EP1351643A1

EP1351643A1 - Therapeutic and training device for the shoulder joint

Info

Publication number: EP1351643A1
Application number: EP01273113A
Authority: EP
Inventors: Andreas Hassler
Original assignee: Oped AG
Current assignee: Oped AG
Priority date: 2001-01-11
Filing date: 2001-12-06
Publication date: 2003-10-15
Anticipated expiration: 2021-12-06
Also published as: US6824498B2; EP1351643B1; WO2002055006A1; JP2004516908A; US20040067832A1; DE10101214C2; ATE278373T1; DE50104047D1; DE10101214A1

Abstract

The invention relates to a therapy and training device for the shoulder joint (43) with a trunk base (21), having a rotational joint base (22) two shoulder extensions (27), respectively associated with a shoulder, rotational around a vertical axis of a shoulder rotational joint means, having an arm extension, respectively spaced apart from the rotational joint base for connection with an arm (42, 48), which is rotationally connected with the shoulder extension (27) around a transverse axis (37) by an upper arm rotational joint means (30), wherein said shoulder extension and/or said arm extension are coupled in movement such that a rotational movement of one shoulder extension, or respectively, one arm extension, causes a rotational movement of the other shoulder extension, or respectively, the other arm extension.

Description

Therapy and training device for the shoulder joint

The present invention relates to a therapy and training device for the shoulder joint with a trunk support, which has two shoulder brackets, each associated with a shoulder on a swivel joint base, which can be pivoted about a vertical axis of a shoulder swivel joint device and which, at a distance from the swivel joint base, has an arm arm for connection to a Have arm which is pivotally connected to the shoulder arm about a transverse axis via an upper arm pivot joint device, the shoulder arms and / or the arm arms being coupled in such a way that a pivoting movement of the one shoulder arm or one arm arm causes a pivoting movement of the other shoulder arm or the other arm arm causes.

Therapy and training devices that are used to treat movement restrictions on one extremity and are based on the principle that the movement of the healthy extremity induces movement of the limb with restricted mobility have so far been used for therapy and movement training of

BESTATIGUNGSKOPIE Knee joints used. Such a therapy and training device is known for example from DE 195 09 465 AI. The known therapy and training device is used to treat movement restrictions on a knee joint and, due to the only essentially uniaxial joint formation of the knee joint, is relatively easily equipped with only one swivel joint device, which articulates a connection between a lower leg holder and a thigh holder, the ideal in therapy operation The pivot axis of the swivel joint device coincides with the patient's knee joint axis.

In practice, due to the frequency of knee injuries and the related knee operations, there is a particularly high need for rehabilitation regarding restricted movement of the knee joint. However, movement restrictions on joints can always be ascertained when a joint has to be immobilized for a longer period of time after a surgical intervention. Of course, this also applies in particular to shoulder injuries or surgical interventions on the shoulder, which can lead to considerable movement restrictions in the shoulder area. However, due to the complexity of the joint situation in the shoulder area, it is not possible to use the known therapy and training device for a corresponding therapy of a shoulder joint.

The present invention is therefore based on the object of proposing a therapy and training device which makes it possible to apply the known therapy principle also to the shoulder joint.

To achieve this object, the therapy and training device has the features of claim 1.

According to the invention, the therapy and training device has a trunk support with a swivel joint base, which is provided with two shoulder brackets, each assigned to a shoulder and pivotable about a vertical axis of a shoulder swivel joint device, each because spaced apart from the swivel joint base have an arm bracket for connection to an arm which is pivotally connected to the shoulder bracket via an upper arm swivel joint device, the shoulder brackets and / or the arm brackets being coupled in such a way that a pivoting movement of the one shoulder bracket or the one arm bracket causes a pivoting movement of the other shoulder arm or the other arm arm.

The structure of the therapy and training device according to the invention takes into account the shoulder anatomy in a special way, which leads to shoulder movements generally also inducing arm or at least upper arm movements and vice versa. For example, a simple forward or backward movement of a shoulder is associated with a slight pivoting movement of the upper arm. Such complex movement relationships require a corresponding joint configuration on the therapy and training device. For the forward or backward movement, it is therefore necessary to form a vertical axis on the therapy and training device, which is arranged as close as possible to the shoulder base. In order to enable the swiveling movement of the upper arm superimposed with the forwards and backwards movement, it is necessary to form a swiveling axis which runs transversely to the vertical axis and which enables a so-called ante and retroversion of the arm, that is to say a forwards and backwards swinging.

The forward and backward movement of the shoulder blade with superimposed forward and backward movement of the arm is made possible by the shoulder arm designed as a joint lever, which connects the

Shoulder swivel device and the upper arm swivel device, that is, the vertical axis and the transverse axis. To transfer the swivel movement carried out on one side of the body with the shoulder blade or the arm or both to the other side of the body, the shoulder arm or the side arm assigned to the other side of the body is arm brackets assigned to the other side of the body, each with its counterpart, coupled in motion.

In particular for repositioning the therapy and training device relative to the patient's upper body, it proves to be advantageous if the swivel joint base is provided with a positioning device

Relative positioning relative to the patient's spine is assigned. This makes it possible to position the therapy and training device on the upper body of the patient even after an interruption of the therapy in order to resume the therapy, without it being necessary to adapt the joint configuration of the therapy and training device to the individual anatomy of the patient.

A particularly direct type of positioning is obtained if the positioning device has a neck receptacle that is adjustable in height along the trunk support on the swivel joint base. The neck pick-up also provides an opportunity to prevent the upper body from performing evasive movements that are voluntary or involuntary during the operation of the therapy and training device, which in particular could impair the desired adaptation of the joint configuration of the therapy and training device to the individual anatomy of the patient , In principle, other correspondingly acting devices can of course also be provided for this.

If on the therapy and training device the arm arm comprises an upper arm arm and a forearm arm, the upper arm arm being connected to the shoulder arm via the upper arm swivel joint device and the lower arm arm being connected to the upper arm arm arm via an elbow joint device comprising at least one pivot axis, it is also possible Include forearm movements. In the simplest form, relative movements of the forearm with respect to the upper arm are sufficient without the movements of the forearm extension like the movements of the upper arm. arm arm and the shoulder arm would have to be transferred to the other side of the body coupled to movement. Since, with a shoulder with restricted movement, relative movements of the forearm with respect to the upper arm can often be carried out without restrictions, a corresponding movement coupling of the forearm extension on both sides can be omitted. On the other hand, since changed relative positions of the forearm relative to the upper arm can very well affect the movements of the shoulder due to the associated mass shift, the relative mobility of the forearm arm can have a positive effect on the success of the therapy.

If, moreover, the elbow joint device has two pivot axes, a vertical axis running transversely to the longitudinal extension of the upper arm arm and a transverse axis in the direction of the longitudinal extension of the upper arm arm, a two-axis joint device is formed which essentially corresponds to the actual anatomical conditions on the elbow joint.

If, moreover, the connection of the arm arm to an arm takes place by means of a connecting device arranged on the forearm arm, e.g. Longitudinal rotation of the upper arm with respect to the upper arm extension is easily possible. It is therefore possible, for example, to dispense with designing the upper arm swivel joint device in such a way that longitudinal rotations of the upper arm arm are also possible.

In a particularly advantageous embodiment of the therapy and training device, at least one forearm arm is provided with an actuating device for triggering a locking device acting on the upper arm swivel joint device, the actuating device being actuated by moving the assigned forearm out of its operating position. This creates a kind of "emergency switch" that prevents the sick shoulder from performing movements that are not guided through the healthy extremity of the opposite side or the healthy shoulder, so that for example, the sick arm cannot fall from a raised position due to the influence of gravity after the connection between the forearm on the healthy side and the forearm extension.

A possible embodiment of such an "emergency switch" can consist, for example, in that a handle knob provided with a switch is provided at the free end of the lower leg receptacle, in which the switch is actuated by releasing the handle.

If the effective length of the upper arm extension can be changed between the upper arm swivel joint device and the elbow joint device, it is possible to compensate for deviations between the swivel axis of the upper arm swivel joint device and the actual swivel axis of the shoulder joint by means of suitable length changes, without resulting in constraint conditions during the movement.

A particularly effective therapy for the rehabilitation of movement restrictions on an affected shoulder joint becomes possible if at least the shoulder swivel joint device and the upper arm swivel joint device on one side of the body are coupled to the shoulder swivel joint device and the upper arm swivel joint device on the other side of the body by means of a coupling device in such a way that a joint movement on one side of the body causes defined joint movement of the corresponding joint device on the other side of the body. Depending on the design of the corresponding coupling device, the induced countermovement can take place in the same direction, in the opposite direction, or also in a defined transmission or reduction ratio.

To prevent unwanted or even harmful movements, for example, you can use the therapy and training device provided joint devices are at least partially provided with devices for limiting joint movements.

In one possible embodiment, the coupling device for coupling the movement of the shoulder swivel joint device is designed as a wheel transmission, wherein the wheel transmission can be designed as a friction wheel or gear transmission.

In a further advantageous embodiment, the coupling device for coupling the movement of the upper arm swivel joint devices is designed as a traction or pressure medium transmission, so that a force transmission with rope or hydraulic fluid can take place for this purpose.

An advantageous modular design of the therapy and training device, which allows easy adaptation to given conditions, is given when the trunk support has a connecting device for connection to a seat frame or generally a seat.

However, the fuselage carrier itself can also be provided with a seat frame, so that the therapy and training device can be used independently of other environmental conditions.

It proves to be particularly advantageous if the seat frame is arranged on the fuselage carrier so that it can be folded out.

An embodiment of the therapy and training device is explained in more detail below with reference to the drawings. Show it:

1 shows an embodiment of a therapy and training device for the shoulder joint in perspective

Representation with the seat frame ready for operation and in neutral position; FIG. 2 shows the therapy and training device according to FIG. 1 with the seat frame folded in; FIG.

3 shows the therapy and training device with an upper arm extension that is longer than that shown in FIG. 1;

4 shows the therapy and training device with the upper arm arm pivoted downward about a transverse axis;

5 shows the therapy and training device with the upper arm arm pivoted upward about the transverse axis;

6 shows the therapy and training device in neutral position and top view;

7 shows the therapy and training device with the shoulder arm pivoted about a vertical axis;

8 shows the therapy and training device with the shoulder arm pivoted out about the vertical axis;

9 shows the therapy and training device with the forearm arm pivoted upward about a transverse axis;

10 shows the therapy and training device with the forearm arm pivoted downward about the transverse axis;

11 shows the therapy and training device with the forearm arm pivoted out about a vertical axis;

12 shows a schematic representation of a first coupling device for coupling the movement of both shoulder arms and a second coupling device for coupling the movement of both upper arm arms of the therapy and training device. 1 shows a therapy and training device 20, which is to be referred to below for short as a therapy device, with a trunk support 21, a swivel joint base 22 arranged on the trunk support 21 and a seat frame 23 also arranged on the trunk support.

The swivel joint base 22 serves to articulate a shoulder / arm joint system 24, which comprises two shoulder / arm joint units 25, 26 which are symmetrical to the swivel joint base 22 or to the trunk support 21, of which only the right shoulder / arm joint unit 25 is shown in more detail below is. The shoulder / arm joint unit 25, like the shoulder / arm joint unit 26, which is not shown in detail, comprises a shoulder arm 27 which is pivotably connected to the swivel joint base 22 about a vertical axis 28 by means of a shoulder swivel joint device 29. The shoulder arm 27, which in the present case is cranked downward, is provided at its distal end with an upper arm swivel joint device 30 in such a way that an arm arm 32 is articulated on the shoulder arm 27 so as to be pivotable about a transverse axis 3 1.

The arm arm 32 has an upper arm arm 33 which is connected directly to the upper arm swivel joint device 30 and a lower arm arm 35 which is articulated via an elbow joint device 34. The elbow joint device 34 enables the forearm arm 35 to be pivoted relative to the upper arm arm 33 about a vertical axis 36 and a transverse axis 37 which extends essentially in the direction of the longitudinal extension of the upper arm arm 33.

1 and 2, the seat frame 23, which is connected to the trunk support 21 via a hinge joint 38, is in the form of a folding frame with a seat plate 39 which can be pivoted against the trunk support 21 and a seat plate 39 which is connected via a hinge joint (not shown) Provide support leg 41. To clarify the proportions and the relative arrangement of the individual parts forming the shoulder / arm joint system 24 or the shoulder / arm joint unit 25, a human body in the sitting position with right-hand extremities is indicated schematically in FIG. 3, with a forearm 42 in one with the Forearm arm 35 is connected position, the right shoulder 43 is located below the shoulder arm 27 and an upper arm 48 extends on the inside to the upper arm arm 33 from the upper arm pivot joint device 30 to the elbow joint device 34.

FIG. 3 furthermore illustrates that the human body is positioned relative to the therapy and training device 20 by means of a positioning device, which in the present case is designed as a neck mount 44 and is part of the swivel joint base 22. The introduction of force for transmission of movement from the shoulder / arm area to the therapy and training device or the shoulder / arm joint system 24 and vice versa takes place via the connection of the forearm 42 to the forearm extension 35 by means of a connecting device 45. In addition, a comparison of FIG. 3 makes 1 clearly shows that the shoulder / arm joint system 24 or the shoulder / arm joint unit 25 can be adapted to the upper extremity of the body by changing the effective length L of the upper arm boom 33, which for this purpose consists of two parts which can be displaced in the longitudinal direction, namely an upper part 46 and a lower part 47. An adjustment of the length of the shoulder arm 27 to the individual body proportions is generally not necessary, but can of course also be provided.

Based on the configuration of the shoulder / arm joint unit 25 shown in FIGS. 1 and 3, here defined as the neutral position, the therapy device 20 in the present embodiment enables the relative positions or movements shown in the following FIGS. 4 to 11. 4 and 5 illustrate the possibility, with the forearm 42 (FIG. 3) connected to the forearm extension 35 via the connecting device 45 (FIG. 3), a forward and backward movement of the entire arm with the forearm 42 angled relative to the upper arm 48 (FIG 3) to be carried out. In this configuration, the forearm extension 35 can be fixed relative to the upper arm extension 33 by setting the elbow joint device 34 in order to set a defined arm flexion angle. The upper arm pivot joint device 30 enables pivoting about the transverse axis 3 1. This forward and backward movement of the upper arm 48 causes a corresponding movement of a shoulder blade 49.

FIG. 12 shows a coupling device 50, which transmits the forward and backward movement carried out with the right body extremity, that is to say here with the upper arm 48, by means of the shoulder / arm joint system 24 to the left upper body extremity, not shown in FIG. 3, and thereby also allows movement induction in the left shoulder. For this purpose, the coupling device 50 acts between the upper arm arm 33 of the right shoulder / arm joint unit 25 shown in FIG. 3 and an upper arm arm 5 1 of the left shoulder / arm joint unit 26 which is assigned to the left upper body extremity. As FIG. 12 shows, the coupling device comprises 50 two power transmission devices designed as deflection cable systems 52, 53. The deflecting rope system 52 acts between two rope pulleys 54, 55, which are arranged on the transverse axis 3 1 of the upper arm pivot joint device 30 in a rotationally fixed manner with the upper arm extension 33 or rotatably on the torso carrier 21. The rope pulley 55 is designed as a double rope pulley and is in a non-positive connection via the deflecting rope system 53 with a further rope pulley 56, which, like the rope pulley 54 on the transverse axis 31 of the upper arm pivot joint device 40 of the left shoulder / arm joint unit 26, is rotatably connected to an upper arm extension 57. By means of the coupling device 50, a pivoting movement of the upper arm arm 33 in the direction of an arrow 58 is thus carried out via the deflecting cable system 52 to the pulley 55 and from the pulley 55 via the deflection cable system 53 to the rotatably connected to the upper arm bracket 57 pulley 56. In the present case, therefore, a pivoting movement of the right upper arm induces a pivoting movement of the left upper arm in the same direction. The induction of a counter-rotating movement is easily possible, for example by means of a crossed cable arrangement of one of the two deflecting cable systems 52, 53.

6 to 8 show a forward and backward movement of the shoulder arm 27 with the forearm arm 35 fixed in its flexion position relative to the upper arm arm 33. In this case, the shoulder arm 27 is pivoted about the vertical axis 28 of the shoulder swivel joint device 29. To transmit this swivel movement starting from the right shoulder / arm joint unit 25 to the left shoulder / arm joint unit 26 (FIG. 6 to 8) (FIG 1) a coupling device 59 shown in FIG. 12 can be used. To transmit the pivoting movement of the right shoulder arm 27, which is pivotably pivoted about the vertical axis 28 in the shoulder pivot joint device 29 to the pivot joint base 22, a bearing end 60 of the shoulder arm 27 is provided with a gear segment 61, which is in engagement with a further gear segment 62, the is formed on a bearing end 63 of a shoulder arm 64 of the left shoulder / arm joint unit 26. Analogously to the bearing end 60, the bearing end 63 of the shoulder arm 64 is mounted in a shoulder swivel joint device 65 of the swivel joint base 22.

The coupling device 59 thus enables a swiveling movement 66 to be transmitted from the right shoulder arm 27 to the left shoulder arm 64, so that, starting from a movement of the right shoulder via the coupling device 59, a corresponding swiveling movement 67 of the left shoulder can be induced. FIGS. 9 and 10 illustrate the pivotability of the forearm extension 35 about the transverse axis 37 of the elbow joint device 34. This pivoting movement can be carried out by means of a coupling device (not shown here) from the right shoulder / arm joint unit 25 to the left shoulder / arm joint unit (not shown in FIG. 9). Arm joint unit 26 are transmitted. But even a motion-decoupled pivotability of the forearm extension 35 of the shoulder / arm joint units 25, 26 enables advantages in the operation of the therapy device 20, since the pivotability of the forearm extension 35 about the transverse axis 37 of the elbow joint devices 34 as well as a pivotability of the forearm extension about the vertical axis 36 (FIG. 11) of the elbow joint devices 34 enable the patient to freely choose the relative position of the forearms relative to the upper arms that is comfortable for him.

Claims

claims

1. Therapy and training device (20) for the shoulder joint with a trunk support (21) which, on a swivel joint base (22), has two shoulder arms (27, 65) which are assigned to a shoulder and which can be swiveled about a vertical axis (28) of a shoulder swivel joint device (29, 65). 64), each of which has an arm arm (32) at a distance from the swivel joint base for connection to an arm which is connected to the shoulder arm so as to be pivotable about a transverse axis (31) via an upper arm swivel joint device (30, 40), the shoulder arm and / or the arm arms are coupled in such a way that a pivoting movement of the one shoulder arm or one arm arm causes a pivoting movement of the other shoulder arm or the other arm arm.

2. Therapy and training device according to claim 1, characterized in that the swivel joint base (22) is assigned a positioning device (44) for relative positioning relative to the spine of a patient.

3. Therapy and training device according to claim 2, characterized in that the positioning device has a neck receptacle (44) that is adjustable in height along the trunk support (21) on the swivel joint base (22).

4. Therapy and training device according to one of the preceding claims, characterized in that the arm extension (22) comprises an upper arm extension (33) and a lower arm extension (35), the upper arm extension via the

Upper arm swivel joint device (30) is connected to the shoulder arm (27), and the lower arm swivel joint is connected to the upper arm arm via an elbow joint device (34) comprising at least one swivel axis (36, 37).

5. Therapy and training device according to claim 4, characterized in that the elbow joint device (34) has two pivot axes (36, 37), a vertical axis (36) transverse to the longitudinal extension of the upper arm arm (33) and a transverse axis (37 ) runs in the direction of the longitudinal extension of the upper arm extension.

6. Therapy and training device according to one of the preceding claims, characterized in that a connection device (45) arranged on the forearm extension (35) is provided for connecting the arm extension (32) to an arm.

7. Therapy and training device according to one of the preceding claims, characterized gek en nz eic hn et that at least one forearm extension arm is provided with an actuating device for triggering a locking device acting on the upper arm swivel joint device, the actuating device being actuated by the associated forearm is moved out of its operating position.

8. Therapy and training device according to one of the preceding claims, characterized in that the effective length of the upper arm extension (33) can be changed between the upper arm swivel joint device (30) and the elbow joint device (34).

9. Therapy and training device according to one of the preceding claims, characterized ge ge ez chne t that at least the shoulder swivel joint device (29) and the upper arm swivel joint device (30) one side of the body with the respective shoulder swivel joint device (65) and the upper arm swivel joint device (40) for coupling the movement other side of the body are coupled by means of a coupling device (50, 59) such that a joint movement on one side of the body brings about a defined joint movement of the corresponding joint device on the other side of the body.

10. Therapy and training device according to claim 9, characterized in that the coupling device (59) for coupling the movement of the

Shoulder pivot joint devices (29, 65) is designed as a wheel gear (61, 62).

11. Therapy and training device according to claim 9, characterized in that the coupling device (50) for coupling the movement of the

Upper arm swivel joint devices (30, 40) is designed as a traction or pressure medium gear (52, 53).

12. Therapy and training device according to one of the preceding claims, characterized g ek ennz e i c hnet that the trunk support has a connecting device for connection to a seat frame.

13. Therapy and training device according to one of claims 1 to 11, characterized in that the trunk support (21) is provided with a seat frame (23).

14. Therapy and training device according to claim 13, characterized g ek enn z e i c hn e t that the seat frame (23) is arranged foldable on the fuselage carrier (21).