The present invention relates to rolling walking devices for patients with a disability.
Walking aids are used for support and therapy of congenital, disease-, accident-, and/or age-related disorders of the human musculoskeletal system. In particular, rolling walking aids are known that allow a patient to be assisted in walking and/or to train the patient's walking ability and/or to at least partially treat the patient's symptoms.
However, some of the known walking aids require the patient to be fixed to the respective walking aid in order to use the walking aid. As a result, the respective patient is dependent on another usually trained person to assist him in getting into the walking aid. Further, fixing the patient to the walking aid and/or adjusting the walking aid to the patient can be complicated and time-consuming.
Furthermore, the walking aids known from the prior art are only insufficiently suitable for the support and/or therapy of patients with a disability of the musculoskeletal system in the area of the hip joint, since they require that the patient uses the walking aid in an essentially upright body posture. In particular, the above-mentioned fixation of the patient to the respective walking aid can result in the patient being forced into an unnatural and/or uncomfortable or even painful body posture, which is usually not conducive to achieving the therapy goal.
In particular, the walking aids known from the prior art are not suitable for patients in whom a disorder of the musculoskeletal system does not permit an essentially upright body posture with a hip joint that is not flexed or only slightly flexed, or only under pain. For example, walking devices known in the prior art are often unsuitable for patients with fixed contractures at the trunk and/or at the extremities, which is often associated with global muscular insufficiency or central movement disorder.
In addition, the known walking aids only insufficiently enable the patient's equilibrioception or rather balance to be trained while walking. Finally, the known walking aids are often unsuitable for moving over uneven surfaces. Even small obstacles, such as doorsteps, are usually insurmountable for the patient during movement due to the small size of the rollers used.
The present invention is therefore based on the task of developing novel walking devices that are easy to construct and to handle and yet can improve the support and/or therapy of patients with a musculoskeletal disability, overcoming at least in part the disadvantages of the prior art discussed above.
This task may be solved by the subject matter of the independent claims of the present invention. Exemplary embodiments are described in the dependent claims.
In one embodiment, an apparatus may comprise a rolling walking device for a person with a disability, wherein the walking device has: a plurality of rollers, at least one support apparatus for the person, wherein the at least one support apparatus is configured so that the person using the rolling walking device can sit on the at least one support apparatus while simultaneously resting with a front side of their upper body at least partially on the at least one support apparatus, optionally also while flexing their hip joint.
Such an arrangement may allow patients with walking disabilities whose mobility is impaired in the area of the hip joint, for example due to a hip flexion contracture, to use the rolling walking device as a walking aid and/or therapy device while leaving the hip joint in a flexed position. In particular, the muscles involved in walking and their coordination may be trained in this way, even in patients who have no or only limited ability to maintain an upright body posture. Patients with a hip extensor muscle strength value according to Janda greater than or equal to 3 may be able use the walking device according to the invention independently. For patients with a hip extensor muscle strength value according to Janda less than 3, support by an assistant or electrical residual strength support may be required.
For example, the invention may allow for assisting and/or treating patients who have any of the following disorders of the musculoskeletal system:
Furthermore, such an arrangement may allow the user to have improved access to various workplaces. Since the user sits on the walking aid and does not push it in front of him or her, the user can move closer to any obstacles such as furniture and/or even partly drive under them. This greatly extends the user's radius of action both inside and outside rooms.
In particular, such an arrangement may also allow patients to use the walking aid according to the invention for whom the use of crutches or rollators may not be possible due to limitations of the upper extremities.
The at least one support apparatus may comprise a seat and at least one upper body support that are adjustable relative to each other.
This may allow the walking device to be adapted to the body size and/or body posture and/or a misalignment of the skeletal muscles of a patient. In particular, such adjustability of the at least one support apparatus may allow the walking device, over a longer period of time, to adapt to the patient's body posture which may steadily improve as the success of therapy progresses.
Further, this may allow some patients who do not have to be restrained to the walking device and may be able to enter the walking device independently or alternatively require only minor assistance from an untrained or trained person to do so.
Additionally, or alternatively, the at least one support apparatus may be designed to be at least partially plastically deformable. This may also allow the at least one support apparatus and thus the walking device to be adapted to an improved and/or changed posture of the patient as a result of using the walking device. Additionally, the support apparatus may thereby be individually adapted to an asymmetrical body posture of the patient.
Another advantage of such an adjustable and/or deformable support apparatus may be that a single walking device can be customized individually for ambulant therapy of multiple patients with different body sizes and/or body postures.
In particular, the at least one support apparatus may be configured to allow the hip joint of the person using the rolling walking device to flex at an angle between 0° and 90°, preferably between 0° and 30°, relative to an upright body position.
In another embodiment, an apparatus may comprise a rolling walking device for a person with a disability, wherein the walking device may comprise: a plurality of rollers, at least one support apparatus for the person, and at least one joint which is configured so that the at least one support apparatus is able to tilt laterally relative to a base surface on which the rolling walking device rolls.
Such a tiltable construction of the support apparatus may lead, for example, to the patient using the walking device being prompted to actively stabilize the support apparatus against tilting. This may cause the patient to adopt a dynamic walking behavior, thereby constantly training the muscles that support walking—in particular the hip muscles, gluteal muscles and adjacent trunk and back muscles—as well as the patient's coordination skills and equilibrioception. Especially in combination with a forward displacement of the upper body, which may be able to be brought about with the aid of the support apparatus, the tiltable construction of the support apparatus may have a positive effect on triggering the walking reflex.
Further, the rolling walking device may have an adjustment apparatus that enables the lateral tilting of the at least one support apparatus to be influenced. In particular, the adjustment apparatus may be configured to influence the lateral tilting in a first tilting direction differently than in an opposite direction of the first tilting direction.
For example, this embodiment may allow the tilting, and thus the dynamic walking behavior that the walking device may cause the patient to perform, to be individually adapted to the severity of the respective disorder of the patient's musculoskeletal system. In particular, the tilting may be adjusted asymmetrically such that the at least one support apparatus may be tilted differently in one direction than in the opposite direction.
Further, the adjustment apparatus may provide a restoring torque against lateral tilting of the at least one support apparatus, wherein the restoring torque may be preferably adjustable. Thereby, in some embodiments, the adjustment apparatus may be configured such that the restoring torque is substantially proportional to the tilting of the at least one support apparatus. This may be achieved, for example, by a spring mechanism which provides the restoring torque for the at least one tiltable support apparatus.
For example, such restoring torque may improve the walking device in that it may support dynamic walking and thus training of the patient's hip and gluteal muscles, as well as adjacent trunk and back muscles. In particular, an adjustment apparatus designed in such a manner may allow a lower restoring torque to act on small tilts that are easily compensated for by the patient than on large tilts that are more difficult to compensate for by the patient.
Further, the restoring torque may be independently adjustable for two tilting directions, for example, to adapt the restoring torque to any asymmetric disturbance of the patient's musculoskeletal system.
Alternatively, or additionally, the walking device may have a limiting apparatus with which the lateral tilting of the at least one support apparatus can be limited, wherein the limiting apparatus may preferably be configured adjustable.
Such a limiting apparatus allow not only the restoring torque but also a maximum possible tilting to be individually adapted to the respective patient.
Further, the limiting apparatus may be configured to be adjustable for two tilting directions independently of each other, for example, in order to individually adapt the maximum possible tilting to an eventual asymmetric disturbance of the patient's musculoskeletal system that may be present.
In another embodiment, an apparatus may comprise a rolling walking device for a person with a disability, wherein the walking device may comprise: a plurality of rollers arranged on a frame element, wherein the frame element is connected to at least one roller via a fastener which is arranged below a rotational axis of the at least one roller.
In one embodiment, the fastener may be disposed in the lower third and in another embodiment, the fastener may be disposed in the lower quarter of the at least one roller.
Such a construction may allow for use of rollers with a much larger diameter, for example, to improve the rolling characteristics of the walking device without compromising the stability of the walking device against lateral overturning.
In some embodiments, the fastener may be pivotally connected or moveably attached to the frame element.
For example, this may allow the fastener of the at least one roller to be configured such that the spatial orientation of the rotational axis of the at least one roller can rotate relative to the rest of the walking device in a large angular range, in particular 360°, which may allow for a very small turning radius.
Further, the fastener of the at least one roller may have a disk-shaped element that may not rotate about the rotational axis of the at least one roller and on which a tire-shaped element of the roller may be rotatably mounted or moveably attached. With such an arrangement, large rollers can be realized without loss of stability.
In some embodiments of the present invention, the walking device may comprise a planar frame element that provides a plurality of adjustable positions for a plurality of components of the walking device to be fastened to the frame element, respectively. In particular, the respective components of the walking device may be detachably fastened to the planar frame element. For example, for this purpose, the flat frame element may have two mounting surfaces between which the components of the walking device may each be adjustably attachable.
Such a construction may allow for the fastening points of the respective components to be individually adapted to the respective patient and additionally or alternatively for the rolling walking device to be quickly and easily disassembled and reassembled if necessary, for example for transport. In particular, this may allow the walking device to be transported in a car, if necessary even in addition to a wheelchair, whereby the user comfort is considerably improved and the frequency of use can be significantly increased. This may not be possible with many alternative walking devices due to the lack of disassemblability.
In some embodiments of the present invention, the planar frame element may comprise a plurality of holes defining the plurality of adjustable positions, wherein at least a portion of the plurality of holes may be arranged in a grid configuration that is preferably substantially triangular, equilateral triangular, or hexagonal.
Such a hole arrangement may make it possible, for example, to develop and manufacture new components and/or add-on parts for the walking device, which may also be attached to already manufactured walking devices, since the hole arrangement is already known. In particular, patient-specific components and/or add-on elements may also be developed, manufactured and attached to already manufactured walking devices in this way. For example, for patients with crossed gait due to increased tone of the hip adducting muscles, stripe blocks could be developed, manufactured and attached to already manufactured walking devices.
In some embodiments of the present invention, the walking device may comprise an adjustable push bar configured to be moved from a first position, in which it may follow the contour of a roller of the walking device, to a second position for pushing the walking device.
Such a push bar may allow the therapist or another person to assist the respective patient in using the walking device, for example when the walking device has to be moved over a doorstep or uphill. At a point in time when the push bar is no longer needed, it may be returned to the first position in which it disturbs the patient using the walking device as little as possible.
In some embodiments of the present invention, the walking device may comprise a brake at which a flexible traction element is arranged such that the brake can be actuated by an actuation of the flexible traction element.
Such an arrangement may allow for use of the brake as a grinding and/or parking brake when the traction element is kept under tension. Furthermore, such an arrangement may allow the brake to be actuated by pushing on and/or pulling on the traction element, which in turn may require less coordination from the user. This may be particularly advantageous for patients with insufficient fist grip and/or insufficient mobility of the fingers. In particular, the flexible traction element may also be designed as a flat textile or net to make it even easier for a patient to actuate the brake.
Certain aspects of the present invention are described in the following with reference to the appended figures. These figures show:
In the following, some embodiments of a rolling walking device are described. Herein, various combinations of features are described with reference to some exemplary embodiments of the present invention. As an example, in the following, a three-wheeled rolling walking device with a large rear wheel and two smaller front wheels as well as a frame, a hand support, a seat and an upper body support is described. However, the claimed walking devices are not limited to such embodiments. Rather, it is to be understood that other combinations of features may also fall within the scope of protection of the invention. In other words, not all features of the described embodiments need to be present to implement the present invention. Furthermore, the embodiments may be modified by combining certain features of one embodiment with one or more features of another embodiment without departing from the disclosure and the scope of protection of the present invention.
In particular, the present invention is not limited to three-wheeled walking devices with a rear wheel, but can be applied to a plurality of different rolling walking devices for a person with a disability.
The terms roller and wheel are used equivalently in the context of the present invention. Further, in the context of the present invention, the term “substantially” is to be understood as “within typical design, construction, manufacturing and/or measurement tolerances”.
Further, both seat 100 and upper body support 110 of the embodiment shown in
Singularly or in their combination, the above-described adjustment options of the support apparatus, which in this embodiment may be provided by the seat 100 and the upper body support 110, may allow for the support apparatus to be adapted to the patient's body posture and/or body size individually and readjustably as needed.
Further, the rolling walking device of
In addition, the walking device of
The substantially centrally arranged rear wheel 150 may be rotatably connected to the rear portion 140-H of the frame. In one embodiment, the rear portion 140-H of the frame may be detachably connected to the front portion 140-V of the frame. Thereby, the rear portion 140-H of the frame may be connected to the front portion 140-V of the frame in various positions, whereby the frame height and/or wheelbase of the walking device can be individually adjusted. Thereby, the rear wheel 150 may be eccentrically fastened to the rear portion 140-H of the frame, as described further below in connection with
The rear part 140-H of the frame may be designed in the form of a single swing arm so that the rear wheel 150 is rotatably connected to the rear part 140-H of the frame on one side only. Alternatively, the rear part 140-H of the frame can also be in the form of a wheel fork to which the rear wheel 150 may be rotatably connected, e.g. by a quick-release axle.
In some embodiments, the rear wheel 150 may have a larger diameter than the front wheels 160. A larger diameter of the wheels 150, 160 of the walking device generally may improve the rolling characteristics of the walking device because, for example, a larger wheel can roll over obstacles such as a doorstep more easily than a smaller wheel. However, the diameter of the rear wheel 150 may be selected to be only as large that the entering of the patient into the walking device and the positioning of the patient's body on the seat 100 and upper body support 110 can be done over the rear wheel 150. In particular, the arrangement of the wheels 150, 160 of the seat 100 and the upper body support 110 shown in
In a further embodiment, instead of a rear wheel 150, an axle assembly comprising at least one wheel may be connected to the frame 140. In particular, this axle assembly may be similar in all or some aspects to the front axle assembly described. This embodiment may be useful for patients who are particularly susceptible to overturning, as it may increase the stability of the walking device. In some embodiments, the axle assembly may be detachably connected to the frame 140 so that it can be exchanged for other axle assemblies or a single rear wheel 150 as required by the patient.
Further, the walking device shown in
Further, the walking device of
Further, at the outer ends of the wheel suspension 192 deflection rollers 170 may be provided which, when the walking device for example comes into contact with a wall, deflect it away from the wall and thereby prevent the walking device from becoming stuck on such a wall during use.
Finally, it is already apparent from
In
The tiltability of the walking device may cause the patient using the walking device to engage in dynamic walking behavior, since the patient must actively provide lateral stabilization of the frame 140. In particular, this may achieve a physiologically desirable walking behavior and, for example, may train not only the leg muscles but also the hip and gluteal muscles and the adjacent trunk and back muscles as well as their coordination. Furthermore, the balance and/or equilibrium of the patients may also be trained.
In some embodiments, the support apparatus formed from seat 100 and upper body support 110—and thus the body of the patient—can be tilted laterally relative to the base surface on which the walking device rolls. In other words, other embodiments of the invention also exist in which, for example, the frame 140 cannot be tilted laterally and/or such a frame as shown in
As shown in
Additionally, two limiting blocks 400 may be provided on the threaded bar 430 and the guide bar 440 in such a manner that when the threaded bar 430 is rotated, the position of the limiting blocks 400 can be moved parallel to the wheel suspension 192 along the guide bar 440. For example, the limiting blocks 400 may comprise internal threads matching the external threads of the threaded bar 430 and can thus be moved along the guide bar 440 by rotating the threaded bar 430. The limiting blocks 400 may be connected via the spring elements 300 to two end blocks 410, which may be pressed against the right and left outer surfaces of the lower part of the connecting bar 194 by the spring elements 300.
If now the connecting bar 194 is deflected from the center position, in which the connecting bar 194 forms approximately a 900 angle with the wheel suspension 192, the spring elements 300 may generate a restoring force against the tilting of the connecting bar 194, the restoring force being transmitted from the spring elements 300 to the lower part of the connecting bar 194 via the end blocks 410. The restoring force generated by the spring elements may result in a restoring torque acting at the joint 230, the amount of which is essentially determined by the product of the spring restoring force and the lever length, i.e. the length of the lower part of the connecting bar 194 measured from the joint 230 to the point of contact of the respective end block 410. As long as the spring elements 300 are operated in a regime that satisfies Hook's law, the restoring force should be proportional to the deflection of the respective spring element 300 from its rest position. Thus, in such a regime, the restoring torque may also be proportional to the tilting angle of the connecting bar 194 from the center position.
In the shown embodiment, the distances between the limiting blocks 400 and the associated end blocks 410 can be adjusted independently of each other, which may allow the spring elements 300 to be preloaded independently of each other and thus provide an asymmetric restoring force against tilting of the connecting bar 194. Further, it may also be possible to use spring elements 300 with different spring constants to further adapt this asymmetry.
By a suitable choice of spring element 300 and the position of the associated limiting block 400, a fixed stop for the tilting of the connecting bar 194 can be realized on one or both sides. In this way, not only can the restoring torque be set by the adjusting and/or limiting apparatus 240, but also a maximum possible tilting can be specified. Like the restoring torque, this maximum tilting can also be set independently for both tilting directions. In the described embodiment, both the stop and the restoring spring force may be set by the position of the limiting blocks 400. However, embodiments are also conceivable in which the stop and the restoring spring force can be set separately from each other and limiting blocks 400 may be used for setting the stop.
As can be seen, for example, in
The wheel 900 may further comprise a tire-shaped element 920 which is rotatably connected to the non-rotating disk-shaped element 910. For example, the tire-shaped element 920 may be rotatably connected to the disc-shaped element 910 via a ball bearing and/or roller arrangement. The shown wheel construction thereby may allow laterally acting forces, which would be transmitted from the walking device via the fastener 930 to the wheel 900, to act on the lower end of the wheel 900 and thereby stabilize the wheel 900 against tilting and thus also the walking device against overturning.
In particular, this may allow the diameter of the wheel 900 to be increased without substantially shifting the point of application of the lateral forces upwards—which may not be the case, for example, with the front wheels 160 shown in
In the assembled state, the outer half 910-A of the disc-shaped element 910 may be fixedly connected to the inner half 910-I via two screws and screw holes 1010. Therefore, the disc-shaped element 910 may be fixedly and non-rotatably connected to the walking device via the fastening apparatus 930, while the tire-shaped element 920 may be rotatably supported by the rotatable rollers 1000.
If the traction element is fastened under appropriate tension, a uniform application of force to the brake 132 may result, such that the brake 132 may act as a grinding brake or also as a parking brake. In addition, such an arrangement may allow the brake 132 to also be applied by pressing on and/or pulling on the flexible traction element 134, as the application of force is in turn transmitted to the brake. This is illustrated in
Number | Date | Country | Kind |
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10 2018 212 291.1 | Jul 2018 | DE | national |
Filing Document | Filing Date | Country | Kind |
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PCT/EP2019/069771 | 7/23/2019 | WO |
Publishing Document | Publishing Date | Country | Kind |
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WO2020/020872 | 1/30/2020 | WO | A |
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