EP0199102A2 - Apparatus for the prophylaxis and therapy of spinal column disorders - Google Patents

Abstract

Based on the finding that, by a defined arrangement of weight elements in the ankle region, a downward displacement of the centre of gravity takes place, resulting in an enforced activation of groups of muscles which are rarely activated in routine sequences of movements and are therefore neglected, a device is proposed which is suitable for prophylaxis and therapy in the field of spinal column disorders and which allows targeted use due to its simple construction and easy and safe handling. <IMAGE>

Description

The present invention relates to the use of a device for the prophylaxis and therapy of spinal disorders. It also relates to an advantageous device for this prophylaxis and therapy, and a method for using the device.

It is known that modern living conditions due to lack of movement and one-sided loads, in addition to the general weakening of the muscular system, lead to a muscular imbalance with muscle parts or muscle groups that are overloaded at certain parts of the body and reduced or weakened elsewhere due to lack of stress. In the predominantly sedentary occupation of broad sections of the population, a weakening of the leg and abdominal muscles and a hard tension of muscle groups in the spine area, mostly above the shoulder blades and in the lumbar area, can often be found. This imbalance is particularly reflected in the area of the spine in the form of clearly visible incorrect posture. Associated incorrect loads (e.g. of intervertebral disc tissue) also partly persist in the consequently disturbed movement sequences and lead to permanent damage.

So far, such damage has mainly been treated by a special, isometrically oriented physiotherapy exercise treatment. Devices for treating such damage are already known, which relieve the pressure on the intervertebral discs and stretch the spine. With these devices (see, for example, DE-OS 30 07 835 and 33 23 138), the patient is hung up with the feet for treatment. This requires a certain amount of equipment and cannot be carried out everywhere, and is not practicable for certain patients (for example the elderly). A major disadvantage, however, is that the strengthening of the usually inadequate spinal musculature as a key point in the prophylaxis of spinal disorders is completely neglected. Even self-treatment with such devices is not completely safe without a competent supervisor, since situations can arise in which the person hanging in the device is no longer able to put the device down without outside help.

The invention has for its object to provide a device suitable for prophylaxis and therapy in the field of spinal disorders, which allows targeted use with simple apparatus construction and simple and safe handling.

According to the invention, this object is achieved for the first time by using a device which surrounds the ankle region of at least one foot with a holder which contains weight elements.

The invention is based on the knowledge that a defined arrangement of weight elements in the ankle area shifts the center of gravity downwards, with the result of a forced activation of muscle groups that are hardly addressed in the usual everyday movement sequence and therefore atrophied as an intended reaction to stabilize the changed unstable balance. During the initially slow and thus more conscious walking, which is inevitably completely upright due to the weight load, effective strengthening of all straightening muscle groups in particular is achieved by activating entire chains of movements with restoration of the frequently disturbed unity of the powerful flow of movement.

These positive effects are particularly important for spinal ailments, as they are caused by poor posture and poor posture and, in the long run, harmful misuse as the cause.

A particularly effective use is possible by using a device in which the overall focus of the weight elements lies outside the plane of movement described by the lower leg axis during the walking process. With regard to the possibilities that can be achieved with such a configuration, reference is made to the later explanations.

Particularly advantageous results are achieved if the overall center of gravity of the weight elements on the outside of the foot, in particular on the side of the ankle joint facing the toes, i.e. lies in front and outside.

For certain treatment cases, it is advisable to make the position of the overall center of gravity the same on both feet in mirror image.

For special treatment cases, it is advisable to choose the position of the overall center of gravity on both feet according to the desired effect.

According to the invention, the total weight of the weight elements must not be too small. Advantageous areas are specified in claims 7 to 10.

The weight distribution must be chosen according to the respective treatment purpose. In addition to a symmetrical weight distribution, an asymmetrical weight distribution can also be advantageous. Particularly advantageous results with regard to the prophylaxis and therapy of spinal disorders are achieved, however, if 20 to 100% more weight is arranged on the one side with respect to the axis of movement than on the other side. This "eccentric" or "eccentric" weight distribution results in a multitude of surprising possibilities for the prophylaxis and therapy of spinal disorders, which will be discussed in more detail later.

Particularly favorable results are achieved if 40 to 80% more weight acts on the one side with respect to the plane of movement than on the other side and the overall center of gravity with such a weight distribution on the outside of the foot and on the side of the ankle joint facing the toes, i.e. "in front and outside".

The device according to the invention for the prophylaxis and therapy of spinal disorders basically consists only of a holder which wraps around the foot in the ankle area and which is set up to accommodate weight elements. In order to achieve the "eccentricity" already mentioned, according to the invention the overall center of gravity of the weight elements lies outside the plane of movement described by the lower leg axis during the walking process. Advantageous further developments of the device in relation to the position of the overall center of gravity result from patent claims 18 to 21.

Appropriate. Areas with regard to the total weight of the weight elements per foot contain claims 22 to 24.

With regard to the weight distribution, it is advantageous to arrange 20 to 100% more weight on one side with respect to the plane of movement than on the other side. An advantageous range is between 40 and 80%.

According to an advantageous development of the invention, the weight elements are combined in a unit which is arranged at the end of a lever arm connected to the holder. A suitable choice of weight and lever arm can be used to achieve special therapeutic effects, which will be discussed later in more detail. In order to enable optimum adjustment in a simple manner, it is advantageous to design the lever arm to be adjustable in length. In order to be able to move the weight out of the axis of the lever arm if necessary, it is expedient if the lever arm is equipped with an adjustable joint.

In a preferred embodiment, the holder is designed as an ankle cuff or in the manner of a galosh. If necessary, however, the holder can also be integrated into the upper of a shoe.

In order to improve walking behavior, it is advisable to enlarge the sole surface of the shoe and / or to make it strongly profiled.

In a preferred embodiment of the invention, the holder consists of two superimposed webs of fabric or foils, in which tubular receiving cavities for the weight elements are formed next to one another by transverse seams running parallel to one another. A holder designed in this way is easy to put on and automatically adapts to any foot shape and foot thickness, since the fabric or film webs only have to be "wrapped" around the foot in the ankle area. The tubular receiving cavities, which are preferably filled with granular weight elements such as sand, steel, lead balls or the like, run essentially parallel to the lower leg axis. Blood and lymph congestion are thus avoided by the interposed low-pressure zones. In this exemplary embodiment, the holder can be fixed by means of a belt or band fastening. So-called "Velcro fasteners" are particularly expedient, however, which enable a particularly variable but nevertheless permanent and easily detachable fixation.

In order to avoid uncomfortable pressure points in the area of the lower edge of the holder, it is expedient for the fabric or film web to have incisions or wedge-shaped recesses in the area between the tubular receiving cavities.

In order to achieve the "eccentricity" of the weight attack already discussed with such a device, larger weights can be arranged in the receiving cavities on one side of the movement plane and smaller weights on the other side of the movement plane. For example, this can be solved constructively by that larger-volume receiving cavities are arranged on one side than on the other side. This results in the desired shift in the overall focus. A particularly simple shift in the overall center of gravity can, however, be produced in such a device in a simple manner by an “overlap” during the application process. With such an overlap, the receiving cavities are arranged in at least two layers on one side of the movement plane and the desired shift in the overall center of gravity is achieved in this way.

By wrapping the foot several times, more layers may be formed on one side of the movement plane than on the other side of the movement plane.

As will be described in the following, effective prophylaxis and therapy is only possible with slow movements. It is therefore advisable to work at a walking speed in the range of 2 to 6 km / h.

The duration of the exposure must be tailored to the particular purpose of treatment and can be several hours if necessary. Advantageous results can be achieved if you work with one bracket per foot for a period of 5 to 30 minutes.

Devices with a holder which wraps around the foot in the ankle area and which are equipped to accommodate weight elements have long been state of the art in various embodiments (see, for example, US Pat. Nos. 3,306,610, 3,427,020, 4,384,714, 3,278,184) and 3,334,898). However, these devices are used exclusively for training the muscles in the foot or. Leg area in a fast movement rhythm, such as when running, and therefore primarily serve to increase performance for athletes.

An absolutely centric weight distribution is always provided for devices of this type. This means that the overall center of gravity of the weight elements always lies in the plane of movement described by the lower leg axis during the walking process. In some cases (see, for example, US Pat. No. 3,306,610), the overall center of gravity in this plane is even (in the walking direction) behind the lower leg axis, so that there is a predominantly tensile effect on the heel area, which primarily occurs in the upper ankle joint due to the lack of one All-round distraction tends to create a stressful tilting moment.

In order to allow relatively fast movements, the known training devices usually have comparatively small weights. However, the effect which can be achieved with a device according to the invention can only be achieved if relatively large weights are slowly moved.

In the therapy principle according to the invention, an effective strengthening of weakened muscle groups is achieved by activating entire chains of movement. This is done by introducing additional moments of force into slow movements, especially in walking.

The shift in the center of gravity due to the eccentric weight distribution goes hand in hand with changes in position and load in and around all the joints involved (from the crown to the sole), which means the aforementioned mobilization and increasing strengthening of previously hardly involved muscle groups and groups to carry out and stabilize the muscles even partially modified movements. With the redistribution of stress, the previously irritated or damaged zones, especially in the area of the spine, are spared in the course of movement, which is also reflected in the relief of pain. Regeneration processes can thus take place in the damaged area without excessive damage caused by excessive pressure or tensile stress.

With the integration of the reactivated muscle groups there is an approximation to the physiological or healthy movement and exercise processes, which are lost in large sections of the population of highly civilized countries at an early age due to lack of exercise and one-sided muscular strain. The deepening into these dynamic connections shows the great importance of the continuous synergistic interaction between the muscular system and the body mass moving in the gravitational field of the earth. A disproportion or lack of coordination inevitably leads to disintegration with harmful stress peaks in the joints or spinal segments involved, and furthermore by the swinging of other body regions often to movement-dynamically unfavorable vibration nodes and bellies as additional non-physiological stress zones, the latter in particular in the area of the spine.

With the permanent repetition of such disturbed movements, signs of wear are inevitable. In the sense of "exercise hygiene", which is gaining in importance due to the increased life expectancy, the novel therapy principle made possible with the training means according to the invention is able to Activate and tighten entire movement chains to counteract the derailment of movement sequences and to prevent costly spinal ailments, or at least to stop them from progressing, by using powerful physiological movement patterns.

By means of the eccentric weight distribution according to the invention, considerable leverage acts at a large distance from the axis of movement and a movement counter to gravity, which enables the user or patient to independently achieve remarkable and otherwise difficult to achieve training effects, in particular of the muscles serving to protect the joints and intervertebral discs and prevent posture damage. In particular, allow astonishingly rapid strengthening of the leg, pelvic and trunk muscles, which, by straightening the spine, can help to correct incorrect posture and thus significantly reduce the tensile and compressive loads on the intervertebral discs and ligament structures.

Active balancing movements triggered by the leverage straighten the pelvis and spine; muscle groups that are often painfully tense, especially in the neck and shoulder area, are loosened by rhythmically counter-swinging the shoulder girdle; the chest enlarges, the breathing deepens. Blockages and structural disorders of spinal sections are suppressed by strengthening the entire back muscles.

According to the invention, simply and consistently, in addition to a job while standing up, a compensation can be made for the muscular imbalance caused by lack of exercise and one-sided stresses in modern everyday life and the associated incorrect posture, which in the long term primarily leads to damage to the spine (intervertebral discs), directly during the course of movement getting produced. In the case of the independent training starting from the elementary upright gait, which also counteracts the generally widespread decline in posture and strength and the associated states of suffering and signs of wear and tear, the holistic strengthening of the holding muscles with emphasis is activated by the activation of complete movement chains with mutual relaxation of muscle groups the moving load and stabilization phases of central importance.

Furthermore, according to the invention, with each step the side of the spinal column sections is relieved by a distraction or pulling action, which reduces the pressure on the intervertebral disc tissue - here also by widening the same side of the chest - alternately during the rhythmic walking process and due to the increased circulation-promoting suction pump effect Metabolism in the bradytrophic intervertebral disc tissue improved.

In addition to these positive effects that promote regeneration and healing processes, the pre-stretching of muscle groups, tendons and ligaments with an alignment of spinal sections and joints, which otherwise avoids painful overstretching of ligament structures in the course of the movement with reflex muscular contractures, provides a stable training basis largely without the otherwise frequent Triggering of demotivating pain conditions, which largely cancel out the muscle building effect of the patient during continued training.

With the distraction, the change in position of the articular surfaces and the muscularly improved joint guidance or posture of the spine, the points of attack of the joint and spinal column damage which always occur at approximately the same damage and weak point during the course of movement become, with the progression of a joint or spinal column disease causally related shear forces are shifted or partially or completely canceled by a change in position in the joint (advantageous shear force vector change in terms of size and direction).

In order to avoid high acceleration forces with damaging shear forces and uncoordinated propulsive movements, fast walking or running training should be avoided. Rather, the mutual strengthening of the leg muscles stabilizing the joint position during the slow walking with the training means according to the invention is of major importance, which also has a decisive influence on the posture and movement of the spinal column sections with the stabilization of the pelvis. For example, a hollow back or a hollow back is at least partially removed if the spinal column posture is not yet fully fixed.

The positive effects listed so far are the result of an eccentric weight distribution as a general basis of the new therapy approach. The noticeable shift in the center of gravity, with the unstable equilibrium changed as a result of the eccentricity, is inevitably connected with the desired activation of muscle groups and muscles that have so far hardly been used in the course of movement Muscle shares. Which muscle groups and to what extent are activated depends on the different moments of force in the movement, which change with the position of the main center of gravity and the eccentric center of gravity in relation to the movement axes effective in the movement and the direction of the gravity vectors. With this muscular activation also an increasing - damaging shear force reducing, tightening and strengthening of whole chains of movements increases with the increase of the weight elements. With the stabilization of the unstable equilibrium, which is changed by the eccentric weight distribution, there are partly controllable, in a therapeutically positive sense usable changes in posture and stress.

Thus, when the swinging leg is guided forward, the main movement takes place about a main axis, approximately vertical on the plane described, parallel to the connecting line between the two hip joints. When centering the training weights directly around the ankles, the increased compensatory movements to maintain the unstable balance are particularly evident in the muscularly stabilized retraction of the entire trunk, in particular both shoulders, with emphasis on the side opposite the swinging leg, and in a strong activation of the abdominal muscles the, based on the entire course of movement, long guidance of the swinging leg in front of the axis of movement. A further strengthening of the muscle activation and mass shift that takes place, which primarily serves to straighten the upper body and strengthen the generally weak abdominal muscles and effectively counteracts hyperlordosis (hollow back formation) or increased kyphosis (rounded back formation) in the area of the thoracic spine by arranging the eccentric weight in the area in front of the upper ankle. A further maximization of these effects is achieved when using an embodiment of the device according to the invention with a displacement of large parts by weight, which increases the eccentricity, e.g. to the end of a forwardly oriented, partially angled and rotatable arm (in this case within the plane of movement). Conversely, the alignment of this arm leads backwards beyond the rear foot, with the focus of training within the movement plane, at the beginning of the movement to move the pelvis forward and to straighten it up, as well as to return the upper body with increased activation of the back extensor muscles. In addition to targeted muscle strengthening, this therapeutic approach is ideal for hyperlordosis (hollow back formation) as well as for hip flexion contracture. Corresponding effects are less pronounced also with the other training means according to the invention with a circularly displaceable eccentric weight distribution. During the walking process, the laterally symmetrical arrangement of both legs when the swinging leg is advanced also results in slight rotational movements of the pelvis and, in the opposite direction, the shoulder girdle with torsional movements in the spinal sections between them. The rotational movements take place about an eccentrically located vertical axis in the longitudinal direction of the body.

Furthermore, to stabilize the unstable balance, compensatory movements to the side with a dorso-ventral (back-belly-facing), approximately horizontal main axis in the area of the lumbar spine take place.

In addition to the activation of these movement components, including the associated mass shifts, which is already increased by the pulling action of the device, an additional reinforcement is required during the movement sequence. due to the laterally eccentric weight shift (with the possibility of a different angle adjustment to the plane of movement) a partially differentiated strengthening of weakened movement chains is possible. When using the device according to the invention with pronounced eccentricity, such moments of movement are considerably increased. The activation of the last-mentioned movement components with a strengthening of the corresponding muscle groups contributes significantly to straightening or stabilizing, in particular also to the reduction of not yet fixed or stiffened lateral spinal curvature - (scoliosis), provided the strength components of these muscle groups, including the back muscles and abdominal muscles, are approximately the same. This dynamic state of affairs corresponds to the fact that spinal coliosis is fundamentally associated with a rotation or torsion of certain spinal column sections. Here, a highly effective approach for an independently performable, muscular asymmetry-side scoliosis treatment offers itself, an increase in effectiveness being possible by varying the weight load of both legs depending on the expression with correspondingly variable devices according to the invention. In this context, as expected, comes the invention devices with a large eccentricity of the training focus are of particular importance, since in one embodiment, in addition to the different weight distribution and circularly in the horizontal plane of the lower leg, the lever arm's different position by means of its angularly lockable angle, which in turn can be locked in different positions, enables further force moments, with indirect certain muscle groups and Spine sections can be addressed.

With regard to the working speed, it should be noted that in order to avoid high acceleration forces with unfavorable shear effects and uncoordinated propulsive movements, rapid walking or running training, in general all rapid movements, are to be avoided with the devices according to the invention.

It is advantageous that the subjectively predominantly pleasant exercise treatment with the devices according to the invention, which leave a feeling of lightness, increased mobility and strength after each exercise completion, can often take place without distraction while standing at work and / or leisure, which is the case with advanced people Damaging sensible, possibly several hours of daily use for the permanent reconstruction of healthy and powerful movements. In order not to attract attention at the workplace, a lighter, externally invisible device with a weight of about 2.5 kg each is sufficient for the highly recommended all-day application, with steady and gentle erection and set-up impulses, which if continued in leisure time by a heavier device ( between 5 and 7.5 kg) can be replaced. It stands to reason that in the case of serious damage, the possibility of such a consequent use can create the basis for the effective re-education of healthy and muscularly stabilized movement patterns.

• Fig. 1 zeigt schematisch in einer Abwicklung ein bevorzugtes Ausführungsbeispiel eines erfindungsgemässen Gerätes,
• Fig. 2 zeigt das Gerät gemäss Fig. 1 in angelegtem Zustand an einem Fuss in einer Draufsicht,
• Fig. 3 zeigt einen Schnitt in der Ebene 111-111 der Fig. 1,
• Fig. 4 zeigt in einer perspektivischen Ansicht schematisch ein weiteres Ausführungsbeispiel der Erfindung, und
• Fig. 5 zeigt in einer Teilansicht eine Weiterbildung des Ausführungsbeispiels gemäss Fig. 4.

In the following, several embodiments of the invention are described in more detail with reference to the accompanying drawings for further explanation and for better understanding.

• 1 shows schematically in a development a preferred embodiment of a device according to the invention,
• 2 shows the device according to FIG. 1 in the attached state on a foot in a plan view,
• 3 shows a section in the plane 111-111 of FIG. 1,
• FIG. 4 schematically shows a further exemplary embodiment of the invention in a perspective view, and
• FIG. 5 shows a development of the exemplary embodiment according to FIG. 4 in a partial view.

In the device shown in FIGS. 1 to 3, the holder 1 consists of two superimposed fabric or film webs 2, which are connected to one another by a seam 3 running along the edge of the web. A number of transverse seams 4 running parallel to one another form tubular receiving cavities 5 between the fabric and film webs 2, which have an approximately rhomboidal shape in cross section and accommodate the weight elements. In the present exemplary embodiment, the weight elements consist of steel or lead balls 6. These steel or lead balls can either be filled directly into the receiving cavities 5 or sewn into appropriately shaped bags 7, which can then be inserted into the receiving cavities 5.

If sacks 7 filled with weight elements are used, the receiving cavities can preferably have closable openings in the region of the upper edge of the holder 1. In this way, bags 7 with different fillings can be inserted into the receiving cavities 5 according to the respective application.

As can be seen from FIG. 1, the holder is provided in the region of its lower edge in the applied state with approximately wedge-shaped cutouts 8 which lie in the region of the transverse seams 5. In this way, the holder 1 can adapt to the shape of the foot when it is in place, so that pressure points and impairment, in particular, of arterial blood flow in this contact area of the holder on the foot are avoided.

As can also be seen from FIG. 1, the holder is equipped with a Velcro strip 9 in the area of its two ends on opposite sides in each case. This Velcro strip 9 is sewn onto the outside of the fabric or film web and is used in a known manner for fastening the holder to the foot, as shown in FIG. 2.

In Fig. 2, reference numeral A denotes the axis of the lower leg of a foot. During the walking process, this axis A defines a movement plane E, which is shown in simplified form in FIG. 2.

As can be seen from FIG. 2, the holder is not centered around the lower leg in the area of the ankle. Rather, in the present case, an overlap is produced on the outside of the foot on the side of the ankle joint facing the toes, so that two layers of receiving cavities 5 are arranged in this area. With such an arrangement, the overall center of gravity of the weight elements is moved out of the plane of movement E to a location on the outside of the foot that lies on the side facing the toes of the foot with respect to the axis of movement defined by the ankle joint.

In the embodiment shown in FIGS. 4 and 5, the holder is designed in the form of an ankle cuff 10. This Knöchimimschette 10 has a receiving sleeve 11, in the bore of a lever arm 12 is inserted. A threaded bore is arranged transversely to the axis of the bore in the receiving bushing 11, and a clamping screw 13 is screwed into this bore. The end of the lever arm 12 resting in the bore can be detachably connected to the receiving bush 11 by means of the clamping screw 13.

At the end opposite the receiving bushing 11, a ball 16 is attached to the lever arm 12, in which the weight elements are combined in one unit.

5 shows a further embodiment of the lever arm 12. As can be seen from the figure, the lever arm 12 in this embodiment consists of sections 12a and 12b which are connected to one another via a ball joint 14. The position of the ball joint 14 can be releasably fixed by a clamping screw 15. With such a configuration, the ball 16 can be brought into practically any position and thus the overall center of gravity can be placed at the point required for the treatment.

In the above explanations, some attempts have been made to highlight some active principles of the device according to the invention with regard to its therapeutic usability, in particular in the case of spinal disorders. Therapeutic use is recommended for all chronic, non-inflammatory spinal disorders, which are associated with a weakness of the muscles as well as incorrect posture and incorrect loading of spinal column sections, especially with asymmetries; Associated pain states, damaging permanent incorrect loading of intervertebral discs, overstretching of ligament structures, cramping and overloading of certain muscle groups, structural disorders of certain spine sections, nerve irritation with pain radiation in the extremities, as well as sensitivity disorders are systematically counteracted.

Claims (27)

1. Use of a device that surrounds the ankle area of at least one foot with a holder that contains weight elements for the prophylaxis and therapy of spinal disorders. 2. Use of the device for the purpose of claim 1, wherein the overall center of gravity of the weight elements lies outside the plane of movement described by the lower leg axis during the walking process. 3. Use of the device for the purpose of claim 1, wherein the overall focus is on the outside of the foot 4. Use of the device for the purpose of claim 1, wherein the overall center of gravity is on the toe side of the ankle joint. 5. Use of the device for the purpose of claim 1, wherein the position of the overall center of gravity is mirror image the same on both feet. 6. Use of the device for the purpose of claim 1, wherein the location of the overall center of gravity is different on both feet. 7. Use of the device for the purpose of claim 1, wherein the total weight of the weight elements per foot is between 2 and 8 kg, preferably between 3.5 and 7 kg. 8. Use of the device for the purpose of claim 1, wherein 50% of the total weight of the weight elements act on each side with respect to the plane of movement. 9. Use of the device for the purpose of claim 1, with a weight distribution according to Claim 8, wherein the distribution of the weight of the weight elements is symmetrical to the lower leg axis. 10. Use of the device for the purpose of claim 1, with a weight distribution according to claim 8, wherein the distribution of the weight of the weight elements is asymmetrical to the lower leg axis. 11. Use of the device for the purpose of claim 1, wherein 20 to 100%, preferably 40 to 80% more weight than on the other side act on the movement plane on one side. 12. Device for prophylaxis and therapy with a foot wrapping around the foot in the ankle area for receiving weight elements, characterized in that the total center of gravity of the weight elements lies outside the movement plane (E) described by the lower leg axis (A) during the walking process. 13. Apparatus according to claim 12, characterized in that the overall center of gravity is on the outside of the foot. 14. Apparatus according to claim 13, characterized in that the overall center of gravity is on the toe side of the ankle joint. 15. Apparatus according to claim 12 to 14, characterized in that the position of the overall center of gravity is mirror image the same on both feet. 16. Apparatus according to claim 12 to 14, characterized in that the position of the overall center of gravity is different on both feet. 17. Apparatus according to claim 12 to 16, characterized in that the total weight of the weight elements per foot is between 2 and 8 kg, preferably between 2.5 and 7.5 kg. 18. Apparatus according to claim 12 to 17, characterized in that in relation to the plane of movement (E) on one side 20 to 100%, preferably 40 to 80% more weight than the other side are arranged. 19. Apparatus according to claim 18, characterized in that the overall center of gravity is on the outside of the foot on the toe side of the ankle joint. 20. Apparatus according to claim 12 to 19, characterized in that the weight elements are combined in a unit which is arranged at the end of a lever arm (12) connected to the holder (1). 21. Apparatus according to claim 20, characterized in that the lever arm (12) is adjustable in length. 22. Apparatus according to claim 20, characterized in that the lever arm (12) is equipped with an adjustable joint (14). 23. Apparatus according to claim 12, characterized in that the holder (1) is designed as an ankle cuff (10). 24. Apparatus according to claim 12, characterized in that the holder is integrated in the upper of a shoe. 25. Apparatus according to claim 18, characterized in that the holder (1) consists of two superimposed fabric or film webs (2) in which, through transverse seams (4) running parallel to one another, adjacent tubular receiving cavities (5) for the weight elements (6 ) are trained. 26. Apparatus according to claim 25, characterized in that for shifting the overall center of gravity, the weight elements on one side of the movement plane (E) have a greater weight than on the other side of the movement plane. 27. Apparatus according to claim 25, characterized in that the receiving cavities (5) for the weight elements on one side of the plane of movement (E) are arranged in two or more layers for shifting the overall center of gravity.

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