Method for operating an orthopedic device and corresponding device

Abstract

The present invention relates to a method for operating an orthopedic technical device, which assists or replaces a first body part of a wearer and has at least one controllable actuator, wherein the method has the following steps: a) determining a time curve of at least one parameter from a measurement value of at least one sensor, wherein the parameter is able to describe the movement state of the wearer; b) identifying the movement state from the at least one determined time curve; and c) controlling the at least one controllable actuator based on the identified movement state, characterized in that the movement state is also identified using a time curve of at least one parameter of a second body part of the wearer.

Description

Technical Field

[0001] The invention relates to a method for operating an orthopedic device which assists or replaces a first body part of a wearer and has at least one controllable actuator, the method comprising the following steps:

[0002] a) determining the time curve of at least one parameter from the measured values ​​of at least one sensor, which parameter is able to describe the movement state of the wearer;

[0003] b) identifying the movement state from at least one determined time curve; and

[0004] c) controlling the at least one controllable actuator as a function of the identified movement state. Background Art

[0005] Orthopedic devices are in particular prostheses and orthoses, which are manufactured for the limbs of the wearer, i.e. arms and / or legs. Here, the orthopedic device is usually arranged on a single limb of the wearer, i.e. a single leg or a single arm. If the orthopedic device is a prosthesis, the prosthesis replaces at least one body part. This can be, for example, a foot, an ankle or a knee, but can also be, for example, a forearm or a hand. Of course, there can also be prostheses that replace multiple body parts. For example, the prostheses manufactured for thigh amputees are set up to replace the knee, ankle and foot.

[0006] The orthosis assists the corresponding body part. On the one hand, this includes support and protection against excessive loads, for example during postoperative rehabilitation, in that, for example, the angle range in which the joint is to be used is limited by the orthosis. Assistance within the framework of the present invention also includes support by reducing the load, which is realized, for example, in sports orthoses or so-called exoskeletons, i.e. portable mechanical structures equipped with actuators if necessary, which are used in the medical field, for example, for rehabilitation or as an alternative to wheelchairs. There are no necessarily restrictions on the user. For example, such an orthosis / such an exoskeleton can also be used to reduce the body load during physical activities, improve functionality and / or reduce the risk of injury.

[0007] Especially if the first body part is a leg or an amputation stump of a leg, it is important and very advantageous to know the movement state of the wearer to adapt the controllable actuator accordingly. Recognizable movement states are, for example, going up and down stairs, walking on a ramp, walking and running at different speeds, standing, sitting, overcoming obstacles in the way or movements that are characteristic for regular work. All these different movement states usually require different control of the controllable actuator.

[0008] It is important here to distinguish the above-described motion state of the wearer of the orthopedic device from the motion state or movement of the corresponding body part. For example, during walking on a plane, the motion state of the wearer of the orthopedic device will not change as long as walking on the plane continues. On the other hand, the movement of a body part (e.g., the knee) changes many times in each step. It goes through a stance phase and a swing phase through different key events (e.g., heel landing). The identification and prediction of these key events are also important for the control of the orthopedic device and have long been known from the prior art. However, within the scope of the invention described here, it is primarily related to the identification of the motion state of the wearer of the orthopedic device and to the following questions: how can the change of the motion state be identified and how can the control of the orthopedic device be matched accordingly.

[0009] Thus, the motion state of the wearer usually lasts for a long time for multiple step cycles, while the motion state of the body part changes over a significantly shorter period of time. This change can be performed multiple times within a single step cycle. Preferably, the at least one controllable actuator is arranged and configured to change the motion state of the body part assisted or replaced by the orthopedic device, i.e. the motion state of the first body part. Typically, the at least one controllable actuator is not configured to change the motion state of the wearer of the orthopedic device.

[0010] The controllable actuator can be, for example, a damping element, for example a hydraulic damper. In particular, in the case of a hydraulic damper, a valve is present in the fluid connection, which valve can be opened or closed, preferably steplessly. As a result, the cross section of the fluid connection is increased or reduced, whereby the resistance to the fluid flow and thus the damping caused by the damping element can be reduced or increased.

[0011] The controllable actuator may also be an actuator by which a certain movement of at least a part of the orthopedic device or a certain movement of the entire orthopedic device can be controlled. This is necessary, for example, in the case of active orthopedic devices, such as active knee joints or active ankle joints, so that the joints of the orthopedic device fulfill the desired function. The controllable actuator can be designed as active or passive, regardless of whether it is a damping element or an actuator.

[0012] Devices and methods for stimulating motor equipment, in particular for electrical stimulation of muscles and nerves, for example by means of electrodes, are also considered controllable actuators within the meaning of the present invention. These controllable actuators can, for example, be arranged on the skin of the wearer and stimulate the subcutaneous muscles by means of electrical impulses. The actuators can also be subcutaneous electrodes, for example electrodes acting on nerves.

[0013] It has long been known from the prior art that the controllable actuator is controlled according to the identified movement state. For this purpose, at least one sensor is set up to record measured values, from which at least one parameter can be determined, the curve of which can illustrate the movement state. In this case, it is not necessary to detect or evaluate and record the time curve over the entire step cycle. This parameter can be, for example, the knee angle of a knee prosthesis or knee orthosis, which is measured, for example, over a step cycle and evaluated in an electrical control device. The maximum knee angle that occurs here varies depending on the movement state. For example, when the wearer of the orthotic device climbs a staircase, the maximum bending angle that occurs in the case of one knee is significantly greater than when he walks on a flat surface. From this, the movement state can be inferred, wherein this information is then used, for example, in the swing phase of the leg to control the controllable actuator so that the knee performs the desired movement.

[0014] On the other hand, it is meaningful, for example, to dorsiflex the leg during the swing phase of the ipsilateral limb when climbing stairs, that is, to lift the toes. This significantly reduces the risk of tripping and allows for smoother and more natural stair climbing.

[0015] The limb that is provided with the orthopedic device and taken care of by it is called the ipsilateral limb. In contrast, the limb that is not provided with the orthopedic device is called the contralateral limb. Here, if the two limbs are, for example, arms or legs, the contralateral limb can correspond to the ipsilateral limb. However, if the ipsilateral limb is a leg, the arm that is not taken care of by the orthopedic device is also called the contralateral arm, and vice versa. This also preferably applies in the sense of the invention when both are located on the same side of the body, i.e., when it comes to the left arm and left leg or the right arm and right leg.

[0016] Traditionally, at least one sensor is used to record measured values, from which the parameters of the ipsilateral limb can be determined. Therefore, for example, the knee angle, ankle angle, different torques, the relative positions of different components, or the speed, acceleration or displacement of a certain point of an orthopedic device can be determined relative to each other or determined in an absolute manner. All these parameters can be used to obtain the state of motion. However, it is disadvantageous that the state of motion can only be obtained when the measured value has been sensed, that is, only after or in the corresponding step. Therefore, the determination of the state of motion can only be traced back all the time. Here, the control of the controllable actuator according to the identified state of motion is always based on the following precondition: the state of motion of the wearer does not change between two steps. The state of motion identified in a step cycle is also considered to be applicable for the next step cycle. When this is not the case and the state of motion changes, disadvantages will occur. This causes that the wearer of an orthopedic device, such as a knee and a lower leg prosthesis, always starts climbing stairs with the contralateral limb. This partially causes that the wearer who wants to climb a staircase must change the standing leg before the staircase so as to start climbing stairs with the correct leg, i.e. the contralateral limb, for them. This is both cumbersome and inconvenient and should also ensure that the wearer of the orthotic device can be identified very easily. The sense of natural movement induced in this way cannot be maintained or can be maintained with great difficulty. Summary of the invention

[0017] The object of the present invention is therefore to further develop a method for operating an orthotic device in such a way that the recognition of movement states is improved and the movements performed by a wearer of the orthotic device with the orthotic device are as similar as possible to natural movements.

[0018] The invention achieves the stated object by a method for operating an orthopedic device according to the preamble of claim 1 , which is characterized in that at least the time curve of at least one parameter of a second body part of the wearer is also used to identify the movement state.

[0019] The invention is based on the recognition that in particular human walking and many other human movements are essentially determined by the coordinated movement of different body parts, in particular two limbs. For example, to take a step, the standing leg must assume the movement of the body's center of gravity and produce forward movement, while the swinging leg must position the foot in such a way that balance and effective weight transfer can be achieved. If, for example, a hand prosthesis is to be used to grasp a railing and support itself on it, this also leads to shoulder movements and, if necessary, chest movements. The invention makes use of the idea of ​​making full use of the relevance of this coupling in order to reconstruct and control the movement of the limited ipsilateral limb at least also from the contralateral movement of the limb. This applies in particular (if not exclusively) to the following intention: to recognize the movement state at the earliest possible point in time.

[0020] At least one actuator of the orthosis can be controlled, for example, in such a way that the movement of the limb being taken care of, which in this case forms a first body part, and / or assistance is performed according to the movement of the contralateral limb, which in this case forms a second body part. For example, in the case of an arm orthosis, at least one sensor can detect the extension of the leg from the flexed position, from which a leg-lifting movement can be inferred. The orthosis is then actuated in such a way that it assists and / or performs a lifting and / or stretching movement of the arm.

[0021] However, it is also possible that the orthosis is an aid to the lumbar vertebrae, which form the first body part and whose flexibility can be adjusted by the actuator. For example, the flexibility changes when a stretching movement of the leg is detected from the flexed position and / or a bending of the elbow is detected from the extended position, in particular when the upper body leans forward. In both cases, the control of the actuator is coupled to the movement of at least one second body part.

[0022] According to the invention, the time curve of a parameter is used to identify the motion state. A single measurement that provides a measured value at a single time point is not sufficient. Advantageously, but not necessarily, the time curve of the parameter is determined over one cycle or particularly preferably over multiple cycles, such as a step cycle, especially in the case of repeated motion. This is usually done by multiple, preferably many, single measurements that provide measured values ​​at corresponding single time points. These results of the single measurements are stored and evaluated as a time curve. Here, multiple single measurements can be performed equally in time. Here, the distance between two single measurements must be small compared to, for example, the length of a step cycle, so that the time curve of the parameter can be obtained from multiple single measurements.

[0023] It is usually advantageous and sufficient to determine the time curve of the parameter not over the entire step cycle but, for example, only over a determined part of a step cycle. In order to identify the movement state, it is usually sufficient to know the parameter at completely determined time points of, for example, a step cycle. For example, these determined time points can be the time points when the heel strikes the ground or the toes separate. In order to determine this time point as accurately as possible, it is necessary or at least advantageous to measure and determine the time curve of the parameter in a determined time period before and after this determined time point. This also belongs to the definition of the time curve according to the invention.

[0024] If the wearer's motion state, that is, in particular the way of his forward movement, has been identified, the controllable actuator can be controlled accordingly. Here, preferably non-single routines and time sequences are executed, which are stored in the data memory of the electronic control unit for the determined motion state. On the contrary, the time curve of the parameters of the second body part is preferably used to control at least one controllable actuator. In this way, it is achieved that the body part assisted or replaced by the orthopedic device moves in a harmonious, natural and as optimally matched manner as possible with the movement of other body parts, in particular the second body part. Therefore, for example, a natural walking posture is produced by matching the movement of the orthopedic device, such as the prosthesis trunk, to the movement of the healthy leg that forms the second body part in this case. Instead of or in addition to this, the second body part can also be an arm, whose natural swinging movement when walking or running is used to control the movement of the leg prosthesis or orthosis.

[0025] Therefore, with the help of the method according to the present invention, in a particularly preferred configuration, not only can the wearer's movement state be identified as early as possible and at least one controllable actuator be controlled accordingly, but the movement of the actuator can also be matched to the movement of different body parts, thereby making the wearer more accepting of the orthopedic device.

[0026] Preferably, the first body part does not directly adjoin the second body part.

[0027] In a preferred configuration, the at least one parameter is the relative position, relative movement and / or relative speed and / or relative acceleration and / or relative angle of the second body part relative to the first body part and / or the relative position, relative movement and / or relative speed and / or relative acceleration and / or relative angle of the first part of the second body part relative to the second part of the second body part. The second body part is preferably a foot, a knee, a thigh, a calf and / or a leg tendon. The second body part is preferably an unattended body part or a part thereof. However, it may also be advantageous that the second body part is, for example, a part of a limb on which an orthopedic device is arranged. Thus, the second body part may be, for example, an amputation stump of a thigh or a leg, on which a prosthesis is arranged, the artificial knee or artificial foot of the prosthesis replacing the first body part, for example.

[0028] To determine the time course of the relative movement, for example, the position of the body parts relative to one another and / or their orientation in a common coordinate system relative to at least one sensor is determined at multiple time points. In particular, the term "position" is also understood to mean a translational and / or rotational orientation relative to one another.

[0029] It is not important here whether a second body part, in particular the contralateral limb, is also taken care of by a further orthopedic device.

[0030] Of particular interest is the leg tendon of the unattended leg as a second body part, which represents the imaginary connecting line between the foot and hip of the limb. Here, the interesting measurement parameters of the leg tendon are in particular the orientation, length, and speed and change of the leg tendon. On the one hand, the leg tendon provides information about the position of the foot of the contralateral limb relative to the center of the body and the center of gravity. Therefore, the leg tendon directly and indirectly provides information about the wearer's travel, stability and / or foot positioning. In addition, even if the movement of the leg tendon is usually not used, the movement of the leg tendon can already be obtained with the help of common sensors. The movement of the proximal end of the leg tendon, that is, the movement of the hip, can already be calculated by the existing sensor device that can be integrated into the orthopedic technology device described here. Especially in the standing phase, a good assumption can be made by the movement of the distal end, that is, by the movement of the foot of the unattended limb. In the swing phase, the movement of the foot, that is, in particular the position of the foot and / or the change of the position of the foot, can be determined by at least one sensor.

[0031] If the proximal and distal points of the leg tendon of the unattended leg are known, then, for example, the leg angle or knee angle can be determined with the aid of the known dimensions of the thigh and calf of the wearer of the orthotic device, which can be interpreted intuitively and used for control rules. The knee angle of the attended side is a validated control parameter.

[0032] Alternatively or in addition to this, in the case of a leg taken care of by an orthopedic device, that is, in the case of an ipsilateral limb, the position of the contralateral foot, that is, the untaken foot, relative to the ipsilateral foot can also be determined. This can be achieved either only in the sagittal plane (Sagittal) or in three dimensions. In many cases, after it can be considered that at least one of the feet is in contact with the ground, the relative measurement of the distance between the ipsilateral foot and the contralateral foot can be regarded as the determination of the absolute trajectory. Direct position measurement is more important than the quadratic integration of acceleration measurement here, because the correct initial conditions are required first when integrating. Of course, the acceleration and the torque acting on the foot can also be determined, and the acceleration and the torque acting can be represented in the form of a measurement column or a time curve. The quadratic integration of time obtains movement. The horizontal component of the foot movement provides an explanation of the time point of the step length and therefore also about the step. Here, the moment when the contralateral foot passes the ipsilateral foot is particularly interesting. This applies to both the stance phase and the swing phase.

[0033] The relative positions of other points relative to one another, for example the ipsilateral knee axis relative to the contralateral foot, may also be of interest. The more sensors used, the more different parameters can be determined for one measurement. Other relative positions can be deduced via the kinematic chain, and thus other parameters can be determined.

[0034] In particular, from various combinations of relative positions and / or relative movements and relative angles, segment angles of the contralateral body side can also be deduced. This relates, for example, to the thigh, calf or foot. Joint angles, such as the contralateral hip angle, knee angle or ankle angle, can thus be determined.

[0035] By means of a clever selection of different sensors for determining different variables, from which different parameters of the second body part can also be determined, it is possible, for example, to determine the contralateral leg movement.

[0036] The at least one sensor is preferably configured to detect an absolute angle, a relative angle, a speed, an acceleration, a force, a pressure, a pressure wave, a torque, an electric field and / or a magnetic field. Pressure waves are also understood to be sound waves, in particular ultrasound waves.

[0037] The first body part is preferably the ipsilateral limb or a part thereof, in particular the foot, ankle and / or knee, and the second body part is another limb, preferably the contralateral limb or a part thereof, preferably the foot, ankle and / or knee.

[0038] In a preferred embodiment, at least one sensor is arranged on a component of the orthopedic device and / or on a first body part and preferably also detects at least the following measured values, from which at least one parameter of a second body part, in particular of a contralateral limb, is determined. Preferably, the at least one sensor is a contactless sensor. There are different measuring principles for selection. For example, the at least one sensor can determine information about the contralateral limb by measuring the influence of electric fields, magnetic fields and / or electromagnetic and electrostatic fields. This is achieved, for example, by the influence of an oscillating circuit or by a capacitive measurement. Such sensors are known to those skilled in the art from the prior art, so that a detailed description is omitted.

[0039] Another operating principle of the contactless measurement is, for example, the determination of propagation times, reflections and interferences of waves which are advantageously emitted by the sensor itself or by another component arranged on the orthotic device and / or on the ipsilateral limb.

[0040] Preferably, the at least one sensor is arranged on a second body part, preferably on the contralateral limb, and preferably also detects at least measured values ​​from which at least one parameter of the functional body part, preferably the contralateral limb, is determined.

[0041] Therefore, at least one sensor advantageously has at least one transmitting device and at least one receiving device. Here, the transmitting device emits measurement radiation, which is advantageously ultrasonic or electromagnetic measurement radiation, such as radar radiation and / or visible light and / or infrared radiation (IR radiation). The receiving device is set up to receive the measurement radiation. With the help of this sensor, the principles of interferometric measurement, triangulation and propagation time measurement of different electromagnets or other measurement radiations can be obtained. Electromagnetic waves in the radio and microwave range (such as radar), near infrared radiation and far infrared radiation and visible light (such as laser radar) can be considered as measurement radiation. For visible light, the corresponding receiving device is, for example, a camera. If the measurement radiation is not electromagnetic radiation, ultrasonic radiation can be used, for example. The measurement radiation emitted by the transmitter arrives on a second body part, preferably on the contralateral limb, and is affected by the second body part. On the one hand, this involves the reflection of the measurement radiation, but the frequency, especially the phase, can also be changed. The receiving device is set up to receive the measurement radiation affected by the second body part and evaluate the information contained therein.

[0042] Advantageously, the receiving device is designed to receive measurement radiation that has been reflected or re-emitted by a second body part, preferably a contralateral limb, and to determine a measured value and thereby at least one parameter from a propagation time, a phase shift, a frequency shift and / or an interference with the emitted measurement radiation. Advantageously, the determination of the parameter and the evaluation of the measured value are not performed in the receiving device, but in an electrical control device, which is also used to control the controllable actuator.

[0043] These methods can be used to determine the orientation, distance, position and, if necessary, the velocity. For example, the Doppler effect is used, in particular, when determining the velocity. All these methods and evaluation methods can be used both in a two-dimensional plane, for example in a sagittal plane, and in three dimensions. In addition, image recognition techniques known in principle from the prior art can be used to determine an object, in particular a contralateral body part or a portion of a contralateral body part.

[0044] Photogrammetry or light sectioning methods can also be used, for example, in order to extract depth information from the measured values ​​of at least one sensor. All of these methods are preferably used in an electrical control device.

[0045] The measurement itself can be performed point by point in a defined plane or in a directional range, for example in a transmission cone. In this case, the entire scene can be covered in a single recording or individual gridding can be performed. In this case, use can be made of the fact that at least one sensor on a first body part or on a component of the orthopedic device moves past a second body part, in particular the contralateral limb, and vice versa. The second body part is thus detected from different angles by the at least one sensor and thus contains different information.

[0046] The transmitter and the receiver are preferably mounted on the same body part, for example on the same side body part or on the opposite side body part. In other configurations, the transmitter and the receiver can also be located on different body parts respectively. In addition, in the case of multiple sensors, it is also possible to realize a combination of arrangements on the same and another body part.

[0047] In a preferred embodiment, at least one transponder and / or tag and / or reflector for the emitted measuring radiation is arranged on the second body part, preferably on the contralateral limb. This is a so-called target, which can be easily identified for the corresponding sensor technology and electromagnetic radiation due to its geometry and / or material properties and has well-defined properties. Active and passive transponders can also be used, so that as soon as they receive the measuring radiation, for example, they emit information for identification or independent measurement results. Such a transponder or target can be integrated, for example, in a bandage or a belt, which is arranged on the second body part or positioned in clothing.

[0048] It has proven to be advantageous that the data of the orthopedic device and / or the wearer are used to determine at least one parameter, in particular for determining at least one parameter of a second body part, preferably of a contralateral limb. This can be, for example, a distance, a possible swing angle or a length specification. Thus, for example, in order to determine the knee angle of the contralateral leg from the leg tendon, it is necessary to know at least roughly, but preferably precisely, the calf length and the thigh length of the wearer of the orthopedic device on the contralateral body side. The relative dimensions of the contralateral body side with respect to the ipsilateral body side can also be converted into absolute dimensions by measuring the absolute measured dimensions of the ipsilateral body side. Thus, for example, the contralateral calf angle corresponds to the ipsilateral calf angle plus the relative angle of the two calves relative to each other.

[0049] Preferably, during operation of the orthopedic device, at least one control variable of at least one controllable actuator is controlled to a setpoint value or a setpoint value curve. This advantageously depends not only on the identified movement state itself, but also on the parameters on which the identification is based, in particular on at least one parameter of the second body part, preferably at least one parameter of the contralateral limb.

[0050] The invention also achieves the stated object by an orthopedic device which assists or replaces a first body part, wherein the orthopedic device has at least one sensor and an electrical control device which is configured to carry out the method described here.

[0051] When determining at least one parameter of the contralateral limb, as already explained, the calculation of the corresponding parameter can be deduced from the sensor data. Alternatively or in addition thereto, missing parameters that cannot be directly obtained with the aid of the sensors used can be determined from existing measurement variables and, if necessary, models or model assumptions. The existing measurement variables can be measurement variables of the ipsilateral body side or measurement variables of the contralateral body side. The corresponding models are, for example, mechanical and kinematic models that describe the individual movements of the limb.

[0052] According to the application example of the method of one embodiment of the present invention, the bending resistance of the orthosis of the knee prosthesis or the knee overlap (knieübergreifend) is reduced. The knee forms the first body part. This reduction or the swing phase opening occurs in the same side standing phase in relation to the leg angle and / or segment angle of the contralateral swing leg phase. The reduction can also occur at least partially when walking downstairs and downhill. This reduction occurs so that when the contralateral foot, i.e. the second body part, is sufficiently close to the same side foot, i.e. the foot on the first body part, stands or has passed the foot on the first body part in the forward direction, the reduction occurs. This targeted reduction of the bending resistance can make the bending resistance in the early standing phase be designed higher than the current one, or prevent further bending after reaching a certain degree of knee bending, and only allow further bending again when the same side foot swings forward far enough. The time point of this reduction and the initial bending resistance can also be related to the walking speed, wherein a higher walking speed leads to a smaller excess of the bending resistance and leads to an earlier reduction. For foot prostheses or orthoses that attach to the foot, the dorsiflexion movement and / or dorsiflexion resistance during the stance phase on the same side can be matched to allow for an easy step ( ). In particular, the beginning of a forward step can be detected by the forward swinging of the opposite body side from a standing position, and dorsiflexion is permitted and / or initiated compared to standing, which facilitates rolling via the foot.

[0053] In another embodiment, the trajectories of the ipsilateral foot and the contralateral foot in the corresponding swing phase are directly determined by the relative distance of the ipsilateral foot relative to the contralateral foot by the ground contact on the corresponding opposite body side. The ipsilateral foot forms a first body part and the contralateral foot forms a second body part. In the case of transtibial care (Versorgung) or ankle-foot orthosis (AFO: ankle-foot orthosis), this gives an indication of the height difference to be overcome. Here, it can be both a positive height difference, i.e. a height difference pointing opposite to gravity, and a negative height difference, i.e. stepping down. The auxiliary device is then controlled in such a way that the foot adapts its inclination or stiffness before the initial contact to the above-mentioned conditions. In particular, when stepping down, the front foot can be made to perform a greater plantar flexion (Plantarflexion) so that it is lifted at the initial contact with the front foot. It is also possible that when climbing upward on the contralateral body side, the ipsilateral foot performs active plantar flexion in its stance phase in order to raise the body's center of gravity and make it easier to overcome the height difference.

[0054] For the care of the overlapping knee, in addition to the relative position of the feet to each other, the movement of the swing leg and the standing leg, especially the movement of the ipsilateral leg tendon and the contralateral leg tendon can also be associated. In this case, multiple second body parts are used. The movement state can be obtained from the relationship between these movements, especially the overcoming of the height difference. Especially when climbing up with the ipsilateral body side, the knee joint can be bent more strongly in the swing phase bending and / or stop in the bending position at the end of the swing phase extension. This makes it easier to overcome the height difference. It is also possible to control the knee prosthesis or the orthosis of the overlapping knee in the swing phase so that the movement of the ipsilateral foot is in a coordinated relationship with the movement of the contralateral leg and with the movement of the ipsilateral thigh or thigh stump. For example, the knee joint can be controlled so that the stride length of the ipsilateral foot in front roughly corresponds to the stride length of the contralateral standing leg. For example, a stronger ipsilateral hip flexion can lead to a smaller knee extension or a stronger knee flexion when the contralateral leg movement remains the same.

[0055] In another example, the knee pre-bend of the knee is matched. If the knee joint stops in a flexed position when climbing uphill and stairs and when lifting the leg at the end of the swing phase, the degree of this pre-bend can be determined in such a way that the leg angles on the same side and on the other side are in a harmonious relationship with each other during initial contact on the same side. Thus, the user determines the step length essentially by the contralateral standing leg movement and by the hip flexion or thigh movement on the same side, on the side of the assistive device.

[0056] Swing phase control is also possible. The flexion and extension resistance or setpoint value of the actuator in the swing phase of the prosthesis side can be set so that a coordinated relationship is established between the leg angle of the contralateral body side in the stance phase and the leg angle of the ipsilateral body side in the swing phase. The rolling movement of the contralateral body side thus predetermines the time point of the ipsilateral body side, wherein the thigh movement of the ipsilateral side has a significant influence on how the orthotic device must intervene in the movement.

[0057] In another example, a swinging motion is identified. Some assistive devices do not have any force sensor means to determine if the attended body side is in contact with the ground. The contralateral leg motion can illustrate if there is a backward walk (where the contralateral standing leg rolls backward), or if the standing leg stands still while the ipsilateral body side under the body swings backward. In the latter case, knee flexion can be allowed or initiated in the case of an overlapped knee, which enables climbing stairs or negotiating an obstacle. Similar schemes can help identify when the user moves the ipsilateral body side forward, for example from standing.

[0058] An important application is stumbling detection. Information about the contralateral leg movement can also provide the following information: whether the user has stumbled. This relates to stumbling in the swinging leg phase on the same side as well as in the swinging leg phase on the contralateral side. On the one hand, it can be detected by a sudden stop of the originally continuous movement or on the other hand by an excessive follow-up (natchilen) of the swinging leg side relative to the rolling movement on the opposite side. The type of reaction when stumbling is detected can also depend on where the opposite body side is located. The foot can be raised and / or the ground clearance can be increased or the foot can be lowered and / or the bending resistance can be increased.

[0059] When the relative distance between the contralateral foot and the ipsilateral foot is sensed with measurement technology, the step length can be directly provided and can be used for activity tracking or for assessing walking symmetry in addition to control. Walking speed can also be determined directly as the distance covered per unit time, rather than being estimated from the rolling speed during the ipsilateral stance phase. BRIEF DESCRIPTION OF THE DRAWINGS

[0060] Some embodiments are explained in more detail below with the aid of the accompanying drawings. In the drawings:

[0061] Figure 1 Four different orthopedic devices are shown in front view respectively;

[0062] Figure 2 showing the worn orthotic technical device in walking mode;

[0063] Figure 3 Show Figure 1Schematic cross-sectional view of the orthopedic device in three different stride positions;

[0064] Figure 4 A schematic diagram illustrating the application of the methods described herein;

[0065] Figure 5 Another example of application is shown;

[0066] Figure 6 A flow chart is shown. DETAILED DESCRIPTION

[0067] Figure 1 Four different care situations are shown from left to right. On the far left, the legs of a wearer of the orthotic device can be seen, wherein the contralateral limb 2 is the left leg and the ipsilateral limb 4 is the right leg. Figure 1 In the leftmost illustration of FIG. 4 , a leg prosthesis having a thigh shaft 6 , a knee joint 8 , a lower leg 10 and a foot 12 is arranged on the ipsilateral limb 4 . It is schematically shown that a sensor is present on the lower leg 10 , which emits measuring radiation 14 in the direction of the contralateral limb 2 .

[0068] In the adjacent illustration, the contralateral limb 2 is again the unattended healthy leg, while this time a lower leg prosthesis is arranged on the ipsilateral limb 4. The lower leg prosthesis has a lower leg trunk 16, to which the lower leg 10 and the foot 12 are attached. A sensor is also arranged here, which emits measurement radiation 14 in the direction of the contralateral limb.

[0069] The third illustration from the left shows a healthy contralateral limb 2 and an intact ipsilateral limb 4, on which an orthotic device in the form of an orthosis is arranged. The orthosis has a thigh frame 18, a calf frame 20 and a knee joint 22, on which a controllable actuator is located. Here, too, a sensor is arranged in the calf region, namely on the calf frame 20, which emits measurement radiation 14 in the direction of the contralateral limb.

[0070] exist Figure 1 In the rightmost illustration of the diagram, the ipsilateral limb 4 is as shown in the leftmost illustration. However, in contrast to the leftmost illustration, the contralateral limb is also taken care of by the orthopedic device, i.e., by the lower leg prosthesis corresponding to the orthopedic device shown from the left in the second illustration. Both orthopedic devices now each have a sensor which emits measurement radiation 14 in the direction of the respective other limb. Figure 1 For the orthotic device shown on the left, ie on the right leg, the opposite body side is the contralateral limb, even if it is taken care of by the additional orthotic device.

[0071] Figure 2The diagram is shown during a step cycle. The contralateral limb 2 is unattended, while the ipsilateral limb 4 has a thigh prosthesis with a thigh shaft 6 , a knee joint 8 , a shank 10 and a foot 12 . Figure 1 The sensor in the embodiment emits measurement radiation 14 towards the center, ie almost exclusively towards the side, while Figure 2 The sensor in is set up to emit measurement radiation 14 in the direction of the contralateral limb 2, even though it is located almost completely in front of the ipsilateral limb. This can be achieved, for example, by making the transmission range into which the sensor emits the measurement radiation 14 so large that sufficient measurement radiation 14 reaches the contralateral limb 2 regardless of the position of the contralateral limb 2. Alternatively, the sensor or in particular the transmission device can be rotated or moved. Alternatively or in addition thereto, the radiation characteristics of the respective sensor can also be adapted.

[0072] This is Figure 3 The foot of the contralateral limb 2 can be seen, and in the cutaway top view the foot 12 of the ipsilateral limb 2 can be seen in different phases of the stride. The ipsilateral limb 4 is just performing the swing phase, while the foot of the contralateral limb 2 is firmly planted on the ground. Figure 3 In the leftmost illustration of the ipsilateral limb, the ipsilateral limb has just lost contact with the ground and the swing phase begins. The measurement radiation 14 is emitted strongly pointing forwards, since the contralateral limb is located in this direction. Figure 3 In the middle of the swing phase shown in the middle of FIG, the ipsilateral limb 4 is located directly next to the contralateral limb, so that the measurement radiation 14 is emitted almost entirely to said side. Figure 3 At the end of the swing phase shown on the right, the foot of the ipsilateral limb 4 is located in front of the foot of the contralateral limb 2 , so that the measurement radiation 14 is emitted mostly backwards.

[0073] Figure 4 This is for the example that the first body part 24, which in the illustrated embodiment is the wearer's right arm, is not necessarily "opposite" the second body part 26, which in the illustrated embodiment is the left ankle. Figure 4 Three positions within a step cycle are shown in which the position of the second body part 26, the left ankle, relative to the other body part, the right ankle, is determined in each case. Figure 4 In the left illustration of FIG. 2 , the second body part 26 is located behind the torso of the wearer. The same applies to the first body part 24. The relative position of the second body part 26 relative to the right ankle is determined, which is indicated by three small lines. During a step cycle, the position of the second body part 26 relative to the right ankle is determined during the swing phase by Figure 4 The position shown in the middle changes until Figure 4The position when the heel strikes the ground is shown on the right in FIG. Accordingly, the movement of the first body part 24 replaced by the arm prosthesis is also controlled.

[0074] Figure 5 This is an example of a second body part 26, which can be located on the same half of the body as the body part 24, on which a sensor 34 is mounted for determining the movement state, in particular the stance phase in the step cycle, which body part 24 is equipped with an orthopedic aid. The sensor can, for example, in the case of an inertial sensor, sense information about the movement state based solely on measurements of the limb 26 equipped with the sensor 34. Likewise, with the aid of the sensor 34 mounted on the body part 26, it is also possible to receive a measurement beam emitted by the opposite leg or reflected or re-emitted.

[0075] Figure 6 1 shows a schematic flow chart of the method described here. Parameters are ascertained from a first body part 24 and at least one second body part 26, whose time curve 28 is determined. A movement state 30 and a movement intention 32 of the wearer are thereby determined, wherein the determined movement state 30 can also be used to determine the movement intention 32. The movement intention 32 and the determined movement state 30 can be used separately from one another or in combination to activate a control device 34 for an actuator.

[0076] Reference Symbols List

[0077] 2 Contralateral limb

[0078] 4 Ipsilateral limb

[0079] 6 Thigh

[0080] 8 Knee joint

[0081] 10. Calf

[0082] 12 Legs

[0083] 14 Measuring Radiation

[0084] 16. Calf

[0085] 18 Thigh Frame

[0086] 20 Calf Frame

[0087] 22 Knee joint

[0088] 24 First Body Part

[0089] 26 Second Body Part

[0090] 28 Time curve

[0091] 30 Movement Status

[0092] 32 Movement Intention

[0093] 34 Sensors

Claims

1. A method for operating an orthopedic device, which assists or replaces a first body part of a wearer and has at least one controllable actuator, wherein: The method comprises the following steps: a) determining, from the measured values ​​of at least one sensor, a time curve of at least one parameter, which is capable of describing the movement state of the wearer; b) identifying the movement state from the at least one determined time curve; and c) controlling the at least one controllable actuator according to the identified motion state, wherein at least a time curve of at least one parameter of a second body part of the wearer is also used to identify the movement state, wherein the at least one sensor has at least one transmitting device and at least one receiving device, wherein the transmitting device emits measuring radiation and the receiving device is configured to receive measuring radiation, It is characterized in that the receiving device receives the measuring radiation reflected or re-emitted by the second body part and determines the measured value and the at least one parameter from the propagation time, phase shift, frequency shift and / or interference with the emitted measuring radiation.

2. The method according to claim 1, characterized in that: The first body part is not directly adjacent to the second body part.

3. The method according to claim 1 or 2, characterized in that: The at least one parameter is the relative position, relative movement and / or relative velocity and / or relative acceleration and / or relative angle of the second body part relative to the first body part, and / or the relative position, relative movement and / or relative velocity and / or relative acceleration and / or relative angle of a first part of the second body part relative to a second part of the second body part.

4. The method according to claim 1 or 2, characterized in that: The at least one sensor is designed to detect an absolute angle, a relative angle, a speed, an acceleration, a force, a pressure, a pressure wave, a torque, an electric field and / or a magnetic field.

5. The method according to claim 1 or 2, characterized in that: The first body part is a limb on the same side or a part of a limb on the same side, and the second body part is another limb.

6. The method according to claim 1 or 2, characterized in that: The at least one sensor is arranged on a component of the orthopedic device and / or on the first body part and also detects at least measured values ​​from which at least one parameter of the second body part is determined.

7. The method according to claim 1 or 2, characterized in that: The measuring radiation is ultrasonic and / or electromagnetic measuring radiation.

8. The method according to claim 1 or 2, characterized in that: At least one transponder and / or tag and / or reflector for the emitted measuring radiation is arranged on the second body part.

9. The method according to claim 1 or 2, characterized in that: The data of the orthotic device and / or the data of the wearer are used to determine the at least one parameter.

10. The method according to claim 1 or 2, characterized in that: At least one controlled variable of the at least one controllable actuator is controlled to a setpoint value or a setpoint value curve which is a function of the detected movement state and of at least one parameter of a functional body part.

11. The method according to claim 5, characterized in that The ipsilateral limb or part of the ipsilateral limb is a foot, an ankle and / or a knee.

12. The method according to claim 5, characterized in that The second body part is the contralateral limb or a part of the contralateral limb.

13. The method according to claim 12, characterized in that The contralateral limb or a part of the contralateral limb is a foot, an ankle and / or a knee.

14. The method according to claim 7, characterized in that The measuring radiation is radar radiation and / or visible light and / or infrared radiation.

15. The method according to claim 9, characterized in that The at least one parameter is at least one parameter of the second body part.

16. The method according to claim 10, characterized in that At least one parameter of the functional body part is at least one parameter of the contralateral limb (2).

17. An orthopedic device for placement on an ipsilateral limb (4), wherein: The orthopedic device has at least one sensor and an electrical control device which is designed to carry out a method according to one of the preceding claims.

Images