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EP0316209A1 - Therapeutic exercise apparatus - Google Patents

Therapeutic exercise apparatus Download PDF

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Publication number
EP0316209A1
EP0316209A1 EP88402707A EP88402707A EP0316209A1 EP 0316209 A1 EP0316209 A1 EP 0316209A1 EP 88402707 A EP88402707 A EP 88402707A EP 88402707 A EP88402707 A EP 88402707A EP 0316209 A1 EP0316209 A1 EP 0316209A1
Authority
EP
European Patent Office
Prior art keywords
carriage
base
axis
gutter
rotation
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP88402707A
Other languages
German (de)
French (fr)
Inventor
Patrick Akcelrod
Bernard Papailhau
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Tasserit Ets
Original Assignee
Tasserit Ets
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Tasserit Ets filed Critical Tasserit Ets
Publication of EP0316209A1 publication Critical patent/EP0316209A1/en
Withdrawn legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B23/00—Exercising apparatus specially adapted for particular parts of the body
    • A63B23/035—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously
    • A63B23/04—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously for lower limbs
    • A63B23/0405—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously for lower limbs involving a bending of the knee and hip joints simultaneously
    • A63B23/0417—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously for lower limbs involving a bending of the knee and hip joints simultaneously with guided foot supports moving parallel to the body-symmetrical-plane by translation
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B21/00—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices
    • A63B21/02—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices using resilient force-resisters
    • A63B21/05—Linearly-compressed elements
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B22/00—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements
    • A63B22/20—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements using rollers, wheels, castors or the like, e.g. gliding means, to be moved over the floor or other surface, e.g. guide tracks, during exercising
    • A63B22/201—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements using rollers, wheels, castors or the like, e.g. gliding means, to be moved over the floor or other surface, e.g. guide tracks, during exercising for moving a support element in reciprocating translation, i.e. for sliding back and forth on a guide track
    • A63B22/203—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements using rollers, wheels, castors or the like, e.g. gliding means, to be moved over the floor or other surface, e.g. guide tracks, during exercising for moving a support element in reciprocating translation, i.e. for sliding back and forth on a guide track in a horizontal plane
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B2208/00—Characteristics or parameters related to the user or player
    • A63B2208/02—Characteristics or parameters related to the user or player posture
    • A63B2208/0242—Lying down
    • A63B2208/0252—Lying down supine
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B23/00—Exercising apparatus specially adapted for particular parts of the body
    • A63B23/035—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously
    • A63B23/03508—For a single arm or leg
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B23/00—Exercising apparatus specially adapted for particular parts of the body
    • A63B23/035—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously
    • A63B23/04—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously for lower limbs
    • A63B23/0494—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously for lower limbs primarily by articulating the knee joints

Definitions

  • the present invention relates to apparatus for therapeutic exercises, and more particularly those making it possible to perform isometric exercises intended to combat atrophy, for example, of the thigh muscles during prolonged immobilization, continued, for example , accident or rheumatic disease.
  • One of the methods currently known for practicing isometric exercises consists in manually moving the limb to be treated, by pushing or counter-pushing in order to force the muscles of this limb to work and therefore help them to find their previous initial shape and quality.
  • This method which can give good results, still has the major drawback of requiring the intervention of a practitioner, for example a physiotherapist, whose professional qualities are not essential for this work.
  • This apparatus comprises a carriage mounted on sliding slides, means for applying to the carriage feedback forces, for example, a weight on which the force of gravity can be exerted, and a gutter for holding the leg mounted. by a pivoting end about an axis perpendicular to the direction of movement of the carriage.
  • this device gives a good result.
  • the gutter no longer moves in a perpendicular plane, in particular , to the axis of rotation of the knee patella of the patient. It follows that, when the patient exerts the efforts on his leg, the gutter can undergo deviations from this plane, which cause dangerous twists to the knee.
  • Apparatus has also been produced which makes it possible to overcome the two drawbacks mentioned above, for example that described in the two French Patent Applications 2 085 118 and 2 454 798.
  • These apparatuses essentially comprise a gutter with two articulated parts. one on the other at one of their ends, their two other ends being pivotally mounted, directly or indirectly, on a rigid base.
  • This embodiment makes it possible to limit the parasitic movements of the gutter as described above, but the cost price of the device is not greatly reduced, because the gutter comprises two holding elements, respectively, of the leg and of the thigh, and that, moreover, it requires a rigid base of a relatively great length.
  • the present invention aims to achieve an apparatus for therapeutic exercises, which is achievable with a small number of standard quality elements, so that it is a low cost price, weight and size significantly lower than those of the devices of the prior art, while giving results of care of as good quality.
  • the present invention relates to an apparatus for therapeutic exercises for a lower limb of a patient, that is to say the leg-thigh assembly, comprising a base, a carriage, means for mounting said carriage moving in a given direction relative to said base, means for exerting a force of feedback against said movement, a groove for holding said patient's leg, substantially between the foot and the knee of said lower limb, and means for pivotally mounting one end of said gutter on said carriage, characterized in that it comprises a bracket for holding a first rotation shaft along a first axis perpendicular to the direction of movement of said carriage, said first shaft being located in the half-space limited by said gutter opposite to that containing said base, and at least one retaining rod of which a first end is rotatably mounted on said first shaft and the second end of which is rotatably mounted on said gutter, by means of bearings and along a second axis of rotation parallel to the first.
  • FIGS 1 to 3 show a same embodiment of the apparatus according to the invention. Consequently, the same references designate the same elements there, whatever the figures on which they appear and whatever the form of representation of these elements, in real or simplified form.
  • the apparatus for therapeutic exercises for a lower limb of an illustrated patient comprises a base 1 and a carriage 2 associated with the base by means 3 so that it moves in a given direction 4 relative to the base. It also includes means 5 for exerting a force of feedback against this movement. The meaning of this feedback depends on how it is necessary to practice therapeutic exercise.
  • the apparatus further comprises a groove 6 for holding the patient's leg 7, substantially between his foot 8 and his knee 9. It also includes means for mounting one end 10 of the pivoting groove on the carriage 2.
  • the apparatus comprises a support bracket 11 of a first rotation shaft 12 along a first axis 13 perpendicular to the direction 4 of movement of the carriage 2.
  • This shaft 12 is located in the half-space 14 limited by the gutter 6 opposite to that 15 containing the base 1.
  • It also comprises at least one connecting rod 16 of which a first end 17 is mounted on the shaft 12 and the second end 18 of which is rotatably mounted on the gutter 6, by means of bearings 19 and according to a second axis of rotation 20, this axis 20 being parallel to the first axis 13 defined above.
  • the bearing means 19 are, for example, constituted by a plurality of bearings 30 defining a plurality of positions on the gutter 6 for the second axis of rotation 20.
  • the plurality of bearings 30 is constituted by a cam 31 pivotally mounted on the gutter 6 by defining a plurality of notches 32, 33 ... in which is adapted to cooperate by rotation a second shaft 34 secured to the end 18 of the connecting rod along the axis 20 .
  • the support bracket 11 advantageously comprises a first 21 and a second 22 legs pivotally mounted, respectively one on the other, along the first axis of rotation 13 and advantageously on the rotation shaft 12.
  • the end 23 of the first tab 21 opposite to that 24 pivotally mounted on the second tab 22 is pivotally mounted around a third axis 25 parallel to the first 13 and second 20 axes, this third axis being linked to the base 1.
  • the end 26 of the second tab 22 opposite to that 27 pivotally mounted on the first 21 is pivotally mounted around a fourth axis 28 parallel to the axes 13, 20 and 25, but connected to the carriage.
  • the carriage 2 is mounted in displacement in the direction 4 relative to the base.
  • the means allowing this movement comprise a slide 35 secured to the base 1 in direction 4, and a ring 36 slidingly mounted on the slide 35, the carriage 2 being secured to said ring.
  • the means 5 for exerting a feedback force comprise a banded spring 37 between a point 38 of the base 1 and a point 39 of the ring 36.
  • the apparatus comprises means 40 for adjusting the tension of the spring. These means are constituted, for example, by a washer 41 slidingly mounted on the slide 35 and a nut 42 cooperating with a threaded part of the slide. By turning it one way or the other, the patient can reduce or increase the length of the spring between the two points 38 and 39.
  • the gutter 6 mentioned above comprises, for example, an amount 43 secured to the carriage, at least one receiving cup 44 of the leg, and adjustable means 45 for mounting the cup on the amount 43 and adjusting its position along this amount.
  • One of the qualities of the structure of the apparatus as described above is to give it great rigidity despite the fact that the elements are, for the most part, mounted to rotate relative to one another.
  • the apparatus comprises two pairs of first and second legs and two connecting rods, the legs and connecting rods being substantially symmetrical with respect to a plane 50 passing through the slide 35 and perpendicular to the first rotation shaft 12, and the two connecting rods 16 then being joined by the same shaft 34.
  • This configuration appears perfectly in FIG. 3.
  • the short length of the gutter 6 as described above allows the base 1 to be advantageously made up of two parts 51, 52.
  • a first part 51 made of rigid material, is for example formed of a tubular frame in metal supporting the third axis 25 and the means 3 for mounting the carriage moving in the direction 4.
  • the second part 52 made of flexible material, it is integral with the first part 51, for example by means of a hinge or equivalent 53, and its length is determined so that patient 54 can sit on it while one of its legs 7 cooperates with the gutter 6.
  • the apparatus described above is used in the following manner, for example for reshaping a thigh muscle.
  • the first tab 21 pivots about the axis 25, FIG. 2, in a senestrorsum movement, while the carriage 2 moves in the direction 4 by compressing the spring 37, because that -this is maintained between the ring 41 and the base 1.
  • the second leg 22 undergoes a dextrorsum rotation about the axis 27, the angle at the top 70 of the triangle formed by the two legs 21, 22 increasing .
  • the connecting rod 16 also undergoes a dextrorsum rotation movement around the axis 13 while being perfectly maintained in the median plane 50 thanks to the structure of the apparatus, in particular the fact that the legs and the connecting rods are split and substantially symmetrical with respect to this plane. There is therefore no transverse action of effort on the knee and the risk of trauma as mentioned in the preamble is eliminated.
  • the patient releases his effort and the limb returns to its folded position under the action of the spring 37 which is released.
  • the force indirectly applied to the rigid part of the base 1 is compensated by the fact that by sitting on the flexible part 52 the patient contributes to exert a counter force reaction which keeps the base 1 in a stable position relative to its body.
  • the angle that the patient's leg and thigh can make in the rest position as shown in FIGS. 2 and 3 is adjusted by means of the different notches 32, 33, ...
  • a given notch and placing it tree 34 we get a determined angle of the gutter relative to the plane of the base.
  • the adjustment of these angle values is well known in itself. It consists in fact of the deformation of a triangle of which two sides defined by the second tab 22 and the link 16 are of constant lengths and whose third side has a variable length defined between the axis of rotation of the base 6 on the carriage 2 and the position of the axis 20 of the shaft 34 in one of the different notches of the cam.

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Orthopedics, Nursing, And Contraception (AREA)
  • Rehabilitation Tools (AREA)

Abstract

The therapeutic exercise apparatus for a lower limb of a patient, that is to say the leg-thigh combination, comprising a base 1, a carriage 2, means 3 for mounting the carriage in displacement in a direction 4, means 37 for exerting a force of counter-reaction to the displacement, a channel 6 for holding the leg 7 and means for pivotably mounting an end 26 of the channel on the carriage 2, comprises a holding bracket 11 of a first shaft 12 of rotation about a first axis perpendicular to the direction 4, the first shaft being located in the half-space 14 limited by the channel 6 opposite that 15 containing the base, and at least one connecting rod 16 linking the shaft 12 and the channel 6. <IMAGE>

Description

La présente invention concerne les appareillages pour exercices thérapeutiques, et plus particulièrement ceux permettant d'effectuer des exercices d'isométrie destinés à lutter contre l'atrophie, par exemple, des muscles de la cuisse lors d'une immobilisation prolongée, suite, par exemple, à un accident ou une maladie rhumatismale.The present invention relates to apparatus for therapeutic exercises, and more particularly those making it possible to perform isometric exercises intended to combat atrophy, for example, of the thigh muscles during prolonged immobilization, continued, for example , accident or rheumatic disease.

L'une des méthodes connues actuellement pour pratiquer des exercices d'isométrie consiste à effectuer manuellement le déplacement du membre à soigner, en effectuant des poussées ou des contre-poussées afin de forcer les muscles de ce membre à travailler et donc les aider à retrouver leurs forme et qualité initiales antérieures. Cette méthode, qui peut donner de bons résultats, présente malgré tout l'inconvénient majeur de nécessiter l'intervention d'un praticien, par exemple un kinésithérapeute, dont les qualités professionnelles ne s'avèrent pas indispensables pour ce travail.One of the methods currently known for practicing isometric exercises consists in manually moving the limb to be treated, by pushing or counter-pushing in order to force the muscles of this limb to work and therefore help them to find their previous initial shape and quality. This method, which can give good results, still has the major drawback of requiring the intervention of a practitioner, for example a physiotherapist, whose professional qualities are not essential for this work.

Il a donc été réalisé des dispositifs permettant, en quelque sorte, de remplacer le praticien, afin que celui-ci se libère pour d'autres tâches plus en rapport avec ses aptitudes professionnelles.Devices have therefore been made which make it possible, in a way, to replace the practitioner, so that he is free for other tasks more related to his professional skills.

C'est ainsi qu'il a été réalisé un appareillage décrit dans le document constitué par la Demande de Brevet Allemand du 4 octobre 1980 publiée sous le numéro 3 037 619.This is how an apparatus described in the document constituted by the German Patent Application of October 4, 1980 published under the number 3 037 619 was produced.

Cet appareillage comporte un chariot monté sur des glissières de coulissement, des moyens pour appliquer au chariot des forces de contre-réaction, par exemple, un poids sur lequel peut s'exercer la force de pesanteur, et une gouttière de maintien de la jambe montée par une extrémité pivotante autour d'un axe perpendiculaire à la direction de déplacement du chariot. En théorie, ce dispositif donne un bon résultat. Cependant, à force d'effectuer des exercices, si certaines pièces constituant l'appareillage ne sont pas réalisées dans les meilleures qualités mécaniques, elles prennent très vite du jeu et il arrive alors que la gouttière ne se déplace plus dans un plan perpendiculaire, notamment, à l'axe de rotation de la rotule du genou du patient. Il s'en suit que, lorsque le patient exerce les efforts sur sa jambe, la gouttière peut subir des déviations par rapport à ce plan, qui entraînent des torsions dangereuses pour le genou. En voulant soigner un traumatisme, on peut donc ainsi en créer d'autres tout aussi néfastes pour le patient.This apparatus comprises a carriage mounted on sliding slides, means for applying to the carriage feedback forces, for example, a weight on which the force of gravity can be exerted, and a gutter for holding the leg mounted. by a pivoting end about an axis perpendicular to the direction of movement of the carriage. In theory, this device gives a good result. However, by dint of performing exercises, if certain parts constituting the apparatus are not made in the best mechanical qualities, they take up play very quickly and it sometimes happens that the gutter no longer moves in a perpendicular plane, in particular , to the axis of rotation of the knee patella of the patient. It follows that, when the patient exerts the efforts on his leg, the gutter can undergo deviations from this plane, which cause dangerous twists to the knee. By wanting to treat a trauma, we can thus create others just as harmful for the patient.

Pour obvier à ces inconvénients, on a réalisé un appareillage comportant des éléments mécaniques de haute qualité et de grande fiabilité. Mais cette technique donne alors à l'appareillage un prix de revient tellement élevé qu'elle le rend inaccessible à beaucoup de praticiens.To overcome these drawbacks, an apparatus has been produced comprising high-quality and high-reliability mechanical elements. But this technique then gives the apparatus a cost price so high that it makes it inaccessible to many practitioners.

Il a aussi été réalisé un appareillage qui permet de pallier les deux inconvénients mentionnés ci-dessus, par exemple celui décrit dans les deux Demandes de Brevets Français 2 085 118 et 2 454 798. Ces appareillages comportent essentiellement une gouttière à deux parties articulées l'une sur l'autre à une de leurs extrémités, leurs deux autres extrémités étant montées pivotantes, directement ou indirectement, sur une embase rigide. Cette réalisation permet de limiter les mouvements parasites de la gouttière tels que décrits ci-avant, mais le prix de revient du dispositif n'est pas tellement diminué, du fait que la gouttière comprend deux éléments de maintien, respectivement, de la jambe et de la cuisse, et que, de plus, elle nécessite une embase rigide d'une relativement grande longueur.Apparatus has also been produced which makes it possible to overcome the two drawbacks mentioned above, for example that described in the two French Patent Applications 2 085 118 and 2 454 798. These apparatuses essentially comprise a gutter with two articulated parts. one on the other at one of their ends, their two other ends being pivotally mounted, directly or indirectly, on a rigid base. This embodiment makes it possible to limit the parasitic movements of the gutter as described above, but the cost price of the device is not greatly reduced, because the gutter comprises two holding elements, respectively, of the leg and of the thigh, and that, moreover, it requires a rigid base of a relatively great length.

La présente invention a pour but de réaliser un appareillage pour exercices thérapeutiques, qui soit réalisable avec un petit nombre d'éléments de qualité standard, afin qu'il soit d'un prix de revient faible, d'un poids et d'un encombrement nettement inférieurs à ceux des dispositifs de l'art antérieur, tout en donnant des résultats de soins d'aussi bonne qualité.The present invention aims to achieve an apparatus for therapeutic exercises, which is achievable with a small number of standard quality elements, so that it is a low cost price, weight and size significantly lower than those of the devices of the prior art, while giving results of care of as good quality.

Plus précisément, la présente invention a pour objet un appareillage d'exercices thérapeutiques pour un membre inférieur d'un patient, c'est-à-dire l'ensemble jambe-cuisse, comportant une embase, un chariot, des moyens pour monter ledit chariot en déplacement suivant une direction donnée par rapport à ladite embase, des moyens pour exercer une force de contre-réaction audit déplacement, une gouttière de maintien de ladite jambe du patient, sensiblement entre le pied et le genou dudit membre inférieur, et des moyens pour monter pivotante une extrémité de ladite gouttière sur ledit chariot, caractérisé par le fait qu'il comprend une potence de maintien d'un premier arbre de rotation suivant une premier axe perpendiculaire à la direction de déplacement dudit chariot, ledit premier arbre étant situé dans le demi-espace limité par ladite gouttière opposé à celui contenant ladite embase, et au moins une bielle de maintien dont une première extrémité est montée en rotation sur ledit premier arbre et dont la seconde extrémité est montée rotative sur ladite gouttière, par des moyens de paliers et suivant un deuxième axe de rotation parallèle au premier.More specifically, the present invention relates to an apparatus for therapeutic exercises for a lower limb of a patient, that is to say the leg-thigh assembly, comprising a base, a carriage, means for mounting said carriage moving in a given direction relative to said base, means for exerting a force of feedback against said movement, a groove for holding said patient's leg, substantially between the foot and the knee of said lower limb, and means for pivotally mounting one end of said gutter on said carriage, characterized in that it comprises a bracket for holding a first rotation shaft along a first axis perpendicular to the direction of movement of said carriage, said first shaft being located in the half-space limited by said gutter opposite to that containing said base, and at least one retaining rod of which a first end is rotatably mounted on said first shaft and the second end of which is rotatably mounted on said gutter, by means of bearings and along a second axis of rotation parallel to the first.

D'autres caractéristiques et avantages de la présente invention apparaîtront au cours de la description suivante donnée en regard des dessins annexés à titre illustratif mais nullement limitatif dans lesquels :

  • La figure 1 représente, vu en perspective, un mode de réalisation d'un appareillage pour exercices thérapeutiques selon l'invention.
  • Les figures 2 et 3 représentent, sous forme schématique, deux vues respectivement de côté et de face du mode de réalisation selon la figure 1, permettant d'expliciter le fonctionnement et les avantages de l'appareillage.
Other characteristics and advantages of the present invention will appear during the following description given with reference to the drawings annexed by way of illustration but in no way limitative in which:
  • FIG. 1 represents, seen in perspective, an embodiment of an apparatus for therapeutic exercises according to the invention.
  • Figures 2 and 3 show, in schematic form, two views respectively from the side and from the front of the embodiment according to Figure 1, to explain the operation and the advantages of the apparatus.

Les figures 1 à 3 représentent un même mode de réalisation de l'appareillage selon l'invention. En conséquence, les mêmes références y désignent les mêmes éléments, quelles que soient les figures sur lesquelles elles apparaissent et quelle que soit la forme de représentation de ces éléments, sous forme réelle ou simplifiée.Figures 1 to 3 show a same embodiment of the apparatus according to the invention. Consequently, the same references designate the same elements there, whatever the figures on which they appear and whatever the form of representation of these elements, in real or simplified form.

L'appareillage d'exercices thérapeutiques pour un membre inférieur d'un patient illlustré comporte une embase 1 et un chariot 2 associé à l'embase par des moyens 3 de façon qu'il se déplace suivant une direction donnée 4 par rapport à l'embase. Il comporte aussi des moyens 5 pour exercer une force de contre-réaction à ce déplacement. Le sens de cette contre-réaction est fonction de la façon dont il est nécessaire de faire pratiquer l'exercice thérapeutique.The apparatus for therapeutic exercises for a lower limb of an illustrated patient comprises a base 1 and a carriage 2 associated with the base by means 3 so that it moves in a given direction 4 relative to the base. It also includes means 5 for exerting a force of feedback against this movement. The meaning of this feedback depends on how it is necessary to practice therapeutic exercise.

L'appareillage comporte en outre une gouttière 6 de maintien de la jambe 7 du patient, sensiblement entre son pied 8 et son genou 9. Il comporte aussi des moyens pour monter une extrémité 10 de la gouttière pivotante sur le chariot 2.The apparatus further comprises a groove 6 for holding the patient's leg 7, substantially between his foot 8 and his knee 9. It also includes means for mounting one end 10 of the pivoting groove on the carriage 2.

Selon une caractéristique de l'invention, l'appareillage comporte une potence de support 11 d'un premier arbre de rotation 12 suivant une premier axe 13 perpendiculaire à la direction 4 du déplacement du chariot 2. Cet arbre 12 est situé dans le demi-espace 14 limité par la gouttière 6 opposé à celui 15 contenant l'embase 1. Il comporte aussi au moins une bielle 16 dont une première extrémité 17 est montée sur l'arbre 12 et dont la seconde extrémité 18 est montée rotative sur la gouttière 6, par des moyens de paliers 19 et suivant un deuxième axe de rotation 20, cet axe 20 étant parallèle au premier axe 13 défini ci-dessus.According to a characteristic of the invention, the apparatus comprises a support bracket 11 of a first rotation shaft 12 along a first axis 13 perpendicular to the direction 4 of movement of the carriage 2. This shaft 12 is located in the half-space 14 limited by the gutter 6 opposite to that 15 containing the base 1. It also comprises at least one connecting rod 16 of which a first end 17 is mounted on the shaft 12 and the second end 18 of which is rotatably mounted on the gutter 6, by means of bearings 19 and according to a second axis of rotation 20, this axis 20 being parallel to the first axis 13 defined above.

Suivant une forme de réalisation préférée, les moyens de paliers 19 sont, par exemple, constitués par une pluralité de paliers 30 définissant une pluralité de positions sur la gouttière 6 pour le deuxième axe de rotation 20. En fait, la pluralité de paliers 30 est constituée par une came 31 montée pivotante sur la gouttière 6 en définissant une pluralité d'encoches 32, 33 ... dans lesquelles est apte à coopérer par rotation un deuxième arbre 34 solidaire de l'extrémité 18 de la bielle suivant l'axe 20.According to a preferred embodiment, the bearing means 19 are, for example, constituted by a plurality of bearings 30 defining a plurality of positions on the gutter 6 for the second axis of rotation 20. In fact, the plurality of bearings 30 is constituted by a cam 31 pivotally mounted on the gutter 6 by defining a plurality of notches 32, 33 ... in which is adapted to cooperate by rotation a second shaft 34 secured to the end 18 of the connecting rod along the axis 20 .

La potence de suport 11 comporte avantageusement une première 21 et une seconde 22 pattes montées pivotantes, respectivement l'une sur l'autre, suivant le premier axe de rotation 13 et avantageusement sur l'arbre de rotation 12. L'extrémité 23 de la première patte 21 opposée à celle 24 montée pivotante sur la seconde patte 22 est montée pivotante autour d'un troisième axe 25 parallèle aux premier 13 et second 20 axes, ce troisième axe étant lié à l'embase 1. De plus, l'extrémité 26 de la seconde patte 22 opposée à celle 27 montée pivotante sur la première 21 est montée pivotante autour d'un quatrième axe 28 parallèle aux axes 13, 20 et 25, mais lié au chariot.The support bracket 11 advantageously comprises a first 21 and a second 22 legs pivotally mounted, respectively one on the other, along the first axis of rotation 13 and advantageously on the rotation shaft 12. The end 23 of the first tab 21 opposite to that 24 pivotally mounted on the second tab 22 is pivotally mounted around a third axis 25 parallel to the first 13 and second 20 axes, this third axis being linked to the base 1. In addition, the end 26 of the second tab 22 opposite to that 27 pivotally mounted on the first 21 is pivotally mounted around a fourth axis 28 parallel to the axes 13, 20 and 25, but connected to the carriage.

Comme décrit ci-dessus, le chariot 2 est monté en déplacement suivant la direction 4 par rapport à l'embase. Les moyens permettant ce déplacement comportent une glissière 35 solidaire de l'embase 1 suivant la direction 4, et une bague 36 montée coulissante sur la glissière 35, le chariot 2 étant solidaire de ladite bague.As described above, the carriage 2 is mounted in displacement in the direction 4 relative to the base. The means allowing this movement comprise a slide 35 secured to the base 1 in direction 4, and a ring 36 slidingly mounted on the slide 35, the carriage 2 being secured to said ring.

Dans le mode de réalisation illustré, les moyens 5 pour exercer une force de contre-réaction comportent un ressort bandé 37 entre un point 38 de l'embase 1 et un point 39 de la bague 36. Pour permettre à chaque patient d'effectuer des exercices adaptés à son cas, l'appareillage comporte des moyens 40 pour régler la tension du ressort. Ces moyens sont constitués, par exemple, par une rondelle 41 montée coulissante sur la glissière 35 et un écrou 42 coopérant avec une partie filetée de la glissière. En le tournant dans un sens ou dans l'autre, le patient peut réduire ou augmenter la longueur du ressort entre les deux points 38 et 39.In the illustrated embodiment, the means 5 for exerting a feedback force comprise a banded spring 37 between a point 38 of the base 1 and a point 39 of the ring 36. To allow each patient to perform exercises adapted to his case, the apparatus comprises means 40 for adjusting the tension of the spring. These means are constituted, for example, by a washer 41 slidingly mounted on the slide 35 and a nut 42 cooperating with a threaded part of the slide. By turning it one way or the other, the patient can reduce or increase the length of the spring between the two points 38 and 39.

La gouttière 6 mentionnée ci-avant comporte, par exemple, un montant 43 solidaire du chariot, au moins une coupelle de réception 44 de la jambe, et des moyens réglables 45 pour monter la coupelle sur le montant 43 et régler sa position le long de ce montant.The gutter 6 mentioned above comprises, for example, an amount 43 secured to the carriage, at least one receiving cup 44 of the leg, and adjustable means 45 for mounting the cup on the amount 43 and adjusting its position along this amount.

L'une des qualités de la structure de l'appareillage telle que décrite ci-dessus est de lui conférer une grande rigidité malgré le fait que les éléments soient, pour la plupart, montés rotatifs les uns par rapport aux autres.One of the qualities of the structure of the apparatus as described above is to give it great rigidity despite the fact that the elements are, for the most part, mounted to rotate relative to one another.

Dans ce but, l'appareillage comporte deux paires de premières et secondes pattes et deux bielles, les pattes et bielles étant sensiblement symétriques par rapport à un plan 50 passant par la glissière 35 et perpendiculaire au premier arbre de rotation 12, et les deux bielles 16 étant alors réunies par un même arbre 34. Cette configuration apparaît parfaitement sur la figure 3.For this purpose, the apparatus comprises two pairs of first and second legs and two connecting rods, the legs and connecting rods being substantially symmetrical with respect to a plane 50 passing through the slide 35 and perpendicular to the first rotation shaft 12, and the two connecting rods 16 then being joined by the same shaft 34. This configuration appears perfectly in FIG. 3.

Comme les différentes pattes et bielles sont dédoublées, elles forment des quadrilatères pour la plupart articulés à leurs sommets, ce qui permet, de façon connue, de maintenir une certaine rigidité dans un plan, notamment le plan 50, même après de nombreuses utilisations répétées du dispositif et même si les axes de rotation ont une qualité de fabrication moyenne dans le but d'abaisser le coût de revient total de l'appareillage.As the different legs and connecting rods are split, they form quadrilaterals for the most part articulated at their vertices, which makes it possible, in a known manner, to maintain a certain rigidity in a plane, in particular the plane 50, even after numerous repeated uses of the device and even if the axes of rotation have an average manufacturing quality in order to lower the total cost of the equipment.

La faible longueur de la gouttière 6 telle que décrite ci-dessus permet à l'embase 1 d'être avantageusement constituée de deux parties 51, 52. Une première partie 51, réalisée en matériau rigide, est par exemple formée d'un cadre tubulaire en métal supportant le troisième axe 25 et les moyens 3 pour monter le chariot en déplacement suivant la direction 4. Quant à la seconde partie 52, réalisée en matériau souple, elle est solidaire de la première partie 51, par exemple au moyen d'une charnière ou équivalent 53, et sa longueur est déterminée pour que le patient 54 puisse s'y asseoir alors que l'une de ses jambes 7 coopère avec le gouttière 6.The short length of the gutter 6 as described above allows the base 1 to be advantageously made up of two parts 51, 52. A first part 51, made of rigid material, is for example formed of a tubular frame in metal supporting the third axis 25 and the means 3 for mounting the carriage moving in the direction 4. As for the second part 52, made of flexible material, it is integral with the first part 51, for example by means of a hinge or equivalent 53, and its length is determined so that patient 54 can sit on it while one of its legs 7 cooperates with the gutter 6.

L'appareillage décrit ci-dessus s'utilise de la façon suivante, par exemple pour remettre en forme un muscle de la cuisse. On commence par placer la jambe 7 dans les coupelles 44 et par l'y maintenir fermement, par exemple au moyen de sangles 60, le patient étant assis sur la deuxième partie souple 52 de l'embase 1.The apparatus described above is used in the following manner, for example for reshaping a thigh muscle. We start by placing the leg 7 in the cups 44 and by holding it firmly there, for example by means of straps 60, the patient being seated on the second flexible part 52 of the base 1.

Pour remuscler sa cuisse, il commande l'allongement de son membre inférieur à l'encontre de l'effort exercé par le ressort qui est préalablement bandé à la bonne valeur déterminée par le praticien au moyen de l'écrou molleté 42.To remuscitate his thigh, he controls the elongation of his lower limb against the force exerted by the spring which is previously bandaged to the correct value determined by the practitioner by means of the knurled nut 42.

Dans ces conditions, lors de cet allongement, la première patte 21 pivote autour de l'axe 25, figure 2, dans un mouvement senestrorsum, pendant que le chariot 2 se déplace suivant la direction 4 en comprimant le ressort 37, du fait que celui-ci est maintenu entre la bague 41 et l'embase 1. Dans ces conditions, la deuxième patte 22 subit une rotation dextrorsum autour de l'axe 27, l'angle au sommet 70 du triangle formé par les deux pattes 21, 22 augmentant. Dans ce mouvement, la bielle 16 subit, elle aussi, un mouvement de rotation dextrorsum autour de l'axe 13 en étant parfaitement maintenue dans le plan médian 50 grâce à la structure de l'appareillage, notamment au fait que les pattes et les bielles soient dédoublées et sensiblement symétriques par rapport à ce plan. Il n'y a donc pas alors d'action transversale d'effort sur le genou et le risque de traumatisme tel que mentionné au préambule est éliminé.Under these conditions, during this elongation, the first tab 21 pivots about the axis 25, FIG. 2, in a senestrorsum movement, while the carriage 2 moves in the direction 4 by compressing the spring 37, because that -this is maintained between the ring 41 and the base 1. Under these conditions, the second leg 22 undergoes a dextrorsum rotation about the axis 27, the angle at the top 70 of the triangle formed by the two legs 21, 22 increasing . In this movement, the connecting rod 16 also undergoes a dextrorsum rotation movement around the axis 13 while being perfectly maintained in the median plane 50 thanks to the structure of the apparatus, in particular the fact that the legs and the connecting rods are split and substantially symmetrical with respect to this plane. There is therefore no transverse action of effort on the knee and the risk of trauma as mentioned in the preamble is eliminated.

Suite à l'allongement du membre inférieur, le patient relâche son effort et le membre revient dans sa position pliée sous l'action du ressort 37 qui se débande. Il est à noter que, lorsque le membre est étendu, l'effort indirectement appliqué sur la partie rigide de l'embase 1 est compensé par le fait qu'en étant assis sur la partie souple 52 le patient contribue à exercer un effort de contre-réaction qui maintient l'embase 1 dans une position stable par rapport à son corps.Following the elongation of the lower limb, the patient releases his effort and the limb returns to its folded position under the action of the spring 37 which is released. It should be noted that, when the limb is extended, the force indirectly applied to the rigid part of the base 1 is compensated by the fact that by sitting on the flexible part 52 the patient contributes to exert a counter force reaction which keeps the base 1 in a stable position relative to its body.

L'angle que peuvent faire la jambe et la cuisse du patient dans la position de repos telle que représentée sur les figures 2 et 3 est ajusté au moyen des différentes encoches 32, 33, ... En choisissant une encoche donnée et en y plaçant l'arbre 34, on obtient un angle déterminé de la gouttière par rapport au plan de l'embase. L'ajustement de ces valeurs d'angle est bien connu en lui-même. Il consiste en effet en la déformation d'un triangle dont deux côtés définis par la deuxième patte 22 et la biellette 16 sont de longueurs constantes et dont le troisième côté a une longueur variable définie entre l'axe de rotation de l'embase 6 sur le chariot 2 et la position de l'axe 20 de l'arbre 34 dans l'une des différentes encoches de la came.The angle that the patient's leg and thigh can make in the rest position as shown in FIGS. 2 and 3 is adjusted by means of the different notches 32, 33, ... By choosing a given notch and placing it tree 34, we get a determined angle of the gutter relative to the plane of the base. The adjustment of these angle values is well known in itself. It consists in fact of the deformation of a triangle of which two sides defined by the second tab 22 and the link 16 are of constant lengths and whose third side has a variable length defined between the axis of rotation of the base 6 on the carriage 2 and the position of the axis 20 of the shaft 34 in one of the different notches of the cam.

Les avantages d'un tel appareillage sont multiples. Son encombrement est réduit, du moins en longueur, au moins de la moitié de ceux de l'art antérieur donnant le même résultat thérapeutique. Sa réalisation est des plus simple et il peut être fabriqué avec des éléments standard ne nécessitant pas une qualité supérieure, mais lui permettant néanmoins d'avoir une durée de vie aussi importante que celle des produits équivalents réalisés avec des éléments dont le prix de revient est très élevé. Enfin, le fait que la potence soit formée de paires de pattes et de bielles reliées pour former des quadrilatères articulés en leurs sommets permet de donner à l'appareillage, malgré les rotations de ces différents éléments les uns par rapport aux autres, une rigidité suffisante pour bien maintenir le membre du patient et éviter que le genou ne subisse des torsions traumatisantes dommageables.The advantages of such an apparatus are multiple. Its size is reduced, at least in length, at least half of that of the prior art giving the same therapeutic result. Its realization is very simple and it can be manufactured with standard elements not requiring a higher quality, but nevertheless allowing it to have a life as important as that of equivalent products made with elements whose cost price is very high. Finally, the fact that the stem is formed of pairs of legs and connecting rods connected to form quadrilaterals articulated at their vertices makes it possible to give the apparatus, despite the rotations of these different elements with respect to each other, sufficient rigidity to secure the patient's limb and prevent the knee from undergoing damaging traumatic twists.

Claims (10)

1. Appareillage d'exercices thérapeutiques pour un membre inférieur d'un patient, c'est-à-dire l'ensemble jambe-cuisse, comportant une embase (1), un chariot (2), des moyens (3) pour monter ledit chariot en déplacement suivant une direction donnée (4) par rapport à ladite embase, des moyens pour exercer une force de contre-réaction audit déplacement, une gouttière de maintien (6) de ladite jambe (7) du patient, sensiblement entre le pied (8) et le genou (9) dudit membre inférieur, et des moyens pour monter pivotante une extrémité de ladite gouttière sur ledit chariot, caractérisé par le fait qu'il comprend une potence de maintien (11) d'un premier arbre de rotation (12) suivant une premier axe (13) perpendiculaire à la direction de déplacement dudit chariot, ledit premier arbre étant situé dans le demi-espace (14) limité par ladite gouttière opposé à celui (15) contenant ladite embase, et au moins une bielle de maintien (16) dont une première extrémité (17) est montée en rotation sur ledit premier arbre et dont la seconde extrémité (18) est montée rotative sur ladite gouttière, par des moyens de paliers (30) et suivant un deuxième axe de rotation (20) parallèle au premier (13).1. Apparatus for therapeutic exercises for a lower limb of a patient, that is to say the leg-thigh assembly, comprising a base (1), a carriage (2), means (3) for mounting said carriage moving in a given direction (4) relative to said base, means for exerting a force of feedback against said movement, a retaining groove (6) of said leg (7) of the patient, substantially between the foot (8) and the knee (9) of said lower limb, and means for pivotally mounting one end of said gutter on said carriage, characterized in that it comprises a support bracket (11) of a first rotation shaft (12) along a first axis (13) perpendicular to the direction of movement of said carriage, said first shaft being located in the half-space (14) limited by said gutter opposite to that (15) containing said base, and at least one holding rod (16), a first end (17) of which is rotatably mounted on the edit first shaft and whose second end (18) is rotatably mounted on said gutter, by means of bearings (30) and along a second axis of rotation (20) parallel to the first (13). 2. Appareillage selon la revendication 1, caractérisé par le fait que ladite potence (11) comporte au moins une première (21) et une seconde (22) pattes montées pivotantes, respectivement l'une sur l'autre, suivant ledit premier axe de rotation (13), l'extrémité (23) de la première patte (21) opposée à celle (24) montée pivotante sur la seconde patte (22) étant montée pivotante autour d'un troisième axe (25) parallèle auxdits premier et second axes, ledit troisième axe étant lié à ladite embase, l'extrémité (26) de ladite seconde patte (22) opposée à celle montée pivotante sur la première étant montée pivotante autour d'un quatrième axe (28) lié audit chariot (2).2. Apparatus according to claim 1, characterized in that said bracket (11) comprises at least a first (21) and a second (22) legs pivotally mounted, respectively one on the other, along said first axis of rotation (13), the end (23) of the first tab (21) opposite to that (24) pivotally mounted on the second tab (22) being pivotally mounted around a third axis (25) parallel to said first and second axes, said third axis being linked to said base, the end (26) of said second tab (22) opposite to that pivotally mounted on the first being pivotally mounted around a fourth axis (28) linked to said carriage (2) . 3. Appareillage selon l'une des revendications 1 et 2, caractérisé par le fait que lesdits moyens de paliers (30) sont constitués par une pluralité de paliers (31) définissant une pluralité de positions sur ladite gouttière pour ledit deuxième axe de rotation.3. Apparatus according to one of claims 1 and 2, characterized in that said bearing means (30) are constituted by a plurality of bearings (31) defining a plurality of positions on said gutter for said second axis of rotation. 4. Appareillage selon la revendication 3, caractérisé par le fait que la pluralité de paliers est constituée par une came montée pivotante sur ladite gouttière et définissant une pluralité d'encoches (32,33) dans lesquelles est apte à coopérer par rotation un deuxième arbre (34) de rotation solidaire de l'extrémité (18) de ladite bielle.4. Apparatus according to claim 3, characterized in that the plurality of bearings is constituted by a mounted cam pivoting on said gutter and defining a plurality of notches (32,33) in which is adapted to cooperate by rotation a second shaft (34) of rotation integral with the end (18) of said connecting rod. 5. Appareillage selon l'une des revendications précédentes, caractérisé par le fait que lesdits moyens (3) pour monter ledit chariot (2) en déplacement suivant une direction donnée (4) par rapport à ladite embase comportent une glissière (35) solidaire de ladite embase (1) suivant ladite direction, et une bague de coulissement (36) montée sur ladite glissière (35), ledit chariot étant solidaire de ladite bague.5. Apparatus according to one of the preceding claims, characterized in that said means (3) for mounting said carriage (2) moving in a given direction (4) relative to said base comprises a slide (35) integral with said base (1) in said direction, and a sliding ring (36) mounted on said slide (35), said carriage being integral with said ring. 6. Appareillage selon la revendication 5, caractérisé par le fait que lesdits moyens pour exercer une force de contre-réaction comportent un ressort (37) bandé entre un point (38) de ladite embase et un point (39) de ladite bague (36).6. Apparatus according to claim 5, characterized in that said means for exerting a feedback force comprises a spring (37) banded between a point (38) of said base and a point (39) of said ring (36 ). 7. Appareillage selon la revendication 6, caractérisé par le fait qu'il comporte des moyens (40) pour régler la tension dudit ressort (37).7. Apparatus according to claim 6, characterized in that it comprises means (40) for adjusting the tension of said spring (37). 8. Appareillage selon l'une des revendications précédentes, caractérisé par le fait que ladite gouttière comporte un montant (43) solidaire dudit chariot, une coupelle de réception (44) de ladite jambe (7), et des moyens (45) réglables pour monter ladite coupelle sur ledit montant.8. Apparatus according to one of the preceding claims, characterized in that said gutter comprises an upright (43) integral with said carriage, a receiving cup (44) of said leg (7), and means (45) adjustable for mount said cup on said upright. 9. Appareillage selon l'une des revendications 5 à 8, caractérisé par le fait qu'il comporte deux paires de premières (21) et secondes (22) pattes et deux bielles (16), lesdites pattes et bielles étant sensiblement symétriques par rapport à un plan (50) passant par ladite glissière (35) et perpendiculaire audit premier arbre de rotation (12).9. Apparatus according to one of claims 5 to 8, characterized in that it comprises two pairs of first (21) and second (22) legs and two connecting rods (16), said legs and connecting rods being substantially symmetrical with respect to to a plane (50) passing through said slide (35) and perpendicular to said first rotation shaft (12). 10. Appareillage selon l'une des revendications précédentes, caractérisé par le fait que ladite embase (1) est constituée de deux parties, une première partie (51) en matériau rigide supportant ledit troisième axe (25) et les moyens (3) pour monter ledit chariot en déplacement, et une seconde partie (52) en matériau souple, solidaire de la première, la longueur de ladite seconde partie étant déterminée pour que ledit patient puisse s'asseoir sur celle-ci quand l'une de ses jambes coopère avec ladite gouttière.10. Apparatus according to one of the preceding claims, characterized in that said base (1) consists of two parts, a first part (51) of rigid material supporting said third axis (25) and the means (3) for mounting said carriage while traveling, and a second part (52) of flexible material, integral with the first, the length of said second part being determined so that said patient can sit on it when one of his legs cooperates with said gutter.
EP88402707A 1987-11-10 1988-10-27 Therapeutic exercise apparatus Withdrawn EP0316209A1 (en)

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FR8715527 1987-11-10
FR8715527A FR2622794B1 (en) 1987-11-10 1987-11-10 APPARATUS FOR THERAPEUTIC EXERCISES

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FR2622794B1 (en) 1990-03-16
US4922892A (en) 1990-05-08
FR2622794A1 (en) 1989-05-12
JPH01155850A (en) 1989-06-19

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