ITFI20110231A1 - ROBOTIC DEVICE FOR REHABILITATION OF UPPER ARTS - Google Patents
ROBOTIC DEVICE FOR REHABILITATION OF UPPER ARTS Download PDFInfo
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- ITFI20110231A1 ITFI20110231A1 IT000231A ITFI20110231A ITFI20110231A1 IT FI20110231 A1 ITFI20110231 A1 IT FI20110231A1 IT 000231 A IT000231 A IT 000231A IT FI20110231 A ITFI20110231 A IT FI20110231A IT FI20110231 A1 ITFI20110231 A1 IT FI20110231A1
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- 210000001364 upper extremity Anatomy 0.000 claims description 9
- 238000005259 measurement Methods 0.000 claims description 7
- 230000000007 visual effect Effects 0.000 claims description 2
- 238000006073 displacement reaction Methods 0.000 claims 1
- 238000000034 method Methods 0.000 description 7
- 238000002560 therapeutic procedure Methods 0.000 description 5
- 208000006011 Stroke Diseases 0.000 description 3
- 210000003414 extremity Anatomy 0.000 description 3
- 230000007246 mechanism Effects 0.000 description 3
- 230000009471 action Effects 0.000 description 2
- 230000001404 mediated effect Effects 0.000 description 2
- 238000011084 recovery Methods 0.000 description 2
- 239000000725 suspension Substances 0.000 description 2
- 102000004219 Brain-derived neurotrophic factor Human genes 0.000 description 1
- 108090000715 Brain-derived neurotrophic factor Proteins 0.000 description 1
- 208000012661 Dyskinesia Diseases 0.000 description 1
- 208000015592 Involuntary movements Diseases 0.000 description 1
- 208000007101 Muscle Cramp Diseases 0.000 description 1
- 208000005392 Spasm Diseases 0.000 description 1
- 230000005540 biological transmission Effects 0.000 description 1
- 210000003169 central nervous system Anatomy 0.000 description 1
- 230000001419 dependent effect Effects 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 230000003993 interaction Effects 0.000 description 1
- 230000003902 lesion Effects 0.000 description 1
- 210000000337 motor cortex Anatomy 0.000 description 1
- 230000017311 musculoskeletal movement, spinal reflex action Effects 0.000 description 1
- 230000007170 pathology Effects 0.000 description 1
- 210000001428 peripheral nervous system Anatomy 0.000 description 1
- 238000011158 quantitative evaluation Methods 0.000 description 1
- 230000008521 reorganization Effects 0.000 description 1
- 230000000472 traumatic effect Effects 0.000 description 1
- 230000002747 voluntary effect Effects 0.000 description 1
- 230000021542 voluntary musculoskeletal movement Effects 0.000 description 1
- 210000000707 wrist Anatomy 0.000 description 1
Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H1/00—Apparatus for passive exercising; Vibrating apparatus; Chiropractic devices, e.g. body impacting devices, external devices for briefly extending or aligning unbroken bones
- A61H1/02—Stretching or bending or torsioning apparatus for exercising
- A61H1/0274—Stretching or bending or torsioning apparatus for exercising for the upper limbs
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- 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
- A63B21/00178—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices for active exercising, the apparatus being also usable for passive exercising
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- 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
- A63B21/00181—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices comprising additional means assisting the user to overcome part of the resisting force, i.e. assisted-active exercising
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- 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
- A63B21/005—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices using electromagnetic or electric force-resisters
- A63B21/0058—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices using electromagnetic or electric force-resisters using motors
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- 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
- A63B21/40—Interfaces with the user related to strength training; Details thereof
- A63B21/4027—Specific exercise interfaces
- A63B21/4033—Handles, pedals, bars or platforms
- A63B21/4035—Handles, pedals, bars or platforms for operation by hand
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- 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
- A63B21/40—Interfaces with the user related to strength training; Details thereof
- A63B21/4041—Interfaces with the user related to strength training; Details thereof characterised by the movements of the interface
- A63B21/4045—Reciprocating movement along, in or on a guide
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- 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
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- 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
- A63B23/12—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously for upper limbs or related muscles, e.g. chest, upper back or shoulder muscles
- A63B23/1209—Involving a bending of elbow and shoulder joints simultaneously
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
- A61H2201/12—Driving means
- A61H2201/1207—Driving means with electric or magnetic drive
- A61H2201/1215—Rotary drive
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
- A61H2201/16—Physical interface with patient
- A61H2201/1602—Physical interface with patient kind of interface, e.g. head rest, knee support or lumbar support
- A61H2201/1635—Hand or arm, e.g. handle
- A61H2201/1638—Holding means therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
- A61H2201/16—Physical interface with patient
- A61H2201/1657—Movement of interface, i.e. force application means
- A61H2201/1659—Free spatial automatic movement of interface within a working area, e.g. Robot
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
- A61H2201/16—Physical interface with patient
- A61H2201/1657—Movement of interface, i.e. force application means
- A61H2201/1664—Movement of interface, i.e. force application means linear
- A61H2201/1666—Movement of interface, i.e. force application means linear multidimensional
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
- A61H2201/50—Control means thereof
- A61H2201/5058—Sensors or detectors
- A61H2201/5061—Force sensors
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- 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
- A63B2022/0094—Exercising apparatus specially adapted for conditioning the cardio-vascular system, for training agility or co-ordination of movements for active rehabilitation, e.g. slow motion devices
Landscapes
- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Physical Education & Sports Medicine (AREA)
- General Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Biophysics (AREA)
- Physics & Mathematics (AREA)
- Electromagnetism (AREA)
- Epidemiology (AREA)
- Pain & Pain Management (AREA)
- Rehabilitation Therapy (AREA)
- Animal Behavior & Ethology (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Manipulator (AREA)
Description
DISPOSITIVO ROBOTICO PER LA RIABILITAZIONE DEGLI ARTI SUPERIORI ROBOTIC DEVICE FOR THE REHABILITATION OF THE UPPER LIMBS
DESCRIZIONE DESCRIPTION
La presente invenzione si riferisce al settore dei dispositivi robotici utilizzati come ausilio in campo medico; in particolare, la presente invenzione à ̈ relativa ad un dispositivo robotico utile nella neuro-riabilitazione degli arti superiori in pazienti emiparetici. The present invention refers to the field of robotic devices used as an aid in the medical field; in particular, the present invention relates to a robotic device useful in the neuro-rehabilitation of the upper limbs in hemiparetic patients.
Come à ̈ noto, le principali cause della disabilità motoria sono dovute ad ictus, e lesioni traumatiche del sistema nervoso centrale o periferico; ed il numero di pazienti afflitti da questo tipo di disabilità à ̈ in costante aumento, all’aumentare dell’età media della popolazione, con la quale aumenta appunto l’incidenza di ictus ed eventi simili. Negli ultimi decenni la richiesta di terapie e metodi riabilitativi efficienti per il recupero funzionale degli arti à ̈ perciò cresciuta di conseguenza. As is known, the main causes of motor disability are due to stroke, and traumatic lesions of the central or peripheral nervous system; and the number of patients afflicted by this type of disability is constantly increasing, as the average age of the population increases, with which the incidence of strokes and similar events increases. In recent decades, the demand for efficient therapies and rehabilitation methods for the functional recovery of the limbs has therefore grown accordingly.
Attualmente le tipiche attività riabilitative consistono nella manipolazione degli arti dei pazienti associati a movimenti volontari o involontari dei pazienti stessi. Anche se per tali tecniche tradizionali à ̈ stata dimostrata l’efficacia quanto a recupero funzionale e riorganizzazione della corteccia motoria (Gomez-Pinilla F. et al. (2002) J. Neurophysiol. 88(5): 2187-95 Voluntary exercise induces a BDNF-mediated mechanism that promotes neuroplasticity), la necessità di eseguire la tecnica in ospedale o comunque in centri medici riabilitativi in cui un terapista deve necessariamente assistere un paziente alla volta comporta che non vi siano strutture e personale a sufficienza per fare fronte alle richieste sempre crescenti di questo tipo di terapie. Currently the typical rehabilitation activities consist in the manipulation of the limbs of the patients associated with voluntary or involuntary movements of the patients themselves. Even if for these traditional techniques the effectiveness has been demonstrated in terms of functional recovery and reorganization of the motor cortex (Gomez-Pinilla F. et al. (2002) J. Neurophysiol. 88 (5): 2187-95 Voluntary exercise induces a BDNF-mediated mechanism that promotes neuroplasticity), the need to perform the technique in hospital or otherwise in medical rehabilitation centers where a therapist must necessarily assist one patient at a time means that there are not enough facilities and staff to meet the requests increasing numbers of this type of therapy.
Per queste ragioni à ̈ particolarmente apprezzata la possibilità di disporre di nuovi mezzi in grado di eseguire le tecniche riabilitative senza la costante supervisione di un terapista, offrendo per di più un tipo di terapia mediata dall’uso di robot, che risulta più intensa e coinvolgente rispetto alla terapia tradizionale somministrata attraverso un terapista, oltre a consentire valutazioni anche quantitative delle grandezze fisiche in gioco, ad esempio della forza esercitata dal braccio del paziente. For these reasons, the possibility of having new means capable of performing rehabilitation techniques without the constant supervision of a therapist is particularly appreciated, offering moreover a type of therapy mediated by the use of robots, which is more intense and involving compared to traditional therapy administered through a therapist, as well as allowing quantitative evaluations of the physical quantities involved, for example the force exerted by the patient's arm.
Fino ad oggi sono stati sviluppati alcuni tipi di dispositivo robotico per la riabilitazione degli arti superiori, il cui funzionamento à ̈ basato sulla presenza di un sensore di forza per la rilevazione e la stima dell’interazione tra paziente e robot; in questi dispositivi, il sensore à ̈ interposto perciò tra il supporto del braccio del paziente ed il robot. Questi dispositivi noti si possono dividere in due categorie, la prima à ̈ quella relativa a disposit ivi come i l Mit-Manus, descritto nel brevetto Statunitense N. US 5,466,213, in cui il supporto del braccio del paziente à ̈ rigido e vincolato ad una cella di carico a sei assi, mentre la seconda categoria à ̈ quella dei dispositivi che utilizzano celle di carico biassiali posizionate su una manopola del tipo “joystick†a cui à ̈ vincolato il polso del paziente; esempi in questa seconda categoria sono i dispositivi Memos, sviluppato sempre dalla Richiedente, e CBM Motus, messo a punto dall’Università Campus Bio-Medico di Roma. Up to now, some types of robotic device have been developed for the rehabilitation of the upper limbs, whose operation is based on the presence of a force sensor for detecting and estimating the interaction between patient and robot; in these devices, the sensor is therefore interposed between the patient's arm support and the robot. These known devices can be divided into two categories, the first is that relating to devices such as the Mit-Manus, described in the US patent No. US 5,466,213, in which the patient's arm support is rigid and bound to a cell load with six axes, while the second category is that of devices that use biaxial load cells positioned on a â € œjoystickâ € type knob to which the patient's wrist is bound; examples in this second category are the Memos devices, also developed by the Applicant, and CBM Motus, developed by the Campus Bio-Medico University of Rome.
Tali dispositivi noti presentano tuttavia degli svantaggi dovuti, nel caso della prima categoria di dispositivi detti sopra, ad una elevata complessità del controllo e al costo delle celle di carico a sei assi. Per i dispositivi nella seconda categoria, che usano celle biassiali senza il supporto per il braccio del paziente, il principale svantaggio à ̈ costituito dal fatto che la manopola tipo “joystick†à ̈ sollecitata non solo con forze e momenti che agiscono nelle tre direzioni spaziali a seguito dell’azione del braccio, ma anche con forze e momenti applicati dal sistema mano-polso, così che la misura delle forze à ̈ meno accurata e precisa. However, these known devices have disadvantages due, in the case of the first category of devices mentioned above, to a high level of control complexity and to the cost of the six-axis load cells. For devices in the second category, which use biaxial cells without support for the patient's arm, the main disadvantage is that the `` joystick '' type knob is stressed not only with forces and moments acting in the three directions space due to the action of the arm, but also with forces and moments applied by the hand-wrist system, so that the measurement of the forces is less accurate and precise.
E’ pertanto sentita l’esigenza di avere a disposizione dispositivi robotici in grado di mettere in atto le tecniche riabilitative degli arti superiori descritte sopra, senza tuttavia presentare gli svantaggi dei dispositivi noti. The need is therefore felt to have available robotic devices capable of implementing the rehabilitation techniques of the upper limbs described above, without however presenting the disadvantages of known devices.
Lo scopo della presente invenzione à ̈ pertanto quello di fornire un dispositivo robotico che risolva le problematiche sopra esposte, ovvero che sia in grado di eseguire in modo efficace la tecnica riabilitativa sul braccio del paziente e garantire una misura accurata della forza esercitata dal braccio stesso, senza utilizzare celle di carico molto costose e complesse da controllare. The purpose of the present invention is therefore to provide a robotic device that solves the problems set out above, i.e. that is able to effectively perform the rehabilitation technique on the patient's arm and ensure an accurate measurement of the force exerted by the arm itself, without using very expensive and complex to control load cells.
Ulteriore scopo del dispositivo robotico secondo l’invenzione à ̈ quello di assicurare il buon funzionamento del dispositivo stesso anche senza il comando e la costante supervisione di un terapista. A further purpose of the robotic device according to the invention is to ensure the proper functioning of the device even without the command and constant supervision of a therapist.
Ancora un ulteriore scopo del dispositivo secondo la presente invenzione à ̈ quello di disporre di un dispositivo robotico che fornisca indicazioni in corso d’opera circa i movimenti effettuati dal paziente e la correttezza del suo posizionamento. Still another object of the device according to the present invention is to have a robotic device that provides indications during the work on the movements performed by the patient and the correctness of his positioning.
Tali scopi vengono raggiunti da un dispositivo robotico per la riabilitazione degli arti superiori, le cui caratteristiche essenziali sono definite nella prima delle rivendicazioni annesse. Ulteriori importanti caratteristiche sono contenute nelle rivendicazioni dipendenti. These objects are achieved by a robotic device for the rehabilitation of the upper limbs, the essential characteristics of which are defined in the first of the appended claims. Further important features are contained in the dependent claims.
Ulteriori caratteristiche e vantaggi del dispositivo secondo la presente invenzione risulteranno chiari dalla descrizione che segue di una sua forma realizzativa fatta a titolo esemplificativo e non limitativo con riferimento ai disegni annessi in cui: Further characteristics and advantages of the device according to the present invention will become clear from the following description of an embodiment thereof made by way of non-limiting example with reference to the attached drawings in which:
- la figura 1 à ̈ una vista dall’alto del dispositivo robotico per la riabilitazione degli arti superiori secondo l’invenzione; - figure 1 is a top view of the robotic device for the rehabilitation of the upper limbs according to the invention;
- la figura 2 Ã ̈ una vista in sezione del dispositivo robotico di figura 1, presa lungo il supporto per il braccio del paziente; - figure 2 is a sectional view of the robotic device of figure 1, taken along the support for the patient's arm;
- la figura 3 à ̈ una vista in prospettiva dall’alto di un componente del dispositivo di figura 1. - figure 3 is a perspective view from above of a component of the device of figure 1.
Con riferimento alle suddette figure à ̈ rappresentato un dispositivo robotico per la riabilitazione degli arti superiori, in particolare per l’attuazione di tecniche neuroriabilitative degli arti superiori in pazienti emiparetici. With reference to the above figures, a robotic device is shown for the rehabilitation of the upper limbs, in particular for the implementation of neurorehabilitation techniques of the upper limbs in hemiparetic patients.
Con particolare riferimento alla figura 1, il dispositivo robotico dell’invenzione comprende un piano di lavoro orizzontale XY, di forma sostanzialmente rettangolare, delimitato da quattro guide lineari 1,2,3,4 su ciascuna delle quali scorre un carrello 5,6,7,8. I carrelli sono movimentati da due viti a ricircolo di sfere 9,10, disposte lungo gli assi X,Y perpendicolari tra loro e intersecanti, connesse all’intersezione da un elemento di connessione 11 che poggia sul piano di lavoro XY tramite una sospensione 12. With particular reference to Figure 1, the robotic device of the invention comprises a horizontal work surface XY, of a substantially rectangular shape, delimited by four linear guides 1,2,3,4 on each of which a trolley 5,6 slides, 7.8. The carriages are moved by two ball screws 9,10, arranged along the X, Y axes perpendicular to each other and intersecting, connected at the intersection by a connection element 11 which rests on the XY worktop by means of a suspension 12 .
Sull’elemento di connessione 11 à ̈ fissata una manopola 13, destinata alla presa da parte della mano del paziente, che si muove sul piano di lavoro XY solidalmente all’elemento di connessione 11 ed alla relativa sottostante sospensione 12. A knob 13 is fixed on the connection element 11, intended for grip by the patient's hand, which moves on the worktop XY integrally with the connection element 11 and the relative underlying suspension 12.
La manopola 13 Ã ̈ munita di una cella di carico biassiale 14 per la misura della forza esercitata dal paziente sulla manopola stessa, di cui in figura 1 Ã ̈ visibile la base. The knob 13 is equipped with a biaxial load cell 14 for measuring the force exerted by the patient on the knob itself, the base of which is visible in figure 1.
Un alloggiamento 15 per il braccio del paziente, preferibilmente di forma ergonomica ad esempio di semicilindro cavo, à ̈ fissato, insieme alla manopola 13 a cui à ̈ solidale, su un supporto 16 che, a sua volta, poggia su una base 17. L'alloggiamento 15, insieme alla manopola 13, costituiscono un insieme ergonomico per l'appoggio del braccio del paziente. A housing 15 for the patient's arm, preferably of an ergonomic shape, for example of a hollow half-cylinder, is fixed, together with the knob 13 to which it is integral, on a support 16 which, in turn, rests on a base 17. L The housing 15, together with the knob 13, constitute an ergonomic assembly for supporting the patient's arm.
Le viti a ricircolo di sfere 9,10 sono rispettivamente attuate da due motori elettrici M1,M2. The ball screws 9,10 are respectively actuated by two electric motors M1, M2.
Blocchi fine-corsa B sono disposti in posizione opportuna al fondo delle guide, in modo da bloccare lo scorrimento del carrello, mantenendolo all’interno del piano di lavoro. End-of-stroke blocks B are arranged in a suitable position at the bottom of the guides, in order to block the sliding of the trolley, keeping it inside the work surface.
Sulla superficie sottostante il piano di lavoro X,Y, possono trovarsi piedini d’appoggio o mezzi di fissaggio a tavoli e piani di lavoro fissi, che favoriscono l’appoggio stabile del presente dispositivo ai piani più diversi. In figura 1 à ̈ mostrata ad esempio una configurazione del presente dispositivo in cui il piano di lavoro X,Y può scorrere su un piano sottostante munito di due guide lineari, che può essere facilmente spostato grazie a due maniglie laterali. On the surface below the worktop X, Y, there may be support feet or means of fixing to fixed tables and worktops, which favor the stable support of this device on the most diverse planes. Figure 1 shows, for example, a configuration of the present device in which the worktop X, Y can slide on an underlying surface equipped with two linear guides, which can be easily moved thanks to two side handles.
Con particolare riferimento alla figura 2, sono mostrati l’alloggiamento 15 per il braccio del paziente, e la manopola 13 fissati sul supporto 16 che poggia, a sua volta, tramite tre o più piedini di appoggio sferici 18, sulla base 17. Preferibilmente almeno due mezzi di fissaggio L1,L2 sono disposti ad opportuna distanza sull’alloggiamento 15 per mantenere il braccio del paziente stabilmente in posizione all’interno dell’alloggiamento stesso durante gli esercizi. Per ragioni di chiarezza della figura, i mezzi di fissaggio L1,L2 non sono illustrati in figura 1. With particular reference to Figure 2, the housing 15 for the patient's arm is shown, and the knob 13 fixed on the support 16 which rests, in turn, by means of three or more spherical support feet 18, on the base 17. Preferably at least two fixing means L1, L2 are arranged at a suitable distance on the housing 15 to keep the patient's arm stably in position inside the housing itself during the exercises. For reasons of clarity of the figure, the fixing means L1, L2 are not shown in figure 1.
La base 17 à ̈ dotata di asole 19,20 nelle quali si inseriscono appositi perni 21,22 sul supporto 16. All'estremità della base 17 in corrispondenza della manopola 13, la base della cella di carico 14 à ̈ vincolata alla base 17 tramite un supporto di interfaccia 23, che ha funzione di sostegno per la base 17 e ne permette la rotazione attorno alla base della cella di carico 14 grazie a cuscinetti 24. Inoltre, la cella di carico 14 si interfaccia con il supporto 16 tramite uno snodo sferico 25. The base 17 is equipped with slots 19,20 in which special pins 21,22 are inserted on the support 16. At the end of the base 17 in correspondence with the knob 13, the base of the load cell 14 is constrained to the base 17 by means of an interface support 23, which acts as a support for the base 17 and allows it to rotate around the base of the load cell 14 thanks to bearings 24. Furthermore, the load cell 14 interfaces with the support 16 via a spherical joint 25.
La forma e le dimensioni delle asole 19,20 determinano l'ampiezza del movimento del supporto 16 rispetto alla base 17 sul piano X,Y in corrispondenza dello snodo sferico 25. Con particolare riferimento alla f igura 3, à ̈ mostrata una configurazione preferita della base 17, in cui due asole 19,20 aventi forma e dimensioni diverse una dall'altra sono mostrate; in particolare, l'asola 19 ha forma ellittica allungata, mentre l'asola 20 ha forma circolare. Questa particolare configurazione permette al supporto 16 una ampiezza e direzioni di spostamento limitate imposte dalla dimensione e dalla forma delle asole. Sempre in figura 3 à ̈ visibile l'area 26 all’interno della quale può variare la zona di fissaggio dello snodo sferico 25. In questo modo la cella di carico 14 può essere deformata dall’azione del braccio del paziente. The shape and dimensions of the slots 19,20 determine the amplitude of the movement of the support 16 with respect to the base 17 on the X, Y plane in correspondence with the ball joint 25. With particular reference to figure 3, a preferred configuration of the base 17, in which two slots 19,20 having different shapes and sizes from each other are shown; in particular, the slot 19 has an elongated elliptical shape, while the slot 20 has a circular shape. This particular configuration allows the support 16 a limited amplitude and directions of movement imposed by the size and shape of the slots. Also in figure 3 the area 26 is visible, inside which the fixing area of the ball joint 25 can vary. In this way the load cell 14 can be deformed by the action of the patient's arm.
Il particolare meccanismo con perni ed asole che collega l’alloggiamento 15 del braccio del paziente alla base 17, tramite il supporto 16, consente di selezionare per la misura con la cella biassiale solo le componenti della forza esercitata dal paziente nel piano X,Y che rappresentano poi le sole variabili di interesse clinico e controllistico, che si vuole valutare con il dispositivo dell’invenzione. The particular mechanism with pins and slots that connects the housing 15 of the patient's arm to the base 17, through the support 16, allows to select for the measurement with the biaxial cell only the components of the force exerted by the patient in the X, Y plane which then represent the only variables of clinical and control interest, which we want to evaluate with the device of the invention.
Ciò consente al dispositivo dell’invenzione di risolvere il problema tecnico messo in evidenza sopra e presente nei dispositivi noti, ossia di realizzare un sistema che permetta la misura precisa ed accurata delle forze esercitate dal paziente usando celle di carico biassiali grazie al fatto che le forze da misurare sono esclusivamente forze planari sul piano X,Y, mentre le altre componenti della forza sono filtrate via dal particolare meccanismo che lega supporto 16 e base 17, come sopra descritto. This allows the device of the invention to solve the technical problem highlighted above and present in known devices, that is to create a system that allows the precise and accurate measurement of the forces exerted by the patient using biaxial load cells thanks to the fact that the forces to be measured are exclusively planar forces on the X, Y plane, while the other components of the force are filtered away by the particular mechanism that binds support 16 and base 17, as described above.
Secondo una forma di realizzazione preferita dell’invenzione la manopola 13 ha impugnatura di forma sferica, e ciò vantaggiosamente consente una presa più ergonomica per il paziente che, per la patologia da cui à ̈ affetto, à ̈ emiparetico o ha comunque una ridotta abilità dell’arto, da cui appunto la necessità di usare il presente dispositivo per la riabilitazione. Manopole con impugnature di forma diversa, ad esempio cilindrica o con presa orientata, possono essere montate nel presente dispositivo. According to a preferred embodiment of the invention, the knob 13 has a spherical handle, and this advantageously allows a more ergonomic grip for the patient who, due to the pathology from which he is suffering, is hemiparetic or has in any case a reduced ability. limb, hence the need to use this device for rehabilitation. Knobs with handles of different shape, for example cylindrical or with oriented grip, can be mounted in the present device.
Il presente dispositivo può inoltre comprendere mezzi di controllo che gestiscono il funzionamento del dispositivo secondo diverse modalità corrispondenti a diverse tipologie di esercizio, standardizzate ed eventualmente personalizzabili a seconda delle esigenze del paziente. L’esercizio consiste generalmente nello spostare la manopola del dispositivo per raggiungere dei punti prefissati sul piano di lavoro X,Y, senza alcun vincolo di traiettoria; se ad esempio, durante l’esercizio, la forza applicata sulla manopola diventa inferiore ad una soglia prefissata, per un intervallo di tempo stabilito, i mezzi di controllo possono intervenire guidando la manopola fino a raggiungere il punto prefissato. The present device can also comprise control means that manage the operation of the device according to different modes corresponding to different types of exercise, standardized and possibly customizable according to the patient's needs. The exercise generally consists in moving the knob of the device to reach preset points on the X, Y work plane, without any trajectory constraint; if, for example, during exercise, the force applied to the knob becomes lower than a predetermined threshold, for a set time interval, the control means can intervene by guiding the knob until it reaches the predetermined point.
Il dispositivo dell’invenzione può inoltre comprendere un’interfaccia visuale e/o acustica che consente al terapista, ma anche allo stesso paziente, di seguire i propri movimenti sul piano di lavoro e controllare il progresso dell’esercizio che si sta compiendo, ricevendo ad esempio segnali acustici ad indicare l’inizio ed il termine di un esercizio o la deviazione da uno schema di esercizio prefissato. The device of the invention can also include a visual and / or acoustic interface that allows the therapist, but also the patient himself, to follow their movements on the work surface and check the progress of the exercise that is being performed , for example by receiving acoustic signals to indicate the beginning and the end of an exercise or the deviation from a predetermined exercise pattern.
Le modalità di funzionamento del dispositivo sono generalmente due: la modalità attiva, in cui il paziente, applicando una forza sulla manopola sensorizzata, ne provoca lo spostamento fino al raggiungimento dei punti prefissati; e la modalità passiva, in cui à ̈ il dispositivo a guidare il movimento della manopola fino a raggiungere i punti prefissati lungo una traiettoria lineare a velocità costante anche in presenza di brusche variazioni di velocità dovute ad esempio a spasmi. Per far questo il dispositivo dell’invenzione à ̈ attuato preferibilmente per mezzo di due motori elettrici in continua, e la trasmissione à ̈ preferibilmente realizzata tramite due viti a ricircolo di sfere. The device operating modes are generally two: the active mode, in which the patient, applying a force on the sensorized knob, causes it to move until the preset points are reached; and the passive mode, in which the device guides the movement of the knob until it reaches the predetermined points along a linear trajectory at constant speed even in the presence of sudden changes in speed due to spasms, for example. To do this, the device of the invention is preferably implemented by means of two continuous electric motors, and the transmission is preferably carried out by means of two ball screws.
I principali vantaggi del presente dispositivo sono il basso costo, molto più contenuto rispetto ai dispositivi noti aventi un livello di precisione accettabile nella misura della forza, ed il peso e le dimensioni, anche queste molto contenute rispetto ai dispositivi noti. Inoltre, nonostante la semplicità della struttura ed il basso costo necessario a realizzarla, il presente dispositivo à ̈ sicuro, robusto ed affidabile. The main advantages of the present device are the low cost, much lower than the known devices having an acceptable level of precision in the measurement of the force, and the weight and dimensions, which are also very low compared to known devices. Moreover, despite the simplicity of the structure and the low cost necessary to make it, this device is safe, robust and reliable.
In particolare, lo speciale supporto per il braccio del paziente consente al dispositivo di filtrare meccanicamente le componenti della forza esercitata dal paziente sulla manopola, scartando le componenti della forza in piani diversi dal piano di lavoro, e rendendo così la misura più accurata ed affidabile. In particular, the special support for the patient's arm allows the device to mechanically filter the components of the force exerted by the patient on the knob, discarding the components of the force in planes other than the work surface, and thus making the measurement more accurate and reliable. .
Per queste sue caratteristiche vantaggiose di elevata efficienza, ingombro ridotto e basso costo, il presente dispositivo si à ̈ rivelato particolarmente utile e di facile impiego negli ambienti ospedalieri così come nelle applicazioni di tele-riabilitazione. Due to these advantageous characteristics of high efficiency, reduced size and low cost, the present device has proved to be particularly useful and easy to use in hospital environments as well as in tele-rehabilitation applications.
Infine, per la sua natura robotica, come spiegato sopra, anche il presente dispositivo offre un tipo di terapia che à ̈ considerata più intensa e coinvolgente rispetto a quella somministrata dal terapista, la cui presenza à ̈ inoltre minimamente richiesta, con il risultato che più richieste possono essere soddisfatte contemporaneamente. Finally, due to its robotic nature, as explained above, this device also offers a type of therapy that is considered more intense and engaging than that administered by the therapist, whose presence is also minimally required, with the result that more requests can be fulfilled simultaneously.
La presente invenzione à ̈ stata fin qui descritta con riferimento a sue forme di realizzazione preferite. È da intendersi che possono esistere altre forme di realizzazione che afferiscono al medesimo nucleo inventivo, tutte rientranti nell’ambito di protezione delle rivendicazioni qui di seguito riportate. The present invention has been described heretofore with reference to its preferred embodiments. It is to be understood that other embodiments may exist which pertain to the same inventive nucleus, all falling within the scope of the protection of the claims set forth below.
Claims (11)
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US20060293617A1 (en) * | 2004-02-05 | 2006-12-28 | Reability Inc. | Methods and apparatuses for rehabilitation and training |
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Title |
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ZOLLO, L.; ACCOTO, D.; TORCHIANI, F.; FORMICA, D.; GUGLIELMELLI, E.: "Design of a Planar Robotic Machine for Neuro-rehabilitation", 2008 IEEE INTERNATIONAL CONFERENCE ONROBOTICS AND AUTOMATION, 19 May 2008 (2008-05-19), pages 2031 - 2036, XP002678160, Retrieved from the Internet <URL:http://ieeexplore.ieee.org/xpl/articleDetails.jsp?tp=&arnumber=4543505&contentType=Conference+Publications&pageNumber%3D2%26searchField%3DSearch_All%26queryText%3DGuglielmelli> [retrieved on 20120619], DOI: 10.1109/ROBOT.2008.4543505 * |
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