Wearing method of sole modular rehabilitation training device

Abstract

The invention relates to a wearing method of a sole modular rehabilitation training device, and relates to the technical field of rehabilitation medical instruments. According to the method, the rehabilitation stage of a patient is dynamically evaluated through the plantar contact area, an adaptive module is selected in combination with an abnormal movement mode, and staged accurate intervention is achieved. In the soft paralysis period, a large-area module combination is adopted to provide supporting stability, and in the recovery period, a distributed module combination is switched to activate proprioceptive sensation; through module inclination angle gradient adjustment, ankle fixing band tension hierarchical control and dynamic position adjustment, abnormal postures of feet are corrected step by step, healthy side compensation is inhibited, and an evaluation-intervention-desensitization closed-loop treatment path is formed. Static intervention limitation of a traditional brace is broken through, the active participation degree of a patient is improved through modular combination and a dynamic adaptation mechanism, the rehabilitation period is shortened, auxiliary-free independent walking is finally achieved, and the device is suitable for multi-scene rehabilitation treatment from hospitals to families.

Description

Technical Field

[0001] The present invention relates to the technical field of neurological rehabilitation, and specifically to a wearing method of a modular plantar rehabilitation training device. Background Art

[0002] In the field of neurological rehabilitation, hemiplegic patients often suffer from abnormal movement patterns such as equinovarus, foot drop, poor control of knee hyperextension, and pelvic lateral compression due to central nerve injury, resulting in gait imbalance and secondary joint injuries. Traditional rehabilitation methods mainly rely on therapists' manual correction and fixed orthotic braces:

[0003] Limitations of manual intervention: Although physical therapies such as manual traction and joint mobilization can improve foot posture in the short term, there are problems such as non-quantifiable treatment parameters and poor efficacy persistence. After discharge, patients are prone to recurrence of abnormal patterns due to lack of professional guidance;

[0004] Defects of fixed braces: Conventional ankle-foot orthoses (AFOs) use rigid structures to limit joint activities and cannot be used independently. Long-term wearing is likely to cause disuse atrophy of plantar muscles. It can neither dynamically adjust the support strength and contact area according to the flaccid stage and recovery stage, nor specifically correct problems such as circumduction gait and ankle-knee coordination disorders;

[0005] Lack of compensatory regulation: Existing technologies mostly focus on local correction of the affected side, ignoring overall posture abnormalities such as pelvic tilt and center of gravity shift caused by compensatory mechanisms of the healthy side, and lack a coordinated correction mechanism to improve the weight-bearing of the affected side through adjustment of the healthy side support surface (such as height-differentiated modules).

[0006] In recent years, although some studies have attempted to monitor plantar pressure through intelligent sensors, there are still two major technical bottlenecks:

[0007] Static intervention mode: Most orthotic devices only provide passive support and cannot guide patients to actively participate in balance training through module combination changes. In particular, there are no dynamic intervention means for complex functional disorders such as ankle-knee movement chain control and pelvic three-dimensional stability;

[0008] Stage connection fault: The treatment plans from the early stage (flaccid stage) to the late stage (recovery stage) of rehabilitation are in a fragmented state, lacking a dynamic assessment mechanism based on the Berg Balance Scale and gait symmetry parameters (such as single-leg standing time > 6 seconds), and it is difficult to achieve a progressive desensitization treatment from device-assisted to independent walking.

[0009] Therefore, there is an urgent need for a dynamic intervention device that can span the entire rehabilitation cycle and has both mechanical correction and nerve remodeling functions to solve the clinical problems of strong dependence and long rehabilitation cycle of traditional methods. Summary of the Invention

[0010] The present invention provides a wearing method for a modular plantar rehabilitation training device to solve the problems of the prior art.

[0011] To solve the above technical problems, the present invention is realized through the following technical solutions: A wearing method for a modular plantar rehabilitation training device, comprising the following steps:

[0012] S1. Patient status assessment:

[0013] Determine the type of abnormal pattern of the patient through clinical observation, including at least one of varus foot, foot drop, external hip rotation, and lateral pelvic compression;

[0014] According to the proportion of the plantar contact area of the patient, determine the rehabilitation stage as the flaccid paralysis stage (contact area > 85%) or the recovery stage (contact area 40% - 60%);

[0015] S2. Function module selection and installation:

[0016] Select the appropriate module from the cylindrical straight section block, step block, wedge block, square flat plate, rectangular flat plate, T-shaped block, and step flat plate according to the abnormal pattern and rehabilitation stage;

[0017] If it is varus foot, snap the wedge block to the outer edge of the midfoot area;

[0018] If it is foot drop, snap the wedge block to the forefoot area and adjust the dorsiflexion traction intensity through the ankle fixation strap;

[0019] If there is lateral pelvic compression, stack the wedge block and the square flat plate in the heel area;

[0020] If there is healthy side compensation, snap the square flat plate to the healthy side heel area;

[0021] S3. Dynamic wearing and adjustment:

[0022] Wear the plantar adapter with the installed module on the patient's foot, and adjust the tightness of the ankle fixation strap through the magic tape;

[0023] During the training process, dynamically replace the module according to the patient's gait feedback:

[0024] If there is a center of gravity shift, snap the T-shaped block to the affected midfoot area or heel area;

[0025] If the support of the affected side is insufficient, replace the rectangular flat plate with a wedge block;

[0026] S4. Stage-based rehabilitation training:

[0027] In the flaccid paralysis stage, use a large-area module combination (contact area > 85%);

[0028] Switch to a decentralized module combination during the recovery period (contact area 40%-60%);

[0029] When the single-leg standing time of the patient meets the standard and the gait symmetry improves, gradually reduce the use of the module until the device is removed;

[0030] S5. Rehabilitation training assisted by a limiting band:

[0031] When using the functional module and the sole adapter, slip the limiting band over the fixing band, and further slip the limiting band over the outside of the other foot. By adjusting the tightness length of the limiting band, limit the abduction amplitude and movement amplitude of the affected foot of the patient, and cooperate with the functional module and the sole adapter to correct the affected foot of the patient.

[0032] In this application, through the modular sole intervention device and the dynamic adjustment method, a stepped rehabilitation system for the abnormal movement patterns of hemiplegic patients is innovatively constructed. With the detachable functional module combination as the core and combined with the dynamic evaluation technology of the sole contact area, precise compensation regulation from the flaccid paralysis period to the recovery period is achieved; through the dynamic adaptation of the module position, shape and mechanical parameters, abnormal patterns such as equinovarus and pelvic offset are corrected while the patient actively participates in the training, forming a closed-loop treatment path of "evaluation-intervention-desensitization", breaking through the technical bottlenecks of strong dependence on traditional fixed braces and long rehabilitation cycles, enabling the patient to finally complete the balance training independently without the assistance device, effectively connecting the hospital treatment and the home rehabilitation scenarios, and promoting the upgrading of neurorehabilitation treatment towards personalization and standardization.

[0033] In a specific embodiment, the inclination angle of the wedge block is adjusted in gradients, and the inclination angle is increased weekly to gradually correct equinovarus;

[0034] The installation position of the T-shaped block is adjusted according to the direction of the center of gravity offset: when it offsets to the healthy side, it is installed in the heel area of the affected side, and when it offsets to the affected side, it is installed in the midfoot area.

[0035] In a specific embodiment, the tightness adjustment of the ankle fixing band needs to meet: the fixing band tension ≤ 10N during the flaccid paralysis period, and gradually increase to 15N-20N during the recovery period.

[0036] In a specific embodiment, a loop is provided on one side of the fixing band, and the limiting band is sleeved and connected to the fixing band by passing through the loop. Magic tapes are provided at both ends of the limiting band for adhesion and fixation.

[0037] In a specific embodiment, when the T-shaped block is clamped to the outside of the healthy-side forefoot area, its transverse extension part extends 10-15 mm beyond the foot edge, and the gait of drawing circles is inhibited by restricting the weight bearing of the fifth metatarsal head.

[0038] In a specific embodiment, the installation of the cylindrical straight-cut segment block satisfies the following requirements: forming a 15°-25° plantar inclination angle during the propulsion phase of gait, and the radius of curvature of the arc surface is set to 120-140 mm, matching the normal arch of the foot and providing progressive pressure spikes.

[0039] In a specific embodiment, a rehabilitation assessment step is also included: when the Berg balance scale score is >40 points and the single-leg standing time is >6 seconds, a step plate with decreasing height is installed in the heel area of ​​the healthy side, with a step height difference of 3-5mm / step, to induce active weight-bearing on the affected side.

[0040] The beneficial effects of the present invention are:

[0041] 1. Through the combination of modular combination design and quantitative assessment of plantar contact area, the fixed intervention mode of traditional braces is broken through. For the flaccid paralysis period (contact area > 85%), large-area module support is used to ensure uniform distribution of plantar pressure; during the recovery period (contact area 40%-60%), it is switched to a decentralized module combination to activate plantar proprioception through local pressure stimulation. Combined with the gradient adjustment of the wedge block inclination angle (5°-30°) and the dynamic displacement compensation of the T-block, it can accurately correct abnormal patterns such as foot inversion and pelvic tilt, effectively improve the efficiency of abnormal gait correction, and avoid muscle atrophy caused by over-reliance on fixed braces;

[0042] 2. Based on the closed-loop treatment pathway of "assessment-intervention-desensitization", the dynamic adjustment mechanism is implemented throughout the entire rehabilitation process. Through the graded control of the tension of the ankle strap (≤10N in the flaccid period, 15-20N in the recovery period) and the modular progressive replacement strategy, the weight-bearing capacity of the affected side is gradually enhanced with the active participation of the patient. BRIEF DESCRIPTION OF THE DRAWINGS

[0043] Figure 1 It is a schematic diagram of the plantar adapter of the present invention.

[0044] Figure 2 It is a schematic diagram of the structure of different modules of the present invention.

[0045] Figure 3 It is a schematic diagram of the assembly structure of the limiting belt of the present invention. DETAILED DESCRIPTION

[0046] The following will be combined with the embodiments of the present invention to clearly and completely describe the technical solutions in the embodiments of the present invention. Obviously, the described embodiments are only part of the embodiments of the present invention, not all of the embodiments. Based on the embodiments of the present invention, all other embodiments obtained by ordinary technicians in this field without making creative work are within the scope of protection of the present invention.

[0047] like Figures 1 to 2Wearing method of a modular plantar rehabilitation training device as shown. Example 1: Wearing method for patients with equinovarus combined with lateral pelvic compression in the flaccid stage

[0048] Patient status assessment:

[0049] The plantar contact area of the patient is 88%, which is determined to be in the flaccid stage; clinical observation shows that there is equinovarus and pelvic compression on the affected side.

[0050] Module installation and adjustment:

[0051] Equinovarus correction: A wedge block with an inclination angle of 5° is clamped on the outer edge of the midfoot area to inhibit equinovarus through lateral pressure;

[0052] Pelvic correction: Stack a wedge block and a square flat plate in the heel area to generate an anterior tilting moment using the height difference to counteract the lateral subsidence of the pelvis;

[0053] Compensation inhibition on the healthy side: Install a square flat plate in the heel area of the healthy side to reduce the support area of the healthy side and force the affected side to actively bear weight.

[0054] Dynamic adjustment:

[0055] During training, it is found that the patient's center of gravity shifts to the healthy side. Immediately install a T-shaped block in the heel area of the affected side to expand the support surface through its lateral extension part and balance the center of gravity distribution. The pulling force of the ankle fixing band is set to 8 N to ensure the stability of the foot and avoid soft tissue damage.

[0056] Example 2: Wearing method for patients with foot drop accompanied by external rotation of the hip in the recovery stage

[0057] Stage determination and module selection:

[0058] The plantar contact area of the patient is 52%, in the recovery stage; there is foot drop and external rotation of the hip. Select a wedge block to fit the forefoot area.

[0059] Module installation:

[0060] Foot drop correction: Clamp the wedge block with the inclined surface facing forward on the forefoot area to promote ankle dorsiflexion by raising the toe angle (15°);

[0061] External rotation of the hip inhibition: Install a stepped block on the outer edge of the foot to limit excessive weight bearing on the little toe side and correct the lower limb force line.

[0062] Gradual desensitization training:

[0063] When the patient can stand on one leg for 6 seconds, replace the square flat plate with a decentralized combination: retain the wedge block in the forefoot area and install a rectangular flat plate in the midfoot area, and the contact area is reduced to 45%. Increase the inclination angle of the wedge block by 2° every week until the foot drop angle is corrected to the neutral position.

[0064] Comparison of technical effects:

[0065] Compared with traditional fixed braces, the device in the flaccid paralysis stage improves the uniformity of plantar pressure distribution by 40% through module combination; after adopting decentralized modules in the recovery stage, the gait symmetry index of patients increases from 0.6 to 0.9. The module gradient desensitization strategy increases the proportion of patients who can get rid of the auxiliary device within 3 months to 82%, which is significantly better than the control group (46%).

[0066] Dynamic adaptation mechanism: Through the topological optimization design of the module card slot, the gradient adjustment of the inclination angle of the wedge block (5° - 30°) is realized to meet the mechanical requirements of different rehabilitation stages;

[0067] Closed-loop feedback system: The plantar pressure sensor is used to monitor the contact area in real time. When contralateral compensation is detected, the control module automatically triggers a warning signal to prompt the replacement of the contralateral module;

[0068] Home rehabilitation connection: The modular design facilitates patients to replace the modules independently at home. Combining with the gait analysis algorithm in the mobile phone APP, a personalized module configuration plan is generated and synchronized to the cloud.

[0069] For Example 3, please refer to Figure 3 as shown in the figure, the limit band-assisted rehabilitation training:

[0070] When using the functional module and the plantar adapter, the limiting band is sleeved on the fixing band. Further, the limit band is sleeved on the outside of the other foot. By adjusting the length of the limit band, the abduction amplitude and movement amplitude of the affected foot of the patient are restricted. Cooperating with the functional module and the plantar adapter, the affected foot of the patient is corrected to improve the rehabilitation effect. A loop is provided on one side of the fixing band. The limit band is sleeved and connected to the fixing band by passing through the loop. Magic tapes are provided at both ends of the limit band for adhesion and fixation.

[0071] Although the embodiments of the present invention have been shown and described, for those of ordinary skill in the art, it can be understood that various changes, modifications, substitutions and variations can be made to these embodiments without departing from the principles and spirits of the present invention. The scope of the present invention is defined by the appended claims and their equivalents.

Claims

1. A method for wearing a modular plantar rehabilitation training device, characterized in that: The following steps are involved: S1. Assessment of patient status: Determine the abnormal pattern of the patient through clinical observation, including at least one of foot inversion, foot drop, hip external rotation, and lateral pelvic compression; According to the proportion of the patient's sole contact area, the rehabilitation stage was determined to be flaccid paralysis (contact area > 85%) or recovery (contact area 40%-60%); S2. Functional module selection and installation: According to the abnormal pattern and the rehabilitation stage, an adaptor module is selected from a cylindrical straight section block, a step block, a wedge block, a square flat block, a rectangular flat block, a T-shaped block and a step flat block; If the foot is inverted, attach the wedge to the outer edge of the midfoot area; If the patient has foot drop, attach the wedge block to the forefoot area and adjust the dorsiflexion stretch intensity through the ankle strap. If there is lateral pelvic compression, superimpose wedge blocks and square flat blocks on the heel area; If there is healthy side compensation, clip the square flat plate to the healthy side heel area; S3. Dynamic wearing and adjustment: Put the plantar adapter with the module installed on the patient's foot and adjust the tightness of the ankle strap with Velcro; During training, modules are dynamically replaced based on patient gait feedback: If there is a center of gravity shift, attach the T-block to the midfoot or heel area of ​​the affected side; If the affected side is not adequately supported, the rectangular flat block is replaced with a wedge-shaped block; S4. Rehabilitation training in stages: During the flaccid period, a large-area module combination (contact area > 85%) was used; Switch to a decentralized module combination (contact area 40%-60%) during the recovery period; When the patient's single-leg standing time reaches the target and the gait symmetry improves, the use of modules is gradually reduced until the device is removed; S5. Limiting belt assisted rehabilitation training: When using the functional module and the plantar adapter, the limiting belt is put on the fixing belt, and the limiting belt is further put on the outside of the other foot. By adjusting the tightness of the limiting belt, the outward extension and movement range of the patient's affected foot are limited. In conjunction with the functional module and the plantar adapter, the patient's affected foot is corrected.

2. The method for wearing the modular plantar rehabilitation training device according to claim 1, characterized in that: The inclination angle of the wedge block is adjusted in a gradient, and the inclination angle is increased weekly to gradually correct the inversion of the foot; The installation position of the T-shaped block is adjusted according to the direction of the center of gravity deviation: when deviating to the healthy side, it is installed in the heel area of ​​the affected side; when deviating to the affected side, it is installed in the midfoot area.

3. The wearing method of the modular plantar rehabilitation training device according to claim 1, characterized in that: The tightness adjustment of the ankle strap must meet the following requirements: the tension of the strap during the paralysis period is ≤10N, and gradually increases to 15N-20N during the recovery period.

4. The method for wearing the modular plantar rehabilitation training device according to claim 1, characterized in that: A ring is provided on one side of the fixing belt, and the limiting belt is inserted through the ring and connected with the fixing belt. Velcro is provided at both ends of the limiting belt for adhesion and fixation.

5. The method for wearing the modular plantar rehabilitation training device according to claim 1, characterized in that: When the T-shaped block is clamped on the outer side of the forefoot area of ​​the healthy side, its lateral extension exceeds the edge of the foot by 10-15 mm, thereby suppressing the circular gait by limiting the load-bearing of the fifth metatarsal head.

6. The method for wearing the modular plantar rehabilitation training device according to claim 1, characterized in that: The installation of the cylindrical straight-cut segment block satisfies the following requirements: a 15°-25° plantar inclination angle is formed during the propulsion phase of gait, and the radius of curvature of the arc surface is set to 120-140 mm, matching the normal arch of the foot and providing progressive pressure spurs.

7. The wearing method of the modular plantar rehabilitation training device according to claim 1, characterized in that: It also includes rehabilitation assessment steps: when the Berg balance scale score is >40 points and the single-leg standing time is >6 seconds, a step-like plate with decreasing height is installed in the heel area of ​​the healthy side, with a step height difference of 3-5mm / step, to induce active weight-bearing on the affected side.

Images