Therapy and training device

Details Therapy and training device Therapy and training device

1998-03-09

2002-07-09

Richman, Glenn E. (Department: 3764)

Exercise devices

User manipulated force resisting apparatus, component...

Utilizing force resistance generated by user only

C482S051000, C482S113000

Reexamination Certificate

active

06416448

ABSTRACT:

FIELD OF THE INVENTION
The present invention relates to therapy and training equipment for constrained knee-joint movement with a lower leg accommodating arrangement and a guiding arrangement, which arrangements can be rotatably connected to one another via an articulated device.
1. Background of the Invention
Knee injuries and the associated knee operations frequently require a prolonged immobilisation of the knee-joint, which leads to a general weakening and impairment of the leg musculature and to restrictions in movement. Appropriate medical aids are therefore used in the treatment of knee injuries or in the post-operative period, which are designed to reduce the restrictions in movement or to counteract, by performing specific movement exercise, the incidence of restricted movement.
Particularly after a crucial ligament operation so-called motor driven rails are used to rehabilitate the joint. These motor driven rails serve to accommodate the injured leg and are provided with a drive device that permits a rotation of a lower leg receptacle relative to a thigh receptacle. This produces a knee-joint, movement, substantially free of any weight loads, so that the mobility of the knee joint can be trained without any damaging weight loads on the ligaments. The disadvantage of the known motor-driven rail is that, on the one hand, a drive (generally an electrical drive) is required to move the motor driven rail, and on the other hand the healthy leg is not involved in the movement, with the result that, particularly in the case of prolonged rehabilitation measures, there is a needless weakening and impairment of the musculature of the healthy leg. With a motor driven rail only a passive exercising of the musculature and tendons is thus possible. Furthermore, motor-driven rails are expensive to purchase on account of their motorised drive, which makes it difficult to carry out such rehabilitation measures, desirable per se, except in hospitals and clinics with technically sophisticated equipment and a corresponding procurement budget. Also, patients have found it difficult to handle and adapt individually to motor driven rails, with the result that these activities generally have to be carried out by trained care staff.
Cable pull arrangements are known, which are substantially simpler devices and can be used for movement therapy on a knee joint, and can be installed on a frame device at the patient's bed and, when coupled to a cable pull, can facilitate movements of the injured leg initiated by the health leg. However, a disadvantage with such cable pull arrangements is that the movement coupling between the healthy leg and the injured leg is not kinematically unambiguous, in other words it does not take place in a constrained manner, and for example there are degrees of freedom of movement in the direction opposite to the cable pull direction or even transverse thereto, which can allow movements that are harmful for the rehabilitation of the knee-joint.
Such cable pull arrangements are therefore also unable to replace the aforedescribed complicated and costly motor-driven rails.
2. Background of the Prior Art
This object is achieved by a device and equipment having the features of claim
1
.
SUMMARY OF THE INVENTION
In the device and equipment according to the invention the guiding arrangement cooperates with the lower leg accommodating arrangement in such a way that, on a rotational movement of one of the lower legs.
By coupling the lower leg accommodating arrangement, which serves to receive the patient's lower leg, to a guiding arrangement, which permits a movement of the lower leg simply along a predetermined movement path, an exactly defined knee-joint movement is provided that excludes damaging loads on the knee-joint. In the therapy and training equipment according to the invention the drive for the load-free movement of the injured leg is provided by a force actuated movement of the healthy leg, with the result that on the one hand an external drive can be dispensed with, while on the other hand the healthy leg at the same time experiences a specific training effect to strengthen the leg musculature, the movements of both the injured leg and healthy leg constituting an effective prophylaxis against thrombosis.
The expression “lower leg accommodating arrangement” used here is intended also to include the possibility of fixing the lower leg for instance on the outside, lying on a rail like device. The essential point is to fix the lower leg in a defined manner that allows the aforedescribed movement sequence.
Advantageous embodiments of the equipment according to the invention are the subject of claims
2
to
4
.
In the embodiment according to claim
5
the guiding arrangement is designed as a thigh receptacle, and the lower leg receptacle serves for the movement-coupled accommodation of both lower legs in such a way that, on rotational movement of one of the lower legs, the other lower leg is constrained to move as a result of the knee bending movement. With this therapy and training equipment a force-free movement of the injured leg can thus be achieved by a force actuated movement of the healthy leg. Through the coupled movement of the healthy leg and injured leg the injured leg is constrained to move during the movement of the healthy leg.
In this way it is on the one hand possible to dispense with a motor drive to effect a load-free movement of the injured leg, while on the other hand the musculature of the healthy leg is trained and toned up by the use of the healthy leg to “drive” the injured leg. In addition there is a propioceptive beneficial effect for the sensory motor control of the injured knee-joint.
In addition to the use of the therapy and training equipment to treat an injured leg, the said equipment can also be used purely as a training or sports equipment to train and tone up the leg musculature of both legs.
If, as is the case in a preferred embodiment, the articulated device is arranged so that its rotational axis is coaxial with the rotational axis of the knee-joints, this ensures that the knee joints are not subjected to turning moments and transverse forces that would otherwise occur if the two rotational axes were not coaxial.
It has proved particularly advantageous if the lower leg receptacle is provided in the heel region with a sliding or roller guide so that it is possible for the lower leg receptacle to slide over a suitably shaped underneath surface when the knee joint moves. This arrangement enables the therapy and training equipment to be used when the patient is supine, i.e. when the patient's buttocks and heels lie substantially in one plane and movement of the injured leg is effected by bending the healthy leg. Especially when using a roller guide, which places fewer demands on the flattest possible shape of the aforementioned underneath surface, the therapy and training equipment can thus be used in a patent's bed.
In order to set and adjust, a specific knee-bending range that is formed to be particularly advantageous for the treatment of the injured leg, the articulated device of the therapy and treatment equipment can be provided with two varying angle stops.
It has proved to be particularly advantageous, especially when using the therapy and training equipment in the patient's bed, if the articulated device is provided with a fixing and locking device for the variable adjustment of a fixed knee-bending position. In this way it is possible to lock the articulated device in a knee-bending position comfortable for the patient in question and thereby establish a rest position in which the patient can remain for a relatively long time without experiencing unpleasant tensions and strains, and without having to remove the therapy and training equipment, beforehand and re-install it when the movement therapy is resumed. This turns out to be particularly important since such therapies are often performed in so-called interval or staggered mode, with more or less long pauses between successive movement sections.
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