The invention relates to an apparatus for automated walking and especially treadmill training according to the preamble of the independent claims.
From Prior Art several such devices are known using a treadmill belt for walking whereas the user is supported by a weight unloading system and/or where the walking on the treadmill belt is further supported by a leg orthosis or leg brace and the weight of such devices can be relieved through additional weight relieving elements as a parallelogram support frame.
EP 1 137 378 discloses an automatic machine, which is used in treadmill therapy (walking therapy) usable for paraparetic and hemiparetic patients and which automatically guides the legs on the treadmill. Said machine consists of a driven and controlled orthotic device, which guides the legs in a physiological pattern of movement, a treadmill and a relief mechanism. The knee and hip joints of the orthotic device are each provided with a drive. Said orthotic device is stabilized on a treadmill with stabilizing means in such a manner that the patient does not have to keep his/her equilibrium. The orthotic device can be adjusted in height and can be easily adapted to different patients.
Further developments of the relief mechanism relate to a device for adjusting the height and the relief force acting on a weight as disclosed in EP 1 586 291 showing two different cable length adjustment means. One is provided to adjust the length of the cable to define the height of the suspended weight. The other is provided to adjust the length of the cable to define the relief force acting on the suspended weight. Another mechanical solution for the adjustment of the relief force can be found in EP 1 908 442.
WO 2010/105773 A1, KR 2013 0038448 A, WO 2012/178171 A2, US 2007/270723 A1, and US 2007/004567 A1 disclose an automated walking/treadmill training device according to the preamble of claim 1.
Based on this prior art it is an object of the invention to improve an apparatus for automated treadmill training with the features of the known devices to better generate the natural gait of a person.
Within prior art documents the weight relief and the pelvis attachment guaranteed the balance of the trained person but did not allow for physiological gait movements in the frontal plane, where the person's center of mass naturally shifts laterally over the stance foot, and in the transverse plane, where the person's pelvic naturally translates and rotates. The capability to shift one's center of mass laterally over the stance foot is crucial for the dynamic balance ability during walking. It is therefore an aim of the present invention to improve the known apparatus for more effective training and higher comfort through physiological gait movements in the frontal and transverse plane, which involves lateral movement and transverse rotation of the legs, pelvic, and trunk.
This object is achieved through the features of the independent claims within the present specification.
An apparatus for automated walking or treadmill training of a user comprises a treadmill having a driven treadmill belt, a pelvis attachment to support the position and/or weight of the user and having attachment elements adapted to be connected to the user. The pelvis attachment comprises a displacement unit for allowing and or supporting a movement of the pelvis of the user held by the attachment elements transverse to and/or rotating about a perpendicular axis to the walking direction provided by the treadmill to provide a more natural and physiological gait during training. The pelvis is attached to the device in a way, that a movement of the pelvis of a user can be supported in view of different degrees of freedom, e.g. lateral or transversal in view of the walking direction, anterior posterior in view of the walking direction and finally for a rotation around the craniocaudal axis of the person to be trained. Rotation of the pelvis around a horizontal axis perpendicular the walking direction, i.e. a mediolateral axis, occurs during normal physiological walking. It is therefore desirable that the apparatus allows freedom and/or provides support in this movement direction because this may lead to a more physiological movement and therefore may improve training effectiveness and comfort.
In this respect the apparatus for automated walking and/or treadmill training of a user is directed to a relative movement of the feet of the user over “ground”. This can be realized with a frame adapted to allow a walking movement of the user in the frame. Within the frame can be the ground and the entire apparatus is rolled with the user through wheels at the frame. The other possibility to effect the relative movement is to provide a treadmill having a driven treadmill belt in the open space of the frame. The displacement unit is provided fixedly relative to the frame. This allows that the displacement unit displaces the user relative to the ground. Preferably, the frame defining the ground comprises further frame parts for fixing or securing the displacement unit.
A weight suspension unit having a cable guided over a guide roller positioned above the pelvis attachment opposite to the treadmill and attached to the pelvis attachment can be provided. The weight suspension unit is provided fixedly relative to the frame. This allows a spatially fixed suspension of the user with respect to the frame. The weight suspension unit comprises a weight suspension displacement unit adapted to move the guide roller essentially perpendicularly to the direction of the section of the cable that has been diverted. This allows influencing the transverse position of the upper body of the person to be trained. Preferably, the weight suspension unit allows a movement of the guide roller in the plane essentially perpendicular to the diverted section of the cable. Accordingly, the guide roller may be moved along and/or perpendicularly to an axis of the guide roller. This allows natural trunk movements associated with natural and physiological gait of the user, i.e. the position of the upper body parts are to be supported and controlled. Additionally a pendulum effect of the trunk of the user is to be prevented. Also, a change in cable length is reduced. The present solution relies on the geometric configuration of pulleys to minimize the rope length change while actuating the end pulley. The direction of the section of the cable that has been diverted is essentially perpendicular to the walking direction, e.g. if the walking direction is essentially horizontal, the direction of the section of the cable that has been diverted is essentially vertical.
For the purpose of supporting the transverse movement of the user during treadmill and/or walking training, the ideal configuration is an embodiment as depicted in
Further embodiments of the invention are laid down in the dependent claims.
The displacement unit can comprise two guide rails inclined one to another, two guiding sleeves each movable along one associated guide rail and a bar connected and articulated through hinge joints with said guiding sleeves for allowing a combined transverse and rotating movement of the user held by the attachment elements connected to the bar.
The apparatus can further comprise an orthotic device comprising at least one orthotic drive for each leg, having at least one cuff for each leg, wherein at least one cuff for each leg is movably attached to a cuff attachment device of the orthotic device for a movement of the respective cuff lateral to the walking direction provided by the treadmill. The orthotic device is secured to the displacement unit. It allows a better contact of user and displacement unit or mill.
The control of actuators and drives for the pelvic movement can be effected by the central control unit of the apparatus and signals from position and force sensors can be used in this respect. The apparatus can also optionally comprise actuator and sensor for the cuff movements controlled by the control unit.
The apparatus can comprise a control unit to control the position of carriage and roller of a weight suspension displacement unit based on the gait phase of the user provided by a signal providing directly or indirectly representative for the orientation of the cable between the guide roller and the harness of the user. A directly representative signal would be a sensor signal showing the actual position of the user. An indirect signal is a signal derived from other part of the apparatus, e.g. through knowledge of the position of the orthotic drives or through knowledge of the cable length provided by sensors in the weight relief unit controlling the cable length. The weight suspension displacement unit is therefore controllable in dependence of the gait phase, i.e. is adapts to the change of the actual postural position of the user during the gait phase, i.e. physiological gait movement phase. This allows a more precise movement control, which is more efficient and comfortable for the user.
A method for operating an apparatus according to the invention comprises the general steps of positioning the pelvis attachment above the opening of the frame at a predetermined height or above the belt. Then a user is attached to the pelvis attachment. Optionally the user is attached to a weight suspension unit which was then previously provided below the intended position of the user. Optionally an orthotic device is attached to the legs of the user, wherein the orthotic leg device as well as pelvis attachment is preferably attached to a weight relief parallelogram or similar unit behind the user. The pelvis attachment is driven and controlled, optionally the weight suspension unit is driven and controlled and optionally the orthotic device is driven and controlled; preferably all by the same control unit.
Especially the weight suspension unit comprises beside the usually length adjustment in view of the walking person the further step of control of the carriage allowing to maintain the roller always above the trunk of the user or in other words, in the middle and in a predetermined distance (=half the space the user takes) in front of the pelvis attachment means. In this respect it possible, but not shown in the drawings to provide a second carriage and a second drive provided perpendicular to the first carriage supporting the roller and which second carriage supports the first carriage so that the roller can also be moved in the walking direction following a forward-and-backward movement of the user. However, this has an effect on the cable length, whereas the first carriage effecting a transverse movement has the effect that the cable length is almost not modified by this displacement and additionally there is almost no force exerted in this direction; only the weight force is applied to this roller.
Known appliances (e.g. the one of US 2007/004567 A1) have large masses that have to be move during every step of the person. The present invention reduces the masses that have to be moved. According to the present invention, only the guide roller, bearing an drives have to be moved.
Preferred embodiments of the invention are described in the following with reference to the drawings, which are for the purpose of illustrating the present preferred embodiments of the invention and not for the purpose of limiting the same. In the drawings,
Apparatus 1 comprises a treadmill 10 at the base having a treadmill frame 11 to be positioned on the ground. Within the treadmill frame 11 is provided a driven treadmill belt 12 which is adapted to move at various speeds through the action of a drive. The movement of the belt is directed from the front end 14 of the apparatus 1 to the back ramp 16. It is in advantage if two hand rails 13 are provided on the sides of the treadmill belt 12 above the side edges of the treadmill frame 11 in order to be grasped by the hands of a person to be trained 400.
The apparatus 1 for automated walking training can be used as a fixed unit and then especially for treadmill training according to the embodiment shown in
A support column 41 is attached at the side of the treadmill frame 11. On the support column 41 is mounted a jib 42 being part of the suspension device 40. Within the jib elements is included a suspension roller displacement unit 48. This suspension roller displacement unit 48 comprises a roller 45 over which the cable 43 is lead to a cross bar 44 being adapted to support a harness attachment 46. The cable 43 is guided from said harness attachment 46 over roller 45 and further internal rollers and elements within the suspension roller displacement unit 48 into the support column 41 which comprises preferably a device for adjusting the height and relief force acting on the weight of the person to be trained which could be built according to EP 1 586 291 or EP 1 908 442 and which can be provided in the support column 41. Of course also other suspension relief mechanism can be used in this respect. It is further contemplated to use the pelvis attachment 50, as disclosed in the following paragraph on its own, since such a pelvis attachment 50 can comprise inherently elements adapted to support the position and/or weight of the user 400 to avoid tipping forward, backward and sideward. The stabilization can therefore only rely on a pelvis attachment 50.
The person to be trained is attached to the pelvis attachment 50 which is mounted through two parallelogram arms 22 to the back post 21 which is attached via support arm 23 to the support column 41 and as such to the frame of the apparatus. This parallelogram device can be provided in line with the disclosure of e.g. EP 1 137 378. It is also possible to provide other connection means of the pelvis attachment to the frame apparatus. The only condition to be fulfilled is the stabilization of the position of the pelvis and the tracking of the up- and-down movement of the pelvis during walking action of the user on the treadmill 10.
The person to be trained is attached via a harness (not shown) to the pelvis attachment 50 and the legs of the person to be trained can be put into the cuffs 35 attached via the cuff attachments units 60 with the linkages 32 and 33 of the leg orthosis 30. The leg orthosis 30 is connected to the pelvis attachment back plate 50 and comprises beside the mentioned upper linkage 33 and lower linkage 32 on each side, i.e. for each leg of the user, two orthosis drives 31 and 36, an upper hip orthosis drive 36 and a lower knee orthosis drive 31. The leg orthosis 30 is optional; in other words, it is possible to use the pelvis attachment means 50 alone or to use the pelvis attachment means 50 together with the leg orthosis 30; and to combine this use of the pelvis attachment means 50 with the use of the suspension device 40. Finally it is also possible to use the suspension device 40 on its own to provide the mentioned freedom of movement of the trunk of the person to be trained.
Further elements of the devices are shown in the additional drawings. The overall control of the drives according to the various embodiments of the invention can be performed by a control unit 70, which can be a personal computer generating and transmitting all control signals to the different drives of the apparatus 1 and receiving the necessary control information from the drives and additional sensors in order to control the different drives to allow the user 400 to perform actively a walking or running movement or to support the user in such an action through actuating the different drives. Such additional sensors can provide the position of the back plate 51, the position of the bar 53, the position of the roller 45, the inclination of the orthosis elements (provided by the drives 31 and 36) etc.
Same elements always receive the same reference numerals in all drawings.
The pelvis attachment 52 can also be provided in an adjustable way in any direction from bar 53. It is especially an advantage, if the attachment 52 can be positioned and adjusted in the down direction towards the bottom, in combination with a displacement of the leg orthosis in the down direction, which would then allow to make a quick adaption to much shorter users as e.g. children to train on the device.
When the user 400 walks on the treadmill 10, his footprints 58 develop on the moving treadmill belt 12 as shown in
Beside allowing this turning of the pelvis attachment around the vertical axis,
Preferably the shifting movement into position 250A is accompanied by specific cuff attachment units 60, 160 and 260. In these cuff attachment units 60, 160 and 260 the cuff in the original position 35, 135, and 235 can shift along the transverse axis into the position 135A and 235A when the user 400 advances his left leg. On the other hand, when the user then advances his right leg the movement will be inverted and the pelvis attachment 250A as well as the cuffs position 135A and 235A will go beyond the “neutral position” (150/35, 135, 235) into a different inclined position opposite to the position shown in
Cuffs 35, 135 and 235 are attached via cuff attachment units 60, 60 and 260 respectively at pelvis attachment 50. Beside the relative displacement of the cuffs 35, 135 and 235 one to another as usually provided within a leg orthosis for the natural gait movement, they can also move laterally relative one to another as described above.
The pelvis attachment portion. 50 comprises a pelvis harness belt element 52 which is adapted to be moved through the linkages as explained below. The pelvis harness belt element 52 is attached to bar 53 which is linked through joints 54 via guiding sleeve 56 to two connection links 55. This allows the user, when moving his pelvis 100, to push onto the bar 53 to slide it with the guiding sleeves 56 on the connection link 55 to effect a rotating movement as well as a transversal movement of his pelvis. In order to support the user in training it is possible to provide a drive 159 being connected to the bar 53 in order to move bar 53 and as such the pelvis attachment 50 along the predetermined curve. It is possible to provide adjustment means to change the angle between the two connecting links 55. They are then adjusted in order to vary the movement of the pelvis attachment position 50. If the connecting links 55 are oriented one parallel to the other then only a transverse movement of the pelvis attachment position is possible. In a more general view, the adjustment unit for the connecting links allow adjusting the forced curve defining the movement range of the bar 53 and thus of the pelvis. The movement profile of the displacement unit can then be adjusted to various training scenarios and movement patterns. The inclination of the guide rails 55 is then adjustable, optionally by a drive (not shown) in order to set a relation between lateral travel and transverse rotation. This is realized in the embodiment of
In order to allow rotation around the mediolateral axis, the pelvis attachment portion 50 may be arranged vertically, i.e. the direction of gravity would be along the bar 53.
The pelvis attachment 52 may be mounted through a passive rotational joint with respect to bar 53. This would allow a user 400 to exert additional transverse rotational movement beyond what the drive 159 provides.
As mentioned above, the pelvis 100 as shown in
The pelvis and trunk of the user is positioned inside the ¾-circle ring 252 comprising the pelvis attachment portion (not shown). The circle ring 252 can be rotated in view of the underlying ring portion 251A by rotating drive 255. The non-rotatable base element 251A is attached on bearings 264 which are mounted on transverse beams 262 whereas the entire pelvis attachment unit together with the rotating pelvis attachment element 252 can be displaced forward and backward through action of the drive 255B. Beams 262 are mounted on bearings 263 which allow a transverse movement on the front bar 261 and the back bar 251B which have a similar function as back plates 51 or 151.
The transversal movement is supported through action of the additional drive 255A attached to beam 262. In other words, when the back pelvis attachment bar 251B is attached at e.g. the parallelogram elements 22 according to
The clamping means 63 are attached at a base plate 65 on which a linear guide rail 66 comprising a dovetail portion serves as the bearing for a complementary linear guide car 67 being attached to a cuff plate 68 onto which cuff 35 is provided in a manner known to the man skilled in the art.
Therefore, the cuffs are movable which allows the pelvis to move more naturally while keeping the feet of the person to be trained in place. In this respect, keeping the feet of the trained person in place means that the feet are always on or near the same longitudinal line on the treadmill belt 12 independent from the position of the pelvis 100 above the legs 59 and feet. It is an advantage, that the cuff displacement can be added in a simple way to existing orthotic devices.
Cable 43 after being turned by roller 45 is then guided as cable portion 43A to a horizontal roller 145A and then as cable portion 43B onto second roller 145B to be diverted into the support column 41 which is shown as the attachment portion 41A in
This suspension roller drive 40 allows a movement of the user below the roller 45 without involving a slack on cable 43, since the lengths of the cable portion beyond roller 45 down to the user harness bar 44 is only changing through the effect of the up-and-down movement of the upper body of the user which can be compensated by a height compensation device as e.g. shown in EP 1 586 291 or EP 1 908 442. There is no additional change by an inclined cable 43 and there are no additional forces acting on the person through such inclined cable 43 as in the prior art. The transverse movement of the roller 45 on carriage 146 according to arrow 147 only changes the length of the cable portion 43A in a negligible amount. Therefore the impact of this change of length can either be neglected or can be taken into account when providing the control signals for controlling the drive 48 actuating the transversal movement of carriage 146. In other words, the harness holding the person to be trained is (indirectly through the cable) movable by a dedicated drive in order to minimize lateral forces on the trunk of the person to be trained that result from gravity. This is equivalent to say that the driven suspension device 40 prevents a pendulum effect. Furthermore, the driven suspension can also be used to separately control the transverse position of the upper body of the person to be trained.
In other words, it is preferred that the middle position of carriage 146 and roller 45 is as shown in
Number | Date | Country | Kind |
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13173315.6 | Jun 2013 | EP | regional |
Filing Document | Filing Date | Country | Kind |
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PCT/EP2014/063053 | 6/20/2014 | WO | 00 |