This application is the U.S. National Phase of, and Applicant claims priority from, International Application No. PCT/EP2014/065407, filed 17 Jul. 2014, and European Patent Application No. DE 10 2013 108 701.9, filed 12 Aug. 2013, both of which are incorporated herein by reference in their entirety.
The invention relates to a therapy device, in particular for the postoperative treatment of body parts and (end) portions thereof, in particular the large toe, according to the preamble of claim 1, to an extremity support according to claim 12, and to a kit according to claim 16.
Therapy devices of the type in question here are known from U.S. Pat. No. 5,297,540, for example. They comprise a rigid foot support and a pivot mechanism with a rotation axis and a toe support. By means of the pivot mechanism, the large toe (also called the hallux) can be supported in a pivotable manner, wherein the toe support usually has fixing means for fixing the large toe. The pivot mechanism thus serves to move the large toe, in particular for the postoperative treatment of abnormal positioning of the large toe, for example hallux valgus, a pathological state of tilting of the large toe, and of arthroses. Corresponding therapy devices can also be used for other joints, e.g. for wrists, fingers or knee joints. To achieve a good therapeutic outcome, the pivoting movement of the body part to be treated, which movement brings about dorsiflexion (the bending of a moving segment in the dorsal direction) and plantar flexion (the movement of the foot or of the toe in the direction of the sole), has to be adapted to the anatomical circumstances of the specific body part. Moreover, it has been shown that conventional therapy devices are often unwieldy and, in particular, are unsuitable for mobile use.
The object of the present invention is therefore to make available an improved therapy device which serves for the postoperative treatment of joints and which is adaptable in a particularly flexible way to the anatomical circumstances of the joint to be treated and, in addition, has a compact and space-saving design and is thus suitable in particular for transport.
In order to achieve the abovementioned object, a therapy device having the features of claim 1 is proposed. The therapy device serves for the postoperative treatment of joints, in particular the joint of the large toe, and has a main body and a moving segment with a support surface for supporting the joint to be treated. The moving segment is mounted on the main body in such a way as to be pivotable about a rotation axis. Moreover, according to the invention, the main body is designed to optionally bear an extremity support on the left-hand side and right-hand side.
An essential aspect of the invention is therefore that the therapy device has a modular configuration with a main body. An extremity support can be mounted on, and in particular attached to, the main body, both on the left-hand side and also on the right-hand side with respect to its longitudinal axis, which extremity support serves, for example, to support a left or right foot during treatment of incorrect functioning or abnormal positioning of joints, such as hallux valgus, or of arthroses, using the therapy device. In this way, the therapy device has a particularly compact design for transport, since the extremity support can be formed separately from the main body and can be removable from the latter. The main body can thus be transported and stored separately from the (bulky) extremity support. Alternatively, it is conceivable for the extremity support to be stowed in a kind of cassette, which can be integrated in the main body. The connection of the extremity support to the main body can be effected, when necessary, simply by means of a snap-fitted, clipped, locked or clamped connection, for example. Alternatively, the extremity support can be secured pivotably on the main body such that, by simply swiveling the extremity support around a longitudinal axis of the main body, it can be mounted on the left-hand side and on the right-hand side. A particular advantage of the invention is therefore that the extremity support can be connected to the main body both from the left-hand side and also from the right-hand side, such that the therapy device can be used particularly flexibly for body parts on the right half of the body and also on the left half of the body. Therefore, besides being particularly compact and cost-effective in design, the therapy device according to the present invention can also be used in a versatile and particularly simple manner. In order to ensure optimal handling of the therapy device, the main body is preferably substantially symmetrical with respect to a longitudinal axis, such that the extremity support can easily be arranged optionally on the left-hand side or right-hand side of the main body.
A therapy device is particularly advantageous in which the rotation axis of the moving segment substantially coincides with the anatomical rotation axis of the body part to be treated. In this way, the pivoting movement of the moving segment is adapted particularly effectively to the anatomical circumstances of the large toe.
A therapy device is also particularly preferable in which the support surface is connected to the moving segment in a releasable and/or displaceable manner. This design permits the exchange of the support surface, such that the main body can cooperate with different support surfaces, for example for different patients or different body parts. This also permits easy cleaning of the support surface. A connection between the support surface and the moving segment can be provided, for example, by means of snap-fitting, locking, clamping or clipping elements, which allow the support surface to be easily released from the moving segment without aids. However, it is also conceivable in principle for the support surface to be formed in one piece with the moving segment, such that the support surface thus forms an integral component of the moving segment. Moreover, the support surface preferably has a fixing mechanism by which the body part to be treated (joint) can be fixed on the support surface, such that the body part follows the movement profile of the moving segment. For example, the fixing mechanism can be in the form of one or more straps extending over the body part, which is located on the support surface, and bearing on said body part.
To ensure that the body part to be treated is mounted movably on the support surface, the support surface is preferably mounted so as to be displaceable relative to the moving segment. For this purpose, the support surface can have a plurality of embedded movable ball elements, for example. Alternatively, a variant is preferred in which a double carriage is provided as support surface for the respective body part to be treated. Moreover, at least one roller element can serve as support surface for the joint to be treated, the rotation axis of the roller element extending transversely with respect to the longitudinal direction of the main body. In this way, the body part to be treated can be moved in all directions on the support surface during a movement of the moving segment. By virtue of the body part to be treated being mounted movably, it is additionally possible to compensate for deviations of the centers of rotation of the moving segment and of the body part. Thus, if the rotation axis of the moving segment deviates from the anatomical rotation axis of the body part, the fixing position of the body part can be moved in such a way that an offset of the rotation axes is compensated. It is thus possible for the pivotable mounting of the body part to be adapted effectively to the anatomical circumstances, ensuring an improved outcome of the therapy provided by the therapy device according to the invention.
To ensure that the therapy device stands in a stable manner, the main body preferably has at least one releasable and/or displaceable stand, and in particular at least one recess for receiving the stand. Several stands are preferably provided, which can serve to support the main body and which in addition can advantageously support an extremity support secured on the main body. By virtue of the movable or releasable configuration of the stand or stands, they can be folded out or mounted in the state of use, whereas, in the state in which the therapy device is not in use, they can be arranged in a space-saving transport state. The stands can additionally be pivoted out. Moreover, the stands can also be adjustable such that an angle between the extremity support and a ground surface on which the main body is arranged can be modified. The adjustment can be effected by means of a rotary screw, for example. The angle can in this way be adapted to different positions of the user during therapy, for example to different seated positions, and can, for example, be about 10°-20°, in particular 15°.
A therapy device is also particularly preferred in which the support surface is delimited by at least one lateral web to prevent bruising of the body part to be treated. The web can be provided either directly on the support surface or on an extremity support connectable to the main body.
A therapy device is moreover preferred in which the main body comprises an integrated drive mechanism for manual (e.g. using a lever) or electrical displacement of the moving segment. For example, the drive mechanism can be a threaded spindle drive or an arc segment drive. Preferably, provision can also be made that the drive mechanism cooperates with an overload safety system. For this purpose, a corresponding control system preferably interacts with the drive mechanism in such a way that it detects when the drive mechanism is switched off in the event of an excess load on the moving segment. An overload state of this kind can be detected, for example, by an increase in the torque of the drive mechanism or a reduction in the speed of the moving segment. Alternatively, in order to provide an overload safety system, the pressure of the body part to be treated, in particular of the large toe, on the support surface can be measured. For this purpose, a pressure sensor is preferably provided which can be integrated in the support surface. If the toe pressure becomes too great, the pressure sensor can generate a corresponding signal, which causes a control system to stop the pivoting movement of the moving segment.
In order to achieve the abovementioned object an extremity support having the features of claim 12 is also proposed. The extremity support comprises connection means for releasably connecting the extremity support to the main body of a therapy device according to the invention. The extremity support is preferably adjustable in size and can thus be adapted individually to different patients. A heel part adjustable in the vertical and/or longitudinal direction is particularly advantageous. Alternatively, break segments, for example, can also be provided which allow the extremity support to be individually adapted in size to a patient. The extremity support preferably has fixing means, in particular in the form of tapes or straps, for fixing the extremities to the extremity support. Finally, the extremity support can be designed as an injection molded part, as a result of which production can be particularly simple and cost-effective.
Finally, in order to achieve the abovementioned object, a kit having the features of claim 16 is also proposed, which kit comprises a therapy device according to the invention and, connectable to said device, an extremity support according to the invention, wherein the extremity support is connectable to a main body of a therapy device according to the invention.
The invention is explained in more detail below with reference to the drawing, in which:
The moving segment 5 is connected to a substantially flat support surface 7 which can either be integrally connected to the moving segment 5 or is secured releasably thereon. The support surface 7 can be connected to the moving segment 5 by a clamped connection or snap-fit connection, for example.
A plate-shaped extremity support 9 is secured releasably on the main body 3 and, in the illustrative embodiment shown in
The therapy device 1 additionally comprises two stands 11 which can be mounted on, and in particular plugged onto, the underside of the main body 3, i.e. the face of the main body 3 directed toward the ground. It is also conceivable in principle to provide only one stand 11 or more than two stands made of metal or plastic, which stands can not only be plugged onto the main body 3 but can also alternatively be mounted rotatably or pivotably thereon. The important point is that the stands 11 provide the relatively narrow main body 3 with the required stability, particularly at the side on which the extremity support 9 is respectively arranged.
It is also clear from
The support surface 7 according to the illustrative embodiment shown in
It is also clear from
In the illustrative embodiment of the invention as shown in
The extremity support 9 is preferably identical on its top and on its underside and can therefore be used either way round. Specifically, it can be arranged on the right-hand side with respect to a longitudinal axis L of the main body 3 (as shown in
As
The main body 3, like the extremity support 9, is preferably an injection molded part that can be produced particularly simply and cost-effectively. However, the main body 3, the extremity support 9 and other parts of the therapy device can also be produced by 3D printing. Other suitable production methods may also be considered. For example, these parts can be milled from a block. The main body 3 is formed along the longitudinal direction L from two halves, which are joined together once the moving segment 5 and the corresponding drive means have been inserted into the main body 3. It is also clear from
In the embodiment according to
In the illustrative embodiment according to
The electric motor 39 is connected to the universal joint 37 via a coupling 45 and a connection shaft 46. The coupling can be made of plastic and, in order to detect the position of the support surface 7, can have a slotted disk, which cooperates with a fork-shaped photoelectric barrier. Moreover, a limit switch can be provided which triggers at a position of maximum dorsiflexion or plantar flexion of the large toe.
Moreover, a control system 43 is provided which, for example, can be configured as an electronics module on a printed circuit board and which controls the function of the electric motor 39. For the pivotable movement of the moving segment 5, the worm gear 35 engages in toothing elements which are arranged on the outside of the arc-shaped moving segment 5, i.e. on the side facing toward the worm gear 35, and which are in particular injection molded there. The maximum excursion of the moving segment 5 in the direction of flexion and in the direction of extension is set by suitable abutment elements and/or limit switches. This purpose can be served by the fork-shaped photoelectric barrier described above and by the limit switch.
Using position determination of the moving segment 5, the control system knows at all times in which position the moving segment 5 is located. If the therapy device 1 is not switched off in the starting position in which the support surface 7 lies substantially in a plane with the extremity support 9, the therapy device must know the position in which it is located when switched back on. Ideally, the device then goes back automatically to the starting position and begins with a startup program. The checking of the position can be effected by various technical elements.
A mechanical overload safety system, for example in the form of a coupling, such as a slip coupling, friction coupling or magnetic coupling, can be provided between the connection shaft 46 and the electric motor 39. However, instead of a mechanical overload safety system, an electrical overload safety system can also be provided, for example by detecting the torque, i.e. the current consumption of the motor. In this case, the resistance of the large toe causes the motor itself to stop. Alternatively, or also in addition, a pressure sensor can be provided on the extremity support and, if necessary, permits the triggering of an emergency stop.
The control system 43 is also preferably provided with corresponding actuation mechanisms or adjustment mechanisms (not shown in the figure) for a person using the therapy device 1. For example, these can include suitable rocker switches and/or rotary buttons and/or push buttons or other actuation and adjustment devices, which are mounted on the main body 3. Alternatively, or also in addition, provision can be made that the drive mechanism 33 can be controlled remotely. It is also conceivable to implement remote control in a cell phone, for example with the aid of a suitable “app”.
As in the illustrative embodiment of the invention shown in
Moreover, it is clear from
The electric motor 61 is connected to the universal joint 63 via a coupling 65 and via a mounted shaft 67. Moreover, a control system 69 is provided which controls the movement profile, in particular with respect to the speed and the pivoting angle of the moving segment 5. In this embodiment too, a mechanical or electrical overload safety system can moreover be provided which, if necessary, switches off the electric motor or is decoupled from the threaded screw 55. The overload safety system can be provided, for example, by means of a pressure sensor which is integrated in the support surface and detects toe pressure and sends resulting measurement signals to the control system. If the pressure exceeds a defined threshold value, a corresponding control signal can be generated, which switches off the electric motor.
Further types of drive that can be used to actuate the moving segment 5 on a pivot trajectory are, for example, an actuation by a linear actuator and by a torsion spring drive. The linear actuator can be mounted on a rocker rotatably in the main body 3 and in this way can effect a pivoting movement of a moving segment and therefore of a support surface. In the case of the torsion spring drive, a torsion spring can effect a pivoting movement of a moving segment 5 with the aid of a geared motor, an eccentric and toothed-wheel couplings.
In this illustrative embodiment too, the main body 3 has a symmetrical configuration, in such a way that the extremity support 9 can be arranged on both sides of the main body 3 with respect to its longitudinal direction L. For this purpose, the extremity support surface 9 is designed in the form of a removable disk which has mirror symmetry with respect to its mid-plane and therefore simply has to be turned through 180° about the longitudinal axis L for use with a body part on the left half of the body.
The extremity support surface 9 has a plurality of slits 75 which lie opposite and adjacent to each other and into which securing means 77 can be introduced in order to secure an extremity, in the present example to secure a foot in the area of the instep and/or of the heel. The slits serve for adaptation to different ergonomic circumstances, such that the therapy device 1 can be used for feet of different sizes.
The same applies also to
Moreover, the extremity support 7 comprises a lever 83 which is spring-mounted and can actuate a bolt 85. To secure the extremity support 9, the main body 3 has recesses 87 into which corresponding projections 89 of the extremity support 9 can engage. At the opposite ends, the main body 3 has a projection 91 which can engage with a form fit in an indent 93 of the extremity support 9. By means of this design, the extremity support 9 can simply be clipped into the indent 29 of the main body 3, with the projections 89 first engaging in the recesses 87 of the main body 3 and the projection 91 then being connected with a form fit to the recess 93, the lever 83 being actuated and the bolt 85 being set back into the extremity support 9. Moreover, an opening (not visible in
As also in the illustrative embodiment according to
The embodiment according to
Consideration is also given to a variant according to
Overall, the present invention makes available an advantageous therapy device which is particularly compact, in particular for transport, and which can be produced easily and cost-effectively and, in addition, can be used flexibly for body parts on the left half and also on the right half of the body. This is achieved in a particularly advantageous manner by an extremity support designed separately from the main body 3, while the main body 3 comprises the actual therapy device in the form of the moving segment 5, the support 7 and the drive mechanism 33.
The stand 11 can be formed separately from the main body 3 and can be secured thereon, in particular reversibly. Moreover, it can be mounted rotatably or pivotably on the main body 3. In the latter embodiment, two or more stands, in particular four stands, can be provided on the main body and can each be moved manually from a transport state to a state of use. If four stands are provided, two stands can be arranged on each of the two sides of the main body 3. If only two stands are provided, they can preferably be pivoted to the left or to the right side of the main body 3. It is possible that the stands are not simply suitable for supporting and stabilizing the main body, but that they also assume a supporting function for the extremity support.
In the context of the above-described embodiments of the invention, an electrical drive mechanism for generating a pivoting movement of the moving segment 5 was explained. However, it is also conceivable in principle to use a hydraulic or pneumatic drive mechanism. The position of the moving segment 5 can moreover be determined not only using the described fork-shaped light barrier, but also, for example, using a Hall IC (encoder), a limit switch or a potentiometer with pinion. For position determination, the therapy device preferably comprises a printed circuit board separate from the control.
As regards a releasable connection between the extremity support 5 and the main body 3, several coupling mechanisms have been explained here which basically involve a clipping, locking or clamping connection. However, it is also conceivable in principle to use other connections which allow the extremity support to be used on both sides in the manner of a reversible plate. For example, a pivotable mounting of the extremity support about a longitudinal axis L of the main body 3 is conceivable which, if necessary, can be moved (pivoted) to the left or right with respect to the longitudinal axis L of the main body 3. For transport, it is also possible, for example, to provide a cassette which is preferably integrated in the main body 3 and in which the extremity support can be stowed. It is also conceivable to use two extremity supports which are arranged on both sides with respect to the longitudinal axis L of the main body 3 and which are each stowed in a cassette, wherein the left or right extremity support surface can be folded out according to requirements.
The movement of the moving segment can be controlled using control technology and in particular by position detection. However, mechanical control of the rotation movement, for example by means of a torsion spring, is also possible. It is also conceivable for movement to be limited by abutment elements. Moreover, the control can preferably implement various programs which, for example, provide different movement patterns and/or speeds, etc.
The geometry of the main body 3 overall is preferably such that the longitudinal axis L, or its axis of symmetry, coincides with the longitudinal axis of the body part that is to be moved. For this purpose, provision is preferably made that the axis of symmetry coincides with the axis of symmetry of the fixing mechanism for fixing the body part.
Moreover, as regards the body part being mounted movably on the support surface 7, a ball bed has been described which permits multidimensional mobility of the body part in any direction on the ball bed. However, an embodiment is preferred in which a support surface is provided in the form of a dual-motion carriage which ensures the necessary mobility of the body part on the moving segment 5. The support surface can then be moved, for example in the longitudinal direction L on the one hand and transverse to the longitudinal direction L on the other hand, by means of suitable carriages.
Moreover, one-dimensional mobility of the body part on the support surface 7 can also be provided not by ball elements but instead, for example, by means of a roller element 115 according to
Alternatively, one-dimensional mobility of the body part can also be provided by a lever system 117, 117′ or 117″ according to
Number | Date | Country | Kind |
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10 2013 108 701 | Aug 2013 | DE | national |
Filing Document | Filing Date | Country | Kind |
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PCT/EP2014/065407 | 7/17/2014 | WO | 00 |
Publishing Document | Publishing Date | Country | Kind |
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WO2015/022142 | 2/19/2015 | WO | A |
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