EP2155129A2 - Orthèse plantaire pour le traitement d'une insuffisance veineuse - Google Patents

Orthèse plantaire pour le traitement d'une insuffisance veineuse

Info

Publication number
EP2155129A2
EP2155129A2 EP08737458A EP08737458A EP2155129A2 EP 2155129 A2 EP2155129 A2 EP 2155129A2 EP 08737458 A EP08737458 A EP 08737458A EP 08737458 A EP08737458 A EP 08737458A EP 2155129 A2 EP2155129 A2 EP 2155129A2
Authority
EP
European Patent Office
Prior art keywords
plantar
orthesis
zone
reservoir
support zone
Prior art date
Legal status (The legal status 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 status listed.)
Withdrawn
Application number
EP08737458A
Other languages
German (de)
English (en)
Inventor
Carlo Subini
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Rizzoli Ortopedia SpA
Original Assignee
Rizzoli Ortopedia SpA
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 Rizzoli Ortopedia SpA filed Critical Rizzoli Ortopedia SpA
Publication of EP2155129A2 publication Critical patent/EP2155129A2/fr
Withdrawn legal-status Critical Current

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
    • A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices ; Anti-rape devices
    • A61F5/01—Orthopaedic devices, e.g. long-term immobilising or pressure directing devices for treating broken or deformed bones such as splints, casts or braces
    • A61F5/14—Special medical insertions for shoes for flat-feet, club-feet or the like

Definitions

  • the present invention relates to a foot orthosis for treatment of lower limb diseases, in particular, of the chronic venous insufficiency. Description of the prior art
  • CVI chronic venous insufficiency
  • the lower limbs have a deep venous circulation and a surface circulation, connected to each other by many vessels, or perforating veins.
  • the venous tree furthermore, has inner valves capable of keeping the blood flow in an antigravitational direction.
  • the return path of the blood from the periphery to the heart is carried out, in fact, against the force of gravity and is assisted especially by squeezing the plantar arch by the body weight and by the contraction of the calf muscle.
  • the return path of the blood from the lower limbs to the heart begins in the periphery, at the capillary branches and is assisted by squeezing the venous sponge in the plantar arch and by muscle pumping, i.e. by the contractions of the muscles of the calf that cause pumping the blood in a thoracic direction, and additionally the intravasal valves that close and prevent the blood to fall backwards.
  • muscle pumping i.e. by the contractions of the muscles of the calf that cause pumping the blood in a thoracic direction
  • intravasal valves that close and prevent the blood to fall backwards.
  • the blood stagnation causes an increase of the pressure in the veins, enlarging the vein walls and causing the blood to leak into the tissues.
  • the stagnation causes, furthermore, an inflammatory process with accumulation of oxygen free radicals that can damage the cells of the vein walls.
  • the oxidation makes the vessels more fragile and permeable, contributing to the formation of edema and
  • CVI chronic venous insufficiency
  • organic venous insufficiency caused by real alterations to the veins, such as varicous veins, after-effects of venous thrombosis, etc.
  • functional venous insufficiency i.e. due to hyper- work of the veins caused by an excessive activity, posture modification, lymphedema, etc.
  • varicous veins which are permanent dilations of the wall of the veins, are associate, in particular, to the number of pregnancies, to the use of oral contraceptives, to water retention and to overweight.
  • Other factors that trigger the onset of varicous veins are familiarity, working posture, chronic constipation. Even a past venous thrombosis of the deep veins assists the onset of varicous veins with a mechanism of hemodynamic compensation.
  • plantar orthoses used for treatment of lower limb diseases correlated to a low blood circulation.
  • the majority of such plantar orthoses has a stiff protrusion at the plantar arch of with the object of stretching the tissues of the plantar boundary of the foot and of avoiding collapse of astragalus bone.
  • plantar orthoses succeed only in part to restore the blood circulation of the foot.
  • one exemplary plantar orthosis for treatment of lower limb diseases, comprising: an insole adapted to be arranged in a shoe and to support the gait of a patient, the insole having a rearfoot support zone, a midfoot support zone and a forefoot support zone;
  • - stimulating means associated with the insole at the support of the midfoot and of the plantar arch and adapted to apply, during the gait of the patient, a pressure on the midfoot and on the plantar arch of the patient's foot, a transversal stepped protrusion associated with the insole at the support of the forefoot, the transversal stepped protrusion being adapted to open/close the metatarsal heads during the gait of the patient to assist the blood reflux.
  • actuating means are provided associated with the insole at the rearfoot support zone, said actuating means receiving a pressure from the foot actuates the stimulating means, such that during the next phase of plantar support, the plantar arch and the midfoot, starting from a not pressed condition, are subject to an action by the stimulating means, this action compressing the venous sponge of the foot for stimulating the blood reflux towards the leg of the blood accumulated in the venous sponge, the blood reflux being assisted by the action of the transversal stepped protrusion that opens progressively the metatarsi, previously closed, according to a fan-like configuration.
  • the actuating means are not more forced by the rearfoot support zone, such that the stimulating means reduce the pressure on the midfoot and on the plantar zone, the transversal stepped protrusion maintaining the action on the metatarsal bones that remain open according to a fan-like configuration assisting the blood reflux.
  • the actuating means continue not to be forced by the rearfoot support zone, such that the stimulating means stop, or reduce, the pressure on the midfoot and on the plantar zone, and contemporaneously the reaction is reduced or ends of the transversal stepped protrusion, so that the metatarsal bones close again approaching to each other, blocking again the blood reflux.
  • the insole comprises at least a first and a second layer overlapped to each other, the actuating means and the stimulating means being arranged between the first and the second layer.
  • the second layer extends above the first layer between the rearfoot support zone and the zone of metatarsal heads at which the transversal stepped protrusion is provided .
  • the actuating means are arranged in a housing made at the surface of the second layer that in use faces towards the first layer.
  • the actuating means and the stimulating means comprise respectively: a first reservoir of flexible material arranged at the rearfoot support zone, a second reservoir also of flexible material arranged at the midfoot and plantar arch support zone, the second reservoir being in fluid dynamic connection with the first reservoir, the first and the second reservoir being selectively inflated by a fluid circulating between them responsive to the position of the load of the patient's body on the foot during the gait.
  • the first and the second reservoir are connected by a duct.
  • first and the second reservoir are connected by a first duct having a check valve adapted to cause the fluid to move from the first to the second reservoir and to prevent backflow, and at least one second duct having a check valve adapted to cause the fluid to move from the second to the first reservoir and to prevent backflow.
  • the fluid is selected from the group comprised of: a gas; a liquid.
  • the actuating means and the stimulating means are associated with at least one sensor adapted to measure a value of pressure on the actuating means and to transmit it to a control unit adapted to actuates selectively the stimulating means responsive to value of the data of pressure.
  • the senor when the pressure increases owing to patient's load at the rearfoot support zone, the sensor operates the stimulating means.
  • the second layer is made of thermoplastic materials, such that it moulds directly on the patient's foot in order to fit perfectly to the shape thereof.
  • the first layer is made of expanded plastic material.
  • the actuating means comprises a cylinder/piston arranged at the rearfoot support zone and the stimulating means comprise a cylinder/piston arranged at the plantar arch and midfoot support zone, the cylinders being connected to each other by a duct, such that by squeezing one of them, the other moves up and vice- versa.
  • the actuating means comprises a plate arranged at the rearfoot support zone and the stimulating means comprise a plate arranged at the plantar arch and midfoot support zone, the cylinders being connected to each other by an arm hinged to said insole, such that by squeezing one of them, the other moves up and vice- versa, obtaining the same effect in the said four steps .
  • Figure 1 shows a perspective view of a plantar orthosis for treatment of lower limb diseases, in particular, chronic venous insufficiency, according to the invention
  • Figure 2 shows a foot in a phase of rearfoot support
  • Figure 3 shows in detail an exploded perspective view of a first exemplary embodiment of the orthosis of figure 1;
  • Figure 4 shows a perspective partially cross sectional view of the orthosis of figure 3 in the rearfoot support phase
  • Figure 9 shows a view similar to figure 4, but in the forefoot support phase
  • Figures 10 and 11 show a forefoot respectively in a configuration with metatarsal heads closed and open;
  • Figure 12 shows a perspective view of an exemplary embodiment of the orthosis of figure 1;
  • Figures 13 and 14 show perspective partially cross sectional views of the plantar orthosis according to figure 12 in two different working configurations
  • Figures 15 and 16 show perspective partially cross sectional views of an exemplary embodiment of the plantar orthosis according to figure 12 in two different working configurations; - Figure 17 shows a further exemplary embodiment of the actuating means and of the stimulating means of the orthosis according to the invention.
  • a plantar orthosis 1, according to the invention for treatment of lower limb diseases of a patient, in particular, owing to venous insufficiency, comprises an insole 2 having a rearfoot support zone 41, a midfoot support zone 42 and a transversal stepped protrusion 43.
  • the insole is made so that, during the gait of a patient, the rearfoot support zone 41, receiving a pressure from the patient's foot in the rearfoot support phase 51, enlarges the midfoot support zone at the plantar arch 52 producing a pressure on the latter.
  • This action combines with the action of the transversal stepped protrusion 43, which is adapted to cause opening/closing the metatarsal heads of the forefoot 53, to assist the blood reflux. Owing to this, a gait with the plantar orthosis 1 as above described allows to obtain the results described hereinafter.
  • the insole 2 can comprise a first layer 3, for example of foam material of polyethylene copolymers, and a second layer 4, for example of linear polyester on a two weft textile base.
  • Second layer 4 is used for forming two reservoirs 11 and 12 united by a duct 13. More precisely, the first reservoir 11 is arranged in the rearfoot zone 41 of the insole, whereas the second reservoir 12 is arranged in the midfoot and plantar arch zone 42.
  • the reservoirs 11 and 12 can be arranged in a housing 6 with complementary shape, for example made at the surface 4b of the second layer 4 that in use faces towards first layer 3.
  • Reservoir 11 can have, for example, a substantially elliptical shape, corresponding substantially to the shape of the rearfoot support zone 51 (figure 2) , whereas reservoir 12 has an elongated shape and is arranged transversally to the foot.
  • the shape, the size and the position of reservoir 12 can be obtained according to the anatomical shape of the patient's foot, and are adapted to apply a correct action, as hereinafter described, in the plantar arch and midfoot support zone 52.
  • the reservoirs 11 and 12 are selectively filled with a fluid 20, for example air or water, which inflates either reservoir 11, now or reservoir 12, according to the position of the load of the patient's body on the foot 50. More in detail, as diagrammatically shown in figure 4, and with reference also o the position of the foot of figure 2, when the patient rests on the rearfoot zone 51 the pressure of the body weight on zone 4 squeezes reservoir 11 causing a movement of the fluid 20 towards reservoir 12 (see also figure 5), which is inflated and raises zone 42 that is located at the midfoot and plantar arch 52 of the patient's foot. Zone 42 remains inflated, owing to the fluid present in reservoir 12, until the patient does not raise rearfoot 51 from zone 41.
  • a fluid 20 for example air or water
  • second reservoir 12 depends on the variation of volume subsequent to the interactions with first reservoir 11, according to the distribution of the loads between the two reservoirs, in turn according to the weight of the patient, the geometry of the reservoirs, the type of fluid, the static pressure of the fluid, the conformation of the shoe.
  • the choice of the size of the duct 13, furthermore, is adapted to change the viscoelastic behaviour of reservoirs 11 and 12.
  • first and the second reservoir 11 and 12 are connected by a first duct having a check valve adapted to cause the fluid to move from the first to the second reservoir and to prevent backflow, and at least one second duct having a check valve adapted to cause the fluid to move from the second to the first reservoir and to prevent backflow.
  • first duct having a check valve adapted to cause the fluid to move from the first to the second reservoir and to prevent backflow
  • second duct having a check valve adapted to cause the fluid to move from the second to the first reservoir and to prevent backflow.
  • reservoir 12 is pressurized in order to cause zone 42 to inflate by applying a first triggering action in the zone 52 of the plantar arch and midfoot support of the foot 50 of the patient.
  • This first stimulus is in any case only partial, since the load of the weight of the patient is born about completely from the rearfoot 51.
  • a successive phase follows diagrammatically shown in figure 6.
  • the foot is completely supported by the ground, distributing the load between rearfoot 51, midfoot 52 and forefoot 53.
  • the zone 41 with reservoir 11 continues to be flat, maintaining reservoir 12 of zone 42 inflated, which is thereafter raised by applying a stimulating action on zone 52 of the midfoot and of the plantar arch, thus compressing the venous sponge and stimulating the blood reflux towards the leg of the blood accumulated in the venous sponge.
  • This blood reflux is assisted by the action of the transversal stepped protrusion 43 that, after receiving part of the load on the foot, reacts on the forefoot 53 by opening of metatarsal bones, which were previously closed at an angle ⁇ l (figure 10) , to a fan-like configuration according to an angle ⁇ 2 (figure 11) .
  • a step of forefoot support 53 follows, during which the load acting on rearfoot 51 is low, or zero (figure 7) .
  • the load dos not act any more on the zone 41 with reservoir 11, and the pressure of the midfoot on zone 42 assists pumping the fluid from reservoir 12 to reservoir 11 (see also figure 9).
  • the action of zone 42 is thereafter lower, or even stopped, and then the compression of the venous sponge is also reduced, whereas the action of the transversal stepped protrusion 43 remains active, which assists still a residual blood reflux from the venous sponge of the foot towards the leg.
  • the actuating means comprises a sensor of force 21 arranged at the rearfoot support zone 41 and the stimulating means comprise an actuator 22 arranged at the plantar arch and midfoot support zone 42.
  • the sensor of force 21 detects a value of pressure at the insole 2 and sends it to a control unit 25 that operates the actuator 22, for example of electromechanical type, responsive to the value of pressure. More in detail, one of the possible mode of operation is the following: when the pressure increases owing to patient's load at the zone 41, control unit 25 operates actuator 22 (figure 13) , which raises stimulation zone 42 of the plantar arch.
  • the control unit 25 discharges actuator 22 (figure 14), which lowers plantar arch stimulation zone 42. Then, even if in a different way with respect to figures 3 and 4, the system is capable to execute all the steps of figures from 5 to 8.
  • the actuating means comprises a cylinder/piston 31 arranged at the rearfoot support zone 41 and the stimulating means comprise a cylinder/piston 32 arranged at zone 42, set between plantar arch and the midfoot.
  • the two cylinders 31 and 32 are connected by a duct 33, such that by squeezing one of them, the other moves up and vice-versa.
  • piston 31 is pressed during the action of the heel in the rearfoot support zone 41, lifting piston 32 (figure 17) .
  • lifting piston 32 (figure 17) .
  • cylinder/piston 31 is raised (figure 16) .
  • the system is capable of executing all the steps of figures from 5 to 8.
  • the stimulating means comprises a plate 61 arranged at the rearfoot support zone (not shown in the figure) and a plate 62 arranged at the zone set between the plantar arch and the midfoot.
  • the two plates 61 and 62 are connected by an arm 63, hinged at point 65 to a support 64 integral to the insole, creating substantially a first type lever. This way, by squeezing one of the two plates, the other moves up and vice-versa.
  • the plate 61 is pressed during the action of the heel in the rearfoot support zone, causing plate 62 to raise (position indicated as continuous line) , which pushes under the plantar arch and the midfoot, as shown by analogy to figures 5 and 6.
  • the plate 31 is raised (shown with dotted line) .
  • the system is capable of carrying out all the steps of figures from 5 to 8.

Landscapes

  • Health & Medical Sciences (AREA)
  • Nursing (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Orthopedics, Nursing, And Contraception (AREA)

Abstract

L'invention porte sur une orthèse plantaire (1) pour le traitement de maladies des membres inférieurs d'un patient, en particulier, dues au phénomène de l'insuffisance veineuse. Ladite orthèse plantaire (1) comporte une semelle (2) présentant une zone de support de la partie arrière du pied (41), une zone de support de la partie moyenne du pied (42) et une saillie étagée transversale (43). La semelle est réalisée de telle sorte que, pendant que le patient marche, la zone de support de la partie arrière du pied (41) qui reçoit la pression du pied du patient dans la région (51) de support de la partie arrière du pied, amène la zone de support de la partie moyenne du pied et la zone (52) de la voûte plantaire à produire une pression sur celle-ci. Ceci se combine à l'action de la saillie étagée transversale (43) qui est conçue pour provoquer une ouverture/fermeture des têtes métatarsiennes de la partie antérieure du pied (53) pour aider le reflux sanguin.
EP08737458A 2007-04-19 2008-04-17 Orthèse plantaire pour le traitement d'une insuffisance veineuse Withdrawn EP2155129A2 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
ITPI20070051 ITPI20070051A1 (it) 2007-04-19 2007-04-19 Ortesi plantare per il trattamento dell'insufficienza venosa
PCT/IB2008/000930 WO2008129389A2 (fr) 2007-04-19 2008-04-17 Orthèse plantaire pour le traitement d'une insuffisance veineuse

Publications (1)

Publication Number Publication Date
EP2155129A2 true EP2155129A2 (fr) 2010-02-24

Family

ID=39855248

Family Applications (1)

Application Number Title Priority Date Filing Date
EP08737458A Withdrawn EP2155129A2 (fr) 2007-04-19 2008-04-17 Orthèse plantaire pour le traitement d'une insuffisance veineuse

Country Status (3)

Country Link
EP (1) EP2155129A2 (fr)
IT (1) ITPI20070051A1 (fr)
WO (1) WO2008129389A2 (fr)

Families Citing this family (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8479413B2 (en) 2008-12-22 2013-07-09 Msd Consumer Care, Inc. Footwear insole for alleviating arthritis pain
CN109620510B (zh) * 2018-12-19 2021-04-09 国家康复辅具研究中心 扁平足智能矫形器及矫形方法
WO2020152377A1 (fr) * 2019-01-23 2020-07-30 Fernandez Macias Abel Orthèse plantaire
CN114831848B (zh) * 2022-03-29 2024-07-23 中国人民解放军总医院第一医学中心 用于足底静脉康复泵的脚套装置

Family Cites Families (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102005017100A1 (de) * 2005-04-13 2006-10-19 Axel Krauss Vorrichtung und Verfahren zum orthopädischen Zurichten von Schuhwerk

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See references of WO2008129389A3 *

Also Published As

Publication number Publication date
ITPI20070051A1 (it) 2008-10-20
WO2008129389A2 (fr) 2008-10-30
WO2008129389A3 (fr) 2008-12-18

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