Patent Grant
10589141
This application claims the benefit of priority to Japanese Application No. 2017-010879, filed Jan. 25, 2017, in the Japanese Patent Office. All disclosures of the document named above are incorporated herein in their entireties by reference.
The present invention relates to an active exercise apparatus for a patient or the like to move their lower limbs by themselves, and more specifically, relates to an apparatus for performing active exercise of lower limbs on a floor.
We have entered into the super-aged society, and osteoarthritis is largely exerting influence on elderly people's healthy life span and is increasing the possibility of bringing them into the state in need of nursing care. As one of countermeasures against this issue, total joint arthroplasty of lower limb is expected to improve significantly the quality of life (QOL), but poses a high risk of deep vein thrombosis (DVT) after surgery.
Deep vein thrombosis (DVT) and subsequent pulmonary embolism (PE) are severe complications in surgery. In addition, the incidence of DVT and PE become higher in environments where the patients' activities are limited due to evacuation from disasters or the like, and therefore preventative measures are required.
Under the current DVT prevention guidelines, pharmacological prevention methods using anticoagulant or the like and physical prevention methods such as early ambulation, wearing elastic stockings, intermittent pneumatic compression devices, and lower limb active exercise are recommended. Among them, the method of increasing blood flow to the leg vein by active exercise is particularly regarded as being effective in the prevention of DVT and PE.
There have been conventionally proposed apparatuses for moving passively or actively ankle joints to increase blood flow to the leg vein (refer to Patent Documents 1 to 3, for example). The apparatuses described in Patent Documents 1 and 2 are configured to assist the dorsal flexion and extension of a user's ankle joints by operating sole holding plates with a drive source such as a motor. The apparatus described in Patent Document 3 is an apparatus for a patient to perform active exercise by themselves and is configured such that right and left holders holding the patient's feet are capable of turning in the horizontal direction and are moved in synchronization in the front-back direction.
There has also been proposed a preventive instrument including sole fixing parts, a wearing part having a belt body wound around and fixed to a user's lower legs, and an elastic part composed of an elastic material to connect the sole fixing parts and the wearing part to exert a biasing force against the rotation of the ankle joints (see Patent Document 4). When the user wearing the preventive instrument performs the plantar flexion motion of the ankle joints, the belt body compresses the sural region to increase the rate of blood flow in the deep veins of the lower legs, and the elastic part applies a load to the plantar flexion motion of the ankle joints, thereby enhancing the motion effect.
Patent Literature 1: Japanese Unexamined Patent Application Publication No. 2008-302019
Patent Literature 2: Japanese Unexamined Patent Application Publication No. 2012-29787
Patent Literature 3: Japanese Unexamined Patent Application Publication No. 2013-34755
Patent Literature 4: Japanese Unexamined Patent Application Publication No. 2016-165365
However, the foregoing conventional instruments for lower limb exercise have such problems as described below. Although it is known that performing exercise to contract and relax soleus muscles would decrease the incidence of thrombosis, the apparatuses described in Patent Documents 1 and 2 are intended to move only the ankle joints while fixing the ankles and shins. The calf muscles and the soleus muscles work on the plantar flexion of the ankle joints. The soleus muscles are site of predilection for thrombosis and are desirably caused to contract. However, when the ankle joints are plantarflexed in a knee extension position, the calf muscles become agonist muscles and thus the soleus muscles may not be sufficiently contracted.
In addition, the apparatuses described in Patent Documents 1 and 2 need a drive source such as a motor, and are larger in size and weight with poor handling properties. Further, these apparatuses are designed for passive exercise and are lower in the effect of preventing DVT as compared to active exercise.
Meanwhile, the apparatus described in Patent Document 3 is designed for patients to move their lower limbs by themselves and perform active exercise, and is expected to be highly effective in preventing DVT. However, the apparatus cannot be said to produce the sufficient contraction of the soleus muscles and is needed to further improve exercise efficiency. The apparatus described in Patent Document 3 is also heavy in weight and is not easy to attach to a bed or the like and adjust the position of the apparatus. Further, the preventive instrument described in Patent Document 4 is not suited for use on a floor and takes a lot of trouble in wearing, and is difficult to apply to the patients immediately after total joint arthroplasty.
Accordingly, an object of the present invention is to provide an active exercise apparatus for lower limbs that allows the user to perform on a floor lower limb active exercise highly effective in preventing thrombosis.
An active exercise apparatus for lower limbs according to the present invention includes at least: a base body; a shaft fixed to the base body such that a central axis is vertical to a surface of the base body; arms that are rotatably attached to the shaft and are extended in two directions at an equal angle with respect to the central axis of the shaft; sole support plates that are attached to leading ends of the arms and rotatable by rotation axes parallel to the surface of the base body; and reaction force exertion members that are installed on back surfaces of the sole support plates to exert a reaction force on backward rotation by the rotation axes parallel to the surface of the base body.
In the active exercise apparatus for lower limbs according to the present invention, the sole support plates supporting a right foot or a left foot may be attached to the leading ends of the arms and rotatable by the rotation axes parallel to the surface of the base body and the rotation axes vertical to the surface of the base body, and the reaction force exertion members may be installed on the back surfaces of the sole support plates.
The sole support plates can be disposed above the base body.
The active exercise apparatus of the present invention may include a mountain-shaped stage that is inclined downward from a center in a front-back direction and has the center positioned on the backs of a user's knees to hold the user's lower limbs with the knees in flexion.
In addition, holding fixtures for holding the user's feet may be attached to the sole support plates. In that case, the holding fixtures may include sole venous plexus compression members.
The active exercise apparatus of the present invention may include hook members for mounting on a fence of a bed.
The active exercise apparatus of the present invention may also include adjustment mechanisms to adjust the positions of the sole support plates in the front-back direction and the vertical direction.
The active exercise here means the ankle joints' dorsal flexion, plantar flexion, inversion, eversion, or composite exercise of two or more of the foregoing motions, for example.
According to the present invention, it is possible to allow the user to perform active exercise highly effective in venous return promotion on a floor and prevent the onset of thrombosis in an efficient way.
Embodiments for carrying out the present invention will be described below in detail with reference to the accompanying drawings. The present invention is not limited to the embodiments described below.
First, an active exercise apparatus according to a first embodiment of the present invention will be described.
[Base Body 1]
The base body 1 is a flat plate-like member, for example, and there is no particular limitation on its size and thickness. However, the base body 1 is desirably sized to support reliably the members such as the shaft 2, the arms 3a and 3b, and the sole support plates 4a and 4b and to be easily installed into or removed from a bed or the like.
[Shaft 2]
The shaft 2 is arranged with a central axis approximately vertical to the surface of the base body 1 and is fixed to the base body 1 by a fixing member such as a bolt. There is no particular limitation on the material and thickness of the shaft 2 as far as it is strong enough to support the arms 3a and 3b, the sole support plate 4a and 4b, and holding fixtures 5a and 5b and withstand a load at the time of use.
[Arms 3a and 3b]
The arm 3a and the arm 3b may be formed integrally or separately as far as they are equal in angle with respect to the central axis of the shaft 2. When the arms 3a and 3b are integrally formed, the center is attached to the shaft 2, and the sole support plates 4a and 4b are attached to the both ends. When the arms 3a and 3b are separately formed, first ends of the arms 3a and 3b are attached to the shaft 2, and the sole support plates 4a and 4b are attached to second ends of the arms 3a and 3b. In that case, the arms 3a and 3b may rotate around the shaft 2 in the horizontal direction independently from each other or in synchronization with each other.
In addition, the arms 3a and 3b may be capable of rotating around the shaft 2 in the horizontal direction at an inner angle α kept constant, for example. As illustrated in
[Sole Support Plates 4a and 4b]
The sole support plate 4a is attached to the leading end of the arm 3a and the sole support plate 4b is attached to the leading end of the arm 3b. These sole support plates 4a and 4b are preferably mounted in positions higher than the upper surface of the base body 1 so that the positions of the user's feet are higher than the heart while using the apparatus on a floor. This enhances the effect of contracting the soleus muscles and increases the blood flow rate of the leg vein. The height of the sole support plates 4a and 4b can be set as appropriate depending on the user's body shape and condition, but is preferably 5 to 10 cm from the floor surface from the viewpoint of promoting blood flow.
In addition, the sole support plates 4a and 4b are rotatable at arbitrary angles with respect to axes x1 and x2 parallel to the surface of the base body 1 and with respect to axes z1 and z2 vertical to the surface of the base body 1. By three rotational motions, that is, the rotation around the shaft 2 as a central axis described above, the rotation around the axes x1 and x2 as central axes, and the rotation around the axes z1 and z2 as central axes, the sole support plates 4a and 4b allow the user to perform the dorsal flexion, plantar flexion, inversion, or eversion of the ankle joints or composite exercise of two or more of the foregoing motions.
In the active exercise apparatus 10 illustrated in
[Reaction Force Exertion Member 7]
In the active exercise apparatus 10 of the embodiment, reaction force exertion members 7 are mounted on the back surfaces of the sole support plates 4a and 4b to exert a reaction force to the backward rotation of the sole support plates 4a and 4b around the axes x1 and x2 parallel to the surface of the base body 1, that is, the plantar flexion motion. Meanwhile, the reaction force exertion members 7 have the force of forward rotation of the sole support plates 4a and 4b around the axes x1 and x2 parallel to the surface of the base body 1 to reduce a load on dorsal flexion motion.
In general, the soleus muscles or the calf muscles contract in the plantar flexion motion, and the anterior tibial muscles contract in the dorsal flexion motion. Therefore, if the user performs the active exercise such as the dorsal flexion and the plantar flexion without application or reduction of a load by the reaction force exertion members 7, the smaller anterior tibial muscles become fatigued earlier than the soleus muscles and the calf muscles, which may inhibit continuance of the active exercise. In contrast, in the active exercise apparatus 10 of the embodiment, the reaction force exertion members 7 reduce the load of the dorsal flexion motion and apply the load of the plantar flexion motion to improve the efficiency of the lower limb active exercise and contract effectively the soleus muscles.
The reaction force exertion members 7 used in the active exercise apparatus 10 may be springs, oil hydraulic cylinders, pneumatic cylinders, or the like. However, springs are preferable from the viewpoints of size reduction of the apparatus and ease of adjusting the magnitude of the reaction force. The magnitude of the reaction force exerted by the reaction force exertion members 7 can be set as appropriate depending on the user's body shape and condition. However, from the viewpoints of improving exercise efficiency and preventing overload on the lower limbs, the load applied to the moment length (about 20 cm) of the sole support plates 4a and 4b is preferably set to a range of from 0.98 N (100 gf) to the user's body weight, that is, the load torque is preferably set to a range from 0.2 Nm to 2×the user's body weight (kg) Nm.
The reaction force exertion members 7 are preferably provided with reaction force adjustment mechanisms capable of adjusting the magnitude of the reaction force depending on the individual user or the user's condition in each day. In addition, in the active exercise apparatus 10 of the embodiment, the reaction force exertion members 7 are provided on the back surfaces of the sole support plates 4a and 4b, and therefore, in the initial state before exercise, the angle formed by the sole support plates 4a and 4b and the surface of the base body 1 is 90° or less.
[Holding Fixtures 5a and 5b]
In the active exercise apparatus 10 of the embodiment, holding fixtures can be attached as necessary to the sole support plates 4a and 4b to hold the user's feet. The “feet” here refers to ankles and lower parts.
There is no particular limitation on the material of the holding fixtures 5a and 5b, but woven fabric, non-woven fabric, synthetic resin, leather, or the like can be used for the holding fixtures 5a and 5b. The holding fixtures 5a and 5b are preferably made from leather for its fit. In addition, there is no particular limitation on the method of attaching the holding fixtures 5a and 5b to the sole support plates 4a and 4b. However, the holding fixtures 5a and 5b are desirably fixed in a firm manner to the sole support plates 4a and 4b by screws or the like such that they do not get displaced or come off during use.
In addition, as illustrated in
[Stage 6]
As illustrated in
[Other Members]
In addition to the foregoing members, the active exercise apparatus 10 of the embodiment may have a counter (not illustrated) for counting the number of times when exercise was performed. There is no particular limitation on the method of measuring by the counter the number of times when exercise was performed. For example, magnetic sensors may be mounted in the sole support plates 4a and 4b to count one when the user can make a stepping motion at an arbitrary plantar flexion angle.
[Operations]
Next, the operations of the active exercise apparatus 10 of the embodiment will be described. To perform active exercise using the active exercise apparatus 10 of the embodiment, for example, the base body 1 is installed on the bottom surface of a bed or the like, and the user in a decubitus position with the knees in flexion at an angle of 20 to 50° sets the right and left soles on the sole support plates 4a and 4b or holds the right and left feet by the holding fixtures 5a and 5b. When the user performs plantar flexion motion with the knees in flexion (in a knee flexion position), the activity of the calf muscles decreases and the activity of the soleus muscles increases relatively. Accordingly, the user can perform active exercise highly effective in promoting venous return on the floor.
Next, the user moves the right foot and the left foot by themselves. For example, when the user stretches the right foot, the sole support plate 4b rotates around the shaft 2, the axis x2, and the axis z2 as central axes, and the right foot makes a plantar flexion motion as illustrated in
In addition, the active exercise apparatus 10 of the embodiment is rotatable at predetermined angles with respect to the axes z1 and z2 vertical to the surface of the base body 1, and allows the inversion and eversion of the ankle joints as well. At that time, the user can also make internal rotational motion and external rotational motion of the hip joints. Further, the active exercise apparatus 10 of the embodiment allows the three rotational motions, that is, the rotation around the shaft 2, the rotation around the axes x1 and x2, and the rotation around the axes z1 and z2 as described above. Accordingly, the user can perform composite exercise of the entire lower limbs including the dorsal flexion, plantar flexion, inversion, and eversion of the ankle joints, the flexion and extension of the knees, and the flexion, extension, internal rotation, and external rotation of the hip joints.
As described above in detail, the active exercise apparatus of the embodiment is configured such that the right and left sole support plates rotate around the shaft and the central axes parallel to the surface of the base body, and rotate around the central axes vertical to the surface of the base body, thereby allowing the user to perform actively the dorsal flexion, plantar flexion, inversion, or eversion of the ankle joints or composite exercise of two or more of the foregoing motions. In particular, the composite exercise in which inversion and eversion are added to the dorsal flexion and plantar flexion motion of the ankle joints is known to be more highly effective in improving lower limb blood flow than in the case of performing singly the plantar flexion and the dorsal flexion motion (for example, refer to D. H. Sochart, K. Hardinge, “The relationship of foot and ankle movements to venous return in the lower limb”, THE JOURNAL OF BONE AND JOINT SURGERY, July 1999, VOL. 81-B, NO. 4, pp. 700 to 704). Accordingly, it can be expected that, by performing active exercise using the apparatus of the embodiment, even a patient immediately after total joint arthroplasty can prevent thrombosis in a highly effective manner.
The conventional apparatuses described above are configured such that the user performs only ankle joint exercise such as the planar and dorsal flexions, inversion, and eversion of the ankle joints while fixing the body parts above the ankles such as the knees. In contrast, with the active exercise apparatus of the embodiment, the user is in a foot raising position and a knee flexion position. Therefore, the user can perform active lower limb composite exercise such as the flexion and extension of the knees, and the flexion, extension, internal rotation, and external rotation of the hip joints in addition to the compound exercise of the ankles. There has not been conventionally any apparatus that allows composite exercise of the entire lower limbs in a recumbent position on a floor. The mechanism of the apparatus of the present invention has been uniquely devised on the basis of the inventor's research.
The active exercise apparatus of the embodiment includes the reaction force exertion members such as springs on the sole support plates to reduce a load in the dorsal flexion direction, and in reverse, apply a load when the sole support plates are pressed down in the plantar flexion direction. Accordingly, it is possible to overcome the problem with the publicly known techniques for interruption of active exercise due to earlier fatigue of the anterior tibial muscles used for dorsal flexion, thereby improving the exercise efficiency and contracting the soleus muscles in a more effective way. As a result, by using the active exercise apparatus of the embodiment, the user can perform on a floor active exercise highly effective in promoting venous return and prevent efficiently the onset of thrombosis and maintain muscle mass.
Further, in the active exercise apparatus of the embodiment, attaching the holding fixtures to the sole support plates and providing the plantar venous plexus compression members to the holding fixtures, it is also possible to further enhance the effect of increasing the blood flow rate by the lower limb active exercise.
Next, an active exercise apparatus according to a second embodiment of the present invention will be described. The first embodiment described above is configured to include two sole support stages for the right and left legs as an example. However, the present invention is not limited to this but may be configured to allow the user to perform exercise while supporting the both right and left legs by one sole support plate.
As illustrated in
The active exercise apparatus of the first embodiment requires the user to move alternately the right and left legs, and is difficult to use for a patient with paralysis in one of the lower limbs, for example. In contrast, the active exercise apparatus 11 of the embodiment allows the user to move the right and left legs in cooperation while supporting the both right and left legs by the one sole support plate 14. This allows even the user with paralysis in one of the legs to perform active exercise of the lower limbs. As a result, the active exercise apparatus 11 is applicable to a wide variety of patients.
In the active exercise apparatus 11 of the embodiment, the integrated right and left sole support plate is provided to allow the user to move the right and left legs in cooperation. Accordingly, the sole support plate does not rotate around axes vertical to the surface of the base body. That is, in the active exercise apparatus 11 of the embodiment, the sole support plate 14 rotates around the shaft 2 and the axes x1 and x2 parallel to the surface of the base body. Accordingly, even with paralysis in one of the lower limbs, the patient can perform actively the dorsal flexion and plantar flexion of the ankle joints.
The active exercise apparatus 11 of the embodiment allows the planar and dorsal flexions of the ankle joints without inversion or eversion. Accordingly, it can be expected that, when being applied to a stroke patient, the active exercise apparatus 11 of the embodiment is effective in preventing the deformation of the feet such as clubfoot. Further, in the active exercise apparatus 11 of the embodiment as well, the reaction force exertion members 7 such as springs are mounted on the sole support plate 14, and the user can contract more effectively the soleus muscles with high exercise efficiency. The configurations and effects of the embodiment other than the foregoing ones are the same as those of the first embodiment.
Next, an active exercise apparatus according to a third embodiment of the present invention will be described.
[Installation Members 21]
The installation members 21 include a base member 22 that is L-shaped in a side view and hook members 23 for mounting on the fence 41 of the bed 40 as illustrated in
The base member 22 of the installation members 21 can be provided with guide holes for adjusting the position of the base body 1 in the front-back direction and guide holes 22a for adjusting the position of the base body 1 in the height direction. In that case, the base body 1 can also be provided with guide holes 1a extending in the front-back direction at the corresponding positions so that the base body 1 can be slid with respect to the base member 22 to adjust the position of the base body 1 in the front-back direction of the base body 1.
Similarly, the hook members 23 can also be provided with guide holes extending in the vertical direction so that the base member 22 can be slid with respect to the hook members 23 to adjust the position of the base body 1 in the vertical direction. This makes it possible to adjust the position of the sole support plate 14 depending on the body shape of the user and the size of the bed, thereby allowing the user to perform active exercise at any time in the optimum position.
Next, an active exercise apparatus according to a modification example of the third embodiment of the present invention will be described. In the third embodiment described above, the installation members 21 including the base member 22 L-shaped in a side view is attached to the flat plate-like base body 1 as an example. However, the present invention is not limited to this but the base member and the base body may be formed integrally.
[Base Body 31]
The base body 31 may have a guide hole 31a in the bottom surface to adjust the position of the shaft 2 in the front-back direction. In addition, the base body 31 may have guide holes 31b in a wall surface to which the hook members 33 are attached to adjust the position of the base body 31 in the vertical (height) direction. The guide hole 31a may be linear in shape or may be configured such that lateral holes are formed in a linear hole at regular intervals, for example.
Meanwhile, for example, the guide holes 31b are linear holes extending in the vertical direction. The hook members 33 can also be provided with guide holes extending in the vertical direction to slide the base body 31 with respect to the hook members 33 and adjust the position of the base body 31 in the vertical direction.
In the active exercise apparatus of the modification example, one of the installation members is integrated with the base body to decrease the parts count and improve handling property. In addition, by providing guide holes to the base body of the modification example as well, it is possible to adjust easily the position of the sole support plates depending on the body shape of the user and the size of the bed. The configurations and effects of the modification example other than the ones described above are the same as those of the third embodiment.
| Number | Date | Country | Kind |
|---|---|---|---|
| 2017-010879 | Jan 2017 | JP | national |
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| Number | Date | Country |
|---|---|---|
| 2 206 536 | Jul 2010 | EP |
| 2008-302019 | Dec 2008 | JP |
| 2012-29787 | Feb 2012 | JP |
| 2013-34755 | Feb 2013 | JP |
| 2016-165365 | Sep 2016 | JP |
| WO 0054848 | Sep 2000 | WO |
| Number | Date | Country | |
|---|---|---|---|
| 20180207467 A1 | Jul 2018 | US |
