WO2025062260A1 - Manipulation unit and rehabilitation apparatus for the upper limb - Google Patents

Abstract

A manipulation unit (1) for a rehabilitation apparatus (9) comprises a frame (10), a handle group (3) movable with respect to said frame (10) and a connection group (2) which connects said handle group (3) to the frame (10) and which comprises : a pronation-supination subgroup (21), which comprises a first kinematic mechanism (4) for transmitting the rotation about a first axis (PS); an abduction-adduction subgroup (22), which comprises a second right track (6) and a second curvilinear left track (7) to transmit the rotation of the handle group (3) about a second axis (AA); a flexion-extension subgroup (23), which comprises a third kinematic mechanism (8), engaged to the handle group (3) to allow the handle group to rotate about a third axis (FE). A rehabilitation apparatus comprises said manipulation unit (1).

Description

MANIPULATION UNIT AND REHABILITATION APPARATUS FOR THE

UPPER LIMB DESCRIPTION

Field of application

[0001] The present invention relates to a manipulation unit for a rehabilitation apparatus for the motor recovery of the upper limb .

[0002] Neurological trauma, orthopedic injury, and joint diseases are widespread medical problems . An individual who has one or more of these disorders may lose motor control of one or more parts of the body, such as the wrist . Recovery of motor capacity often takes months or years for affected human tissues to repair and brain function to resume .

[0003] Several scientific studies have shown that rehabilitative physical therapy is critical to achieving improved motor recovery performance and in particular helps to optimize the range, strength, and precision of restored motor function and may also help stimulate the reorganization of brain processes .

[0004] Therefore, some robotic solutions for upper limb motor rehabilitation have been proposed in the last decade . [0005] Known rehabilitation apparatuses usually consist of joysticks that are passively movable or connected to active movement systems . [0006] The human upper limb achieves complex movements involving combinations of three basic degrees of freedom such as flexion-extension, pronation-supination and abduction-adduction (e . g . , the upper limb may perform a combination of flexion and abduction or extension and supination) in a substantially ellipsoidal working space . Fig . 1 is a schematic representation of the degrees of freedom of the wrist .

[0007] Disadvantageously, the rehabilitation apparatuses of the prior art often allow the movement of the wrist in a single degree of freedom (known as DOF ) .

[0008] Therefore, disadvantageously, the rehabilitation devices currently used do not allow natural mobilization of the wrist in all its degrees of freedom . For example, the devices described in the prior art documents US20190201273A1 , WO2018093448A2 , US20170209737A1 allow the passive movement of the wrist only in two degrees of freedom and are not suitable for performing abduction/adduction movements .

[0009] However, complete functional rehabilitation of the upper limb depends largely on the degree of mobilization of the wrist .

Solution of the invention

[0010] There appears to be a significant need therefore to provide a manipulation unit for a rehabilitation apparatus that is capable of overcoming the drawbacks typical of the prior art .

[0011] In particular, the obj ect of the present invention is to provide a manipulation unit and a rehabilitation apparatus for the upper limb to largely cover the range of motion of the wrist joint .

[0012] More specifically, the object of the present invention is to provide a rehabilitation apparatus that allows the movements of the human wrist in its three degrees of freedom (DOF ) , as shown in the accompanying Fig . 1 : f lexion/extension (FE ) , abduction/adduction, also called ulnar deviation/radial deviation (AA) , pronation/ supination (PS ) .

[0013] It is also an object of the present invention to provide an apparatus that largely covers the range of motion (ROM) of the wrist of a human subject for each individual degree of freedom, i . e . 85/ 70 degrees in pronation/ supination, 35/20 degrees in abduction/adduction and 75/ 70 degrees in f lexion/extension .

[0014] A further object of the present invention is to provide a rehabilitation apparatus suitable for delivering a torque as close as possible, preferably at least equal, to that actually delivered by the human wrist , i . e . , from the literature, about 10 Nm in pronation-supination, 15 Nm in flexion-extension and 10 Nm in abduction-adduction . [0015] Such requirement is satisfied by a manipulation unit and by a rehabilitation apparatus according to the accompanying independent claims . The claims dependent thereon describe preferred or advantageous embodiments of the invention, comprising further advantageous features . [0016] According to the present invention, a manipulation unit for a rehabilitation apparatus for the motor recovery of a subject ' s upper limb comprising :

- a frame suitable for being fixed to said rehabilitation apparatus ;

- a handle group movable with respect to said frame and comprising a handle graspable by the subject ;

- a connection group which connects said handle group to the frame and extends so as to identify a first pronation-supination axis , a second abduction-adduction axis , and a third flexion-extension axis , said first axis , second axis , and third axis being orthogonal to one another, wherein the connection group comprises a pronationsupination subgroup, an abduction-adduction subgroup, and a flexion-extension subgroup; wherein :

- the pronation-supination subgroup comprises a first kinematic mechanism connected to the frame and suitable for transmitting a rotation about the first axis ; the abduction-adduction subgroup comprises a second right track and a second left track which are curvilinear, extending at least partially about the second axis and which are slidingly engaged with the kinematic mechanism so as to allow the rotation of the handle group about the second axis ;

- the flexion-extension subgroup comprises a third kinematic mechanism joined to the second right track and the second left track so that the motion of said second right and left tracks is transmitted to said third kinematic mechanism; and wherein the handle group is slidingly engaged with the third kinematic mechanism, and is suitable for running along a curvilinear trajectory to rotate about said third axis .

[0017] According to the present invention, a rehabilitation apparatus comprises a manipulation unit according to the present invention and an electronic control unit operatively and electronically connected to such a manipulation unit configured to process one or more electronic signals from the manipulation unit and/or to execute a plurality of evaluation, exercise, or correction modules .

Description of the drawings

[0018] The features and advantages of the manipulation unit and rehabilitation apparatus will become apparent from the following description of some preferred embodiments , given by way of indicative and non-limiting example, with reference to the attached figures , wherein :

- Fig . 1 is a schematic representation of the basic movements in the degrees of freedom of a human wrist ;

- Fig . 2 is a perspective view of a manipulation unit in one embodiment of the present invention in the neutral position;

- Fig . 3a and 3b are two perspective views of a manipulation unit in one embodiment of the present invention, in pronation and supination;

- Fig . 4a and 4b are two perspective views of a manipulation unit in one embodiment of the present invention, in radial and ulnar deviation;

- Fig . 5a and 5b are two perspective views of a manipulation unit in one embodiment of the present invention, in flexion and extension;

- Fig . 6 shows a manipulation unit in one embodiment of the present invention, wherein the handle has implemented a complex movement given by the sum of several basic movements of the wrist ;

- Fig . 7 shows a handle group according to one embodiment of the present invention;

- Fig . 8 shows a manipulation unit according to one embodiment of the present invention, wherein the handle is grasped by a subject ;

- Fig . 9 is a perspective view of a rehabilitation apparatus according to an embodiment of the present invention;

- Fig . 10 is a perspective view of a rehabilitation apparatus according to one embodiment of the present invention, wherein the handle is grasped by a subject in the standing position .

Detailed description

[0019] With reference to the aforesaid figures , a manipulation unit 1 for a rehabilitation apparatus 9 for the motor recovery of the upper limb is collectively indicated with the reference number 1 . In particular, in this discussion reference is made to a rehabilitation apparatus 9 for articulating the wrist of a sub ject .

[0020] In one embodiment , the rehabilitation apparatus 9 comprises a manipulation unit 1 and an electronic control unit 90 operatively and electronically connected to said manipulation unit 1 .

[0021] In one embodiment , the electronic control unit 90 is configured to process one or more electronic signals from the manipulation unit 1 and/or to carry out a plurality of evaluation, operation, or correction modules .

[0022] The manipulation unit 1 comprises a frame 10 and a handle group 3 movable with respect to said frame 10 .

[0023] In the accompanying figures , for simplicity, the frame 10 is represented with only the mechanical supporting structure but it is clear that in one embodiment the frame 10 comprises further structural and/or aesthetic components , not shown in Fig . 2 to 6 for simplicity of discussion .

[0024] The handle group 3 comprises a handle 30 suitable for being grasped by the hand of a subject and a handle support 32 on which the handle 30 is engaged .

[0025] The manipulation unit 1 further comprises a connection group 2 that connects the handle group 3 to the frame 10 and that allows the translation and/or rotation of the handle group 3 with respect to said frame 10 .

[0026] In an advantageous embodiment , the handle group 3 is movable with respect to the frame 10 in three degrees of freedom (DOF ) .

[0027] Preferably, these three degrees of freedom are designated in accordance with the three degrees of freedom of the human wrist , as referred to in Fig . 1 , and in particular identify three main movement axes , associable with three axes of movement of the wrist j oint :

- a first pronation-supination axis PS ;

- a second abduction-adduction axis AA (or radial-ulnar deviation) ; a third flexion-extension axis FE .

[0028] These three axes represent a Cartesian tern and are all orthogonal to each other .

[0029] The flexion-extension, pronation-supination, and abduction-adduction movements may be reduced in a simplified manner to rotations of the wrist joint about these axes . The complex movements of the wrist , therefore, may be broken down into a series of such simple rotations . [0030] The connection group 2 is suitable for allowing the motion of the handle group 3 with respect to the frame 10 in these three degrees of freedom, i . e . about such first axis PS, second axis AA, third axis FE .

[0031] The connection group 2 comprises three connection subgroups 21 , 22 , 23 , each allowing the movement of the handle group 3 about the first axis PS, the second axis AA, or the third axis FE, respectively .

[0032] In particular, said three connection subgroups 21 , 22 , 23 are a pronation-supination subgroup 21 , an abduction-adduction subgroup 22 , and a flexion-extension subgroup 23 .

[0033] In particular, the handle group 3 is directly connected to the flexion-extension subgroup 23 . The pronation-supination subgroup 21 is directly connected to the frame 10 . The abduction-adduction subgroup 22 is interposed between the flexion-extension subgroup 23 and the pronation-supination subgroup 21 and connects them together .

[0034] In other words , in order, the connection between the handle group 3 and the frame 10 meets the flexion-extension subgroup 23 , the abduction-adduction subgroup 22 , and the pronation-supination subgroup 21 .

[0035] Each subgroup is connected to the adjacent subgroup in a movable manner and in particular as explained hereinafter .

[0036] The pronation-supination subgroup 21 comprises a first kinematic mechanism 4 connected to the frame 10 and suitable for transmitting a rotation about the first axis PS ;

[0037] In a preferred embodiment , the first kinematic mechanism is a first curvilinear track 4 , preferably with a circumferential arc, extending at least partially about the first axis PS between a right end 41 and a left end 42 . This curvilinear track 4 is slidingly engaged to the frame 10 .

[0038] The circumferential arc identified by the first curvilinear track 4 defines a first sliding plane A perpendicular to the first axis PS .

[0039] In one embodiment , the frame 10 comprises a first guide assembly 50 in which such curvilinear track 4 slides . [0040] In a preferred embodiment , the first guide assembly 50 comprises a plurality of rotating rollers , preferably four or eight rotating rollers , suitable for guiding and facilitating the sliding of the first curvilinear track 4 with respect to the frame 10 .

[0041] Preferably, the first curvilinear track 4 identifies a semi-circumference centered on the first axis PS . That is , preferably, the first curvilinear track 4 is semicircular .

[0042] Due to its shape, the sliding of the first curvilinear track 4 occurs in both allowed directions and results in an oscillation about the first axis PS and, due to the connection made with the handle group 3 , achieves the pronation-supination of the hand grasping the handle 30 .

[0043] In one embodiment , the curvilinear track 4 slides in the first guide assembly 50 along its entire length from the right end 41 to the left end 42 and vice versa .

[0044] Advantageously, the pronation-supination subgroup 21 thus obtained allows a radius of movement of 65/ 65 degrees in pronation/ supination to be achieved .

[0045] The abduction-adduction subgroup 22 comprises a second right track 6 and a second left track 7 , which are curvilinear and parallel to each other .

[0046] Advantageously, the abduction-adduction subgroup 22 according to the present invention is suitable for not interfering with the movement of the wrist grasping the handle and allows a complete movement of the subject ' s wrist that in other systems , for example involving the positioning of the prone hand, is not facilitated or is even hindered .

[0047] The second right track 6 extends between a right free end 61 and a right connecting end 62 identifying a second right sliding plane B orthogonal to the second axis AA (preferably, orthogonal to the first sliding plane A) .

[0048] The second left track 7 extends between a left free end 71 and a left connecting end 72 identifying a second left sliding plane B' parallel to the second right sliding plane B .

[0049] The second right track 6 and the second left track 7 are preferably mirrored with respect to the first axis PS . Preferably, these right and left tracks 6 and 7 extend in two circumferential arcs , even more preferably identical to each other ( i . e . having the same length) .

[0050] Even more preferably, these circumferential arcs are identified by an angle at the center between 145 and 150 degrees , more preferably equal to 147 . 75 degrees .

[0051] The second right track 6 and the second left track 7 are slidingly engaged with the first curvilinear track 4 . [0052] Preferably, the pronation-supination subgroup 21 comprises a right guide element 51 projecting from the right end 41 and a left guide element 52 projecting from the left end 42 of the first curvilinear track 4 .

[0053] In a preferred embodiment , these guide elements 51 , 52 extend from the first curvilinear track 4 in the direction identified by the first axis PS, i . e . , the right guide element 51 extends from the right end 41 in the second right sliding plane B and the left guide element 52 extends from the left end 42 into the second left sliding plane B' , respectively .

[0054] The right guide element 51 slidingly engages the second right track 6 and the left guide element 52 slidingly engages the second left track 7 .

[0055] The second right track 6 and the second left track 7 therefore slide in the respective right 51 or left 52 guide elements so that a rotation with respect to the second axis AA is transmitted to the handle group 3 , i . e . so that the abduction-adduction movement is simulated .

[0056] Preferably, the right guide element 51 and the left guide element 52 comprise respective rotating rollers , preferably four on the right and four on the left , for guiding and facilitating the sliding of the respective second right 6 and left 7 tracks .

[0057] In one embodiment , the second right track 6 and the second left track 7 move solidly with each other .

[0058] In one embodiment , the second right track 6 and the second left track 7 slide for their entire length from the relative free end 61 , 71 to the relative connecting end

62 , 72 and vice versa .

[0059] For the neutral position of the wrist , the second right track 6 and the second left track 7 are mounted in such a way that the relative right and left free ends 61 , 71 are offset in the direction of the ulnar deviation at an angle of +3 . 1 degrees with respect to a vertical plane . [0060] Advantageously, the abduction-adduction subgroup 22 thus obtained allows a radius of movement of 60 degrees in ulnar deviation and 35 degrees in radial deviation to be achieved .

[0061] Advantageously, by virtue of the fact that they have free ends , the second right track 6 and the second left track 7 may be designed to be longer in length to allow even greater movement radii (where necessary and sensible and without generating interference in the movement of the unit ) .

[0062] The flexion-extension subgroup 23 comprises a third kinematic mechanism 8 joined to the second right track 6 and to the second left track 7 so that the motion of said second right and left track 6, 7 is transmitted to said third kinematic mechanism 8 .

[0063] In a preferred embodiment , the third kinematic mechanism 8 is a third curvilinear track 8 extending between a first end portion 81 and a second end portion 82 . The third curvilinear track 8 extends mainly into a third sliding plane C orthogonal to the third axis FE .

[0064] In one embodiment , the third track 8 identifies a circumferential arc centered in the third axis FE .

[0065] Preferably, the third curvilinear track 8 defines a semi-circumference centered on the third axis FE . That is , preferably, the third curvilinear track 8 is semicircular . [0066] The third curvilinear track 8 is rigidly connected to the second right track 6 and to the second left track 7 , preferably at the end portions 81 , 82 thereof .

[0067] In particular, the first end portion 81 is constrained to the right connecting end 62 of the second right track 6, and the second end portion 82 is constrained to the left connecting end 72 of the second left track 7 .

[0068] The expression "rigidly connected" means that the third curvilinear track 8 is suitable for moving solidly - rigidly, in fact - with the second right track and the second left track 6, 7 .

[0069] The handle group 3 is slidingly engaged to the third curvilinear track 8 , i . e . it slides on the track 8 about the third axis FE .

[0070] In particular, the handle support 32 comprises a third guide group 53 in which the third curvilinear track 8 is slidingly engaged .

[0071] In one embodiment , the third curvilinear track 8 slides along its entire length from the first end portion

81 to the second end portion 82 and vice versa .

[0072] Preferably, the third guide group 53 comprises rotating rollers , preferably four, to for guiding and facilitating the sliding of the third curvilinear track 8 into the third guide group 53 .

[0073] Advantageously, the flexion-extension subgroup 23 thus achieved allows a radius of movement of 70 degrees in flexion and 70 degrees in extension to be obtained .

[0074] In one embodiment , each connection subgroup 21 , 22 , 23 is provided with a relevant plurality of motors (not shown) configured to actively drive the movement of each track with respect to the relevant elements or guide groups .

[0075] Preferably, said motors are connected to respective position sensors which transmit to the electronic control unit 90 , operatively and electronically connected to said manipulation unit 1 , the position of the handle group 3 with respect to said first axis PS, second axis AA, third axis FE .

[0076] Preferably, the motors are operable by the electronic control unit to compensate for any weight imbalances due to gravity . That is , such motors are configured to keep the handle surface in line with the positioning of the forearm in the neutral position, along the first axis PS . [0077] More generally, the motors are operable to compensate for the force of gravity instantaneously in each position assumed by the rehabilitation apparatus .

[0078] Preferably, the motors are connected to the relevant subgroup by means of a single-stage transmission system with pinion and toothed belt .

[0079] In an advantageous embodiment , the subgroups , and in particular, preferably, the relevant motors , are connected to position sensors , which transmit to the electronic control unit 90 the position of the handle group 3 with respect to the frame 10 .

[0080] In one embodiment , the connection subgroups are at least partially enclosed by covering enclosures having a purely aesthetic and safety purpose .

[0081] Preferably, the first curvilinear track 4 and/or the second right track 6 and/or the second left track 7 and/or the third curvilinear track 8 are made of aluminum .

[0082] In one embodiment , the rotating rollers are made of bronze .

[0083] In a preferred embodiment , the outer diameter of the first curvilinear track is between 167 mm and 170 mm, preferably equal to 168 . 56 mm .

[0084] In one embodiment , the outer diameter of the second right track 6 and the second left track 7 is between 237 mm and 240 mm, preferably it is 238 . 38 mm . [0085] In one embodiment , the outer diameter of the third curvilinear track 8 is between 160 and 165 mm, preferably equal to 163 . 63 mm .

[0086] In other words , when the subject grasps the handle 30 , the pronation-supination subgroup 21 allows the pronation and supination of the human wrist-forearm assembly with rotational movements about the first axis PS, the abduction-adduction subgroup 22 allows the radial and ulnar deviation of the human wrist with rotational movements about the second axis AA, the flexion-extension subgroup 23 allows the flexion and extension of the wrist with rotational movements about the third axis FE .

[0087] Preferably, each subgroup 21 , 22 , 23 is equipped with a relevant motor and a transmission system based on toothed belts , which are not essential for the operation of the rehabilitation apparatus . In fact , each subgroup may be used both with and without the motor installed .

[0088] That is , the rehabilitation apparatus is suitable for operating in an active assisted or resistive manner by means of the torques delivered by the motors to each affected subgroup, but it is also possible to move the handle group without activating the motor, i . e . , to use the rehabilitation apparatus passively .

[0089] For example, in use, a subject grasps the handle 30 so that the anatomical axes of the wrist correspond to the virtual axes of the device .

[0090] The user may therefore move the handle 30 by performing the rotational movements characteristic of the human wrist , both individually and in combination with each other in complex movements .

[0091] With reference to Fig . 7 , the handle 30 extends in a substantially vertical preferential extension direction Y and is suitable for being grasped by the hand of a subject , preferably with the palm of the hand identifying a substantially vertical plane in which lies such preferential extension direction Y, which closes about said handle 30 .

[0092] Preferably, the preferential extension direction Y is parallel to the third axis FE .

[0093] In one embodiment , the handle 30 comprises an upright 300 and a grasping element (not shown) arranged above the upright 300 . The grasping element is preferably made of a soft and/or yielding material, preferably expanded ( for example foam or rubber or padded fabric) and may be shaped to facilitate the correct positioning of the hand .

[0094] Preferably, the rehabilitation apparatus 1 comprises an upper limb locking system that fixes the subject ' s forearm and hand in the correct position . Preferably, such a locking system comprises a wrist locking group 200 , a hand locking group 201 , and an elbow locking group 202 , as shown for example in Fig . 8 .

[0095] Preferably, the hand locking group 201 is integrated into the handle group 3 and in particular into the upright 300 of the handle .

[0096] In a preferred embodiment , the handle 30 is engaged in a linearly translatable manner with respect to the handle support 32 .

[0097] According to one aspect of the invention, the handle 30 is linearly translatable with respect to the handle support 32 , preferably along a horizontal direction X orthogonal to the preferential extension direction Y .

[0098] Preferably, the horizontal direction X is parallel to, even more preferably coincident with, the first axis PS .

[0099] In one embodiment , the handle support 32 comprises a linear guide slidingly engaged with the handle 30 .

[00100] In one embodiment , the linear guide comprises a pair of sliding rods 39 extending in the horizontal direction X . The handle 30 comprises a foot 35 connected to a pair of carriages 37 sliding on said sliding rods 39 . Preferably, the sliding rods 39 are cylindrical, and such pair of carriages 37 is equipped with recirculating ball bushings 38 that facilitate their sliding on said rods .

[00101] In one embodiment , the linear guide further comprises a locking mechanism suitable for fixing the position of the handle 30 along such linear guide .

[00102] Preferably, the linear guide has a stroke of between 90 and 100 mm, preferably equal to 95 mm .

[00103] Advantageously, this embodiment makes the manipulation unit 1 adaptable to both adults and children and, more generally, adjustable to adapt to the patient ' s anthropometric measurements . Advantageously, therefore, this manipulation unit 1 may be customized to operate as faithfully as possible with each subj ect .

[00104] Furthermore, advantageously, this function allows an additional degree of freedom to be provided to the motion of the wrist , possibly leaving the guide free to slide even during operation .

[00105] Consequently, this embodiment makes the handle movable in four degrees of freedom .

[00106] According to a further advantage, this linear guide makes it possible to compensate for the biomechanics of the wrist joint , which is not a perfectly spherical joint .

[00107] In an advantageous embodiment , the handle group 3 further comprises a position sensor 5 configured to detect the instantaneous position of the handle 30 on the linear guide .

[00108] In a preferred embodiment , the position sensor is a magnetic linear encoder and comprises a chip board positioned below the foot 35 of the handle 30 , and a magnetic belt 500 integral with the handle support 32 , near which such a board slides - preferably substantially in contact - to transmit the position of the handle 30 with respect to the linear guide .

[00109] Preferably, the magnetic belt 50 is positioned between the sliding rods 39 .

[00110] Advantageously, the addition of a position sensor makes it possible to measure the instantaneous position of the handle - and thus , of the subject ' s hand - on the linear guide while performing rehabilitation tasks . Given the position and knowing the motor torque values , it is possible to correctly estimate the force applied by the rehabilitation apparatus to the user .

[00111] In the prior art , the measurement of these forces is usually estimated by assuming the handle to be halfway through its stroke, clearly returning values far from the actual ones . Experimental tests have revealed that the average error in estimating the force of interaction with this methodology is equal to about 12 . 9% of the effective force .

[00112] Advantageously, this sensor therefore allows an accurate knowledge of the forces exchanged between the user and the device, which is essential for improving the reliability of the results and for leading to safer conditions of use .

[00113] The electronic control unit 90 is configured to receive and process signals collected and sent by the manipulation unit 1 and to return control feedback, either automatic or manually controlled, to the manipulation unit 1 based on the reading and processing of these signals .

[00114] Preferably, the electronic control unit 90 is configured to command the manipulation unit 1 to carry out a plurality of evaluation, operation, or correction modules . For example, the electronic control unit 90 commands the manipulation unit 1 to carry out an evaluation module with which to evaluate the motor and proprioceptive function of the subject ' s wrist by passively reading the movement of the manipulation unit 1 or to carry out an exercise module with which to train the rehabilitation of the subject ' s wrist by actively controlling the manipulation unit 1 .

[00115] According to one aspect , the electronic control unit is configured to drive the motors to compensate for any weight imbalances of the manipulation unit due to gravity .

[00116] According to one aspect , the frame 10 constitutes the load-bearing structure of the manipulation unit 1 .

[00117] In one embodiment , the frame 10 comprises at least one support base 100 suitable to support the upper limb of a subject , preferably the sub ject ' s forearm .

[00118] The support base 100 is therefore adapted, sized, and shaped, preferably curved, to ergonomically receive a forearm of a subject .

[00119] Preferably, the support base 100 has a support pad that faces the subject ' s forearm to comfortably allow for the support , even prolonged, thereof .

[00120] The present invention also relates to a rehabilitation apparatus 9 comprising a manipulation unit 1 according to any embodiment described in the present discussion .

[00121] In one embodiment , for example with reference to Fig . 9 and 10 , the rehabilitation apparatus 9 comprises a load-bearing structure 900 suitable for supporting the manipulation unit 3 and the electronic control unit 90 . Preferably, the load-bearing structure 900 is provided with wheels 920 to allow easy movement thereof .

[00122] In one embodiment , the rehabilitation apparatus 9 further comprises a display and interface unit 95 comprising one or more display and control systems 950 , for example one or more displays .

[00123] Preferably, the load-bearing structure further comprises a height adjustment system 96, for example a telescopic upright , suitable for adjusting the height of the manipulation unit 1 and/or the interface and display system 95 so that it is suitable for the height and/or position of the patient , whether sitting, standing, or lying down .

[00124] In one embodiment , the rehabilitation apparatus 9 comprises an inclination system that is suitable for adjusting the inclination of the manipulation unit 1 with respect to the load-bearing structure 900 , i . e . suitable for rotating the entire manipulation unit 1 with respect to the load-bearing structure 900 .

[00125] Advantageously, this system allows the working axes of the manipulation unit 1 to be fitted with the axes of the upper limb of a subject even when the subject is not able to assume an upright position, for example due to physical problems , or when the subject is not able to position the arm correctly due to elbow f lexion/extension deficiencies .

[00126] The manipulation unit 1 described in this discussion may be applied to various applications .

[00127] In particular, the present discussion describes , without being limiting in nature or without loss of generality, the application of the manipulation unit 1 in a rehabilitation apparatus 9 for the upper limb, which may be used, for example, in the hospital or at the home of the subject to be treated . [00128] Furthermore, the described manipulation unit finds application in a device for evaluating motor capacity . The device may be used, for example, to collect data on the movement , force, and sensory function of the patient in a therapeutic session and/or in multiple sessions . These data may help therapists to quantify patient improvements and/or to identify problem areas on which to focus treatment . It may also be used for preventive evaluations , such as the prevention of accidents at work .

[00129] A further application may be in a research tool to study the brain and how it controls , coordinates , and perceives movement and body position . The device may be used to map the activity of the wrist with respect to brain activity . Using technology that is able to monitor or visualize brain activity, such as electromyography (EMG) , electroencephalography (EEG) , positron emission tomography (PET) or functional magnetic resonance imaging ( fMRI ) , it is possible to map the relationships between wrist movements and brain activity .

[00130] Furthermore, the manipulation unit 3 finds application inside a sports training device . The device may be used to train or evaluate sensorimotor conditions of the wrist in sports such as climbing, tennis , and golf . [00131] Furthermore, the manipulation unit finds application in a training device for upper limb prostheses .

[00132] Furthermore, the manipulation unit is used in the field of video game controllers , in virtual reality, and in the remote control of remote stations .

[00133] Innovatively, the present invention solves the drawbacks of the rehabilitation apparatuses of the prior art .

[00134] Advantageously, the rehabilitation apparatus according to the present invention includes three groups of rotation for the respective three degrees of freedom of the connected wrist in a single device .

[00135] According to a further advantage, the rehabilitation apparatus allows the complete radius of movement about the axes to be reached in a fixed position . That is , advantageously, the geometric constraints of the construction of the apparatus do not pose limits to the movement of the handle by the subject .

[00136] According to a further advantage, in particular, the tracks that make up the pronation-supination subgroup are such as to allow for the pronation-supination motion while keeping the handle grasped and thus achieving a complete movement of the subject ' s wrist .

[00137] Advantageously, the rehabilitation apparatus comprises tracks and rollers designed to gently couple and slide with each other without generating unwanted spaces and vibrations .

[00138] According to a further advantage, the entire radius of movement of the wrist within the three degrees of freedom may be reached both passively ( i . e . , without the provision of driving torque by the motors ) and in an assisted and/or perturbative and/or resistive manner ( i . e . , with the provision of driving torque by the motors ) . [00139] Advantageously, the manipulation unit is versatile and may be used without motors or with motors .

[00140] Advantageously, the abduction-adduction subgroup is suitable for allowing a rotation about the second axis AA of a sufficient amount of degrees to cover the typical range of movement of the human wrist .

[00141] Therefore, advantageously, the manipulation unit is suitable for faithfully simulating the motion of the wrist of a healthy subject .

[00142] Advantageously, the manipulation unit is adapted to implement both the simple movements in the three separate degrees of freedom and the complex movements deriving from a combination thereof .

[00143] Advantageously, the manipulation unit is symmetrical and may therefore be used by both the upper left and upper right limbs of a subject .

[00144] According to a further advantage, the manipulation unit is not affected by interference between the subgroups of the connection group during the movement thereof .

[00145] It is clear that , to the embodiments of the aforesaid rehabilitation apparatus and the aforesaid manipulation unit , a person skilled in the art , in order to meet specific needs , may make variations or substitutions of elements with other functionally equivalent ones .

[00146] These variants are also contained within the scope of protection as defined by the following claims .

Moreover, each variant described as belonging to a possible embodiment may be implemented independently of the other variants described .

Claims

1. A manipulation unit (1) for a rehabilitation apparatus (9) for the motor recovery of a subject's upper limb, comprising:

- a frame (10) suitable for being fixed to said rehabilitation apparatus (9) ;

- a handle group (3) movable with respect to said frame (10) and comprising a handle (30) graspable by the subject;

- a connection group (2) which connects said handle group (3) to the frame (10) and extends so as to identify a first pronation-supination axis (PS) , a second abductionadduction axis (AA) , and a third flexion-extension axis (FE) , said first axis (PS) , second axis (AA) , and third axis (FE) being orthogonal to one another, wherein the connection group (2) comprises a pronationsupination subgroup (21) , an abduction-adduction subgroup (22) , and a flexion-extension subgroup (23) ; wherein :

- the pronation-supination subgroup (21) comprises a first kinematic mechanism (4) connected to the frame (10) and suitable for transmitting a rotation about the first axis (PS) ;

- the abduction-adduction subgroup (22) comprises a second right track (6) and a second left track (7) which are curvilinear, extending at least partially about the second axis (AA) and which are slidingly engaged with the kinematic mechanism so as to allow the rotation of the handle group (3) about the second axis (AA) ;

- the flexion-extension subgroup (23) comprises a third kinematic mechanism (8) joined to the second right track

(6) and the second left track (7) so that the motion of said second right and left tracks (6, 7) is transmitted to said third kinematic mechanism (8) ; and wherein the handle group (3) is slidingly engaged with the third kinematic mechanism (8) , and is suitable for running across a curvilinear trajectory to rotate about said third axis (FE) .

2. Manipulation unit (1) according to claim 1, wherein the curvilinear second right track (6) and second left track

(7) are parallel to each other.

3. Manipulation unit (1) according to claim 1 or 2, wherein the first kinematic mechanism is a first curvilinear track (4) extending at least partially about the first axis (PS) and slidingly engaged with the frame (10) to allow the rotation of the handle group (3) about the first axis (PS) .

4. Manipulation unit (1) according to claim 3, wherein the first curvilinear track (4) is semicircular and extends in a semi-circumference about the first axis (PS) between a right end (41) and a left end (42) defining a first sliding plane (A) perpendicular to the first axis (PS) and wherein the frame (10) comprises a first guide assembly (50) in which said first curvilinear track (4) slides, said guide assembly (50) comprising a plurality of rotating rollers (500) , preferably four or eight in number, suitable for guiding the sliding of the first curvilinear track (4) with respect to the frame (10) .

5. Manipulation unit (1) according to any one of the preceding claims, wherein the second right track (6) extends between a right free end (61) and a right connecting end (62) identifying a second right sliding plane (B) orthogonal to the second axis (AA) and wherein the second left track (7) extends between a left free end (71) and a left connecting end (72) identifying a second left sliding plane (B' ) parallel to the second right sliding plane (B) .

6. Manipulation unit (1) according to any one of the preceding claims, wherein the second right track (6) and the second left track (7) extend in two circumferential arcs having the same length and mirroring each other.

7. Manipulation unit (1) according to claim 6, wherein said circumferential arcs are identified by an angle in the center between 145 and 150 degrees, preferably equal to 147.75 degrees.

8. Manipulation unit (1) according to any one of the preceding claims, wherein the first curvilinear track (4) is semicircular and extends in a semi-circumference about the first axis (PS) between a right end (41) and a left end (42) and wherein the pronation-supination subgroup (21) comprises a right guide element (51) projecting from said right end (41) and a left guide element (52) projecting from said left end (42) , and wherein the right guide element (51) slidingly engages the second right track (6) and the left guide element (52) slidingly engages the second left track (7) so that the second right track and the second left track (6, 7) are suitable for transmitting a rotation to the handle group (3) with respect to the second axis (AA) .

9. Manipulation unit (1) according to claim 8, wherein the right guide element (51) and the left guide element (52) comprise respective rotating rollers for guiding and facilitating the sliding of the respective second right and left tracks (6, 7) with respect to the first curvilinear track (4) .

10. Manipulation unit (1) according to any one of the preceding claims, wherein the second right track (6) and the second left track (7) move solidly with each other.

11. Manipulation unit (1) according to any one of the preceding claims, wherein the third kinematic mechanism (8) is a third curvilinear track (8) extending at least partially about the third axis (FE) .

12. Manipulation unit (1) according to claim 11, wherein the third curvilinear track (8) is semicircular and extends in a semi-circumference about the third axis (FE) between a first end portion (81) and a second end portion (82) defining a third sliding plane (C) perpendicular to the third axis (FE) and is rigidly connected to the second right track (6) at the first end portion (81) and to the second left track (7) at the second end portion (82) .

13. Manipulation unit (1) according to claim 11, wherein the handle group comprises a handle support (32) supporting the handle ( 30 ) , said handle support (32) comprising a third guide group (53) in which the third curvilinear track (8) is slidingly engaged, said guide group (53) comprising rotating rollers, preferably four in number, for guiding and facilitating the relative sliding between the third curvilinear track (8) and the third guide group (53) .

14. Manipulation unit (1) according to any one of the preceding claims, comprising a plurality of motors connected to the first subgroup (21) , the second subgroup (22) , and the third subgroup (23) , said motors being connected to respective position sensors which transmit to an electronic control unit (90) operatively and electronically connected to said manipulation unit (1) the position of the handle group (3) with respect to said first axis (PS) , second axis (AA) , third axis (FE) .

15. Manipulation unit (1) according to claim 13, wherein the handle support (32) comprises a linear guide and the handle (30) is slidingly engaged with said linear guide, and wherein the linear guide comprises a pair of sliding rods (39) and the handle (30) comprises a foot (35) connected to a pair of carriages (37) slidingly engaged on said sliding rods (39) .

16. Manipulation unit (1) according to claim 15, wherein the handle group (3) comprises a position sensor (5) configured to detect the instantaneous position of the handle (30) on the linear guide, said position sensor (5) being a magnetic linear encoder and comprising a chip board positioned below the foot (35) of the handle (30) and a magnetic belt (30) integral with the handle support (32) , near which such a board slides to transmit the position of the handle (30) with respect to the linear guide.

17. A rehabilitation apparatus (9) comprising a manipulation unit (1) according to any one of the preceding claims and an electronic control unit (90) operatively and electronically connected to such a manipulation unit (1) , said electronic control unit (90) being configured to process one or more electronic signals from the manipulation unit (1) and/or execute a plurality of evaluation, exercise, or correction modules.

18. Rehabilitation apparatus (9) according to claim 17, comprising:

- a load-bearing structure (900) suitable for supporting the manipulation unit (1) and the electronic control unit (90) ,

- a height adjustment system (96) , suitable for adjusting the height of the manipulation unit (1) so that it is suitable for the height and/or position of the subject to be treated,

- an inclination system, suitable for adjusting the inclination of the manipulation unit (1) with respect to the load-bearing structure (900) .