Stimulation application, especially for an orthosis or a cuff

Abstract

Stimulation application (1), especially for an orthosis or a cuff, with a plurality of stimulation fields (2a, 2b, 3a, 3b, 4) arranged in at least two rows (2, 3), wherein these rows (2, 3) are each arranged such that between two adjacent rows (2, 3) there is a space (7) free of stimulation fields (2a, 2b, 3a, 3b, 4) for receiving a joint or for placement along a limb, wherein in the area of ​​the first ends (8) or the second ends (9) of the rows (2, 3) a supply field (20) is provided which is connected to at least one supply element (5) for supplying a stimulation medium coming from a stimulation medium source, wherein the stimulation fields (2a, 2b, 3a, 3b, 4) are connected in such a way that the stimulation medium passes through these stimulation fields (2a, 2b, 3a, 3b, 4) from the supply element (5) at one end (8, 9) to the other end (9, 8) of the rows (2, 3), wherein the stimulation application (1) extends in one plane.

Description

[0001] The invention relates to a stimulation unit, in particular for an orthosis or a cuff, with a plurality of stimulation fields, wherein the stimulation insert can be attached to a part of the body in the case of application.

[0002] From CA 1 085 251 A, a cuff for applying locally varying pressures to a patient's extremities is known. This is achieved by having a chamber within the cuff that is divided into several subchambers, which are interconnected by channels. The subchambers can be pressurized with compressed air. The diameter of the channels decreases from the compressed air inlet to the subchambers further away from the inlet. This results in the pressure in the subchamber immediately adjacent to the inlet being higher than in the subsequent subchamber, and so on. This design creates a rolling effect in which, due to the decreasing pressure gradient, the subchambers fill up sequentially from the compressed air inlet, thus producing a massaging motion in one direction away from the compressed air inlet. This stimulates blood flow from the compressed air inlet to the last subchamber.If the direction of the decreasing pressure gradient points towards the heart, this will alleviate the risk of thrombosis.

[0003] From US patent 4,029,087 A, a device is known by which compression pressure can be applied to a patient's limb to force blood out of spaces in the tissue of the limb in order to reduce swelling associated with edema in that limb. For this purpose, the device has a pressure cuff extending along and enclosing the limb, which contains a plurality of separate fluid pressure chambers. These fluid pressure chambers are arranged along the limb from the end of the pressure cuff furthest from the heart to the end closest to the heart.By filling the fluid pressure chambers with fluid, pressure is exerted on the enclosed tissue of the limb, creating a pressure gradient along the limb. This gradient progressively decreases during periodic compression cycles, starting from the fluid pressure chambers furthest from the heart and moving towards those closer to it. Tubes or openings are provided between adjacent fluid pressure chambers for this purpose.

[0004] From German patent application GB 2 324 246 A, a device for the local drainage of blood from tissue in a limb is known in order to create a bloodless area for surgery. For this purpose, the device is designed in a cuff-like shape and divided into a plurality of spirally arranged chamber segments, with adjacent chamber segments being connected to each other via bidirectional valves that open or close depending on the pressure gradient. The chamber segment furthest from the heart is connected via a valve to a pressure source to inflate and deflate the chamber segments.

[0005] US Patent 6,007,559 A discloses a vascular support device that exerts a statically graduated pressure as a minimum pressure on the limb enclosed by the device throughout its application in order to drain the tissue in that area of ​​blood. For this purpose, the device has a plurality of inflatable chambers that extend along the limb and can, for example, be arranged in a matrix. The pressure gradient extends from the chamber furthest from the heart, which is connected to a fluid source for supplying fluid to the chambers, to the chamber closest to the heart and is achieved by a suitable cycle of pressure variation, which can be repeated. Pressure-reducing connections, not described in detail, are present between the chambers. Further prior art information can be found in DE 692 32 191 T2 and the online article "Electrotherapy" by Lena Machetanz from July 6, 2019 (URL:).

[0006] The object of the invention is to present an alternative device which can be installed in particular in the area of ​​a joint and which uses compressed air as a stimulation medium, as well as being suitable for other stimulation media in general.

[0007] The problem is solved by a stimulation insert with the features of claim 1. The stimulation insert according to the invention has a plurality of stimulation fields that are traversed starting from a supply field connected to at least one supply element. Such a plurality of stimulation fields arranged one after the other is referred to as a series within the scope of this application. There are at least two of these series of stimulation fields that are arranged relative to each other such that there is a free space between them, which serves to accommodate a joint or to be attached along a limb. This makes it possible to place the stimulation insert around a joint and to apply the rolling effect not in the area of ​​the joint, but around it, thereby subjecting the soft tissue located there to the rolling effect mentioned in the problem.At the first ends of each row, a supply line field is provided, which is connected to at least one supply element for introducing a stimulation medium. In an advantageous embodiment, all rows have a single, common supply element. Stimulation media are understood to be media that can produce a rolling effect. These include, in particular—but not exclusively—the compressed air used in the prior art described above according to the Canadian patent, or other gases, electrical stimulation current such as that used, for example, in rehabilitation therapy after a sports injury, but also liquids such as water or oil. According to the invention, the stimulation fields are interconnected in such a way that the stimulation medium flows through them from the supply element to the second end of each row, thereby producing the desired rolling effect.The form this connection takes depends on the stimulation medium used. Specific embodiments for the stimulation media compressed air and electric current are listed in the dependent claims.

[0008] An advantageous embodiment of the invention provides that the second ends of the rows are adjacent to each other. This creates a closed free space without stimulation fields, which can be placed on the joint, and the effect is applied in a ring-like pattern around the joint. In particular, a circular shape can be achieved for the free space, but other shapes, such as an ellipse or a lens, are also possible.

[0009] The problem is also solved by a stimulation device with the features of claim 2, which, unlike the one mentioned above, is designed such that a second or further row is not necessarily required. The at least one row is spirally arranged around the space free of stimulation fields for accommodating a joint or for attachment along a limb, and the stimulation fields are interconnected in such a way that the stimulation medium flows through them from the supply element at one end of the row to the other end. This provides another form that is suitable for treating the respective body area with a massage effect.

[0010] The problem is also solved by a stimulation device with the features of claim 3, which, unlike the two mentioned above, is designed such that the at least one row is arranged circularly around the space free of stimulation fields for accommodating a joint or for attachment along a limb, and the stimulation fields are interconnected in such a way that the stimulation medium passes through them in both directions of the row, starting from the supply element. This provides yet another form suitable for treating the respective body area with a massage effect.

[0011] The problem is also solved by a stimulation insert with the features of claim 4, which, unlike the one mentioned above, is designed such that it has only one row that is curved around the space free of stimulation fields for receiving them, and the stimulation fields are traversed from one end to the other. Such a design is particularly suitable for enclosing one side of an ankle.

[0012] The problem is also solved by a stimulation device with the features of claim 5, which, unlike the one mentioned above, is designed in such a way that it is formed in a straight series and has a recess as a free space for receiving a joint or for attaching it along a limb.

[0013] An advantageous embodiment of the invention provides for a further stimulation insert according to the invention, wherein a common supply line element for both stimulation inserts is arranged in a bridge extending between the two stimulation inserts. This allows both sides of an ankle to be treated simultaneously, thus reducing the treatment time. At the same time, the supply line centrally located between the two stimulation inserts ensures symmetrical airflow through both stimulation inserts when compressed air is used as the stimulation medium. When compressed air is used as the stimulation medium in this way, a further advantageous embodiment includes an air outlet in the bridge, which is connected to the last stimulation field of each stimulation insert.This allows the compressed air to be extracted from each individual stimulation insert after it has passed through. A further advantageous improvement, when using two stimulation inserts, involves both inserts being identical in design and positioned as mirror images at the two ends of the connecting bridge. This ensures good coverage of both sides of the ankle when used on one foot.

[0014] An advantageous embodiment of the invention provides for exactly two rows. Such a configuration can be easily manufactured and readily attached to the area to be treated.

[0015] A further advantageous embodiment of the invention provides that the size and shape of the free space are tailored to the type and intended use of the orthosis or cuff. The number of stimulation fields per row and the associated length of the rows depend on the joint or limb for which the stimulation insert is to be used. The shape and size of the free space between two adjacent rows of stimulation fields also depend on this. For example, the free space for accommodating the knee joint is larger for a stimulation insert in the knee joint area than for a stimulation insert in the elbow joint area. Furthermore, the lengths of the individual rows are longer for a stimulation insert in the knee joint area than for one in the elbow joint area.

[0016] A further advantageous improvement involves all rows sharing a common feed element. This saves parts and reduces costs, as only a single feed element is required. Furthermore, it eliminates the need for synchronization between two separate feed elements – as might be the case with other alternatives – to ensure consistent rolling motion across the individual rows.

[0017] A preferred choice for the stimulation medium is electric current, with the stimulation fields then being electrodes. Here, one can make use of the electrostimulation methods known particularly in the field of rehabilitation therapies, which can be used even more efficiently with a stimulation device according to the invention than is currently done in rehabilitation therapies, where usually only two electrodes are attached to the skin and current then flows between these two electrodes.

[0018] An advantageous embodiment of the invention provides that the electrodes are connected via a cable, in particular a ribbon cable, to a microprocessor which controls the power supply to the individual electrodes. With such a microprocessor, which is responsible for controlling the individual electrodes and to which they are connected via cables, many different pre-programmed procedure sequences can be carried out, whereby selection between these sequences can be made very easily, for example, via a menu on a display, or adjustment to the required form of therapy can be made by means of a switch on the device.

[0019] An advantageous embodiment of the invention provides for a multiplexer circuit between the microprocessor and the electrodes. This allows each individual electrode to be controlled very easily by the microprocessor, so that each electrode can be individually controlled in terms of timing, amplitude, and waveform. The time delays can also be implemented by the microprocessor or switching transistors.

[0020] A further advantageous embodiment of the invention provides that the stimulation insert has a portable battery as a power source. This makes it possible to operate the orthosis or cuff, into which a stimulation insert according to the invention is placed, independently of an electrical power source that is fixed in one location, for example, a wall socket. Given that a stimulation insert according to the invention has very low power consumption, such batteries can be made very small and lightweight, thus not causing significant inconvenience for the wearer of an orthosis or cuff.This makes it possible to use an orthosis or cuff with a stimulation insert according to the invention in dynamic use, even when changing location – unlike when exercising on a treadmill or exercise bike, for example – i.e., during activities such as jogging, housework, or driving; this also applies to home therapy. Alternatively, the standard 220 V mains power supply can be used if location independence is not required. The stimulation insert then has a plug that can be inserted into a standard wall socket.

[0021] An advantageous embodiment of the invention provides that a time-delay element is arranged between each adjacent electrode. This provides a very simple solution for generating the rolling effect according to the invention, so that stimulation proceeds sequentially from the lead element towards the second end of each row. Preferably, the time-delay elements are designed as capacitors and / or a chain of shift registers with switching transistors controlled by them.

[0022] As an alternative to electrical stimulation, compressed air can also be used as the stimulation medium. In such a case, the stimulation fields are air chambers, and the supply element is an air inlet, preferably designed as a connection nipple for an air hose. In a preferred embodiment, the last air chamber of at least one of the rows is connected to an air outlet – which can also be combined collectively for all rows. The use of compressed air in the stimulation device according to the invention has the advantage that it can be very simply constructed, and the rolling effect is comparable to that of a massage or lymphatic drainage, where pressure is also exerted on the tissue being treated – unlike when using electrical stimulation.

[0023] In an advantageous further development of the stimulation device according to the invention, when using compressed air as the stimulation medium, adjacent air chambers are connected to each other via an air passage. Such a design is very simple to implement and inexpensive to manufacture. In an advantageous further development of the invention, the air passages have a clear opening of 2 to 5 mm, preferably 3.5 mm. This allows for a rolling motion that is beneficial for its therapeutic effect. Preferably, two films, each with a thickness of, for example, 0.4 mm, are welded together, with the weld width being approximately 1-2 mm.

[0024] An advantageous embodiment of the invention provides that all rows are connected to a common air outlet. As already explained above regarding the air inlet, this simplifies the design of the invention and also eliminates the need for additional parts. Preferably, the air outlet is arranged adjacent to the air inlet. This allows the stimulation unit according to the invention to be very compact. Alternatively, instead of the air outlet, a sensor connection can be provided at its position, which can be connected to an air pressure sensor for measuring the air pressure at the end furthest from the air inlet.

[0025] A further advantageous embodiment of the invention provides that an inlet valve is located in the supply element and an outlet valve or a sensor connection is located in the air outlet. This enables precise control of the air pressure in the chambers, leading to the most optimal therapeutic effect due to the precisely defined rolling effect. Preferably, the outlet valve is designed to open when a predefined air pressure in the chambers is exceeded. Since the outlet valve / sensor connection is connected to the last chamber of each chamber, i.e., the air chamber last filled with compressed air, the final air pressure can be set (with respect to the outlet valve) or measured (with respect to the sensor connection), and individually adjusted to the required therapy and the area around the joint being treated.

[0026] Alternatively, the inlet valve and outlet valve / sensor connection can also be located not in the supply element or in the air outlet, but in their periphery outside the stimulation unit in an air hose or on a pump that is connected to the stimulation unit during operation.

[0027] An advantageous embodiment of the invention provides that the air pressure at the inlet valve is constant between 0.3 and 2.0 bar, preferably 0.5 bar, or that the air pressure is adjustable. It is clear to those skilled in the art that the pressures specified throughout the application are given above atmospheric pressure.

[0028] An advantageous embodiment of the invention provides that the inflation time is between 2 and 6 s, preferably 4 s; the holding time is between 4 and 12 s, preferably 8 s; and the deflation time is between 6 and 14 s, preferably 10 s. These measures cover the parameters most suitable for therapeutic use.

[0029] A further advantageous embodiment of the invention provides that the stimulation insert, with the exception of the bonding agent, consists of a thermoplastic polyurethane or a polyvinyl chloride. This allows the stimulation insert to be manufactured very simply when using compressed air as the stimulation medium. The individual walls between the adjacent stimulation fields can be produced, for example, by welding together two films forming the upper and lower surfaces; the same applies to the outer walls that enclose the stimulation insert from the environment.

[0030] A further advantageous development for all conceivable stimulation media involves arranging the stimulation fields, particularly the air chambers and / or the electrodes, in a meandering pattern within a row. This achieves good guidance of the rolling motion from the air inlet to the other end of each row. Especially when using compressed air as the stimulation medium, the rolling motion can be very precisely controlled in terms of timing.

[0031] A further advantageous embodiment of the invention provides that the connecting element comprises elastic textiles, cords, bandages, a hook-and-loop fastener, a zipper, or a snap fastener. These connecting elements are very easy to handle and allow a secure connection between the stimulation insert and the cuff or orthosis, while also being very easy to release, yet simultaneously ensuring a sufficiently high level of security against unintentional disconnection.

[0032] Preferably, the stimulation insert according to the invention is connected to a cuff made of chloroprene rubber or elastic textiles, to a rubber mat, to a bandage, or to an orthosis. This allows it to be connected to the joint to be treated or fixed at the desired location on the body in a very simple manner, since the stimulation insert is embedded either in the cuff or in the orthosis, each of which has the necessary connecting means to fix the entire assembly at the desired location.

[0033] When using electric current as the stimulation medium, it is preferred that the cable connecting the electrodes to the microprocessor, in particular the flat ribbon cable, be arranged in an intermediate compartment formed on the cuff or orthosis. This ensures that the cable does not obstruct the view and is securely guided within the cuff or orthosis, preventing damage to the cable even under high stress on the cuff or orthosis.

[0034] An advantageous embodiment of the invention provides that horizontally extending wings are formed at the first ends of the rows, extending to the left and right, with stimulation fields arranged at the second ends of the rows. This provides a larger and more complex stimulation element, which offers particular advantages for the back, as it not only encloses a joint—in the back, these are the vertebrae of the spine, which are enclosed by the rows in the direction of the heart—but also allows for additional stimulation of the underlying tissue in a horizontal direction over a portion or even the entire back. In contrast to an embodiment of the rows with meanderingly arranged stimulation fields, a straight arrangement of the stimulation fields is preferred in the horizontally extending wings.

[0035] A further advantageous embodiment of the invention provides that the rows have a butterfly shape and that at least one supply element or further supply elements are arranged at the free ends of the rows, which lie side by side. A butterfly shape is understood to be a shape that connects two devices with V- or U-shaped arranged rows in such a way that their free, i.e., second ends, remain free even in the butterfly shape. This makes it possible to perform more complex treatments of certain areas of the body, while retaining all the advantages of the stimulation device according to the invention already described above.

[0036] A further advantageous embodiment of the invention provides that the stimulation device has at least one connecting element for attachment to an orthosis or a cuff. These devices can be particularly well positioned on the body part to be treated.

[0037] A further advantageous embodiment of the invention provides that the at least one connecting element is designed as a positioning aid, in particular as a sliding coupling, for easy connection to the orthosis or cuff. This allows for particularly easy positioning of the stimulation insert in the orthosis or cuff, and connection to a pump via a hose is easily possible.

[0038] Further advantages and details of the invention are described below with reference to the exemplary embodiments illustrated in the figures. The figures show: Fig. 1: a first stimulation device according to the invention for a knee joint, which operates with compressed air, Fig. 2a: a first stimulation insert according to the invention for the back, which works with compressed air, Fig. 2b: a second stimulation insert according to the invention for the back, which works with compressed air, Fig. 3a: a second stimulation device according to the invention for a knee joint, which operates with compressed air, Fig. 3b: a third stimulation device according to the invention for a knee joint, which operates with compressed air, Fig. 3c: a fourth stimulation insert according to the invention for a knee joint, which operates with compressed air, Fig. 4a: a first stimulation insert according to the invention for an ankle, which operates with compressed air, Fig. 4b: a second stimulation insert according to the invention for an ankle, which operates with compressed air, Fig. 4c: a third stimulation insert according to the invention for an ankle, which works with compressed air, Fig. 4d: a fourth stimulation insert according to the invention for an ankle, which operates with compressed air, Fig. 5: a stimulation insert according to the invention for a knee joint, which operates with electric current, and Fig. 6: a schematic representation of a stimulation insert for compressed air according to the invention, which is connected to a pump.

[0039] Fig. Figure 1 shows a first embodiment of a stimulation insert 1 according to the invention for a knee, which operates with compressed air as the stimulation medium. The stimulation insert 1 has two rows 2, 3 of air chambers 2a, 2b, 3a, 3b, 4. Each row 2, 3 corresponds to one leg of the U-shaped stimulation insert 1. The first ends 8 and the second ends 9 of the rows 2, 3 are arranged at the junction of the two legs. The rows 2, 3 are arranged such that a free space 7 is formed between them – starting from their first ends 8 – in which a joint can be accommodated when the stimulation insert 1 is used – for example, by being incorporated into a cuff or orthosis. Fig. 1. Due to its shape and dimensions, this is a knee joint, for which the stimulation insert 1 is designed. For other joints, the proportions are modified and adapted to the respective joint.

[0040] In the area where the legs are joined, a supply element 5 is required – when using compressed air, as in the exemplary embodiment of the Fig. In the case of Figure 1, an air inlet, which is also referred to below by the reference symbol “5”, and a sensor connection 6 are arranged side by side. The air inlet 5 is connected via a hose to a compressed air source (neither of which are shown), which supplies the stimulation insert 1 with compressed air. A pressure sensor 23 (see Figure 1) is connected to the sensor connection 6 via a hose. Fig. 6 - In another embodiment, a vent valve 25 is connected to the sensor connection 6 via an air hose 26, which measures the air pressure in the last air chamber 3b. If this exceeds a predetermined value, for example 1.5 bar, the compressed air source is switched off via a suitable device known to those skilled in the art.

[0041] The sensor connection 6 is only formed in the right-hand, second row 3 and is connected to the last air chamber 3b via a drainage channel 13. The left-hand, first row 2 has no connection to a sensor connection 6; rather, the last air chamber 2b there forms the end of the chain of air chambers 2a, 4, 2b.

[0042] At the lowest edge of the leg of the stimulation insert 1, a first air chamber 2a, 3a is formed, which functions as a single element for both the left row 2 and the right row 3; this means that, in the present embodiment, the first air chamber 2a of the left, first row 2 and the first air chamber 3a of the right, second row 3 coincide. This coincidence is not mandatory; the two first air chambers 2a, 3a can also be formed as separate elements. An air passage 11 is formed between the air inlet 5, which is arranged within an inlet chamber 15, and the first air chamber 2a, 3a. Four air chambers 4 are successively connected to the first air chamber 2a, 3a in each row 2, 3, with an air passage 11 formed between each of these in the walls 16 that separate them from one another. The last element in each row 2, 3 is the aforementioned last air chamber 2b, 3b.The direction of airflow 17, determined by the air openings 11 in the walls 16, is meandering and extends – starting from the bottom in the figure – from the first end 8 to the second end 9 of each row 2, 3. The number of air chambers 4 between the first air chambers 2a, 3a and the last air chambers 2b, 3b depends on the application, i.e., which joint it is to be attached to, and the size of the individual air chambers 2a, 2b, 3a, 3b, 4. The air openings 11 do not all have to be the same size. For example, it is also possible to make them progressively smaller in the direction of the airflow 17.

[0043] In the illustrated embodiment, the air passages 11 are all the same size – they have a clear opening of 3.5 mm. The air passages 11 are formed by welding together an upper and a lower plastic film, each 0.4 mm thick in this embodiment, with a weld width of 1–2 mm. These values ​​are only examples and can vary considerably depending on the application.

[0044] Due to the small size of the air passages 11 compared to the air chambers 2a, 2b, 3a, 3b, 4, the inflow of compressed air via the air inlet 5 results in a progressive filling of the individual air chambers 2a, 2b, 3a, 3b, 4 in the order of their meandering arrangement from bottom to top. During use, the stimulation insert 1 is positioned around the joint such that its second ends 9 point towards the heart. This creates an increasing pressure on the tissue around the joint, moving from bottom to top towards the heart. This is comparable to lymphatic drainage. This effect is referred to below as the rolling motion.

[0045] In principle, the stimulation insert 1 can also be arranged in the opposite direction, i.e., with its free, second ends 9 pointing away from the heart. However, in such an arrangement, it is preferable to use the other stimulation insert 1 described above in the general description, in which a supply element 5 is formed at each of the free, second ends 9 and a sensor connection 6 is provided in the region of the first ends 8. Either one or two air outlets can be provided – although one air outlet is not strictly necessary, as the air can also escape through the air inlets 5.

[0046] For the in Fig. In the second row shown on the right, the air pressure at sensor connection 6 increases steadily and with a time delay compared to the air pressure in the first air chamber 3a. If a predefined value is exceeded at sensor connection 6, a pump 21 (see Figure 1) can be activated. Fig. 6), which serves to fill the stimulation insert 1, is switched off. The air in the stimulation insert 1 then escapes via the inlet valve 24, which is switched to a venting mode in which the air escapes into the environment. Alternatively, a venting valve 25 can also be arranged between the inlet valve 24 and the stimulation insert 1 via an air hose (see Fig. 6), which is switched to its venting mode. Alternatively to or in addition to this venting valve 25 arranged upstream of the stimulation insert 1, a venting valve 25 can be arranged downstream of the stimulation insert 1 upstream of the pressure sensor 23 (see Fig. 6) be arranged; then one or both vent valves 25 are switched to their venting mode. When the air pressure falls below a predefinable value, the pump 21 switches back to its pumping mode and refills the first air chamber 3a via the air inlet 5. This cycle repeats until the application is stopped. A holding mode can be inserted between the end of the pumping mode and the beginning of the suction mode, in which the air pressure in the stimulation insert 1 is kept constant. For example, 0.5 bar is used as the value for switching to the holding mode and then subsequently to the suction mode. Alternatively, predefinable fixed inflation times, for example 4 s, holding times, for example 8 s, and venting times, for example 10 s, can also be specified. In both cases, the rolling effect described above is achieved, similar to lymphatic drainage. Based on Fig. Section 4 below describes another procedure for filling and venting the stimulation insert 1.

[0047] In another embodiment of the invention, not shown, the pump 21 can be switched to its suction mode after reaching the predefinable value for the air pressure, and the air is extracted from the air chambers 3a, 3b, 4 until a lower predefinable value of the air pressure is reached. Then the pump 21 is switched back to its pumping mode and the cycle repeats.

[0048] The stimulation insert can, for example, be made of two layers of thermoplastic polyurethane, which are welded together along the walls 16 between the air chambers 2a, 2b, 3a, 3b, 4 and the outer walls. Other materials with suitable manufacturing processes can be used equally well to obtain a stimulation insert 1 according to the invention.

[0049] To achieve optimal application, the stimulation insert 1 is preferably integrated into a cuff or orthosis, as familiar to professionals – such a cuff can, for example, be made of chloroprene rubber. To create a detachable and secure connection between the latter and the stimulation insert 1, they are joined, for example, using zippers, snaps, or hook-and-loop fasteners. Other materials mentioned above for both the cuff and the connecting elements are equally suitable.

[0050] In Fig. Figure 2a is a first embodiment of a stimulation insert 1 according to the invention for the back, using compressed air as the stimulation medium. This insert is designed for a different purpose – instead of a knee, it is intended for the back. The surrounding joints, located in the free space 7 between the two essentially vertically extending rows 2, 3, are vertebrae.

[0051] In principle, the first embodiment for the back is identical to the first embodiment for a knee, so that identical or equivalently functioning parts are provided with identical reference numerals. The following discussion focuses primarily on the differences compared to the first embodiment for a knee.

[0052] The shape and size of the free space 7 are adapted for use around the vertebrae. The number, shape, and size of the air chambers 2a, 2b, 3a, 3b, 4 in the two vertical rows 2, 3 also differ. The air inlet 5 is formed in an inlet chamber 15 – at its left end in the illustrated case, although this is by no means a limiting factor – which extends over the entire width of two horizontally extending wings 12, which are present in addition to the two rows 2, 3. Air chambers 4 are located in the wings 12, which are connected to each other by walls 16 with air passages 11. The sensor connection 6, which is arranged as in the first embodiment and performs the same functions, is located in the leftmost air chamber, which is an outlet chamber 18.

[0053] The airflow 17 proceeds such that the compressed air flows through the air inlet 5 into the inlet chamber 15. From there, it flows through the air passage 15 in the wall 16 into the first air chamber 2a, 3a, which—as in the first embodiment—is shared by the first row 2 and the second row 3. The second air chamber 4, located directly above it, is also shared by both rows 2, 3. After this, the first row 2 and the second row 3 divide—as in the first embodiment—and their air chambers 4 are arranged in a meandering pattern upwards towards the second ends 9. A transfer channel 14 connects to the outside of each of the last air chambers 2b, 3b of rows 2, 3, which directs the compressed air downwards again into the respective air chamber 4 of the two wings 12, which are arranged towards the center.From there, the compressed air flows outwards in each wing 12; in the left wing 12 it ends in the outlet chamber 18, in which the sensor connection 6 is located.

[0054] In addition to the drainage effect of the rows 2, 3 already known from the first embodiment, the wings 12 generate an additional rolling movement directed outwards, i.e. away from the spine.

[0055] In Fig. Figure 2b shows a second embodiment of a stimulation insert 1 for the back according to the invention, using compressed air as the stimulation medium. It differs essentially in two ways from the embodiment according to Figure 2b. Fig. 2a on.

[0056] The first difference is that the transmission channel 14 is replaced by two further stimulation fields 4, so that there are three adjacent columns of stimulation fields 4, i.e. one more column than in both embodiments according to Fig. 2a.

[0057] The second difference is that the space 7 free of stimulation fields 4 is filled with material by a filler piece 33. If the filler piece 33 is made of the same material as the rest of the stimulation insert 1, i.e., a plastic film, it can be integrally formed with the rest of the stimulation insert 1. By filling the free space 7 with the filler piece 33, the entire stimulation insert 1 gains greater mechanical stability. This stability is achieved in the exemplary embodiment according to Fig. 2b is further increased by the fact that the space between the respective wing 12 and the adjoining row 2, 3 is also filled by a filler piece 33.

[0058] In Fig. 3a is an alternative embodiment of Fig. 1 for a knee joint, thus a second embodiment for a knee, is shown. There are two main differences compared to the first embodiment for a knee according to Fig. 1: Firstly, stimulation fields 2a, 2b, 3a, 3b, 4 of the two rows 2, 3 are not arranged in a meandering pattern, but in a straight line one behind the other. Secondly, the two rows 2, 3 are not oriented in a U- or horseshoe shape, but have an almost straight upper edge. The free space 7 for the knee joint is achieved by the stimulation fields 2a, 2b, 3a, 3b, 4 of the two rows 2, 3 being narrower in the area of ​​their central, common inlet chamber 15 than at the two ends 8, 9. This shape allows for a different application of the stimulation insert 1 around the knee joint. In this case, the two rows 2, 3 are applied from the thigh in such a way that the knee joint is largely enclosed from above.

[0059] Instead of the non-meandering arrangement of the stimulation fields 2a, 2b, 3a, 3b, 4, these can also be arranged in a meandering pattern - as in the third and fourth embodiments for a knee of the Fig. 3b and Fig. 3c shown - arranged so that essentially the only difference is due to the straight shape compared to the U-shape of the Fig. 1. In terms of functionality, this embodiment is otherwise the same as those of the preceding embodiments, so that it does not need to be discussed in more detail here.

[0060] In Fig. Figure 3b shows a third embodiment of a knee. Here, the knee joint 35 is shown schematically – unlike in the other figures relating to a knee. The main difference to the second embodiment according to Fig. 3a consists – in addition to the meandering arrangement of the stimulation fields 4 already mentioned above – in the fact that the stimulation insert 1 is not straight, but curved – comparable Fig. 1 but with less curvature - is formed.

[0061] In Fig. Figure 3c shows a fourth embodiment of a knee joint. The main difference from the second embodiment according to Fig. 3a consists – in addition to the meandering arrangement of the stimulation fields 4 already mentioned above – in the fact that the air inlet 5 and the sensor connection 6 are arranged at one end and not in the middle of the stimulation insert 1. As a result, this embodiment has only one drainage channel 13 – on the top side.

[0062] In Fig. Figure 4a shows a first embodiment of an ankle bone 32. This embodiment differs fundamentally in some points from those of the Fig. 1, Fig. 2 to Fig. 3. The following section will focus primarily on these fundamental differences.

[0063] In addition to the single stimulation insert 1, a further stimulation insert 30 is present, which is essentially a mirror image of the first stimulation insert 1. The two stimulation inserts 1, 30 are connected to each other via a bridge 31. An air inlet 5 is located in the bridge, from which compressed air flows into an inlet chamber 15. This chamber extends into each of the two stimulation inserts 1, 30, and the compressed air flows into a first air chamber 2a at the respective first end 8 of each stimulation insert 1, 30. From there, the compressed air flows successively through air chambers 4, which are arranged in a U-shape, with the first leg of the U-shape being very short at the first end 8 of each stimulation insert 1, 30.The compressed air flows through a final air chamber 2b at the second end 9 of each stimulation insert 1, 30 before flowing via a drainage channel 13 to a common outlet chamber 18 in the bridge. A sensor connection 6 and an air outlet are located there. Adjacent air chambers 2a, 2b, 4 are separated from each other by walls 16, as in the other embodiments, and connected to each other by air passages 11 formed therein. The sequence of air chambers 2a, 4, 2b flowing through one another is not meandering as in the embodiments of the . Fig. 1 and Fig. 2a, Fig. 2b, Fig. 3b and Fig. 3c arranged, but in a straight line as in the embodiment shown in the Fig. 3a; however, an alternative meandering arrangement can also be used, as in the second embodiment for an ankle according to Fig. 4b - which is otherwise the same as in Fig. The embodiment shown in 4a is illustrated.

[0064] The devices according to the Fig. 4a and Fig. 4b are placed around both sides of the ankle 32 of a foot in such a way that the respective long leg of the U-shape – the leg with the respective second end 9 – extends laterally along the lower leg towards the knee. The respective middle leg of the U-shape, when in place, runs essentially parallel to the sole of the foot along the side of the foot. The respective stimulation insert 1, 30 rests on the instep of the foot towards the respective short leg of the U-shape; this also applies to the respective short leg. This results – as can be clearly seen from Fig. 4 recognizable - the ankle bone 32 L-shaped. In the Fig. 4a and Fig. Figure 4b shows the state in which only the first stimulation insert 1 is placed around one side of the ankle 32. Subsequently, the bridge 31 is folded under the sole of the foot, and then the second stimulation insert 30 is placed on the back of the foot around the ankle (not shown) on the side of the foot shown, analogous to the first stimulation insert 1. Thus, both sides of the ankle 32 are each surrounded in an L-shape by a stimulation insert 1, 30, and the effect of the compressed air extends to both sides of the ankle 32.

[0065] The in Fig. The third embodiment of an ankle shown in 4c differs from the two shown in the Fig. 4a and Fig. The embodiment shown in Figure 4b differs essentially only in that the bridge 31 – with its integrated air inlet 5 and sensor connection 6 – is not positioned between the two parts of the stimulation insert 30 in such a way that it lies under the sole of the foot when applied, but rather rests against the calf (not shown). This embodiment is particularly suitable for injuries in the lower foot, especially in the ankle area and the patellar tendon. It strongly promotes blood circulation and / or the removal of tissue fluid, starting at the toes, extending towards the ankles, and continuing to the lymphatic system in the lower leg. This allows various types of swelling to subside more quickly.

[0066] In contrast, jetty 31 is located at the one in Fig. The embodiment shown in Figure 4d depicts an ankle support in the positioned position over the instep (not shown). Here, the bridge 31 is very thin and short and – unlike the embodiments according to the Fig. 4a to 4c - the air inlet 5 and the sensor connection 6 are not located in this, but at the first end 8 of the in Fig. 4d left part of the stimulation insertion 30.

[0067] In contrast to the other embodiments of the Fig. 1, Fig. 2 to Fig. 3 is the flow of compressed air in each individual stimulation application 30 of the embodiments of the Fig. 4a to 4d not starting from the respective center of the stimulation insertion 1, 30 in both directions, but from - in Fig. 4a shown above - first end 8 to - in Fig. 4a shown below - second end 9. The flow of compressed air therefore only occurs in one direction and not in opposite directions, as in the embodiments of the Fig. 1, Fig. 2 to Fig. 3.

[0068] In Fig. Figure 5 shows an embodiment that differs from the previous embodiments with regard to the stimulation medium used. Instead of the compressed air used there, which flows successively through air chambers 2a, 2b, 3a, 3b, 4, an electric current is used here, which is transmitted to the body via spatially distributed electrodes. However, since the geometric structure is very similar and the electrodes are like those in Figure 5, the embodiment can be adapted to the body in Figure 5. Fig. Since the air chambers 2a, 2b, 3a, 3b, 4 shown in Figure 1 act as stimulation fields, the same reference symbols are used for the electrodes as above for the air chambers, namely 2a, 2b, 3a, 3b, 4. The essential differences from the first embodiment according to Figure 1 are discussed below. Fig. 1. Parts that are identical or have the same effect are provided with identical reference numerals. The shape of the stimulation insert 1 is the same as that of the first embodiment according to... Fig. 1, since this one is also intended for the knee joint.

[0069] Instead of two layers of thermoplastic polyurethane, a carrier layer 19 is present here, on which the electrodes 2a, 2b, 3a, 3b, 4 are applied. The electrodes 2a, 2b, 3a, 3b, 4 are interconnected by a cable 10. This cable 10 is connected to a switching device 22, here in the form of a microprocessor, via a control line 27, which supplies the current required for the application to the respective electrode 2a, 2b, 3a, 3b, 4. The interface between the control line 27 and the cable 10 is located in the initial electrode 15, which is connected to the inlet chamber 15 in the embodiments according to the Fig. 1 and Fig. 2 corresponds. In particular, two basic principles are possible for generating a result equivalent to the above-mentioned rolling motion, by supplying current to the individual electrodes 2a, 2b, 3a, 3b, 4 in a predetermined sequence that meanders from the first end 8 to the second end 9.

[0070] The first concept features a cable 10 that runs in the desired sequence from one electrode 2a, 2b, 3a, 3b, 4 to the next, and between any two adjacent electrodes 2a, 2b, 3a, 3b, 4, a suitable circuit, for example with a capacitor, is installed. This capacitor charges up and, with a time delay, supplies current to the subsequent electrode 2a, 2b, 3a, 3b, 4. The process begins with the initial electrode 15, which is identical for both rows 2, 3 – thus providing only a single, matching first electrode 2a, 3a for both rows 2, 3. The cable 10 then splits into one for the first row 2 and one for the second row 3, connecting the electrodes 4, 2b, 3b along the path formed by the Fig. 1 and Fig. The two known paths are connected. The circuits between adjacent electrodes 2a, 2b, 3a, 3b, 4 are not shown. The last electrode 2b, 3b of each row 2, 3 is not connected to any other part, since the electric current – ​​unlike compressed air – does not need to be transported out of the stimulation insert 1 in a suitable manner – the current is automatically transferred to the user's skin.

[0071] In the other preferred principle - not shown - each individual electrode 2a, 2b, 3a, 3b, 4 is connected to a microprocessor which controls the desired electrode 2a, 2b, 3a, 3b, 4 according to a predetermined program sequence - which may also be changed during operation - and thus supplies current to it.

[0072] The cable 10 used can in all cases be a flat ribbon cable, preferably running in an intermediate layer of the cuff or orthosis into which the stimulation insert 1 is placed. The shape and amplitude of the current used can be varied and adapted to individual needs. The electrodes 2a, 2b, 3a, 3b, 4 are, for example, powered by a multiplexer circuit. The required voltage can be derived from various pulse energy storage concepts, such as capacitive or inductive discharge, a pulse-operated converter, or another principle known to those skilled in the art. Stimulation via the electrodes 2a, 2b, 3a, 3b, 4 can, for example, be achieved using individual pulses or by means of an alternating voltage signal, whereby the waveform can be adjusted to the specific application.Individual adjustments can also be made to skin resistance, electrode moisture, and cuff pressure. Since the energy required for the stimulation current used is very low, a portable battery can be used as a power source. This has the advantage that the entire device is mobile and can be used by the user even while moving around.

[0073] Another principle is to integrate the electronics directly into the cuff or orthosis to which the stimulation device is connected via the connecting elements – for example, directly into individual electrodes 2a, 2b, 3a, 3b, 4. This would also allow for time-delayed stimulation at successive electrodes 2a, 2b, 3a, 3b, 4. This can be achieved, for example, with a chain of shift registers and the switching transistors controlled by them. A stimulation pulse would then travel along an imaginary line from electrode 2a, 2b, 3a, 3b, 4 to electrode 2a, 2b, 3a, 3b, 4.

[0074] The arrangements of the stimulation fields 2a, 2b, 3a, 3b, 4 according to the embodiments of the Fig. 2, Fig. 3 to Fig. 4. Instead of being operated with compressed air, they can in principle also be converted so that they – like the exemplary embodiment of the Fig. 5 - can be powered by electricity.

[0075] In Fig. Figure 6 schematically shows a stimulation device 1 in conjunction with a pump 21 and a switching device 22, in particular this can be designed as a computer, as well as other necessary devices.

[0076] Due to the schematic representation of the stimulation unit 1 and for the sake of clarity, only its first row 2 with the first stimulation field 2a, the last stimulation field 2b and another, intermediate stimulation field 4 is shown, and not also the second row 3 and further stimulation fields 4. Fig. 1, Fig. 2, Fig. 3 to Fig. 4 shown.

[0077] The first stimulation field 2a is accessible via its air inlet 5 (see Fig. 1) connected to an inlet valve 24, which in turn is connected to the pump 21 via an air hose 26. Between the inlet valve 24 and the stimulation insert 1, the air hose 26 branches, and a vent valve 25 is located at the end of this branch. Another vent valve 25 is located at the end of a branch in an air hose 26 that connects the sensor port 6 (see Figure 1) to the last stimulation field 2b. Fig. 1) and a pressure sensor 23 for measuring the air pressure in the stimulation insert 1 is provided at the sensor connection 6. Instead of two vent valves 25, it is also possible to provide only one vent valve 25, whereby it is irrelevant with regard to the invention which of the two illustrated vent valves 25 is omitted. The pressure sensor 23 is connected to the switching device 22 via a data line 28, which is connected to the pump 21, the inlet valve 24 and the two vent valves 25 via control lines 27. The stimulation insert 1 - which is in Fig. 6 is only very schematically represented by three stimulation fields 2a, 3a, 4 - is located in a cuff 29, by means of which simple attachment to a body part to be treated is possible.

[0078] While the pump mode is active, compressed air is pumped from the pump 21 through the air hose 26 and the open inlet valve 24 into the stimulation insert 1. The two vent valves 25 in the branches before and after the stimulation insert 1 are closed. In pump mode, the air chambers 2a, 4, and 2b are thus filled sequentially, in the order of their arrangement. While the pump mode is active, the air pressure at the outlet of the stimulation insert 1 is measured by a pressure sensor 23 connected to it via an air hose 26. The data about the current air pressure is transmitted from the pressure sensor 23 via the data line 28 to the control unit 22, which may be a computer, for example. In this control unit 22, the currently measured air pressure is compared with a predefined air pressure that can be set by the user.

[0079] As long as the measured air pressure is below the set air pressure, the switching device 22 sends a signal via a control line 27 to the pump 21 to continue pumping compressed air into the stimulation insert 1.

[0080] When the preset air pressure is reached, the switching device 22 sends a signal to the pump 21 via the aforementioned control line 27, which stops the pump and prevents any further compressed air from being pumped into the stimulation insert 1. Simultaneously, the switching device 22 sends a signal via another control line 27 to close the inlet valve 24. The air pressure in the air chambers 2a, 4, 2b of the stimulation insert 1 is then held constant for a preset time, which can be set by the user, thus creating a holding mode.

[0081] After the specified time for the holding mode has elapsed, the control unit 22 sends a signal via further control lines 27 to open the outlet valves 25, resulting in a transition to the venting mode. Due to the overpressure in the stimulation insert 1 compared to the ambient air, to which a connection exists after the outlet valves 25 are opened, air flows out of the air chambers 2a, 4, 2b of the stimulation insert 1. This outflow is further accelerated by the pressure exerted on the stimulation insert 1 by the cuff 29 due to its arrangement within the cuff 29. During this venting mode, the air pressure behind the stimulation insert 1 continues to be measured by the pressure sensor 23, and the measured values ​​are transmitted to the control unit 22 via the data line 28. There, the currently measured value is compared with a user-defined value.

[0082] Once this value falls below the set point, the control unit 22 switches the pump 21 (along with its other components) back to the pumping mode described above. For this purpose, the outlet valves 25 are closed via corresponding signals through control lines 27, the inlet valve 24 is opened via a corresponding signal, and the pump 21 is switched on again to fill the stimulation insert 1. The sequence described above, with pumping mode, holding mode, and venting mode, then repeats.

[0083] This process achieves the effect already described above as the rolling effect.

[0084] As an alternative to the procedure just described, which depends on the measured air pressure values ​​in stimulation insert 1, a procedure can also take place that operates strictly according to predetermined times for pump mode, hold mode, and suction or venting mode, as already mentioned above. Fig. 1 and Fig.2 was described; for example, inflation time 4 s, holding time 8 s and deflation time 10 s. This alternative has the advantage that it can be implemented with less technical effort.

[0085] For the expert, it goes without saying that the holding mode is skipped when the relevant time is set to zero, so that the system switches directly from pump mode to venting mode. Instead of "passive" venting by simply opening the outlet valves 25, "active" venting can also take place, as described above as suction mode, in which the pump 21 extracts the air from the stimulation insert 1. Reference symbol list 1 stimulation session 2 first row 2a first stimulation field, air chamber, electrode 2b last stimulation field, air chamber, electrode 3 second row 3a first stimulation field, air chamber, electrode 3b last stimulation field, air chamber, electrode 4 Stimulation field, air chamber, electrode 5 Supply element, air inlet 6 Sensor connection 7 free space 8 first end 9 second end 10 cables 11 Air passage 12 wings 13 Drainage channel 14 Transfer channel 15 Inlet chamber, initial electrode 16 Wall 17 Airflow 18 Outlet chamber 19 Carrier layer 20 supply field 21 Pump 22 Switching device 23 Pressure sensor 24 Inlet valve 25 Vent valve 26 air hose 27 Control line 28 data lines 29 cuff 30 stimulation uses 31 Bridge 32 ankles 33 Filler piece 34 Supply channel 35 Knee joint

Claims

[1] Stimulation application (1), especially for an orthosis or a cuff, with a plurality of stimulation fields (2a, 2b, 3a, 3b, 4) arranged in at least two rows (2, 3), wherein these rows (2, 3) are each arranged such that between two adjacent rows (2, 3) there is a space (7) free of stimulation fields (2a, 2b, 3a, 3b, 4) for receiving a joint or for placement along a limb, wherein in the area of ​​the first ends (8) or the second ends (9) of the rows (2, 3) a supply field (20) is provided which is connected to at least one supply element (5) for supplying a stimulation medium coming from a stimulation medium source, wherein the stimulation fields (2a, 2b, 3a, 3b, 4) are connected in such a way that the stimulation medium passes through these stimulation fields (2a, 2b, 3a, 3b, 4) from the supply element (5) at one end (8, 9) to the other end (9, 8) of the rows (2, 3), wherein the stimulation application (1) extends in one plane. [2] Stimulation application (1), especially for an orthosis or a cuff, with a plurality of stimulation fields (2a, 2b, 3a, 3b, 4) arranged in at least two rows (2, 3), wherein these rows (2, 3) are each arranged such that between two adjacent rows (2, 3) there is a space (7) free of stimulation fields (2a, 2b, 3a, 3b, 4) for receiving a joint or for placement along a limb, wherein in the area of ​​the first ends (8) of the rows (2, 3) a supply field (20) is provided which is connected to at least one supply element (5) for feeding in a stimulation medium coming from a stimulation medium source, wherein the stimulation fields (2a, 2b, 3a, 3b, 4) are connected in such a way that the stimulation medium passes through these stimulation fields (2a, 2b, 3a, 3b, 4) from the supply element (5) at one end (8, 9) to the other end (9, 8) of the rows (2, 3), wherein the second end (9) is connected to an outlet chamber (18) in which a sensor connection (6) is provided. [3] Stimulation application (1), especially for an orthosis or a cuff, with a plurality of stimulation fields (2a, 2b, 3a, 3b, 4) arranged in at least one row (2, 3), wherein this series (2, 3) is arranged circularly around a space (7) free of stimulation fields (2a, 2b, 3a, 3b, 4) for receiving a joint or for attaching along a limb, wherein a supply field (20) is provided which is connected to at least one supply element (5) for supplying a stimulation medium coming from a stimulation medium source, wherein the stimulation fields (2a, 2b, 3a, 3b, 4) are connected to each other in such a way that the stimulation medium passes through them starting from the supply element (5) in one direction of the series (2, 3). [4] Stimulation application (1), especially for an orthosis or a cuff, with a plurality of stimulation fields (2a, 2b, 4) arranged in a row (2), wherein this series (2) is curved around a space (7) free of stimulation fields (2a, 2b, 4) to accommodate a joint or to be attached along a limb, wherein in the region of the first end (8) of the series (2) a supply field (20) is provided which is connected to at least one supply element (5) for supplying a stimulation medium coming from a stimulation medium source, wherein the stimulation fields (2a, 2b, 4) are connected in such a way that the stimulation medium passes through them from the supply element (5) at one end (8, 9) to the other end (9, 8) of the series (2). [5] Stimulation application (1), especially for an orthosis or a cuff, with a plurality of stimulation fields (2a, 2b, 4) arranged in a row (2), wherein this row (2) is straight and the stimulation fields (2a, 2b, 4) are narrower in one area than at the two ends (8, 9), so that the outer contour of the row (2) has a recess as a free space (7) for receiving a joint or for attaching along a limb, wherein in the region of the first end (8) of the series (2) a supply field (20) is provided which is connected to at least one supply element (5) for supplying a stimulation medium coming from a stimulation medium source, wherein the stimulation fields (2a, 2b, 4) are connected in such a way that the stimulation medium passes through them from the supply element (5) at one end (8, 9) to the other end (9, 8) of the series (2), wherein the stimulation application (1) extends in one plane. [6] Stimulation application (1), especially for an orthosis or a cuff, with a plurality of stimulation fields (2a, 2b, 4) arranged in a row (2), wherein this row (2) is straight and the stimulation fields (2a, 2b, 4) are narrower in one area than at the two ends (8, 9), so that the outer contour of the row (2) has a recess as a free space (7) for receiving a joint or for attaching along a limb, wherein in the region of the first end (8) of the series (2) a supply field (20) is provided which is connected to at least one supply element (5) for supplying a stimulation medium coming from a stimulation medium source, wherein the stimulation fields (2a, 2b, 4) are connected in such a way that the stimulation medium passes through them from the supply element (5) at one end (8, 9) to the other end (9, 8) of the series (2), wherein the second end (9) is connected to an outlet chamber (18) in which a sensor connection (6) is provided. [7] Stimulation insert (1) according to one of the preceding claims, with a further such stimulation insert (30), wherein the supply element (5) for both stimulation inserts (1, 30) is arranged in a bridge (31) which extends between the two stimulation inserts (1, 30). [8] Stimulation device (1) according to one of the preceding claims, wherein the stimulation medium is electric current and the stimulation fields (2a, 2b, 3a, 3b, 4) are electrodes. [9] Stimulation device (1) according to claim 8, wherein the electrodes are connected via a cable (10), in particular a flat ribbon cable, to a microprocessor which controls the power supply to the individual electrodes. [10] Stimulation device (1) according to one of claims 8 or 9, wherein a time delay element is arranged between each adjacent electrode. [11] Stimulation insert (1) according to one of claims 1 to 7, wherein the stimulation medium is compressed air, the stimulation fields (2a, 2b, 3a, 3b, 4) are air chambers and the supply element (5) is an air inlet (5). [12] Stimulation insert (1) according to claim 11, wherein adjacent air chambers (2a, 2b, 3a, 3b, 4) are connected to each other via an air passage (11). [13] Stimulation device (1) according to one of the preceding claims, wherein the stimulation fields (2a, 2b, 3a, 3b, 4), in particular the air chambers or the electrodes, are arranged in a meandering pattern within a row (2, 3). [14] Stimulation insert (1) according to one of the preceding claims, wherein it is connected to a cuff made of chloroprene rubber or elastic textiles, to a rubber mat, to a bandage or to an orthosis. [15] Stimulation insert (1) according to one of the preceding claims, wherein in the area of ​​the first ends (8) of the rows (2, 3) horizontally extending wings (12) are formed to the left and right, the stimulation fields (4) of which are arranged following the second ends (9) of the rows (2, 3). [16] Stimulation device (1) according to one of the preceding claims, wherein exactly two rows (2, 3) are present. [17] Stimulation insert (1) according to one of the preceding claims, wherein all rows (2, 3) have a common lead element (5).

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