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WO2019025838A1 - Ensemble de stimulateurs avec capteurs pour prothèses de jambe - Google Patents

Ensemble de stimulateurs avec capteurs pour prothèses de jambe Download PDF

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Publication number
WO2019025838A1
WO2019025838A1 PCT/IB2017/054792 IB2017054792W WO2019025838A1 WO 2019025838 A1 WO2019025838 A1 WO 2019025838A1 IB 2017054792 W IB2017054792 W IB 2017054792W WO 2019025838 A1 WO2019025838 A1 WO 2019025838A1
Authority
WO
WIPO (PCT)
Prior art keywords
stimulators
sensor
stimulator
leg
sole
Prior art date
Application number
PCT/IB2017/054792
Other languages
German (de)
English (en)
Inventor
Andreas Aigner
Klaus KOTEK
Rainer Schultheis
Original Assignee
Saphenus Medical Technology Gmbh
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Saphenus Medical Technology Gmbh filed Critical Saphenus Medical Technology Gmbh
Priority to PCT/IB2017/054792 priority Critical patent/WO2019025838A1/fr
Publication of WO2019025838A1 publication Critical patent/WO2019025838A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/50—Prostheses not implantable in the body
    • A61F2/60—Artificial legs or feet or parts thereof
    • A61F2/66—Feet; Ankle joints
    • 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
    • A61H23/00—Percussion or vibration massage, e.g. using supersonic vibration; Suction-vibration massage; Massage with moving diaphragms
    • A61H23/02—Percussion or vibration massage, e.g. using supersonic vibration; Suction-vibration massage; Massage with moving diaphragms with electric or magnetic drive
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/50—Prostheses not implantable in the body
    • A61F2/78—Means for protecting prostheses or for attaching them to the body, e.g. bandages, harnesses, straps, or stockings for the limb stump
    • A61F2/80—Sockets, e.g. of suction type
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/50—Prostheses not implantable in the body
    • A61F2002/5058—Prostheses not implantable in the body having means for restoring the perception of senses
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/50—Prostheses not implantable in the body
    • A61F2/68—Operating or control means
    • A61F2002/6827—Feedback system for providing user sensation, e.g. by force, contact or position
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/50—Prostheses not implantable in the body
    • A61F2/68—Operating or control means
    • A61F2002/6881—Operating or control means optical
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/50—Prostheses not implantable in the body
    • A61F2/68—Operating or control means
    • A61F2/70—Operating or control means electrical
    • A61F2002/705—Electromagnetic data transfer
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/50—Prostheses not implantable in the body
    • A61F2/68—Operating or control means
    • A61F2/70—Operating or control means electrical
    • A61F2002/708—Operating or control means electrical electrically self charging
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/50—Prostheses not implantable in the body
    • A61F2/76—Means for assembling, fitting or testing prostheses, e.g. for measuring or balancing, e.g. alignment means
    • A61F2002/7615—Measuring means
    • A61F2002/7635—Measuring means for measuring force, pressure or mechanical tension
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/50—Prostheses not implantable in the body
    • A61F2/76—Means for assembling, fitting or testing prostheses, e.g. for measuring or balancing, e.g. alignment means
    • A61F2002/7615—Measuring means
    • A61F2002/764—Measuring means for measuring acceleration
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/50—Prostheses not implantable in the body
    • A61F2/76—Means for assembling, fitting or testing prostheses, e.g. for measuring or balancing, e.g. alignment means
    • A61F2002/7615—Measuring means
    • A61F2002/7645—Measuring means for measuring torque, e.g. hinge or turning moment, moment of force
    • 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
    • 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
    • A61H2201/165—Wearable interfaces
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/0404—Electrodes for external use
    • A61N1/0408—Use-related aspects
    • A61N1/0456—Specially adapted for transcutaneous electrical nerve stimulation [TENS]
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/36014—External stimulators, e.g. with patch electrodes
    • A61N1/3603—Control systems
    • A61N1/36034—Control systems specified by the stimulation parameters

Definitions

  • the invention relates to a prosthetic leg sensor stimulator arrangement with a sensor part for the lower leg sole according to the preamble of claim 1.
  • Such arrangements have been created for leg prostheses, which should give the user an improved gait and thus a better Gehmonykeit.
  • the CN205286620 U discloses a prosthesis with pressure sensors, wherein the pressure sensors are each individually arranged on the sole and each pressure sensor is connected to a stimulator.
  • W098 / 25552 AI shows a prosthesis with two sensors on a sole, which are connected to a sensor control. In each case one of the sensors in the front part of the foot and a sensor in the rear part of the foot are shown, wherein the sensors are each connected via wires to an electronic unit.
  • WO2006 / 101445 A1 discloses a sensing sensor feedback system for a missing extremity, wherein a plurality of sensors are arranged on a prosthesis and are connected to a processor.
  • the patient did not normally feel the skin (surface) of the stump of the leg on this depicted foot or in the areas of the nerve area, as it were, but, as it were, his sole, the actually amputated leg.
  • a total of six pressure sensors were arranged in the heel area, in the middle area, in the forefoot area and in the toe area.
  • a pressure sensor was thus arranged in six gangline-typical sole sections of the prosthetic sole, via a data link and a control with one nerve stimulator / (actuator) for information transmission the corresponding six physionomy typical Nervearealabroughe connected.
  • the six stimulators used at that time were designed to give a vibration signal in the shaft of the prosthesis opposite the foot shown per sole section to indicate to the patient that precisely this sole portion of the sole was now subjected to pressure.
  • vibration was felt on the imaged foot which, with some training by the patient, was perceived as pressure.
  • the vibrators used as stimulators in this construction produced a short-term vibration as soon as the pressure sensor received a pressure signal at the corresponding sole area.
  • Object of the present invention is now to further develop the known structure, so that the patient gets a better foot feeling and in addition to the digital information and a qualitative and quantitative z.
  • each gangway-typical sole portion is now net zugeord instead of previously only one at least two sensors namely a first sensor and a second sensor or an n-th sensor. These are connected via a data connection and via a controller with one stimulator each.
  • an information source pressure sensor
  • at least two information sources and each imaged sole section are available for each sole section and not only a more digitally acting stimulation source but at least two which are now not digital but are analogous.
  • the advantage now lies in the fact that these two stimulators or stimulation sources can deliver independent signals, which may, however, be perceived as a mixed signal by the patient in the relevant nerve region section.
  • it is now possible to deliver a much more precise stimulation, or stimulation which now suddenly gives the patient a much more precise understanding of the processes on the artificial sole, both qualitatively and quantitatively.
  • the first sensor is connected to a first stimulator and the second sensor is connected to a second stimulator and every nth sensor is connected to an nth stimulator.
  • the decisive factor is that, according to the invention, the first stimulators and second stimulators or nth stimulators are designed such that they are independent of one another on a used prosthetic leg in the case of application Nerve excitation signals can give to the patient to convey the qualitative mixed statement of at least two stimulators per sole section on the events on the artificial sole.
  • the invention is not limited to the application to leg stumps with groomed or laid nerve endings but rather - with appropriate training effort for the patient or user - on any skin or body regions (nerve areas) are provided.
  • the stimulators are - as known per se - arranged on a support which can be applied to a physiology typical skin area of a leg prosthesis wearer (10).
  • the physionomy typical skin area (9a) is - as known per se, approximately beinform similar or solitary. In any case, the best results are expected, as already published in 2015, when the physionomy-typical skin area lies above a nerve endings area, which was previously redirected with the help of a targeted sensory reinnervation with the nerves of the nervus Suralis responsible for the periosteum.
  • each competent nerve end is assigned to the matching to the sole sections stimulator.
  • the reactivated nerve endings can be arranged in arbitrary positions, for example along a line or in the form of a checkerboard pattern, as long as only the stimulators come to lie in the correct order in relation to these positions of the nerve endings.
  • the stimulators consist of - as known per se - vibration stimulators (comparable to vibrators in mobile telephones) or pressure stimulators (parts which generate electromechanical or pneumatic pressure stimuli) or temperature stimulators (heat elements arranged like a matrix - similar to FIG a thermodynamic jerk) or electro-stimulators (stimulus currents or the like) or light stimulators (eg LEDs or laser diodes) or a combination of at least two of said stimulators.
  • the alternatives also include Biological or chemical stimulators by dosing delivered appropriate substances.
  • the prosthetic limb sensor stimulator assembly in one embodiment, is equipped with vibratory stimulators that, when in use, deliver different vibration frequencies, or deliver equal vibration frequencies at different times, or deliver combinations thereof. This allows a trained user to also distinguish and assign signals, even if not specific nerves (from the amputee leg) are addressed with it.
  • the pressure-exerting stimulators are preferably to press different / deep pressure to discriminate and / or deliver / exert the same pressure at different times, or deliver / exert combinations thereof.
  • using temperature stimulators different temperatures (hot / cold) or equal temperatures are dispensed at different times, or combinations thereof are dispensed analogously. In the case of a variant with electro-stimulators would preferably different
  • pressure stimulators it is preferred if they are electromagnetically or pneumatically excitable.
  • the invention is not limited thereto, but also hydraulic, mechanical, chemical, biological or especially thermodynamic stimulators can be used. Decisive in these variants is that the user feels a clear stimulus on the skin. As a result, the garters or the like are also which are used as stimulator wearer to apply with a certain bias.
  • the user's eyes can also be used as a stimulation information receiver.
  • a stimulation information receiver This by means of e.g. Screen (monitor, display) or in particular by means of a data glasses are formed, which are equipped so that they represent the actual - possibly partial - load on the denture sole - possibly over false colors in the operating state of a prosthesis user.
  • the data connection can be constructed in the context of the invention wired or wireless.
  • the controllers are preferably constructed such that they also allow data transmission - if appropriate only - to external data receivers (13).
  • sole auxiliary sensors may be provided in one embodiment of the invention, which are equipped so that in the operating state additional information in the data connection or in the controls and / or in the display - such as location information, location - ⁇ precisesong,
  • the controller may be equipped with an operator interface via which a denture user / user or physiotherapist may enter command commands or control values, data transmission and / or stimulator activation, and / or the sensors of the sensors To influence auxiliary sensors and in particular information about the ground or the selected gait, shoe type or environmental conditions or the like. to enter or to transfer. Understandably, it is preferred that the sensors, the auxiliary sensors, the data transmission, the controllers and / or the stimulators are battery operated.
  • at least one voltage or current generator is provided, which is connectable / connected to the prosthetic leg (12) and by the dedmungsgemässe use of the prosthesis an energy storage device such as battery, battery, capacitor or the like. supplied with electrical energy.
  • the voltage or current generator is preferably constructed piezoelectrically, electromechanically or photovoltaically.
  • the invention is not limited by these suggestions for improvement. It is generally preferred to also "energy harvesting", as a prosthetic leg is usually used in an energetic environment.Energy harvesting means the method of generating energy locally from the environment / nature without explicit connection to a charging device.
  • the stimulators may be attached / attached to at least one of the following places / objects for the intended use:
  • a tire which means all kinds of tires, such as arm, leg, neck, front, etc.
  • a special embodiment of the invention provides that in addition to the typical gang sole sections also at least one physionomy typical groin section - ie the lateral border of a (artificial) foot with at least one or two sensors and stimulators associated therewith.
  • lateral impacts or forces can be detected and displayed to the user.
  • the number of required sensors it is necessary to balance between a minimum in order to obtain proper information about a gait and a maximum at which the user may be overstimulated. Accordingly, it is proposed to provide correspondingly at least 6 or 8 stimulators or 6 or 8 sensors, wherein also at least 12 sensors in at least 6 physionomy typical sole sections are a good choice. An optimum will depend for each user on how intact reactivated nerves are and / or how adaptive the user is. Particularly advantageous is a structure in which the at least two (or more) sensors per physiology typical sole portion (3) are applied successively along the hydrograph so that they respond to each other in normal gear (rolling the foot along the hydrograph).
  • This prior art EP2962726A1 also discloses sensors which can distinguish the "pressed / not pressed” state and accordingly provide digital information from the sole sections like the prototype, while according to the invention also by the different information and stimulations from at least two sensors per sole section Intermediate values or analog values can be signaled, which allow, for example, to detect a course along a hydrograph.
  • Fig. 1 is a view of a basic structure of a system for
  • Fig. 2 is a view of the basic interaction of the sensors and the associated hydrographs according to the invention
  • FIG. 3 shows an overview of the structure of a stimulator / actuator system in a schematized view to illustrate a unit
  • Fig. 4 is an illustration of the basic structure of the overall system with
  • Fig. 5 is a sketch-like representation of an embodiment of a
  • Stimulators / Actors unit with conical Garter eg for a leg stump 6 is a schematic representation of a further embodiment of a stimulator / actuator unit with a band-shaped garter, for example for a leg, an arm or another band-shaped comprehensive body point
  • Fig. 7 shows an overview of the interaction of the feedback system
  • a leg prosthesis 12 can be provided with a shoe. This shoe also serves as a receptacle for a leg prosthesis sole 2. This leg prosthesis sole 2 serves as a support of the sensor part 1 or itself constitutes a sensor part.
  • the sensor part 1 is subdivided into several pysionomy-typical sole sections 3 (FIG. 2). Each of these physiology typical sole sections 3 contains a precise set number (at least two) of sensors 4 (here only schematically and overview drawn), which are responsible for the signal recording of pressures on the leg prosthesis 2.
  • auxiliary sensors 14 can be provided. These may e.g. Accelerations, temperature, position, or the like measure up.
  • the energy needed to operate the entire system is provided by a battery 18 housed anywhere in the shoe or prosthesis.
  • a current generator 19 is provided, e.g. from kinetic energy gains electricity.
  • another power generator 19a can be used for energy, which is for example constructed so that two mutually resiliently supported parts are moved by the walking motion and equipped with electromagnetic power extraction elements.
  • a data connection 5 provides the interface for communication with a controller 6a in the actuator area (FIG. 3) or to a controller 6b in an external data receiver 13, for example. B. in a user interface 15 (Fig.7).
  • Fig.l thus gives only a brief overview of the structure of an inventive sole sensor. It is important that the prosthesis per se is not part of the invention.
  • the inventive system can be integrated into a wide variety of different prostheses. If necessary, it can even be used for non-amputees, e.g. to perform walking exercises, in patients whose leg nerves are not functioning optimally, so they themselves z. It would be crucial in such patients that a sensor sole 2 according to the invention is connected to stimulators 7 according to the invention which respond to suitable skin areas on the patient in order to provide him with the information to transmit from the sensor sole 2 under his foot.
  • sensors 4 are still the subject of research. In any case, at least two are provided per limited physiology-typical sole portion 3 in order to arrive at the improved sensor-actuator sensation result per physionomy-typical sole portion 3 according to the invention.
  • Operation is generally via rechargeable batteries (batteries) 18.
  • the charging of these rechargeable batteries 18 takes place, for example, via a charging connection 28 (here a conventional charging cable or a wireless charging via capacitive or inductive resonance systems is provided).
  • a charging connection 28 here a conventional charging cable or a wireless charging via capacitive or inductive resonance systems is provided.
  • a wireless charging device can be arranged in the region of a wheelchair, so that the patient, when sitting down, automatically brings his prosthesis into the area of this charging device and thus an automatic charge takes place.
  • the charging can also take place or via the so-called “energy harvesting", in which energy is “extracted” from the direct environment (several methods known per se are possible there).
  • the function of the controller 6 consists essentially of the different timing of the sensors 4 (pressure by walking and by the respective background design) corresponding to the electronics usable signals to generate and then forward them by data transfer 5 to the other systems.
  • the different sensors 4 each physiological typical sole section 3 and the respective associated stimulators 7 provide different complementary signals, so that the user not only digital information from a single sensor per sole section receives but just a mixed signal from at least two sensors 4 / stimulators 7 coming.
  • the sensor part 1 is part of the leg prosthesis sole 2 (not shown in Fig. 2).
  • This sensor part 1 is subdivided into transition line-typical sole sections 3 which are defined along the hydrograph - that is, the line which results as the contact line between foot and ground when a foot is walking on the ground.
  • the gait line and the sole sections 3 may vary from patient to patient or from art base to artificial foot, however, there is an average distribution of these sole sections determinable by the orthopedist per shoe size - as symbolically represented.
  • Each of these hydrographs is assigned an exactly determined number of gangway-typical sole sections 3.
  • Each of these gangline-typical sole sections 3 are now assigned individual (at least two) sensors 4a, 4b and 4n. In this way, it is possible to associate a rolling movement from heel to ball (or vice versa) a corresponding hydrograph and to detect independent signals using these sensors 4a, 4b, 4n. Now, if one of the sensors 4a, 4b, 4n provides a signal that is not usually on the expected hydrograph, it may indicate an unexpected movement (eg, shock) or an abnormally generated background (eg, sidewalk or pebble on the ground ) getting closed.
  • an unexpected movement eg, shock
  • an abnormally generated background eg, sidewalk or pebble on the ground
  • the power to operate the assembly is provided by the battery 18.
  • the auxiliary sensor 14 provides additional information about the current operating state of the leg prosthesis sole 2.
  • As an additional source of energy of the Power generator 19 are used.
  • the control of the signals in the sole area 6 is accomplished by the processing of the signals and the generation of the required pulses.
  • FIG. 3 The skin 22 of the leg stump remaining after an amputation serves the leg prosthesis wearer 10 as an assembly aid for a prosthesis to which the entire system according to the invention is connected.
  • a Physionomiewithn skin area 9 this is a skin area that is due to its physionomic properties suitable sensor stimuli from the sensor part 1 well absorb (it does not necessarily be connected with Moneven) - lie the nerve pathways on leg 11 and form in this application Physionomy Typical Nerve Area Section 8. Both this physionomy typical skin area 9 and the physionomy typical nerve area section 8 can now be used as the point of contact for the stimulators 7 (not seen in FIG. 3).
  • a liner 21 (rubber-like sock part) is first applied for mounting the shaft 27 with the prosthetic leg 12 and the inside of the leg prosthesis 20.
  • the garter 23 is performed as arm / leg 24 with the stimulator carrier 25 or alternatively the garter 23 a with the stimulator carrier 25 a launched.
  • This structure is exemplary and may optionally differ, in that the liner 21 is absent or replaced by another device. It is also possible, if appropriate, to modify the sequence of this construction so that the garter belt 23 comes underneath the liner 21 or is integrated in the liner 21.
  • the processing of the signals and the preparation of these signals for a suitable control of the stimulators 7 takes place by means of the control 6a in the actuator area.
  • the data to be evaluated are transmitted via the data connection 5.
  • a charging port 28 serves to supply the system and charge the energy storage. By means of the main switch 30, the system can be switched on or off.
  • the garters 23 with the actuators 7 can be attached to various places on the human body. As in the prior art prototype, an application near the stump will be preferred. Quite conceivable (and still to be explored) is also the area of thigh, arm, forehead, non-amputee leg, etc. Each sensory area of the human body can presumably be trained to stimulate the sensor signals via the inventive stimulators so that the user a "foot feel" wins, ie this improved system can be used both with and without TSR operation.
  • TSR surgery In addition to improved walking sensation, TSR surgery sometimes reduces or even eliminates phantom pains, so in many cases TSR surgery will be preferred. Also denture wearers, who are not satisfied with the so-called liner 21, as by the constant contact with the skin here sometimes difficulties with respect. Skin irritations and reactions result. There are already prostheses without liners. These too are supported by the system according to the invention.
  • the shaft on which the prosthesis is mounted is usually a custom-made for the respective denture wearer. This is made by the orthopedic technician especially for this prosthesis and the patient. Accordingly, both the sensor part 1 and the carrier for the stimulators 7 can be adapted.
  • a further particular embodiment of the invention provides that the garter 23a can also be used as a so-called “massage band.” If the patient wishes, he switches the prosthesis into the massage mode and can complete helpful therapy programs. In this mode, the sensor signals of the sensor part are ignored, but a massage-typical stimulation is performed.
  • a prosthetic leg 10 forms with his prosthetic leg 12 and his footwear during use a unit.
  • the leg prosthesis sole 2 and the sensor part 1 are installed in the shoe and serve the required signals for the signal processing of the control in the sole area 6, the control in the actuator area 6a and the control in the external data receiver 6b (controls are not in Fig. 4) to see).
  • an additional auxiliary sensor 14d can be provided in the region of the shaft 27 in the region of the shaft 27, an additional auxiliary sensor 14d can be provided.
  • a supplemental battery 18d may provide the system in the shaft 27 with additional energy.
  • a current generator 19c By inserting a current generator 19c, the entire system in the shaft 27 can be powered independently of the existing charging port 28.
  • the entire system with a charger 29 can be charged by means of charging cable or wirelessly.
  • a charger 29 (not visible in Fig. 4) can be charged by means of charging cable or wirelessly.
  • an auxiliary sensor 14e an auxiliary signal, by a battery 18e additional energy and by a Electric generator 19f be provided independent of the charger charge.
  • the invention also includes systems in which auxiliary sensors 14 or the non-amputated leg or arm, the head odgl. come. In combination of all signals, sometimes very helpful information about the ground or, more generally, about the environment - e.g. Wind pressure, temperature, position of the patient in the room udgl.
  • Fig. 5 The garter 23a is used in connection with the stimulator carrier 25a for receiving or attachment of the stimulators 7a, 7b, 7n.
  • the number of these actuators is only an example and is representative of different combinations that can be installed in this area.
  • the arrangement of the sensors in this embodiment is designed such that the hydrographs (- Fig. 2) and the correspondingly arranged sensors 4a, 4b, 4n (not shown in Fig. 5) can be imaged realistically using the stimulators 7a, 7b, 7n ,
  • the controller in the actuator area 6a generates the control signals for all stimulators 7 on the stimulator carrier 25a from the data received from the data connection 5.
  • the auxiliary sensors 14a additionally present in the garter 23a can be used to provide additional information for the control in the actuator area 6a.
  • the battery 18b is available. This battery 18b can be charged, for example by means of an external charger 29 at the charging port 28.
  • An additional option is to provide the required energy for charging the battery 18b by means of the current generator 19d. In the case of the current generator 19d, this energy supplies either an external, wirelessly coupled charger 29 or, in the case of a self-sufficient energy supply, the current generator 19d itself.
  • the concrete shape of the garter belts 23 are very diverse. Depending on the application site, these can be adjusted accordingly. The biggest problem is the shape of the sole sensor (according to the artificial foot) to be able to depict it accordingly on the garter belt.
  • Auxiliary sensors 14 also help to measure and better interpret the most diverse signals and environmental parameters.
  • Fig. 6 The garter 23 is used in connection with the stimulator carrier 25 for receiving or attachment of the stimulators 7a, 7b, 7n.
  • the number of these actuators / stimulators 7 is only an example and is representative of different combinations that are placed in this area.
  • the arrangement of the sensors 4 is designed so that the hydrographs (- Fig. 2) and the correspondingly arranged sensors 4a, 4b, 4n (not shown in Fig. 6) can be imaged realistically using the stimulators 7a, 7b, 7n.
  • the controller in the actuator area 6a generates the control signals for all stimulators 7 on the stimulator carrier 25 from the data received from the data connection 5.
  • the auxiliary sensors 14b additionally present in the garter 23 can be used to provide additional information for the controller 6a in the actuator area.
  • battery 18c is available. This battery 18 c can be charged, for example by means of an external charger 29 at the charging port 28.
  • An additional option is to provide the required energy for charging the battery 18c by means of the current generator 19b. In the case of the current generator 19b, this energy supplies either an external, wirelessly coupled charger 29 or, in the case of a self-sufficient energy supply, the current generator 19b itself.
  • FIG. 7 In the case of inpatient care, a physiotherapist 16 (or similar) interrupts a data connection 5 the leg prosthesis wearer 10 and the external Data receiver 13 on. As a result, it is possible to exchange important data between the controller in the external data receiver 6b and the controller 6, 6a of the leg prosthesis carrier 10 by means of a stationary user interface 15.
  • the physiotherapist 16 sets up a data connection 5 between the leg prosthesis wearer 10 and the external data receiver 13. This makes it possible, by means of a portable operating interface 15 important data between the controller 6b in the external data receiver 13 and the controller 6, 6a of the leg prosthesis wearer 10 exchange.
  • the data transmission 5 thus not only serves to control the actuators, but is also the interface to the "command station.”
  • the data can be accessed by means of stationary or mobile devices (eg mobile telephone)
  • the user can influence the control either by specific influence or by automatic mechanisms, eg he can enter the worn footwear or let the current ground (sand, gravel, asphalt) flow into the control.
  • the detected soil black ice, solid asphalt, or the like
  • the detected soil is taken as an opportunity to automatically adjust the control accordingly.

Landscapes

  • Health & Medical Sciences (AREA)
  • General Health & Medical Sciences (AREA)
  • Transplantation (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Rehabilitation Therapy (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Pain & Pain Management (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Epidemiology (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Prostheses (AREA)

Abstract

La présente invention concerne un ensemble de stimulateurs avec capteurs pour prothèses de jambe muni d'une partie avec capteurs (1) pour la semelle (2) de prothèse de jambe, qui dispose d'au moins deux capteurs (4) dans des segments de semelle (3) typiques de la démarche qui sont reliés, à l'aide d'une liaison de données (5) et d'au moins une commande (6), à un stimulateur/(actionneur) (7) provoquant une excitation nerveuse, à un segment de zone nerveuse (8) typique de la physionomie. Chaque premier capteur (4a) est relié à un premier stimulateur (7a) et chaque second capteur (4b) est relié à un second stimulateur (7b) et chaque n-ième capteur (4n) est relié à un n-ième stimulateur (7n) de même que les premier (7a) et second (7b) stimulateurs ou n-ièmes stimulateurs (7n) sont conçus de telle sorte qu'ils puissent délivrer, en cas d'utilisation, des signaux d'excitation nerveuse indépendants les uns des autres à une prothèse de jambe (12) utilisée. Grâce à cette structure, des signaux/informations nettement améliorés sont transmis à l'utilisateur sur sa démarche.
PCT/IB2017/054792 2017-08-04 2017-08-04 Ensemble de stimulateurs avec capteurs pour prothèses de jambe WO2019025838A1 (fr)

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Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN110859688A (zh) * 2019-12-06 2020-03-06 中国科学院长春光学精密机械与物理研究所 一种用于假肢控制的智能鞋及假肢的控制方法
AT521791B1 (de) * 2019-06-18 2020-07-15 Dr Tomaz Kos Rückmeldungssystem für eine Prothese, insbesondere für eine Armprothese, und Verfahren zum Erzeugen eines Stimulus für den Träger der Prothese mittels eines solchen Rückmeldungssystems
WO2021084502A1 (fr) 2019-10-31 2021-05-06 Saphenus Medical Technology Gmbh Dispositif de substrat de stimulateur et dispositif de stimulation de cellules nerveuses
CN114177472A (zh) * 2021-11-30 2022-03-15 中国人民解放军总医院第四医学中心 一种应用于下肢假肢的植入式电刺激感知反馈系统
US11833064B1 (en) 2022-06-03 2023-12-05 JSG IP Ventures, LLC System and methods for residual limbs of amputees

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WO1998025552A1 (fr) 1996-12-10 1998-06-18 Novacare Orthotics And Prosthetics East, Inc. Systeme et procede utilises pour donner une sensibilite dans un membre protethique ou presentant une deficience sensorielle
WO2003086235A2 (fr) 2002-04-12 2003-10-23 Trustees Of Boston University Prothese sensorielle pour le controle d'equilibre ameliore
WO2006101445A1 (fr) 2005-03-23 2006-09-28 össur hf Dispositif et procede de stabilisation d'une feuille d'acier
US20080300692A1 (en) * 2006-12-14 2008-12-04 Chas. A. Blatchford & Sons Limited Prosthetic Ankle and Foot Combination
WO2015193856A1 (fr) 2014-06-20 2015-12-23 Scuola Superiore S.Anna Dispositif de rétroaction haptique
EP2962726A1 (fr) 2014-07-03 2016-01-06 Alfred Meier-Koll Systeme d'excitation de sensations fantomes
DE102014013441A1 (de) 2014-09-11 2016-03-17 Matthias Arend Sensorsystem für eine Beinprothese
CN205286620U (zh) 2015-12-10 2016-06-08 泸州医学院附属医院 膝下假肢姿态矫正装置

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Publication number Priority date Publication date Assignee Title
WO1998025552A1 (fr) 1996-12-10 1998-06-18 Novacare Orthotics And Prosthetics East, Inc. Systeme et procede utilises pour donner une sensibilite dans un membre protethique ou presentant une deficience sensorielle
WO2003086235A2 (fr) 2002-04-12 2003-10-23 Trustees Of Boston University Prothese sensorielle pour le controle d'equilibre ameliore
WO2006101445A1 (fr) 2005-03-23 2006-09-28 össur hf Dispositif et procede de stabilisation d'une feuille d'acier
US20080300692A1 (en) * 2006-12-14 2008-12-04 Chas. A. Blatchford & Sons Limited Prosthetic Ankle and Foot Combination
WO2015193856A1 (fr) 2014-06-20 2015-12-23 Scuola Superiore S.Anna Dispositif de rétroaction haptique
EP2962726A1 (fr) 2014-07-03 2016-01-06 Alfred Meier-Koll Systeme d'excitation de sensations fantomes
DE102014013441A1 (de) 2014-09-11 2016-03-17 Matthias Arend Sensorsystem für eine Beinprothese
CN205286620U (zh) 2015-12-10 2016-06-08 泸州医学院附属医院 膝下假肢姿态矫正装置

Cited By (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
AT521791B1 (de) * 2019-06-18 2020-07-15 Dr Tomaz Kos Rückmeldungssystem für eine Prothese, insbesondere für eine Armprothese, und Verfahren zum Erzeugen eines Stimulus für den Träger der Prothese mittels eines solchen Rückmeldungssystems
AT521791A4 (de) * 2019-06-18 2020-07-15 Dr Tomaz Kos Rückmeldungssystem für eine Prothese, insbesondere für eine Armprothese, und Verfahren zum Erzeugen eines Stimulus für den Träger der Prothese mittels eines solchen Rückmeldungssystems
EP3753536A1 (fr) 2019-06-18 2020-12-23 Kos, Tomaz Système de rétroaction pour une prothèse, en particulier pour une prothèse de bras, et procédé de génération d'un stimulus pour le support de la prothèse au moyen d'un tel système de rétroaction
WO2021084502A1 (fr) 2019-10-31 2021-05-06 Saphenus Medical Technology Gmbh Dispositif de substrat de stimulateur et dispositif de stimulation de cellules nerveuses
CN110859688A (zh) * 2019-12-06 2020-03-06 中国科学院长春光学精密机械与物理研究所 一种用于假肢控制的智能鞋及假肢的控制方法
CN110859688B (zh) * 2019-12-06 2021-07-16 中国科学院长春光学精密机械与物理研究所 一种用于假肢控制的智能鞋及假肢的控制方法
CN114177472A (zh) * 2021-11-30 2022-03-15 中国人民解放军总医院第四医学中心 一种应用于下肢假肢的植入式电刺激感知反馈系统
US11833064B1 (en) 2022-06-03 2023-12-05 JSG IP Ventures, LLC System and methods for residual limbs of amputees
WO2024211915A1 (fr) * 2022-06-03 2024-10-10 JSG IP Ventures, LLC Systèmes et procédés pour membres résiduels d'amputés

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