RU2698987C1 - Device for generation of motor skills walking in children with infantile cerebral paralysis (dtsp) and with diseases of locomotor system - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine. Device for generation of motor skills of walking in children with infantile cerebral paralysis and with diseases of locomotor system includes means for fixation of child to adult person and possibility of simultaneous locomotion of adult and child. Said agents contain shields with handles that can be fixed on the front surface of the thigh of each adult's leg and an adult's lumbar belt configured to be connected to the shields. Handles are attached perpendicularly to free ends of handles by means of detachable connection. Ends of handles are made with possibility of detachable protective chain installation on them.

EFFECT: invention provides higher effectiveness, safety and comfort of training, as well as reduced labor intensity and complexity of physiotherapy of children with ICP and locomotor disorders with lighter forms of disease.

6 cl, 5 dwg

Description

FIELD OF TECHNOLOGY

The invention relates to the field of medicine as physiotherapy, and in particular to devices that help patients or people with limited mobility to move, and can be used, for example, to teach walking and / or rehabilitation of children with a diagnosis of cerebral palsy (cerebral palsy) and diseases musculoskeletal system.

BACKGROUND

A device is known [RU2131232C1, publ. 06/10/1999] for physiotherapy of cerebral palsy by forming the initial passive motor skills of walking in a child, containing a jumpsuit with left and right foot, in which the child is placed in the front "jumpsuit", hung in front on the shoulders of the physiotherapist. Physiotherapist when walking with his hands can carry out the child synchronous forced movements of the arms or legs, characteristic of walking.

The disadvantages of the device include the fact that it is problematic to use it for training children with disorders of the musculoskeletal system with milder forms of the disease, as it is intended for children with severe cerebral palsy. The possibility of implementing only forced movements with the child’s hands and the stiffness of movement due to the large number of parts of this design are also associated with this drawback.

A device for physiotherapy of cerebral palsy by the formation of motor skills of walking in a child [RU2272609 C2, publ. 03/27/2006], which contains a jumpsuit with a left and right foot, as well as additionally containing an adult jumpsuit made with feet having upper parts for the feet of the child, the adult jumpsuit on the upper part of each foot being equipped with a device for fixing the same, left and right , feet of children’s overalls, a latch is installed in the area of each leg for fastening the same leg of the child’s overalls, and chest straps are placed in the shoulder girdle to support the trunk in a straightened state part of the children's overalls, while the sleeves of the children's overalls are equipped with external rods in the wrist area, with the help of which the physiotherapist in adult overalls manually controls the pendulum-like movement of the child’s hands in the children's overalls.

The disadvantages of this device include the inflatable cavity of the sleeves, which are equipped with devices for manual control of the child’s hands, which, as in the previous analogue, is due to the severe form of cerebral palsy. Inflatable cavities inhibit the child’s shoulder and forearm movements, which can lead to atrophy of the muscle groups of the upper limbs. Using the device can lead to increased influence of the cervical tonic symmetric reflex during prolonged training.

The nearest technical solution is a device [US6325023 (B1) - 2001-12-04], allowing an adult to help learn to stand and walk the child, while keeping both hands free for other tasks. The device consists of two belts for fastening on the bodies of an adult and a child, and a seat belt. Common footwear is provided for the legs. The adult's belt and the child's belt are connected to each other to allow the child to have significant freedom of movement, while the adult supports and helps the child walk. A seat belt attaches the child to the adult, so that the child has substantial freedom of movement.

The disadvantages of this technical solution include the following:

- the suit does not provide optimal biomechanics of the child’s movement when walking (hands are in limbo);

 - the duration of the training is possible only a short period of time, which is associated with the lack of additional support points in the child;

- during training, all the main load goes to the lower back of an adult.

Thus, there is a need to create a device for the development of active motor skills of walking and motor skills of the coordinated movement of arms and legs in patients with cerebral palsy and diseases of the musculoskeletal apparatus with milder forms of the disease.

SUMMARY OF THE INVENTION

The basis of the invention is the task of creating a rehabilitation training device with enhanced functionality to restore lost motor activity of the upper and lower extremities for the treatment of children with cerebral palsy and disorders of the musculoskeletal system.

The technical result is to increase the duration, effectiveness, safety and comfort of training, as well as reducing the complexity and complexity of physiotherapy in children with cerebral palsy and musculoskeletal disorders with milder forms of the disease.

The task is achieved in that, like the known device for the formation of motor walking skills in children with cerebral palsy and diseases of the musculoskeletal system, it contains means for fixing the child to an adult (physiotherapist) and for simultaneous locomotion of an adult and a child.

New is that the mentioned means of fixation include flaps 1 with handles 2, designed to be installed on the front surface of the thigh of each leg of an adult and a fixation system 3 for securing flaps on the corresponding thigh of an adult, as well as the lumbar belt of an adult 4, including fixation elements with flaps one.

In addition, the flaps 1 are made in the form of a curved elastic plate of rectangular or square shape at the same time with the handles 2, while the inner surface of the flaps is made with the possibility of pressing the adult to the front surface of the thigh, and the handles are located in the center of the flap and perpendicular to its outer surface.

In addition, the inner surface of the flaps is smooth and partially repeats the shape of the front surface of the adult's thigh, while the edges and corners of the plate are rounded to prevent abrasions of the adult's skin during operation.

In addition, at least two slots for passing the straps of the fixation system belts 3 around the corresponding thigh of an adult are made along the edges of two opposite lateral sides of the flaps, and at least one slot for passing the tapes of the straps of the fixation elements on the upper side of each flap (belts) for attaching the shields to the lumbar belt 4.

In addition, the handles are perpendicular to the free ends of the shield handles by means of a movable detachable connection so that the child can hold on to them during operation and for possible replacement - for a convenient “grip” of the child.

It is advisable that the device includes paired sandals: adults and children for additional synchronization of the steps of an adult and a child.

Preferably, a protective chain 6 is attached between the handles 5 to prevent the child from falling.

Additionally, the device may contain paired sandals 7 to synchronize the steps of an adult and a child.

As well as the latch 8 on the shin of an adult for attaching the same shin of a child.

Of great importance when walking is the coordinated movement of the upper and lower extremities, the so-called "cross coordination", in which the forward movement of the right leg is combined with the forward movement of the left arm, and vice versa.

The external auxiliary motor device proposed in the present invention is intended to generate stepwise automatism in a vertical position, restoring a full-fledged step, walking reflex in children with central nervous system problems and multiple disorders from an early age.

The technique of moving “one step forward” is the exoskeleton principle. The movement begins with the movement of the adult’s leg, due to which the child’s arms are moved forward and upward and moves one step further, then the other leg of the adult is moved and the child takes the next step.

The proposed device allows you to conduct lengthy workouts that do not lead to fatigue of the parents and the child himself, due to the fact that the child during training has additional support on the handles with handles. Handles will protect the child from falling to the left or right side. For parents, this device allows you to be in a natural position (vertical), which eases the load on the lower back.

BRIEF DESCRIPTION OF THE DRAWINGS

Figure 1 shows an example of the use of the proposed device.

In FIG. 2a is a drawing of shields with handles; FIG. 2b shows a constructive solution for connecting shields with handles.

In FIG. Figure 3 shows the system for fixing the flaps on the lumbar belt and on the legs of an adult.

Figure 4 shows a photograph of paired sandals to synchronize the steps of an adult and a child.

DETAILED DESCRIPTION OF THE INVENTION

The device contains shields 1 (Fig. 1), intended for fastening on the front surface of the adult thigh (patella in the form of shields with handles), made integral with the handles 2 and the fixing system 3 for fixing them on the adult's thigh, an adult lumbar belt 4, including fixation means with shields 3.

The design of the shields is shown in FIG. 2. Shields 1 are made by casting (3D modeling) of polymeric materials with high strength and elasticity. The handles 2, located in the center of the flap and perpendicular to its surface, are cast at the same time with the flaps 1. The flaps 1 are cast in the form of a curved plate of rectangular or square shape, partially repeating the shape of the front surface of the adult's thigh, while along the edges of the three sides of the plates: two side and top slots for passing the belts of the fixing system 3. The shields are preferably made in a thickness of 8 to 10 mm. When making a rectangular plate, it is preferable that the width of the flap is from 122 to 125 mm and the height of the flap is from 140 to 145 mm. The length of the handle of the shield, preferably from 305 to 310 mm, the width of the handle from 20 to 22 mm, the height of the handle from 26 to 30 mm.

The fixation system 3 (Fig. 3) for securing the said shields 1 on the hips of an adult is a system consisting of two belts (tapes) for wrapping around each leg (thigh) and two belts (tapes) for connecting the shields to the belt. Used polypropylene tapes 40 mm wide, fasteks 40 mm and, accordingly, velcro fastenings 40 mm. Means for fixing the lumbar belt 4 with the shields also consist of two similar tapes of fastex belts, mounted on the lumbar belt. The lumbar belt is made by sewing from synthetic fabric. Preferably, the belt width is from 100 to 120 mm, the belt length is from 800 to 830 mm .

Handles 5 are attached (screwed) to the inner sides of the free edges of the handles 2 by means of a threaded connection. The size of the handles is selected individually for the "grip" of the child.

Between the handles to prevent the child from falling, a protective metal chain 6 can be placed that will connect the handles 5.

For additional synchronization of the steps of an adult and a child, the device has paired sandals 7 made of micropores using the sewing method (shown in Fig. 4).

Additional means of fixing the child to the adult for attaching the same calf to the calf of the adult are made in the form of two knitted and elastic ribbons with velcro mounts.

The device operates as follows.

The general practitioner (adult) puts on a lumbar belt 4 and connects the belt to the shields 1, which in turn are fastened by a system of belts 3 on the thigh of each adult leg, then, in case of using additional devices for locomotion, they fix their feet and their feet in paired sandals 7, fixes his lower legs with the help of a latch 8 to the same lower legs of the child.

The child holds on to the handles 5. The trainer-therapist gives a warning command to go forward, and begins to go forward, taking precautionary measures. Next, test steps begin with the leg of an adult (trainer-therapist), which the child gets used to. The movements are carried out according to the law of “cross coordination,” in which the forward movement of the right leg of the trainer-therapist is combined with the forward movement of the left arm of the child, and vice versa. The movement of the child, in which the forward movement of the right hand is combined with the forward movement of the left leg. The load should always be on the lumbar belt of the trainer-therapist, to whom the shields 1 with handles 5 for the child are fixed. The child should not hang on walkers, but try to take steps on their own, try to stand, while feeling safe and secure.

In a group of children with cerebral palsy, they studied the peculiarities of the biomechanical characteristics of motor actions when walking during training using the proposed device.

The study involved 30 children aged 3 to 5 years, including 18 boys and 12 girls. The main group consisted of 15 children, including 10 boys and 5 girls moving with the use of the proposed device - an experimental sample created to test the invention. 15 children had the ability to independent locomotion. The control group consisted of 10 children of the same age.

Example 1. Analysis of the orientation of the links of the body, their location in space and attitude to the support.

Children performed the exercise "walking on the simulator - an electric treadmill" - on a horizontal surface. To analyze the orientation of the parts of the body, their location in space and their relation to the support, the Motion Tracking method was used. Spatial movements of body parts were recorded using a Vision Research Phantom video camera. The results obtained allow us to highlight the main differences in the construction of a dynamic walking stereotype in children with disabilities using the auxiliary motor system of the proposed device. With its use, changes in the structure of movement of the shoulder girdle and upper limbs can be considered as compensatory: the vertical movements of the shoulder adjust to the movements of the general center of gravity. Hands move back and forth with greater amplitude, to reduce the moment of inertia they are bent at the elbow joints, which increases the load on the muscles of the upper limb.

Example 2. Analysis of the bioelectric activity of the deltoid muscles and lower extremities.

Assessment of the bioelectric activity of the muscles was carried out using a computer electroneuromyogrof. The work of the muscles of the upper and lower extremities when walking is mainly dynamic in nature, the greatest load falls on powerful muscle groups. In children with cerebral palsy and disorders of the musculoskeletal system moving using the proposed auxiliary motor device, the alternation of the phases of tension and muscle relaxation for a long time does not cause fatigue.

The proposed device allows, in comparison with the closest analogue, to expand the therapeutic functional capabilities of the device, increase the efficiency, safety and comfort, as well as reduce the complexity and complexity of physiotherapy for cerebral palsy and children with disorders of the musculoskeletal system. The child patient feels not only more secure, but also more comfortable and interested, the effectiveness of education and / or rehabilitation increases. In contrast to the known devices, the proposed method allows to develop motor skills of coordinated movements of the arms and legs, while ensuring synchronized movement of opposing arms and legs. Training can be conducted for a long time or continuously, or cyclically, with stops for a break. The ability to adjust the frequency, length of steps and pace of walking.

Claims (6)

1. A device for the formation of motor walking skills in children with cerebral palsy and with diseases of the musculoskeletal system, including means for fixing the child to an adult and the possibility of simultaneous locomotion of an adult and a child, characterized in that the said means contain shields with handles, made with the possibility of their fastening on the front surface of the thigh of each leg of an adult, and the lumbar belt of an adult, made with the possibility of its connection with the shield E, and perpendicular to the free ends of the arms by means of a releasable connection fixed against each other the handle, the ends of the handles are adapted to installation of the removable protective chain. 2. The device according to claim 1, characterized in that the shields are made in the form of a curved elastic plate of rectangular or square shape along with the handles, while the inner surface of the shields is made with the possibility of pressing the adult to the front surface of the thigh, and the handles are located in the center of the shield and perpendicular its outer surface. 3. The device according to claim 2, characterized in that the inner surface of the shields is smooth and partially repeats the shape of the front surface of the adult's thigh, while the edges and corners of the plate are rounded to prevent abrasions of the adult's skin during operation. 4. The device according to paragraphs. 1 or 2 or 3, characterized in that, at the edges of two opposite lateral sides of the shields are made at least two slots for passing through them tape belts for fastening the shields on the corresponding hip of an adult, and at least one slot on the upper side of each shield for passing belt tapes for attaching the shields to the lumbar belt, which also contains similar fastening elements for connecting to the shields. 5. The device according to claim 1, characterized in that the device contains paired sandals: adults and children for additional synchronization of the step of an adult and a child. 6. The device according to p. 1, characterized in that the device contains additional fixation elements for fixing the lower leg of the child to the same lower leg of an adult.

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