The present invention relates to a therapeutic walking trainer. Such walking trainers are designed to help patients who have had surgery on their hips or who have had a stroke to learn how to walk naturally again.
The natural gait cycle is formed of a standing leg phase and a swinging leg phase. A gait cycle begins and ends when the heel touches the ground. The standing leg phase comprises three sub-phases: a touching down or landing phase, a standing phase and a push-off phase. The swinging leg phase is divided into an early swinging leg phase, in which the foot leaves the floor and the lower leg swings rearwards and upwards up to an approximately 60 to 80 degree flexion in the knee joint. In the subsequent middle swinging leg phase, the leg is brought forward in a bent position with a knee flexion of 60 to 80 degrees. In the final phase of the swinging leg, the foot is again lowered toward the floor or in the direction of a walking surface with the heel being the first to set down again.
Stroke patients are usually able to initiate the swinging leg phase. Often, however, their own actions are not (yet) sufficient to carry out all sub-phases of the swinging leg phase.
It is therefore an object of the present invention to provide the user with a therapeutic walking trainer that supports the (re) learning of a natural gait cycle.
For this purpose, there is in particular a foot receiving portion for receiving at least a sub-region the forefoot of a user or for forming a connection with a toe of a shoe, with at least one main carrier that can be displaced in and/or counter to an adjustment direction, and with an actively and/or passively operated adjustment unit for the relative adjustment, oriented substantially perpendicular to the adjustment direction of said foot receiving portion relative to the at least one main carrier.
This has the advantage of supporting users who have difficulty moving the bent leg forward in the swinging leg phase. In this phase, the therapeutic walking trainer takes on a facilitating role by adjusting or moving in and/or counter to the direction of adjustment. To allow the foot of the user to roll naturally during the standing leg phase it has proven useful when a free space is formed in or on the main carrier and if the free space is configured such that a surface area or a walking surface can be tread on by at least a part of the user's foot. In a mobile version, this surface area or walking surface can, for example, be the floor or, in a stationary version, also the (endless) belt of a treadmill. Therefore, the therapeutic walking trainer is also stationary operable, wherein even then the main carrier does not need to move through the space, but instead a movement of the walking trainer is carried out relative to the treadmill surface.
According to an exemplary embodiment of a stationary version of the therapeutic walking trainer, the main carrier has a tread surface which is adapted so as to be tread on by the user's foot or the shoe. The dimension of this tread surface is selected such that a human foot can preferably stand on it flat without projecting beyond the surface area of the main carrier.
The main carrier can be assigned a drive for the motorized adjustment or moving of the main carrier in and/or counter to the adjustment direction. Thus, the forward movement of the user, in particular of the swinging leg, is supported by a motor. This motor can be an electric motor which is supplied by a battery or another energy source.
Alternatively, or additionally, a traction element or a pressure element is provided. Possible traction elements are a rope, a cord, a chain or the like. A possible pressure element is a, preferably rigid, push rod. The traction element or the pressure element can be operated by a therapist during exercise, wherein the traction element or the pressure element support the user's or patient's swinging leg phase. In order for the foot positioned in the walking trainer to follow through in the swinging leg phase, the therapist pulls or pushes the walking trainer forward, with the traction element in the adjustment direction, until the patient's heel again touches down on the walking surface.
The traction element or the pressure element is coupled or can be coupled to the main carrier, as a result of which the main carrier can be pushed, pulled or pressed in and/or counter to the adjustment direction. This ensures that the traction element can engage at or below the center of gravity of the therapeutic walking trainer in order to avoid tipping.
The traction element or the pressure element is coupled or can be coupled to the supporting carrier such that the main carrier can be pushed, pulled or pressed by actuating the supporting carrier in and/or counter to the adjustment direction by means of the traction element or by means of the pressure element.
Some stroke patients are unable to move their tibialis anterior muscle or dorsal extensor, which in some cases can lead to so-called foot drop. In order to help the patient lift their foot it has therefore proven to be advantageous if the adjustment unit comprises a supporting carrier connected at one end to the main carrier and at the other end, rotatably or non-rotatably, to the foot receiving portion. The foot receiving portion and/or the supporting carrier is thereby associated with an actuator by means of which the foot receiving portion and/or the supporting carrier are adjustable relative to the main carrier between a raised position and a lowered position. The adjustment can be made gradually or continuously. For a smooth raising and lowering of the forefoot, however, a continuous adjustment is preferred. When the foot receiving portion is non-rotatably connected to the supporting carrier, the foot receiving portion can receive the toe of the foot such that the foot can be inclined due to the elasticity of the toe of the foot. Although the preferably releasable connection of the toe of the shoe is configured with the foot receiving portion, the toe—as in a cross-country ski binding—can be elastically deformed. By this elastic toe of the foot, a tilting or a pivoting of the sole of the foot with respect to the supporting carrier can be achieved. In a non-rotatable coupling of the foot receiving portion with the supporting carrier, these two components can also be formed in one piece as foot supporting carriers.
The actuator can also be provided with an actuator drive for the motor-driven adjustment of the foot receiving portion and/or the supporting carrier. In this embodiment, an actuator drive formed by an electric motor is preferably realized, which can adjust the supporting carrier and/or the foot receiving portion between a raised position and a lowered position. In other words, the actuator acts as a foot lifter. In a healthy person, this task is carried out by the tibialis anterior muscle.
In this context, it has been found useful when the traction element or the pressure element is coupled to or can be coupled to the actuator, that the foot receiving portion and/or the supporting carrier are adjustable between the raised and lowered position by actuating the actuator by means of the traction element or by means of the pressure element, and that the main carrier can be pushed, pulled or pressed in and/or counter to the adjustment direction by actuating the actuator by means of the traction element or by means of the pressure element. The actuator can thus perform two different tasks simultaneously, namely on the one hand that of a foot lifter, in particular a forefoot lifter, and on the other hand that of the forward movement of the entire therapeutic walking trainer during the swinging leg phase.
A simple mechanical structure can be achieved in that the actuator is connected in an articulated manner to the main carrier and in that the actuator is assigned a control element which interacts with a control cam provided on the foot receiving portion and/or on the supporting carrier. In this case, the foot receiving portion and/or the supporting carrier are adjustable by adjusting the control element relative to the control cam between the raised and lowered positions.
The actuator can be designed as a rocker arm which is pivotably mounted on the main carrier, which by pivoting can adjust the foot receiving portion and/or the supporting carrier between the raised position and the lowered position. This has the advantage that a traction element or a pressure element can act on the rocker arm with a force by means of which the natural lifting movement of the foot can be simulated.
It has proven advantageous if one or more measuring sensors are assigned to the supporting carrier and/or the foot receiving portion. This measuring sensor is designed, for example, as an inclination sensor. If the inclination sensor is associated with the supporting carrier, the inclination of the supporting carrier with respect to the main carrier arranged on the walking surface can be detected and documented by a control computer. Additionally, or alternatively, the inclination sensor can be attached to the foot receiving portion so that its inclination with respect to the supporting carrier is measurable and documented by the control computer. In both cases, a display device can provide the user with feedback about the values detected by the measuring sensor (biofeedback).
Furthermore, it has proven advantageous if the measuring sensor is designed as a torsion sensor that detects the torsion of the supporting carrier and/or the foot receiving portion. This way, it can be determined whether the user is directionally stable, i.e., whether the latter is walking in a straight line.
Furthermore, a strain sensor (DMS) can be provided on the supporting carrier and/or the foot receiving portion. This allows for the strain of the individual components to be detected.
The main carrier can be mounted in a rail, for example in a sliding rail. The adjustment direction of the therapeutic walking trainer can be determined by the rail profile.
A preferred stationary embodiment of the therapeutic walking trainer is characterized in that the foot receiving portion is mounted slidably relative to the at least one main carrier in such a way that a lateral displacement of the foot or the toe of the user's shoe relative to the adjustment direction is made possible. During everyday walking, a normal healthy person uses a slight lateral variation in the placement of the foot so as to maintain postural control (balance) optimally upright. This embodiment is provided because thereby, the user's or patient's foot can be displaced laterally by a few centimeters during the swinging leg phase.
In order to limit the range of motion of the lateral displacement, a further development provides that a limiting unit is provided, which is adapted to enable limited lateral deflection of the user's foot or toe of the shoe. To this end, the limiting unit can include stop elements which limit lateral mobility of the foot to about 20 cm, preferably to about 10 cm, further preferably to about 5 cm.
In order to prevent falls, an alternative therapeutic walking trainer is characterized in that a holder is provided which comprises a harness system. In one embodiment, the harness system is designed so as to protect the user from falls. Alternatively, or additionally, the harness system is configured to relieve a portion of the person's body weight (partial weight relief), which means that the user's legs have to take on less weight. The holder is preferably formed of a vertical part, a horizontal part, and a bent section connecting the vertical part to the horizontal part. As a result, a falling user can be caught or intercepted from above.
Further scope of applicability of the present invention will become apparent from the detailed description given hereinafter. However, it should be understood that the detailed description and specific examples, while indicating preferred embodiments of the invention, are given by way of illustration only, since various changes and modifications within the spirit and scope of the invention will become apparent to those skilled in the art from this detailed description.
The present invention will become more fully understood from the detailed description given hereinbelow and the accompanying drawings which are given by way of illustration only, and thus, are not limitive of the present invention, and wherein:
In the figures, several therapeutic walking trainers are shown which comprise a foot receiving portion 1 for receiving a sub-region of the forefoot of a user or for forming a preferably releasable connection with the toe of a shoe. Furthermore, at least one main carrier 3 which can be displaced in and/or counter to an adjustment direction 4 is provided.
In addition, the therapeutic walking trainers include an actively and/or passively operable adjustment unit 30 for the relative adjustment, oriented substantially perpendicular to the adjustment direction 4, of said foot receiving portion 1 relative to the at least one main carrier 3.
In the walking trainers according to
In both cases, however, the supporting carrier 2 is pivotally connected at the other end to a main carrier 3, wherein the main carrier 3 is adjustable or displaceable in and/or counter to an adjustment direction 4.
If the foot receiving portion 1 is pivotally arranged relative to the supporting carrier 2, a first pivot joint 12 (supporting carrier-foot receiving portion joint) is provided between the supporting carrier 2 and the foot receiving portion 1, by means of which a rotation of the foot receiving portion 1 against the supporting carrier 2 is possible about an axis 13a arranged substantially perpendicular to the adjustment direction 4. In an inexpensive version of the walking trainer, a pin bearing is provided as a pivotal connection between the supporting carrier 2 and the foot receiving portion 1.
Furthermore, the pivotal connection between the supporting carrier 2 and the main carrier 3 is provided so that the supporting carrier 2 is pivotally mounted relative to the main carrier 3. In this case, a second pivot joint 14 (supporting carrier-main carrier pivot joint) is provided, which is also rotatable about an axis 13b oriented substantially perpendicular to the adjustment direction 4. Here, a pin bearing is also provided in an inexpensive embodiment.
As can be seen in particular from the plan view of the mobile version of a therapeutic walking trainer in
To drive the main carrier 3 forward, on the one hand a drive may be provided by means of which the main carrier 3 and thus the entire therapeutic walking trainer can be adjusted or displaced by a motor. Alternatively, however, a pressure element, for example a push rod on the base frame, can engage in particular on the rear cross beam 18 so as to push the therapeutic walking trainer in the adjustment direction 4 or pull it counter to the adjustment direction 4.
As is apparent from the figures, in the present case rollers 20 are attached to the main carrier 3, by means of which the therapeutic walking trainer is displaceable or adjustable in and/or counter to the adjustment direction 4. In the present case, the rollers 20 are formed by wheels 21 arranged on axes 22 which are connected to the main carrier 3. An alternative embodiment provides that individual wheels 22, preferably even all of the wheels 22, can be driven by the drive. In the present case, exactly four rollers 20 are provided, wherein another number is possible as well. Instead of wheels 22, other sliding elements can also be provided, by means of which the therapeutic walking trainer is adjustable in and/or counter to the adjustment direction 4.
The mode of operation of all of the present therapeutic walking trainers is intended to be explained in more detail by
First, the heel of the user reaches the floor or the walking surface 6 (
The standing leg phase is followed by the swinging leg phase, which begins with the lifting of the leg after the standing leg phase. The thigh is raised by the hip flexors of the user and the lower leg by the knee flexors of the user, wherein the foot 7 initially remains passive (
In the middle swinging leg phase, the leg is displaced forward by the increased hip flexion, while the knee is angled approximately 90 degrees (
3. In this configuration, the foot 7 can be guided with distance from the walking surface 6 to the front, that is to say in the direction of the adjustment direction 4. In other words, the therapeutic walking trainer supports the foot 7 of the user with a suitable “trajectory”. In this phase, flexion in the hip joint is also the greatest.
In the final swinging leg phase, the leg is again lowered in the direction of the walking surface 6, wherein the knee is actively stretched and the foot 7 is held in the neutral position (
The therapeutic walking trainer supports the foot 7 of the user in every single phase, so that an almost natural gait cycle can be achieved with the walking trainer.
In the present case, the actuator 9 is pivotally mounted on the main carrier 3, in particular on the longitudinal beams 17a, 17b. Furthermore, a control element 10 is formed on the actuator 9, which is movable along a surface or a control cam 11 on the supporting carrier 2. By means of the control element 10 sliding along the control cam 11, the supporting carrier 2 and thus the foot receiving portion 1 can be raised or lowered.
A traction element 8 can be provided to raise or lower the user's forefoot, as is shown for example in
Instead of sliding elements 27, wheels 22, in particular powered wheels 22, can also be used to adjust or displace the therapeutic walking trainer in the guide rail 28 in and/or counter to the adjustment direction 4. This can be seen in the walking trainer according to
All walking trainers preferably have the property that the actuators and/or supporting units that support the natural gait cycle only intervene in those cases where the user actually requires support. That is, only then when the user alone is not able to provide the required action.
The invention being thus described, it will be obvious that the same may be varied in many ways. Such variations are not to be regarded as a departure from the spirit and scope of the invention, and all such modifications as would be obvious to one skilled in the art are to be included within the scope of the following claims.
This nonprovisional application is a continuation of International Application No. PCT/EP2017/067691, which was filed on Jul. 13, 2017, and which is herein incorporated by reference.
Number | Date | Country | |
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Parent | PCT/EP2017/067691 | Jul 2017 | US |
Child | 16741420 | US |