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WO2025052286A1 - Walking rehabilitation apparatus for persons limited in their mobility - Google Patents

Walking rehabilitation apparatus for persons limited in their mobility Download PDF

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Publication number
WO2025052286A1
WO2025052286A1 PCT/IB2024/058633 IB2024058633W WO2025052286A1 WO 2025052286 A1 WO2025052286 A1 WO 2025052286A1 IB 2024058633 W IB2024058633 W IB 2024058633W WO 2025052286 A1 WO2025052286 A1 WO 2025052286A1
Authority
WO
WIPO (PCT)
Prior art keywords
user
support
movement
bar
bars
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.)
Pending
Application number
PCT/IB2024/058633
Other languages
French (fr)
Inventor
Sebastian Tobler
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.)
Gby SA
Original Assignee
Gby SA
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 Gby SA filed Critical Gby SA
Publication of WO2025052286A1 publication Critical patent/WO2025052286A1/en
Pending legal-status Critical Current
Anticipated expiration legal-status Critical

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Classifications

    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B21/00—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices
    • A63B21/00181—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices comprising additional means assisting the user to overcome part of the resisting force, i.e. assisted-active exercising
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/103—Measuring devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • A61B5/11—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor or mobility of a limb
    • A61B5/112—Gait analysis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/103—Measuring devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • A61B5/11—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor or mobility of a limb
    • A61B5/1126—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor or mobility of a limb using a particular sensing technique
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H1/00—Apparatus for passive exercising; Vibrating apparatus; Chiropractic devices, e.g. body impacting devices, external devices for briefly extending or aligning unbroken bones
    • A61H1/02—Stretching or bending or torsioning apparatus for exercising
    • A61H1/0237—Stretching or bending or torsioning apparatus for exercising for the lower limbs
    • A61H1/0255—Both knee and hip of a patient, e.g. in supine or sitting position, the feet being moved together in a plane substantially parallel to the body-symmetrical plane
    • A61H1/0262—Walking movement; Appliances for aiding disabled persons to walk
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H3/00—Appliances for aiding patients or disabled persons to walk about
    • A61H3/008—Appliances for aiding patients or disabled persons to walk about using suspension devices for supporting the body in an upright walking or standing position, e.g. harnesses
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B21/00—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices
    • A63B21/00178—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices for active exercising, the apparatus being also usable for passive exercising
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B21/00—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices
    • A63B21/15—Arrangements for force transmissions
    • A63B21/151—Using flexible elements for reciprocating movements, e.g. ropes or chains
    • A63B21/154—Using flexible elements for reciprocating movements, e.g. ropes or chains using special pulley-assemblies
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B22/00—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements
    • A63B22/0002—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements involving an exercising of arms
    • A63B22/001—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements involving an exercising of arms by simultaneously exercising arms and legs, e.g. diagonally in anti-phase
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B22/00—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements
    • A63B22/02—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements with movable endless bands, e.g. treadmills
    • A63B22/0235—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements with movable endless bands, e.g. treadmills driven by a motor
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B22/00—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements
    • A63B22/02—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements with movable endless bands, e.g. treadmills
    • A63B22/0235—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements with movable endless bands, e.g. treadmills driven by a motor
    • A63B22/0242—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements with movable endless bands, e.g. treadmills driven by a motor with speed variation
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B23/00—Exercising apparatus specially adapted for particular parts of the body
    • A63B23/035—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously
    • A63B23/04—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously for lower limbs
    • A63B23/0405—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously for lower limbs involving a bending of the knee and hip joints simultaneously
    • A63B23/047—Walking and pulling or pushing a load
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B69/00—Training appliances or apparatus for special sports
    • A63B69/0057—Means for physically limiting movements of body parts
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B69/00—Training appliances or apparatus for special sports
    • A63B69/0064—Attachments on the trainee preventing falling
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/12—Driving means
    • A61H2201/1207—Driving means with electric or magnetic drive
    • A61H2201/1215—Rotary drive
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/12—Driving means
    • A61H2201/1207—Driving means with electric or magnetic drive
    • A61H2201/123—Linear drive
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/12—Driving means
    • A61H2201/1253—Driving means driven by a human being, e.g. hand driven
    • A61H2201/1261—Driving means driven by a human being, e.g. hand driven combined with active exercising of the patient
    • A61H2201/1269—Passive exercise driven by movement of healthy limbs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/16—Physical interface with patient
    • A61H2201/1602—Physical interface with patient kind of interface, e.g. head rest, knee support or lumbar support
    • A61H2201/1635—Hand or arm, e.g. handle
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A61H2201/5058—Sensors or detectors
    • A61H2201/5061—Force sensors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2203/00—Additional characteristics concerning the patient
    • A61H2203/04—Position of the patient
    • A61H2203/0406—Standing on the feet
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B24/00—Electric or electronic controls for exercising apparatus of preceding groups; Controlling or monitoring of exercises, sportive games, training or athletic performances
    • A63B24/0087—Electric or electronic controls for exercising apparatus of groups A63B21/00 - A63B23/00, e.g. controlling load
    • A63B2024/0093—Electric or electronic controls for exercising apparatus of groups A63B21/00 - A63B23/00, e.g. controlling load the load of the exercise apparatus being controlled by performance parameters, e.g. distance or speed
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B2208/00—Characteristics or parameters related to the user or player
    • A63B2208/02—Characteristics or parameters related to the user or player posture
    • A63B2208/0204—Standing on the feet
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B2220/00—Measuring of physical parameters relating to sporting activity
    • A63B2220/50—Force related parameters
    • A63B2220/51—Force
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B23/00—Exercising apparatus specially adapted for particular parts of the body
    • A63B23/035—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously
    • A63B23/12—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously for upper limbs or related muscles, e.g. chest, upper back or shoulder muscles
    • A63B23/1209—Involving a bending of elbow and shoulder joints simultaneously

Definitions

  • the present invention relates to an apparatus for gait rehabilitation for persons with limited mobility.
  • the present invention also relates to a method for gait rehabilitation using this apparatus.
  • gait rehabilitation devices for people with limited mobility, including treadmills, which are generally used so that a therapist can make dynamic corrections to posture and gait. People can be secured or even supported via a harness. The speed of the treadmill is generally set by the therapist. However, the chosen speed may not be adapted to the person's motor abilities. In addition, these devices generally do not allow for the synchronization of arm and leg movements. Many devices are suitable for running, but not for exercise or gait rehabilitation.
  • An aim of the present invention is therefore to propose an apparatus for gait rehabilitation comprising a treadmill whose movement speed is adapted to preserve the balance and dynamics of gait specific to the person.
  • Another object of the present invention is to provide an apparatus for actively correcting the gait of this person.
  • Another object of the present invention is to propose a method for gait rehabilitation using the above-mentioned apparatus.
  • the apparatus comprises a treadmill on which a user can walk, a support, a first and a second support bar or a first and a second handle connected to the support in order to allow forward and backward movement of the first and second support bars or of the first or second handles.
  • the first and second support bars or the first or second handles are intended to be pushed or pulled by the user.
  • the apparatus further comprises means for applying to each support bar and/or to each handle a driving force or resistance against the movements induced by the user, and a control device configured to control said means and the speed of movement of the treadmill as a function of one or more parameters.
  • the first and second support bars are parallel to the direction of travel of the treadmill and are connected to the support so that their respective movements are constrained in the direction of travel in two opposite directions.
  • the first and second support bars each comprise a sensor, preferably a strain gauge, oriented so as to measure a force in the direction of the longitudinal axis of the support bar.
  • the first and second support bars are each connected to the support by at least one connecting bar comprising a sensor, preferably a strain gauge, oriented so as to measure a force in the direction of the longitudinal axis of the connecting bar.
  • the first and second support bars are each connected to the support by two connecting bars, preferably connected to each end of the respective support bar.
  • Each connecting bar comprises a sensor, preferably a strain gauge, oriented so as to measure a force in the direction of the longitudinal axis of the connecting bar.
  • the parameter or one of the parameters is calculated as a function of one of the following data or a combination of at least two of these data:
  • the user is equipped with several sensors placed on different regions of interest, the parameter or one of the parameters is calculated as a function of the movement of the user measured by the sensors.
  • the apparatus further comprises a link winch for attaching a limb of the user.
  • the control device is configured to further actuate the winch depending on the movement of one of the two support bars.
  • the apparatus further comprises a link winch for attaching a body support system as well as force sensors for measuring the vertical force applied by the user to the support bars.
  • the control device is further configured to control the winch as a function of the force measured on the support bars in order to relieve the user's arms.
  • the method comprises a step of previously equipping the user of the apparatus with several sensors and controlling the control device so that it performs the following steps: i) collecting in real time the measurements of the sensors when the user walks on the treadmill; ii) calculating in real time the position of the center of gravity of the user according to the measurements of the sensors, and iii) controlling in real time the movement of the treadmill according to the position of the center of gravity of the user.
  • control device calculates in real time a value relating to the phase shift of the movement of the user's arms and legs based on the measurements from the sensors and modifies the speed of movement of the treadmill based on said value.
  • one of the user's legs is attached to a link, for example at the knee, the link being connected to a winch.
  • the method further comprises controlling the control device to operate the winch to pull the leg forward in accordance with the rearward movement of one of the two support bars.
  • the user is supported by a body support connected to a winch.
  • the control device actuates, according to the method, the winch to raise or lower the body support depending on the vertical force applied by the user to the support bars.
  • An additional aspect of the invention relates to an alternative method of gait rehabilitation using the apparatus according to one of the aforementioned embodiments.
  • This method consists of controlling the control device to actuate said means in order to apply to each support bar a driving force or a resistance against the movements induced by the user according to one of the data following or a combination of at least two of these data:
  • the means are in the form of an electric motor.
  • the control device drives the motor so that it generates said resistance.
  • the intensity of the resistance is controlled as a function of the force exerted by the user on the support bars in the direction of the longitudinal axis of said support bars.
  • FIG. 1 represents a schematic perspective view of the apparatus for gait rehabilitation according to one embodiment of the invention
  • FIG. 2 shows a perspective view of a more advanced apparatus for gait rehabilitation, according to one embodiment
  • FIG. 3 illustrates a perspective view at the level of the installation of the motors on the upper part of the bar support
  • Figure 4 represents a detailed view of a motor mounted on a tie bar, which is mounted on the cross bars of the upper part of the bar support of Figure 3
  • - Figure 5 shows a perspective view of a support bar of the apparatus of Figure 2 mounted close to one end of each connecting bar;
  • FIG. 6 shows an exploded view of the support bar of Figure 5;
  • FIG. 7a) to 7c) respectively represent an upper part of the connecting bar connecting the support bar to the attachment bar, a longitudinal sectional view of the connecting bar and a view of the lower part of this connecting bar;
  • FIG. 8 represents a user of the device equipped with sensors
  • the apparatus 10 for the rehabilitation of walking for people with limited mobility comprises a treadmill 12, a bar support 13, as well as a first and a second support bar 16a, 16b parallel to the direction of movement of the treadmill 12 and pivotally mounted on the support 13 so that their respective movements are constrained in the direction of walking in two opposite directions.
  • the support 13 comprises an upper part 14 arranged above the conveyor belt 12 and held for example by four posts 15 arranged at the four corners of the structure and resting on the ground or on a frame.
  • the upper part 14 can be fixed to a ceiling.
  • the upper part 14 of the support 13 is intended to support the two support bars 16a, 16.
  • this upper part comprises a first and a second transverse bar 23 which are oriented perpendicular to the support bars 16a, 16b.
  • Each transverse bar 23 can be actuated around its respective axis by an electric linear actuator 18, for example a jack or a linear motor.
  • the actuator may be in the form of a spring.
  • each support bar 16a, 16b are connected respectively to the first and second transverse bars 23 by two connecting bars 24.
  • the first and second support bars 16a, 16b are intended to be pushed in the direction of travel or pulled in the opposite direction by the user.
  • the actuator 18 is configured to be able to apply to each support bar 16a, 16b a driving force or a resistance against the movements induced by the user.
  • the apparatus 10 further comprises a control device configured to control, on the one hand, the actuator 18 of each support bar 16a, 16b and, on the other hand, one or more motors of the treadmill 12 as a function of one or more parameters.
  • the control device comprises an acquisition module for collecting data measured by different sensors, an analysis module for processing this data and deducing therefrom in particular the intention of the user and a control module configured to operate the actuator 18 of each support bar 16a, 16b and the motor or each motor of the treadmill as a function for example of the intention of the user.
  • the control device can be controlled by control software executed by a processor.
  • a parameter can for example be calculated as a function of the force applied to each support bar 16a, 16b by the user, in particular in the direction of walking, the speed of movement each grab bar, the distance/range of travel of each grab bar, or a combination of all three ( Figure 9a).
  • the apparatus 100 comprises a treadmill 112, a bar support 113 similar to the first embodiment to constrain the movements of two support bars 116 in the direction of the user's walking in two opposite directions.
  • the upper part 114 of the bar support comprises two transverse bars 123a whose ends are fixed to two longitudinal bars 123b extending in the direction of the user's walking.
  • Two attachment bars 127 are fixed to the transverse bars 123a so as to also extend in the direction of the user's walking.
  • Two connecting bars 124 arranged respectively at the front and at the rear of the user during a rehabilitation session are pivotally mounted at the ends of each attachment bar 127 by means of a first fixing support 126 fixed to an upper part 124a of the connecting bar 124.
  • These two connecting bars 124 will be referred to hereinafter as front and rear connecting bars.
  • the two connecting bars arranged respectively at the front and at the rear of the user are pivotally mounted on a first and a second support resting on the ground on either side of the treadmill.
  • first and second support bars are each connected to the support by a single connecting bar. More particularly, one end of the latter is connected to the corresponding support bar substantially midway between its two ends, the other end of the connecting bar being pivotally mounted to the support.
  • a first and a second actuator 118 which are for example each in the form of a linear type or rotary linear type electric motor, are mounted to be connected to the corresponding tie bar 127 on the one hand, and to the upper part 124a of the corresponding rear connecting bar 124 on the other hand.
  • one end of the housing 118a of the mounter 118 is pivotally mounted by means of a first fixing bracket 128a to a second fixing bracket 128b, which is fixed to the corresponding tie bar 127.
  • the motor 118 comprises a slider 119 movable along its longitudinal axis and the distal end of which comprises an attachment member 119a connected to a second fixing support 129 mounted on the upper part 124a of the corresponding rear connecting bar 124.
  • the two attachment bars 217 are connected to the two transverse bars 123a so as to be able to slide along them in order to be able to adjust the distance between these two bars to adjust the spacing between the two support bars 116 so that it is adapted to the size of the user and in particular the span of his arms.
  • a connecting piece 130a, 130b is pivotally mounted at each end of each support bar 116.
  • the connecting piece 130a, 130b comprises a channel passing right through the piece and inside which is arranged a segment of a lower part 124b respectively of the rear and front connecting bar.
  • This lower part 124b is preferably in the form of a tube and comprises a plurality of orifices 125 along its longitudinal axis (see Figure 7c) while each connecting piece 130a, 130b comprises at least two orifices located on two opposite sides of the piece in order to be able to adjust the height of the support bars 116 also according to the size of the user, then to secure them at the chosen height for example by means of a pin passing through one of the holes 125 of the lower part 124b of the connecting bar 124 and the two holes of the connecting piece 130a, 130b.
  • each support bar 116 incorporates a sensor 140 in order to measure the force exerted by the user when the latter pushes each support bar in the direction of walking or pulls on it in the opposite direction by reproducing the natural swinging movement of the arms during walking.
  • the support bar 116 comprises a linear bearing 142, for example of cylindrical shape, connected to one end of this bar and mounted inside a bearing support 144, for example of tubular shape, in order to be able to move relative to it.
  • the sensor is, for example, a strain gauge 140 on which two fixing rods 146 are mounted on two opposite sides.
  • One of these fixing rods is connected to the linear bearing 142 secured to the support bar 116 while the other end is fixed to a fixed part inside the bearing support 144 close to one end of this support.
  • the bearing 142 is mounted inside the bearing support 144 so that this fixed part, the strain gauge 140 and the bearing 142 are arranged side by side in the bearing support 144.
  • the fixing rods 146 apply two opposite forces to the strain gauge 140 tending to extend the latter along the axis of the corresponding support bar 116 when the user pulls alternately on the two support bars 116, while the fixing rods 146 apply two forces in the opposite direction to the strain gauge 140 tending to compress the latter along the axis when the user pushes alternately on the two support bars 116.
  • the force exerted by the user when the latter pushes each support bar in the direction of travel or pulls on each bar in the opposite direction, reproducing the movement Natural arm swing during walking can be measured based on data provided by each motor.
  • each connecting bar comprises two distinct parts, namely the upper part 124a comprising a tubular segment and the lower part 124b in the form of a tube, previously described, partially mounted in two linear bearings 160 arranged at a distance from each other in the tubular segment of the upper part 124a.
  • the sensor 150 is mounted in a housing 126a forming an integral part of the first and second fixing parts 126, 129 of each connecting bar 124.
  • the sensor 150 is for example a strain gauge on which two fixing rods 156 are mounted on two opposite sides. One of these fixing rods is connected to the housing 126a while the other fixing rod is fixed to one end of the tube 124b.
  • the measurement of the vertical force applied to the support bars by the user during a rehabilitation session can be determined as a function of the combination of the measurements obtained by the four sensors 150.
  • Each motor 118 is configured to be able to be controlled to apply to each support bar 16a, 16b a driving force or resistance against the movements induced by the user according to different intensities.
  • the apparatus 100 further comprises a control device configured to control, on the one hand, each motor 118 of each support bar 116 and, on the other hand, one or more motors of the treadmill 112 as a function of one or more parameters, in particular a parameter calculated as a function of the force applied to each support bar 116 by the user, in particular in the direction of walking, the speed of movement of each support bar, the distance/amplitude of movement of each support bar or a combination of the three as already mentioned.
  • a control device configured to control, on the one hand, each motor 118 of each support bar 116 and, on the other hand, one or more motors of the treadmill 112 as a function of one or more parameters, in particular a parameter calculated as a function of the force applied to each support bar 116 by the user, in particular in the direction of walking, the speed of movement of each support bar, the distance/amplitude of movement of each support bar or a combination of the three as already mentioned.
  • the control device comprises for this purpose an acquisition module for collecting data measured by different sensors, an analysis module for processing this data and deducing therefrom in particular the intention of the user and a control module configured to operate each motor 118 of each support bar 16a, 16b and the motor or each motor of the treadmill as a function, for example, of the intention of the user.
  • the speed of each support bar can be determined based on the data provided by each motor.
  • the intensity of the aforementioned driving force or resistance can be calculated based on this parameter.
  • Each motor 118 illustrated in Figure 3 can be programmed to:
  • Using the motor as a spring has the advantage of allowing the variation of different parameters, in particular the intensity of the resistance dynamically and the amplitude of the stroke.
  • the stroke is therefore known which makes it possible to know the amplitude of movement of the support bars.
  • the user is equipped with several sensors which may be, for example, inertial measurement units (IMUs) 30 placed on different regions of interest as illustrated in FIG. 8.
  • the sensors 30 may, for example, be attached to the user's feet, hands, shoulders and hips.
  • the user's various movements during walking are measured.
  • the parameters relating to the user's movements may be used to control the motor or motors moving the treadmill 12, 112 forward ( Figure 9b).
  • the user's center of gravity may be calculated in real time by the analysis module of the control device based on sensor data to detect, for example, a forward movement of the center of gravity, in which case the control module is configured to control the or each motor of the treadmill 12, 112 and/or the resistance on the bars 16a, 16b, 116 so as to reconfigure the position of the center of gravity.
  • the apparatus may further comprise at least one winch 20, 120.
  • a lower limb and/or the pelvis of the user may be attached to a link, in particular by a rope or a cable connected to the winch 20, 120.
  • the control device is configured to actuate the winch 20, 120 in order to pull a lower limb forward as a function of the rearward movement of one of the two support bars 16a, 16b, 116 (figure 9c).
  • the rope or cable may be attached at the knee of the right leg.
  • the winch 120 is actuated by the controller when the user pulls the support bar 16b rearward with his or her left hand to bring the right leg forward.
  • two independent winches may be provided.
  • the rope or cable of each winch may be attached to the knee of each leg.
  • the two winches are operated alternately by the control device when the user alternately pulls the support bars 16a, 16b backwards with his right hand and left hand respectively in order to bring his left leg and right leg forward so as to reproduce the natural movements of walking.
  • the winches may be controlled independently of each other so as to control the movement of each leg. The force applied to each leg as well as the amplitude of the controlled movement may be different.
  • the winches can be controlled in a synchronized manner with the movement of the bars 16a, 16b, 116. It is thus possible to exercise the synchronization of the arms and legs, and the rotation of the pelvis, when walking.
  • the structure 14, 114 of the apparatus 10, 100 may comprise an additional winch 22, 122 for attaching a body support system, for example a harness.
  • the sensors 150 of the apparatus 100 make it possible to measure the force applied by the user to the support bars 16a, 16b, 116.
  • the control device is configured to operate the winch 22, 122 to raise or lower the body support depending on the force applied by the user to the support bars 16a, 16b ( Figure 9d). This avoids overloading the user's arms.
  • the support bars can be replaced by simple handles which are each connected to the upper part of the support by a single connecting bar or to a first and a second support which are arranged on either side of the treadmill.
  • the support bars are not necessarily parallel but can be oblique in a plane coinciding or parallel to the transverse plane of the patient.

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Abstract

The invention relates to a walking rehabilitation apparatus (10; 100) for persons limited in their mobility. The apparatus (10; 100) comprises a treadmill (12; 112) on which a user can walk, a support (14; 114), and a first and a second supporting bar (16a, 16b; 116) or a first and a second handle that are connected to the support (14; 114) in order to allow a forward and backward movement of the first and second supporting bars (16a, 16b; 116) or of the first or second handles; the first and second supporting bars (16a, 16b; 116) or the first or second handles are to be pushed or pulled by the user. The apparatus further comprises means (18; 118) for applying to each supporting bar (16a, 16b; 116) or to each handle a driving force or a resistance against the movements induced by the user, and a control device configured to control said means (18; 118) and the speed of movement of the treadmill (12; 112) according to one or more parameters.

Description

Appareil pour la rééducation de la marche pour des personnes limitées dans leur mobilité Device for gait rehabilitation for people with limited mobility

Domaine technique Technical field

[0001] La présente invention concerne un appareil pour la rééducation de la marche pour des personnes limitées dans leur mobilité. La présente invention concerne également une méthode de rééducation de la marche utilisant cet appareil. [0001] The present invention relates to an apparatus for gait rehabilitation for persons with limited mobility. The present invention also relates to a method for gait rehabilitation using this apparatus.

Etat de la technique State of the art

[0002] Il existe déjà des appareils de rééducation de la marche pour des personnes limitées dans leur mobilité, notamment des tapis roulants qui sont généralement utilisés afin qu'un thérapeute puisse apporter des corrections dynamiques de la posture et de la marche. Les personnes peuvent être sécurisées voire soutenue via un harnais. La vitesse de déplacement du tapis roulant est généralement fixée par le thérapeute. Il se peut toutefois que la vitesse choisie ne soit pas adaptée aux capacités motrices de la personne. De surcroit, ces appareils ne permettent généralement pas d'exercer la synchronisation entre les mouvements des bras et ceux des jambes. De nombreux appareils sont adaptés à la course, mais pas à l'exercice ou à la rééducation de la marche. [0002] There are already gait rehabilitation devices for people with limited mobility, including treadmills, which are generally used so that a therapist can make dynamic corrections to posture and gait. People can be secured or even supported via a harness. The speed of the treadmill is generally set by the therapist. However, the chosen speed may not be adapted to the person's motor abilities. In addition, these devices generally do not allow for the synchronization of arm and leg movements. Many devices are suitable for running, but not for exercise or gait rehabilitation.

Bref résumé de l'invention Brief summary of the invention

[0003] Un but de la présente invention est par conséquent de proposer un appareil pour la rééducation de la marche comportant un tapis roulant dont la vitesse de déplacement est adaptée pour préserver l'équilibre et la dynamique de la marche propres à la personne. [0003] An aim of the present invention is therefore to propose an apparatus for gait rehabilitation comprising a treadmill whose movement speed is adapted to preserve the balance and dynamics of gait specific to the person.

[0004] Un autre but de la présente invention est de proposer un appareil pour corriger activement la démarche de cette personne. [0005] Un autre but de la présente invention est de proposer une méthode pour la rééducation de la marche utilisant l'appareil susvisé. [0004] Another object of the present invention is to provide an apparatus for actively correcting the gait of this person. [0005] Another object of the present invention is to propose a method for gait rehabilitation using the above-mentioned apparatus.

[0006] Ces buts sont atteints notamment par un appareil pour la rééducation de la marche pour des personnes limitées dans leur mobilité. L'appareil comporte un tapis roulant sur lequel un utilisateur peut marcher, un support, une première et une seconde barre d'appui ou une première et une seconde poignée connectées au support afin de permettre un mouvement vers l'avant et l'arrière des première et secondes barres d'appui ou des première ou seconde poignées. Les première et seconde barres d'appui ou les première ou seconde poignées sont destinées à être poussées ou tirées par l'utilisateur. L'appareil comporte en outre des moyens pour appliquer à chaque barre d'appui et/ou à chaque poignée une force entraînante ou une résistance à l'encontre des mouvements induits par l'utilisateur, et un dispositif de commande configuré pour contrôler lesdits moyens et la vitesse du déplacement du tapis roulant en fonction d'un ou plusieurs paramètres. [0006] These aims are achieved in particular by an apparatus for gait rehabilitation for people with limited mobility. The apparatus comprises a treadmill on which a user can walk, a support, a first and a second support bar or a first and a second handle connected to the support in order to allow forward and backward movement of the first and second support bars or of the first or second handles. The first and second support bars or the first or second handles are intended to be pushed or pulled by the user. The apparatus further comprises means for applying to each support bar and/or to each handle a driving force or resistance against the movements induced by the user, and a control device configured to control said means and the speed of movement of the treadmill as a function of one or more parameters.

[0007] Selon une forme de réalisation, les première et seconde barres d'appui sont parallèles au sens de marche du tapis roulant et sont connectées au support de sorte à ce que leurs mouvements respectifs soient contraints dans la direction de la marche dans deux sens opposés. [0007] According to one embodiment, the first and second support bars are parallel to the direction of travel of the treadmill and are connected to the support so that their respective movements are constrained in the direction of travel in two opposite directions.

[0008] Selon une forme de réalisation, les première et seconde barres d'appui comportent chacune un capteur, de préférence une jauge de contrainte, orienté de sorte à mesurer une force dans la direction de l'axe longitudinal de la barre d'appui. [0008] According to one embodiment, the first and second support bars each comprise a sensor, preferably a strain gauge, oriented so as to measure a force in the direction of the longitudinal axis of the support bar.

[0009] Selon une forme de réalisation, les premières et seconde barres d'appui sont chacune reliées au support par au moins une barre de liaison comportant un capteur, de préférence une jauge de contrainte, orienté de sorte à mesure une force dans la direction de l'axe longitudinal de la barre de liaison. [0010] Selon une forme de réalisation, les premières et seconde barres d'appui sont chacune reliées au support par deux barres de liaison, de préférence connectées à chaque extrémité de la barre d'appui respective. Chaque barre de liaison comporte un capteur, de préférence une jauge de contrainte, orienté de sorte à mesure une force dans la direction de l'axe longitudinal de la barre de liaison. [0009] According to one embodiment, the first and second support bars are each connected to the support by at least one connecting bar comprising a sensor, preferably a strain gauge, oriented so as to measure a force in the direction of the longitudinal axis of the connecting bar. [0010] According to one embodiment, the first and second support bars are each connected to the support by two connecting bars, preferably connected to each end of the respective support bar. Each connecting bar comprises a sensor, preferably a strain gauge, oriented so as to measure a force in the direction of the longitudinal axis of the connecting bar.

[0011] Selon une forme de réalisation, le paramètre ou l'un des paramètres est calculé en fonction d'une des données suivantes ou d'une combinaison d'au moins deux de ces données : [0011] According to one embodiment, the parameter or one of the parameters is calculated as a function of one of the following data or a combination of at least two of these data:

- la force appliquée sur chaque barre d'appui par l'utilisateur dans le sens de la marche ou le sens opposé, - the force applied to each support bar by the user in the direction of travel or the opposite direction,

- la vitesse de déplacement de chaque barre d'appui, et- the speed of movement of each support bar, and

- la distance de placement (amplitude de déplacement) de chaque barre d'appui. - the placement distance (range of movement) of each support bar.

[0012] Selon une forme de réalisation, l'utilisateur est équipé de plusieurs capteurs placés sur différentes régions d'intérêt, le paramètre ou l'un des paramètres est calculé en fonction du mouvement de l'utilisateur mesurés par les capteurs. [0012] According to one embodiment, the user is equipped with several sensors placed on different regions of interest, the parameter or one of the parameters is calculated as a function of the movement of the user measured by the sensors.

[0013] Selon une forme de réalisation, l'appareil comporte en outre un treuil à lien pour l'attache d'un membre de l'utilisateur. Le dispositif de commande est configuré pour actionner en outre le treuil en fonction du déplacement de l'une des deux barres d'appui. [0013] According to one embodiment, the apparatus further comprises a link winch for attaching a limb of the user. The control device is configured to further actuate the winch depending on the movement of one of the two support bars.

[0014] Selon une forme de réalisation, l'appareil comporte en outre un treuil à lien pour l'attache d'un système de soutien corporel ainsi que des capteurs de force pour mesurer la force verticale appliquée par l'utilisateur sur les barres d'appui. Le dispositif de commande est configuré en outre pour commander le treuil en fonction de la force mesurée sur les barres d'appui afin de soulager les bras de l'utilisateur. [0015] Un autre aspect de l'invention porte sur une méthode de rééducation de la marche utilisant l'appareil selon l'une des formes de réalisation susvisées. La méthode comporte une étape consistant à équiper préalablement l'utilisateur de l'appareil de plusieurs capteurs et de commander le dispositif de commande afin qu'il effectue les étapes suivantes : i) collecter en temps réel les mesures des capteurs lorsque l'utilisateur marche sur le tapis roulant ; ii) calculer en temps réel la position du centre de gravité de l'utilisateur en fonction des mesures des capteurs, et iii) contrôler en temps réel le déplacement du tapis roulant en fonction de la position du centre de gravité de l'utilisateur. [0014] According to one embodiment, the apparatus further comprises a link winch for attaching a body support system as well as force sensors for measuring the vertical force applied by the user to the support bars. The control device is further configured to control the winch as a function of the force measured on the support bars in order to relieve the user's arms. [0015] Another aspect of the invention relates to a method for gait rehabilitation using the apparatus according to one of the aforementioned embodiments. The method comprises a step of previously equipping the user of the apparatus with several sensors and controlling the control device so that it performs the following steps: i) collecting in real time the measurements of the sensors when the user walks on the treadmill; ii) calculating in real time the position of the center of gravity of the user according to the measurements of the sensors, and iii) controlling in real time the movement of the treadmill according to the position of the center of gravity of the user.

[0016] Selon une forme de réalisation, le dispositif de commande calcule en temps réel une valeur relative au déphasage du mouvement des bras et des jambes de l'utilisateur en fonction des mesures des capteurs et modifie la vitesse de déplacement du tapis roulant en fonction de ladite valeur. [0016] According to one embodiment, the control device calculates in real time a value relating to the phase shift of the movement of the user's arms and legs based on the measurements from the sensors and modifies the speed of movement of the treadmill based on said value.

[0017] Selon une forme de réalisation, l'une des jambes de l'utilisateur est attachée à un lien, par exemple au niveau du genou, le lien étant relié à un treuil. La méthode consiste en outre à commander le dispositif de commande pour qu'il actionne le treuil afin de tirer la jambe vers l'avant en fonction du déplacement vers l'arrière de l'une des deux barres d'appui. [0017] According to one embodiment, one of the user's legs is attached to a link, for example at the knee, the link being connected to a winch. The method further comprises controlling the control device to operate the winch to pull the leg forward in accordance with the rearward movement of one of the two support bars.

[0018] Selon une forme de réalisation, l'utilisateur est soutenu par un soutien corporel relié à un treuil. Le dispositif de commande actionne, selon la méthode, le treuil pour lever ou abaisser le soutien corporel en fonction de la force verticale appliquée par l'utilisateur sur les barres d'appui. [0018] According to one embodiment, the user is supported by a body support connected to a winch. The control device actuates, according to the method, the winch to raise or lower the body support depending on the vertical force applied by the user to the support bars.

[0019] Un aspect additionnel de l'invention porte sur une méthode alternative de rééducation de la marche utilisant l'appareil selon l'une des formes de réalisation susvisées. Cette méthode consiste à piloter le dispositif de commande pour actionner lesdits moyens afin d'appliquer à chaque barre d'appui une force entraînante ou une résistance à l'encontre des mouvements induits par l'utilisateur en fonction d'une des données suivantes ou d'une combinaison d'au moins deux de ces données: [0019] An additional aspect of the invention relates to an alternative method of gait rehabilitation using the apparatus according to one of the aforementioned embodiments. This method consists of controlling the control device to actuate said means in order to apply to each support bar a driving force or a resistance against the movements induced by the user according to one of the data following or a combination of at least two of these data:

- la force appliquée par l'utilisateur sur chaque barre d'appui dans la direction de l'axe longitudinal de ladite barre, - the force applied by the user to each support bar in the direction of the longitudinal axis of said bar,

- la vitesse de déplacement chaque barre d'appui, et - the speed of movement of each support bar, and

- la distance de déplacement (amplitude de déplacement) de chaque barre d'appui, ou - the travel distance (travel range) of each support bar, or

[0020] Dans une forme de réalisation, les moyens sont sous la forme d'un moteur électrique. Le dispositif de commande pilote le moteur afin qu'il génère ladite résistance. L'intensité de la résistance est contrôlée en fonction de la force exercée par l'utilisateur sur les barres d'appui dans la direction de l'axe longitudinal desdites barres d'appui. [0020] In one embodiment, the means are in the form of an electric motor. The control device drives the motor so that it generates said resistance. The intensity of the resistance is controlled as a function of the force exerted by the user on the support bars in the direction of the longitudinal axis of said support bars.

Brève description des figures Brief description of the figures

[0021] Des exemples de mise en œuvre de l'invention sont indiqués dans la description illustrée par les figures annexées dans lesquelles : [0021] Examples of implementation of the invention are indicated in the description illustrated by the appended figures in which:

- la figure 1 représente une vue schématique en perspective de l'appareil pour la rééducation de la marche selon une forme d'exécution de l'invention ; - figure 1 represents a schematic perspective view of the apparatus for gait rehabilitation according to one embodiment of the invention;

- la figure 2 représente une vue en perspective d'un appareil plus avancé pour la rééducation de la marche, selon une forme de réalisation ; - Figure 2 shows a perspective view of a more advanced apparatus for gait rehabilitation, according to one embodiment;

- la figure 3 illustre une vue en perspective au niveau de l'installation des moteurs sur la partie supérieure du support de barres ; la figure 4 représente une vue détaillée d'un moteur monté sur une barre d'attache, laquelle est montée sur les barres transversales de la partie supérieure de support de barres de la figure 3 ; - La figure 5 représente une vue en perspective d'une barre d'appui de l'appareil de la figure 2 montée proche d'une extrémité de chaque barre de liaison ; - Figure 3 illustrates a perspective view at the level of the installation of the motors on the upper part of the bar support; Figure 4 represents a detailed view of a motor mounted on a tie bar, which is mounted on the cross bars of the upper part of the bar support of Figure 3; - Figure 5 shows a perspective view of a support bar of the apparatus of Figure 2 mounted close to one end of each connecting bar;

- la figure 6 représente une vue éclatée de la barre d'appui de la figure 5; - Figure 6 shows an exploded view of the support bar of Figure 5;

- les figures 7a) à 7c) représentent respectivement une partie supérieure de la barre de liaison reliant la barre d'appui à la barre d'attache, une vue en coupe longitudinale de la barre de liaison et une vue de la partie inférieure de cette barre de liaison; - figures 7a) to 7c) respectively represent an upper part of the connecting bar connecting the support bar to the attachment bar, a longitudinal sectional view of the connecting bar and a view of the lower part of this connecting bar;

- la figure 8 représente un utilisateur de l'appareil équipé de capteurs, et - Figure 8 represents a user of the device equipped with sensors, and

- la figures 9a à 9d illustrent différentes méthodes pour opérer l'appareil de la figure 1 ou de la figure 2. - Figures 9a to 9d illustrate different methods for operating the apparatus of Figure 1 or Figure 2.

Exemples de mode de réalisation de l'invention Examples of embodiments of the invention

[0022] Selon la figure 1, l'appareil 10 pour la rééducation de la marche pour des personnes limitées dans leur mobilité, comporte un tapis roulant 12, un support de barres 13, ainsi qu'une première et une seconde barre d'appui 16a, 16b parallèles au sens de déplacement du tapis roulant 12 et montées pivotantes sur le support 13 de sorte à ce que leurs mouvements respectifs soient contraints dans la direction de la marche dans deux sens opposés. [0022] According to Figure 1, the apparatus 10 for the rehabilitation of walking for people with limited mobility, comprises a treadmill 12, a bar support 13, as well as a first and a second support bar 16a, 16b parallel to the direction of movement of the treadmill 12 and pivotally mounted on the support 13 so that their respective movements are constrained in the direction of walking in two opposite directions.

[0023] Plus particulièrement, le support 13 comporte une partie supérieure 14 disposée au-dessus du tapis roulant 12 et maintenue par exemple par quatre poteaux 15 agencés aux quatre coins de la structure et reposant sur le sol ou sur un bâti. Selon une variante, la partie supérieure 14 peut être fixée à un plafond. La partie supérieure 14 du support 13 est destinée à supporter les deux barres d'appui 16a, 16. A cet effet, cette partie supérieure comporte une première et une seconde barre transversale 23 qui sont orientées perpendiculairement aux barres d'appui 16a, 16b. Chaque barre transversale 23 est actionnable autour de son axe respectif par un actionneur linéaire électrique 18, par exemple un vérin ou un moteur linéaire. Selon une variante d'exécution, l'actionneur peut être sous la forme d'un ressort. [0023] More particularly, the support 13 comprises an upper part 14 arranged above the conveyor belt 12 and held for example by four posts 15 arranged at the four corners of the structure and resting on the ground or on a frame. According to a variant, the upper part 14 can be fixed to a ceiling. The upper part 14 of the support 13 is intended to support the two support bars 16a, 16. For this purpose, this upper part comprises a first and a second transverse bar 23 which are oriented perpendicular to the support bars 16a, 16b. Each transverse bar 23 can be actuated around its respective axis by an electric linear actuator 18, for example a jack or a linear motor. According to an alternative embodiment, the actuator may be in the form of a spring.

[0024] Les deux extrémités de chaque barre d'appui 16a, 16b sont reliées respectivement aux première et seconde barres transversales 23 par deux barres de liaison 24. [0024] The two ends of each support bar 16a, 16b are connected respectively to the first and second transverse bars 23 by two connecting bars 24.

[0025] Les première et seconde barres d'appui 16a, 16b sont destinées à être poussées dans le sens de la marche ou tirées dans le sens opposé par l'utilisateur. L'actionneur 18 est configuré pour pouvoir appliquer à chaque barre d'appui 16a, 16b une force entraînante ou une résistance à l'encontre des mouvements induits par l'utilisateur. [0025] The first and second support bars 16a, 16b are intended to be pushed in the direction of travel or pulled in the opposite direction by the user. The actuator 18 is configured to be able to apply to each support bar 16a, 16b a driving force or a resistance against the movements induced by the user.

[0026] L'appareil 10 comporte en outre un dispositif de commande configuré pour contrôler, d'une part, l'actionneur 18 de chaque barre d'appui 16a, 16b et, d'autre part, un ou plusieurs moteurs du tapis roulant 12 en fonction d'un ou plusieurs paramètres. A cet effet, le dispositif de commande comporte un module d'acquisition pour collecter des données mesurées par différents capteurs, un module d'analyse pour traiter ces données et en déduire notamment l'intention de l'utilisateur et un module de commande configuré pour opérer l'actionneur 18 de chaque barre d'appui 16a, 16b et le moteur ou chaque moteur du tapis roulant en fonction par exemple de l'intention de l'utilisateur. Le dispositif de commande peut être contrôlé par un logiciel de commande exécuté par un processeur. [0026] The apparatus 10 further comprises a control device configured to control, on the one hand, the actuator 18 of each support bar 16a, 16b and, on the other hand, one or more motors of the treadmill 12 as a function of one or more parameters. For this purpose, the control device comprises an acquisition module for collecting data measured by different sensors, an analysis module for processing this data and deducing therefrom in particular the intention of the user and a control module configured to operate the actuator 18 of each support bar 16a, 16b and the motor or each motor of the treadmill as a function for example of the intention of the user. The control device can be controlled by control software executed by a processor.

[0027] Un paramètre peut par exemple être calculé en fonction de la force appliquée sur chaque barre d'appui 16a, 16b par l'utilisateur notamment dans la direction de la marche, de la vitesse de déplacement chaque barre d'appui, de la distance/amplitude de déplacement de chaque barre d'appui ou d'une combinaison des trois (Figure 9a). [0027] A parameter can for example be calculated as a function of the force applied to each support bar 16a, 16b by the user, in particular in the direction of walking, the speed of movement each grab bar, the distance/range of travel of each grab bar, or a combination of all three (Figure 9a).

[0028] Selon la forme de réalisation illustrée par les figures 2 à 7, l'appareil 100 comporte un tapis roulant 112, un support de barres 113 similaire à la première forme de réalisation pour contraindre les mouvements de deux barres d'appui 116 dans la direction de la marche de l'utilisateur dans deux sens opposés. [0028] According to the embodiment illustrated by figures 2 to 7, the apparatus 100 comprises a treadmill 112, a bar support 113 similar to the first embodiment to constrain the movements of two support bars 116 in the direction of the user's walking in two opposite directions.

[0029] En référence à la figure 3, la partie supérieure 114 du support de barres comporte deux barres transversales 123a dont les extrémités sont fixées sur deux barres longitudinales 123b s'étendant dans la direction de la marche de l'utilisateur. Deux barres d'attache 127 sont fixées aux barres transversales 123a de sorte à s'étendre également dans le sens de la marche de l'utilisateur. Deux barres de liaison 124 agencées respectivement à l'avant et à l'arrière de l'utilisateur lors d'une séance de rééducation sont montées pivotantes aux extrémités de chaque barre d'attache 127 par l'intermédiaire d'un premier support de fixation 126 fixé sur une partie supérieure 124a de la barre de liaison 124. Ces deux barres de liaisons 124 seront dénommées ci- après barres de liaison avant et arrière. [0029] With reference to Figure 3, the upper part 114 of the bar support comprises two transverse bars 123a whose ends are fixed to two longitudinal bars 123b extending in the direction of the user's walking. Two attachment bars 127 are fixed to the transverse bars 123a so as to also extend in the direction of the user's walking. Two connecting bars 124 arranged respectively at the front and at the rear of the user during a rehabilitation session are pivotally mounted at the ends of each attachment bar 127 by means of a first fixing support 126 fixed to an upper part 124a of the connecting bar 124. These two connecting bars 124 will be referred to hereinafter as front and rear connecting bars.

[0030] Selon une autre forme de réalisation non-illustrée, les deux barres de liaison agencées respectivement à l'avant et à l'arrière de l'utilisateur sont montées pivotantes sur un premier et un second support reposant sur le sol de part et d'autre du tapis roulant. [0030] According to another embodiment not illustrated, the two connecting bars arranged respectively at the front and at the rear of the user are pivotally mounted on a first and a second support resting on the ground on either side of the treadmill.

[0031] Selon une autre forme de réalisation non-illustrée, les première et seconde barres d'appui sont chacune reliées au support par une barre de liaison unique. Plus particulièrement, une extrémité de celle-ci est connectée à la barre d'appui correspondante sensiblement à mi-distance entre ses deux extrémités, l'autre extrémité de la barre de liaison étant montée pivotante au support. [0032] Un premier et un second actionneur 118, qui sont par exemple chacun sous la forme d'un moteur électrique de type linéaire ou du type linéaire rotatif, sont montés pour être connectés à la barre d'attache 127 correspondante d'une part, et à la partie supérieure 124a de la barre de liaison arrière correspondante 124 d'autre part. Plus particulièrement, en référence aux figures 2 et 3, une extrémité du boitier 118a du monteur 118 est montée pivotante par l'intermédiaire d'un premier support de fixation 128a à un second support de fixation 128b, lequel est fixé à la barre d'attache 127 correspondante. Le moteur 118 comporte un coulisseau 119 déplaçable le long de son axe longitudinal et dont l'extrémité distale comporte un organe d'attache 119a connecté à un second support de fixation 129 monté sur la partie supérieure 124a de la barre de liaison arrière correspondante 124. [0031] According to another embodiment not illustrated, the first and second support bars are each connected to the support by a single connecting bar. More particularly, one end of the latter is connected to the corresponding support bar substantially midway between its two ends, the other end of the connecting bar being pivotally mounted to the support. [0032] A first and a second actuator 118, which are for example each in the form of a linear type or rotary linear type electric motor, are mounted to be connected to the corresponding tie bar 127 on the one hand, and to the upper part 124a of the corresponding rear connecting bar 124 on the other hand. More particularly, with reference to Figures 2 and 3, one end of the housing 118a of the mounter 118 is pivotally mounted by means of a first fixing bracket 128a to a second fixing bracket 128b, which is fixed to the corresponding tie bar 127. The motor 118 comprises a slider 119 movable along its longitudinal axis and the distal end of which comprises an attachment member 119a connected to a second fixing support 129 mounted on the upper part 124a of the corresponding rear connecting bar 124.

[0033] Les deux barres d'attache 217 sont reliées aux deux barres transversales 123a de manière à pouvoir coulisser le long de celles-ci afin de pouvoir régler la distance en ces deux barres pour ajuster l'écartement entre les deux barres d'appui 116 afin qu'il soit adapté à la taille de l'utilisateur et en particulier l'envergure de ses bras. [0033] The two attachment bars 217 are connected to the two transverse bars 123a so as to be able to slide along them in order to be able to adjust the distance between these two bars to adjust the spacing between the two support bars 116 so that it is adapted to the size of the user and in particular the span of his arms.

[0034] En référence à la figure 5, une pièce de connexion 130a, 130b est montée pivotante à chaque extrémité de chaque barre d'appui 116. La pièce de connexion 130a, 130b comporte un canal traversant la pièce de part en part et à l'intérieur duquel est agencé un segment d'une partie inférieure 124b respectivement de la barre liaison arrière et avant. Cette partie inférieure 124b est sous la forme d'un tube de préférence et comporte une pluralité d'orifices 125 le long de son axe longitudinal (cf. figure 7c) tandis que chaque pièce de connexion 130a, 130b comporte au moins deux orifices situés sur deux côtés opposés de la pièce afin de pouvoir régler en hauteur les barres d'appui 116 également en fonction de la taille de l'utilisateur, puis de les sécuriser à la hauteur choisie par exemple au moyen d'une goupille traversant l'un des orifices 125 de la partie inférieure 124b de la barre de liaison 124 et les deux orifices de la pièce de connexion 130a, 130b. [0034] With reference to Figure 5, a connecting piece 130a, 130b is pivotally mounted at each end of each support bar 116. The connecting piece 130a, 130b comprises a channel passing right through the piece and inside which is arranged a segment of a lower part 124b respectively of the rear and front connecting bar. This lower part 124b is preferably in the form of a tube and comprises a plurality of orifices 125 along its longitudinal axis (see Figure 7c) while each connecting piece 130a, 130b comprises at least two orifices located on two opposite sides of the piece in order to be able to adjust the height of the support bars 116 also according to the size of the user, then to secure them at the chosen height for example by means of a pin passing through one of the holes 125 of the lower part 124b of the connecting bar 124 and the two holes of the connecting piece 130a, 130b.

[0035] Selon une forme de réalisation illustrée en particulier par la figure 6, chaque barre d'appui 116 intègre un capteur 140 afin de mesurer la force exercée par l'utilisateur lorsque celui-ci pousse chaque barre d'appui dans le sens de la marche ou tire sur celle-ci dans le sens opposé en reproduisant le mouvement naturel de balancement des bras au cours de la marche. La barre d'appui 116 comporte un palier linéaire 142, par exemple de forme cylindrique, connecté à une extrémité de cette barre et monté à l'intérieur d'un support de palier 144, par exemple de forme tubulaire, afin de pouvoir se déplacer par rapport à celui-ci. [0035] According to an embodiment illustrated in particular by FIG. 6, each support bar 116 incorporates a sensor 140 in order to measure the force exerted by the user when the latter pushes each support bar in the direction of walking or pulls on it in the opposite direction by reproducing the natural swinging movement of the arms during walking. The support bar 116 comprises a linear bearing 142, for example of cylindrical shape, connected to one end of this bar and mounted inside a bearing support 144, for example of tubular shape, in order to be able to move relative to it.

[0036] Le capteur, est par exemple une jauge de contrainte 140 sur laquelle est monté sur deux côtés opposés deux tiges de fixation 146. L'une de ces tiges de fixation est connectée au palier linéaire 142 solidaire de la barre d'appui 116 alors que l'autre extrémité est fixée sur une partie fixe à l'intérieur du support de palier 144 proche d'une extrémité de ce support. Plus précisément, le palier 142 est monté à l'intérieur du support de palier 144 de sorte que cette partie fixe, la jauge de contrainte 140 et le palier 142 soient agencés côte à côte dans le support de palier 144. [0036] The sensor is, for example, a strain gauge 140 on which two fixing rods 146 are mounted on two opposite sides. One of these fixing rods is connected to the linear bearing 142 secured to the support bar 116 while the other end is fixed to a fixed part inside the bearing support 144 close to one end of this support. More precisely, the bearing 142 is mounted inside the bearing support 144 so that this fixed part, the strain gauge 140 and the bearing 142 are arranged side by side in the bearing support 144.

[0037] Ainsi, les tiges de fixation 146 appliquent deux forces opposées sur la jauge de contrainte 140 tendant à étendre celle-ci le long de l'axe de la barre d'appui correspondante 116 lorsque l'utilisateur tire alternativement sur les deux barres d'appui 116, tandis que les tiges de fixation 146 appliquent deux forces dans le sens inverse sur la jauge de contrainte 140 tendant à comprimer celle-ci le long de l'axe lorsque l'utilisateur pousse alternativement sur les deux barres d'appui 116. [0037] Thus, the fixing rods 146 apply two opposite forces to the strain gauge 140 tending to extend the latter along the axis of the corresponding support bar 116 when the user pulls alternately on the two support bars 116, while the fixing rods 146 apply two forces in the opposite direction to the strain gauge 140 tending to compress the latter along the axis when the user pushes alternately on the two support bars 116.

[0038] Selon une variante d'exécution, la force exercée par l'utilisateur lorsque celui-ci pousse chaque barre d'appui dans le sens de la marche ou tire sur chaque barre dans le sens opposé en reproduisant le mouvement naturel de balancement des bras au cours de la marche peut être mesurée en fonction des données fournies par chaque moteur. [0038] According to an alternative embodiment, the force exerted by the user when the latter pushes each support bar in the direction of travel or pulls on each bar in the opposite direction, reproducing the movement Natural arm swing during walking can be measured based on data provided by each motor.

[0039] L'appareil 100 permet également de mesurer la force verticale appliquée sur les barres d'appui 116 par l'utilisateur au cours d'une séance de rééducation. Selon une forme de réalisation, un capteur 150 est intégré à cet effet dans les barres de liaison avant et arrière 124 connectant chaque barre d'appui 116 aux barres d'attache 127 respectives. Plus particulièrement, selon les figures 7a à 7c, chaque barre de liaison comporte deux parties distinctes, à savoir la partie supérieure 124a comprenant un segment tubulaire et la partie inférieure 124b sous forme de tube, préalablement décrite, montée partiellement dans deux paliers linéaires 160 agencés à distance l'un de l'autre dans le segment tubulaire de la partie supérieure 124a. Le capteur 150 est monté dans un boitier 126a faisant partie intégrante des première et seconde parties de fixation 126, 129 de chaque barre de liaison 124. [0039] The apparatus 100 also makes it possible to measure the vertical force applied to the support bars 116 by the user during a rehabilitation session. According to one embodiment, a sensor 150 is integrated for this purpose in the front and rear connecting bars 124 connecting each support bar 116 to the respective attachment bars 127. More particularly, according to FIGS. 7a to 7c, each connecting bar comprises two distinct parts, namely the upper part 124a comprising a tubular segment and the lower part 124b in the form of a tube, previously described, partially mounted in two linear bearings 160 arranged at a distance from each other in the tubular segment of the upper part 124a. The sensor 150 is mounted in a housing 126a forming an integral part of the first and second fixing parts 126, 129 of each connecting bar 124.

[0040] A l'instar du capteur intégré dans les barres d'appui 116, le capteur 150 est par exemple une jauge de contrainte sur laquelle est monté sur deux côtés opposés deux tiges de fixation 156. L'une de ces tiges de fixation est connectée au boitier 126a alors que l'autre tige de fixation est fixée à une extrémité du tube 124b. Ainsi, la mesure de la fore vertical appliquée sur les barres d'appui par l'utilisateur au cours d'une séance de rééducation peut être déterminée en fonction de la combinaison des mesures obtenues par les quatre capteurs 150. [0040] Like the sensor integrated in the support bars 116, the sensor 150 is for example a strain gauge on which two fixing rods 156 are mounted on two opposite sides. One of these fixing rods is connected to the housing 126a while the other fixing rod is fixed to one end of the tube 124b. Thus, the measurement of the vertical force applied to the support bars by the user during a rehabilitation session can be determined as a function of the combination of the measurements obtained by the four sensors 150.

[0041] Chaque moteur 118 est configuré pour pouvoir être piloté pour appliquer à chaque barre d'appui 16a, 16b une force entraînante ou une résistance à l'encontre des mouvements induits par l'utilisateur selon différentes intensités. [0041] Each motor 118 is configured to be able to be controlled to apply to each support bar 16a, 16b a driving force or resistance against the movements induced by the user according to different intensities.

[0042] A l'instar de la première forme de réalisation, l'appareil 100 comporte en outre un dispositif de commande configuré pour contrôler, d'une part, chaque moteur 118 de chaque barre d'appui 116 et, d'autre part, un ou plusieurs moteurs du tapis roulant 112 en fonction d'un ou plusieurs paramètres notamment un paramètre calculé en fonction de la force appliquée sur chaque barre d'appui 116 par l'utilisateur notamment dans la direction de la marche, de la vitesse de déplacement de chaque barre d'appui de la distance/amplitude de déplacement de chaque barre d'appui ou d'une combinaison des trois comme déjà mentionné. Le dispositif de commande comporte à cet effet un module d'acquisition pour collecter des données mesurées par différents capteurs, un module d'analyse pour traiter ces données et en déduire notamment l'intention de l'utilisateur et un module de commande configuré pour opérer chaque moteur 118 de chaque barre d'appui 16a, 16b et le moteur ou chaque moteur du tapis roulant en fonction par exemple de l'intention de l'utilisateur. [0042] Like the first embodiment, the apparatus 100 further comprises a control device configured to control, on the one hand, each motor 118 of each support bar 116 and, on the other hand, one or more motors of the treadmill 112 as a function of one or more parameters, in particular a parameter calculated as a function of the force applied to each support bar 116 by the user, in particular in the direction of walking, the speed of movement of each support bar, the distance/amplitude of movement of each support bar or a combination of the three as already mentioned. The control device comprises for this purpose an acquisition module for collecting data measured by different sensors, an analysis module for processing this data and deducing therefrom in particular the intention of the user and a control module configured to operate each motor 118 of each support bar 16a, 16b and the motor or each motor of the treadmill as a function, for example, of the intention of the user.

[0043] La vitesse de chaque barre d'appui peut être déterminée en fonction des données fournies par chaque moteur. L'intensité de la force entraînante ou de la résistance susvisées peut être calculée en fonction de ce paramètre. [0043] The speed of each support bar can be determined based on the data provided by each motor. The intensity of the aforementioned driving force or resistance can be calculated based on this parameter.

[0044] Chaque moteur 118 illustré à la figure 3 peut être programmé pour : [0044] Each motor 118 illustrated in Figure 3 can be programmed to:

- pousser et tirer le second support de fixation 129 de la partie supérieure 124a de la barre de liaison arrière afin d'impartir une force entraînante à chaque barre d'appui 116 vers respectivement l'arrière et l'avant, ou - pushing and pulling the second fixing bracket 129 of the upper part 124a of the rear connecting bar in order to impart a driving force to each support bar 116 towards the rear and the front respectively, or

- réaliser la fonction d'un ressort afin d'exercer une résistance sur le support de fixation 129 de la partie supérieure 124a de la barre de liaison lorsque l'utilisateur tire sur la barre d'appui et d'assister le mouvement de la barre d'appui vers l'avant. - perform the function of a spring in order to exert resistance on the fixing support 129 of the upper part 124a of the connecting bar when the user pulls on the support bar and to assist the movement of the support bar forward.

[0045] L'utilisation du moteur en tant que ressort a l'avantage de permettre la variation de différents paramètres, notamment l'intensité de la résistance de manière dynamique et l'amplitude de la course. La course est donc connue ce qui permet de connaître l'amplitude de déplacement des barres d'appui. [0045] Using the motor as a spring has the advantage of allowing the variation of different parameters, in particular the intensity of the resistance dynamically and the amplitude of the stroke. The stroke is therefore known which makes it possible to know the amplitude of movement of the support bars.

[0046] Il va de soi que les moteurs peuvent être montés différemment pour agir sur les barres de liaison avant et non pas sur les barres de liaison arrière. [0046] It goes without saying that the engines can be mounted differently to act on the front connecting rods and not on the rear connecting rods.

[0047] Selon une forme de réalisation, l'utilisateur est équipé de plusieurs capteurs qui peuvent être par exemple des unités de mesure inertielle (IMU) 30 placés sur différentes régions d'intérêt comme illustré à la figure 8. Les capteurs 30 peuvent par exemple être fixés au niveau des pieds, des mains, des épaules et des hanches de l'utilisateur. Les différents mouvements de ce dernier au cours de la marche sont mesurés. Les paramètres relatifs aux mouvements de l'utilisateur peuvent être utilisés pour contrôler le moteur ou les moteurs faisant avancer le tapis roulant 12, 112 (Figure 9b). Par exemple, le centre de gravité de l'utilisateur peut être calculé en temps réel par le module d'analyse du dispositif de commande en fonction des données des capteurs afin de détecter par exemple un mouvement vers l'avant du centre de gravité, auquel cas le module de commande est configuré pour contrôler le moteur ou chaque moteur du tapis roulant 12, 112 et/ou la résistance sur les barres 16a, 16b, 116 de manière à reconfigurer la position du centre de gravité. [0047] According to one embodiment, the user is equipped with several sensors which may be, for example, inertial measurement units (IMUs) 30 placed on different regions of interest as illustrated in FIG. 8. The sensors 30 may, for example, be attached to the user's feet, hands, shoulders and hips. The user's various movements during walking are measured. The parameters relating to the user's movements may be used to control the motor or motors moving the treadmill 12, 112 forward (Figure 9b). For example, the user's center of gravity may be calculated in real time by the analysis module of the control device based on sensor data to detect, for example, a forward movement of the center of gravity, in which case the control module is configured to control the or each motor of the treadmill 12, 112 and/or the resistance on the bars 16a, 16b, 116 so as to reconfigure the position of the center of gravity.

[0048] L'appareil selon l'une des formes de réalisation susvisées peut comporter en outre au moins un treuil 20, 120. Un membre inférieur et/ou le bassin de l'utilisateur peut être attaché à un lien, notamment par une corde ou un câble relié au treuil 20, 120. Le dispositif de commande est configuré pour actionner le treuil 20, 120 afin de tirer un membre inférieur vers l'avant en fonction du déplacement vers l'arrière de l'une des deux barres d'appui 16a, 16b, 116 (figure 9c). [0049] Par exemple, pour un utilisateur qui a de la peine à contrôler sa jambe droite pour avancer, la corde ou le câble peut être attaché au niveau du genou de la jambe droite. Le treuil 120 est actionné par le dispositif de commande lorsque l'utilisateur tire la barre d'appui 16b vers l'arrière avec sa main gauche afin de ramener la jambe droite vers l'avant. [0048] The apparatus according to one of the aforementioned embodiments may further comprise at least one winch 20, 120. A lower limb and/or the pelvis of the user may be attached to a link, in particular by a rope or a cable connected to the winch 20, 120. The control device is configured to actuate the winch 20, 120 in order to pull a lower limb forward as a function of the rearward movement of one of the two support bars 16a, 16b, 116 (figure 9c). [0049] For example, for a user who has difficulty controlling his or her right leg to move forward, the rope or cable may be attached at the knee of the right leg. The winch 120 is actuated by the controller when the user pulls the support bar 16b rearward with his or her left hand to bring the right leg forward.

[0050] Pour un utilisateur qui a de la peine à contrôler ses deux jambes, il peut être prévu deux treuils indépendants. La corde ou le câble de chaque treuil peut être attaché au niveau du genou de chaque jambe. Les deux treuils sont actionnés alternativement par le dispositif de commande lorsque l'utilisateur tire alternativement les barres d'appui 16a, 16b vers l'arrière avec respectivement sa main droite et sa main gauche afin de ramener sa jambe gauche et sa jambe droite vers l'avant de sorte à reproduire les mouvements naturels de la marche. Les treuils peuvent être contrôlés indépendamment l'un de l'autre de manière à contrôler le mouvement de chaque jambe. La force appliquée sur chaque jambe ainsi que l'amplitude du mouvement contrôlé peuvent être différentes. [0050] For a user who has difficulty controlling both legs, two independent winches may be provided. The rope or cable of each winch may be attached to the knee of each leg. The two winches are operated alternately by the control device when the user alternately pulls the support bars 16a, 16b backwards with his right hand and left hand respectively in order to bring his left leg and right leg forward so as to reproduce the natural movements of walking. The winches may be controlled independently of each other so as to control the movement of each leg. The force applied to each leg as well as the amplitude of the controlled movement may be different.

[0051] Les treuils peuvent être contrôlés de manière synchronisée avec le déplacement des barres 16a, 16b, 116. Il est ainsi possible d'exercer la synchronisation des bras et des jambes, et la rotation du bassin, lors de la marche. [0051] The winches can be controlled in a synchronized manner with the movement of the bars 16a, 16b, 116. It is thus possible to exercise the synchronization of the arms and legs, and the rotation of the pelvis, when walking.

[0052] L'utilisation d'un ou plusieurs câbles pour assister le mouvement vers l'avant d'une jambe ou des deux jambes de l'utilisateur ainsi que l'utilisation des barres pour coordonner les mouvements des bras de l'utilisateur permettent ainsi de stimuler le réseau locomoteur spinal. [0052] The use of one or more cables to assist the forward movement of one or both legs of the user as well as the use of the bars to coordinate the movements of the user's arms thus makes it possible to stimulate the spinal locomotor network.

[0053] Selon une forme de réalisation, la structure 14, 114 de l'appareil 10, 100 peut comporter un treuil additionnel 22, 122 pour l'attache d'un système de soutien corporel, par exemple un harnais. Les capteurs 150 de l'appareil 100 permettent de mesurer la force appliquée par l'utilisateur sur les barres d'appui 16a, 16b, 116. Le dispositif de commande est configuré pour actionner le treuil 22, 122 afin de lever ou abaisser le soutien corporel en fonction de la force appliquée par l'utilisateur sur les barres d'appui 16a, 16b (figure 9d). Cela permet d'éviter une surcharge au niveau des bras de l'utilisateur. [0054] On comprendra que diverses modifications et/ou améliorations évidentes pour un homme du métier peuvent être apportées à l'appareil de rééducation qui fait l'objet de la description susvisée sans sortir du cadre de la présente invention définie par les revendications annexées. Par exemple, les barres d'appui peuvent être remplacées par de simple poignées qui sont chacune reliées à la partie supérieure du support par une barre de liaison unique ou à un premier et à un second support qui sont agencés de part et d'autre du tapis roulant. En outre, les barres d'appui ne sont pas nécessairement parallèles mais peuvent être obliques dans un plan coïncidant ou parallèle au plan transversal du patient. [0053] According to one embodiment, the structure 14, 114 of the apparatus 10, 100 may comprise an additional winch 22, 122 for attaching a body support system, for example a harness. The sensors 150 of the apparatus 100 make it possible to measure the force applied by the user to the support bars 16a, 16b, 116. The control device is configured to operate the winch 22, 122 to raise or lower the body support depending on the force applied by the user to the support bars 16a, 16b (Figure 9d). This avoids overloading the user's arms. [0054] It will be understood that various modifications and/or improvements obvious to a person skilled in the art can be made to the rehabilitation apparatus which is the subject of the above description without departing from the scope of the present invention defined by the appended claims. For example, the support bars can be replaced by simple handles which are each connected to the upper part of the support by a single connecting bar or to a first and a second support which are arranged on either side of the treadmill. Furthermore, the support bars are not necessarily parallel but can be oblique in a plane coinciding or parallel to the transverse plane of the patient.

Claims

Revendications Claims 1. Appareil (10 ; 100) pour la rééducation de la marche pour des personnes limitées dans leur mobilité, comportant un tapis roulant (12 ; 112) sur lequel un utilisateur peut marcher, un support (14 ; 114), une première et une seconde barre d'appui (16a, 16b ; 116) ou une première et une seconde poignée connectées au support (14 ; 114) afin de permettre un mouvement vers l'avant et l'arrière des première et secondes barres d'appui (16a, 16b ; 116) ou des première ou seconde poignées, lesdites première et seconde barres d'appui (16a, 16b ; 116) ou lesdites première ou seconde poignées étant destinées à être poussées ou tirées par l'utilisateur, l'appareil comportant en outre des moyens (18 ; 118) pour appliquer à chaque barre d'appui (16a, 16b ; 116) ou à chaque poignée une force entraînante ou une résistance à l'encontre des mouvements induits par l'utilisateur, et un dispositif de commande configuré pour contrôler lesdits moyens (18 ; 118) et la vitesse du déplacement du tapis roulant (12 ; 112) en fonction d'un ou plusieurs paramètres. 1. Apparatus (10; 100) for gait rehabilitation for persons with limited mobility, comprising a treadmill (12; 112) on which a user can walk, a support (14; 114), a first and a second support bar (16a, 16b; 116) or a first and a second handle connected to the support (14; 114) in order to allow forward and backward movement of the first and second support bars (16a, 16b; 116) or of the first or second handles, said first and second support bars (16a, 16b; 116) or said first or second handles being intended to be pushed or pulled by the user, the apparatus further comprising means (18; 118) for applying to each support bar (16a, 16b; 116) or to each handle a driving force or a resistance against movements induced by the user, and a control device configured to control said means (18; 118) and the speed of movement of the treadmill (12; 112) as a function of one or more parameters. 2. Appareil (10 ; 100) selon la revendication 1, dans lequel les première et seconde barres d'appui (16a, 16b ; 116) sont parallèles au sens de marche du tapis roulant (12 ; 112) et sont connectées au support (14 ; 114) de sorte à ce que leurs mouvements respectifs soient contraints dans la direction de la marche dans deux sens opposés. 2. Apparatus (10; 100) according to claim 1, wherein the first and second support bars (16a, 16b; 116) are parallel to the direction of travel of the treadmill (12; 112) and are connected to the support (14; 114) so that their respective movements are constrained in the direction of travel in two opposite directions. 3. Appareil (100) selon l'une des revendications précédentes, dans lequel les première et seconde barres d'appui (116) comportent chacune un capteur (140), de préférence une jauge de contrainte, orienté de sorte à mesurer une force dans la direction de l'axe longitudinal de la barre d'appui (116). 3. Apparatus (100) according to one of the preceding claims, wherein the first and second support bars (116) each comprise a sensor (140), preferably a strain gauge, oriented so as to measure a force in the direction of the longitudinal axis of the support bar (116). 4. Appareil (100) selon l'une des revendications précédentes, dans lequel les premières et seconde barres d'appui (116) sont chacune reliées au support (114) par au moins une barre de liaison (124) comportant un capteur (150), de préférence une jauge de contrainte, orienté de sorte à mesure une force dans la direction de l'axe longitudinal de la barre de liaison (124). 4. Apparatus (100) according to one of the preceding claims, wherein the first and second support bars (116) are each connected to the support (114) by at least one connecting bar (124) comprising a sensor (150), preferably a strain gauge, oriented so as to measure a force in the direction of the longitudinal axis of the connecting bar (124). 5. Appareil (100) selon la revendication précédente, dans lequel les premières et seconde barres d'appui (116) sont chacune reliées au support (114) par deux barres de liaison (124), de préférence connectées à chaque extrémité de la barre d'appui (116) respective, chaque barre de liaison (124) comportant un capteur (150), de préférence une jauge de contrainte, orienté de sorte à mesure une force dans la direction de l'axe longitudinal de la barre de liaison (124). 5. Apparatus (100) according to the preceding claim, wherein the first and second support bars (116) are each connected to the support (114) by two connecting bars (124), preferably connected to each end of the respective support bar (116), each connecting bar (124) comprising a sensor (150), preferably a strain gauge, oriented so as to measure a force in the direction of the longitudinal axis of the connecting bar (124). 6. Appareil (10 ; 100) selon l'une des revendications précédentes, dans lequel ledit paramètre ou l'un des paramètres est calculé en fonction de la force appliquée sur chaque barre d'appui (16a, 16b ; 116) par l'utilisateur dans le sens de la marche ou le sens opposé, de la vitesse de déplacement de chaque barre d'appui ou de la distance de déplacement de chaque barre d'appui. 6. Apparatus (10; 100) according to one of the preceding claims, wherein said parameter or one of the parameters is calculated as a function of the force applied to each support bar (16a, 16b; 116) by the user in the direction of walking or the opposite direction, the speed of movement of each support bar or the distance of movement of each support bar. 7. Appareil (10 ; 100) selon l'une des revendications précédentes, dans lequel l'utilisateur est équipé de plusieurs capteurs (30) placés sur différentes régions d'intérêt, et dans lequel ledit paramètre ou l'un des paramètres est calculé en fonction du mouvement de l'utilisateur mesurés par les capteurs. 7. Apparatus (10; 100) according to one of the preceding claims, in which the user is equipped with several sensors (30) placed on different regions of interest, and in which said parameter or one of the parameters is calculated as a function of the movement of the user measured by the sensors. 8. Appareil (10 ; 100) selon l'une des revendications précédentes, comportant en outre un treuil à lien (20 ; 120) pour l'attache d'un membre de l'utilisateur, le dispositif de commande étant configuré pour actionner en outre le treuil (20 ; 120) en fonction du déplacement de l'une des deux barres d'appui (16a, 16b ; 116). 8. Apparatus (10; 100) according to one of the preceding claims, further comprising a link winch (20; 120) for attaching a limb of the user, the control device being configured to further actuate the winch (20; 120) as a function of the movement of one of the two support bars (16a, 16b; 116). 9. Appareil (10 ; 100) selon l'une des revendications précédentes, comportant en outre un treuil à lien (22 ; 122) pour l'attache d'un système de soutien corporel ainsi que des capteurs de force pour mesurer la force appliquée par l'utilisateur sur les barres d'appui (16a, 16b ; 116) et dans lequel le dispositif de commande est configuré en outre pour commander le treuil (22 ; 122) en fonction de la force mesurée sur les barres d'appui. 9. Apparatus (10; 100) according to one of the preceding claims, further comprising a link winch (22; 122) for attaching a body support system as well as force sensors for measuring the force applied by the user to the support bars (16a, 16b; 116) and wherein the control device is further configured to control the winch (22; 122) as a function of the force measured on the support bars. 10. Méthode de rééducation de la marche utilisant l'appareil selon l'une des revendications précédentes, comportant une étape consistant à équiper l'utilisateur de l'appareil (10 ; 100) de plusieurs capteurs, le dispositif de commande effectuant les étapes suivantes : 10. Method for rehabilitating walking using the apparatus according to one of the preceding claims, comprising a step consisting of equipping the user of the apparatus (10; 100) with several sensors, the control device carrying out the following steps: - collecter en temps réel les mesures des capteurs lorsque l'utilisateur marche sur le tapis roulant (12 ; 112), - collect sensor measurements in real time when the user walks on the treadmill (12; 112), - calculer en temps réel la position du centre de gravité de l'utilisateur en fonction des mesures des capteurs, et - calculate in real time the position of the user's center of gravity based on sensor measurements, and - contrôler en temps réel le déplacement du tapis roulant (12 ; 112) en fonction de la position du centre de gravité de l'utilisateur. - control in real time the movement of the treadmill (12; 112) according to the position of the user's center of gravity. 11. Méthode selon la revendication précédente, dans laquelle le dispositif de commande calcule en temps réel une valeur relative au déphasage du mouvement des bras et des jambes de l'utilisateur en fonction des mesures des capteurs et modifie la vitesse de déplacement du tapis roulant (12 ; 112) en fonction de ladite valeur. 11. Method according to the preceding claim, in which the control device calculates in real time a value relating to the phase shift of the movement of the arms and legs of the user as a function of the measurements of the sensors and modifies the speed of movement of the treadmill (12; 112) as a function of said value. 12. Méthode selon l'une des revendications 10 ou 11, dans laquelle l'une des jambes de l'utilisateur est attachée à un lien, par exemple au niveau du genou, le lien étant relié à un treuil (20 ; 120), la méthode consistant à piloter le dispositif de commande pour actionner le treuil (20 ; 120) afin de tirer la jambe vers l'avant en fonction du déplacement vers l'arrière de l'une des deux barres d'appui (16a, 16b ; 116). 12. A method according to either of claims 10 or 11, wherein one of the user's legs is attached to a link, for example at the knee, the link being connected to a winch (20; 120), the method comprising controlling the control device to operate the winch (20; 120) to pull the leg forward as a function of the rearward movement of one of the two support bars (16a, 16b; 116). 13. Méthode selon l'une des revendications 10 à 12, dans laquelle l'utilisateur est soutenu par un soutien corporel relié à un treuil (22 ; 122), la méthode consistant à piloter le dispositif de commande pour actionner le treuil (22 ; 122) pour lever ou abaisser le soutien corporel en fonction de la force appliquée par l'utilisateur sur les barres d'appui (16a, 16b ; 116). 13. A method according to any one of claims 10 to 12, wherein the user is supported by a body support connected to a winch (22; 122), the method comprising controlling the control device to operate the winch (22; 122) to raise or lower the body support depending on the force applied by the user to the support bars (16a, 16b; 116). 14. Méthode de rééducation de la marche utilisant l'appareil selon l'une des revendications 1 à 9, dans laquelle la méthode consiste à piloter le dispositif de commande pour actionner lesdits moyens (18 ; 118) afin d'appliquer à chaque barre d'appui (16a, 16b ; 116) une force entraînante ou une résistance à l'encontre des mouvements induits par l'utilisateur en fonction de la force appliquée par l'utilisateur sur chaque barre d'appui dans la direction de l'axe longitudinal de ladite barre (16a, 16b ; 116), de la vitesse de déplacement de chaque barre d'appui ou de la distance de déplacement de chaque barre d'appui. 14. A method of gait rehabilitation using the apparatus according to one of claims 1 to 9, wherein the method consists of controlling the control device to actuate said means (18; 118) in order to apply to each support bar (16a, 16b; 116) a driving force or resistance against the movements induced by the user in depending on the force applied by the user to each support bar in the direction of the longitudinal axis of said bar (16a, 16b; 116), the speed of movement of each support bar or the distance of movement of each support bar. 15. Méthode selon la revendication précédente, dans laquelle lesdits moyens sont sous la forme d'un moteur électrique (118), le dispositif de commande pilotant le moteur afin qu'il génère ladite résistance, l'intensité de la résistance étant contrôlée en fonction de la force exercée par l'utilisateur sur les barres d'appui dans la direction de l'axe longitudinal desdites barres. 15. Method according to the preceding claim, in which said means are in the form of an electric motor (118), the control device driving the motor so that it generates said resistance, the intensity of the resistance being controlled as a function of the force exerted by the user on the support bars in the direction of the longitudinal axis of said bars.
PCT/IB2024/058633 2023-09-05 2024-09-05 Walking rehabilitation apparatus for persons limited in their mobility Pending WO2025052286A1 (en)

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