This disclosure relates to systems such as flexible orthoses which can be used to provide support to a patient's leg during, for example, physical rehabilitation.
Individuals suffering from injuries or other clinical conditions may benefit from supportive orthoses. Ankle-foot orthotics (AFO's) are commonly used to provide support to users who wish to retain mobility, but need additional support to do so safely and without risking injury or delaying recovery. AFO's may include a leaf spring, which provides resistance to certain types of motion, including dorsiflexion (or flexion of the foot upward toward the lower leg).
A typical leaf spring can be understood as having a single spring constant or stiffness, which is determined by the geometry and material properties of the leaf spring. This is an important property of the AFO, as it will affect the amount of support provided, as well as the degree of flexibility and mobility permitted to the user while he or she wears the AFO.
Often, however, users would benefit from alterations to the stiffness of the leaf spring after that value has already been set. For example, clinical prediction of the user's needs may not be accurate, and the user may decide that they need more or less support after using the AFO for a period of time. The user's condition may also change after fitting due to progress of disease or progress of training. In other cases, a user's circumstances may change. For example they may move from a home with no stairs to a home with many stairs. Since climbing stairs requires deflecting the leaf spring prior to applying weight bearing load, a stiffer leaf spring may impede stair climbing whereas a more flexible spring would accommodate stair climbing better. Another example is when a patient gains increased ambulatory capacity, they may gain an increased sense of what is possible. As a user gains skill with the orthosis and as they improve their general physical conditioning, they may desire to increase the power available from the orthosis to support new, more demanding activities. These types of customizations are not available using traditional orthoses.
Moreover, a leaf spring having a single spring constant may not be optimal for users who wish to have lower resistance to dorsiflexion for smaller movements (e.g., lifting the foot a small amount to clear the edge of a stair) but higher resistance to dorsiflexion in the context of larger movements (e.g., overextension). Such resistance profiles are not available using traditional orthoses.
Accordingly, there is a need for a system that provides variable stiffness which can be tuned to a patient's needs in accordance with his or her clinical condition, environment, or the activities in which he or she is engaged. Moreover, there is a need for a system which can provide different levels of resistance in response to different degrees of dorsiflexion.
The following presents a simplified summary in order to provide a basic understanding of some aspects described herein. This summary is not an extensive overview of the claimed subject matter. It is intended to neither identify key or critical elements of the claimed subject matter nor delineate the scope thereof. Its sole purpose is to present some concepts in a simplified form as a prelude to the more detailed description that is presented later.
In some embodiments, a system for supporting a user's limb may be provided. The system may include one or more of a foot plate configured to engage the user's foot, a coupling configured to engage a portion of the user's leg, a first leaf spring disposed between the foot plate and the coupling, and a second leaf spring extending alongside at least a portion of the first leaf spring. In some embodiments, a space is defined between the first leaf spring and the second leaf spring. In some embodiments, the space between the first leaf spring and the second leaf spring may be configured to receive one or more spacers of a plurality of spacers, such that a dorsiflexion resistance profile of the system differs depending on how many and which of the one or more spacers is positioned within the space.
The system may be configured such that the space between the first leaf spring and the second leaf spring has a lateral distance d1 when the system is in a first state in which an external load is not applied. The system may be further configured such that the space between the first leaf spring and the second leaf spring has a lateral distance d2, which is less than d1, when the system is in a second state in which an external load is applied.
In some embodiments, the distance between the first leaf spring and the second leaf spring may progressively decrease under increasing loads, and a slope of a stress-strain curve of the system may increase when the distance reaches zero. In some embodiments, a spacer may be disposed in the space between the first leaf spring and the second leaf spring.
In some embodiments, the system may include a plurality of spacers including at least a first spacer and a second spacer. The system may have a first dorsiflexion resistance profile when only the first spacer is disposed in the space between the first leaf spring and the second leaf spring. The system may have a second dorsiflexion resistance profile when the second spacer is disposed, alone or in combination with the first spacer, in the space between the leaf spring and the second leaf spring. The second dorsiflexion resistance profile may be different than the first dorsiflexion resistance profile.
In some embodiments, the first spacer may have a first compression characteristic, and the second spacer has a second compression characteristic that is different than the first spacer. In some embodiments, the first spacer may be removable from the space between the first leaf spring and the second leaf spring by applying a load to the system in a plantarflexion direction. In some embodiments, the first spacer may have a first compressing state in which the spacer has a first resistance to compression, and a second compressing state in which the first spacer has a second resistance to compression that is greater than the first resistance to compression. In some embodiments, the first spacer may comprise a foam.
In some embodiments, the system may have a first loading state in which the system has a first resistance to dorsiflexion, and a second loading state in which the system has a second resistance to dorsiflexion that is greater than the first resistance to dorsiflexion. In some embodiments, the system may transition from the first loading state to the second loading state when a predetermined dorsiflexion value is exceeded. In some embodiments, the predetermined dorsiflexion value may be between 6° and 15°.
In some embodiments, a method for supporting a user's limb may be provided. The method may be performed using a system including one or more of: (i) a foot plate configured to engage the user's foot, (ii) a coupling configured to engage a portion of the user's leg, (iii) a first leaf spring disposed between the foot plate and the coupling, and/or (iv) a second leaf spring extending alongside at least a portion of the first leaf spring, such that a space is defined between the first leaf spring and the second leaf spring. In some embodiments, the method may include determining, based on a first use scenario, that a first dorsiflexion resistance profile of the system is desired. The method may further include determining, based on the first dorsiflexion resistance profile, that a first spacer should be placed in the space defined between the first leaf spring and the second leaf spring. In some embodiments, the method may further include placing the first spacer in the space defined between the first leaf spring and the second leaf spring to achieve the first dorsiflexion resistance profile.
In some embodiments, a first spacer may be selected, based on the first dorsiflexion resistance profile, from a plurality of spacers having different compression characteristics. In some embodiments, it may be determined, based on a second use scenario, that a second dorsiflexion resistance profile is desired, and a second spacer having different compression characteristics may be selected. In some embodiments, the second spacer may be placed in the space defined between the first leaf spring and the second leaf spring. In some embodiments, the first spacer may be removed from the space defined between the first leaf spring and the second leaf spring. In some embodiments, the step of removing the first spacer from the space defined between the first leaf spring and the second leaf spring may include applying a load to the system in a plantarflexion direction.
In some embodiments, the first spacer may be a resilient member. In some embodiments, the first spacer may have a first compressing state in which the spacer has a first resistance to compression, and a second compressing state in which the first spacer has a second resistance to compression that is greater than the first resistance to compression. In some embodiments, the first spacer may comprise a foam.
In some embodiments, a plurality of spacers may be placed in the space between the first leaf spring and the second leaf spring.
In some embodiments, the first dorsiflexion resistance profile may include a first loading state in which the system has a first resistance to dorsiflexion, and a second loading state in which the system has a second resistance to dorsiflexion that is greater than the first resistance to dorsiflexion. In some embodiments, the first dorsiflexion resistance profile may include a transition from the first loading state to the second loading state at a predetermined dorsiflexion value. In some embodiments, the predetermined dorsiflexion value may be between 6° and 15°.
Further variations encompassed within the systems and methods are described in the detailed description of the invention below.
The accompanying drawings, which are incorporated herein and form part of the specification, illustrate various, non-limiting embodiments of the present invention. In the drawings, like reference numbers indicate identical or functionally similar elements.
While aspects of the subject matter of the present disclosure may be embodied in a variety of forms, the following description and accompanying drawings are merely intended to disclose some of these forms as specific examples of the subject matter. Accordingly, the subject matter of this disclosure is not intended to be limited to the forms or embodiments so described and illustrated.
Unless defined otherwise, all terms of art, notations and other technical terms or terminology used herein have the same meaning as is commonly understood by one of ordinary skill in the art to which this disclosure belongs. All patents, applications, published applications and other publications referred to herein are incorporated by reference in their entirety. If a definition set forth in this section is contrary to or otherwise inconsistent with a definition set forth in the patents, applications, published applications, and other publications that are herein incorporated by reference, the definition set forth in this section prevails over the definition that is incorporated herein by reference.
Unless otherwise indicated or the context suggests otherwise, as used herein, “a” or “an” means “at least one” or “one or more.”
This description may use relative spatial and/or orientation terms in describing the position and/or orientation of a component, apparatus, location, feature, or a portion thereof. Unless specifically stated, or otherwise dictated by the context of the description, such terms, including, without limitation, top, bottom, above, below, under, on top of, upper, lower, left of, right of, in front of, behind, next to, adjacent, between, horizontal, vertical, diagonal, longitudinal, transverse, radial, axial, etc., are used for convenience in referring to such component, apparatus, location, feature, or a portion thereof in the drawings and are not intended to be limiting.
Furthermore, unless otherwise stated, any specific dimensions mentioned in this description are merely representative of an exemplary implementation of a device embodying aspects of the disclosure and are not intended to be limiting.
As used herein, the terms “substantially” and “substantial” refer to a considerable degree or extent. When used in conjunction with, for example, an event, circumstance, characteristic, or property, the terms can refer to instances in which the event, circumstance, characteristic, or property occurs precisely as well as instances in which the event, circumstance, characteristic, or property occurs to a close approximation, such as accounting for typical tolerance levels or variability of the embodiments described herein.
As used herein, the terms “optional” and “optionally” mean that the subsequently described, component, structure, element, event, circumstance, characteristic, property, etc. may or may not be included or occur and that the description includes instances where the component, structure, element, event, circumstance, characteristic, property, etc. is included or occurs and instances in which it is not or does not.
In some embodiments, the foot plate 101 may receive an insert 102 which may be molded or padded to comfortably support a user's foot. In some embodiments, the coupling may be configured to engage, directly or indirectly, a portion of the user's leg. For example, as illustrated in the exemplary embodiment shown in
In some embodiments, the second leaf spring 110 may extend alongside at least a portion of the first leaf spring 108. For example, as illustrated in the exemplary embodiment shown in
For some users, it may be beneficial to provide a system that provides relatively less resistance to dorsiflexion up to a predetermined value of dorsiflexion, and greater resistance beyond that predetermined value. For example, during a normal gait, an ankle may flex in a late stance phase of a step up to a certain value, before the foot is lifted and the dorsiflexion is released. Flexion up to this value may be needed to permit an optimal gate, whereas flexion beyond this value may be undesirable and may potentially lead to injury or impede rehabilitation.
In some embodiments, the system 100 may have a first loading state in which the system has a first resistance to dorsiflexion, and a second loading state in which the system has a second resistance to dorsiflexion that is greater than the first resistance to dorsiflexion. As used herein, the term resistance to dorsiflexion does not refer to a resistive force itself, but instead refers to a tendency of the system to generate resistive force in response to an applied degree of dorsiflexion. In this sense, a resistance to dorsiflexion of the system is akin to a spring constant or elastic modulus of the system. In some embodiments, the system 100 may transition from the first loading state to the second loading state when a predetermined dorsiflexion value is exceeded. In some embodiments, the predetermined dorsiflexion value may be between 2° and 30°, 4° and 20°, 6° and 15°. In some embodiments, the predetermined dorsiflexion value may be approximately 12°.
In some embodiments, the transition from the first loading state to the second loading state may occur due to an interaction between the first leaf spring 108 and the second leaf spring 110. In embodiments in which a spacer is not disposed between the first leaf spring 108 and the second leaf spring 110, the system may deform with relatively less resistance until the space 114 between the first leaf spring 108 and the second leaf spring 112 is closed, and the two leaf springs contact one-another. Beyond this point, the system 100 may present substantially higher resistance to further dorsiflexion. For example, a slope of a stress-strain curve of the system may increase when the lateral distance between the first leaf spring 108 and the second leaf spring 110 reaches zero.
In embodiments in which one or more spacers 112 are disposed between the first leaf spring 108 and the second leaf spring 110, a dorsiflexion resistance profile of the system 100 may be governed in part by compression characteristics of the one or more spacers 112. In some embodiments, a spacer may have a first compressing state in which the spacer has a first resistance to compression, and a second compressing state in which the spacer has a second resistance to compression that is greater than the first resistance to compression. In some embodiments, one or more spacers may comprise a foam material. In some embodiments, the foam material may have a relatively lower resistance to compression in a first state, such as during compression or expulsion of air disposed within cells of the foam. In some embodiments, the foam material may have a relatively higher resistance to compression in a second state, such as during compression of the cell walls against one another, after air has largely been compressed or expelled from the foam. In other embodiments, one or more spacers may comprise elastomeric materials. One such embodiment is discussed with reference to
In some embodiments, the system 100 may transition from the first loading state (e.g., lower resistance to dorsiflexion) to the second loading state (e.g., higher resistance to dorsiflexion) when one or more spacers 112 disposed between the first leaf spring 108 and the second leaf spring 110 transition from the first compressing state to the second compressing state. For example, a spacer 112 may transition from the first compressing state to the second compressing state when the system 100 reaches a predetermined dorsiflexion value, which may be between 2° and 30°, 4° and 20°, 6° and 15°. In some embodiments, the predetermined dorsiflexion value may be approximately 12°.
In some embodiments, a plurality of spacers having different compression characteristics may be provided. In some embodiments, placing different spacers between the first leaf spring 108 and the second leaf spring 110 may provide the system 100 with different dorsiflexion resistance profiles. For example, a resistance to dorsiflexion may be higher or lower in one or both of the first loading state or the second loading state, depending on the selection of the spacer. Additionally or alternatively, the transition from the first loading state to the second loading state may occur at a higher or lower predetermined dorsiflexion value, depending on the selection of the spacer. For example, the predetermined dorsiflexion value at which the system 100 transitions from the first loading state to the second loading state may be approximately 12° when a first spacer is used, and approximately 8° when a second spacer having different compression characteristics is used.
In step 602, it may be determined, based on a first use scenario, that a first dorsiflexion resistance profile of the system is desired. A use scenario may include any number of relevant considerations. For example, a use scenario may be as simple as specifying that the system is to be used for one or more of walking, running, climbing stairs, and/or playing certain sports. In other cases, a use scenario might contemplate characteristics of a user, such as their height, weight, activity levels, clinical factors, or rehabilitation progress. Based on these and any other relevant factors, a desired dorsiflexion resistance profile may be determined. The determined dorsiflexion resistance profile may have any of the characteristics described above. For example, it may be appropriate to select a higher resistance profile for a larger user, or it may be appropriate to select a resistance profile with a relatively low resistance in a first loading state but a high resistance in a second loading state for a user who desires relatively high mobility during normal use but wishes to guard against overextension.
In step 604, it may be determined, based on the first dorsiflexion resistance profile, that a first spacer should be placed in the space defined between the first leaf spring and the second leaf spring. For example, upon identifying a desired dorsiflexion resistance profile, one may determine whether a system provides the desired dorsiflexion resistance profile without using a spacer, or whether a spacer is needed to obtain the desired dorsiflexion resistance profile. In optional step 606, a first spacer may be selected, based on the first dorsiflexion resistance profile, from a plurality of spacers having different compression characteristics. In step 608, the first spacer may be placed in the space defined between the first leaf spring and the second leaf spring to achieve the first dorsiflexion resistance profile.
In some embodiments, the method 600 may further include determining, based on a second use scenario, that a second dorsiflexion resistance profile is desired. For example, the first use scenario may contemplate a user walking, and the second use scenario may contemplate the same user running or climbing stairs. In other exemplary embodiments, the first use scenario may contemplate the user walking relatively early in their rehabilitation, and the second use scenario may contemplate the user walking later in their rehabilitation. In some embodiments, the method 600 may further include selecting, based on the second dorsiflexion resistance profile, a second spacer having different compression characteristics than the first spacer, and placing the second spacer in the space defined between the first leaf spring and the second leaf spring. In some embodiments, the first spacer may be removed before the second spacer is placed between the first leaf spring and the second leaf spring. Third, fourth, fifth, etc. spacers may likewise be used to achieve third, fourth, fifth, etc. resistance profiles appropriate for respective use scenarios, as desired.
In some embodiments, multiple spacers may be placed within the space between the first leaf spring and the second leaf spring simultaneously. In some embodiments, providing multiple spacers may allow greater flexibility in controlling a resistance profile of the system. For example, the system may have multiple loading state transitions as a compression limit of each spacer is reached.
In some embodiments, the system 100 may be in a first loading state while first spacer 202 is being deformed, and may transition to a second loading state when the lateral distance is reduced to engage the one or more secondary spacers 212. In some embodiments, the length of the one or more secondary spacers 212 may be varied to determine the point at which the system transitions from the first loading state to the second loading state. In some embodiments, smaller secondary spacers 212 may be positioned in series within the cavity 204 such that a combined length of the secondary spacers 212 may be varied by adding or subtracting one or more secondary spacers 212.
While the subject matter of this disclosure has been described and shown in considerable detail with reference to certain illustrative embodiments, including various combinations and sub-combinations of features, those skilled in the art will readily appreciate other embodiments and variations and modifications thereof as encompassed within the scope of the present disclosure. Moreover, the descriptions of such embodiments, combinations, and sub-combinations is not intended to convey that the claimed subject matter requires features or combinations of features other than those expressly recited in the claims. Accordingly, the scope of this disclosure is intended to include all modifications and variations encompassed within the spirit and scope of the following appended claims.
This application claims priority to U.S. Provisional Application No. 62/802,925, filed Feb. 8, 2019.
| Number | Date | Country | |
|---|---|---|---|
| 62802925 | Feb 2019 | US |