WO2011128588A1 - Dynamic orthosis of the type lifting the foot - Google Patents
Dynamic orthosis of the type lifting the foot Download PDFInfo
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- WO2011128588A1 WO2011128588A1 PCT/FR2011/050847 FR2011050847W WO2011128588A1 WO 2011128588 A1 WO2011128588 A1 WO 2011128588A1 FR 2011050847 W FR2011050847 W FR 2011050847W WO 2011128588 A1 WO2011128588 A1 WO 2011128588A1
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- sole
- rod
- foot
- dynamic
- cavity
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- 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
- A61F5/0104—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 without articulation
- A61F5/0111—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 without articulation for the feet or ankles
- A61F5/0113—Drop-foot appliances
Definitions
- the invention relates, in a general manner, to the technical field of orthopedics. It relates, more particularly, a dynamic orthosis of the type called "foot lifter", which improves the walking pattern of patients with a partial or total deficit of the dorsal flexor muscles of the ankle.
- This deficit which can be unilateral or bilateral, is common to many pathologies of various origins, central or peripheral.
- the consequence of such a muscle deficit is to have a dangling foot, that is to say to be unable to perform a dorsal flexion of the ankle or to maintain an angle of ankle neutral, in other words, an angle of 90 °. All the motor tasks requiring the muscle group that is in deficit here, such as walking in particular, are then largely affected.
- the foot lift type orthoses generally used in combination with a shoe, have the main function of avoiding these problems, preventing excessive plantar flexion and therefore excessive lowering of the foot, when the latter is in suspension.
- Such articulation systems comprise one or more mechanically de fi ned axes, and do not by themselves create a damping effect.
- these known foot lifts offer freedom of movement more or less important, and they may also include mechanical assistance to bring the angle of the ankle to a defined value.
- the present invention aims to overcome the various disadvantages mentioned above, and its purpose is, in particular, to provide a foot lifter providing patients with a walking pattern as close as possible to that observed in healthy subjects, both during the oscillating phase that during the support phase, while maintaining a simple, lightweight and sufficiently resistant.
- the subject of the invention is a dynamic foot lift orthosis, of the type comprising a hinge system located at the level of the ankle, and interposed between a shaft having at its upper end a leg embrace, a part, and a sole provided to take place under the foot, on the other hand, this foot lifter being essentially characterized by the fact that the articulation system is a damping system consisting of an elastically deformable interface, interposed between the lower end of the rod, on the one hand, and the upper rear portion of the sole, on the other hand, said elastic interface comprising a cavity accommodating an elastically deformable material and secured to the upper rear portion of the sole, the end base of the rod being in contact with the elastic material filling the cavity, this elastic interface ensuring freedom of movement in the sagittal planes and / or fronts tal, while having a damping effect.
- the configuration of the elastic interface does not here produce a hinge about a mechanically defined axis, while allowing a variation of the angle formed by
- the cavity of the elastic interface is formed integrally with the sole.
- the lower end of the stem is advantageously mechanically linked to a point of attachment, for example by means of a screw, to the upper rear part of the sole.
- the rod may be constituted by a blade of elastically deformable material, for example stainless steel or composite material, spring blade type. A simple hole in this blade allows the passage of the connecting screw with the sole.
- the elastically deformable material is preferably held in place in the cavity by an adhesive device, applied to the corresponding surfaces of this material and the cavity, or by mechanical means.
- This elastically deformable material is advantageously a polymer, such as rubber or latex. The choice of the polymer, among many polymers with different elastic characteristics, makes it possible to better adapt the orthosis to the expectations and needs of the patients.
- the angle defined by the longitudinal axis of the rod, and the surface of the sole, can be between 80 ° and 1 10 °, when the orthosis is not subjected to any stress.
- the foot lift-type orthosis object of the invention, comprises at least two reinforcements that protrude under the underside of the sole at the level of the front zone. foot, the height of the reinforcements not being constant over their entire length, so that these reinforcements have a maximum height zone.
- the damping system controls the abatement of the foot on the ground following the installation of the heel during the attack of a step, or controls the closure of the ankle angle during the support phase, and offers a freedom articular corresponding to eversion / inversion movements
- the rigidity induced by the presence of reinforcements offers the patient a safe support surface and reproduces the unfolding of the foot on the ground at the end of the support phase, during walking.
- the zone of maximum height of each reinforcement is advantageously located in line with the area of the upper face of the sole which, in use, supports the metatarsal bar of the foot.
- the tipping point formed by such a zone of maximum height reinforcements under the sole, promotes the course of the step ensuring continuity of movement, this in combination with the elastically deformable interface which plays a vital role during the various phases a walk.
- the reinforcements are two in number, the respective longitudinal axes of these two reinforcements being divergent from the rear to the front of the sole.
- Each of these two reinforcements is advantageously of increasing height, from the ends of the reinforcement to the zone of maximum height located at an intermediate point of the length of the reinforcement.
- Figure 1 is an overall perspective view of a foot lifter according to the present invention
- FIG. 2 is a perspective view showing, on an enlarged scale, the detail of the zone of the damping system of this foot lifter,
- Fig ure 3 is a view from the rear of this zone of the damper system
- FIG. 4 is a vertical sectional view of the elastically deformable interface constituting the damping system
- Figure 5 is a partial side view of this foot lifter, showing more particularly the sole with its reinforcements
- Figure 6 is a bottom view of the sole
- Figure 7 is a diagram illustrating the operation of the foot lifter object of the invention, during the successive phases of walking,
- Figure 8 is a sectional view similar to Figure 4, illustrating a variant of this foot lifter.
- the foot lifter comprises a sole 2 and a stem 3, which take place respectively, in use, under the foot of the patient and behind the leg of the patient.
- the low end 3a of the rod 3 is connected, by a damping system 4, to the upper rear portion 2a of the sole 2.
- the rod 3 is constituted by a blade of elastically deformable material, for example stainless steel or composite material, which is in particular of the lameressort type.
- the upper end 3b of this rod 3 carries a leg embrace 5, designed to grip the upper part of the leg of the patient.
- the leg brace 5 is adjustable to the size of the leg for example by a hook and loop closure system.
- the sole 2 made of polyolefin such as polypropylene, has an upper face 6 which corresponds to the shape and dimensions of the patient's arch. Under its inner face 7, the sole 2 comprises two longitudinal reinforcements 8 and 9, detailed below, located under the forefoot zone.
- the material of this soleplate forms a cavity 10 open upwards, the horizontal section of the cavity 10 being greater than that of the rod 3.
- the cavity 10 is filled with an elastically deformable material 11 which may be a polymer.
- the lower end 3a of the rod 3 is engaged in the cavity 1 0 and is in contact with the elastic material January 1.
- this lower end 3a of the rod 3 is secured mechanically with the upper rear portion 2a of the sole 2 by means of a screw 12, located at the base of the cavity 10 and passing through a hole in the rod 3.
- the corresponding surfaces of this elastic material January 1 and the cavity 10 are secured by an adhesive 13, which may be glue of appropriate nature (see Figure 4).
- the elastic material 11 is held in the cavity 10 by a simple mechanical means, for example by an interlocking principle.
- the arrangement of the damping system 4 is such that, when the foot lifter is not subjected to any stress, the angle defined by the longitudinal axis of the rod 3, on the one hand, and by the average plane of the sole 2, on the other hand, is between 80 ° and 1 10 ° (see Figure 5).
- the choice of this angle a is likely to influence the walking pattern described below.
- this damping system 4 provides freedom of movement in the Sagittal plane, as indicated by the arrows F1 ( Figure 2) and also in the frontal plane, as indicated by the arrows F2 ( Figure 3).
- the two reinforcements 8 and 9 have a length L, and are arranged slightly divergent from the rear to the front of the sole 2.
- This zone of maximum height of each reinforcement 8 or 9 is located in line with the area of the upper face 6 of the sole 2 which supports the metatarsal bar of the patient's foot.
- Reinforcements 8 and 9 thus formed and localized, stiffen the front portion of the foot, while facilitating the unwinding of the foot during walking, providing a tipping point at the forefoot during the course of the step, ensuring the continuity of the movement.
- the operation of the foot lifter is as follows when walking:
- position B the dorsal flexion movement of the ankle is assisted by the restitution of the stored energy, in the previous phase, during the compression of the elastic material 1 1 and / or the back flexion of the stem 3.
- position C the ankle angle is neutral.
- the elastic material 11 and the rod 3 are temporarily subject to no stress.
- End of support or propulsion phase (position D): the rod 3 deforms in bending forward, while the foot is “unwound” by tilting around the maximum height zone reinforcements 8 and 9, which ensures the continuity of the "unfolding" of the foot.
- - Oscillating phase (E position): the stiffness of the damping system 4 and the constituent materials of the rod 3 and the sole 2 allows the foot to be maintained with an ankle angle may be between 80 ° and 1 10 ° , while the foot does not touch the ground anymore. The orthesis then fully plays its role of "foot lifter".
- the lower end 3a of the rod 3 is positioned in the cavity 10 in front of the elastic material January 1, which allows the elastic material January 1 to intervene especially in the pitch attack phase by the heel, as described above.
- the lower end 3a of the rod 3 is positioned, in the cavity 10, behind the elastic material 11.
- the operation of the foot lifter is more oriented towards that of an anti-collapse damping system, intervening during the support phase, in case of muscle deficit of the plantar flexors.
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Abstract
Description
Orthèse dynamique de type releveur de pied Dynamic foot lift type orthosis
L'invention concerne, d'une façon générale, le domaine technique de l'orthopédie. Elle a pour objet, plus particulièrement, une orthèse dynamique du type dit « releveur de pied », qui permet d'améliorer le schéma de marche de patients ayant un déficit partiel ou total des muscles fléchisseurs dorsaux de la cheville. The invention relates, in a general manner, to the technical field of orthopedics. It relates, more particularly, a dynamic orthosis of the type called "foot lifter", which improves the walking pattern of patients with a partial or total deficit of the dorsal flexor muscles of the ankle.
Ce déficit, qui peut être unilatéral ou bilatéral, est commun à de nombreuses pathologies d'origines diverses, centrale ou périphérique. La conséquence d'un tel déficit musculaire est d'avoir un pied ballant, c'est-à-dire d'être dans l'incapacité d'effectuer une flexion dorsale de la cheville ou de mainten ir un angle de chevil le neutre, autrement dit un angle de 90°. L'ensemble des tâches motrices sollicitant le groupe musculaire ici déficitaire, comme la marche en particulier, sont alors largement affectées. Ainsi, la crainte d'une chute liée à la possibilité d'accrocher le sol avec la pointe du pied, lors de la phase oscillante de la marche, conduit le patient à développer des stratégies motrices de compensation, telles que le steppage (flexion excessive de la hanche) ou le fauchage (genou en extension associé à une circumduction de la hanche à concavité interne), qui perturbent sensiblement les performances motrices. This deficit, which can be unilateral or bilateral, is common to many pathologies of various origins, central or peripheral. The consequence of such a muscle deficit is to have a dangling foot, that is to say to be unable to perform a dorsal flexion of the ankle or to maintain an angle of ankle neutral, in other words, an angle of 90 °. All the motor tasks requiring the muscle group that is in deficit here, such as walking in particular, are then largely affected. Thus, the fear of a fall linked to the possibility of hitching the ground with the tip of the foot, during the oscillating phase of walking, leads the patient to develop compensatory motor strategies, such as stepping (excessive bending hip) or mowing (knee extension associated with circumjunctive hip concavity internal), which significantly disrupt motor performance.
Les orthèses de type releveur de pied, généralement utilisées en association avec une chaussure, ont pour principale fonction d'éviter ces problèmes, en prévenant une flexion plantaire excessive donc un abaissement excessif du pied, lorsque ce dernier est en suspension. De nombreuses réalisations de releveurs de pied, avec ou sans articulation au niveau de la cheville, ont été déjà proposées à cet effet. The foot lift type orthoses, generally used in combination with a shoe, have the main function of avoiding these problems, preventing excessive plantar flexion and therefore excessive lowering of the foot, when the latter is in suspension. Many achievements of foot lifts, with or without articulation at the ankle, have already been proposed for this purpose.
La plupart des releveurs de pied sont excessivement rigides, et se présentent ainsi comme une orthèse monobloc, dépourvue d'articulation, en forme générale d 'équerre, avec u ne branche « verticale » munie d'une embrasse jambière et une branche « horizontale » prenant place sous le pied - voir par exemple le document de brevet GB 2 188 550 A. Lors du port de ce genre de releveur de pied, les libertés articulaires sont plus ou moins restreintes, avec pour conséquence fonctionnelle majeure l'apparition d'une marche dite « saccadée ». Most foot lifts are excessively rigid, and thus present as a one-piece orthosis, devoid of articulation, in the general shape of a square, with a "vertical" branch provided with a leg embrace and a "horizontal" branch taking place under the foot - see for example the patent document GB 2 188 550 A. When wearing this type of foot lifter, the freedom of the joints are more or less restricted, with the major functional consequence of the appearance of a so-called "jerky" walk.
Pour diminuer cette conséquence néfaste et ainsi tenter de To reduce this harmful consequence and thus to try to
« fluidifier » la marche, quelques releveurs de pied connus présentent dessystèmes d'articulation situés au niveau de la cheville. - voir par exemple l es docu ments d e brevets WO02/065942A2, US2003/0153859A1 et US 6102881 A. "Fluidify" the walk, some known foot lifters present articulation systems located at the level of the ankle. see for example WO02 / 065942A2, US2003 / 0153859A1 and US 6102881A.
De tels systèmes d'articulation comportent un ou plusieurs axes méca n iq u em ent défi n is , et ne créent pas par eux-mêmes un effet d'amortissement. Such articulation systems comprise one or more mechanically de fi ned axes, and do not by themselves create a damping effect.
Grâce à leur système d'articulation, interposé entre une tige pouvant comporter à son extrémité haute une embrasse jambière, d'une part, et une semelle prenant place sous le pied, d'autre part, ces releveurs de pied connus offrent des libertés articulaires plus ou moins importantes, et ils peuvent aussi comporter une assistance mécanique pour ramener l'angle de la cheville à une valeur définie. Thanks to their articulation system, interposed between a rod that may have at its upper end a leg warmer, on the one hand, and a sole taking place under the foot, on the other hand, these known foot lifts offer freedom of movement more or less important, and they may also include mechanical assistance to bring the angle of the ankle to a defined value.
Au vu de ce qui précède, les réalisations existantes sont, pour la plupart, compliquées à fabriquer et à mettre en place, lourdes à porter, difficilement réglables et/ou fragiles. In view of the above, the existing achievements are, for the most part, complicated to manufacture and set up, heavy to wear, difficult to adjust and / or fragile.
La présente invention a pour but de pallier aux divers inconvénients précédemment évoqués, et son but est, en particulier, de fournir un releveur de pied offrant aux patients un schéma de marche aussi proche que possible de celui observé chez des sujets en bonne santé, tant lors de la phase oscillante que lors de la phase d'appui, tout en conservant une réalisation simple, légère et suffisamment résistante. The present invention aims to overcome the various disadvantages mentioned above, and its purpose is, in particular, to provide a foot lifter providing patients with a walking pattern as close as possible to that observed in healthy subjects, both during the oscillating phase that during the support phase, while maintaining a simple, lightweight and sufficiently resistant.
A cet effet, l'invention a pour objet une orthèse dynamique de type releveur de pied, du genre comportant un système d'articulation situé au niveau de la cheville, et interposé entre une tige comportant à son extrémité haute une embrasse jambière, d'une part, et une semelle prévue pour prendre place sous le pied, d'autre part, ce releveur de pied étant essentiellement caractérisé par le fait que le système d'articulation est un système amortisseur constitué par une interface élastiquement déformable, interposée entre l'extrémité basse de la tige, d'une part, et la partie arrière haute de la semelle, d'autre part, ladite interface élastique comprenant une cavité accueillant un matériau élastiquement déformable et solidaire de la partie arrière haute de la semelle, l'extrémité basse de la tige étant en contact avec le matériau élastique rempl issant la cavité, cette interface élastique assurant une liberté de mouvement dans les plans sagittal et/ou frontal, tout en ayant un effet d'amortissement. On notera que la configuration de l'interface élastique ne réalise pas ici une articulation autour d'un axe mécan iquement défini, tout en permettant une variation de l'angle formé par la tige et la semelle du releveur de pied, avec un effet d'amortissement. For this purpose, the subject of the invention is a dynamic foot lift orthosis, of the type comprising a hinge system located at the level of the ankle, and interposed between a shaft having at its upper end a leg embrace, a part, and a sole provided to take place under the foot, on the other hand, this foot lifter being essentially characterized by the fact that the articulation system is a damping system consisting of an elastically deformable interface, interposed between the lower end of the rod, on the one hand, and the upper rear portion of the sole, on the other hand, said elastic interface comprising a cavity accommodating an elastically deformable material and secured to the upper rear portion of the sole, the end base of the rod being in contact with the elastic material filling the cavity, this elastic interface ensuring freedom of movement in the sagittal planes and / or fronts tal, while having a damping effect. It will be noted that the configuration of the elastic interface does not here produce a hinge about a mechanically defined axis, while allowing a variation of the angle formed by the stem and the sole of the foot lifter, with an effect of 'amortization.
Dans un mode de réalisation simple, la cavité de l'interface élastique est formée d'un seul tenant avec la semelle. In a simple embodiment, the cavity of the elastic interface is formed integrally with the sole.
L'extrémité basse de la tige est avantageusement liée de façon mécanique en un point de fixation, par exemple au moyen d'une vis, à la partie arrière haute de la semelle. The lower end of the stem is advantageously mechanically linked to a point of attachment, for example by means of a screw, to the upper rear part of the sole.
La tige peut être constituée par une lame en matériau élastiquement déformable, par exemple en acier inoxydable ou en matériau composite, du type lame ressort. Un simple trou ménagé dans cette lame permet le passage de la vis de liaison avec la semelle. The rod may be constituted by a blade of elastically deformable material, for example stainless steel or composite material, spring blade type. A simple hole in this blade allows the passage of the connecting screw with the sole.
Le matériau élastiquement déformable est, de préférence, maintenu en place dans la cavité par un dispositif adhésif, appliqué sur les surfaces correspondantes de ce matériau et de la cavité, ou par un moyen mécanique. Ce matériau élastiquement déformable est avantageusement un polymère, tel que caoutchouc ou latex. Le choix du polymère, parmi de nombreux polymères aux caractéristiques élastiques différentes, permet d'adapter au mieux l'orthèse aux attentes et besoins des patients. The elastically deformable material is preferably held in place in the cavity by an adhesive device, applied to the corresponding surfaces of this material and the cavity, or by mechanical means. This elastically deformable material is advantageously a polymer, such as rubber or latex. The choice of the polymer, among many polymers with different elastic characteristics, makes it possible to better adapt the orthosis to the expectations and needs of the patients.
L'angle défini par l'axe longitudinal de la tige, et par la surface de la semelle, peut être compris entre 80° et 1 10°, lorsque l'orthèse n'est soumise à aucune contrainte. The angle defined by the longitudinal axis of the rod, and the surface of the sole, can be between 80 ° and 1 10 °, when the orthosis is not subjected to any stress.
En combinaison avec la configuration précédemment définie de son système amortisseur, l'orthèse de type releveur de pied, objet de l'invention, comporte au moins deux renforts qu i font saillie sous la face inférieure de la semelle au niveau de la zone avant du pied, la hauteur des renforts n'étant pas constante sur toute leur longueur, de sorte que ces renforts présentent une zone de hauteur maximale. In combination with the previously defined configuration of its damper system, the foot lift-type orthosis, object of the invention, comprises at least two reinforcements that protrude under the underside of the sole at the level of the front zone. foot, the height of the reinforcements not being constant over their entire length, so that these reinforcements have a maximum height zone.
Alors que le système amortisseur contrôle l'abattement du pied au sol qui suit la pose du talon lors de l'attaque d'un pas, ou contrôle la fermeture de l'angle de cheville pendant la phase d'appui, et offre une liberté articulaire correspondant aux mouvements d'éversion/inversion, la rigidité induite par la présence des renforts offre au patient une surface d'appui sûre et reproduit le déroulement du pied au sol en fin de phase d'appui, lors de la marche. La zone de hauteur maximale de chaque renfort est avantageusement située à l'aplomb de la zone de la face supérieure de la semelle qui, en utilisation, supporte la barre métatarsienne du pied. While the damping system controls the abatement of the foot on the ground following the installation of the heel during the attack of a step, or controls the closure of the ankle angle during the support phase, and offers a freedom articular corresponding to eversion / inversion movements, the rigidity induced by the presence of reinforcements offers the patient a safe support surface and reproduces the unfolding of the foot on the ground at the end of the support phase, during walking. The zone of maximum height of each reinforcement is advantageously located in line with the area of the upper face of the sole which, in use, supports the metatarsal bar of the foot.
Le point de bascule, formé par une telle zone de hauteur maximale des renforts sous la semelle, favorise le déroulement du pas en assurant la continuité du mouvement, ceci en combinaison avec l'interface élastiquement déformable qui joue un rôle primordial au cours des différentes phases de la marche. The tipping point, formed by such a zone of maximum height reinforcements under the sole, promotes the course of the step ensuring continuity of movement, this in combination with the elastically deformable interface which plays a vital role during the various phases a walk.
Dans un mode de réalisation, les renforts sont au nombre de deux, les axes longitudinaux respectifs de ces deux renforts étant divergents de l'arrière vers l'avant de la semelle. Chacun de ces deux renforts est avantageusement de hauteur croissante, depuis les extrémités du renfort vers la zone de hauteur maximale située en un point intermédiaire de la longueur du renfort. In one embodiment, the reinforcements are two in number, the respective longitudinal axes of these two reinforcements being divergent from the rear to the front of the sole. Each of these two reinforcements is advantageously of increasing height, from the ends of the reinforcement to the zone of maximum height located at an intermediate point of the length of the reinforcement.
L'invention sera mieux comprise à l'aide de la description qui suit, en référence au dessin schématique annexé représentant, à tire d'exemples, quelques formes d'exécution de cette orthèse dynamique de type releveur de pied. The invention will be better understood with the aid of the description which follows, with reference to the appended schematic drawing showing, by way of examples, some embodiments of this dynamic foot lift type orthosis.
Figure 1 est une vue d'ensemble, en perspective, d'un releveur de pied conforme à la présente invention, Figure 1 is an overall perspective view of a foot lifter according to the present invention,
Figure 2 est une vue en perspective montrant, à échelle agrandie, le détail de la zone du système amortisseur de ce releveur de pied, FIG. 2 is a perspective view showing, on an enlarged scale, the detail of the zone of the damping system of this foot lifter,
Fig ure 3 est une vue par l'arrière de cette zone du système amortisseur, Fig ure 3 is a view from the rear of this zone of the damper system,
Figure 4 est une vue en coupe verticale de l'interface élastiquement déformable, constituant le système amortisseur, FIG. 4 is a vertical sectional view of the elastically deformable interface constituting the damping system,
Figure 5 est une vue de côté partielle de ce releveur de pied, montrant plus particulièrement la semelle avec ses renforts, Figure 5 is a partial side view of this foot lifter, showing more particularly the sole with its reinforcements,
Figure 6 est une vue de dessous de la semelle, Figure 6 is a bottom view of the sole,
Figure 7 est un schéma illustrant le fonctionnement du releveur de pied objet de l'invention, lors des phases successives de la marche, Figure 7 is a diagram illustrating the operation of the foot lifter object of the invention, during the successive phases of walking,
Figure 8 est une vue en coupe similaire à la figure 4, illustrant une variante de ce releveur de pied. Figure 8 is a sectional view similar to Figure 4, illustrating a variant of this foot lifter.
En se référant d'abord à la figure 1 , le releveur de pied comprend une semelle 2 et une tige 3, qui prennent place respectivement, en utilisation, sous le pied du patient et derrière la jambe du patient. L'extrémité basse 3a de la tige 3 est reliée, par un système amortisseur 4, à la partie arrière haute 2a de la semelle 2. Referring first to Figure 1, the foot lifter comprises a sole 2 and a stem 3, which take place respectively, in use, under the foot of the patient and behind the leg of the patient. The low end 3a of the rod 3 is connected, by a damping system 4, to the upper rear portion 2a of the sole 2.
La tige 3 est constituée par une lame en matériau élastiquement déformable, par exemple en acier inoxydable ou en matériau composite, qui est en particulier du type lameressort. L'extrémité haute 3b de cette tige 3 porte une embrasse jambière 5, prévue pour enserrer la partie haute de la jambe du patient. The rod 3 is constituted by a blade of elastically deformable material, for example stainless steel or composite material, which is in particular of the lameressort type. The upper end 3b of this rod 3 carries a leg embrace 5, designed to grip the upper part of the leg of the patient.
L'embrasse jambière 5 est ajustable à la grosseur de la jambe par exemple par un système de fermeture auto-agrippant. The leg brace 5 is adjustable to the size of the leg for example by a hook and loop closure system.
La semelle 2, réalisable en polyoléfine telle que polypropylène, possède une face supérieure 6 qui correspond à la forme et aux dimensions de la voûte plantaire du patient. Sous sa face intérieure 7, la semelle 2 comporte deux renforts longitudinaux 8 et 9, détaillés plus bas, situés sous la zone avant du pied. The sole 2, made of polyolefin such as polypropylene, has an upper face 6 which corresponds to the shape and dimensions of the patient's arch. Under its inner face 7, the sole 2 comprises two longitudinal reinforcements 8 and 9, detailed below, located under the forefoot zone.
Dans la partie arrière haute 2a de la semelle 2, comme le montrent plus particulièrement les figures 2 à 4, le matériau de cette semelle forme une cavité 1 0 ouverte vers le haut, la section horizontale de la cavité 10 étant supérieure à celle de la tige 3. La cavité 10 est remplie d'un matériau élastiquement déformable 1 1 pouvant être un polymère. L'extrémité basse 3a de la tige 3 est engagée dans la cavité 1 0 et se trouve en contact avec le matériau élastique 1 1 . De plus, cette extrémité basse 3a de la tige 3 est solidarisée mécaniquement avec la partie arrière haute 2a de la semelle 2 au moyen d'une vis 12, située à la base de la cavité 10 et traversant un trou de la tige 3. In the upper rear part 2a of the sole 2, as shown more particularly in FIGS. 2 to 4, the material of this soleplate forms a cavity 10 open upwards, the horizontal section of the cavity 10 being greater than that of the rod 3. The cavity 10 is filled with an elastically deformable material 11 which may be a polymer. The lower end 3a of the rod 3 is engaged in the cavity 1 0 and is in contact with the elastic material January 1. In addition, this lower end 3a of the rod 3 is secured mechanically with the upper rear portion 2a of the sole 2 by means of a screw 12, located at the base of the cavity 10 and passing through a hole in the rod 3.
Pour maintenir le matériau élastique 1 1 dans la cavité 10, les surfaces correspondantes de ce matériau élastique 1 1 et de la cavité 10 sont solidarisées par un adhésif 13, pouvant être de la colle de nature appropriée (voir figure 4). En variante, le matériau élastique 1 1 est maintenu dans la cavité 1 0 par u n moyen mécan iq ue simple, par exem ple par un principe d'emboîtement. To maintain the elastic material 1 1 in the cavity 10, the corresponding surfaces of this elastic material January 1 and the cavity 10 are secured by an adhesive 13, which may be glue of appropriate nature (see Figure 4). As a variant, the elastic material 11 is held in the cavity 10 by a simple mechanical means, for example by an interlocking principle.
L'agencement du système amortisseur 4 est tel que, lorsque le releveur de pied n'est soumis à aucune contrainte, l'angle a défini par l'axe longitudinal de la tige 3, d'une part, et par le plan moyen de la semelle 2, d'autre part, est compris entre 80° et 1 10°(voir figure 5). Le choix de cet angle a est susceptible d'influer sur le schéma de marche décrit plus bas. On notera aussi que ce système amortisseur 4 procure une liberté de mouvement dans le plan sagittal, comme l'indiquent les flèches F1 (figure 2) et aussi dans le plan frontal, comme l'indiquent les flèches F2 (figure 3). The arrangement of the damping system 4 is such that, when the foot lifter is not subjected to any stress, the angle defined by the longitudinal axis of the rod 3, on the one hand, and by the average plane of the sole 2, on the other hand, is between 80 ° and 1 10 ° (see Figure 5). The choice of this angle a is likely to influence the walking pattern described below. It will also be noted that this damping system 4 provides freedom of movement in the Sagittal plane, as indicated by the arrows F1 (Figure 2) and also in the frontal plane, as indicated by the arrows F2 (Figure 3).
En se référant aux figures 5 et 6, les deux renforts 8 et 9 possèdent une longueur L, et sont disposés de façon légèrement divergente, de l'arrière vers l'avant de la semelle 2. La hauteur de chaque renfort 8 ou 9, sous la face inférieure 7 de la semelle 2, part d'une valeur nulle aux deux extrémités 14 et 15 du renfort, pour croître jusqu'à une hauteur maximale H dans une zone intermédiaire de la longueur L du renfort. Cette zone de hauteur maximale de chaque renfort 8 ou 9 se situe à l'aplomb de la zone de la face supérieure 6 de la semelle 2 qui supporte la barre métatarsienne du pied du patient. Referring to Figures 5 and 6, the two reinforcements 8 and 9 have a length L, and are arranged slightly divergent from the rear to the front of the sole 2. The height of each reinforcement 8 or 9, under the lower face 7 of the sole 2, part of a zero value at both ends 14 and 15 of the reinforcement, to grow to a maximum height H in an intermediate region of the length L of the reinforcement. This zone of maximum height of each reinforcement 8 or 9 is located in line with the area of the upper face 6 of the sole 2 which supports the metatarsal bar of the patient's foot.
Les renforts 8 et 9, ainsi constitués et localisés, rigidifient la partie avant du pied, tout en facilitant le déroulement du pied lors de la marche, en offrant un point de bascule au niveau de l'avant du pied lors du déroulement du pas, en assurant la continuité du mouvement. Reinforcements 8 and 9, thus formed and localized, stiffen the front portion of the foot, while facilitating the unwinding of the foot during walking, providing a tipping point at the forefoot during the course of the step, ensuring the continuity of the movement.
Plus précisément, en se référant à la figure 7, le fonctionnement du releveur de pied s'établit comme suit lors de la marche : More precisely, referring to FIG. 7, the operation of the foot lifter is as follows when walking:
- Phase d'attaque du pas par le talon (position A) : le mouvement de flexion plantaire, c'est-à-dire l'abattement du pied au sol, est contrôlé par la déformation du matériau élastique 1 1 du système amortisseur 4, sous la contrainte d'un mouvement de recul de la tige 3 dans la cavité 10. Après avoir atteint la compression maximale du matériau élastique 1 1 , une déformation en flexion vers l'arrière de la tige 3 assure la continuité du mouvement. Ces déformations successives se substituent à la contraction excentrique des muscles fléchisseurs dorsaux déficitaires. - Step attack phase by the heel (position A): Plantar flexion movement, that is to say, the foot abatement on the ground, is controlled by the deformation of the elastic material 1 1 of the damping system 4 , under the constraint of a recoil movement of the rod 3 in the cavity 10. After reaching the maximum compression of the elastic material January 1, bending deformation rearward of the rod 3 ensures the continuity of movement. These successive deformations replace the eccentric contraction of the deficit dorsal flexor muscles.
- Phase de début d'appui (position B) : le mouvement de flexion dorsale de la cheville est assisté par la restitution de l'énergie emmagasinée, dans la phase précédente, lors de la compression du matériau élastique 1 1 et/ou de la flexion arrière de la tige 3. - Support start phase (position B): the dorsal flexion movement of the ankle is assisted by the restitution of the stored energy, in the previous phase, during the compression of the elastic material 1 1 and / or the back flexion of the stem 3.
- Phase de m il ieu d'appu i (position C) : l'angle de cheville est neutre. Le matériau élastique 1 1 et la tige 3 ne sont soumis momentanément à aucune contrainte. - Support phase (position C): the ankle angle is neutral. The elastic material 11 and the rod 3 are temporarily subject to no stress.
- Phase de fin d'appui ou de propulsion (position D) : la tige 3 se déforme en flexion vers l'avant, tandis que le pied se « déroule » en basculant autour de la zone de hauteur maximale des renforts 8 et 9, ce qui assure la continuité du « déroulement » du pied. - Phase oscillante (position E) : la raideur du système amortisseur 4 et des matériaux constitutifs de la tige 3 et de la semelle 2 permet au pied d'être maintenu avec un angle de cheville a pouvant être compris entre 80° et 1 10°, alors que le pied ne touche plus le sol . L'orthèse joue alors pleinement son rôle de « releveur de pied ». End of support or propulsion phase (position D): the rod 3 deforms in bending forward, while the foot is "unwound" by tilting around the maximum height zone reinforcements 8 and 9, which ensures the continuity of the "unfolding" of the foot. - Oscillating phase (E position): the stiffness of the damping system 4 and the constituent materials of the rod 3 and the sole 2 allows the foot to be maintained with an ankle angle may be between 80 ° and 1 10 ° , while the foot does not touch the ground anymore. The orthesis then fully plays its role of "foot lifter".
La modification de l'angle a, défini par l'axe longitudinal de la tige 3 et par le plan moyen de la semelle 2, permet d'influer sur le cycle de marche précédemment décrit. Ainsi, un angle plus « fermé » a pour conséquences : The modification of the angle a, defined by the longitudinal axis of the rod 3 and the middle plane of the sole 2, can influence the previously described walking cycle. Thus, a more "closed" angle has the following consequences:
- une augmentation de l'action de relevage du pied en phase oscillante (position E), an increase in the lifting action of the foot in the oscillating phase (position E),
- une augmentation de l'effet d'amortissement lors de l'abattement du pied au sol, au cours de la phase d'attaque du pas par le talon (position A). - An increase in the damping effect during the descent of the foot on the ground, during the attack phase of the step by the heel (position A).
A l'inverse, un angle plus « ouvert » a pour conséquences : Conversely, a more "open" angle has the following consequences:
- une diminution de l'action de relevage du pied en phase oscillante (position E), a decrease in the lifting action of the foot in the oscillating phase (position E),
- une augmentation de la propulsion générée par l'orthèse (position D), pouvant être expliquée par une déformation précoce vers l'avant de la tige 3 dès la phase de milieu d'appui (position C). an increase in the propulsion generated by the orthosis (position D), which can be explained by early deformation towards the front of the stem 3 from the support medium phase (position C).
De pl us , l e choix des caractéristiques élastiques du système amortisseur 4, donc du matériau élastique 1 1 , a une influence sur le fonctionnement et permet d'adapter au mieux le releveur de pied aux attentes et besoins des patients. In addition, the choice of the elastic characteristics of the damping system 4, and therefore of the elastic material 11, has an influence on the operation and makes it possible to adapt the foot lifter to the patients' expectations and needs.
On notera que, dans le mode de réalisation décrit jusqu'ici et comme le montre plus particulièrement la figure 4, l'extrémité basse 3a de la tige 3 est positionnée, dans la cavité 10, en avant du matériau élastique 1 1 , ce qui permet au matériau élastique 1 1 d'intervenir notamment dans la phase d'attaque du pas par le talon, comme décrit ci-dessus. Note that, in the embodiment described so far and as shown more particularly in Figure 4, the lower end 3a of the rod 3 is positioned in the cavity 10 in front of the elastic material January 1, which allows the elastic material January 1 to intervene especially in the pitch attack phase by the heel, as described above.
Dans une variante, illustrée par la figure 8, l'extrémité basse 3a de la tige 3 est positionnée, dans la cavité 10, en arrière du matériau élastique 1 1 . Dans cette variante, le fonctionnement du releveur de pied est davantage orienté vers celui d'un système amortisseur anti-effondrement, intervenant lors de la phase d'appui, en cas de déficit musculaire des fléchisseurs plantaires. In a variant, illustrated in FIG. 8, the lower end 3a of the rod 3 is positioned, in the cavity 10, behind the elastic material 11. In this variant, the operation of the foot lifter is more oriented towards that of an anti-collapse damping system, intervening during the support phase, in case of muscle deficit of the plantar flexors.
(Dans ce qui précède, les mots «avant » et « arrière » sont utilisés par référence au sens du pied). (In the above, the words "before" and "backward" are used by reference to the direction of the foot).
On ne s'éloignerait pas du cadre de l'invention, telle que définie dans les revendications annexées : - en modifiant les détails de forme de l'orthèse et de ses composants, It is not departing from the scope of the invention, as defined in the appended claims: by modifying the shape details of the orthosis and its components,
- en particulier, en modifiant le nombre et la disposition des renforts faisant saillie sous la semelle, par exemple en prévoyant des renforts parallèles et non pas divergents, - In particular, by modifying the number and the arrangement of the reinforcements protruding under the sole, for example by providing parallel reinforcements and not diverging,
- en réalisant les composants de l'orthèse en tous matériaux ou combinaisons de matériaux appropriés, ceci concernant en particulier le matériau élastiquement déformable du système amortisseur et celui de la tige, by realizing the components of the orthosis in any suitable materials or combinations of materials, this particularly concerning the elastically deformable material of the damping system and that of the rod,
- en maintenant le matériau élastiquement déformable de l'articulation dans la cavité par tous moyens adaptés, by maintaining the elastically deformable material of the articulation in the cavity by any suitable means,
- en ayant recours à tous moyens équivalents, par exemple en remplaçant la vis par un rivet pour lier mécaniquement la tige à la semelle. - using all equivalent means, for example by replacing the screw with a rivet to mechanically bind the rod to the sole.
Claims
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| FR1052875A FR2958843B1 (en) | 2010-04-15 | 2010-04-15 | DYNAMIC ORTHESIS TYPE FOOT RELEASE |
| FR10/52875 | 2010-04-15 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| WO2011128588A1 true WO2011128588A1 (en) | 2011-10-20 |
Family
ID=42937191
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| PCT/FR2011/050847 Ceased WO2011128588A1 (en) | 2010-04-15 | 2011-04-13 | Dynamic orthosis of the type lifting the foot |
Country Status (2)
| Country | Link |
|---|---|
| FR (1) | FR2958843B1 (en) |
| WO (1) | WO2011128588A1 (en) |
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2017100740A1 (en) * | 2015-12-10 | 2017-06-15 | Ossur Iceland Ehf | Orthotic system |
Citations (7)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| GB2188550A (en) | 1986-03-19 | 1987-10-07 | John Alan Drew | Ankle foot orthosis |
| US5897514A (en) * | 1998-02-09 | 1999-04-27 | Currier; Mark R. | Range of motion limiter |
| US6102881A (en) | 1999-04-23 | 2000-08-15 | Todd R. Quackenbush | Hinged drop foot brace |
| WO2002065942A2 (en) | 2001-02-15 | 2002-08-29 | Spaulding Rehabilitation Hospital Corporation | Ankle-foot orthosis with plantarflexor torque assistance |
| US20030153859A1 (en) | 2002-01-28 | 2003-08-14 | Hinshon Patrick Scott | Articulating ankle-foot orthosis |
| US20040194344A1 (en) * | 2003-04-05 | 2004-10-07 | Tadin Anthony G. | User-customizable insoles for footwear and method of customizing insoles |
| WO2006088466A1 (en) * | 2005-02-15 | 2006-08-24 | Ian K Engelman | An articulated orthosis providing lift assist |
-
2010
- 2010-04-15 FR FR1052875A patent/FR2958843B1/en not_active Expired - Fee Related
-
2011
- 2011-04-13 WO PCT/FR2011/050847 patent/WO2011128588A1/en not_active Ceased
Patent Citations (7)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| GB2188550A (en) | 1986-03-19 | 1987-10-07 | John Alan Drew | Ankle foot orthosis |
| US5897514A (en) * | 1998-02-09 | 1999-04-27 | Currier; Mark R. | Range of motion limiter |
| US6102881A (en) | 1999-04-23 | 2000-08-15 | Todd R. Quackenbush | Hinged drop foot brace |
| WO2002065942A2 (en) | 2001-02-15 | 2002-08-29 | Spaulding Rehabilitation Hospital Corporation | Ankle-foot orthosis with plantarflexor torque assistance |
| US20030153859A1 (en) | 2002-01-28 | 2003-08-14 | Hinshon Patrick Scott | Articulating ankle-foot orthosis |
| US20040194344A1 (en) * | 2003-04-05 | 2004-10-07 | Tadin Anthony G. | User-customizable insoles for footwear and method of customizing insoles |
| WO2006088466A1 (en) * | 2005-02-15 | 2006-08-24 | Ian K Engelman | An articulated orthosis providing lift assist |
Cited By (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2017100740A1 (en) * | 2015-12-10 | 2017-06-15 | Ossur Iceland Ehf | Orthotic system |
| US10561514B2 (en) | 2015-12-10 | 2020-02-18 | Ossur Iceland Ehf | Orthotic system |
| US11717431B2 (en) | 2015-12-10 | 2023-08-08 | Ossur Iceland Ehf | Orthotic system |
| US11779484B2 (en) | 2015-12-10 | 2023-10-10 | Ossur Iceland Ehf | Orthotic system |
Also Published As
| Publication number | Publication date |
|---|---|
| FR2958843A1 (en) | 2011-10-21 |
| FR2958843B1 (en) | 2013-02-15 |
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