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WO2006073374A1 - Orthose exomusculaire - Google Patents

Orthose exomusculaire Download PDF

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Publication number
WO2006073374A1
WO2006073374A1 PCT/SI2005/000039 SI2005000039W WO2006073374A1 WO 2006073374 A1 WO2006073374 A1 WO 2006073374A1 SI 2005000039 W SI2005000039 W SI 2005000039W WO 2006073374 A1 WO2006073374 A1 WO 2006073374A1
Authority
WO
WIPO (PCT)
Prior art keywords
orthosis
elastic element
elastic
exomuscular
shows
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/SI2005/000039
Other languages
English (en)
Inventor
Zlatko Matjacic
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
INSTITUT RS ZA REHABILITACIJO
Original Assignee
INSTITUT RS ZA REHABILITACIJO
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by INSTITUT RS ZA REHABILITACIJO filed Critical INSTITUT RS ZA REHABILITACIJO
Publication of WO2006073374A1 publication Critical patent/WO2006073374A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices ; Anti-rape devices
    • A61F5/01—Orthopaedic devices, e.g. long-term immobilising or pressure directing devices for treating broken or deformed bones such as splints, casts or braces
    • A61F5/0102—Orthopaedic devices, e.g. long-term immobilising or pressure directing devices for treating broken or deformed bones such as splints, casts or braces specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices ; Anti-rape devices
    • A61F5/01—Orthopaedic devices, e.g. long-term immobilising or pressure directing devices for treating broken or deformed bones such as splints, casts or braces
    • A61F5/0102—Orthopaedic devices, e.g. long-term immobilising or pressure directing devices for treating broken or deformed bones such as splints, casts or braces specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations
    • A61F2005/0132—Additional features of the articulation
    • A61F2005/0179—Additional features of the articulation with spring means

Definitions

  • AFO ankle foot orthosis
  • AFO is a very popular orthosis that is used either in drop-foot condition or when a correction of foot posture is needed due to spastic or contractured plantarflexor muscle group.
  • the application of solid AFO will stabilize ankle joint, however it will preclude motion in the ankle joint, thereby changing significantly biomechanical requirements at the knee and hip joints.
  • exoskeletal systems which serve as exoskeletal framework.
  • exoskeletal systems inevitably comprises of artificial joints, which are used to stabilize biological joints and by doing that significantly limit mobility of these joints.
  • exomuscular framework conceptually consists of mechanical cuffs that firmly adhere to pelvis and lower extremities segments that serve as mechanical base for elastic strings of various lengths and mechanical stiffness that are used for correction of joints postures and mechanical stiffness of multi-jointed system.
  • Figure 1 shows a sagittal plane projection of a walking subject
  • Figure 2 shows a sagittal plane projection of a walking subject with addition of the elastic element (5)
  • Figure 3 shows a sagittal plane projection of a walking subject with addition of the elastic element (6)
  • Figure 4 shows a sagittal plane projection of a walking subject with addition of the elastic element (7)
  • Figure 5 shows a sagittal plane projection of a walking subject with addition of the elastic element (8) and elastic element (9);
  • Figure 6 shows a sagittal plane projection of a walking subject with addition of the elastic element (10);
  • Figure 7 shows a sagittal plane projection of a walking subject with addition of the elastic element (11);
  • Figure 8 shows a sagittal plane projection of a walking subject with addition of the elastic element (12) and elastic element (13);
  • Figure 9 shows a sagittal plane projection of a walking subject with addition of the elastic element (14);
  • Figure 10 shows a sagittal plane projection of a walking subject with addition of the elastic element (5);
  • Figure 11 shows a sagittal plane projection of a walking subject with addition of the elastic element (8);
  • Figure 12A conceptual design of elastic elements (5-14);
  • Figure 12B the fixation of elastic elements (5-14) to a designated cuff (1-3);
  • Figure 13A typical requirement when designing mechanical characteristics of elastic elements (5-14);
  • Figure 13B shows force-length graph for two possible stiffness values;
  • Figure 13C shows both possible solutions within single mechanical design of elastic element (8);
  • Figure 14 shows possible addition to the elastic elements (5-
  • Cuff elements embracing the pelvis cuff 1 , thigh cuff 2, shank cuff 3 and shoe fixation framework 4 provide firm base for the remaining of the exomuscular orthosis disclosed in the following figures.
  • Cuff elements 1-3 can be made of appropriate material normally used in orthotics such as polypropylene, while shoe fixation framework 4 can be made of aluminum or other appropriate material that can be shaped in a way to provide firm base.
  • Shoe fixation framework 4 can be conveniently attached to the shoe through the shoe heel.
  • Cuff element 1 can be equipped with straps that can be placed over person shoulder's to enable more even distribution and partially relief of loading forces on the pelvis.
  • FIG. 2 Left side of Figure 2 is similar to Figure 1 with addition of the elastic element 5 which connects anteriorly to pelvis cuff 1 on one end and thigh cuff 2 on the other end.
  • This elastic element 5 should be used to compensate the force of contracture of gluteus maximus muscle (hip extensor) or in case of iliacus muscle weakness (hip flexor).
  • FIG. 2 schematic action of the stretched elastic element 5, which acts to increase hip flexion angle, is shown. Schematics drawn in figures 2 - 8 are all organized in the above described way.
  • FIG. 3 shows the application of elastic element 6, which connects, anteriorly to pelvis cuff 1 on one end and shank cuff 3 on the other end.
  • elastic element 6 mimics the action of biarticular muscle rectus femoris and should be used to compensate the force of contracture of hamstring muscle group (hip extensor, knee flexor) or in case of rectus femoris weakness (hip flexor, knee extensor).
  • the right side of Figure 3 shows action of the strecthed elastic element 6, which acts to increase hip flexion and knee extension angles.
  • FIG. 4 Left side of Figure 4 shows the application of elastic element 7, which connects, anteriorly to thigh cuff 2 on one end and shank cuff 3 on the other end.
  • elastic element 7 mimics the action of vastus muscle group and should be used in case of vastus muscle group weakness (knee extensor).
  • the right side of Figure 4 shows action of the stretched elastic element 7, which acts to increase knee extension angle.
  • FIG. 5 shows the application of elastic element 8, which connects, anteriorly to shank cuff 3 on one end and shoe fixation framework 4 on the other end.
  • elastic element 8 mimics the action of tibialis anterior muscle and should be used to compensate the force of contracture of soleus muscle (ankle plantarflexor) or in case of tibialis anterior weakness (ankle dorsiflexor).
  • elastic element 9 which connects anteriorly to thigh cuff 2 on one end and shoe fixation framework 4 on the other end, is shown. In this way elastic element 9 mimics the action of nonexistent human muscle and should be used to compensate contracture of biarticular gastrocnemius muscle (ankle plantarflexor, knee flexor).
  • the middle graph of Figure 5 shows action of the strecthed elastic element 8, which acts to increase ankle dorsiflexion angle.
  • the right side of Figure 5 shows action of the strecthed elastic element 9, which acts to increase knee extension and ankle dorsiflexion angles.
  • Left side of Figure 6 shows the application of the elastic element 10 which connects posteriorly to pelvis cuff 1 on one end and thigh cuff 2 on the other end.
  • This elastic element 10 should be used to compensate the force of contracture of iliacus muscle (hip flexor) or in case of gluteus maximus muscle weakness (hip extensor).
  • On the right side of Figure 6 schematic action of the stretched elastic element 10, which acts to increase hip extension angle, is shown.
  • FIG. 7 Left side of Figure 7 shows the application of elastic element 11 , which connects, posteriorly to pelvis cuff 1 on one end and shank cuff 3 on the other end.
  • elastic element 11 mimics the action of biarticular hamstring muscle and should be used to compensate the force of contracture of rectus femoris muscle group (hip flexor, knee extensor) or in case of hamstring muscle group weakness (hip extensor, knee flexor).
  • the right side of Figure 11 shows action of the stretched elastic element 11 , which acts to increase hip extension and knee flexion angles.
  • FIG. 8 shows the application of elastic element 12, which connects, posteriorly to shank cuff 3 on one end and shoe fixation framework 4 on the other end.
  • elastic element 12 mimics the action of soleus muscle and should be used in case of soleus muscle weakness (ankle plantarflexor).
  • the application of elastic element 13 which connects posteriorly to thigh cuff 2 on one end and shoe fixation framework 4 on the other end, is shown.
  • elastic element 13 mimics the action of gastrocnemius muscle and should be used in case of biarticular gastrocnemius muscle weakness (ankle plantarflexor, knee flexor).
  • the middle graph of Figure 8 shows action of the stretched elastic element 12, which acts to increase ankle plantarflexion angle.
  • the right side of Figure 5 shows action of the stretched elastic element 13, which acts to increase knee flexion and ankle dorsiflexion angles.
  • Figure 9 shows frontal plane view.
  • Left side of Figure 9 shows the application of elastic element 14 which connects laterally to pelvis cuff 1 on one end and thigh cuff 2 on the other end.
  • Elastic element 14 mimics the action of hip abductors and should be used in case of hip adductors contracture or in case of hip abductor weakness.
  • the right side of Figure 9 shows action of stretched elastic element 14, which acts to increase hip abduction angle.
  • Figure 10 shows possible attachment sites for elastic element 5, which can be used to provide additional action on the hip external rotation in case of hip internal rotators contracture. With shown positioning of elastic element 5 we simultaneously obtain corrective action of hip posture in the sagittal and transverse planes.
  • the right side of Figure 10 shows action of stretched elastic element 5, which acts to increase hip external rotation angle.
  • left side of Figure 11 shows possible attachment sites for elastic element 8, which can be used to provide additional action on the ankle external rotation in case ankle invertors contracture. With shown positioning of elastic element 8 we simultaneously obtain corrective action of ankle posture in the sagittal and frontal planes.
  • the right side of Figure 11 shows action of stretched elastic element 8, which acts to increase ankle eversion angle.
  • all elastic elements 5-14 can be attached to designated cuffs 1-3 or shoe fixation framework 4 in such a way to act also in other planes of particular joint motion.
  • Figure 12A shows conceptual design of elastic elements 5 -14, which consists of three parts: rigid part 17, made of very stiff fabric or other suitable material, elastic band 18, made of stretchable fabric or other suitable material and rigid part 19 with holes 20, made of very stiff fabric or other suitable material.
  • Figure 12B shows the fixation of elastic elements 5-14 to a designated cuff 1-3 or shoe fixation framework 4. Rigid part 19 with holes 20 is attached through one of the holes 20 to a designated cuff 1-3 or shoe fixation framework 4 by means of fixation element 21 while rigid part 17 is connected at the free end to a ski-boot type of clip 16, which consists of steel wire loop and solid handle. Clip 16 is used to attach and stretch elastic elements 5-14 on a hook element 15, which is imbedded into a designated cuff 1-3.
  • Figure 13A shows typical requirement when designing mechanical characteristics of elastic elements 5-14. This is done on the example of elastic element 8 characteristics when counteracting soleus muscle contracture in the ankle joint. In order to overcome resulting static force of soleus muscle contracture and positioning the ankle joint to a desired posture elastic element 8 have to be of length / and should sustain force F 0 .
  • Figure 13B shows force-length graph for two possible stiffness values. It is clear that required force F 0 can be obtained within lower stiffness K if it is stretched for length d 2 and also with higher stiffness 2K if stretched for lenght (J 1 .
  • Figure 13C shows both possible solutions within single mechanical design of elastic element 8.
  • Left graph shows elastic element 8 in resting state.
  • Elastic band 18 as shown in Figure 12A is composed from two elastic bands 22, 23, while rigid part 19 has two holes 24, 25 separated in the distance (J 2 -Cl 1 .
  • the middle graph shows stretched elastic element 8 in such a way that both elastic bands 22, 23 are engaged and stretched, while the rigid part with holes 19 should be attached through lower hole 25.
  • the right graph shows situation when only one elastic band 22 is engaged and stretched, while the rigid part 19 with holes 24, 25 should be attached through higher hole 24.
  • F 0 In both cases we obtain required length / and required force F 0 of elastic element 8.
  • the stiffness of the elastic element 8 is 2K
  • the stiffness is only K.
  • This principle can be extended to more elastic bands 22, 23 and more holes 24, 25 that can be more closely positioned. In such way we can easily change dynamic properties of each elastic element 5-14. With the described concept we can design orthosis that allow us much better selection of biomechanical characteristics of the lower limb - orthosis interaction.
  • Figure 14 shows a possible addition to the elastic elements 5-14.
  • another element 26 which is longer than both elastic bands 22, 23 and as such slack and does not contribute to force generation when the whole structure is at resting length.
  • elastic element 5-14 When elastic element 5-14 is stretched it exhibits stiffness 2K as long as stretch is shorter than d ⁇ as displayed on the graph at the right side of Figure 14.
  • Elastic elements 5-14 can be of two different lengths, one for uniarticular muscles and the other for Particular muscles. Since elastic elementsm 5 -14 are composed also from rigid part 19 with holes 20,24,25, which can be longer and have more holes than presented in Figure 13C, elastic elements 5-14 of same size can accommodate different heights and segment lengths. We can imagine that for example three different sizes would be sufficient to cover geometric requirements ranging from small children to adults. Due to the proposed conceptual design of elastic elements they can easily be adjusted to desired length /, providing required force F 0 and exhibiting dynamic stiffness depending on the needs of particular patient. The same physical system can be re-adjusted as the biomechanical requirements (due to reduced spasticity of particular muscles for example) change through course of training.

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  • Health & Medical Sciences (AREA)
  • Nursing (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Orthopedics, Nursing, And Contraception (AREA)
  • Rehabilitation Tools (AREA)

Abstract

L’invention concerne une orthose exomusculaire permettant de contrer le fonctionnement pathologique de groupes musculaires particuliers en permettant la restauration de posture de segments de membre inférieur et en permettant la sélection de rigidité mécanique des éléments d’orthose. Elle concerne une orthose exomusculaire comprenant des manchons (1,2,3) et un cadre de fixation de chaussure (4) connectés mutuellement avec des éléments élastiques (5 -14), où chaque élément élastique (5-14) se compose de pièces rigides (17,19) avec une bande élastique intermédiaire (18) ou des bandes (22,23). Une pièce rigide (17) est fixée sur un élément à crochet (15) d’un manchon supérieur (1,2,3) et une pièce rigide (19) est montée avec un élément de fixation (21) sur un manchon inférieur (2, 3) ou un cadre de fixation de chaussure (4) par l’intermédiaire d’un trou désiré (20, 24,25).
PCT/SI2005/000039 2005-01-07 2005-12-12 Orthose exomusculaire Ceased WO2006073374A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
SI200500006 2005-01-07
SIP-200500006 2005-01-07

Publications (1)

Publication Number Publication Date
WO2006073374A1 true WO2006073374A1 (fr) 2006-07-13

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Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/SI2005/000039 Ceased WO2006073374A1 (fr) 2005-01-07 2005-12-12 Orthose exomusculaire

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WO (1) WO2006073374A1 (fr)

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4100918A (en) * 1977-03-25 1978-07-18 Indiana University Foundation Dynamic orthotic knee extension assist device
US4556054A (en) * 1983-11-21 1985-12-03 Paulseth Stephen G Ankle orthosis
US4865023A (en) * 1988-04-20 1989-09-12 Craythorne Colin M Ankle support apparatus
DE4239789A1 (de) * 1992-11-26 1994-06-01 Faust Mueller Christa Vorrichtung zur Haltungsverbesserung bzw. -korrektur und Verwendung dieser Vorrichtung
US6213922B1 (en) * 1992-01-31 2001-04-10 Ajurveda Device for treatment of patients with disturbed posture and motor activity
WO2002065942A2 (fr) * 2001-02-15 2002-08-29 Spaulding Rehabilitation Hospital Corporation Orthese pedi-jambiere permettant d'assister le couple des muscles de flexion plantaire

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4100918A (en) * 1977-03-25 1978-07-18 Indiana University Foundation Dynamic orthotic knee extension assist device
US4556054A (en) * 1983-11-21 1985-12-03 Paulseth Stephen G Ankle orthosis
US4865023A (en) * 1988-04-20 1989-09-12 Craythorne Colin M Ankle support apparatus
US6213922B1 (en) * 1992-01-31 2001-04-10 Ajurveda Device for treatment of patients with disturbed posture and motor activity
DE4239789A1 (de) * 1992-11-26 1994-06-01 Faust Mueller Christa Vorrichtung zur Haltungsverbesserung bzw. -korrektur und Verwendung dieser Vorrichtung
WO2002065942A2 (fr) * 2001-02-15 2002-08-29 Spaulding Rehabilitation Hospital Corporation Orthese pedi-jambiere permettant d'assister le couple des muscles de flexion plantaire

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