Rehabilitation assisting shoe for hemiplegic patient

Abstract

The invention relates to the technical field of medical instruments, in particular to a rehabilitation assisting shoe for a hemiplegic patient, which comprises a high shoe body, a lengthened shoe tongue and a ratchet wheel fixing device positioned at the malleolus medialis. An L-shaped foot sleeving opening is formed in the back of the shoe body and used for achieving horizontal placement of the foot after the shoe body is unfolded. The lengthened shoe tongue spans the instep and extends to the medial malleolus, and the tightness of the rope is adjusted through the ratchet device. A heel supporting plate customized through 3D printing, an ankle-foot joint orthosis and a personalized insole are integrated in the shoe body, the orthosis is fixed to the shoe sole through a limiting groove and structural adhesive, and a pressure dispersion layer is arranged on a contact interface. A patient can conveniently put on and take off the rehabilitation device with one hand, and walking comfort and rehabilitation effect are remarkably improved while biomechanical stability of ankle joints is guaranteed.

Description

Technical Field

[0001] This invention relates to the field of medical device technology, and in particular to a rehabilitation assistive shoe for hemiplegic patients. Background Technology

[0002] Ankle-foot orthoses are a commonly used clinical intervention. They correct ankle joint alignment through exogenous mechanical support, and have significant clinical value in preventing muscle contractures, improving gait stability, and reshaping walking function. However, in practice, existing ankle-foot orthoses usually need to be used in conjunction with the patient's own regular shoes, i.e., they are two-piece designs.

[0003] This split-type orthosis has several problems that urgently need to be addressed: First, in order to resist the muscle tension of ankle inversion and plantar flexion in hemiplegic patients, ankle-foot joint orthoses usually use a rigid structure, which can easily lead to excessive local pressure on the skin, resulting in poor wearing comfort; second, most existing orthoses lack personalized design based on the patient's foot shape, resulting in limited corrective effect; third, the relative position between the orthosis and the shoe is difficult to fix. During walking, the orthosis is prone to rotation or displacement, causing changes in the ankle joint support angle, failing to provide stable and continuous corrective force, and may even cause secondary injury due to positional displacement. Summary of the Invention

[0004] The purpose of this invention is to provide a rehabilitation assistive shoe for hemiplegic patients, in order to solve the technical problems of the existing ankle and foot orthoses used for hemiplegic patients being used separately from regular shoes, such as cumbersome wearing procedures, easy axial displacement and radial rotation of the orthoses within the shoe, and inability to perform precise force line rehabilitation correction according to the patient's foot structure.

[0005] The present invention provides a rehabilitation assistive shoe for hemiplegic patients, including a shoe body with a high-top support structure. The rear part of the shoe body is constructed with an L-shaped foot opening. The L-shaped foot opening extends vertically downward from the upper edge of the shoe body to the heel, and then extends horizontally on the force-bearing side at the heel, so that the rear part of the shoe body forms a three-dimensional open foot insertion space.

[0006] An extended tongue covers the opening of the shoe body. The proximal end of the extended tongue is fixed to the outer ankle side of the shoe body, and the distal end crosses the instep area and wraps around to the inner ankle side of the shoe body. A ratchet fixing device is provided on the inner ankle side to cooperate with the extended tongue. The ratchet fixing device integrates an automatic locking roller. One end of the fastening rope is wound around the roller, and the other end passes through the guide channel inside the extended tongue. By rotating the external knob of the ratchet fixing device, the roller is driven to rotate, generating axial tension, so as to achieve a wrap-around tightening of the extended tongue around the foot and ankle.

[0007] In some embodiments, the vertical extension path length of the L-shaped foot opening is 80% to 90% of the total height of the shoe upper, the horizontal extension path of the L-shaped foot opening is set according to the width of the patient's foot and its end extends to the stress support area of ​​the side wall of the shoe cavity, and a flexible sealing pleat is provided at the edge of the L-shaped foot opening.

[0008] In some embodiments, the ratchet fixing device is installed in an area 1cm to 3cm in front of the medial ankle, and the fastening cord is made of high-strength polyethylene fiber and has an S-shaped or Z-shaped wiring inside the extended shoe tongue; the ratchet fixing device has a one-way self-locking mechanism and a quick release mechanism that allows the reel to disengage by pulling up the knob.

[0009] In some embodiments, the inner wall of the heel portion of the shoe body is connected to a 3D-printed custom support plate, and the inner surface contour of the 3D-printed custom support plate is generated by modeling based on the physiological curvature data of the patient's heel and lower leg.

[0010] A prefabricated limiting groove is provided on the inner sole surface of the shoe body. The shape of the limiting groove matches the bottom base of the 3D printed custom ankle and foot joint orthosis. The ankle and foot joint orthosis is fixed in the limiting groove by physical embedding and structural adhesive bonding.

[0011] In some embodiments, a pressure-dispersing layer is included, which is made of a cushioning material with nonlinear mechanical characteristics and fixed to the inner interface of the 3D-printed custom support plate. At positions corresponding to the patient's medial malleolus, lateral malleolus and navicular bone, the pressure-dispersing layer is provided with decompression grooves, which are filled with soft gel.

[0012] In some embodiments, the shoe includes a wear-resistant underlayer and a 3D-printed insole disposed between the wear-resistant underlayer and the insole surface, wherein the 3D-printed insole overlaps with the bottom base within the limiting groove in the vertical direction.

[0013] Compared with the prior art, the present invention has the following beneficial effects:

[0014] 1. Regarding ease of wear, this invention utilizes the structural coupling of an L-shaped foot opening and a ratchet fixation device on the medial malleolus side, changing the reliance of traditional rehabilitation shoes on bilateral hand coordination. The fully open rear space provided by the L-shaped opening allows the affected foot to enter the shoe cavity without complex plantar flexion or dorsiflexion movements, which is particularly crucial for patients with ankle joint contractures or increased muscle tone. The knob design on the medial malleolus side takes advantage of the ease of operation of the unaffected hand of hemiplegic patients, achieving uniform tightening of the entire shoe through a simple rotation, thus substantially improving the patient's daily living self-care ability.

[0015] 2. Regarding orthopedic mechanical stability, this invention transforms the ankle-foot orthosis, originally an external accessory, into an integral part of the shoe structure through a limiting groove. This integrated design eliminates frictional loss and relative sliding between the orthosis and the insole in a split structure, achieving high-precision maintenance of the corrective force line during dynamic walking. The 3D customized features of the support plate ensure 100% matching between physical support points and anatomical force points, thereby achieving effective control of foot drop during the swing phase and rigid correction of foot inversion during the support phase.

[0016] 3. Regarding biomechanical compatibility and comfort, the introduction of a pressure-dispersing layer and gradient-hardness insoles addresses the mechanical mismatch between rigid orthotic materials and soft tissues. Targeted decompression of bony prominences achieves a more even distribution of contact pressure. Simultaneously, the 3D-printed insoles actively intervene in plantar pressure, optimizing the trajectory of the pressure center point and guiding patients to establish a gait pattern closer to physiological states, thus reducing the risk of secondary knee and hip injuries caused by gait abnormalities.

[0017] 4. In terms of psychological rehabilitation and social participation, the integrated design of this invention significantly reduces the external volume of the rehabilitation shoe, making its appearance more like that of ordinary sports shoes. Attached Figure Description

[0018] To more clearly illustrate the technical solutions in the embodiments of the present invention or the prior art, the drawings used in the description of the embodiments or the prior art will be briefly introduced below. Obviously, the drawings described below are only some embodiments of the present invention. For those skilled in the art, other drawings can be obtained based on these drawings without creative effort.

[0019] Figure 1 This is a side view of the rehabilitation assistive shoe for hemiplegic patients according to the present invention;

[0020] Figure 2 This is a schematic diagram of the back of the rehabilitation assistive shoe for hemiplegic patients according to the present invention.

[0021] In the picture:

[0022] 1-Extended tongue; 2-Ratchet fixing device; 3-Shoe body; 4-Abrasion-resistant bottom layer; 5-L-shaped slip-on opening. Detailed Implementation

[0023] The following will be based on embodiments of the present invention. Figures 1-2 The technical solutions in the embodiments of the present invention will be clearly and completely described together. Obviously, the described embodiments are only some embodiments of the present invention, and not all embodiments.

[0024] Example

[0025] This invention provides a rehabilitation assistive shoe for hemiplegic patients. The shoe includes a shoe body 3. In the structural design of the shoe body 3, to address the problem of foot stiffness and inability to smoothly insert a regular shoe opening caused by increased ankle muscle tension in hemiplegic patients, an L-shaped slip-on opening 5 is constructed on the back area of ​​the shoe body 3. This L-shaped slip-on opening 5 is not a traditional single linear opening, but a three-dimensional open structure composed of vertically downward cuts and horizontally extending lateral cuts. Specifically, the vertical cuts start from the upper edge of the shoe upper, extend along the center line or side of the heel to the stress area near the outsole, and then turn to extend horizontally. This design alters the physical boundaries of the shoe cavity; when the L-shaped slip-on opening 5 is open, the rear of the shoe body 3 presents a shovel-like open space. During the process of putting on shoes, hemiplegic patients do not need to perform the complex actions of probing with their toes and lifting their heels as with regular shoes. Instead, they simply place their affected foot on top of the open L-shaped instep 5, and use the natural weight of their lower limb or slight assistance from their unaffected hand to insert their foot into the shoe cavity in one go along a horizontal path. This insertion method simulates the biomechanical path of wearing slippers, avoiding the dorsiflexion resistance of the ankle joint during the process of putting on shoes.

[0026] After the foot enters the shoe cavity, an extended tongue 1 is attached to the shoe body 3 to achieve effective wrapping and mechanical fixation. The physical dimensions of the extended tongue 1 are much larger than those of a regular tongue, and its proximal end is fixed to the outer ankle edge of the shoe body 3 by sewing or heat pressing. The length of the extended tongue 1 is sufficient to span the entire instep area and wrap around to the inner ankle side of the shoe body 3.

[0027] Inside the extended shoe tongue 1, a high-strength fastening rope is pre-embedded. This rope is made of low-elongation polyethylene fiber material. A ratchet fixing device 2, positioned at the medial malleolus, cooperates with the end of the extended shoe tongue 1. For hemiplegic patients, when putting on shoes while seated, the affected leg is usually crossed over the unaffected leg. At this time, the medial malleolus area is within the optimal operating field of vision and radius of the unaffected hand. The ratchet fixing device 2 integrates a miniature scroll, a one-way pawl mechanism, and a pressure release lever.

[0028] When the patient uses their unaffected hand to rotate the outer knob of the ratchet fixing device 2 clockwise, the roller drives the fastening rope to contract axially, thereby pulling the extended shoe tongue 1 tightly towards the inner ankle. As the number of rotations increases, the tension generated by the rope is evenly distributed in the instep and anterior ankle area covered by the extended shoe tongue 1, achieving a circumferential locking of the ankle joint.

[0029] The heel of the shoe body 3 is connected to a 3D-printed custom-made plate that fits the heel. The manufacturing process of this plate begins with a three-dimensional laser scan of the patient's ankle and foot.

[0030] The manufacturing process is as follows: a handheld 3D scanner is used to acquire point cloud data of the patient's limb surface in the corrected position; computer-aided design software is used to triangulate the point cloud data and extract the anatomical contours of the heel and lower leg; the geometric shape of the support plate is designed based on the extracted contour lines to ensure that its inner surface fits the patient's skin surface in geometric space 100%.

[0031] The support plate is manufactured using a carbon fiber reinforced thermoplastic composite material through fused deposition modeling, resulting in extremely high specific strength and specific stiffness. The support plate is fixed to the heel lining and outer shell of the shoe body 3 via an embedded structure. Its upward extension forms a semi-encircling support for the lower leg, while its downward extension conforms to the sole structure. Understandably, this customized rigid support structure acts directly on the calcaneus and distal tibia and fibula, generating continuous lateral support force to counteract inversion muscle tension and maintain a neutral ankle position during walking.

[0032] On the inner sole surface of the shoe body 3, i.e., the support surface in contact with the sole of the foot, a limiting groove adapted to the orthotic base is pre-formed by molding or CNC machining. The ankle-foot joint orthosis used in this invention is not a separate accessory, but an integrated component embedded in the limiting groove and securely connected to the inside of the sole with structural adhesive. This connection method eliminates relative sliding of the orthosis inside the shoe, ensuring efficient transmission of biomechanical corrective forces.

[0033] At the bottom of the shoe body 3, there is a wear-resistant bottom layer 4. The wear-resistant bottom layer 4 is made of synthetic rubber material with high wear resistance and high friction coefficient. Its surface has complex anti-slip texture. The thickness distribution of the wear-resistant bottom layer 4 is thinner in the front and thicker in the back. There is a specific shock-absorbing zone in the heel. The microporous structure of the material absorbs the impact load at the moment of landing.

[0034] The internal space of the shoe body 3 is filled with a pressure-dispersing layer, which is located between the 3D-printed custom support plate and the patient's skin. Its core material is medical-grade slow-rebound memory foam. When the ratchet fixing device 2 applies a tightening force, the pressure-dispersing layer transforms any potential localized point pressure into a large-area uniform contact pressure through its own elastic deformation.

[0035] For bony protrusions such as the medial and lateral malleoli, the pressure dispersion layer is locally thinned or perforated at the corresponding locations and filled with silicone pads with lower modulus, thereby achieving avoidance and protection of sensitive areas.

[0036] To better understand the usage of this invention, the operation process in a practical application scenario is as follows:

[0037] When the patient needs to put on shoes, first, by turning the quick release switch of the ratchet fixing device 2 with one hand, the internal roller is in a free rotation state, and the fastening rope is loosened accordingly.

[0038] The patient then flips the extended tongue 1 outwards and unfolds the L-shaped opening 5 to the sides and back, at which point the rear of the shoe body 3 is completely open. The patient sits in a wheelchair or on the edge of a bed, using their unaffected hand to support the affected knee, allowing the affected foot to slide naturally into the shoe cavity. Due to the L-shaped opening 5, the heel can directly rest within the cup-shaped groove formed by the 3D-printed custom support plate, without needing to overcome the friction of the shoe upper.

[0039] After the foot is inserted, the patient will reposition the extended shoe tongue 1 to cover the instep;

[0040] Next, the patient uses their unaffected hand to rotate the ratchet fixation device 2 at the medial malleolus. As the knob is turned, the ratchet mechanism makes a crisp clicking sound, and the rope generates tension, causing the extended shoe tongue 1 to generate a combined inward and backward pulling force. This pulling force not only presses the foot firmly onto the insole, but also, through the synergistic effect of the extended shoe tongue 1 and the heel support plate, locks the ankle joint at the preset correction angle.

[0041] During walking, when the heel of the affected side strikes the ground, the rigid connection between the 3D-printed custom support plate and the sole ensures the consistency of the ground force line and prevents excessive inversion of the foot. As the foot's center of gravity shifts forward, the 3D-printed insole and pressure-dispersing layer work together to distribute the body weight evenly across the entire sole, avoiding excessive pressure on the base of the fifth metatarsal bone, which is common in hemiplegic patients.

[0042] The foregoing has shown and described the basic principles, main features, and advantages of the present invention. It will be apparent to those skilled in the art that the invention is not limited to the details of the exemplary embodiments described above, and that the invention can be implemented in other specific forms without departing from its spirit or essential characteristics. Therefore, the embodiments should be considered illustrative and non-limiting in all respects, and the scope of the invention is defined by the appended claims rather than the foregoing description. Thus, all variations falling within the meaning and scope of equivalents of the claims are intended to be included within the scope of the invention. No reference numerals in the claims should be construed as limiting the scope of the claims.

[0043] Furthermore, it should be understood that although this specification describes embodiments, not every embodiment contains only one independent technical solution. This narrative style is merely for clarity. Those skilled in the art should consider the specification as a whole, and the technical solutions in each embodiment can also be appropriately combined to form other embodiments that can be understood by those skilled in the art.

Claims

1. A rehabilitation assistive shoe for hemiplegic patients, characterized in that, The shoe body (3) includes a high-top support structure. The rear part of the shoe body (3) is constructed with an L-shaped foot opening (5). The L-shaped foot opening (5) extends vertically downward from the upper edge of the shoe upper to the heel and extends horizontally to the force-bearing side at the heel, so that the rear part of the shoe body (3) forms a three-dimensional open foot insertion space. An extended tongue (1) is covered at the opening of the shoe body (3). The proximal end of the extended tongue (1) is fixed to the outer ankle side of the shoe body (3), and its distal end crosses the instep area and goes around to the inner ankle side of the shoe body (3). A ratchet fixing device (2) that cooperates with the extended tongue (1) is provided on the inner ankle side. An automatic locking roller is integrated inside the ratchet fixing device (2). One end of the fastening rope is wound around the roller, and the other end passes through the guide channel inside the extended tongue (1). By rotating the external knob of the ratchet fixing device (2), the roller is driven to rotate to generate axial tension, thereby realizing the encircling tightening of the foot and ankle by the extended tongue (1).

2. The assistive shoe according to claim 1, characterized in that, The vertical extension path length of the L-shaped foot opening (5) is 80% to 90% of the total height of the shoe upper. The horizontal extension path of the L-shaped foot opening (5) is set according to the width of the patient's foot and its end extends to the force support area of ​​the side wall of the shoe cavity. Flexible sealing pleats are provided at the edge of the L-shaped foot opening (5).

3. The assistive shoe according to claim 1, characterized in that, The ratchet fixing device (2) is installed in the area 1cm to 3cm in front of the inner ankle. The fastening rope is made of high-strength polyethylene fiber and is S-shaped or Z-shaped inside the extended shoe tongue (1). The ratchet fixing device (2) has a one-way self-locking mechanism and a quick release mechanism that allows the roller to be released by pulling the knob upward.

4. The assistive shoe according to claim 1, characterized in that, The inner wall of the heel of the shoe body (3) is connected to a 3D printed custom support plate. The inner surface contour of the 3D printed custom support plate is modeled and generated based on the physiological curvature data of the patient's heel and lower leg. A prefabricated limiting groove is provided on the inner sole surface of the shoe body (3). The shape of the limiting groove matches the bottom base of the 3D printed customized ankle and foot joint orthosis. The ankle and foot joint orthosis is fixed in the limiting groove by physical embedding and structural adhesive bonding.

5. The assistive shoe according to claim 4, characterized in that, It includes a pressure-dispersing layer, which is made of a cushioning material with nonlinear mechanical characteristics and fixed to the inner interface of the 3D printed custom support plate. At the positions corresponding to the patient's medial malleolus, lateral malleolus and navicular bone, the pressure-dispersing layer is provided with pressure-reducing grooves, which are filled with soft gel.

6. The assistive shoe according to claim 4, characterized in that, It includes a wear-resistant bottom layer (4) and a 3D printed insole disposed between the wear-resistant bottom layer (4) and the insole surface, wherein the 3D printed insole overlaps with the bottom base in the limiting groove in the vertical direction.

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