Patent Grant
7137959
The present invention relates generally to apparatus useful in rehabilitative programs for paraplegic and quadriplegic individuals, and even health maintenance programs for individuals that are totally unable to care for themselves such as those in a deep coma, and more particularly to method and apparatus for assisting such individuals to exercise in a true walking manner, and concomitantly for implementing rhythmic modulation of blood flow and pressure in a manner generally suitable for reestablishing nominally acceptable cardiovascular circulation and muscular tissue regeneration throughout the body and particularly in the lower extremities.
Paraplegic and quadriplegic individuals have by definition suffered traumatic injuries to their spinal cords that have rendered them unable to sense contact with and/or to control functions of the portions of their bodies located beyond their injury sites. Of first concern and most immediate danger following such an injury is a loss of ability to adequately control blood pressure and to regulate distribution of blood flow beyond the injury site. It can take days or even weeks for such individuals to re-acquire sufficient blood pressure control to allow them to be put into a sitting position without “blacking out” for lack of blood flow through their brains. Specifically, their ability to adequately control cardiovascular system arterioles and pre-capillary sphincters has been significantly compromised, and furthermore, major portions of their venous pumping systems have been substantially deactivated as a result of the obvious inactivity of their legs. Also of concern for such individuals as well as those that are totally bedridden for any reason is the difficulty they experience in servicing infections due to any cause as a consequence of compromised cardiovascular circulation. In fact, such infections are a major cause of death for such individuals even while they remain hospitalized.
It is believed herein that the present inventor's previous experience with particular reference to a claimed “method for enhancing a patient's cardiovascular activity and health” described in U.S. Pat. No. 6,261,250 B1 entitled METHOD AND APPARATUS FOR ENHANCING CARDIOVASCULAR ACTIVITY AND HEALTH THROUGH RHYTHMIC LIMB ELEVATION and issued to Edward H. Phillips on Jul. 17, 2001, and a claimed “method for enhancing physical activity and cardiovascular health” described in U.S. Pat. No. 6,592,502 B1 entitled METHOD AND APPARATUS FOR ENHANCING PHYSICAL AND CARDIOVASCULAR HEALTH, AND ALSO FOR EVALUATING CARDIOVASCULAR HEALTH and issued to Edward H. Phillips on Jul. 15, 2003 is pertinent to solving the cardiovascular circulation problems of paraplegic and quadriplegic individuals described above. Because of their obvious pertinence to the subject at hand, both the '250 and '502 patents are expressly incorporated herein by reference.
Of additional interest herein however, is the possibility of retraining paraplegic and quadriplegic, and even severely brain injured individuals, to gradually begin to support their own weight and perhaps even eventually to walk on their own via utilization of method and apparatus for enabling them to continuously exercise in a true walking manner while supporting selectively increased portions of their own weight. This is believed herein to be feasible because of experiments previously conducted with a paraplegic individual on apparatus configured in accordance with the incorporated '502 patent wherein that individual not only dramatically improved her cardiovascular circulation and developed muscle mass having improved tone, but she was able to voluntarily fire her mid-torso, hip flexor and thigh muscles as though she were walking. In fact, in so doing she was so violently firing her thigh muscles that she was hyper-extending her knees.
This is particularly exciting in view of recent experiments wherein new genetically matched spinal cord is formed and then positioned in such a manner as to link the previously severed spinal cord elements of paraplegic and quadriplegic patients. In some cases such experiments have been conducted with tissue grown from embryonic tissue, while in other and perhaps even more exciting cases, such experiments have been conducted with tissue grown from the patients' own DNA after that DNA had been directly harvested via their olfactory cavities. One problem with these recent experiments however, is an observed difficulty in retraining these patient's neurological systems to correlate signals coming in a “South-North direction” with actual bodily locations and to concomitantly direct operative commands to particular muscle groups in a “North-South direction”. Another problem is a tendency for many paraplegic individuals to selectively contract some muscle groups in such a manner that their lower extremities tend to physically interfere with one another during any type of exercise. Thus, positive control of foot and knee location is a requirement for any effective rehabilitative equipment. It is believed herein that the apparatus to be disclosed hereinbelow will resolve such problems and that the repetitive walking motion induced by it will prove to be instrumental in achieving the herein expressed goals. Thus, providing method and apparatus for implementing the above-described improved cardiovascular circulation, growth of high quality muscle mass, and support of selected portions of their own weight and perhaps even of walking by paraplegic, quadriplegic and brain injury patients are primary objects of the present invention.
There are of course other handicapped or partially handicapped persons that are desirous of regaining the ability to walk. Obvious examples of such persons are those acclimating to newly fashioned artificial lower limbs (i.e., unfortunately now including military, other war victims, and even more recently, those that suffered lower limb amputations as a result of the tsunami that occurred in the Indian ocean), victims of stroke, the 60,000 diabetics who suffer lower limb amputations each year in the U.S. alone, and those with any form of neuromuscular disease. Thus, providing such individuals with apparatus for implementing the above-described support of selected portions of their own weight while re-acclimating to walking is yet another object of the present invention.
These and other objects are achieved via utilization of walking motion apparatus presented in a preferred embodiment of the present invention by a supinely disposed patient in implementing a substantially normal walking motion while supporting a selected portion of his or her weight. Also respectively presented in first, second, third and, fourth alternate embodiments are elevation drive, rhythmic limb elevation drive, foot guiding, and patient handling mechanisms therefor. Further, presented in a fifth alternate preferred embodiment of the present invention are methods for improving cardiovascular circulation, growing high quality muscle mass, supporting selected portions of such a patient's own weight, and even of enabling that patient to fire muscle groups normally utilized in walking. As is more fully explained below, the walking motion apparatus is configured such that a wheel chair bound individual can utilize it in all respects without assistance, and such that even a quadriplegic or severely brain injured individual can utilize it with minimal assistance. For convenience in further discussion however, utilization of the walking motion apparatus is assumed to be by a wheel chair bound individual having nominal use of his or her hands and arms (hereinafter “patient”) unless its use by a quadriplegic or severely brain injured individual is specifically indicated.
The walking motion apparatus preferably comprises all of the elevation drive, rhythmic limb elevation drive, foot guiding, and patient handling mechanisms in order to enable all of the above listed benefits. When so configured, patients are able to set the walking motion apparatus up in a customized manner with regard to their desired leg stroke, hip elevation, walking frequency, and weight-supporting fraction. Further, they are able to get into it and properly attach themselves to the rhythmic limb elevation drive mechanism, and finally, to operate the walking motion apparatus—all without assistance. This is deemed herein to be necessary because it should be recognized that such patients prefer to take care of themselves insofar as possible, and particularly to do so without being manhandled. And of course, it is appropriate to eliminate or at least reduce therapist assistance for obvious economic reasons.
In actually utilizing the walking motion apparatus, a wheelchair bound patient first dons appropriate knee braces comprising hinged bails. Then he or she uses a controller to position the elevation drive mechanism to an intermediate position whereat he or she can conveniently open a rhythmic limb elevation drive unit comprised in the rhythmic limb elevation drive mechanism and set leg stroke length. Then he or she resets the elevation drive and patient handling mechanisms to base positions whereat a pivoting seat back portion of the patient handling mechanism is oriented with respect to a seating platform such that together they are disposed in an upright seating position at normal wheelchair height. Next, he or she moves to a position laterally proximate to the seating platform, and if desired, positions a “buddy board” for transition from the wheelchair to the seating platform. Then using his or her hands on the wheelchair, buddy board and/or the seating platform, the patient moves onto the seating platform in a centered position whereat he or she is positioned astride a “horn” portion of the of the pivoting seat back (i.e., a bicycle seat-like protrusion extending from the seat back in a nominally orthogonal direction thereto but of course nominally parallel to the seating platform) that is nestled within a pocket formed in the seating platform when the pivoting seat back is disposed in the upright seating position. Again using the controller, the patient moves the patient handling mechanism forward, and if desired, rotates the pivoting seat back portion thereof to locations whereat he or she can conveniently position his or her shoes upon shoe orienting protrusions located upon articulated slide assemblies and affix them thereat with comprised hook and loop (i.e., “Velcro”) straps. Next, the patient attaches knee elevating pulley-supported lines of the rhythmic limb elevation drive mechanism to the hinged bails of the knee braces. Then again using the controller and observing his or her legs via an overhead spherical mirror, the patient next moves the patient handling mechanism to a location that will optimize the intended walking motion. Then still using the controller, the patient rotates the pivoting seat back and him- or herself into a horizontal position whereat he or she is located supinely with his or her thighs straddling the horn portion of the seat back thus being centered thereon during walking exercises to follow. Yet again using the controller, the patient activates the elevation drive mechanism to a selected angular elevation angle whereat he or she is supporting a selected portion of his or her weight and presets a selected walking frequency. Finally, he or she grabs arm elevating pulley-supported lines and activates the rhythmic limb elevation drive mechanism via lateral arm motion against a latching on/off switch to implement the intended walking exercise. Whenever the scheduled walking exercise program is completed, the patient stops the rhythmic limb elevation drive unit by again activating the latching on/off switch, and then extricates him- or herself from the walking motion apparatus by reversing the above described procedure.
A walking motion apparatus elevation drive mechanism used for selectively elevating operative portions of the walking motion apparatus is presented in a first alternate preferred embodiment of the present invention. Operative components of the elevation drive mechanism comprise a guide block mounted roll and yaw-axes constraining bearing slidingly positioned along a rail fixedly attached to a nominally horizontal member of a stationary floor mounted frame by a nut that is engaged by a lead screw that is in turn rotationally positioned by a suitable drive gearmotor; and an offset pitch axis constraining tie-rod, where a first end of the tie-rod is swivelingly attached to a vertical member of the stationary floor mounted frame while the bearing and other end of the tie-rod are operatively attached to and utilized to selectively elevate an angularly elevating frame upon which all of the other above named mechanisms are mounted via operation of the drive gearmotor.
A walking motion apparatus rhythmic limb elevation drive mechanism used for implementing intended walking exercises is presented in a second alternate preferred embodiment of the present invention. Similarly to RLE apparatus presented in the incorporated '502 patent, respective first and second limb groups respectively including left and right articulated slide assemblies, and corresponding legs and opposing hands are supportingly coupled to a frame structure of the rhythmic limb elevation drive mechanism by first and second sets of pulley-supported lines. The rhythmic limb elevation drive mechanism of the present invention is differentiated from the RLE apparatus presented in the incorporated '502 patent however, in that it comprises a compact rhythmic limb elevation drive unit having primary and secondary sheave assemblies for actively driving the first and second sets of pulley-supported lines in an oscillating translational manner and thus drivingly implement the desired walking motions of the patient's first and second limb groups. The primary sheave assembly is utilized for generating the fundamental walking motion while the secondary sheave assemblies are driven in a selected phase leading manner and utilized for implementing proper knee flexure of each leg within that fundamental walking motion. This is accomplished via linkages to the knees provided by pulley blocks through which the pulley-supported lines from the secondary sheave assemblies are coupled to selected sheaves of the primary sheave assembly. Preferably then, the rhythmic limb elevation drive unit comprises: primary and secondary hubs constrained for oscillating rotational motion; multiple primary sheaves mounted upon and drivingly coupled to the primary hub, and first and second secondary sheaves mounted upon and drivingly coupled to first and second secondary hubs with the first and second sets of pulley-supported lines being selectively attached to the various sheaves including knee supporting pulley-supported lines coupled both to selected sheaves of the primary sheave assembly and to the first and second secondary sheaves via the knee supporting pulley blocks; a gearmotor having a driven output shaft that rotates continuously at a selected rotational speed during operation of the rhythmic limb elevation drive unit; and continuous rotation to oscillating rotational motion conversion apparatus including a fixed member fixedly mounted upon the output shaft of the gearmotor, an adjustable sliding element comprising an eccentric shaft member, an adjustment assembly for positioning the adjustable sliding element at a preselected eccentricity with respect to the output shaft of the gearmotor, a first cam follower mounted upon the eccentric shaft member, a Scotch yoke assembly adapted for being driven by the first cam follower, a primary ball-screw spline assembly comprising a first shaft member having ball screw raceways and ball spline grooves crossing one another, a ball spline nut, a first ball screw nut and a ball bearing supported outer race surrounding the first ball screw nut, the first shaft member of which being fixedly coupled to and driven by the Scotch yoke assembly, a second cam follower also mounted upon the eccentric shaft member, cam blocks also adapted for being driven by the first cam follower, a stop block for limiting inward travel of the cam blocks, and secondary ball-screw spline assemblies each comprising second shaft members having ball screw raceways and ball spline grooves crossing one another, ball spline nuts, second ball screw nuts, and ball bearing supported outer races surrounding the second ball screw nuts, the second shaft members being fixedly coupled to and intermittently driven by the cam blocks beyond their stop block limited positions, the continuous rotation to oscillating rotational motion conversion apparatus for drivingly coupling the output shaft of the gearmotor to the primary and secondary hubs for driving the primary and secondary hubs and sheaves in a rotational oscillating manner at a frequency equal in value to the rotational speed of the output shaft with a selected phase relationship between the primary and secondary hubs and sheaves, and thereby driving the first and second sets of pulley-supported lines in a translational oscillating manner and thus drivingly implementing the desired rhythmic limb elevation (hereinafter “RLE”) motions of the patient's first and second limb groups at that frequency in a natural walking motion including appropriate flexing of the knees.
A walking motion apparatus foot guiding mechanism for controlling the patient's foot location and motions is presented in a third alternate preferred embodiment of the present invention. In the foot guiding mechanism left and right articulated slide assemblies are positioned for longitudinal movement along left and right rails. First and second pulley-supported lines driven by the rhythmic limb elevation drive unit are attached to the upper ends of the left and right articulated slide assemblies while a single pulley-supported line is utilized to functionally couple their lower ends in order to ensure that upward forces exerted thereupon by a patient are properly applied to the rhythmic limb elevation drive unit via an opposing articulated slide assembly and pulley-supported line. In addition, proper foot and leg articulation is controlled during the walking exercise via locating the patient's shoes on posterior foot supporting plates via protrusions formed on the posterior foot supporting plates and selectively positioned and mating shoe orienting grooves formed in the patient's shoes, and then retaining them thereon with the above mentioned hook and loop straps. The posterior foot supporting plates are coupled to adjustable trailing link members by under heel articulation points and the adjustable trailing link members are in turn coupled to the articulated slide assemblies' slide members via ball-of-the-foot articulation points. Longitudinal positions of the under heel articulation points are adjustable with respect to the ball-of-the-foot articulation points in the general manner found in “clamp-on” roller skates in order to properly accommodate various patient foot sizes.
A walking motion apparatus patient handling mechanism for allowing the patient to enter and utilize the walking motion apparatus is presented in a fourth alternate preferred embodiment of the present invention. As mentioned hereinabove, the patient handling mechanism comprises a seating platform and a pivoting seat back located with respect to one another such that the horn portion of the seat back nestles within the pocket formed in the seating platform when the seat back is disposed in an upright seating position. The pivoting seat back is constrained for pivotal rotation about a transverse pivot axis constrained for controlled motion along a slide axis that is nominally orthogonal to the foot guiding mechanism and located in a relatively elevated manner such that adequate clearance is provided for ensuing leg motion during the walking exercise after seat back is rotated into a horizontal position. Elevation toward the horizontal position is accomplished via vertical motion of a powered slide whereby a transverse hip axis is constrained for motion in a direction nominally parallel to the foot guiding mechanism. This ensures that the distance between the patient's hips and the foot guiding mechanism remains nominally constant as the seat back is elevated. Further, the seat back itself is mounted upon a longitudinally oriented (e.g., after the seat back has attained its nominally horizontal position) short stroke slide component of the pivoting mechanism. The short stroke slide is provided for accommodating normal up-and-down motions that the patient will experience during the walking exercise. Finally, the pivoting mechanism is adjustably coupled to the angularly elevating frame via a powered slide assembly constrained for longitudinally oriented motion (e.g., motion nominally orthogonal to the with respect to the foot guiding mechanism) in order to provide for the above-mentioned overall positioning of the patient handling mechanism.
In addition, interchangeable seat backs are accommodated via a seat back interchanging mechanism located above the short stroke slide. This is deemed necessary herein because patients come in all torso lengths and girths. Furthermore, different seat back designs are required for patients having varying degrees of torso control. For instance, a quadriplegic or brain injured patient may need torso and even head constraints while a patient nearly ready to walk on his or her own would desire a compliant seat back, or perhaps even an articulated seat back.
Finally, methods for improving a patient's cardiovascular circulation, growing high quality muscle mass, and even of firing muscle groups normally utilized in walking are presented in a fifth alternate preferred embodiment of the present invention. These methods are implemented in conjunction with utilization of a walking motion apparatus comprising at least the rhythmic limb elevation drive and foot guiding mechanisms wherein a supinely disposed patient can affect a substantially normal walking motion, and wherein a first and most general method comprises the steps of: the patient donning appropriate knee braces comprising hinged bails; positioning the patient in the supine position under the rhythmic limb elevation drive mechanism; positioning and affixing the patient's shoes upon left and right articulated slide assemblies comprised in the foot guiding mechanism; attaching first and second limb groups each including one of the hinged bails and an opposing hand to first and second sets of pulley-supported lines comprised in the rhythmic limb elevation drive mechanism; and activating a rhythmic limb elevation drive unit comprised in the rhythmic limb elevation drive mechanism at a selected walking frequency.
In addition, the present invention is directed to a second and enhanced version of the first method wherein the walking motion apparatus additionally comprises an elevation drive mechanism whereby the supinely disposed patient can affect the substantially normal walking motion while supporting a selected portion of his or her weight, and thus wherein the method comprises the additional step of: activating and positioning the elevation drive mechanism at an angular elevation whereat the patient is supporting a selected portion of his or her weight prior to activating the rhythmic limb elevation drive unit at the selected walking frequency.
The present invention is also directed to a still further enhanced third version of the method wherein the walking motion apparatus additionally comprises a patient handling mechanism whereby the patient can, without assistance, set up and get into the walking motion apparatus, properly attach him- or herself to the rhythmic limb elevation drive mechanism, and operate the walking motion apparatus, wherein the method comprises the patient performing the steps of: positioning the elevation drive mechanism to an intermediate position whereat he or she can conveniently open the rhythmic limb elevation drive unit comprised in the rhythmic limb elevation drive mechanism even while being wheelchair bound; opening the rhythmic limb elevation drive unit; setting stroke length; closing the rhythmic limb elevation drive unit; resetting the elevation drive mechanism to its base position; moving to a position laterally proximate to a pivoting seat back and seating platform comprised in the patient handling mechanism and located generally under the rhythmic limb elevation drive mechanism; moving onto the seating platform in a centered position whereat the patient is positioned against the seat back and astride a “horn” portion thereof nestled within a pocket formed in the seating platform; moving the patient handling mechanism forward, and if desired, rotating the pivoting seat back to a location whereat the patient can conveniently position his or her shoes upon the left and right articulated slide assemblies; positioning and affixing his or her shoes thereon; attaching first and second sets of knee elevating pulley-supported lines to the hinged bails; moving the patient handling mechanism to a location sufficiently removed from the foot guiding mechanism for optimizing the intended walking motion; rotating the seat back into a horizontal position whereat the patient is located supinely with his or her thighs straddling the horn portion of the seat back and thus keeping him or her centered thereon during the ensuing walking exercise; activating and positioning the elevation drive mechanism at the angular elevation whereat the selected portion of the patient's weight is self supported; presetting the rhythmic limb elevation drive unit comprised in the rhythmic limb elevation drive mechanism at the selected walking frequency; grabbing first and second arm elevating pulley-supported lines; and activating the rhythmic limb elevation drive unit at the selected walking frequency.
In a first aspect then, the present invention is directed to providing a walking motion apparatus for drivingly implementing true walking exercise by an incapacitated patient comprising: a foot guiding mechanism having left and right supporting rails, and left and right articulated slide assemblies adapted for having the patient's left and right feet respectively coupled thereto in a supportive manner and positioned for movement along the left and right supporting rails; first and second hinged bails for supporting the patient's left and right knees; a first set of pulley-supported lines for supporting and driving a first limb group of the patient including his or her left foot via the left articulated foot slide assembly, his or her left knee via the first hinged bail, and his or her right hand; a second set of pulley-supported lines for supporting and driving a second limb group of the patient including his or her right foot via the right articulated foot slide assembly, his or her right knee via the second hinged bail, and his or her left hand; a rhythmic limb elevation drive unit for driving the first and second sets of pulley-supported lines in an oscillating translational manner and thus drivingly implementing the desired walking motions of the patient's first and second limb groups; and a frame structure for mounting the foot guiding assembly, rhythmic limb elevation drive unit and supporting the patient.
In a second aspect, the present invention is directed to the walking motion apparatus of the first aspect wherein the rhythmic limb elevation drive unit comprises: knee supporting pulley blocks coupled to the hinged bails; primary, and first and second secondary hubs constrained for oscillating rotational motion; a primary sheave assembly mounted upon and drivingly coupled to the primary hub, and first and second secondary sheaves mounted upon and drivingly coupled to the first and second secondary hubs, where the first and second sets of pulley-supported lines are selectively attached to the various sheaves with first and second double ended ones thereof being attached to and coupling selected sheaves of a primary sheave assembly and the first and second secondary sheaves via the knee supporting pulley blocks; a gearmotor having a driven output shaft that rotates continuously at a selected rotational speed during operation of the rhythmic limb elevation drive unit; and continuous rotation to oscillating rotational motion conversion apparatus for drivingly coupling the output shaft of the gearmotor to the primary and secondary hubs for driving the primary and secondary hubs and sheaves in an oscillating rotational manner at a frequency equal in value to the rotational speed of the output shaft, and thereby driving the first and second sets of pulley-supported lines in an oscillating translational manner and thus drivingly implementing the desired RLE motions of the patient's first and second limb groups at that frequency in a natural walking motion including appropriate flexing of the knees.
In a third aspect, the present invention is directed to the walking motion apparatus of the second aspect wherein the continuous rotation to oscillating rotational motion conversion apparatus comprises: a primary ball-screw spline assembly comprising a first shaft member having ball screw raceways and ball spline grooves crossing one another, a ball spline nut, a ball screw nut and a ball bearing supported outer race surrounding the ball screw nut; a Scotch yoke assembly fixedly coupled to the first shaft member; a first cam follower adapted for continuously driving the Scotch yoke assembly; secondary ball-screw spline assemblies each comprising second shaft members having ball screw raceways and ball spline grooves crossing one another, ball spline nuts, ball screw nuts and ball bearing supported outer races surrounding the ball screw nuts; cam blocks fixedly coupled to the second shaft members; a stop block for limiting inward travel of the cam blocks; a second follower for intermittently driving the cam blocks beyond their stop block limited positions; an eccentric shaft member for concomitantly driving the first and second cam followers; and a transverse slide assembly comprising a fixed member fixedly mounted upon the output shaft of the gearmotor, an adjustable sliding element comprising the eccentric shaft member, and an adjustment assembly for positioning the adjustable sliding element at a preselected eccentricity with respect to the output shaft of the gearmotor.
In a fourth aspect, the present invention is directed to the walking motion apparatus of the first aspect wherein the foot guiding mechanism having left and right supporting rails, and left and right articulated slide assemblies further comprises: first and second pulley-supported lines of the first and second sets of pulley-supported lines being respectively attached to upper ends of the left and right articulated slide assemblies; a single pulley-supported line for coupling lower ends of the left and right articulated slide assemblies in order to ensure continuous downward motion of the left or right articulated slide assembly not instantly being urged upwards by its respective first or second pulley-supported line in the event of an upward force being exerted thereon by a patient, and that any such upward force is properly applied to the rhythmic limb elevation drive unit via the other articulated slide assembly and respective pulley-supported line; and articulative foot supporting assemblies for articulatively coupling the patient's feet to the articulated slide assemblies in order to allow for proper foot and leg articulation during a walking exercise.
In a fifth aspect, the present invention is directed to the walking motion apparatus of the fourth aspect wherein the articulative foot supporting assemblies comprise: posterior foot supporting plates having shoe orienting protrusions for orienting and supporting a patient's shoes formed with corresponding grooves; straps for holding the patient's shoes in place on the posterior foot supporting plates as located by the foot orienting protrusions; adjustable trailing link members coupled to the posterior foot supporting plates by under heel articulation points, the adjustable trailing links being adjustable in order to properly accommodate various patient foot sizes; slide members slidingly coupled to the rails; and ball-of-the-foot articulation points for coupling the adjustable trailing link members to the slide members.
In a sixth aspect, the present invention is directed to the walking motion apparatus of the first aspect wherein the frame structure includes an elevation drive mechanism comprising: a stationary floor mounted frame; an angularly elevating frame rotationally coupled to the stationary floor mounted frame whereupon the foot guiding mechanism and rhythmic limb elevation drive unit are mounted, and the patient is supportively located with respect to either; a controller; and angular elevation drive apparatus operatively adapted for selective rotational positioning of the angularly elevating frame with respect to the stationary floor mounted frame in response to operation of the controller.
In a seventh aspect, the present invention is directed to the walking motion apparatus of the sixth aspect wherein the angular elevation drive apparatus comprises: a rail fixedly mounted on a nominally horizontal member of the stationary floor mounted frame; a guide block slidingly coupled to the rail; a nut affixed to the guide block; a drive gearmotor; a lead screw drivingly coupled to the drive gearmotor and engaging the nut; a roll and yaw-axes constraining bearing mounted upon the guide block; off-axis vertical and arm members respectively included as portions of the stationary floor mounted and angularly elevating frames; and a pitch axis constraining tie-rod for coupling tie-rod anchor points of the off-axis vertical and arm members one to another with a predetermined span length therebetween, whereby the angularly elevating frame can be angularly elevated in dependence upon instant locations of the guide block along the rail as implemented by controlled operation of the drive gearmotor via the controller.
In an eighth aspect, the present invention is directed to the walking motion apparatus of the first aspect wherein the walking motion apparatus additionally includes a patient handling mechanism comprising; a seating platform; a pivoting seat back having a nominally orthogonal horn portion wherein the pivoting seat back is located with respect to the seating platform such that the horn portion nestles within a pocket formed in the seating platform when the pivoting seat back is disposed in an upright seating position; a pivoting mechanism adapted for rotationally elevating the pivoting seat back into a nominally supine position; and a drive mechanism for drivingly elevating and pivoting the seat back in accordance with the positional constraints imposed by the pivoting mechanism.
In a ninth aspect, the present invention is directed to the walking motion apparatus of the eighth aspect wherein the pivoting seat back and pivoting mechanism comprise: a transverse pivot axis about which the seat back pivots that is located in a relatively elevated manner such that adequate clearance is provided for ensuing leg motion during the walking exercise after seat back is rotated into a horizontal position; a transverse hip axis constrained for powered motion along a nominally vertical axis such that the distance between a patient's hips and a foot guiding mechanism remains nominally constant as the seat back is elevated; a longitudinally oriented short stroke slide component for slidingly mounting the seat back along a longitudinal axis in order to accommodate normal up-and-down motions that a patient experiences during a walking exercise; and a powered slide assembly for adjustably coupling the pivoting mechanism to the angularly elevating frame along the longitudinal axis for appropriately locating the patient's hips with respect to the foot guiding mechanism.
In a tenth aspect, the present invention is directed to a method for improving a paraplegic or quadriplegic patient's cardiovascular circulation, growing high quality muscle mass, and even of firing muscle groups normally utilized in walking, wherein the method is implemented in conjunction with utilization of a walking motion apparatus comprising at least rhythmic limb elevation drive and foot guiding mechanisms wherein a supinely disposed such patient can affect a substantially normal walking motion, and wherein the method comprises the steps of: the patient donning appropriate knee braces comprising hinged bails; positioning the patient in the supine position under the rhythmic limb elevation drive mechanism; positioning and affixing the patient's shoes upon left and right articulated slide assemblies comprised in the foot guiding mechanism; attaching first and second limb groups each including one of the hinged bails and an opposing hand to first and second sets of pulley-supported lines comprised in the rhythmic limb elevation drive mechanism; and activating a rhythmic limb elevation drive unit comprised in the rhythmic limb elevation drive mechanism at a selected walking frequency.
In an eleventh aspect, the present invention is directed to the method of the eleventh aspect wherein the walking motion apparatus additionally comprises an elevation drive mechanism whereby the supinely disposed patient can affect the substantially normal walking motion while supporting a selected portion of his or her weight, and wherein the method comprises the additional step of: activating the elevation drive mechanism to an angular elevation whereat the patient is supporting a selected portion of his or her weight prior to activating the rhythmic limb elevation drive unit at the selected walking frequency.
In a twelfth and final aspect, the present invention is directed to a method for improving a paraplegic or quadriplegic patient's cardiovascular circulation, growing high quality muscle mass, and even of firing muscle groups normally utilized in walking, wherein the method is implemented in conjunction with utilization of a walking motion apparatus comprising rhythmic limb elevation drive, foot guiding, elevation drive and patient handling mechanisms whereby the patient can, without assistance, set up and get into the walking motion apparatus, properly attach him- or herself to the rhythmic limb elevation drive mechanism and operate the walking motion apparatus in order to achieve a substantially normal walking motion while supported in a selectively elevated supinely disposed position, and wherein the method comprises the patient performing the steps of: positioning the elevation drive mechanism to an intermediate position whereat he or she can conveniently open the rhythmic limb elevation drive unit comprised in the rhythmic limb elevation drive mechanism even while being wheelchair bound; opening the rhythmic limb elevation drive unit; setting stroke length; closing the rhythmic limb elevation drive unit; resetting the elevation drive mechanism to its base position; moving to a position laterally proximate to a pivoting seat back and seating platform comprised in the patient handling mechanism and located generally under the rhythmic limb elevation drive mechanism; moving onto the seating platform in a centered position whereat the patient is positioned against the seat back and astride a “horn” portion thereof nestled within a pocket formed in the seating platform; moving the patient handling mechanism forward, and if desired, rotating the pivoting seat back to locations whereat the patient can conveniently position his or her shoes upon the left and right articulated slide assemblies; positioning and affixing his or her shoes thereon; attaching first and second sets of knee elevating pulley-supported lines to the hinged bails; moving the patient handling mechanism to a location sufficiently removed from the foot guiding mechanism for optimizing the intended walking motion; rotating the seat back into a horizontal position whereat the patient is located supinely with his or her thighs straddling the horn portion of the seat back and thus keeping him or her centered thereon during the ensuing walking exercise; activating and positioning the elevation drive mechanism at the angular elevation whereat the selected portion of the patient's weight is self supported; presetting the rhythmic limb elevation drive unit comprised in the rhythmic limb elevation drive mechanism at the selected walking frequency; grabbing first and second arm elevating pulley-supported lines; and activating the rhythmic limb elevation drive unit at the selected walking frequency.
A better understanding of the present invention will now be had with reference to the accompanying drawing, wherein like reference characters refer to like parts throughout the several views therein, and in which:
With reference first to
The elevation drive mechanism 14 is adapted for rotationally elevating the walking motion apparatus 10 from an initial position whereat the patient 12 is horizontally disposed in a supine position and “walking” on a vertically disposed foot guiding mechanism 18 as shown in
In
As shown in both of
With further reference now to
Utilization of the elevation drive mechanism 14 described above results in a minimal required floor space of slightly over 3 feet wide by perhaps only about 9 feet long for the walking motion apparatus 10 as well as it fitting under an eight-foot ceiling. This is illustrated in
Similarly to RLE apparatus presented in the incorporated '502 patent, a first limb group 90a including the first articulated slide assembly 30a, the hinged bail 44 flexibly linked to the first knee brace 32a, and the opposite or second one of the patient's hands 34b is supportingly coupled to the frame structure 86 by a first set of pulley-supported lines 22a, 24 and 28b, and a second limb group 90b including the second articulated slide assembly 30b, the hinged bail 44 flexibly linked to the second knee brace 32b and the opposite or first one of the patient's hands 34a is supportingly coupled to the frame structure 86 by a second set of pulley-supported lines 22b, 26 and 28a. As depicted in
With reference now to
Within the rhythmic limb elevation drive unit 36, the primary and secondary hubs 96a and 96b are mounted along the first and second axes 94 and 98, and the driven output shaft 104 of the gearmotor 102 is positioned along a third axis 110 that nominally intersects and is orthogonal to both of the first and second axes 94 and 98. A yoke member 112 of the Scotch yoke assembly 106 is fixedly coupled to a non-rotating shaft member 114 (i.e., having ball screw raceways and ball spline grooves crossing one another) of the ball-screw spline assembly 108 in accordance with a method depicted in
A rotary nut ball screw sub-assembly 124 of the ball-screw spline assembly 108 is used for converting the oscillating translational motion of the non-rotating shaft member 114 into an oscillating rotational motion of the primary hub 92. A ball bearing supported outer race 126 of the rotary nut ball screw sub-assembly 124 is fixedly mounted to the drive housing 100 with its rotational axis substantially coincident with the first axis 94. The primary hub 92 is mounted to a nut member 128 of the rotary nut ball screw sub-assembly 124 whereby the primary hub 92 and primary sheaves 46 are driven with the desired oscillating respective rotational motions.
In addition, similar but physically smaller first and second ball-screw spline assemblies 130a and 130b (also available from THK America, Inc.) are respectively utilized for similarly mounting and converting the eccentric motion of the shaft member 122, and second cam follower 118b mounted thereon, into the desired oscillating rotational motions of the secondary hubs 96a and 96b, and the secondary sheaves 48a and 48b. Cam blocks 132 mounted on the ends of non-rotating shaft members 134 of the ball-screw spline assemblies 130a and 130b facilitate this via bearing against the second cam follower 118b as a consequence of the reflected weight of the knees of the patient 12.
The ball-screw spline assemblies 130a and 130b are of course each positioned concentrically about the second axis 98, which second axis 98 is located at a selected phase leading angle of perhaps 60 degrees with respect to of the first axis 94. This results in the oscillating motions of the secondary hubs 96a and 96b, secondary sheaves 48a and 48b, and secondary portions 24b and 26b of the pulley-supported lines 24 and 26 leading the corresponding oscillating motions of the primary hub 92, primary sheaves 46, pulley supported lines 22a and 22b, and 28a and 28b, and primary portions 24a and 26a of the pulley-supported lines 24 and 26 by corresponding leading phase angles of 60 degrees.
In addition, a stop block 136 is utilized to limit motions of the cam blocks 132 such that contact between the cam blocks 132 and the second cam follower 118b is limited to approximately 240 degrees of rotation of the driven output shaft 104. The resulting superposition of either of the primary and secondary portions 24a and 24b of the pulley supported line 24, or the primary and secondary portions 26a and 26b of the pulley supported line 26 is shown in
In detail, the method of fixedly coupling a shaft to a machine element having a flat surface depicted in
As particularly depicted in
Drive forces are transmitted from the first cam follower 118a to the yoke member 112 via either of hardened flat surfaces 176 of half-round bearing members 178 and mating female seats 180 formed in the yoke member 112. Utilization of the half-round bearing members 178 for this purpose is desirable because it allows the hardened flat surfaces 176 to position themselves in a juxtaposed manner with the outer surface of the first cam follower 118a irregardless of component mounting surface tolerances and/or load sourced deflections.
Preferably whenever a patient 12 intends to pre-select a new stroke length, the gearmotor 102 is first stopped at a position whereat the fourth axis 120 is nominally positioned along the first axis 94 at a location nearest the primary hub 92 in the manner depicted in
With reference now to
The slide members 190 and longitudinally oriented rails 192 can of course be formed in a variety of known ways. As particularly depicted in
As depicted in
It is of course necessary to provide for proper patient foot and lower leg location with respect to either of the left and right articulated slide assemblies 30a and 30b during all phases of the desired walking motion. As shown somewhat in
The adjustable trailing link members 222 are formed in the bifurcated manner described in detail below so that their lengths can be adjusted such that ball-of-the-foot flexure points 216 of each of the patient's shoes 208 fall directly between the ball-of-the-foot articulation points 228 prior to use of the walking motion apparatus 10. This is most effectively done by moving rear elements 230 of the adjustable trailing link members 222 with respect to front elements 232 thereof such that alignment marks 234 are aligned with appropriate ones of shoe size depicting marks 236 before clamping the front elements 232 to the rear elements 230.
The front and rear elements 232 and 230 are formed with respective interleaving dovetail shaped and angled fingers 238 and 240 such that the rear elements 230 can slide longitudinally with respect to the front elements 232 but not separate from them. As shown particularly in
After they are properly positioned, the front elements 232 are clamped to the rear elements 230 via flat head bolts 246 and clamping nuts 248 pulling juxtaposed ones of the angled fingers 240 against the center dovetail shaped fingers 238. Cavities (not shown) are formed in the tops of the second extrusion profiles 204 in order to provide clearance for the clamping nuts 248 whenever the adjustable trailing link members 222 are collapsed downward against the second extrusion profiles 204.
Forward portions of the front elements 232 are formed in a generally thickened manner with longitudinally oriented slots 250 suitable for accepting fingers 252 formed on the posterior foot supporting plates 218. Then whenever the posterior foot supporting plates 218 and adjustable trailing link members 222 are collapsed downward against one another and against the second extrusion profiles 204, their top surfaces 254 and 256, along with top surfaces 258 of the forefoot supporting members 226, combine to form shoe supporting surfaces 260 equidistant from and parallel to the top surfaces 262 of the left and right longitudinally oriented rails 192. And finally, it is preferred to limit upward motions of the under heel articulation points 224 during each stride via either of cam followers 264 making contact with a travel limiting bar 266 (i.e., shown in
With reference now to
Elevation toward the horizontal position is accomplished via a motion of a powered vertical slide assembly 280 comprising yet another guide block 64″ moving along another rail 60″ and powered by another Cyclo type drive gearmotor 76′ and lead screw 74′ moving a nut member 282′ vertically from its initial position 282″. This applies driving torque to an arm assembly 284 via tie rods 286 whereby the arm assembly 284 rotates about the transverse pivot axis 276. This causes various motions including constrained vertical motion of a transverse hip axis 288 and rotational motions of the arm assembly 284 and seat back 270 as indicated by the various arrows 290 plus minor translational motion of the transverse pivot axis 276 as required to accommodate the span between the transverse pivot and transverse hip axes 276 and 288. This ensures that the distance between the patient's hips 292 (shown in
The seat back 270 itself is mounted upon a longitudinally oriented short stroke slide 294. The short stroke slide 294 is provided for accommodating normal up-and-down motions that the patient 12 will experience during the walking exercise. Finally, all of the above described components of the patient handling mechanism 20 are adjustably coupled to the angularly elevating frame 56 via a slide assembly 296 implemented by a side-by-side pair of guide blocks 64′″ moving along a rail 60′″ affixed to a longitudinally extending arm 310 and powered by still another Cyclo type drive gearmotor 76″ (shown in
In addition, interchangeable seat backs 270 are accommodated via a seat back interchanging mechanism 298 located above the short stroke slide 294. This is deemed necessary herein because patients 12 come in all torso lengths and girths. Furthermore, different seat back designs are required for patients having varying degrees of torso control. For instance, the particular seat back 270 depicted in
In actually utilizing the walking motion apparatus 10, a wheelchair bound patient 12 uses a controller 300 (shown in
Depicted in
Finally, presented in a fifth alternate preferred embodiment of the present invention are methods for improving a patient's cardiovascular circulation, growing high quality muscle mass, and even of firing muscle groups normally utilized in walking as depicted in
Depicted in
Finally, depicted in
Having described the invention, however, many modifications thereto will become immediately apparent to those skilled in the art to which it pertains, without deviation from the spirit of the invention. For instance, alternate elevation drive mechanisms and/or patient handling mechanisms could be utilized without deviation from the spirit of the invention. In any case, such modifications clearly fall within the scope of the invention.
It is believed herein that utilization of the walking motion apparatus 10 of the present invention by paraplegic, quadriplegic, brain injured and various other handicapped patients in implementing the above described walking exercise would be of significant value to them, and therefore, that the walking motion apparatus 10 will find broad acceptance both here in America and abroad.
This application claims priority of U.S. Provisional Patent Application Ser. Nos. 60/635,902 filed Dec. 14, 2004 and 60/645,247 filed Jan. 19, 2005.
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| Number | Date | Country | |
|---|---|---|---|
| 20060128537 A1 | Jun 2006 | US |
| Number | Date | Country | |
|---|---|---|---|
| 60645247 | Jan 2005 | US | |
| 60635902 | Dec 2004 | US |
