WO2005018453A1 - Dispositif mecatronique portable pour l'analyse de la biomecanique des articulations - Google Patents

Dispositif mecatronique portable pour l'analyse de la biomecanique des articulations Download PDF

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Publication number
WO2005018453A1
WO2005018453A1 PCT/IT2003/000517 IT0300517W WO2005018453A1 WO 2005018453 A1 WO2005018453 A1 WO 2005018453A1 IT 0300517 W IT0300517 W IT 0300517W WO 2005018453 A1 WO2005018453 A1 WO 2005018453A1
Authority
WO
WIPO (PCT)
Prior art keywords
joint
axis
accordance
mechatronic device
support
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.)
Ceased
Application number
PCT/IT2003/000517
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English (en)
Inventor
Andrea Scoglio
Franco Zaccone
Silvestro Micera
Paolo Dario
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.)
Scuola Superiore di Studi Universitari e di Perfezionamento SantAnna
Original Assignee
Scuola Superiore di Studi Universitari e di Perfezionamento SantAnna
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 Scuola Superiore di Studi Universitari e di Perfezionamento SantAnna filed Critical Scuola Superiore di Studi Universitari e di Perfezionamento SantAnna
Priority to AU2003265142A priority Critical patent/AU2003265142A1/en
Priority to PCT/IT2003/000517 priority patent/WO2005018453A1/fr
Priority to EP03818279A priority patent/EP2004049A1/fr
Publication of WO2005018453A1 publication Critical patent/WO2005018453A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/45—For evaluating or diagnosing the musculoskeletal system or teeth
    • A61B5/4528—Joints
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/103—Measuring devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • A61B5/107—Measuring physical dimensions, e.g. size of the entire body or parts thereof
    • A61B5/1071—Measuring physical dimensions, e.g. size of the entire body or parts thereof measuring angles, e.g. using goniometers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/103—Measuring devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • A61B5/11—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor or mobility of a limb
    • A61B5/1121—Determining geometric values, e.g. centre of rotation or angular range of movement
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6801—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be attached to or worn on the body surface
    • A61B5/6813—Specially adapted to be attached to a specific body part
    • A61B5/6828—Leg

Definitions

  • the present invention relates to a wearable mechatronic device for the analysis of joint biomechanics and, more particularly, for monitoring the movements of body joints. More precisely, the invention relates to a device that makes it possible to measure and analyze in real time the movements of articulated body joints with one or two degrees of freedom (capable of being applied, for example, to the knee) .
  • Background of the invention The growing interest shown in recent years by the medical and bio-engineering environment in studies of posture and locomotion has provided a strong stimulus for the development of devices and methods of acquiring and processing data and signals obtained from body parts and surfaces both in static positions and in movement.
  • the relative measurements call for all the anatomical coordinates to be calculated with respect to a fixed anatomical point, while the absolute measurements require the anatomical coordinates to be related to a fixed external reference point.
  • electro-mechanical systems comprising articulated quadrilateral devices and electrogoniometers .
  • the latter are devices capable of detecting a single movement of rotation for each joint, so that - in the case, for example, of an essentially two- dimensional joint like the knee - there have to be installed two separate electrogoniometers, each operating on a single axis of rotation (flexion-extension axis, transverse rotation axis) .
  • United States patent No. 4883069 describes an instrument for the measurement of the movement of the knee in the three reference planes . The measurement is made by means of three rotoidal potentiometers mounted on three axes positioned at 90° with respect to each other. The potentiometers are positioned on a single support (triaxial joint) placed in a lateral position with respect to the knee.
  • the support of the potentiometers is defined by a tubular mechanical structure attached to the lower limb by means of a band-type fastening system placed upstream (femur) and downstream (tibia/thigh) of the knee.
  • the device In the medical field the device is used for both therapeutic and technical-sporting uses.
  • the device is triaxial, light and of limited encumbrance, the device has a single axis of rotation in line with the physiological one of the patient. As far as the remaining two axes are concerned, it carries out an indirect measurement, because these axes are not in line with the corresponding physiological axes. Consequently, the kinematic solution adopted in this patent produces an error that becomes larger as the distance between the kinematic axis of the system and the corresponding physiological axis of the knee becomes greater.
  • the device in accordance with US 4883069 is not provided with points for direct fixing to the knee.
  • the fastening points are referred to the muscular parts of the lower limb.
  • the system being devoid of objectively determinate references, is not capable of assuring that even the same patient will wear it in the same position on two successive occasions: in the absence of any direct fastening points on the knee, in fact, the positioning of the sensitive part of the device (reading system) cannot assure proper alignment with the appropriate kinematic axis of rotation.
  • the considered system of attachment to the lower limb is constituted by a system of bands that inevitably introduces relative sliding between the mechanical system and the lower limb.
  • the device is not equipped with a system of alignment to anatomical parts, so that it is possible to measure only the magnitude of the rotation relative to the joint that is being examined, though without knowing the starting point, and it is not therefore possible to make comparisons between measurements made at different times.
  • Other widely used systems are the optical ones, which are normally based on two operating principles. The first
  • system of passive markers with threshold recognition is based on the positioning on the body of the interested patient of small markers that can be recognized by an infrared rays system.
  • a series of two or more telecameras are placed around the element in movement and capture the markers within their field of vision.
  • a suitable software system using complex mathematical algorithms, performs a correlation of the various positions of the markers, resorting to different perspectives to calculate the space coordinates of each marker and exploiting the principle of redundance of the information available for each point.
  • optical systems of the passive-marker type with form recognition make use of a single infrared telecamera capable of capturing the contours of the image of the object to be examined, which are then analyzed to determine the position of the various parts of the body and its gestures.
  • Both methods require that there must be no disturbing elements between the transmitter and the receiver. This means that the work environment must be such as to permit these systems to be operated without any occurrence of interferences or shadow zones caused by possible discontinuities between emitter and receiver.
  • These systems do not give rise to the typical drawback of numerous movement analysis systems that consists of the presence of connecting cables between the measuring system and the support for storing and analyzing the data.
  • the principal difficulty associated with their use is the impossibility of maintaining the position of the markers constant at the points defined by the joint on account of the small relative movements that occur between the skin and the bone structure. Furthermore, their use calls for highly specialized personnel to process the data and implies considerable costs.
  • the magnetic systems of which the 3 SPACE FASTRACK device manufactured by the US firm Polhemus is an example, generally make use of a source that emits a magnetic field and a small sensor that refers its own position and orientation with respect to the emission source.
  • the object of the present invention is to provide a mechatronic device that can readily be worn by the user (patient) , is simple to use for the operator (phisician) and capable of monitoring with sufficient accuracy the dynamic behaviour of a body joint such as, for example, the knee.
  • Another aim of the present invention is to provide a wearable mechatronic device of the aforementioned type that will make it possible to read the angles of a body joint in a simple and rapid manner and with a small positioning error.
  • Another aim of the present invention is to provide a wearable mechatronic device of the aforementioned type that will assure wide freedom of movement for the user/ patient by not making use of any cables to connect it to a central data acquisition unit.
  • Yet another aim of the present invention is to provide a wearable mechatronic device of the aforementioned type that will be symmetrical, i.e. can be adapted in a very brief space of time for use on both the limbs.
  • the magnetic sensor means comprise a first element carrying at least one Hall sensor and a second element, hinged to the first element around an axis and carrying at least one magnet
  • the positioning means comprise a first connection for the magnetic sensor means arranged on the support in a position intermediate with respect to its two ends, so that the hinge axis can be brought into substantial alignment with the axis of rotation of the joint.
  • Second connections are arranged upstream of and, respectively, downstream of the first connection and are connected to the first and the second element of the magnetic sensor means .
  • the reference number 1 indicates an elastic tubular support of the type used in common commercial knee braces intended to be applied to a lower limb at the knee joint.
  • Fixed to the support 1 is a mechatronic structure comprising a unit for the detection of flexion-extension movements (movements of the femur- tibia joint in the sagittal plane) , generically indicated by 2, and a unit for the detection of abduction-adduction movements (movements of the femur-tibia joint in the frontal plane), generically indicated by 3.
  • the flexion-extension movement is the rotation movement of the knee in the sagittal plane around an axis passing through the femoral epicondyles.
  • the abduction-adduction (or varus/valgus) movement of the knee is the angular movement of the tibia with respect to the femur in the frontal plane.
  • the two rotation axes as aforesaid are indicated in Figure 1 by, respectively, X and Y.
  • Support 1 is provided with connection means for the two detection units 2 and 3.
  • For unit 2 that detects the flexion-extension movement in particular, there are provided a central connection 4 arranged in an intermediate position on support 1 and two terminal connections 5 and 6 arranged in proximity of the ends of support 1 and therefore above and below the central connection 4 in the direction of the length of support 1.
  • a central connection 7 arranged on support 1 in an intermediate position, substantially at 90° with respect to central connection 4 provided for unit 3, and two terminal connections 8 and 9 arranged in proximity of the ends of support 1 and therefore above and below central connection 7 and substantially arranged at right angles with respect to the corresponding terminal connections 5 and 6 provided for unit 2.
  • the central connections 4 and 7 and the terminal connections 5, 6 and 8, 9 are fixed to the support 1 in any known manner, for example by means of gluing or with screws .
  • Central connection 7 of detection unit 3 is arranged in such a position on support 1 as to permit it to be readily positioned in coincidence with the rotula of the knee and to this end it is provided with a central opening, not visible in the figures, for visual centring of the rotula.
  • the relative position of central connection 4 of detection unit 2 with respect to the position of central connection 7 of detection unit 3 is such that they will be situated substantially on the tibial condyles when support 1 is worn in such a way that central connection 7 is positioned on the rotula and aligned with the axis of the varus/valgus movement .
  • a fine adjustment system to regulate the position of the sensor unit applied to him, and this will be described in greater detail further on.
  • a sensor unit 10b Fixed to the central connection 7 of unit 3 for detecting the abduction-adduction movements there is a sensor unit 10b carrying movement sensors that will be described further on.
  • Sensor unit 10a (10b) is a body made up of two parts or elements 11a, 12a (lib, 12b) rotatably connected to each other around an axis perpendicular to the plane in which they lie, this axis substantially coinciding with the axis X (Y) of the knee.
  • element 11a (lib) has a substantially C-shaped part within which element 12a (12b) is engaged.
  • Appendices 13a, 14a are rotatably connected to fork-shaped ends 15a, 16a (15b, 16b) around axes coplanar with the plane in which there lies sensor 10a (10b) and perpendicular to rods 17a, 18a (17b, 18b) , which are slidingly mounted in respective tubular guides 19a, 20a (19b, 20b) connected to slides 21a, 22a (21b, 22b) frictionally engaging with the terminal connections 5 and 6 (8 and 9) .
  • each of the two detection units 2 and 3 is provided with an active articulation, namely the one between the two elements 11a, 12a (lib, 12b) of the respective sensor unit 10a (10b) , by means of which it detects the corresponding movement of the body joint, and a passive articulation, namely the one between rods 17a, 18a (17b, 18b) and sensor unit 10a (10b) , by means of which a detection unit follows the movement that the other unit is called upon to detect.
  • an active articulation namely the one between the two elements 11a, 12a (lib, 12b) of the respective sensor unit 10a (10b)
  • a passive articulation namely the one between rods 17a, 18a (17b, 18b) and sensor unit 10a (10b)
  • a detection unit follows the movement that the other unit is called upon to detect.
  • element 11a (lib) there may be mounted a reference goniometer 23a (23b) - shown only in a schematic manner - for the initial regulation (search for
  • the sliding connections between the rods and the relative terminal connections assure a correct operation even in the presence of possible small positioning errors - and the relative kinematic errors that derive therefrom - and make it possible for the two units to be quickly and easily attached to the elastic support 1. Furthermore, in the case of unit 3 for the detection of the abduction- adduction movement, since this unit is positioned frontally on the rotula and therefore very far from the neutral axis of the lower limb, identified as a projection of the axis of the rods of unit 2, the unit is subject to cyclical lengthenings and shortenings due to the flexion and extension of the knee, both of which are compensated without any mechanical interference by the sliding connection between rods 17b, 18b and respective tubular guides 19b and 20b.
  • connection between slides 21a, 22a (21b, 22b) carrying tubular guides 19a, 20a (19b, 20b) and respective terminal connections 5, 6 (8, 9) is accomplished by means of a transversely slidable jointing system, i.e. in the direction at right angles to the longitudinal axis of the limb.
  • the connection is moderately forced, so that the position of slides 21a, 22a (21b, 22b) with respect to corresponding terminal 5, 6 (8, 9) can be adjusted by making the former slide on the latter.
  • the connection between the sensor unit 10a for the flexion-extension movement and the respective central attachment pad 4, on the other hand makes it possible to obtain a fine adjustment of the position of slide 24 on said terminal connection.
  • This regulation is necessary in order to identify unambiguously the position of the flexion-extension detection unit 2 with respect to the femur-tibia reference joint, which is identified by the position of femoral epicondyles, given the different morphological dimensions of the users.
  • the position of the rotula is the sole absolute positioning of the system that is indifferent to the different size of each particular user.
  • central connection 4 which is in any case fixed to support 1 in such a way as to be situated in proximity of the femur- tibia joint once support 1 has been applied, is provided with a seating 25 with a perimetric groove 25a with which the edge 24a of slide 24 is slidingly engaged.
  • an elastic presser 26 capable of engaging selectively with one of the corresponding blind holes 27 provided along the edge 24a of the slide 24, thus constituting a snap connection between the two elements.
  • This regulation must be such as to permit an excursion of at least 25 mm with a distance between the holes 26 of the order of 5 mm.
  • the mutual locking of the components can be obtained, for example, by means of a stop pin 28 situated on central connection 4 and readily handled by the operator. A slight tightening of the pin is sufficient to univocally fix the position determined by the elastic presser 28 situated on the opposite side of the central connection 4.
  • Sensor unit 10a is connected to the respective central connection 7 by means of a bayonet joint 29.
  • connection makes it possible for the detection unit to be rapidly attached to and detached from elastic support 1 and this, in turn, makes it possible for the device for measuring movements of body joints with two degrees of freedom to be quickly converted into a device for measuring movements of body joints with one degree of freedom and vice versa.
  • the device in accordance with the invention can be employed both for the right leg and the left leg by simply detaching detection unit 2 from connections 4, 5 and 6 and then re-attaching it to the corresponding connections (not visible in the figures) provided on the diagonally opposite part of elastic support 1.
  • the transduction system utilized for transforming the angular displacement between the two elements 11a, 12a (lib, 12b) of sensor unit 10a (10b) around the respective rotation axis into electric signals is based on the principle of the Hall effect. According to this effect, an appropriate voltage (source) applied to a semiconductor element will cause an induced current to flow within it. If no magnetic field is present at the ends of the semiconductor, the voltage output will be almost zero. When the semiconductor (basic Hall element) is placed in a magnetic field oriented at right angles to the Hall current, the (voltage) output will be directly proportional to the intensity of the magnetic field.
  • the Hall sensor is essentially a transducer that responds with a voltage output whenever the applied magnetic field changes.
  • the characteristic voltage- displacement curve of a Hall-effect sensor is similar to a Gaussian curve, so that, working on a part of this curve, it is possible to obtain, in a repeatable manner and with negligible hysteresis, a practically linear pattern of the voltage variation due to the displacement that has been produced between the sensor and the magnetic source.
  • the Hall sensor is fixed to element 11a (lib)
  • the magnet is fixed to element 12a (12b) .
  • the inverse arrangement is altogether equivalent.
  • the output signals of the transducer are acquired (conditioned and digitalized) by a local electronic system 30 integral with the knee brace or worn by the user, on his belt for example, and connected by means of two wires to the sensorized support and transmitted, by means of radio-frequency communication for example, to a receiving unit connected to a remote processing system 31.
  • a local electronic system 30 integral with the knee brace or worn by the user, on his belt for example, and connected by means of two wires to the sensorized support and transmitted, by means of radio-frequency communication for example, to a receiving unit connected to a remote processing system 31.
  • the device in accordance with the present invention can also be mounted indifferently on either of the lower limbs without any substantial modification and doing nothing other than shifting the detection unit 2 from one side of elastic support 1 to the other.
  • the operator has to identify some reference points on the patient's body and, more precisely, two significant points of the bone structure of the femur that can be easily identified by touch, for example, the minor trochanter (or femur head) and the major trochanter, situated respectively in the frontal plane and the sagittal plane, the femoral epicondyles and two significant points of the tibio-tarsal joint of the ankle (forming part of the astragalus for example) , these once again referred to the sagittal and frontal planes, and then align rods 17b and 18b of the varus/valgus detection unit 3 with them.
  • the minor trochanter or femur head
  • the major trochanter situated respectively in the frontal plane and the sagittal plane, the femoral epicondyles and two significant points of the tibio-tarsal joint of the ankle (forming part of the astragalus for example)
  • the device in accordance with the present invention can also be applied to the joints of animals (such as, for example, horses) .
  • Variants and/or modifications may be introduced in the wearable mechatronic device for monitoring the movements of body joints in accordance with the present invention without departing from the scope of the invention as defined in the claims attached hereto.

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Abstract

L'invention concerne un dispositif mécatronique portable permettant de surveiller les mouvements d'une articulation corporelle. Ledit dispositif comprend un support (1) pouvant être appliqué sur le membre pourvu de l'articulation, des détecteurs magnétiques (10a, 10b) qui sont placés de manière à correspondre à au moins un axe de rotation (X, Y) de l'articulation et qui peuvent engendrer un signal électrique d'une intensité corrélée à la magnitude du mouvement angulaire autour dudit axe, un dispositif (17 a, b ; 22 a, b ; 24 ; 29) qui sert à positionner le détecteur magnétique en fonction de l'axe de rotation et qui peut être fixé sur ledit support (1) sur l'articulation, ainsi qu'au-dessus et au-dessous de celle-ci.
PCT/IT2003/000517 2003-08-26 2003-08-26 Dispositif mecatronique portable pour l'analyse de la biomecanique des articulations Ceased WO2005018453A1 (fr)

Priority Applications (3)

Application Number Priority Date Filing Date Title
AU2003265142A AU2003265142A1 (en) 2003-08-26 2003-08-26 A wearable mechatronic device for the analysis of joint biomechanics
PCT/IT2003/000517 WO2005018453A1 (fr) 2003-08-26 2003-08-26 Dispositif mecatronique portable pour l'analyse de la biomecanique des articulations
EP03818279A EP2004049A1 (fr) 2003-08-26 2003-08-26 Dispositif mecatronique portable pour l'analyse de la biomecanique des articulations

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/IT2003/000517 WO2005018453A1 (fr) 2003-08-26 2003-08-26 Dispositif mecatronique portable pour l'analyse de la biomecanique des articulations

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WO2005018453A1 true WO2005018453A1 (fr) 2005-03-03

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PCT/IT2003/000517 Ceased WO2005018453A1 (fr) 2003-08-26 2003-08-26 Dispositif mecatronique portable pour l'analyse de la biomecanique des articulations

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EP (1) EP2004049A1 (fr)
AU (1) AU2003265142A1 (fr)
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