WO2019038653A1

WO2019038653A1 - Device for motor re-education in postural dysfunctions

Info

Publication number: WO2019038653A1
Application number: PCT/IB2018/056268
Authority: WO
Inventors: Andrea SAGGINI; Susanna MORICI
Original assignee: CORPO 53 Srl
Current assignee: CORPO 53 Srl
Priority date: 2017-08-24
Filing date: 2018-08-20
Publication date: 2019-02-28
Anticipated expiration: 2020-02-24
Also published as: IT201700095769A1

Abstract

Device for motor re-education in postural dysfunctions comprising a platform (1), a member for stationary motricity (2) arranged above the platform (1), a supporting member (4) adapted to support the weight of the patient (3), said supporting member (4) horizontally extending above the member for stationary motricity (2), a harness (5) adapted to be worn by the patient (3), said device comprising one or more lifting slings (8, 9) adapted to connect the harness (5) to the supporting member (4) at one or more connecting points (15, 16) arranged on the supporting member (4) along a vertical direction above the member for stationary motricity (2), the vertical distance (H) between said one or more connecting points (15, 16) and the member for stationary motricity (2) being adjustable.

Description

"DEVICE FOR MOTOR RE-EDUCATION IN POSTURAL DYSFUNCTIONS"

The present invention concerns a device for motor re^¬ education in postural dysfunctions according to the preamble of the main claim.

The devices for motor re-education in postural dysfunctions are used for the development of global motricity in stationary environment.

These devices for motor re-education in postural dysfunctions allow the patient having a postural problem, which can be caused by diseases, traumas, incorrect habits or the like, to have his/her global motricity evaluated, optimized and increased by at least partially supporting his/her weight and by guiding his/her movements during the activity of stationary motricity. These devices for motor re-education in postural dysfunctions usually comprise a member for patient's stationary motricity {such as a treadmill, which allows static walking, or an elliptical trainer, which guides walking according to an elliptical movement of the inferior limbs, or else a stepper, which simulates ascending steps) , a supporting member, often of bridge- crane type, with two pillars and a crossbeam, a harness adapted to be worn by the patient, and lifting slings made, for example, of belts or ropes and adapted to constrain the harness to the supporting member, usually the crossbeam, and to support the patient's weight thereby reducing the load on the legs.

Currently, there are several manufacturers of devices for motor re-education in postural dysfunctions, one of the most important is Reha . One of the problems of today-available machines for motor re-education in postural dysfunctions is their size, which makes them difficult to transport and therefore not suitable for a small rehabilitation center.

Another problem is that current devices for motor reeducation in postural dysfunctions have poor effectiveness .

Object of the present invention is therefore to provide a device for motor re-education in postural dysfunctions that allows to overcome the above mentioned drawbacks, in particular an object is to implement a device for motor re-education in postural dysfunctions that can be more easily transported.

Another object is to provide a device that is more effective in performing its function of motor re^¬ education in postural dysfunctions.

These objects are achieved by a device for motor reeducation in postural dysfunctions whose inventive characteristics are highlighted by the claims.

The invention will be better understood by the following detailed description provided for illustration purposes only, thus without limitation, of a preferred embodiment illustrated in the accompanying drawings in which:

fig. 1 shows a perspective view of a device according to the invention;

fig. 2 shows a front view of said device;

fig. 3 is an enlargement of the upper portion of figure 2 , with the addition of arrows that show some possible adjustments;

fig. 4 shows a front view of the upper portion of a variation of the device according to the invention. It was surprisingly discovered that one of the reasons for the lack of effectiveness of the devices currently available in motor re-education in postural dysfunctions is the fact that the patient is subject, during the activity of stationary motricity (e.g. the assisted walking on a treadmill) , to horizontal and torsional forces that alter his/her movement.

It was also surprisingly discovered that another reason for the lack of effectiveness of the devices currently available in motor re-education in postural dysfunctions is that they do not sufficiently guide the patient's movements .

In fact, it has been observed that the length of the lifting slings in current devices for motor re-education in postural dysfunctions allows an excessive oscillation of the patient, who is therefore not sufficiently guided in his activity of stationary motricity.

These oscillations cause the patient to undergo significant horizontal forces and torsions, thereby creating stress and discomfort in the patient.

Another reason for the lack of effectiveness is that, in current devices, the lifting slings cannot be sufficiently adapted to the different needs of the patients .

Each patient needs constraints able to be tailored to his or her particular sizes: for example, a child is shorter than an adult.

In current devices, this generally involves longer lifting slings with longer free-oscillation length, less control of the patient's movements and therefore less effectiveness . In other cases, some patients have or tend to have one shoulder more raised than the other or tend to unbalance the weight more to the right or more to the left.

In addition, the width of the shoulders varies from patient to patient: if the distance between the lifting slings cannot be adjusted and therefore adapted to the patient, the patient can be subjected to horizontal and torsional forces that make more difficult to perform correct movements.

If the device for motor re-education in postural dysfunctions cannot be tailored to different types of patients, its effectiveness is doomed to be moderately poor .

The device for motor re-education in postural dysfunctions according to the invention allows these problems to be solved, guiding the patient better, allowing a fine adjustment suitable for each patient of the length, the position and the reciprocal distance of the lifting slings and also obtaining the advantage of an easier transportability of the machine.

With reference to figures 1 to 3, it can be seen that the device for motor re-education in postural dysfunctions according to the invention comprises a platform 1, a member for stationary motricity 2, such as a treadmill (depicted in the figures) or a stepper or another similar member arranged above the platform 1 and adapted to allow walking of a patient 3 so that the patient's trunk remains substantially stationary with respect to the device for motor re-education in postural dysfunctions, a supporting member 4 adapted to support the weight of the patient 3. In the embodiments shown, this supporting member 4 comprises a pillar 6 vertically extending from the platform 1 to the side of the member for stationary motricity 2 and a crossbeam 7 horizontally extending above the platform 1 and above the member for stationary motricity 2.

The pillar 6 has at least two mutually sliding parts for adjusting the height of the supporting member 4 and thus the total height HT of the device.

It is of course possible for the supporting member 4 to have a different structure, but in any case this supporting member extend both vertically and horizontally so that at least part of the supporting member is above the member for stationary motricity 2, i.e. directly on the vertical axis.

Therefore, the patient can stand on the member for stationary motricity 2 and at least part of the supporting member A extends vertically to support the weight of the patient during the assisted walking, thereby at least partially reducing the load on the legs. The device according to the invention comprises horizontal postural constraints 13, both front and rear ones, adapted both to maintain a proper three-dimensional position for the sternum scapulohumeral subsystem, i.e. the shoulders, the pelvis subsystem i.e. the pelvic region, and to provide adeguate support as well as spatial alignment for the vertebral relay subsystem, i.e. the spine.

In addition, the device according to the invention comprises a harness 5 adapted, when constrained to the supporting member 4, to be worn by the patient 3 and to support his/her weight.

This harness 5 is adjustable to fit different patient sizes, and the device can also be equipped with two or more harnesses, for patients of very different sizes, for example one suitable for a child and one suitable for an adult .

The device according to the invention comprises one or more lifting slings 8 and 9, which are adapted to connect the harness 5 to the supporting member 4 at one or more connecting points 15 and 16 arranged on the supporting member 4 in a vertical direction above the member for stationary motricity 2.

The term "lifting slings" refers to flexible elements able to support the weight of the patient. Therefore, these lifting slings 8 and 9 can comprise, for example, ropes, belts, flexible metal cables or chains.

In the examples shown in the figures, the device according to the invention comprises a first lifting sling 8 and a second lifting sling 9, for connecting the harness 5 to the supporting member 4.

Since the supporting member has variable or adjustable height, the distance H in a vertical direction between these one or more connecting points 15 and 16 and the member for stationary motricity 2 or the platform 1 is adjustable and can be reduced in order to simultaneously reduce the f ee-oscillation lengths LI and L2 of the lifting slings 8 and 9, so as to better constrain the patient and guide him/her in performing the correct movements .

With free-oscillation lengths LI and L2 of the lifting slings 8 and 9 is meant the distance between the first or second connecting points 15 and 16 where the lifting slings 8 and 9 connect to the supporting member 4 and the corresponding attaching elements 14 to attach the harness 5 to the lifting slings 8 and 9, when the harness 5 is worn by the patient who is on the member for stationary motricity 2 in a suitable position for performing his/her motor re-education exercise.

If the member for stationary motricity is a stepper or member in which the patient's shoulders do not always remain at the same height, the device according to the invention may comprise a system of elastic rewinding or active adjustment of the lifting slings, which allows their free-oscillation lengths to be tailored to the changing height of the patient's shoulders during exercise, always applying the same weight supporting force and maintaining a reduced load on the patient's legs .

The member for stationary motricity 2 has a walking direction S that, in case of the treadmill shown in figure 1, corresponds for example to the sliding direction with respect to which a left side LS, a right side LD, a front side LA and a back side LP can be determined (figure 1).

Thanks to a device adapted to horizontally and mutually move the first and second connecting points 15 and 16 (see the horizontal arrows in figure 3) said first and second connecting points 15 and 16, as well as the first and second lifting slings 8 and 9, have an adjustable mutual distance D in the horizontal direction, in order to fit the width of the patient's shoulders.

This allows traction in vertical direction to be exerted by the lifting slings 8 and 9 in order to counter the weight of the patient, thereby greatly reducing the horizontal components of the force applied to the patient .

Obviously, in order to reduce the free-oscillation lengths Ll and L2 of the lifting slings 8 and 9, the harness is preferably provided with straps 12 or belts which wrap round the patient's shoulders, and these straps 12 have attaching elements 14, such as rings, at the left shoulder and the right shoulder, so that by means of these attaching elements 14 the first lifting sling 8 can be connected to a point of the harness 5 corresponding to the right shoulder of the patient 3 and the second lifting sling 9 can be connected to a point of the harness 5 corresponding to the left shoulder of the patient 3.

In addition, to compensate for the fact that one shoulder may have a height different from the other, it is preferable that at least one of these lifting slings 8 and 9 or them both have adjustable free-oscillation lengths Ll and L2.

The free-oscillation lengths Ll and L2 of the lifting slings 8 and 9 can be adjusted, i.e. increased or decreased, by a winding device to wind the lifting slings 8 and 9 that is arranged in the crossbeam, so that the free-oscillation lengths Ll and L2 may not correspond to the lengths of the lifting slings 8 and 9.

Obviously, the free-oscillation length Ll of the first lifting sling 8, preferably, can be adjusted independently of the free-oscillation length L2 of the second lifting sling 9. To reduce the bulk and improve the transportability of the device according to the invention, said supporting member 4 extends from the platform 1 vertically, or at least in a direction having a vertical component, at only one side of the member for stationary motricity 2 or of the platform 1, for example the right side LD as in figure 1 or at two adjacent sides, for example the right side LD and the back side LP.

This shape of the supporting member allows the bulk, that an overhead crane structure would have, to be reduced. Since the supporting member 4 has an adjustable height, for example by means of the mutual sliding of the two parts making up the pillar 6, the entire device according to the invention also has an adjustable total height HT. Preferably, said height HT can be adjusted or varied up to a value lower than two meters, for easier transport of the device.

It is better if this total height HT can be adjusted or varied up to a value lower than 1.5 m.

This can be achieved, for example, by a telescopic single or multi-stage pillar that comprises two or more reciprocally sliding parts and that can be lowered by bringing the crossbeam 7 very close to the pillar 1 and to the member for stationary motricity 2, which can be removed from the platform 1.

In order to reduce the f ee-oscillation lengths LI and L2 of the lifting slings, the device according to the invention may comprise, as shown in figure 4, a first rigid supporting member 20 connected to the crossbeam 7 and adapted to be connected to the first strap 8 and a second rigid supporting member 21 connected to the crossbeam 7 and adapted to be connected to the second strap 9.

Said first and second rigid support elements 20 and 21 are adapted to lower the first and second connecting points 15 and 16, respectively, by bringing them closer to the shoulders of patient 3 and reducing the free- oscillation lengths LI and L2 of the respective lifting slings 8 and 9.

One or both of said first and second rigid supporting elements 20 and 21 may comprise a guide for the first and second lifting slings 8 and 9, respectively: for example, the lifting slings 8 and 9 may pass through this guide, which reduces their f ee-oscillation lengths LI and L2, thereby preventing the free oscillation of the element portion that is inserted in the guide.

This way, the free-oscillation lengths LI and L2 of the lifting slings 8 and 9 can become significantly smaller than the vertical dimension of the patient's head.

In order to be less troublesome and as far away as possible from the patient's head, each of said first and second rigid supporting elements 20 and 21 can comprise an annular element, at least as large as the patient's head, shaped as a circle, square or rectangle, for example .

Each of these first and second rigid supporting elements can have the shape, for example, of a large ring with a diameter of 20 cm or more and rigidly connected to the crossbeam 7, the line joining the centers of the two rings being substantially in line with the patient's shoulders.

These first and second rigid supporting elements may also be arranged obliquely (not shown for simplicity) , but so that the first and second connecting points 15 and 16 are directly above the patient's shoulders and close to the patient's head.

The supporting member 4 may comprise, for example inserted in the crossbeam 7, a manual or electrical and/or mechanical device for adjusting the reciprocal distance D between said first and second lifting slings 8 and 9 , according to the arrows in figure 3, and for reducing their free-oscillation lengths Ll and L2.

In its operation, the device can be transported to the rehabilitation center by lowering the crossbeam 7 as much as possible and reducing the total height HT, so that the dimensions are as small as possible.

Once positioned the device according to the invention, the supporting member is raised, for example by extending the pillar 6 to a height adapted to allow the patient to stand on the member for stationary motricity 2 without touching the crossbeam 7 with the head.

The patient wears the harness 5, the lifting slings 8 and 9 are lowered and one end thereof is connected to the attaching elements 14, which are arranged on the straps 12 of the harness 5, respectively on the left shoulder and the right shoulder.

The height of the pillar 6 is lowered until the crossbeam 7 is just above the head of the patient 3.

The distance D between the first and second lifting slings 8 and 9 is adjusted to fit the shoulder width of the patient 3.

The free-oscillation lengths Ll and L2 of the lifting slings 8 and 9 are reduced. The free-oscillation lengths LI and L2 of the lifting slings 8 and 9 are also independently adjusted, in order to adapt each lifting sling to the height of the patient's shoulder which the lifting sling is connected to.

This can be done either by adjusting the distance between the crossbeam 7 and the member for stationary motricity 2 or by independently adjusting the length of each of the lifting slings.

Horizontal postural constraints 13 are leaned against the front and back of the patient's shoulders, pelvis and spine .

Thanks to the possibility of greatly reducing the total height HT of the device according to the invention, the latter can take a compact shape useful for facilitating its transport.

The device for motor re-education in postural dysfunctions according to the invention allows multiple fine adjustments based on the features of each single patient, in particular it allows to adjust:

the distance H between the first and second connecting points 15 and 16 and the member for stationary motricity 2;

the free-oscillation lengths LI and L2 of the lifting slings 8 and 9;

the distance D between the first and the second lifting slings 8 and 9 or, equivalently, the distance D between the first and the second connecting points 15 and 16.

Thanks to these characteristics, when the patient is working on this member for stationary motricity, he/she is subject to reduced horizontal and torsional forces compared to today-available devices for motor re^¬ education in postural dysfunctions.

The reduction of the free-oscillation lengths Ll and L2 of the lifting slings, compared to known devices, strongly reduces the patient's oscillating movements in his activity of stationary motricity.

Since the patient is better guided in performing the correct movements, this results in greater effectiveness of the rehabilitation therapy.

An advantageous feature of the invention is that the free-oscillation lengths Ll and L2 of the lifting slings 8 and 9 can be greatly reduced by the presence of said first and second rigid supporting elements 20 and 21 which extend from the crossbeam 7, thereby bringing the first and second connecting points 15 and 16 significantly closer to the patient's shoulders and resulting in a large increase in the patient's natural oscillation frequency, and a reduction to a minimum of his/her oscillations.

Claims

1. Device for motor re-education in postural dysfunctions comprising a member for stationary motricity (2), a supporting member (4) adapted to support the weight of the patient (3), said supporting member (4) horizontally extending above the member for stationary motricity (2) , a harness (5) adapted to be worn by the patient (3) , said device comprising one or more lifting slings (8, 9) adapted to connect the harness (5) to the supporting member (4) at one or more connecting points (15, 16) arranged on the supporting member (4) along a vertical direction above the member for stationary motricity ( 2 ), characterized in that the vertical distance

(H) between said one or more connecting points (15, 16) and the member for stationary motricity (2) can be adjusted .

2. Device for motor re-education in postural dysfunctions according to claim 1, characterized by comprising a platform (1), said member (2) for stationary motricity being adapted to be placed on said platform

(I) -

3. Device for motor re-education in postural dysfunctions according to claim 1 or 2, characterized in that said member for stationary motricity (2) has a walking direction (S) having a left side (LS) , a right side (LD) , a front side (LA), and a rear side (LP), said supporting member (4) extending along a direction having a vertical component either at only one side (LD) of the member for stationary motricity (2) or at two adjacent sides .

4. Device for motor re-education in postural dysfunctions according to one or more of the preceding claims, characterized in that it comprises at least one first and one second lifting slings (8, 9) for connecting the harness (5) respectively to a first and a second connecting point (15, 16) of the supporting member (4), said first and second connecting points (15, 16) having an adjustable reciprocal distance (D) along the horizontal direction.

5. Device for motor re-education in postural dysfunctions according to the preceding claim, characterized in that the first lifting sling (8) is adapted to be connected to a point of the harness {5} corresponding to the right shoulder of the patient (3), the second lifting sling (9} is adapted to be connected to a point of the harness (5) corresponding to the left shoulder of the patient (3) .

6. Device for motor re-education in postural dysfunctions according to one or more of claims 4 and 5, characterized in that at least one of said lifting slings (8, 9) has an adjustable f ee-oscillation length {LI, L2) .

7. Device for motor re-education in postural dysfunctions according to the preceding claim, characterized in that the free-oscillation length (11) of the first lifting sling (8) can be adjusted independently of the free-oscillation length (L2) of the second lifting sling ( 9) .

8. Device for motor re-education in postural dysfunctions according to one or more of the preceding claims, characterized by comprising an adjusting system for the active adjustment of the lifting slings, the adjusting system being adapted to tailor the free- oscillation length (Ll and L2 ) of the lifting slings (8 and 9} to the variable height of the patient's shoulders during the exercise of stationary motricity.

9. Device for motor re-education in postural dysfunctions according to one or more of preceding claims, characterized in that its total height {HT) along the vertical direction, can be adjusted, said total height (HT) being adjustable up to a value lower than two meters .

10. Device for motor re-education in postural dysfunctions according to the preceding claim, characterized in that said total height (HT) can be adjusted up to a value lower than 1.5 m.

11. Device for motor re-education in postural dysfunctions according to one or more of preceding claims, characterized in that said supporting member (4) comprises a vertical pillar (6) and a horizontal crossbeam (7), said pillar (6) comprising at least two mutually sliding portions for adjusting its height.

12. Device for motor re-education in postural dysfunctions according to one or more of preceding claims, characterized by comprising a first rigid supporting element (20) , connected to the crossbeam (7) and adapted to be connected to the first lifting sling (8), and a second rigid supporting element (21), connected to the crossbeam (7) and adapted to be connected to the second lifting sling (9), said first and second rigid supporting elements (20, 21) being adapted to reduce the free-oscillation length (Ll and L2) of the first and second lifting slings (8, 9} .

13. Device for motor re-education in postural dysfunctions according to the preceding claim, characterized in that one or both of said first and second rigid supporting elements {20, 21} comprise a guide .

14. Device for motor re-education in postural dysfunctions according to claim 12 or 13, characterized in that one or both said first and second rigid supporting elements (20, 21) comprise an annular element having at least the size of the patient's head.