Classifications

• • 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
  • A61H3/00—Appliances for aiding patients or disabled persons to walk about
  • A61H3/008—Appliances for aiding patients or disabled persons to walk about using suspension devices for supporting the body in an upright walking or standing position, e.g. harnesses
• • 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
  • A61H3/00—Appliances for aiding patients or disabled persons to walk about
  • A61H3/04—Wheeled walking aids for patients or disabled persons
• • 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
  • A61H3/00—Appliances for aiding patients or disabled persons to walk about
  • A61H3/04—Wheeled walking aids for patients or disabled persons
  • A61H2003/043—Wheeled walking aids for patients or disabled persons with a drive mechanism
• • 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
  • A61H2201/1619—Thorax
  • A61H2201/1621—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
  • A61H2201/1602—Physical interface with patient kind of interface, e.g. head rest, knee support or lumbar support
  • A61H2201/1628—Pelvis
  • A61H2201/163—Pelvis 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
  • A61H2201/1602—Physical interface with patient kind of interface, e.g. head rest, knee support or lumbar support
  • A61H2201/1635—Hand or arm, e.g. handle
• • 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
  • A61H2201/1652—Harness
• • 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
  • A61H2201/5023—Interfaces to the user
  • A61H2201/5043—Displays
• • 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
• • 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
  • A61H2201/5064—Position sensors
• • 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
  • A61H2201/5092—Optical sensor
• • 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
  • A61H2230/00—Measuring physical parameters of the user
  • A61H2230/62—Posture
  • A61H2230/625—Posture used as a control parameter for the apparatus

Definitions

• the field of the invention is that of physiotherapy.
• the invention relates to an autonomous device for outpatient rehabilitation.
• the device according to the invention is particularly suitable for the functional rehabilitation of persons who have suffered an acute neurological accident, for example a cerebrovascular accident, a traumatic brain injury or an incomplete spinal cord injury, and persons suffering from neurological pathologies. chronic progressive diseases such as multiple sclerosis or Parkinson's disease.
• Proper rehabilitation of walking involves reproducing to a patient a varied set of movements of walking in a precise manner, respecting the physiological rhythm of walking.
• a known technique of reeducation of walking without advancing is to walk the patient on a treadmill.
• mobilizing therapists throughout a rehabilitation program to assist a patient to achieve steps has the disadvantage of being very expensive.
• each leg of a patient has been thought to equip each leg of a patient with a functional orthosis forming an exoskeleton, to guide its movement on the treadmill.
• a disadvantage of this technique implementing an exoskeleton is that it requires a great effort to the patient, and that it can not be performed only with subjects with good cardiovascular health.
• Another disadvantage of this known technique is that the laying or removal of an exoskeleton is a long operation.
• Another disadvantage of this technique is that it may not be suitable for elderly patients, who are more reluctant to accept new technology.
• a common disadvantage of these known techniques of walking rehabilitation without advancing is that the dynamics of walking on treadmill, or using a device driving the feet of a patient in an elliptical pedaling motion, is different from that on floor.
• the proprioceptive information received by the central nervous system of the patient during re-education sessions using these known techniques is therefore insufficient to allow complete rehabilitation of the functions of walking.
• a disadvantage of this guided progression technique is that the cost of fitting out a rehabilitation circuit is important.
• Another disadvantage of this technique is that it is bulky.
• This technique of guided progression also has the drawbacks that the path taken by the patient following the rail or the cable is fixed, and that it does not allow to rotate the patient on itself.
• a motorized walker was also proposed to support a non-autonomous patient and to help him move on the ground, after having equipped his legs with electrodes to induce their relaxation via electrical stimulations and an exoskeleton to guide their movement.
• This technique using a motorized walker is however suitable only in the early stages of gait rehabilitation. In particular, it does not allow the patient to practice walking on his own.
• This technique also has the disadvantage of being complex. Another disadvantage of this technique is that it does not allow to simply control the trajectory of the patient. It also does not allow the patient to navigate on his own.
• Another disadvantage of this technique is that it does not adapt the speed of progression of the walker to the rhythm of the patient, in the case for example where it feels joint pain or tires quickly.
• the invention therefore particularly aims to overcome the disadvantages of the state of the art mentioned above.
• the invention aims to provide an ambulatory rehabilitation device that allows a patient who has lost the autonomy of walking to practice to practice each movement of walking, and in particular to change direction or to rotate on itself.
• the invention particularly aims to exercise a patient walking movements in ambulatory situation and on soils of varied nature.
• An object of the invention is also, in at least one embodiment of the invention, to allow the patient to go by himself.
• Another object of the invention is to provide such a technique that can provide a gradual and / or gradual rehabilitation of a patient, and can be implemented in both early stages of rehabilitation in more advanced phases.
• the purpose of the invention is to provide such a technique that makes it possible to implement novel therapeutic scenarios designed around diversified and complementary exercises.
• Yet another objective of the invention is to provide such a technique which makes it possible to adapt the level of assistance provided to the patient.
• Yet another object of the invention is to provide such a technique which is compact.
• Another object of the invention is to provide such a technique that can be implemented in a city medical office, the home of a patient, and / or outside.
• the invention also aims to provide such a technique whose use is simple and acceptable for a patient and / or a therapist. Yet another object of the invention is to provide such a technique which is reliable, safe and safe for a patient.
• an ambulatory rehabilitation device comprising a mobile structure for assisting an individual, and in particular a non-autonomous patient, in the exercise of at least one movement of the walk presenting means of supporting said individual.
• support means that the individual can be carried completely by the structure, to which he can for example be suspended, but it can also be a partial support allowing reduce the weight of the body on the legs only partially, or support only in the event of a fall or imbalance of the individual.
• said mobile structure comprises a motorized carriage with automatic guidance.
• the invention proposes to implement a motorized trolley with automatic guidance to accompany and secure a non-autonomous individual being rehabilitated in its progression on the ground, and allow it to practice natural walking voluntary.
• the carriage is able to move on a predefined course without the intervention of the re-educated individual or a third party.
• a motorized carriage with automatic guidance being autonomous in its movements, the patient or the therapist do not have to intervene to push or direct the carriage.
• said support means comprise a support harness capable of gripping at least a portion of the trunk of said individual, preferably a portion of said individual's pelvis, said harness being secured to a deformable support movably mounted relative to the frame of said structure.
• the support harness surrounds the pelvis and / or the pelvic girdle of the individual.
• the level of support of the individual can be adapted by varying the vertical position of the mobile deformable support.
• the patient in the early phases of rehabilitation, the patient can be suspended from the structure which then supports all its weight, and then as the progress of the patient, it can be expected to gradually reduce the support provided by the harness to the patient , lowering the mobile support.
• a deformable support makes it possible in particular to improve the lateral support of the patient and to prevent an imbalance thereof.
• said deformable support comprises at least one omnidirectional arm secured to a connecting strap with said harness.
• said deformable support comprising two arms, each of said arms is actuated by a separate motor.
• said deformable support is attached to one end of a cable of a winch.
• an ambulatory rehabilitation device such as those described above comprises means for controlling the balance of said individual acting on an actuating motor of said winch and / or said deformable support, comprising means for detecting a variation of the electrical power absorbed by said motor and means for measuring a horizontal displacement of said cable.
• an ambulatory rehabilitation device such as those described above comprises:
• the individual can simply interact with the carriage via a gripping element, such as a handle for example, and send him guidance instructions.
• a gripping element such as a handle for example
• the patient can control the speed of progression of the motorized carriage with the help of the gripping element, and thus accelerate or otherwise slow down along a predefined course .
• the patient is given the opportunity to control the speed and direction of the motorized carriage, and thus to accelerate, slow down and change direction as he sees fit.
• a control member of the carriage such as a handle
• the control of this member on the carriage has priority over that of the gripping element made available to the patient.
• such an ambulatory rehabilitation device comprises means for identifying a state of imbalance of said individual arranged so as to be able to activate said balance control means, comprising means for comparing said one or more signals delivered by said one or more gripping elements with at least one predetermined reference signal.
• an ambulatory rehabilitation device such as those described above comprises:
• automatic guiding means of said carriage comprising means for controlling the actuating means of at least one driving wheel of said trolley according to said data representative of the approach of said individual.
• the patient drives the cart in a totally intuitive and transparent way for him.
• such an ambulatory rehabilitation device comprises:
• means for identifying an imbalance state of said individual arranged so as to be able to activate said balance control means comprising means for comparing said datum with at least one predetermined reference datum.
• said means for determining said data representative of the approach of said individual are configured so as to take into account for the determination of said data at least one parameter specific to said individual belonging to the group comprising:
• said means for obtaining said plurality of information comprises a measuring device belonging to the group comprising at least:
• the number of these measuring devices is limited to three, and preferably two.
• such a structure has means for calculating at least one comparative datum representative of the displacement of said individual, and in particular the distance traveled or the speed of movement of said individual, and means for displaying said one or more comparative data.
• FIGS. 1A and 1B are diagrammatic perspective views, respectively front and rear, of an exemplary embodiment of an ambulatory rehabilitation device according to the invention
• FIG. 2 is a detailed view of the deformable mobile support of the ambulatory rehabilitation device presented with reference to FIGS. 1A and 1B;
• FIG. 3 illustrates another exemplary embodiment of an ambulatory rehabilitation device of the invention, having two grip handles, in which the patient can take control of the device and walk around freely;
• Figure 4 is a view of a third exemplary embodiment of an ambulatory rehabilitation device according to the invention guided automatically from the observation of the patient's gait;
• FIG. 5 is a synoptic representation of the control system of the ambulatory rehabilitation device presented with reference to FIG. 4.
• the principle of the invention is based in particular on the implementation of a motorized trolley with automatic guidance to accompany a non-autonomous individual during a walk on the ground, without having to mobilize a therapist and without provide a complex infrastructure.
• the invention makes it possible to recreate varied ambulation conditions on the ground approaching the voluntary natural walk, allowing complete rehabilitation of the individual and improvement of his endurance. Moreover, it can advantageously be used on a soil with relief, outside a building for example.
• FIGS. 1A and 1B An embodiment of an autonomous ambulatory rehabilitation device according to the invention is shown in perspective and schematically during a rehabilitation session in FIGS. 1A and 1B, respectively seen from the front and from the front. 'back.
• This device 10 comprises a mobile structure 11 assisting a patient 12 suffering from a cerebrovascular accident in the exercise of walking along a predetermined path 13.
• the movable structure 11 comprises a self-guided motorized carriage 14, also known by the term agv, whose chassis 141 is surmounted by a gantry 15, at the top of which is mounted a horizontal beam laser sensor 126.
• This motorized laser guide truck 14 known per se, whose position is determined by odometry, is designed to follow the path 13 automatically, or in other words without the intervention of the therapist or the patient.
• three reflective beacons 120 have been placed at locations in the room where the precisely identifiable session takes place.
• the path 13 defined by the therapist following the patient specifically for this session is stored in a memory of a supervision unit 125 housed inside the gantry 15.
• a USB type connector is provided on an amount of the gantry 15 to allow the therapist to connect his personal computer to the supervisory unit 125 and load a new course.
• a shell 111 covers the gantry 15 and the frame 141 of the carriage 14. It is pierced with a flared opening 112 to provide a wide field of view to the patient 12.
• a support device 16 of the patient 12 is mounted on the gantry 15.
• This support device 16 comprises a deformable mobile stem 115 suspended at the end of a cable 121 winding on a winch 116 fixed to the top of the gantry 15.
• the bracket 115 is formed of a platform 21 carrying two independent omnidirectional telescopic arms 22, 23, and preferably holonomic displacement, each actuated by a separate motor 24 or 25.
• a double strap 118 is attached to each of the arms 22 and 23.
• the ends of each double strap 118 are connected to a panty harness 119 enclosing the patient's pelvis 12.
• the support harness 119 can be moved up or down, so as to decrease or on the contrary increase the weight supported by the legs of the patient 12, by winding or unwinding the cable 121 of the winch 116.
• the position of the cable 121 is slaved according to the measurement of the intensity of the electric current called by the drive motor 122 of the winch 116 so as to maintain this weight, and therefore the load supported by the cable 121, constant.
• the therapist may decide to reduce the support provided by the harness based on the progress of the patient.
• the actuation of the bracket 115 and the winch is controlled by a real-time electronic controller 17 embedded on the structure 11, shown in dashed lines in Figures 1A and 1B.
• the situations in which the patient is out of equilibrium are identified by measuring the horizontal displacements of the cable 121 and by detecting the abrupt variations in the electrical power absorbed by the drive motor 122.
• the controller 17 continuously acquires signals delivered by a position sensor making it possible to measure the position of the cable 121 and by an ammeter sensor measuring the value of the intensity of the current called by the drive motor 122 of the winch 116.
• a control signal of the actuating members of the bracket 115, and in this case of the two actuating motors 24 and 25 of the arms 22 is generated by the controller 17, in order to move the straps 118 and thus act on the position of the pelvis of the patient 12 to restore the balance of the patient.
• the bracket is also equipped with a mechatronic or optical sensor for example to measure the inclination of the cable relative to the vertical (not shown in Figure 1) whose data are used by the supervision unit 125 to determine the position of the patient's bust.
• the displacement of the carriage 14 is also controlled by the on-board real-time controller 17.
• This controller 17 has a communication interface with the on-board supervision unit 125, which provides it with data for guiding the truck.
• the supervision unit 125 is advantageously built around a modular software architecture, which is therefore scalable and easy to reconfigure.
• the controller 17 makes it possible to control an electric servomotor 18 driving in rotation and directing two drive wheels with differential drive 142 mounted on the rear of the carriage 14 according to the control instructions received from the controller 17.
• each of the driving wheels in a specific motor-steering turret, equipped with a geared motor acting on the direction of the wheel and a geared motor for driving the wheel in rotation to the forward or backward.
• the servomotor 18 is supplied with electricity by a rechargeable battery 19, for example of the acid-lead gel or lithium-ion type.
• a rechargeable battery 19 for example of the acid-lead gel or lithium-ion type.
• Load pads 110 mounted outside the frame 141 of the carriage 14 allow recharging the battery 19 without disassembly.
• a free running wheel 143 is mounted in the axis of the carriage which allows the structure 11 to marry small radii of curvature and to turn on itself, and facilitates the advance backwards.
• the structure 11 has a fixed grip handle 114, allowing the patient 12 to adjust the instantaneous speed of the carriage 14 on the path 13.
• This handle 114 is advantageously equipped with force sensors (not shown in FIGS. 1A and 1B) measuring the intensity of the forces exerted on it by a patient's hand 12, connected to an interface of the controller 17.
• controller 17 is programmed so that the speed of movement of the patient is substantially proportional to the intensity of the clamping it exerts on the handle.
• the patient can thus simply adjust the speed of execution of each step according to his ability to walk. He can also respond to requests from the therapist who asks him to accelerate on certain portions of the course.
• the controller 17 automatically controls the stopping of the carriage if the analysis of the signals delivered by the force sensors equipping the handle 114 reveals that the patient tightly and strongly tightened the handle. Indeed, if he loses his balance, the patient will grip the handle reflexively. It can be seen in FIG. 1A that the shell 111 carries a display console 113 which delivers to the patient 12 information on its progress and its performances, which confers to a certain extent a playful aspect to the re-education session, and allows to encourage the patient and / or to reinforce his motivation.
• the information output by the console 113 is, for example, the speed of travel, the trajectory, the amplitude of the strides, the contact forces, etc.
• the therapist can also use this console as a control console, in order to adjust certain parameters of the session.
• safety devices such as for example a laser scanner, intended to prevent an impact with an object or a person, and to alert the therapist when a shock is imminent are provided .
• a laser scanner intended to prevent an impact with an object or a person, and to alert the therapist when a shock is imminent.
• the truck gradually slowed down.
• the truck stops automatically.
• FIG. 3 is a detailed view of another example of an ambulatory rehabilitation device 31 according to the invention, constituting a variant of the embodiment detailed above, enabling the patient to take control of the automatic guided carriage and to move about. freely in the room.
• This device 31 has a structure identical to the structure 11, furthermore advantageously equipped with a second fixed grip 33 instrumented with force sensors.
• multi-axis force sensors are arranged in sufficient numbers and in a suitable arrangement on each handle to allow a measurement of the direction and intensity of the forces exerted on each of the handles by one or other of the patient's hands 32.
• force return handles also called kinesthetic handles or haptic handles
• they may be force-return handles containing an electric motor that provides resistance to the rotation of an outer ring handled by the patient.
• the patient can vary the speed of advance of the carriage along a predetermined path by grasping one or other of the handles 114 and 32.
• the patient 32 When grasping the two handles 114 and 33, the patient 32 controls both the forward speed and the direction of the carriage 34, and can thus move autonomously in the room.
• the carriage When the patient releases one of the two handles, the carriage automatically switches to automatic guidance.
• the device 31 is then automatically directed by the shortest path to a position of the preset course, before resuming the course of the course.
• the ambulatory rehabilitation device is permanently controlled manually by the patient, and that it stops, or that it is programmed to progress in a straight line, when the patient releases the patient. one of the handles.
• the automatic guidance of the carriage 41 of the rehabilitation device 40 is operated by means of an estimate of the patient's gait 42, which is interpreted as a reflection of the traveling intentions. of the patient.
• This estimation of the patient's gait is based on the determination of a data representative of this approach. It is obtained by a real-time simulation of the dynamic behavior of a virtual dummy representing the patient 42, based in particular on a digital reconstruction of the posture of the patient 42.
• the patient is instrumented with a limited number of sensors. It has indeed cleverly chosen to equip the portion of the harness 43 in contact with the patient's back of an inertial unit 44, and each foot of the patient of another inertial unit 45.
• FIG. 5 which details the control system of the ambulatory rehabilitation device 40
• the data provided by the inertial units 44 and 45 concerning the position and the displacement of the patient's pelvis and feet are collected regularly by the patient.
• supervision module 51 These data are used within this supervision module by a software application 52 based on a dynamic modeling of the virtual manikin representing the patient to animate this virtual model.
• the virtual digital mannequin model implemented in this embodiment of the invention is constructed by coupling a model kinematics of the 45-degree-of-freedom skeleton built around a tree chain of rigid elements in articular abutment, with a biomechanical model taking into account anthropometric parameters such as gender, age, and patient size, and integrating parameters specific to the pathology of the patient, allowing to assign an envelope, or skin, the manikin and manage its interaction with the external environment.
• the biomechanical model used for determining the representative data of the patient's gait takes into account the stage of rehabilitation and / or the physical condition of the patient. -this.
• the forces exerted by the patient on the device 40 are calculated within the software application 52 and optimization strategies by quadratic criterion, consisting for example of minimizing muscle fatigue, are applied to manage the equilibrium of the manikin so Reflex and generate instructions transmitted to the controller 53 controlling the actuation of the arms of the mobile deformable stem 46 and / or the winch 47.
• the application 52 also automatically determines a datum representative of the patient's gait from which is extracted the patient's intention to change direction, or to accelerate or slow down, for example. It then transmits a guidance instruction including directional data and speed data to the controller 53, which in turn controls the driving motor of the driving wheels of the carriage 41 accordingly.
• the structure of the ambulatory rehabilitation device 40 thus moves transparently for the patient without his having to interact directly with it.
• the patient who is not required to grasp a handle to guide or adjust the speed of the carriage 40, can swing his arms along the body, in a normal natural walking position.
• the software application 52 also advantageously makes it possible to monitor the patient's posture by calculating a datum representative of the patient's posture, and to identify whether the patient is in a state of imbalance of the patient, by comparing this datum with a base. predetermined reference data.
• an optical marker such as an infra-red reflective ball, an accelerometer, or a magnetic marker

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• Health & Medical Sciences (AREA)
• Epidemiology (AREA)
• Pain & Pain Management (AREA)
• Physical Education & Sports Medicine (AREA)
• Rehabilitation Therapy (AREA)
• Life Sciences & Earth Sciences (AREA)
• Animal Behavior & Ethology (AREA)
• General Health & Medical Sciences (AREA)
• Public Health (AREA)
• Veterinary Medicine (AREA)
• Rehabilitation Tools (AREA)
• Manipulator (AREA)

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• 2011
  • 2011-02-10 FR FR1151065A patent/FR2971419B1/fr active Active
• 2012
  • 2012-02-10 WO PCT/FR2012/050297 patent/WO2012107700A2/fr not_active Ceased
  • 2012-02-10 EP EP12708903.5A patent/EP2672944B2/fr active Active
  • 2012-02-10 DK DK12708903.5T patent/DK2672944T4/da active
  • 2012-02-10 EP EP16186762.7A patent/EP3132786A1/fr not_active Withdrawn
• 2014
  • 2014-03-26 FR FR1452546A patent/FR3002437B1/fr not_active Expired - Fee Related

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