GB2552358A

GB2552358A - Rehabilitation device

Info

Publication number: GB2552358A
Application number: GB1612626.0A
Authority: GB
Inventors: Omar Ward Ross
Original assignee: Individual
Current assignee: Individual
Priority date: 2016-07-21
Filing date: 2016-07-21
Publication date: 2018-01-24
Also published as: GB201612626D0

Abstract

A rehabilitation device 10 comprises one or more wearable parts, such as a forearm support for upper limb of a patient. The device 10 further comprises a primary cable 20 extending between a wearable part 22 adjacent a part of the limb to be moved and an actuator 26. In use, the actuator 26 is configured to apply a tension force to the primary cable 20 so as to move the part of the limb in a desired direction. An optional secondary cable 30 with a biasing member 36 may be used antagonistically with the primary cable 20 to return the part of the limb to a resting position. Disclosed examples cause a pincer grip between thumb and forefinger (figure 1), wrist flexion (figure 5b) and forearm pronation / supination (Figures 6a and 6b).

Description

(54) Title of the Invention: Rehabilitation device

Abstract Title: Rehabilitation device for upper limb (57) A rehabilitation device 10 comprises one or more wearable parts, such as a forearm support for upper limb of a patient. The device 10 further comprises a primary cable 20 extending between a wearable part 22 adjacent a part of the limb to be moved and an actuator 26. In use, the actuator 26 is configured to apply a tension force to the primary cable 20 so as to move the part of the limb in a desired direction. An optional secondary cable 30 with a biasing member 36 may be used antagonistically with the primary cable 20 to return the part of the limb to a resting position. Disclosed examples cause a pincer grip between thumb and forefinger (figure 1), wrist flexion (figure 5b) and forearm pronation / supination (Figures 6a and 6b).

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REHABILITATION DEVICE

The present disclosure relates to a rehabilitation device, and, more particularly, to a neurological rehabilitation device to aid functional recovery of an upper limb following a neurological injury such as a stroke or the like.

The present disclosure provides a rehabilitation device comprising a wearable part, for securely positioning the device on an upper limb of a patient; and a cable section extending between the wearable part adjacent a part of the limb to be moved and an actuator, wherein, in use, the actuator is configured to apply a tension force to the cable section so as to move the part of the limb in a desired direction. By using such a simple arrangement of an actuator and cable for achieving the desired movement, the rehabilitation device is simple to set up and use, and is lightweight.

In example implementations, the cable section comprises a proximal end and a distal end, and the wearable part comprises an attachment member, such as a connector, a clip, an eyelet or a pulley wheel, for engaging the distal end of the cable section adjacent the part of the limb to be moved.

In example implementations, the wearable part of the rehabilitation device includes an upper limb support, comprising at least one strap for attaching to the upper limb of the patient, and/or a platform for supporting components for the device.

In example implementations, a sensor may be used for detecting movement and providing a signal to an actuator to apply a tension force to the cable. For example, the sensor may detect one or more of: movement of the part of the upper limb to be moved, and movement corresponding to a desired movement of the part of the upper limb to be moved. A magnitude of the tension force applied by the actuator, or the length of time for which the tension force is applied, may be determined based on the magnitude of movement detected by the sensor. Thus, the rehabilitation device may be used through different recovery stages. For example, when the patient has little or no movement in the impaired limb, the sensor may detect movement of the opposite limb of the patient to control the actuator to effect a mirroring movement. As functional recovery of the impaired limb improves, the sensor may detect an initial movement of the impaired limb and control the actuator to effect an appropriate further movement.

In example implementations, a biasing member may be provided for biasing a part of the upper limb to be moved into a resting position thereof. In other example implementations, a second cable section may be used for applying a counter tension force against the movement of the part of the limb by the first cable section. Thus, the rehabilitation device is able to return the limb to the resting position, to allow repetitions of the movement in a series of exercises, without the need for additional actuators that would otherwise increase the weight of the device.

In example implementations, the device further comprises a control unit for controlling an actuator to apply a tension force to the cable section so as to move the part of the limb in accordance with one or more predefined rehabilitation exercises.

Further features of example implementations of the present disclosure are set out in the following description and accompanying claims.

Example implementations of the present disclosure are described below with reference to the accompanying drawings, in which:

Figure 1 is a side view of a rehabilitation device in accordance with the present disclosure;

Figure 2A is a side view of a part of the rehabilitation device in accordance with a first example implementation of the present disclosure, showing the hand of a patient in a resting position;

Figure 2B is a side view of the part of the rehabilitation device of Figure 2A, showing the hand of the patient in a pincer grip position;

Figure 3A is a top view of a part of the rehabilitation device of Figures 2A and 2B;

Figures 3B and 3C are side and end views of a finger cap and a side view of a thumb cap, respectively, forming wearable parts of the rehabilitation device of Figures 2A and 2B;

Figure 4A is a top view and Figure 4B is a bottom view of a part of a rehabilitation device in accordance with a second example implementation of the present disclosure;

Figure 5A is a side view of the rehabilitation device in accordance with the second example implementation of the present disclosure, showing the hand of a patient in a palmar flexed, resting position;

Figure 5B is a side view of the rehabilitation device of Figure 5A, showing the hand of the patient in a dorsiflexed position;

Figure 6A is a top view of a rehabilitation device in accordance with a third example implementation of the present disclosure, showing the forearm of a patient in a resting, pronated position, and

Figure 6B is a top view of the rehabilitation device of Figure 6A, showing the forearm of the patient in a supinated position

Figure 7 is a block diagram of a control system for use with a rehabilitation device in accordance with the present disclosure, and

Figure 8 is a side view of an actuator for use with a rehabilitation device in accordance with the present disclosure.

In the following description of example implementations of the present disclosure with reference to the drawings, similar features are assigned the same or similar reference numerals.

Figure 1 shows an overview of a rehabilitation device 10 according to the present disclosure. In particular, the device 10 comprises one or more wearable parts or components arranged to be positioned securely over a part of a patient's impaired (e.g., hemi-paretic) upper limb. In the example implementations of the present disclosure, the one or more wearable parts include a glove 40 (shown in dotted outline), a thumb cap 12 and a finger cap 14 arranged to be worn on the hand of the patient, a forearm support or brace 16 and one or more adjustable straps 18, 19. The forearm support 16 is attachable by at least one of the adjustable straps 18 around the proximal and/or distal forearm of the patient and is arranged for supporting device components (e.g., actuator, control unit etc.), as described further below, which may be enclosed in a housing 44.

The device 10 further comprises a primary cable 20 for providing a desired movement of a patient's limb from a resting position as part of a rehabilitation exercise. In particular, the primary cable 20 has a distal end 22 for attachment to a wearable part of the device 10 (e.g., finger cap 14) at a position adjacent the part of the patient's limb to be moved and a proximal end 24 for attachment to a wearable part at a position remote from the attachment at the distal end 22.

The primary cable 20 is further connected to an actuator 26. The actuator 26 is configured to apply a tension force to the primary cable 20, in order to move the part of the patient's limb in the desired manner. In particular, in accordance with example implementations, the actuator 26 is configured to shorten the length of primary cable 20 between the attachment to the wearable part at the distal end 22 and the actuator 26, thereby pulling along the primary cable 20 so as to achieve the desired movement of the patient's limb. In the example implementation of Figure 1, the actuator 26 is mounted on the forearm support 16 at a position adjacent the patient's dorsal wrist and is configured to shorten the primary cable 20 extending to distal end 22 of the primary cable 20 attached to the wearable part (e.g., finger cap 14) adjacent the part of the limb to be moved. As the skilled person will appreciate, the actuator 26 may be provided at any suitable position along the length of the primary cable 20. Figure 1 further shows an optional adjustable strap 19 positioned adjacent the patients' elbow, with an attachment 54, which may be used to secure the distal end 22 of the primary cable 20 in example implementations as described further below.

In example implementations of the present disclosure, the device 10 may further comprise one or more secondary cables 30 for returning the patient's limb to the resting position as part of the rehabilitation exercise. In Figure 1, a proximal end 34 of the secondary cable 30 may be associated with a biasing member such as a biasing spring 36. In other configurations, the proximal end 34 of the secondary cable 30 may be attached to an actuator (not shown). A distal end 32 of the secondary cable 30 may be attached to a wearable part of the device 10 (e.g., finger cap 14) adjacent the part of the patient's limb to be moved, but positioned antagonistically opposite the attachment for the distal end 22 of primary cable 20. Thus, in such example implementations, the device 10 is configured to apply a tension force to the secondary cable 30, in order to move the corresponding part of the patient's limb antagonistically to the movement caused by the primary cable 20 and thus back to the resting position.

Further details of rehabilitation devices 10 according to example implementations of the present disclosure, for providing specific types of movement as part of one or more rehabilitation exercises, are described below with reference to Figures 2 to 6. Each of the example implementations described below may use at least some of the wearable parts and attachments members shown in the overview of Figure 1.

First Example Implementation - Pincer Grip Movement

Figures 2 and 3 show a rehabilitation device 110 according to 1 first example implementation of the present disclosure. The device 110 of Figures 2 and 3 is designed for the functional recovery of a pincer grip movement between the opposable thumb and forefinger of an impaired (e.g., hemi-paretic) hand of a patient. The device 110 comprises a thumb cap 112, configured to be worn over the thumb, and a finger cap 114, configured to be worn over, for example, the forefinger of the impaired hand. Typically, the patient may wear a glove 140 (shown in dotted outline) on the impaired hand, and the thumb cap 112 and the finger cap 114 are worn over the glove 140. As shown in Figure 3C, the thumb cap 112 includes a guide member 113 positioned on an outer surface thereof, the guide member 113 including a guide channel 113a, such as a substantially L-shaped channel, for guiding a primary cable 120 to extend in a desired direction. Similarly, as shown in Figure 3B, the finger cap 114 includes an attachment member 115 for the primary cable 120 and, in the illustrated implementation, an attachment member 117 for a secondary cable 130, respectively positioned on an outer surface thereof. Optional secondary cable 130 may attach with attachment member 117 of finger cap 114 as described further below. The attachment member 115 for the primary cable 120 is configured for securely attaching a distal end 122 of the primary cable 120 to a required position on the finger. Similarly, the attachment member 117 for the optional secondary cable 130 is configured for securely attaching a distal end 132 of the secondary cable 130 to a required position on the finger, as described further below.

As shown in Figures 2 and 3, in use, a distal end 122 of the primary cable 120 is attached to the attachment member 115 of the finger cap 114 worn on the forefinger of the impaired hand. Any suitable configuration for attaching the distal end 122 of the primary cable 130 to the attachment member 115 is possible, for attaching the primary cable 120 to the finger cap 114. For example, as shown in Figure 3B, the primary cable 120 may be joined to the corresponding attachment member 115 by a simple knot. Alternatively, the primary cable 120 may include a connector (not shown) at the distal end 122 thereof for engagement with a complementary connector (not shown) of the corresponding attachment member 115. From the distal end 122, the primary cable 120 passes across a gap 170 between the forefinger and thumb and through the guide channel 113a of the guide member 113 of the thumb cap 112 so as to change the general direction thereof. The primary cable 120 then extends from the guide member 113 of the thumb cap 112 along a medial side of the thumb of the impaired hand to an actuator (not shown), for example at a position as shown in Figure 1.

In addition, as shown in Figures 2A, 2B and 3A, the optional secondary cable 130 has a distal end 132 for attachment to the attachment member 117 of the finger cap 114. For example, as shown in Figure 3B, the secondary cable 130 may be joined to the corresponding attachment member 117 by a simple knot. Alternatively, the secondary cable 130 may include a connector (not shown) at the distal end 132 thereof for engagement with a complementary connector (not shown) of the corresponding attachment member 117. The secondary cable 130 may be connected at its proximal end 134 to a biasing spring 136 attached to the dorsal outer surface of the glove 140 worn on the patient's impaired hand. In this case, as shown in Figure 3A, the secondary cable 130 may pass through guide members formed by, for example, eyelets 138 extending along the medial dorsal surface of the forefinger of the glove 140. In alternative implementations in which a glove is not worn by the patient, a supporting surface with one or more straps (not shown) may be used to secure the biasing spring 136 in position on the patient's hand for operation thereof.

Referring to Figures 2 and 3, the location, configuration and orientation of the attachment members 115 and 117 for the primary and secondary cables 120, 130 on the outer surface of the finger cap 114 with respect to the patient's forefinger, enables effective operation of the device 110. In particular, the attachment member 115 for the primary cable 120 of the finger cap 114 attaches the distal end 122 of the primary cable 120 to a medial, distal tip of the forefinger, as shown in Figure 3A. As the skilled person will appreciate, this location at the medial, distal tip of the forefinger corresponds to the area of the forefinger that contacts the thumb in a pincer grip position, as shown in Figure 2B. It is noted that this position is slightly offset from the medial line of the forefinger towards the thumb and is essentially dependent upon human anatomy. The attachment member 117 for the secondary cable 130 of the finger cap 114, which is optional, attaches the distal end 132 of the secondary cable 130 to a dorsal surface of the fingertip above the nail, as shown in Figures 2A and 3A. As the skilled person will appreciate, this location corresponds to an area of the forefinger antagonistically opposite the area of the pad of the finger that contacts the thumb in the pincer grip position.

Moreover, the location, configuration and orientation of the guide member 113 for the primary cable 130 on the outer surface of the thumb cap 112 with respect to the patient's thumb may also contribute to the effective operation of the device 110. In particular, the guide member 113 is configured so that the primary cable 120 is movable through, and guided by, the guide channel 113 to maintain the desired position. In particular, the guide member 113 is located to position the primary cable 130 so that is extends from the forefinger across the gap 170 between the forefinger and the thumb to a location on the thumb cap 112, which generally corresponds to the area of the thumb that contacts the forefinger in the pincer grip position. In addition, the guide channel 113a is configured and orientated (e.g., in the L-shape described above) so that the primary cable 130 may extend therefrom along a medial side of the thumb of the hand to an actuator (not shown), as described above.

The device 110 may further comprise a sensor, described further below with reference to Figure 7. In example implementations, the sensor may be positioned on the dorsal surface of the forefinger of the patient's impaired hand. For example, the sensor may be provided adjacent the secondary cable 130 running along the dorsal surface of the forefinger as shown in Figure 2. The sensor detects movement of the forefinger, and, in particular, bending of the forefinger towards the pincer grip position. Upon detecting movement, the sensor provides a signal to the actuator, which responds by applying a tension force to the primary cable 120. A parameter of the tension force may be based on the magnitude of movement detected. For example, the magnitude and/or time duration of the tension force applied by the actuator may be proportional to the amount of movement detected. In other example implementations, a sensor may be used with the patient's unimpaired hand, and respond to movement to enable mirroring of the movement of the unimpaired hand by the impaired hand by controlling the actuator.

The device 110 may further comprise an electronic control unit, such as a microprocessor, for controlling operation of the actuator to provide movement according to one or more rehabilitation exercises, as described further below with reference to Figure 7. In example implementations, the control unit may operate in conjunction with the sensor discussed above. The control unit and actuator may be mounted on the support surface and/or a support strap ofthe wearable component, according to design requirements.

The operation ofthe device 110 will now be described with reference to Figures 2A and 2B. The patient may wear a glove 140 on an impaired hand, the finger cap 114 and the thumb cap 112 are respectively positioned over the patient's forefinger and thumb of the glove 140. A distal end 122 of a primary cable 120 is attached to a corresponding attachment member 115 of the finger cap 114, passed through the guide channel 113a of the guide member 113 of the thumb cap 114 and extended along the medial side of the thumb towards the patient's wrist where it is attached to an actuator. In addition, a biasing spring 136 is positioned on the dorsal surface of the glove 140 and is attached to a corresponding attachment member 117 of the finger cap 114 by means of a secondary cable 130, which may extend through eyelets 138.

In a resting or default position shown in Figure 2A, the biasing spring 136 biases the forefinger of the impaired hand to an open position, with a gap 170 between the forefinger and the thumb. The primary cable 120 is in a relaxed state and extends from the attachment member 115 at the tip of the forefinger, through the guide member 113 on the thumb, to the actuator, since no tension force is applied by the actuator. The patient turns on the control unit that controls the actuator to perform a rehabilitation exercise and starts the pincer grip exercise. For example, in the case of some recovered neuromuscular movement, the patient may attempt to move the forefinger and opposed thumb of the impaired hand towards each other, and this movement may be detected by a sensor on the impaired hand. Alternatively, the patient may use external manual movement, for example by manipulation of the finger by the patient's other hand, which may by detected by a sensor of the impaired hand. In other cases, the patient may mirror the desired movement by moving the unimpaired hand, which may be detected by a sensor used with the patient's unimpaired hand. In any of these cases, the sensor detects the forefinger/thumb movement, and sends a signal to the actuator (e.g., either directly or via the control unit as described below with reference to Figure 7), which applies an appropriate tension force to the primary cable 120. This tension force shortens the length ofthe section ofthe primary cable 120 between the attachment 115 at its distal end 122 and the actuator, and pulls the tip of the forefinger towards the thumb into the pincer grip position, as shown in Figure 2B, against the resistance of the biasing spring 136. The patient and/or control unit may then control the actuator to remove the tension force from the primary cable 120, and the biasing spring 136 returns the forefinger to the original resting position shown in Figure 2A. The patient and/or control unit may control operation of the actuator, for example using an unimpaired hand, to allow repetition of the pincer grip exercise.

As the skilled person will appreciate, various modifications may be made to the first example implementation. For example, the finger cap 114 may be worn on a finger of the patient other than the forefinger, such as the patient's middle finger. In this case, the location, configuration and orientation of the attachment 115 for the primary cable 120 to the finger cap 114 will be adapted appropriately. In addition, the thumb and finger caps may be integrated within the glove 140. Moreover, an additional secondary cable with a biasing member, such as a biasing spring, may be used to bias the thumb into the resting position as shown in Figure 2A.

Second Example Implementation - Wrist Palmar Flexion and Dorsiflexion

Figures 4 and 5 show a rehabilitation device 210 according to second example implementation of the present disclosure. The device 210 of Figures 4 and 5 is designed for the functional recovery of palmar flexion and dorsiflexion of the wrist of an impaired (e.g., hemi-paretic) forearm of a patient. The device 210 comprises a forearm support 216, such as a brace or orthotic, configured to be worn over the impaired forearm together with a glove 240. Typically, the forearm support 216 comprises a pair of straps 218 that can be adjustably secured around the patient's forearm by means of fasteners such as buckles, Velcro® or other suitable forms of fastening. As shown in Figures 5A and 5B, the forearm support 216 comprises a surface for supporting device components (e.g., actuator, control unit etc.) in a housing 244 mounted thereon, and includes straps 218 adjacent each end thereof for securing to respective parts of the patient's forearm.

As shown in Figure 4A, an attachment member 215 for a primary cable 220 is provided on the dorsal surface of the glove 240 near the centre of the hand, to which the distal end 228 of the primary cable 220 is attached by a suitable connection, as described above. The proximal end 222 of the primary cable 220 is controlled by an actuator 226 housed in the housing 244, as described below. As shown in Figure 4B, an attachment member 217 for an optional secondary cable 230 may be provided on the distal palmar surface of the glove 240 near the centre of the hand, to which the distal end 232 of the secondary cable 230 is attached by a suitable connection, as described above. The secondary cable 230 is attached to a biasing spring 236 mounted on a connection surface 248 of a support strap 218 of forearm support 216 on the distal, palmar surface of the forearm.

As with the first example implementation, the location, configuration and orientation of the attachment members 215, 217 for the primary and secondary cables 220, 230 with respect to the patient's wrist contribute to the effective operation of the device 210. In particular, the attachment member 215 for the primary cable 220 is configured so that the primary cable 220 is movable under tension along a longitudinal direction of the forearm for dorsiflexion of the wrist as shown in Figure 5B. Furthermore, the attachment member 217 for the secondary cable 230 is configured so that the biasing spring 236 is configured to bias the wrist in an antagonistically opposed direction for flexion or semi-flexion of the wrist, corresponding to a resting position as shown in Figure 5A.

The device 210 of the second example implementation may further comprise a sensor, as described below with reference to Figure 7, positioned, for example, on the dorsal surface of the patient's wrist. For example, the sensor may be provided adjacent the primary cable 220 running along the dorsal surface of the forearm as shown in Figure 4A. The sensor detects movement of the wrist, and, in particular, upward bending of the hand with respect to the forearm. Upon detecting movement, the sensor provides a signal to the actuator 226, which responds by applying a tension force to the primary cable 220. A parameter of the tension force may be based on the magnitude of movement detected. For example, the magnitude and/or time duration of the tension force applied by the actuator 226 may be proportional to the amount of movement detected.

The operation of the device 210 of the second example implementation will now be described with reference to Figures 5A and 5B. The patient wears the glove 240 on an impaired hand, with an attachment member 215 for the primary cable 220 on the dorsal surface of the glove 240 and an optional attachment member 217 for a secondary cable 230 on the palmar surface of the glove 240. A distal end 222 of a primary cable 220 is attached to the corresponding attachment member 215 and the primary cable 220 extends across the wrist and longitudinally along the forearm where it is attached, at its proximal end 224, to the actuator 226 in the housing 244 on the forearm support 216 of the device 210. As the skilled person will appreciate, the actuator 226 may be located at any suitable position along the length of forearm support 216. In addition, a biasing spring 236 is positioned on the palmar surface of the forearm at or near the wrist and is attached to the corresponding attachment member 217 by means of a secondary cable 230.

In a resting or default position shown in Figure 5A, the biasing spring 236 biases the wrist of the impaired hand to a flexed position. The primary cable 220 is in a relaxed state and extends from the attachment member 215 at the central dorsal surface of the hand to the actuator 226 on the forearm support 216 of the device 210, since no tension force is applied by the actuator. The patient turns on the control unit that controls the actuator 226 to perform a rehabilitation exercise and starts the dorsiflexion exercise. For example, in the case of some recovered neuromuscular movement, the patient may attempt to move the hand upwards at the wrist, and this movement may be detected by a sensor on the impaired hand. Alternatively, the patient may use external manual movement, for example by manipulation of the hand by the patient's other hand, which may by detected by a sensor of the impaired hand. In other cases, the patient may mirror the desired movement by moving the unimpaired hand, which may be detected by a sensor used with the patient's unimpaired hand. In any of these cases, the sensor detects the movement, and sends a signal to the actuator (e.g., via a control unit), which applies an appropriate tension force to the primary cable 220. This tension force shortens the section of the primary cable 220 between the distal end 222 at the attachment member 215 and the actuator 226, and pulls the hand upwards into the dorsiflexed position, as shown in Figure 5B, against the resistance of the biasing spring 236. The patient and/or control unit may then control the actuator 226 to remove the tension force from the primary cable 220, and the biasing spring 236 returns the hand to the original, flexed resting position shown in Figure 6A. The patient and/or control unit may control operation of the actuator 226, for example using an unimpaired hand, to allow repetition of the dorsiflexion exercise.

Third Example Implementation - Pronation and Supination of Forearm

Figures 6A and 6B show a rehabilitation device 310 according to third example implementation of the present disclosure. The device of Figures 6A and 6B is designed for the functional recovery of pronation and supination movement of an impaired (e.g., hemiparetic) forearm of a patient. The device 310 comprises an elbow strap 319 configured to be worn around the impaired forearm near the elbow and a forearm support 316 including a wrist strap 318 configured to be worn near the wrist. As described above, forearm support 316 includes a surface for supporting device components and can be adjustably secured around the patient's forearm by means of fasteners such as buckles, Velcro® or the like. In addition, elbow strap 319 may comprise a supporting surface for device components and can be adjustably secured around the patient's forearm by means of fasteners such as buckles, Velcro® or the like.

As shown in Figures 6A and 6B, the device 310 further comprises a cable 300, having a primary cable section 320 and a secondary cable section 330 as described below, that extends around a pulley system 350. In particular, cable 300 is wound around at least one pulley wheel 352 mounted on the forearm support 316 at a position at or near the patient's dorsal wrist. As described further below, the pulley wheel 352 is rotated by an actuator 326 to control the tension force applied to the primary and cable sections 320, 330, as described below. As shown in Figure 6A, the actuator, pulley wheel and other components may be housed in a housing 344 mounted on the supporting surface of forearm support 316.

As shown in Figures 6A and 6B, the primary section 320 of the cable extends from the pulley wheel 352 diagonally across the patient's dorsal forearm and down the lateral side (i.e. thumb side) of the forearm to the palmar forearm where is securely attached (e.g., by a knot or suitable connector as described above) to an attachment member 354 on the elbow strap 319 adjacent the patient's proximal ulna. Similarly, the secondary section 330 of the cable, which is joined to the primary section 320 of the cable, extends from pulley wheel 352 diagonally across the patient's dorsal forearm and down the other side (i.e., little finger side) of the forearm to the palmar forearm where is securely attached (e.g., by a knot or suitable connector as described above) to the attachment member 354 on the elbow strap 319. As shown in Figure 6B, the secondary section 330 of the cable extends across the patient's palmar forearm in a diagonally opposite direction to the primary section 320 of the cable 300 so that the primary and secondary cable sections meet at the attachment member 354. The primary and secondary cable sections 320, 330 may be guided into, and maintained in, the required extended positions by means of grooves or eyelets associated with the forearm support 316 or otherwise.

As the skilled person will appreciate, since cable 300 forms a single continuous loop in the pulley system 350 comprising the at least one pulley wheel 352 and attachment member 354, the length of the primary section 320 of the cable is adjustable with respect to the secondary section 330 of the cable and vice verso. In particular, the proximal end of the looped cable is controlled by the actuator 326, to change the length of the primary section 320 with respect to the secondary section 230, by winding the cable 300 in either direction around the pulley wheel 352.

The location of the pulley wheel 352 at the point of maximum rotation of the forearm and the attachment member 354 at the point of maximum rotation of the forearm contribute to the effective operation of the device 310. In particular, the attachment member 354 is located at the proximal ulna, which is substantially stationary during pronation/supination of the forearm, whilst the pulley wheel 352 is located at the wrist, which is fully rotated (through approximately 180 degrees by rotation of the radius around the ulna of the forearm) during pronation/supination of the forearm. Thus, rotation of the pulley wheel 352 in a first direction applies tension to, and thus shortens, the primary cable section 320 with respect to the secondary cable section 330, thereby rotating the forearm in supination. Conversely, rotation of the pulley wheel 352 in second direction, opposite to the first direction, applies tension to, and thus shortens, the secondary cable 330 section with respect to the primary cable section 320, thereby rotating the forearm in pronation. Thus, and as the skilled person will appreciate, the first and second cable sections 320, 330 operate antagonistically to rotate the forearm between the prone and supine positions shown in Figures 6A and 6B.

The device 310 of the third example implementation may further comprise a sensor, such as a myoelectric sensor, positioned on a surface adjacent the patient's bicep and/or triceps muscles. The sensor detects the myoelectric signals from the muscle during supination and pronation. Upon detecting movement, the sensor provides a signal to the actuator 326, which responds by rotating the cable about the proximal pulley wheel 352 to shorten either the first cable section 320 or the second cable section 330, as descried below. A parameter of the tension force may be based on the magnitude of movement detected. For example, the magnitude and/or time duration of the tension force applied by rotation by the actuator may be proportional to the amount of movement detected.

The operation of the device of the third example implementation will now be described with reference to Figures 6A and 6B. The patient wears the forearm support 316 and elbow strap 319 on an impaired forearm including the pulley system 350 as described above. In particular, a cable 300 extends in a loop around a pulley wheel 352 adjacent the wrist on the forearm support 316 and is attached at both ends to attachment member 354 adjacent the proximal ulna on the elbow strap 319, with primary and secondary cable sections 320, 330 extending in opposite diagonal directions, as described above. An actuator 326 in the housing 344 on the forearm support 316 is configured to rotate the pulley wheel 352 in opposite directions.

In a resting or default position shown in Figure 6A, the impaired hand is in a prone position with the palm facing down. The primary and secondary cable sections 320, 330 are of substantially equal length and are subject to a similar tension force. The patient turns on the control unit that controls the actuator 326 to perform a rehabilitation exercise and starts the supination/pronation exercise. For example, in the case of some recovered neuromuscular movement, the patient may attempt to rotate the wrist and forearm outwardly so that the palm faces up, and this movement may be detected by a sensor, such as a myoelectric sensor on the impaired wrist. Alternatively, the patient may use external manual movement, for example by manipulation of the wrist by the patient's other hand, which may by detected by a myoelectric sensor on the impaired bicep muscles. In other cases, the patient may mirror the desired movement by moving an unimpaired hand, which may be detected by a myoelectric sensor on the unimpaired arm. In any of these cases, the sensor detects the movement, and sends a signal to the actuator 326 (e.g., via a control unit as described below), which rotates the pulley wheel 352 in a first direction that applies a tension force to the primary section 320 of the cable. This tension force shortens the primary cable section 320 as it is pulled around the pulley wheel 352 into the secondary cable section 330, and pulls the wrist diagonally so as to rotate the forearm upwardly/outwardly (i.e., supinate) into the supine position, as shown in Figure 6B. At the same time, the secondary cable section 330 lengthens through the rotation of the pulley wheel 356, and so does not apply an antagonistic tension force against the rotational movement (i.e., supination). The patient and/or control unit may then control the actuator 326 to rotate the proximal pulley wheel 352 in a second direction opposite to the first direction so as remove the tension force from the primary cable section 320. At the same time, a tension force is applied to the secondary cable section 330, which thereby shortens, and pulls the wrist diagonally so as to rotate the forearm downwardly/inwardly (i.e., pronate) back to the resting, prone position as shown in Figure 6A. The patient and/or control unit may control operation of the actuator 326, for example using an unimpaired hand, to allow repetition ofthe supination/pronation exercise.

Figure 7 a block diagram of a control system 60 for use with a rehabilitation device 10 in accordance with the present disclosure. Control system 60 may be used in conjunction with any of the first, second and third example implementations of the device, as described above. In particular, control system 60 comprises a sensor 62, a control unit 64 and an actuator 26. As described above, sensor 62 may be used to detect a movement of the part of the upper limb, which may be a recovered movement of the impaired limb or a movement of the corresponding unimpaired limb. Any suitable type of sensor 62 may be used that is able to detect movement with the required level of sensitivity. For example, the sensor may comprise a flex sensor for positioning between two parts of a limb to detect relative movement such as pincer grip movement, wrist dorsiflexion or similar movements, as in the first and second example implementations. A suitable flex sensor is the SEN-10264 sensor available from SparkFun Electronics. Alternatively, the sensor may comprise a myoelectric sensor, which detects muscle tension due to movement of certain muscle groups, including rotation, as in the third example implementations. A suitable myoelectric sensor is the MyoWare muscle sensor available from Advancer Technologies, LLC. Other types of sensor are possible and contemplated by the present disclosure. Upon detecting movement, such as flexion or rotation, the sensor 62 provides a sensing signal indicative of the detected movement (e.g., magnitude, speed and/or direction of movement) along a signal line 66 to control unit 60.

Control unit 64 may comprise any suitable control device such a microprocessor, ASIC device etc., for controlling the actuator 26 to apply a tension force to a primary cable 20 or cable section, as described above. In example implementations, control unit 64 may be configured, for example pre-programmed or programmable by a user, to perform a series of rehabilitation exercises by controlling the actuator 26. The control unit 64 may the receive the sensing signal from the sensor 62 over signal line 66, and, in response, second a corresponding control signal over signal line 68 to actuator 26. In particular, the control signal may control the actuator 26, during the rehabilitation exercise, to apply a tension force to the primary cable 20 based on the sensing signal (e.g., proportional to the magnitude, speed and/or direction of movement detected by sensor 62). As the skilled person will appreciate, the control unit 64 may be configured to process the sensing signal (e.g., by smoothing) in order to ensure that the actuator is controlled to apply a stable, safe tension force to the primary cable 20. The control system 60 may be enclosed, either entirely or in part, in a housing 44, which may be mounted on a support surface of the device 10 as described above.

Figure 8 is a side view of an actuator 26 for use with a rehabilitation device 10 in accordance with the present disclosure. Actuator 26 may be used in conjunction with any of the first, second and third example implementations of the device, as described above. The actuator 26 shown in Figure 8 comprises an actuator for rotating the primary cable 20 around a reel. In particular, the actuator may rotate the cable in a first direction to reduce the length of the primary cable 20, by winding the cable onto the reel, thereby applying a tension force. Conversely, the actuator may rotate the cable in a second direction, opposite to the first direction, to increase the length of the primary cable 20, thereby relaxing the cable and/or removing the tension force. Any suitable type of actuator 26 may be used such as a servo motor, stepper motor or DC motor.

As the skilled person will appreciate, example implementations of the rehabilitation device according to the present disclosure have numerous advantages. For example, the device is simple and easy to set up and use, lightweight and relatively inexpensive, thereby enabling a patient to start rehabilitation exercises at an earlier stage of recovery than conventional devices, which require assistance to set up and use, and are more heavy and are relatively expensive.

Features described in relation to one or more of the example implementations may be used in combination with features or combinations of features described in relation to one or more other example implementations. Furthermore, the default/resting and active positions of the limb described in relation to each of the example implementations may be reversed.

As the skilled person will appreciate, various modifications and changes may be made to the described example implementations. For example, whilst the described implementations provide movement by applying a tension force to a cable, any suitable flexible cord, string or belt may be used. Similarly, whilst the described implementations provide a biasing force to return to a default or resting position, other types of biasing member may be used. Moreover, the biasing member used in any implementation may be selected to provide a suitable antagonistic biasing force according to design requirements. In addition, for simplicity, the described example implementations comprise features for a particular type of rehabilitation exercise/movement. As the skilled person will appreciate, the features of one or more of the example implementations may be combined into a single, integrated rehabilitation device to enable the patient to perform multiple types of rehabilitation exercises and movements. The location, configuration and orientation of the described attachments members may be varied according to design and anatomical requirements and patient needs, and padding to the wearable parts may be easily added to ensure patient comfort. It is intended to include all such variations, modifications and equivalents which fall within the spirit and scope of the present disclosure, as defined in the accompanying claims.

Claims

CLAIMS:

1. A rehabilitation device comprising:

a wearable part for securely positioning the device on an upper limb of a patient;

5 and a cable section extending between the wearable part adjacent a part of the limb to be moved and an actuator, wherein, in use, the actuator is configured apply a tension force to the cable section so as to move the part of the limb in a desired direction.

2. A device as claimed in claim 1, wherein:

the cable section comprises a proximal end and a distal end, and the wearable part comprises an attachment member for engaging the distal end of the cable section adjacent the part of the limb to be moved.

3. A device as claimed in claim 2, wherein the attachment member comprises one or more of: a connector, a clip, an eyelet or a pulley wheel.

4. A device as claimed in any one of the preceding claims, wherein the wearable part 20 includes an upper limb support, the upper limb support comprising at least one of:

at least one strap for attaching to the upper limb of the patient, and a platform for supporting components for the device.

5. A device as claimed in any one of the preceding claims, further comprising:

a sensor for detecting movement, wherein the sensor is configured to detect one or more of: movement of the part of the upper limb to be moved, and movement corresponding to a desired movement of the part of the upper limb to be moved;

wherein, in response to detecting movement, the sensor is configured to provide a 5 signal to an actuator to apply a tension force to the cable.

6. A device as claimed in claim 5, wherein a parameter, for example a magnitude or time duration, of the tension force applied by the actuator is determined based on the magnitude of movement detected by the sensor.

7. A device as claimed in any one of the preceding claims, further comprising:

a biasing member for biasing a part of the upper limb to be moved into a resting position thereof, or a second cable section, for applying a counter tension force against the movement of 15 the part of the limb by the first cable section.

8. A device as claimed in any one of the preceding claims, further comprising:

a control unit for controlling an actuator to move the cable section apply a tension force to the cable section so as to move the part of the limb in accordance with one or more

20 predefined rehabilitation exercises.

9. A device as claimed in claim 8, wherein the control unit is programmable.

10. A device as claimed in any one of the preceding claims, the device for the functional 25 recovery of a pincer grip movement between the opposable thumb and finger of an impaired hand of a patient, the device comprising:

wearable parts including a finger cap configured to be worn on at least one finger of a hand of a patient and a thumb cap configured to be worn on a thumb of a hand of a patient;

a primary cable having a proximal end and a distal end, and an actuator for applying a tension force to the primary cable;

wherein the primary cable extends from the distal end attached to the finger cap at a location at or adjacent to the pad of a finger on which the finger cap is worn, through a guide member in the thumb cap at or adjacent a position opposite to the pad of a thumb on which the thumb cap is worn and along the medial line of the thumb to the actuator.

11. A device as claimed in claim 10, wherein the actuator is configured to apply a tension force to the proximal end of the primary cable so as to shorten the length of the primary cable between the actuator and the finger cap and thereby move the finger towards the thumb in a pincer grip position.

12. A device as claimed in any one claims 1 to 9, the device for the functional recovery of a flexion and dorsiflexion wrist movement of an impaired forearm of a patient, the device comprising:

wearable parts including a forearm support comprising a wrist strap configured to be worn around the wrist of a patient and a glove configured to be worn on a hand of the patient;

wherein the primary cable extends from the distal end attached to the dorsal surface of the glove, along a medial dorsal line of the hand to the actuator.

13. The device as claimed in claim 13, wherein the actuator is configured to apply a tension force to the proximal end of the primary cable so as to shorten the length of the primary cable between the actuator and the distal end attached to the glove and thereby move the hand upwards with respect to the wrist into a dorsiflexed position.

14. A device as claimed in any one of claims 1 to 8, the device for the functional recovery of a pronation and supination movement of an impaired forearm of a patient, the device comprising:

wearable parts including a forearm support comprising a wrist strap configured to be 10 worn around the wrist a patient and an elbow strap configured to be worn around the forearm of the patient adjacent the elbow thereof;

a cable comprising a primary cable section on one side and a secondary cable section on an opposite side;

a pulley system comprising a pulley wheel, wherein the cable extends in a loop 15 around the pulley system, and an actuator for rotating the pulley wheel;

wherein the cable is attached at both its ends to an attachment member on the elbow strap, the attachment member for positioning adjacent the proximal ulna of the impaired forearm of the patient and extends around the pulley wheel at the dorsal wrist of

20 the impaired forearm of the patient, and wherein the cable crosses over itself at a position along the forearm of the patient between the attachment member and the pulley wheel.

15. A rehabilitation device substantially as hereinbefore described, with reference to, and as shown in, any one or more of the accompanying drawings.

Intellectual

Property

Office

Application No: GB1612626.0 Examiner: Mr Philip Osman