GB2250211A - Apparatus for improving the mobility of neurologically impaired persons - Google Patents

Abstract

Apparatus for improving the functional posture and mobility of persons suffering from neurological impairment comprises a free-standing wheeled chassis 20 supporting a seat in the configuration of a saddle 24. The saddle shaped seat provides pelvic support for a neurologically impaired person and the chassis includes one or more surfaces 35 which provide upper-body support for that person. <IMAGE>

Description

Apparatus for Improving the Mobility of Neurologically Impaired Persons This invention relates to apparatus for improving the functional posture and mobility of people who are neurologically impaired More especially, but not exclusively, the invention relates to assessment frames to aid the treatment of physically handicapped and neurologically impaired people and to wheelchairs which provide inter alia enhanced mobility and support for such people.

It is well accepted that people with spinal curvature, rotation of the pelvis and windswept legs or limited hip flexion cannot be stably or comfortably seated on conventional chairs or wheelchair seats. These deformities are most common in people with neurological impairment due to cerebral palsy, head injury or multiple sclerosis whose spastic condition can be made worse by lack of support.

It is also accepted that good support below the pelvis and under the ribcage can release spastic limbs for voluntary activity.

The present invention sets out to provide apparatus by which such support is provided. More especially, this invention sets out to provide apparatus by which optimal functional postures of patients suffering from neurological impairment can be assessed and defined, and apparatus by which, following such assessments, increased mobility can be achieved.

According to the present invention in one aspect, there is provided apparatus for improving the functional posture and mobility of persons suffering from neurological impairment, the apparatus comprising a freestanding wheeled chassis supporting a seat in the configuration of a saddle which provides pelvic support for a neurologically impaired person and including one or more surfaces which provide upper-body support for that person.

By "saddle" is meant a seat which is generally triangular in plan view and whose seating surface tapers inwardly towards its front end.

In another aspect, the invention provides a wheelchair having a seat in the shape and configuration of a saddle.

In a further aspect, there is provided a wheelchair adapted selectively to receive a saddle in place of a conventional seat.

The saddle may be carried by a bracing arm capable of being attached at its ends to side members of the seat frame of the wheelchair. The saddle may be releasably mounted on the bracing arm or may be formed integral therewith.

The bracing arm may be configured such that when assembled onto a wheelchair, its centre lies below its points of attachment to the wheelchair side members.

Thus, the bracing arm may be constructed as a "V"; alternatively, a central portion of the bracing arm may curve or be similarly shaped to define a well into which a saddle locates when carried by the arm.

The length of the bracing arm may be varied to accommodate variations in the distance between appropriate side members of different wheelchairs.

In an alternative construction, the bracing arm is generally straight or includes a generally straight mid section. In this construction, the saddle may be slidably mounted on the bracing arm to vary its position between the wheelchair side members. In this construction and that previously described, the saddle mounting may be such as to enable adjustments to be made to saddle inclination, height and angular setting.

The bracing arm may be releasably mounted on the side members of the seat frame. Alternatively, the bracing arm may be releasably connected to one side member and may be pivotable about the other side member, thereby enabling the wheelchair to be folded in the conventional way for storage purposes.

In a still further aspect, the invention provides a kit of parts for selectively replacing a conventional seat of a wheelchair with a saddle, the kit comprising a bracing arm adapted to support a saddle seat, the bracing arm being of a length sufficient to span the distance between supportive side members of the wheelchair and including means by which its ends can be releasably or permanently secured to such side members.

The length of the bracing arm may be varied to enable it to be fitted to two or more wheelchairs having different seat frame widths.

In a yet further aspect, there is provided a wheelchair which includes a saddle supported on a bracing arm which in turn is supported by side members of the wheelchair frame, the bracing arm being so shaped and dimensioned that its point of attachment to the saddle lies below its points of attachment to the side members.

The bracing arm may be constructed from any suitable material and may be circular or square in cross-section.

The bracing arm may be straight, angled or curved, or a combination of these shapes.

In another aspect, the invention provides apparatus for assessing the level and positioning of support required to improve the posture and mobility of a patient suffering from neurological impairment, the apparatus including a free-standing wheeled chassis which includes a cross-frame comprising a pair of frame members each connected for selective pivotal movement about an upstanding column which supports a seat in the shape and configuration of a saddle, each frame member including at least two vertically spaced elongate cross-members to which carriers of support members for use in assessing the needs of a patient can be secured.

One or more of the carriers for the support members preferably comprises a generally straight elongate section for attachment to the cross members of a frame member and an end section turned through an angle (preferably approximately 900) for receiving one or more support members. The carriers and the frame members may be constructed from tubes of round, oval, square or other cross-section.

Preferably, the apparatus includes at least two support members for supporting the upper body (especially the chest) of the patient. These support members may be adapted to receive one or more harnesses to provide additional support fot the patient. Additionally, the apparatus preferably includes one or two additional supports for the feet of the patient; one or two hip supports; and/or one or two knee supports. The supports preferably take the form of pads mounted on relative short elongate members. The mounting of the pads onto their respective members may be through universal couplings providing a wide range of possible angular settings of the pad with respect to the member. Locking means are provided to lock the pad in position, Means are provided to secure the straight sections of the elongate carriers to two cross-members of the respective frame member. The carriers may be secured to the cross-members by one or more adjustable fittings movable along the length of and about the circumference of the respective cross-member. Locking means may be provided to lock the carriers in position.

The invention will now be described b way of example only with reference to the accompanying diagrammatic drawings in which: Figures 1 and 2 are perspective views of apparatus in accordance with the invention for inclusion in a wheelchair, Figure 1 being an exploded view; Figure 3 is a perspective view of alternative apparatus in accordance with the invention shown secured to the seat frame of a wheelchair; Figure 4 is a perspective view of an assessment frame in accordance with the invention; Figure 5 is a perspective view to and enlarged scale of a central folding mechanism of the frame illustrated in Figure 4; Figure 6 is a plan view from above of a locking mechanism of the frame illustrated in Figures 4 and 5; and Figure 7 is an exploded view of a ball and socket joint of the frame illustrated in Figure 4.

The apparatus illustrated in Figures 1 and 2 of the drawings is intended to be fitted to a conventional wheelchair including a seat frame having side members connected by a pair of pivotable bracing arms. The essential difference between a conventional wheelchair and a wheelchair in accordance with the invention is the seat provided for the user. In a conventional wheelchair a canvas or plastics seat is generally provided, this extending over and between the side members of the frame to define a generally rectangular or square shaped seating surface whose front edge lies generally normal to the supporting side members of the seat frame.

In the construction illustrated in Figure 1, the conventional canvas or plastics seat is replaced with a saddle 1. The saddle is carried by a bracing arm 2 which may be releasably or permanently secured to the side members of the seat frame by brackets 3. The brackets 3 are formed with holes 4 for receiving fittings which pass into complementary holes formed in the side members of the frame. The bracing arm 2 may be secured to the side members by any conventional means, these including screws, nuts and bolts, or suitably shaped clips. Alternatively, on occasions when the arm 2 is to be a permanent feature of the chair, the brackets 3 may be welded to the frame side members.The bracing arm 2 is angled so that its centre lies in a plane below that which contains its points of attachment to the seat frame side members.

Positioning of the saddle in this way lowers the centre of gravity of the chair when occupied so increasing chair stability. The bracing arm 2 includes a pair of downwardly inclined members 5 each of which is formed in two telescopically slidable sections 5a,5b to enable the distance between the brackets 3 to be varied. The arm 2 carries a post 6 on which a saddle fixing bracket 7 is mounted.

The bracing arm may be released from the seat frame of the chair to enable the chair to be collapsed in the conventional manner for ease of storage. Alternatively, or additionally, the bracing arm may be releasably attached to one side member of the seat frame and be pivotably secured to the other side member to enable the arm, with or without the saddle attached, to pivot upwardly about the respective frame member. The chair can then be folded in the conventional way for ease of storage.

As will be clear from Figures 1 and 2, the saddle seat is generally triangular in plan view and tapers inwardly towards its front end. The seat may be padded with one or more pieces or layers of resilient material for increased comfort.

Turning now to Figure 3, the saddle seat 1 illustrated is shown mounted on a seat frame of a conventional wheelchair. The seat frame forms part of a wheelchair chassis; for ease of reference, the wheels, braking mechanisms and other conventional features of a wheelchair have not been illustrated. As explained previously, such a frame includes a pair of side members 8 connected together for pivotal movement through bracing arms 9. A back support 10 is retained between uprights 11 and arm rests 12 are supported by vertical members of the frame which supports the side members 8. In the construction illustrated in Figure 3, a bracing arm 14 comprising a generally straight metal bar is employed and the saddle 1 is mounted for sliding movement along the bar to enable its position between the wheelchair sides to be adjusted.The bracing arm 14 is attached to the side members 8 in any of the several ways discussed above.

One advantage of a wheelchair in accordance with the invention is that the spacings between each side of the saddle and the seat frame provide for increased leg movement thereby enabling the user to use the chair both in its conventional mode and as a walking frame. A further advantage, again arising from the increased leg movement permitted, is that a neurologically impaired user can propel and steer the wheelchair by using one or both feet in contact with the ground. This is particularly advantageous when the chair is to be used by someone whose disability is such that they only have one hand free to propel and manoeuvre the wheelchair. In these circumstances the user can counteract the turning movement occasioned when propelling a wheelchair with only one hand through foot contact with the floor.

Turning now to Figures 4 to 7 of the drawings, the assessment frame illustrated comprises a free standing wheeled chassis 20 which includes a cross-frame comprising a pair of frame members 21 each connected for selective pivotal movement about an upstanding column 22 within which an elongate post 23 carrying a seat 94 can slide telesccpically. The seat 24, as for seat 1 described above in relation to Figures 1 to 3, is in the shape and configuration of a saddle. The upper section of the post 23 is turned through a right angle to define a generally horizontally extending seat support section to enable the saddle seat 24 to be selectively positioned a greater or lesser distance from the column 22.As illustrated, the saddle seat 24 projects forwardly into the space defined by neighbouring frame member halves to provide increased leg movement for a user of the frame. The column can, however, be locked in any desired position relative to the frame members 21 and it may be the case that, for certain patients, it would be preferable to locate the saddle seat 24 so that it is positioned over one of the frame members 21 rather than between such members.

Each frame member 21 comprises a pair of upstanding wheel-supporting posts 25 joined together by two generally horizontally extending cross-members 26. The posts 23,25 and cross-members 26 conveniently comprise metal tubes jointed together by conventional couplings and socket joints 27. The wheels or castors 28 are provided with brakes 29.

The frame members 21 are each connected to the column 22 by lockable couplings 30. As will be seen from Figures 5 and 6, the lockable coupling 30 includes a spring loaded plunger 31 operable selectively to lock the two frame members 21 in any given angular relationship or to release the members 21 to enable ths to be folded one against the other for ease of storage.

The post 23 can be locked in any required vertical location within the column 22 by grub screws 32.

The cross-members 26 act as vertically spaced supports to which the carriers of a variety of supports (including the saddle seat 24) can be clamped through one or more releasable clamps 39 mounted for sliding movement on the cross-members 26. The clamps 39 are rotatable about their respective cross-members to give a variety of clamping positions for locating the carriers of the supports. The clamps may be secured in place by any conventional means, these including grub screws or more sophisticated quick release mechanisms.

In Figure 4, a rib cage support 33 and two foot supports 34 are illustrated. The rib cage support 33 comprises a pair of inwardly facing chest and back pads 35 embraced by a harness 36 including quick release catches 37. The support 33 is carried by two tubular carrier members 3 each secured by clamps 39 to neighbouring half cross-members 21. A cross piece 40 is provided, this comprising a pair of arms joined by a twin joint 42 including grub screws 43. The foot supports 34 include foot pads 44 supported on tubular carrier members 5 secured to the cross-members 26 of neighbouring half cross-members 21 by clamps 39.

The height. position and angular setting of the supports can readily be selected and varied to meet the requirements of individual patients.

Other supports similar to those illustrated may be provided, these including knee, hip, neck and head supports. In each case, it is anticipated that the method and means of attaching such supports to the chassis 20 will be the same or similar to that or those illustrated.

Figure 7 illustrates in greater detail a typical ball and socket joint for connecting supports such as the chest and foot supports illustrated to the respective carrier members. As shown, the joint includes a ball 46 carried by a mild steel right-angled neck piece 47 which supports a fixing plate 48 including an upstanding screw fitting 49 for receiving a threaded boss of the post of the support in question. The ball 46 is entrapped within a nut 5 which can be screwed onte a threaded nipple 51 of the adjoining frame member. A spring 52 is positioned between the ball and the nipple body te lock one component of the nipple body to the other. A grub screw 53 is positioned to lock the ball joint tube to the supporting carrier member.

As mentioned previously, the present invention sets out to provide apparatus b which optimal functional postures of patients suffering from neurological impairment can be assessed and defined, and apparatus by which, following such an assessment, increased mobility for the patient can be achieved. People with spinal curvature, rotation of the pelvis and windswept legs or limited hip flexion cannot be seated stably or in comfort on an ordinary chair or wheelchair seat. These deformities are most common in people with neurological impairment due to cerebral palsy, head injury or multiple sclerosis whose spastic condition can be made worse by lack of support.

The saddle seat of the present invention supports the pelvis directly, regardlesss of leg position, and removes the twisting effect of windswept legs on the pelvis, or the pelvic tilt caused by bringing thighs horizontal when the hips are stiffly extended.

When fitted into a wheelchair, the saddle seat also, as explained previously, allows free movement of legs and so may be used to help stroke sufferers to retain reflex walking patterns whilst relearning balance. In many cases, walking may be practised in safety whilst sitting.

For those stroke patients who are unable to recover walking ability, wheelchair mobility and manoeuvring can be more effective because the unaffected leg can assist one-handed propulsion, manoeuvring and braking.

When used in an assessment frame, the saddle seat is used to demonstrate the effect of correct pelvic support on sitting balance and with ribcage side supports may also show improvement in head control The additions supports for feet, knees, hips and other parts of the body effectively personalise the saddle and allow a handicapped user to adjust to the upright position and develop a new functional shape before permanent seating is designed and made.

It will be understood that the foregoing is merely exemplary of wheelchairs in accordance with the invention and that modifications can readily be made thereto without departing from the true scope of the invention.

Claims (26)

CLAIMS:

1. Apparatus for improving the functional posture and mobility of persons suffering from neurological impairment, the apparatus comprising a free-standing wheeled chassis supporting a seat in the configuration of a saddle which provides pelvic support for a neurologically impaired person and including one or more surfaces which provide upper-body support for that person.

2. Apparatus as claimed in Claim 1 wherein the wheeled chassis comprises a wheelchair having a seat in the shape and configuration of a saddle.

3. Apparatus as claimed in claim 2 wherein the wheelchair is adapted selectively to receive a saddle in place of a conventional seat.

4. Apparatus as claimed in claim 2 wherein the saddle seat is carried by a bracing arm capable of being attached at its ends to side members of the seat frame of the wheelchair.

5. Apparatus as claimed in claim 4 wherein the saddle seat is mounted on the bracing ana.

6. Apparatus as claimed in claim 4 or claim 5 wherein the bracing arm is configured such that when assembled onto a wheelchair, its centre lies below its points of attachment to the wheelchair side members.

7. Apparatus as claimed in claim 6 wherein the bracing arm is constructed as a "V".

8. Apparatus as claimed in claim 6 wherein a central portion of the bracing arm is shaped to define a well into which the saddle seat locates when carried by the arm.

9. Apparatus as claim in any one of claims 4 to 8 wherein the length of the bracing arm is variable to accomodate variations in the distance between appropriate side members of different wheelchairs.

10. Apparatus as claimed in claim 4 wherein the bracing arm is generally straight or includes a generally straight mid section.

11. Apparatus as claimed in claim 10 wherein the saddle seat is slidably mounted on the bracing arm to accomodate variations in its positions between the wheelchair side members.

12. Apparatus as claimed in any one of claims 4 to 11 wherein the saddle seat mounting is such as to enable adjustments to be made to the saddle seat inclination, height and angular setting.

13. Apparatus as claimed in any one of claims 4 to 12 wherein the bracing arm is releasably mounted on the side members of the seat frame.

14. Apparatus as claimed in any one of claims 4 to 12 wherein the bracing arm is releasably connected to one side member and is mounted for pivotable movement about the other side member.

15. A kit of parts for selectively replacing a conventional seat of a wheelchair with a saddle, the kit comprising a bracing arm adapted to support a saddle seat, the bracing arm being of a length sufficient to span the distance between supportive side members of the wheelchair and including means by which its end can be releasably or permanently secured to such side members.

16. A wheelchair which includes a saddle supported on a bracing arm which in turn is supported by side members of the wheelchair frame, the bracing arm being so shaped and dimensioned that its point of attachment to the saddle lies below its points of attachment to the side members.

17. Apparatus for assessing the level and positioning of support required to improve the posture and mobility of a person suffering from neurological impairment, the apparatus including a free-standing wheeled chassis which includes a cross-frame comprising a pair of frame members each connected for selective pivotal movement about an upstanding column which supports a seat in the shape and configuration of a saddle, each frame member including at least two vertically spaced elongate cross-members to which carriers of support members for use in assessing the needs of a person can be secured.

18. Apparatus as claimed in claimed 17 wherein one or more of the carriers for the support members comprises a generally straight elongate section for attachment to the cross members of a frame member and an end section turned through an angle for receiving one or more support members.

19. Apparatus as claimed in claim 17 or claim 18 wherein the carriers and the frame members are constructed from tubes of round, oval, square or other cross-section.

20. Apparatus as claimed in any one of claims 17 to 19 wherein the apparatus includes at least two support members for supporting the upper body of the person.

21. Apparatus as claimed in claim 20 wherein the support members are adapted to receive one or more harnesses to provide additional support for the person.

22. Apparatus as claimed in claim 20 or claim 21 wherein the apparatus includes at least one additional support for the feet of the person; at least one hip support; and/or at least one knee support.

23. Apparatus as claimed in claim 22 wherein the supports take the form of pads mounted on relative short elongate members.

24. Apparatus as claimed in claim 23 wherein the mounting of the pads onto their respective member is through universal couplings.

25. Apparatus as claimed in claim 24 wherein locking means are provided to lock each pad in position.

26. Apparatus for improving the functional posture and mobility of persons suffering from neurological impairment substantially as herein described and as described with reference to Figures 1 and 2, or Figure 3 or Figures 4 to 7 of the accompanying drawings.