The present disclosure is generally directed to a device and related methods for balance training.
One third of ambulatory individuals with chronic spinal cord injury will suffer at least one fall every 6 months. Furthermore, many of these falls result in serious injuries, resulting in hospitalization and increased healthcare related costs. Traditionally, it has been estimated that nearly 50% of all falls reported result from a slip occurring during walking. However, there are currently no effective interventions for reducing or preventing slips.
Current strategies to address balance deficits in individuals with spinal cord injury include dynamic and static activities. Training anticipatory balance strategies are easily achieved in the physical therapy setting, such as when someone prepares to step over an obstacle. Reactive balance strategies, or those that occur once someone has lost their balance, are harder to achieve consistently. Reactive balance responses utilized by individuals may include an ankle strategy, hip strategy or a stepping response to catch their balance to avoid a fall.
Perturbation training, which involves an externally induced force to the patient, is one tactic to elicit a reactive balance response. It is thought that with this type of trial and error training individuals can modify their response and improve their control of their center of mass within their base of support. Application of this type of perturbation training, however, is limited to external pushes at the trunk, shoulder, or upper leg. There is no currently available equipment in the physical therapy setting that creates a perturbation at the foot or slip while standardizing the perturbation parameters. Thus, it would be beneficial to have a device that could be used during physical therapy to train and strengthen patients, including the elderly or those with spinal cord injury, to reduce slip related falls.
The present disclosure is directed to a slip training device that comprises a frame, at least one platform disposed on the frame, and rotatable elements disposed below the at least platform. The frame has a first end and a second end, and a pair of lateral sides extending between the first end and the second end. The at least one platform is configured to be placed in a moveable position where the platform is moveable along the frame or a stationary position where the platform is stationary with respect to the frame. The rotatable elements allow the movement of the at least one platform along the frame.
The present disclosure is further directed a slip training device that comprises a frame, a plurality of platforms disposed on the frame, and a plurality of translational elements disposed below each platform. The frame has a first end and a second end, and a pair of lateral sides extending between the first end and the second end. Each platform is configured to be placed in a movable position where the platform is moveable along the frame or a stationary position where the platform is stationary with respect to the frame. The plurality of translational elements allows the movement of the platform along the frame.
Turning to the drawings, wherein like reference numerals refer to like elements, the present disclosure is illustrated as being implemented in a suitable environment. The following description is based on embodiments of the claims and should not be taken as limiting the claims with regard to alternative embodiments that are not explicitly described herein.
The device 10 may be folded into two segments using a hasp 80. In such an embodiment, each lateral side 18 consists of two members, thereby allowing the device to be folded. Further, wheels 70 on each end of the device may be provided to allow the device 10 to be rolled into use or storage. The device 10 may be comprised of wood, plastic, or other suitable materials.
Each opening 40 may contain one or more rotatable elements 60. The rotatable elements 60 shown in
In an embodiment, the device 10 may have a length of 1.7 m and a width of 0.43 m. Each platform 21 may be movable towards and away from each of the first end 16 and the second end 17 of the outer frame 15. In an embodiment, a platform 21 may have a length of 11.75 inches. Each platform may have a width of 0.42 m. The platforms may be located between separators 35, allowing about 0.1 m of movement longitudinally of the platform 21. The present disclosure, however, is not limited to the dimensions provided above and may vary in other embodiments. Within the substrate 30, there may be openings 40 spaced such that all openings 40 are at least partially underneath a platform 21 when the device is assembled. In one embodiment, there are four circular openings 40 cut into the substrate 30, all located directly beneath a platform 21 in the assembled device such that they are completely hidden from a user's sight. The rotatable elements 60 may take various forms. For instance, a rotatable element 60 may be a 19 mm metal ball bearing.
When using the device 10, a user places his or her foot on the platform 21a positioned adjacent to the first end 16, and begins to walk toward the second end 17 on top of successive platforms 21b-21h. Some of the platforms 21a-21h may not have rotatable elements 60 positioned in the substrate openings 40 below the platform. Other platforms 21a-21h may have rotatable elements 60 positioned in the substrate openings 40 below the platform. When the user steps on such a movable platform, the force from the user's gait moves the platform backwards towards the first end 16. This movement creates an unpredictable perturbation that replicates the movement of the user slipping on a slippery surface, such as ice. The therapist may identify in advance which platforms are not fixed to the device 10, or the therapist may allow the user to discover which platforms are not fixed while the user is walking along the platforms 21. When a user places his or her weight on a movable platform 21, the platform rolls along the rotatable elements 60 positioned below the platform 21. This can require the user to engage the muscles responsible for upright balance.
The device 110 is used to train in the same manner as device 10. When using the device 110, a user places his or her foot on the platform 121a positioned adjacent to the first end 116, and begins to walk toward the second end 117 on top of successive platforms 121b-f. Although
In the embodiment of
The bottom surface of platform 221 is further provided with a brace member 227. The member 227 may take the form of a bracket with a U-shaped cross-section mounted to the bottom surface of the platform, the bracket having a base 227a and two legs 227b extending therefrom. However, in alternate embodiments, the brace may take another form such as a pair of legs mounted directly to the bottom surface of the platform 221. The legs 227b may have a plurality of pairs of holes or openings 228 through which pins 226 may be inserted. The device 210 further may have a vertical separator 236 with a bottom end that is rigidly affixed to a separator 235 and a top end that extends upwardly therefrom. To limit the amount of movement of the platform, the top end of the vertical separator 236 is inserted between the legs 227b of the bracing member 227 and pins 226 are inserted transversely through a respective pair of holes 228 in the legs 227b. The height of the vertical separator 236 is low enough to allow the bottom surface of the platform 221 to pass over it, but high enough to collide with the pins 226 when the user moves the platform 221 along the length of the device 210. Thus, the vertical separator 236 limits the amount the platform 221 can move along the lateral sides 218a, 218b by colliding against the pins 226. To allow the platform 221 to move a greater amount, the distance between the openings 228 into which the pins 226 are inserted is increased. Conversely, to decrease the movement of the platform 221, the pins 226 are inserted into adjacent pairs of openings 228. If the pins 226 are positioned immediately adjacent to the vertical separator 236, the separator 236 is trapped and the platform 221 is not allowed to move and remains stationary.
When using the device 210, a user places his or her foot on the platform 221a positioned adjacent to the first end 216, and begins to walk toward the second end 217 on top of successive platforms 221a-c. Although
The therapist may identify in advance which platforms are not fixed to the device 210, or the therapist may allow the user to discover which platforms are not fixed while the user is walking along the platforms 221. If the user steps on a stationary platform, then the user can walk across that platform normally. When a user places his or her weight on a movable platform 221, this may require the user to engage the muscles responsible for upright balance to prevent a fall. Whether a particular platform is moveable or stationary can be changed each time the user traverses the device. By repeatedly traversing the device, each time with potentially different moveable platforms, individuals can be trained to modify their response, exercise the muscles responsible for upright balance, and improve their control of their center of mass within their base of support. Having better control of their center of mass helps to reduce slip related falls.
In the various embodiments described above, the rotatable elements take the form of wheels. However, it should be understood that any translational mechanism can be used that enables movement of the platforms along the frame. Examples of translational mechanisms include rollers, casters, linear guides, and linear rails.
This patent claims priority to U.S. Provisional Patent Application Ser. No. 62/674,499, filed May 21, 2018, entitled “Slip Training Device and Related Methods.” The entirety of U.S. Provisional Patent Application Ser. No. 62/674,499 is incorporated herein by reference.
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