RU2694174C1 - Device for hand fingers rehabilitation - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine. Hand rehabilitating device comprises a glove with a collar, lengthwise pockets on the back surface of the fingers of the glove, elements of their burdening and attaching. At the end of each finger of the glove there is a rigid fingertip with a retainer on its top. Retainer comprises, in one plane, leg with two hooks of equal length and with bent ends towards fingertip. Thickness of hook is equal to diameter of retainer leg, and distance between lower surface of hooks and surface of fingertip exceeds thickness of weighting element. Weighting element is resiliently resilient with the possibility of its one end attachment to the retainer, and of the other end, with the possibility of the attachment point selection, to the cuff, which contains on the back surface the looping element of the velcro fabric fastener, and on the inner surface at one its end the fastening hook element and a handle.

EFFECT: invention provides more effective development of stiff joints and increased force of hand fingers by regulation of power load on muscle flexors and extensors selectively and dosed for each finger.

4 cl, 16 dwg

Description

The invention relates to rehabilitation medicine and medical technology, namely, devices, mechanotherapy and is intended for the rehabilitation of patients with impaired motor functions of the fingers.

Bruises, sprains, fractures, gunshot wounds, prolonged crush, thermal and chemical lesions, surgery or prolonged immobilization with the inaction of the fingers, acquired and congenital diseases of the nervous and vascular systems, as well as inflammatory and degenerative-dystrophic processes often lead to the development of motor disorders of the functions of the fingers of the hand [Watson-Jones R. Fractures of the bones and damage to the sustat. Publisher "Medicine". M. 1972. P. 411-412]. Such patients, especially with stiffness in the joints and with hypotension of the flexor muscles and extensor fingers of the hand, need rehabilitation. Rehabilitation is also aimed at preventing reflex contractures of intact fingers and preventing secondary changes in tissues [Rozov, VI, Blokhin, VN in the Multi-Volume Surgery Guide edited by V.D. Chaklina. State publishing house of medical literature. Medgiz M. 1960. Volume 9, p. 342]. Active rehabilitation involves not only increasing mobility in the joints, but also strengthening the muscles of the flexors and extensors of the fingers [Multi-volume guide to orthopedics and traumatology. Volume 1 M. Publishing House "Medicine". 1967, Стр. 766. Dreving E.F. "Traumatology". M. 2002]. There are many simple devices for the development of finger joints and finger flexor muscle training: rubber balls, elastic rings, various expanders [http://fb.ru/article/166266/kistevoy-espander-polza-i-vred]. but their use does not always meet the expectations of patients. Stationary devices operating on electricity are expensive and often the conditions for their treatment are not convenient for patients. The use of well-known means of rehabilitation of patients with movement disorders of the fingers of the hand, including joint stiffness and hypotonia of the extensor muscles and flexor muscles, sometimes does not lead to the desired results, which prompted us to develop a new portable device.

From the patent of the Russian Federation No. 2471467 on the method of rehabilitation of the extensor contractures of the fingers of the hand, means are known for implementing the method. The development of movements in the constricted joints of the fingers of the hand is carried out by immersion of the constricted fingers for the entire length of them in a loose mass selected from a number of peas, millet, rice and heated to 60 ° C. After complete immersion of the fingers, they are kept in the bulk mass, then the fingers are slowly removed and re-immersed into the bulk mass to somewhat greater depth. These movements are carried out until complete cooling of the mass. The procedure is performed daily, 3-4 times a day and the sessions are carried out until the extension contracture is completely eliminated.

The disadvantage of this tool is the dependence of the patient on the availability of a source of heating and a food product, the significant cost of the food product, the repeated sessions during the day and the indefinite duration of the entire treatment time, which is not acceptable to all patients. It shows no signs of expanding the possibilities of rehabilitation of patients with impaired motor functions of the fingers, increasing the efficiency of developing stiff joints and increasing the strength of the fingers, by adjusting the force load on the flexor and extensor muscles selectively and metered for each finger.

Known mechanotherapeutic apparatus for the brush according to the patent of Russian Federation №2033128, which is intended for the rehabilitation of patients with various injuries and diseases of the brush. On the basis of the apparatus, the side posts and the central rack are installed. One of the side racks has the ability to move along the groove of the base. Thrust handles with protruding threaded ends are attached to the side posts for fixing the lock nut of the plate, in the slot of which a massage roller is installed. On the central rack mounted transmission gearbox, made in the form of a gear pair with output shafts. L-shaped handles are rigidly mounted on the ends of the shafts. The loading element is a rod, at one end of which a thread is cut to move loads, and on the other there is a groove for installation on one of the shafts with a locking screw. A set of goods in the form of metal washers allows you to dispense the load in the range from 0.1 kg to 2.5 kg.

The disadvantages of this device - the complexity of its manufacture, the bulkiness and the need for the premises and the second person to work on it, as well as significant costs. In the apparatus, there are no signs of expanding the possibilities of using it in different conditions, with an increase in the efficiency of developing stiff joints and an increase in the strength of the fingers of the hand by adjusting the force load on the flexor and extensor muscles selectively and metered for each finger.

Our device is known for the rehabilitation of the brush according to the patent of Russian Federation №99115555, which contains a dynamometer, an element for training the coordination of brush movements with a contact pen, a registrar of finger movements and a task card. Interconnected map change signal generator, card changer, light and sound alarm unit and unit of the number of movements, rhythm signal generator, rhythm frequency master and blocks for recording and controlling the frequency of rhythm signals. In this case, the apparatus contains a force dispenser with a lever for resisting the movement of fingers with a regulator of a dosed decrease in the degree of resistance of the lever, provided by a unit including an electromagnet, a transistor efforts regulator and resistors. In addition, it has an element to improve the accuracy of coordination of finely differentiated movements of the fingers with a pointer connected to the unit for registering the number of closures at a specified time.

The disadvantages of this device - the complexity of its design and high cost, limited use only in a medical institution with the presence of electricity and a specialist servicing the device, as well as increased costs. It shows no signs of expanding the possibilities of rehabilitation, with an increase in the efficiency of developing stiff joints and an increase in the strength of the muscles of the fingers of the hand by regulating the force load on the muscles of the flexors and extensors selectively and dosed for each finger.

Known glove to train the muscles of the brush according to the patent of Russian Federation №2307639. It contains the back and the palmar walls, is provided with cavities fixed on the back side of each of the fingers, with the weight elements placed inside.

The disadvantage of this glove is the absence in it of signs of expanding the possibilities of rehabilitation of patients with impaired motor functions of the fingers of the hand with an increase in the efficiency of developing stiff joints and an increase in the strength of the muscles of the fingers by adjusting the force load on the flexor and extensor muscles for each finger.

The closest in technical essence to the proposed device is the glove on the patent of Russian Federation №2307639, which we take as a prototype, and its disadvantages are described above.

The technical result consists in expanding the possibilities of rehabilitation of patients with impaired motor functions of the fingers of the hand, increasing the effectiveness of developing stiff joints and increasing the power of the fingers' muscles by adjusting the force load on the flexor and extensor muscles selectively and metered for each finger.

The technical result is achieved in that the device for the rehabilitation of the fingers of the hand includes a glove with a cuff, longitudinal pockets on the back surface of the fingers of the glove, elements of burdening and attaching them. At the end of each finger of the glove there is a rigid fingertip with a retainer on its top. The latch contains a leg with two hooks of the same length and opposite directivity in the sagittal plane with curved ends in the direction of the fingertip. The thickness of the hook is equal to the diameter of the clamp leg. The gap between the bottom surface of the hooks and the surface of the fingertip is greater than the thickness of the burden element. In this case, the burdening element is made elastically elastic with the possibility of attaching one end to the fixative, and the other end, with the choice of the location, to the cuff. The cuff contains fasteners made of velcro fabric, on the back surface of which there is a looped fastener element made of velcro fabric, and on the inner surface of the cuff at one of its ends there is a hook fastener element and a handle.

In the preferred embodiment of the device, each element of the finger extension is an elastically tensile cord, in the upper part of which there is a slot with an extension in the center, and a hook element of a velcro fabric is attached to the lower part of the inner surface of the cord. The length of the slot is greater than the total length of one hook and the thickness of the clamp leg, but less than the total length of two hooks.

In another preferred embodiment of the device, a different burdening element for bending the fingers is made in the form of a thin leaf spring. The upper end of the spring has a curved part with a longitudinal notch and with an expanded hole in its center with the possibility of inserting retainer hooks into the notch. The length of the cut in the leaf spring is less than the total length of the two hooks of the retainer. The expanded hole is larger than the diameter of the clamp foot. To the other end of the leaf spring is attached elastically stretchable extension with a fastener from the hook element velcro fabric at its end.

In a further preferred embodiment of the device, on the outer surface of the cuff, vertically arranged labels controlling the level of attachment of the fastener of the burden member are made.

Brief description of graphic images. FIG. 1 shows the device in the assembled state for training the extensor muscles of the fingers of the right hand, view from the palmar surface. FIG. 2 - the same, view of the right hand from the back surface. FIG. 3 - detail of the device - fingertip with the holder of the end of the element of the burden, front view. FIG. 4 - the same detail, top view. FIG. 5 - device detail - glove cuff with a looped fastener element made of velcro fabric, view from the outer surface. FIG. 6 - the same cuff, view from the inner surface. FIG. 7-part of the device - an element of burdening - elastically tensile cord, view from the outer surface. FIG. 8 - the same cord, view from the inner surface. FIG. 9 - the same cord, side view. FIG. 10 - a replaceable element of burdening - a thin lamellar spring, front view. FIG. 11 - the same thin leaf spring, side view. FIG. 12 - the same thin lamellar spring, top view. FIG. 13 - the initial position of the device prepared for the development of the muscle strength of the flexors of the fingers of the right hand, the element of burden with tension attached to the cuff, view from the back surface of the glove. FIG. 14 - the same device in operation after active flexion of fingers. FIG. 15 - The initial position of the device with a burdening element attached to the cuff for training the muscle strength of the extensors of the fingers of the left hand, view from the palm of the glove. FIG. 16-device in the position of actively straightened fingers with a load on the extensor muscles of the fingers of the left hand, side view from the side of the little finger.

FIG. 1-16 are designated: 1 - palm of the right glove; 2 - hard fingertip attached to the fifth finger of the glove; 3 - the holder of the end of the element burdening on top of the fingertip of the fifth finger of the glove; 4 - glove cuff with velcro loop fastener; 5 - vertically located metric marks on the cuff of the glove; 6 - the lower end of the burdening element (elastically tensile strand) of the extensor of the fifth finger; 7 - hard fingertip of the first finger; 8 - holder of the burdening element on top of the fingertip of the first finger of the glove; 9 - the element of burdening the first finger; 10 - the lower end of the element of the burden of the first finger; 11 - through pocket on the first finger of the glove; 12 - the upper hole of the pocket of the first finger of the glove; 13 - the lower hole of the pocket of the first finger of the glove; 14 - through pocket on the fifth finger of the glove; 15 - the upper hole of the pocket of the fifth finger of the glove; 16 - bottom hole pocket fifth

finger gloves; 17 - the lower end of the element of the burden of the fifth finger gloves; 18 - leg of the holder element of the burden; 19 - left hook of the holder; 20 - the right hook of the holder of the holder element of the burden; 19 - left hook of the holder; 20 - right hook holder; 21 is a looped fastener element made of Velcro fabric on the outer surface of the cuff; 22 - the upper edge of the cuff; 23 - concealed edge of the cuff; 24 - covering the edge of the cuff; 25 - inner smooth surface of the cuff; 26 is a velcro hook fastener element on the covering part of the end 24 of the cuff; 27 - the handle at the covering part of the cuff; 28 - round hole (expansion) in the center of the longitudinal section at the upper end of the elastically tensile strand; 29 - the end part of the longitudinal section in the heavy; 30 - the initial part of the longitudinal section in the heavy; 31 - hook element fastener made of velcro fabric at the bottom of the elastically tensile strand; 32 - the lower part of the cord under fastener 31; 33 - removable element of the burden - a plate spring (its flat part, replacing the tape elastically tensile strand), view from the outer surface; 34 is the smoothed lower edge of the leaf spring 33; 35 - hole in the lower end of the leaf spring; 36 — Elastic-tensile plate spring extension; 37 - curved part of the leaf spring 33; 38 — a circular extension in the center of a cut-out in the folded portion of a leaf spring; 39 - the end portion of the notch in the folded portion 37 of the leaf spring; 40 - the beginning of the cutout in the bent part of the leaf spring; 41 is a hook element fastener extension 36 of the leaf spring 33; 42 - hook element fastener 31 of the extension 36 of the leaf spring of the first finger fastened to the loop element of the cuff 4; 43 —the hook element of the fastener 31 of the fifth spring plate spring fastened to the loop element of the cuff 4; 44 —the hook element of the fastener 31 of the strand 9 of the first finger fastened to the loop element of the cuff 4; 45 - hook element fastener 31 strand 9 of the fifth finger fastened to the loop element of the cuff 4.

A specific example of the use of the claimed device in a patient with stiffness of the joints of the fingers of the hand and weakness of the extensor muscle strength. To develop the joints of the fingers and to train the strengthening of the extensor muscles of the fingers, a glove of the claimed device is worn on the patient's hand. The glove, to improve air exchange in it, is made of air-permeable material. In the fingers of the gloves over their joints, in order to alleviate the pressure on them of the elements burdening the fingers while bending, thick lining is made. Fingers and hand flex as much as possible. Elastic elastic band made of rubber or rubberized fabric of each finger is attached to the retainer. To do this, through the hole 28 and the slit 30 of the resilient elastic strand, the hook 19 and the leg 18 of the holder 3 are pulled. After pulling the other end of the strand after moving the leg 18 into the slit 30, the second hook 20 is held through the other part of the slit 29. fingertip retainer 2. In a similar way, elastic elastic strands of other fingers are attached to the retainers on the fingertip of the glove. Then the fingers and the brush are flexed as much as possible and the elastic-elastic cord with a tension determined for each finger and with a focus on the marks 5 on the cuff, is alternately fastened with a hook element of the fastener 31 of the cord to the loop element 21 of the cuff 4. The device is ready for use. By repeatedly extending the fingers with increased load, the patient trains the extensor muscles, strengthening their strength. When the extensor muscles are relaxed, returning the fingers to the initial flexion position spontaneously exercises the tension, improving the development of the joint.

If necessary, strengthening the muscles of the flexor of the fingers detach the lower ends of the elastic elastic strands of the fingers. When the hands and fingers are unbent, the lower ends of the straps of each finger are guided through the upper opening of the corresponding pocket of the finger of the glove and out through the lower opening. With a certain tension for each finger and with a focus on the marks 5 on the cuff, hook elements of fasteners 31 are alternately fastened to the loop element 21 on the back surface of the cuff 4. The patient flexes the fingers with the burden, increasing their strength. After relaxation of the flexor muscles, the return of the fingers to the extension position spontaneously exercises a weight, while repeated movement in the joint improves its development.

The second concrete example of the execution of the device for the development of joints and training the muscles of the flexors of the fingers of the hand when they are weak with the use of another element of the burden with a greater load - plate spring. To do this, through the hole 38 and the beginning of the notch 40 of the folded part 37 of the leaf spring, the hook 19 and the leg 18 of the clamp 3 are moved. Then the leg 18 is moved to the end of the notch 39, and the second hook 20 is held in the notch. The folded part 37 of the leaf spring is turned transversely to the hooks 19 and 20. The leaf spring is attached to the finger strap retainer. The free end of the leaf spring with the elastically tensile extension 36 is inserted through the upper opening into the pocket of the finger of the glove and brought out. The glove of the device is worn on an open hand and fingers. The loop element of the extension 36 with a certain tension and focusing on the marks 5, is fastened to the cuff. The device is ready for work and the patient begins to flex the fingers of the hand, developing the joints, loading and training the muscles of the flexors of the fingers. After the cessation of the flexing of the fingers and the relaxation of the flexor muscles, the stretched elastic-stretch extensions 36 tighten the rounded end 34 of the plate, which spontaneously extends the finger. Repetitive movements in the joint with active flexion and passive extension of the fingers with a spring plate, develop joints with their stiffness.

The significance of the differences of the claimed device from the chosen prototype is as follows. The presence of a hard fingertip gloves at the end of each finger with a latch on its top ensures reliable and accurate attachment of the weight element to the end of the finger. Execution on the clamp of two hooks of the same length with curved ends in the direction to the fingertip, ensures the reliability of holding the end of the burden element at its location both in the palm of your hand and on the back of the brush. The implementation of the distance between the bottom surface of the hooks and the surface of the fingertip is greater than the thickness of the burdening element, which allows the hooks of the retainer to be carried freely and quickly into the slot of the burdening element. Making in the upper part of the strand a slot with an extension in the center when its length is greater than the total length of one hook and the thickness of the clamp leg ensures quick successive holding of the hooks of the clamp into the slot of the strand and reliable attachment of the strand to the clamp rod. Making the length of the slot is less than the total length of the two hooks and placing curved hooks when moving the fingers back and forth under tensioning the cord ensures that it is held by the leg and the supporting hook, which increases the reliability of attaching the cord to the retainer on the finger. The presence on the lower part of the inner surface of the cord of the hook element of the fastener ensures reliable attachment of the cord to the cuff in the proper place. The implementation of the tension elastically tensile for each finger allows you to change its tension and adjust the degree of burdening each finger individually. After attaching one end of the cord to the retainer, it expands the possibility of choosing the place and level of attachment of its other end on the cuff. The use of fasteners made of velcro fabric fasteners in the device simplifies, accelerates and increases the reliability of the connection of the device elements with different sizes of the hand and fingers. In the device it is possible to replace one element of a burden with another with a different design.

The implementation of the element of the burden of another design in the form of a plate spring allows you to increase the load on the flexor muscles and without the patient's efforts (for example, paralysis) and the fingers return to the extension position of the plate spring when it is straightened. Placing only a portion of the leaf spring in the pocket of the finger of the glove, leaving its ends free, makes it easy to attach it to the retainer and hold the other end into the pocket of the finger. The presence of the curved part of the leaf spring with a longitudinal cut, the width of which is larger than the diameter of the clamp leg, and with a cutout length in the leaf spring less than the total length of the two hooks of the lock, provides free insertion of the hooks with the leg into the cutout. After turning the bent part of the leaf spring with the location of the elongated notch transversely to the hooks, it ensures reliability of attaching it to the stem with an emphasis in a round hole, and retaining the retainer hooks, which prevents the spontaneous release of the plate from the retainer. The presence of a spring extension at the other end of the plate with a fastener at its end provides, after the completion of the flexing of the fingers, pulling up and returning the lower end of the plate to its original position. Execution in the straight end of the plate hole creates the possibility of attaching to it a resiliently tensile extension. When the plate is bent on the outer surface of the finger, its lower end moves in the pocket, and the tensile extension attached end to the cuff extends the entire structure of the burden element. Vertically located metric divisions on the outer surface of the cuff allow you to control the level of attachment of the lower end of the burden element and dose the degree of burdening of any one or several fingers. The presence of the handle on the cuff simplifies and accelerates the proper tension of the cuff and the fastening of its ends to each other, which provides a reliable support on the wrist of the cuff and on it elements of burdening.

Thus, the proposed device expands the possibilities of rehabilitation of patients with impaired motor functions of the fingers and increases the efficiency of the development of stiff joints and increases the strength of the finger muscles by adjusting the repeated force load on the muscles, both flexors and extensors, selectively and metered for each finger. The patient can use the invented portable device independently in almost any conditions. The use of the developed device for the rehabilitation of fingers is applicable in traumatology and orthopedics, neurology and neurosurgery, physical therapy, the patient himself at home, as well as in sports.

Claims (4)

1. Device for rehabilitation of fingers, including a glove with a cuff, longitudinal pockets on the back surface of the fingers of the glove, elements of burdening and attaching them, characterized in that at the end of each finger of the glove there is a rigid fingertip with a retainer on its top, and the retainer contains in one leg with two hooks of the same length and with curved ends towards the fingertip, the hook thickness is equal to the diameter of the clamp leg, and the distance between the bottom surface of the hooks and the surface of the hook ik more thickness of the element of the burden, while the element of the burden is made of elastic elastic with the possibility of attaching one end to the latch, and the other end, with the possibility of choosing the place of attachment, to the cuff, which contains on the back surface a looped element of the fastener made of velcro, and on the inside the surface at one end of its hook element fastener and handle. 2. The device according to p. 1, characterized in that each element of the extension of the fingers is represented by an elastically tensile cord, in the upper part of which a slot is made with an extension in the center, and a hook fastener element made of velcro fabric is attached to the lower part of the inner surface of the cord, and the slits are smaller than the total length of the two hooks, but larger than the total length of one hook and the thickness of the clamp leg. 3. The device according to claim 1, characterized in that the burden element of another design is made in the form of a leaf spring, its upper end has a bent part with a longitudinal cut, the length of which is less than the total length of the two hooks of the fixer, and the width is greater than the diameter of the fixator leg, To the other end of the leaf spring is attached an elastically stretchable extension with a fastener from a hook element of a Velcro fabric at its end. 4. The device according to PP. 1-3, characterized in that on the outer surface of the cuff made vertically spaced marks the level of attachment of the element of the burden.

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