à la première roue dentée (77), la première roue dentée (77) ayant un diamètre supérieur au diamètre de la deuxième roue dentée (77') pour mettre en oeuvre un rapport de transmission de sorte qu'une fraction d'un tour du troisième arbre (82) corresponde à un nombre donné de tours du premier arbre (65).
  5. Machine (1) selon la revendication 3 ou 4, dans laquelle l'extrémité du troisième arbre (82) opposée à la première roue dentée (77) est solidaire de la plaque mobile (79), de sorte que la rotation de l'arbre (84) central et donc du troisième arbre (82) amène la plaque mobile (79) à basculer.
  6. Machine (1) selon l'une quelconque des revendications de 1 à 5, dans laquelle des moyens élastiques (81), de préférence un ressort à gaz, sont placés entre la plaque mobile (79) et la plaque de base (75), lesquels moyens élastiques, à travers une tringlerie (81a, 81b), appliquent une force sur la plaque mobile (79) de sorte que la charge résultant du poids du patient (P) soit soulagée.
  7. Machine (1) selon l'une quelconque des revendications de 1 à 6, dans laquelle l'actionneur (95) comprend un moteur (96) connecté par un couplage à une vis sans fin (97), la vis sans fin (97) étant insérée dans un élément tubulaire (98) qui comprend à une extrémité une charnière (95a) se connectant au support de tibia (91), et à l'extrémité opposée un rouleau (99), un élément circulaire (100) qui a la fonction d'un patin de glissement de la vis elle-même à l'intérieur de l'élément tubulaire (98) étant de préférence contraint sur la tête de la vis sans fin (97).
  8. Machine (1) selon l'une quelconque des revendications de 2 à 7, dans laquelle le siège inclinable (9, 109) comprend un premier élément de siège (13), un deuxième élément de siège (14) et des troisièmes éléments de siège (16a, 16b), dans laquelle le deuxième élément de siège (14) est soit extensible soit rétractable par rapport au premier élément de siège (13) et dans laquelle les troisièmes éléments de siège (16a, 16b) sont pliables perpendiculairement au plan du premier élément de siège (13).
  9. Machine (1) selon l'une quelconque des revendications de 1 à 8, comprenant des éléments de retenue (23) qui comprennent un coussin central (24) et deux coussins latéraux (25a, 25b) et sont agencés pour supporter le torse du patient antérieurement et par rapport à une oscillation latérale.
  10. Machine (1) selon l'une quelconque des revendications de 2 à 9, dans laquelle le cadre (3) comprend une structure de support (103) qui comprend un élément de support (60) pour le système d'articulation (132) auquel le siège inclinable (109) et les guidons (118) sont couplés de manière mobile, dans laquelle le système d'articulation (132) comprend des premier, deuxième, troisième, quatrième et cinquième bras (133a, 133b, 133c, 133d 133e), dans laquelle :
    - le premier bras (133a) est associé au siège inclinable (109), le premier bras étant articulé à l'élément de support (60) au moyen de deux ressorts à piston (61, 62), par exemple des ressorts à gaz ;
    - le deuxième bras (133b) comprend une première extrémité articulée au premier bras (133a) et une deuxième extrémité articulée à une première extrémité du troisième bras (133c) ;
    - le troisième bras (133c) comprend une deuxième extrémité articulée à une première extrémité du quatrième bras (133d) ;
    - le quatrième bras (133d) comprend une deuxième extrémité articulée à l'élément de support (60) ;
    - le cinquième bras (133e) comprend une première extrémité articulée adjacente à la première extrémité du troisième bras (133c) et une deuxième extrémité articulée à l'élément de support (60), un actionneur linéaire (63) étant articulé sur un côté à l'élément de support (60) et sur l'autre côté à la jonction entre le deuxième bras (133b) et le troisième bras (133c).
EP21183639.0A 2021-07-05 2021-07-05 Machine de rééducation motrice Active EP3970681B1 (fr)

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CN119679613A (zh) * 2025-02-10 2025-03-25 首都医科大学附属北京康复医院（北京工人疗养院） 一种间歇式跟腱牵拉联合小腿按摩仪

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US3824994A (en) * 1973-01-29 1974-07-23 R S Reciprocating Trainer Ente Reciprocating walker
US9248071B1 (en) * 2013-03-15 2016-02-02 Ergoflex, Inc. Walking, rehabilitation and exercise machine
ES2587983T3 (es) 2013-10-25 2016-10-28 Polibrixia S.R.L. Máquina de ejercicio físico
US10881572B2 (en) * 2013-12-13 2021-01-05 ALT Innovations LLC Natural assist simulated gait therapy adjustment system
US11045381B2 (en) * 2017-07-20 2021-06-29 Bose Corporation Augmenting human motion
IT201800010921A1 (it) 2018-12-10 2020-06-10 Polibrixia S R L Macchina di traslo-rotazione

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