WO2001072256A1 - Splint for passive arm mobilisation - Google Patents

Abstract

The invention concerns passive mobilisation of limbs. More particularly, it concerns a splint characterised in that: the brachial assembly consists of an arm (15) borne by the substantially horizontal rotating output shaft (18) of a gear motor unit (19) adapted in adjustable manner on the support, said arm comprising means for a brachial splint (31) to be fixed laterally adjustable and, in its distal part, an adapter (35) for the ante-brachial assembly (2); the ante-brachial assembly includes a proximal arm (40) provided with means (37) matching the adapter (35) and bearing at its tip a distal extension (42) whereon is mounted at least an ante-brachial splint (45). The invention is applicable to splints designed for ambulatory rehabilitation.

Description

 ARM PASSIVE MOBILIZATION SPACE

TECHNICAL AREA

The present invention relates to the field of functional rehabilitation of the limbs and it relates, more particularly, to the functional rehabilitation of the arm by mobilization of the shoulder and elbow joints.

For many years, it has been found to be advantageous to mobilize the limbs following reconstructive, orthopedic or trauma surgery operations on the joints, whether the lower or upper limbs.

PRIOR ART

The prior art has proposed a number of solutions for implementing such a technique which has proved to be particularly advantageous when the mobilization which occurs is of the passive type, that is to say that it is imposed on the joints of the limb concerned without the subject having to intervene by voluntary control of the muscles responsible for the mobilization of the joints. It has even been found that it was advantageous to implement such a technique by proceeding to the establishment of protocols defining the conditions of flexion-extension, of rotation, that is to say the angular ranges concerned as well as the functional frequencies to restore full mobility at the end of the shortest possible series of rehabilitation sessions. It is in this sense that so-called passive mobilization is opposed to another technique called active mobilization.

To carry out such a so-called passive mobilization, the proposals of the prior art generally involved a support structure based on at least two articulated segments which can be moved in amplitude of articulation independently and / or simultaneously by the intermediate of suitable motor organs. The constructive proposals which have been made can be considered satisfactory, although generally their unitary design, as well as their size, pose a certain number of practical problems.

Among these, it is worth mentioning a weak, if not zero adaptability as regards the putting into service of the same equipment capable of ensuring passive mobilization independently of a left arm or a right arm without the subject or the personnel serving is required to carry out long, complicated and sometimes delicate operations.

Mention should also be made of a certain not insignificant bulk which, moreover, offers little possibility of adaptation to the morphology of the member to be mobilized, be it the length of the articular segments or even the specific angulations which exist. possibly between the arm and the forearm and for which necessary adaptations must take place between the articulated segments constituting the splint. Another drawback that can be attributed to the splints recommended by the prior art is that of the difficulty of adjustment and adaptation so that the point of articulation of the splint itself relative to its support can be adjusted or adapted to coincide with the scapulo-humeral articulation of the limb to be mobilized. Finally, to finish, it is also necessary to highlight the overall size as well as the mass represented by such splints which are very frequently not very compatible with a mobilization practice carried out on an outpatient basis.

The object of the invention is to remedy the above drawbacks by proposing a new upper limb mobilization splint which is light, compact, easily adjustable and adaptable to the morphological characteristics of the arm to be mobilized and which can be transformed very quickly by the user himself to correspond to a mobilization splint either of a left arm or a right arm. STATEMENT OF THE INVENTION

To achieve the above objectives, the passive mobilization splint of the arm, which is of the type comprising, on the one hand, a support on which is orientable an adjustable brachial assembly, provided with means for immobilizing the arm and, on the other hand, an antebrachial, adjustable assembly, provided with means for immobilizing the forearm and extending with or without angulation relative to the brachial assembly is characterized in that - said brachial assembly is consisting of an arm carried by the substantially horizontal rotating output shaft of a gearmotor unit adjustable in an adjustable manner on the support, said arm comprising means for adjustable lateral fixing of a brachial groove and, at its distal part, an adapter of the antebrachial assembly - said antebrachial assembly comprises a proximal arm provided with means complementary to the adapter and carrying at the end a distal extension on which is mounted at least one ant groove e-brachial.

Various other characteristics will emerge from the description given below with reference to the appended drawings which show, by way of nonlimiting examples, embodiments of the subject of the invention.

BRIEF DESCRIPTION OF THE DRAWINGS

Fig. 1 is a perspective of a constructive form of the splint according to the invention. Fig. 2 is a partial perspective showing, on a different scale, a component of the splint.

Fig. 3 is a perspective showing an example of application of the splint in a constructive development.

Fig. 4 is a side elevation corresponding to the plane IV-IV of FIG. 3.

Fig. 5 is a perspective showing a development of the splint. Fig. 6 is a perspective similar to FIG. 1, but illustrating a development in relation to the variant according to FIG. 5.

Fig. 7 is a perspective illustrating another alternative embodiment.

BEST WAY TO IMPLEMENT THE INVENTION

According to the exemplary embodiment illustrated by FIGS. 1 and 2, the mobilization splint of the upper limb, designated as a whole by the reference I, is constituted by a brachial assembly 1 and by an antebrachial assembly 2. The splint I is intended to be adapted on a support 3 which essentially comprises a sheath 4, of generally vertical orientation, carrying a bracket 5 whose vertical branch 6 can be adapted and adjusted in angular position, that is to say in azimuth on the axis XX 'of the sheath 4 by means of an adjustment member 7, advantageously constituted by two notched half-nuts 8 and 9 belonging respectively to the sheath 4 and to the vertical branch 6. An immobilization in the desired angular position can take place in different ways, in particular by a blocking member, such as 10, which is for example constituted by a button and a needle screw or the like cooperating with a groove 11 in the vertical branch 6.

The bracket 5 comprises a substantially horizontal branch 12 reserved for mounting the splint I and more particularly of the brachial assembly 1. To this end, the brachial assembly 1 comprises an arm 15 which is preferably and advantageously constituted by two longitudinal members 16, of respective telescopic shape, capable of being adjusted in length by means of an adjustment member 17. The longitudinal members 16 are wedged angularly on the substantially horizontal rotating output shaft 18 of a geared motor group 19 , for example of the electrical and reversible type, which is advantageously disposed between the side members 16 and which is provided at its base with a flange or the like 20 adaptable to the branch 12 of the bracket 5. A locking member 21 cooperates with the flange 20 and the horizontal branch 12 so as to allow the motor 19 to be immobilized in a suitable position, so that the shaft 18 can be placed properly in relation to apl omb with the head of the scapulohumeral joint of the upper limb to be mobilized. Such an adjustment is also made possible by organizing the support 3 so that the axis XX 'of the sleeve 4 can be moved in the double direction of the arrow fi. To this end, it is advantageous to mount the support 3 in a chassis 24 (fig. 3) by constituting the support 3 for example by two sleeves 4 linked by two members such as 25 capable of sliding in one or more slides of the chassis 24 in which or in relation to which the members 25 can be immobilized in particular by a locking member 26.

The chassis 24, as shown in FIGS. 3 and 4, is advantageously carried by a frame 27 forming part of the carrying structure 28 of a seat, such as 29, capable of being occupied by a subject whose right arm or left arm must be subjected to passive mobilization by means of the splint according to the invention.

So as to offer the possibilities of suitable adjustment and adaptation, the chassis 24 is mounted adjustable in the double direction of the vertical arrow f ₂ on the frame 27 on which it can be immobilized by adjusting members 30. By means described above, it therefore becomes possible to place, relative to the seat 29, a sheath 4 situated to the right or to the left by adjusting the position of the corresponding vertical axis XX ′ with respect to the scapulo-femoral articulation concerned. by means of the chassis 24 and the adjusting member 26.

In the same vein, the height adjustment as a function of the morphology of the subject can intervene by means of adjustment members 30 making it possible to immobilize the chassis 24 on the frame 27 in the required position.

In addition, as has been mentioned, each sheath 4 comprises the adjustment means 7, so that it is possible to immobilize the splint in an orientation of the assemblies 1 and 2 parallel to the sagittal plane such as Pi, to the plane frontal such as P ₂ or at an intermediate orientation such as the plane P ₃ shown diagrammatically only by way of example as being situated at 45 ° with respect to the two previous planes.

The brachial segment 1 is provided with a brachial groove 31 which can be adapted by a "removable fixing device 32 on the arm 15, and""pl particularly, on one or the other of the longitudinal members 16. Thus, at from an adaptation illustrated in Fig. 1, in which the brachial groove 31 corresponds to a straight arm, it is possible to very quickly modify the lateral orientation of the groove 31 by means of the device 32 to ensure its fixation on the second spar 16 of so that the brachial assembly 1 then corresponds to an adaptation for a left arm when the splint must be adapted to the other sleeve 4.

The brachial assembly 1 is provided at its distal end with an adapter 35 which is reserved for mounting the antebrachial assembly 2. Such an adapter 35 is advantageously constituted by a slide provided with a blocking or adjusting member 36, such a slide being able to receive a plate 37 or the like forming part of the antebrachial assembly 2. The slide 35 is advantageously oriented to be parallel to the shaft 18 and to be of the double entry type.

In an embodiment illustrated in FIG. 1, the antebrachial assembly 2 comprises a proximal arm 40 which is linked to the plate 37 by means of a blocking and azimuth adjustment nut 41 making it possible to orient the proximal arm 40, either in one direction directly parallel to the brachial assembly 1, or in an oblique direction relative to the latter.

The proximal arm 40 is intended to receive a distal extension 42 adjustable telescopically in particular by a locking member 43. The distal extension is provided at its distal end with a locking and orientation nut 44 for an antebrachial groove 45 advantageously but not necessarily provided with a palm grip 46.

To constitute the splint I, it suffices to engage the plate 37 in the slide 35 when the assembly 1 has been mounted in the sheath 4 of the support 3. After adaptation of the member to be re-educated in the gutters 31 and 45, the adjustments adaptive are made and the nut 7 is adjusted so as to orient the splint according to the type of passive mobilization to be applied for example parallel to the plane Pi.

The power supply to the motor 19 rotates the output shaft 18 in either direction of the arrow f ₃ , so that the subject's arm is stressed in elevation from 20 to for example 180 ° depending on the program reversible motor supply 19.

When the splint is adapted on the support 4 so that its general direction corresponds to the plane P ₂ , then the supply of the motor 19 allows the arm to be subjected to a passive mobilization in abduction-adduction at amplitudes which are also adjustable according to the reversible motor supply 19. It goes without saying that if by means of the nut 7 the orientation of the splint is chosen for example parallel to the plane P ₃ , the supply of the motor 19 then makes it possible to subject the arm to a mobilization according to a movement including elevation and abduction-adduction. Figs. 5 and 6 show an alternative embodiment of the splint in which the brachial assembly 2 is composed of two half-arms 50 and 51 respectively called proximal and distal. The proximal half-arm 50 is advantageously constituted by two longitudinal members 52 which are linked by a crosspiece or spacer 53 at their proximal parts and which are wedged angularly on a rotating output shaft 54 at their distal parts. The rotating shaft 54 is part of an electric motor with two directions of rotation 55 which is advantageously disposed between the two side members 52 and which carries, opposite the spacer 53, an adapter 56 advantageously constituted by a slide of the same type that the slide 35 and which is oriented parallel to the spacer 53. The choice of constituting the proximal half-arm 50 by means of two longitudinal members 52 is adopted so as to make possible the mounting of the proximal half-arm 50 by l 'one of the side members 52 or the other in relation to the slide 35, so that the proximal half-arm is oriented either in the left direction relative to the assembly 1 as shown in FIG. 6 to correspond to a mobilization splint of the right arm, or in reverse orientation when it is a question of adapting said splint for the mobilization of a left arm.

The adapter 56 is designed to receive the distal half-arm 51 which consists of a plate 57 secured to a bar 58 preferably tubular provided with a locking member 59 capable of ensuring the adaptation and adjustment of the extension distal 42, as described with reference to FIG. 1.

The distal half-arm 51 is advantageously completed by an elbow gutter or elbow support 60 which can be fixed on the plate 57 or even on the bar 58.

As shown in fig. 6, when the proximal half-arm 50 is fitted on the slide 35 of the brachial assembly 1 arranged as illustrated in FIG. 1, the distal half-arm 51 can be mounted by the plate 57 in the adapter 56 so that the bar 58 extends parallel to the longitudinal members 52 in a 90 ° orientation relative to the brachial assembly 1. In this situation, the reversible power supply to the motor 55 makes it possible to move the latter in one or the other direction of the arrow f and consequently to move the distal half-arm 51 and the extension 42 in an internal rotation movement or external rotation of the forearm assuming that the motor 19 is not supplied simultaneously.

It is obvious that simultaneous feeding sequences can intervene to achieve mobilization of the arm by bringing into play, as the case may be, an elevation of the arm in the sagittal plane or a combination of abduction-adduction elevation, for example in the P ₃ plane with internal-external rotation of the forearm. Fig. 7 shows that in order to maintain such a combined movement, it is advantageous to use a power controller 61 connected by lines 62 and 63 to the motors 19 and 55. Such a controller can advantageously be adapted on the chassis 24 and comprises, either a rechargeable electrical energy source, or a connection socket to a distribution network. The controller is provided with a monitor 64 adjustable by buttons 65 and 66 for adapting the speed of the motors and their reversible operating ranges by ensuring a predominant dependence in which a functional synchronization is established so that a proportion preset is maintained in the alternative functional engine cycles. Such synchronization being for example fixed at an equality of 1 degree for 1 degree with the establishment of a relation of dependence of the supply of the motor 55 as a slave compared to the supply of the motor 19 as master.

As in the previous example, the splint according to this embodiment can be adjusted in correspondence with the moφhology of the articular segments of the arm and forearm by the slide 35, by the adapter 56 and by the telescopic adjustment. between bar 58 and extension 42. POSSIBILITY OF INDUSTRIAL APPLICATION

The invention finds an application particularly suitable for putting into practice the technique of mobilization of the upper limb carried out on an outpatient basis.

The invention is not limited to the examples described and shown since various modifications can be made thereto without departing from its scope.

Claims

1. Passive arm mobilization splint, of the type comprising: - On the one hand, a support (3) on which is pivotally mounted an adjustable brachial assembly (1), constituted by an arm (15) carried by the substantially horizontal rotating output shaft (18) of a power unit reduction gear (19) adapted in an adjustable manner on the support, said arm comprising means (31) for immobilizing the arm to be mobilized, and, on the other hand, an antebrachial assembly (2), adjustable, provided with means ( 45) immobilization of the forearm and extending with or without angulation relative to the brachial assembly, characterized in that said brachial assembly is provided with means for adjustable lateral fixation of a brachial groove (31) and comprises, at its distal part, an adapter (35) of the antebrachial assembly (2), - Said antebrachial assembly comprises a proximal arm (40, 50) provided with means (37, 52) complementary to the adapter (35) and carrying at the end a distal extension (42) on which is mounted at least one anterior groove - brachial (45). 2. Splint according to claim 1, characterized in that the geared motor group (19) is mounted adjustable on a bracket (5) substantially horizontal which is adapted, by azimuth adjustment means (7) on a sheath (4) making part of the support (3). 3. Splint according to claim 2, characterized in that the azimuth adjustment means (7) consist of two notched half-nuts (8 and 9) associated with a locking member (10). 4. Splint according to claim 1, characterized in that the adapter (35) is constituted by a double entry slide whose axis is substantially parallel to the output shaft (18) of the motor unit (19). 5. Splint according to claim 1, characterized in that the antebrachial assembly (2) comprises - a proximal arm (40) mounted adjustable in orientation on a plate (37) cooperating with the adapter (35) so that said arm is located substantially in the plane of the arm of the brachial assembly (1) - a distal extension (42) provided with an antebrachial groove. 6. Splint according to claim 5, characterized in that the antebrachial groove (45) is provided with a palmar grip (46). 7. Splint according to claim 1, characterized in that the antebrachial assembly (2) comprises - A proximal half-arm (50) able to cooperate with the adapter (35) of the brachial assembly (1) to extend in a general direction orthogonal to that of said assembly and angularly wedged by its distal part on the substantially horizontal output shaft (54) of a geared motor group (55), - a distal half-arm (51) adaptable on the coφs of said group to extend in the same direction as the proximal half-arm, - And a distal extension (42) provided with a gutter (45). 8. Splint according to claim 7, characterized in that the geared motor group (55) is provided with a slide (56), with double inlet, substantially parallel to the shaft (54) of said group to cooperate with a plate (57 ) carried by the distal half-arm. 9. Splint according to claim 7 or 8, characterized in that the distal half-arm carries an elbow pad (60). 10. Splint according to claim 1, 5 or 7, characterized in that the distal extension (42) is mounted telescopically adjustable relative to the arm (40, 58). 11. Splint according to claim 1, characterized in that the flush of the brachial assembly (1) is constituted by two telescopic beams (16), adjustable, on one of which the brachial groove (31) is mounted adjustable. 12. Splint according to claim 7, characterized in that the proximal half-arm (50) of the antebrachial assembly (2) is constituted by two longitudinal members (52). 13. Splint according to one of claims 1, 7, 11 or 12 is characterized in that the arms (15, 40, 50, 51) and the adapters (35, 56) constitute reversible mounting means for the constitution of '' a splint reserved for either the right arm or the left arm. 14. Splint according to claim 1, characterized in that the support (3) is adapted on a seat (29) and comprises two sleeves (4) for mounting the splint in relation either with the right side or with the side left of the seat. 15. Splint according to claim 14, characterized in that the support (3) is adapted to a seat by means of an adjustable frame (24). 16. Splint according to claim 15, characterized in that the support (3) consists of two sleeves (4) connected by at least one profiled member (25) mounted adjustable in a slide presented by the frame (24). 17. Splint according to claim 7, characterized in that the power supplies of the motors (19 and 55) are synchronized. 18. Splint according to claim 17, characterized in that the power supplies of the motors are established in dependency relation, the motor (19) being master and the motor (55) slave. 19. Splint according to claim 17 or 18, characterized in that the power supplies of the motors (19 and 55) are established to maintain a relationship of angular rotation of the output shafts from 1 degree to 1 degree.