Back orthosis and garment containing a back orthosis

Abstract

Back orthosis (10,11), containing: - a lap belt (30) for application to the pelvis of a wearer, with a lumbosacral positionable central section (31) and a left side section (32) with a left lap belt end (33) and a right side section (34) with a right lap belt end (35) extending laterally therefrom, wherein the lap belt ends (33, 35) can be connected to one another under tension for application, - a right shoulder strap (22) for fitting over the wearer's right shoulder, which is connected via its first end (26) to the left side section (32) of the lap belt (30), and - a left shoulder strap (24) for fitting over the wearer's left shoulder, which is connected via its first end (27) to the right side section (34) of the lap belt (30), wherein the right shoulder strap (22) and the left shoulder strap (24) intersect at a central upper dorsal crossing point (41) when worn, a central lower dorsal crossing point (43) when worn, and at two lateral crossing points (42, 44) when worn, characterized in that the back orthosis has a guide module (100) associated with the shoulder straps (22, 24), the guide module (100) comprising: - a first guide element (101), - a second guide element (102) - a third guide element (103) - a fourth guide element (104) - a first connecting element (141) - a second connecting element (142) - a third connecting element (143) - a fourth connecting element (144) - a fifth connecting element (145), wherein the first connecting element (141) is positioned at the dorsal central upper crossing point (41) and connects the first guide element (101) and the second guide element (102) to one another as a joint, wherein the second connecting element (142) is positioned at the first lateral crossing point (42) and connects the first guide element (101) and the third guide element (103) to one another as a joint, wherein the third connecting element (143) is positioned at the second lateral crossing point (44) and connects the second guide element (102) and the fourth guide element (104) to one another as a joint, wherein the third guide element (103) and the fourth guide element (104) cross over in the region of the dorsal central lower crossing point (43), wherein the right shoulder strap (22) is connected to the guide module (100) via its second end (23) and the left shoulder strap (24) is connected to the guide module (100) via its second end (25).

Description

[0001] The invention relates to a back orthosis for the treatment and prevention of back pain. The system comprises a lap belt and two independent left and right shoulder straps extending from it, which cross over several times in the back area.

[0002] Back support belt systems are used to straighten the upper body, for example, to treat and correct poor posture and curved spines, such as those caused by osteoporosis. Common back support belt systems and orthoses essentially consist of a lap belt that can be fastened under tension over the pelvis or hip of a patient, or generally of a wearer, and which then forms a base for the application of force to the back. Common systems also include straps or support rails that extend from the lap belt and are intended to reposition or support the shoulders in spatial relation to the spine, or the upper spinal section in relation to the lower spinal section, through targeted force application. The interaction of these elements is intended to mechanically stabilize the wearer's spine and straighten it, particularly in the area of ​​the shoulders and upper thoracic spine.The tighter the shoulder straps are tightened, the more the shoulders should be pulled back, which allows the upper body to be straightened.

[0003] Back support harness systems are also designed to help reduce back strain when lifting and carrying loads, particularly by preventing excessive strain by specifically absorbing and distributing the forces generated, particularly in the shoulder area. Support harnesses are designed to transfer the forces acting on the upper body, primarily via the arms and shoulders, directly to the pelvis or torso when lifting and carrying loads. This bridges the gap and relieves strain on the spine. In addition, a back support harness system is designed to remind the wearer to adopt a harmful, protective posture in the event of excessively incorrect upper body posture, and to provide a feeling of security and stability. Back support harness systems are therefore also intended to improve occupational safety for healthy individuals. At the same time, the back support harnesses are designed to guide and limit movement in a controlled manner to prevent incorrect postures that are detrimental to the back when lifting or carrying loads.This is useful in occupational safety, rehabilitation, and certain sporting activities. Back strap-based orthoses are known from JP 2011-62245 A, JP 2001-224613 A, and US Pat. No. 5,499,965 A.

[0004] A disadvantage of known back support belt systems or back orthoses of this type is their complex structure, which makes them difficult for the wearer to put on and why incorrect use can hardly be ruled out. The generally rigid design of known supports with support elements and straps does help to achieve a supportive effect, but does not allow for sufficient individual adjustment to the specific indication, the specific therapy requirement and / or the anatomical characteristics of the wearer. Particularly when the user is moving, during certain phases of movement, under particular strain or even when tightening the back support belt system during or after application, the support belt system can unintentionally slip on the body (migration) into a position that not only severely impairs the wearing comfort but can also render the orthosis essentially ineffective.In practice, patients with limited mobility in particular find it difficult to put on such belt systems and to maintain the necessary tension on the support elements and the pelvic belt after putting them on. It can also be difficult to properly apply an orthosis that has already been pre-tensioned to provide sufficient support under this tension. Pre-tensioned shoulder straps can pull the pelvic belt they are connected to upwards, particularly into the upper waist section, toward the lower rib cage, even during application, making it impossible to achieve a proper fit around the pelvis.

[0005] DE 10 2018 211 431 A1 discloses a back support belt system that makes it easier to put on the wearer.

[0006] The invention was based on the technical problem of improving such back support belt systems or back orthoses, such as reclining orthoses, which are based at least on a basic structure containing a pelvic belt holder with force-introducing shoulder straps extending therefrom, in such a way that not only is application to the wearer uncomplicated, but also that migration of the system, particularly of the pelvic holder, is effectively prevented during application or use, especially when the wearer moves. This should improve the support and relief effect of such systems and also allow them to be maintained throughout the entire period of wear.

[0007] The technical problem is completely solved by the novel back orthosis according to claim 1 and the garment according to claim 12.

[0008] The technical problem is solved in particular by back orthosis containing: - a lap belt for application to the pelvis of a wearer, with a lumbar / sacral positionable central section and, extending laterally from it, a left side section with a left lap belt end and a right side section with a right lap belt end, whereby the lap belt ends can be connected to each other under tension for application, - a right shoulder strap for fitting over the wearer's right shoulder, which is connected by its first end to the left side section of the lap belt, and - a left shoulder strap for placing over the wearer's left shoulder, which is connected via its first end to the right side section of the lap belt, wherein the right shoulder strap and left shoulder strap intersect at a dorsal central upper crossing point when worn, a dorsal central lower crossing point when worn, and at two lateral crossing points when worn, wherein the back orthosis has a guide module associated with the shoulder straps, wherein the guide module comprises: - a first guide element, - a second guide element - a third guide element - a fourth guide element - a first connecting element - a second connecting element - a third connecting element - a fourth connecting element - a fifth connecting element, wherein the first connecting element is positioned at the dorsal central upper intersection point and connects the first guide element and the second guide element to one another as a joint, wherein the second connecting element is positioned at the first lateral intersection point and connects the first guide element and the third guide element to one another as a joint, wherein the third connecting element is positioned at the second lateral intersection point and connects the second guide element and the fourth guide element to one another as a joint, wherein the third guide element and the fourth guide element cross in the region of the dorsal central lower intersection point, and wherein the right shoulder strap is connected to the guide module via its second end and the left shoulder strap is connected to the guide module via its second end,in particular, wherein the right shoulder strap is reversibly connected to the fourth guide element via its second end and wherein the left shoulder strap is reversibly connected to the third guide element via its second end.

[0009] The present invention is therefore particularly characterized by a guide module comprising various guide elements and connecting elements. The first, second, third, and fourth guide elements form a diamond shape via the connecting elements and the intersection of the third guide element and the fourth guide element, wherein the diamond can be varied in shape and angle via the articulated mounting by the connecting elements and the displaceability of the third guide element and the fourth guide element in the intersection region. In particular, the height, i.e. the distance between the first connecting element and the intersection region of the third and fourth guide elements in the region of the dorsal, central, lower intersection point, can also change. The guide module therefore comprises at least one diamond-shaped element which is variable in height and width due to the articulated connection of the guide elements, thus representing a scissors diamond.

[0010] In the dorsal area, the shoulder straps are preferably guided along the guide elements, so that a change in the position and / or length of the shoulder straps affects the guide elements and leads to a change in the height or width of the diamond element of the guide module. At the same time, the guide elements preferably guide the straps, so that in this area the strap paths are also diamond-shaped.

[0011] Surprisingly, it has now been shown that these diamond-shaped strap paths on the wearer's back better prevent the orthosis from slipping. When sitting down or bending over, the back lengthens, thus tensioning the diamond structure of the guide module. Since diamonds are, so to speak, two interconnected pairs of scissors, the guide module can very well follow the changes in length caused by movement without the entire system losing stability. This change in length can be an extension or a compression, depending on the wearer's movement. The present invention can, in particular, minimize or prevent the back orthosis from slipping up when the wearer sits down. The geometric shape of the guide module, i.e. the diamond, changes particularly between the wearer's "sitting" and "standing" positions.

[0012] The four guide elements thus form the four legs of a rhombus, whereby the articulated mounting in three connecting elements and the movable crossing of the third guide element and the fourth guide element enable a change in shape, i.e. a change in length and width.

[0013] Preferably, the guide module can be connected to the lap belt either directly to the third guide element and the fourth guide element via a fourth connecting element and a fifth connecting element, or indirectly via additional elements located in between. Thus, further diamonds or half-diamonds can be formed below the described diamond shape of the guide module by additional guide elements and connecting elements.

[0014] In a preferred embodiment, the third guide element is connected directly to the middle section of the lap belt via the fourth connecting element as a joint and the fourth guide element is connected directly to the middle section of the lap belt via the fifth connecting element as a joint.

[0015] In this embodiment, the first guide element, the second guide element, the third guide element and the fourth guide element form a rhombus, wherein the sections of the third guide element and the fourth guide element between the area in which these two guide elements intersect and the fourth guide element and the fifth guide element, with which these two guide elements are connected to the lap belt, form a further half rhombus.

[0016] In an alternative embodiment, the fourth connecting element connects the third guide element and a fifth guide element to one another as a joint, wherein the fifth connecting element connects the fourth guide element and a sixth guide element to one another as a joint, wherein the fifth guide element is connected to the central section of the lap belt via a sixth connecting element as a joint and the sixth guide element is connected to the central section of the lap belt via a seventh connecting element as a joint.

[0017] In a preferred embodiment, the second ends of the shoulder straps are variably adjustable on the associated guide elements or the fourth and the third guide element each have at least one deflection element through which the associated shoulder strap is guided and the second end can be reversibly and variably fastened to the shoulder strap.

[0018] According to the invention, "deflection element" is primarily understood to mean an eyelet or ring for passing a strap or rope through, but also a mounted pulley or pulley block. A slip-inhibiting or slip-enhancing coating can be provided, depending on the intended application.

[0019] The deflection elements in the guide elements allow the shoulder straps to be adjusted to fit themselves. This allows a single orthosis design to cover a variety of sizes.

[0020] Also disclosed, and not part of the invention, is that the shoulder straps do not run along the guide module, but rather end at the top of the guide module and are attached there. The guide module forms an intermediate piece on the back between the shoulder straps and the lap belt. Thus, the guide module, or rather the guide elements, are part of the belt path.

[0021] In a preferred embodiment, the guide elements are formed from a flexible material that is essentially inelastic in the pulling direction, for example plastic, leather or metal, in particular spring steel.

[0022] In a preferred embodiment, the guide elements can be formed from spring leaves, for example, made of metal. This has the advantage that the guide elements can be adapted to the body shape and can be used in various thicknesses. It also allows for standardization, which can reduce production costs.

[0023] Additional rods can also be assigned to the guide module and, in particular, to the guide elements. These can follow the course of the guide elements, in particular, they can follow their longitudinal course in the middle of the guide elements. Alternatively, additional rods can also directly connect connecting elements, for example, the central upper connecting element and the pelvic belt, or the two lateral connecting elements. This makes it possible to upgrade the back orthosis with rods along the course of the spine, depending on the indication. This can be helpful for back problems, especially scoliosis.

[0024] In a further embodiment, the support belt system is guided in separate cross guides at least at the intersection points of the shoulder strap loops. This serves, in particular, to simplify the fit of the back orthosis on the wearer or user, as the cross guides hold the intersecting shoulder straps in the correct positions. Preferably, at least one such cross guide is provided at the upper central intersection point on the back.

[0025] Preferably, the cross guides are integrated into the corresponding connecting elements.

[0026] For example, openings in the connecting elements can form such cross guides.

[0027] In a preferred embodiment, the first connecting element, the second connecting element, and / or the third connecting element have through-openings through which the right shoulder strap and the left shoulder strap are slidably guided. Preferably, the first connecting element, the second connecting element, and the third connecting element each have a first through-opening through which the right shoulder strap is slidably guided and each have a second through-opening through which the left shoulder strap is slidably guided.

[0028] The connecting elements either connect two guide elements to each other or one guide element to the lap belt. The two guide elements, or the guide element and the lap belt, are connected to each other via a hinge. The connecting elements therefore not only serve as a connection but also as a hinge to ensure the desired mobility around an axis. The connecting elements can be designed as rivets or screws, for example, that extend through holes in the guide elements or through the material of the lap belt. Elongated holes can also be provided as corresponding holes in the guide elements if required.

[0029] Elongated holes are particularly useful when additional diamonds or half-diamonds are formed beneath the described diamond shape of the guide module using additional guide elements and connecting elements. This allows for greater freedom of movement, which is advantageous, for example, if the wearer has scoliosis.

[0030] The connecting elements, in particular the connecting elements that articulate two guide elements together, can also be designed as solid-state joints. They can, for example, be made of a more flexible material than the guide joints. In such a design, the guide module can be formed in one piece. For example, the individual components of the guide module can be materially connected via flexible / elastic connections, so that the guide module is a two-component element. Additional slots in the connecting elements or in the one-piece guide module can increase the material's tendency to move. The slots can, for example, be meander-shaped or have other geometries.

[0031] Suitable embodiments for such connecting elements that enable the desired mobility in one axis are known to the person skilled in the art.

[0032] In a preferred embodiment, an articulated force introduction belt is attached to the fourth connecting element and the fifth connecting element, with the force introduction belts being reversibly connected to the lap belt. This is particularly suitable for the embodiment of the back orthosis in which the third guide element and the fourth guide element are not directly connected to the lap belt.

[0033] Suitable embodiments and materials for the shoulder straps are known to those skilled in the art, for example, from DE 10 2018 211 431 A1. The shoulder straps can alternatively be designed as a cable pull system or a Bowden cable.

[0034] The shoulder straps can be elastic, inelastic, partially elastic, or flexible but inelastic.

[0035] The shoulder straps can be tensioned by a variable and flexible attachment of the straps to the lap belt and / or to the guide elements. Alternatively, for example, when using a Bowden cable or cable pull system, tensioning elements can also be provided, such as tension knobs for winding the tensioning cable.

[0036] It can also be provided that the shoulder straps are each split into two sections, thus comprising a first section and a second section, with the two sections being connected to each other via a deflection element. One section can be firmly connected to the deflection element, while the other strap section can be guided through the deflection element and then reversibly connected to itself, for example, via a hook-and-loop fastener. This can make it easier for the wearer to tighten the shoulder straps.

[0037] In a preferred embodiment, the first ends of the shoulder straps are reversible, in particular connected to the lap belt via a Velcro fastener.

[0038] For example, the left and right side sections of the lap belt can have fastening areas to which the first ends of the shoulder straps can be reversibly and freely positioned. This allows for basic tightening and positioning of the shoulder straps.

[0039] The lap belt itself can be fastened in a conventional manner, for example, with a hook-and-loop fastener at both ends of the lap belt, particularly under tension. Corresponding design options for a lap belt are known to those skilled in the art.

[0040] In preferred embodiments of the invention, at least one region of the shoulder straps is designed as a particularly elastic strap section.

[0041] According to the invention, an "elastic strap section" is primarily understood to mean an elastic, i.e., flexible, band that can be stretched under tensile stress, particularly in the form of a woven strap. Functionally equivalent designs, particularly elastomer bands, preferably made of rubber, silicone rubber, polyurethane, and the like, are also encompassed. Alternatively, this also includes elastic tensioning cables with inserts of elastomer fibers. It is intended that these elastic strap sections, particularly in comparison to the other sections of the shoulder straps, are more elastic, i.e., more stretchable under tensile stress. In a preferred variant, these elastic strap sections are the only components of the shoulder straps that are stretched, i.e., lengthened, under the tensile forces that can occur during proper use of the orthosis, particularly when bending the back.

[0042] This elastic strap section is preferably arranged in that area of ​​the shoulder straps which extends upwards over the upper back to the shoulders. Since the change in length when bending the back is particularly pronounced in this area of ​​the body, the particularly elastic strap section arranged there can reduce excessive tension in the straps, i.e. it can compensate for this through its own stretch when bending. Due to its stretchability, the elastic strap section serves on the one hand to limit the tensile force transmitted from the shoulder straps to the lap belt, which further prevents the lap belt from migrating. On the other hand, it can also compensate for the change in length of the back when bending, which holds the shoulder straps in position on the shoulder, allows freedom of movement and increases the comfort and effectiveness of the back belt system.

[0043] In one variant, this elastic end section is additionally provided with a separately designed mechanical stretch limiter running parallel to the elastic section. The stretch limiter can be designed as at least one less elastic or inelastic band connected to each end of the elastic section. Depending on the desired therapeutic goal or intended application of the system, this can serve to control movement during flexion. In particular, excessive flexion of the back should be prevented, which can be therapeutically indicated, for example, in post-operative rehabilitation or in the field of occupational safety when lifting loads for reclination and posture improvement and the resulting improvement in load introduction in the back.

[0044] In a preferred embodiment, an elastic belt section is formed between the first end of the shoulder strap and the lateral crossing point, the elasticity of which is equal to or higher than that of the shoulder strap itself.

[0045] The back support harness system reminds the wearer to adopt a more gentle posture, specifically an upright posture, if their upper body posture is incorrect – in particular if their torso is bent sharply forward and, in the worst case, if their back is in a forward-leaning position. Lifting loads with a curved spine shifts the load onto the front part of the ventral column of the vertebral body. By straightening the spine and lifting from the knees (upright posture), the load is distributed more evenly across the ventral column. The wearer can adopt an upright posture particularly when they experience increased tension via the shoulder harness system when their upper body is bent forward. The lap belt acts as an “anchor” and establishes the central fixed point, which is used to generate a force on the shoulders in a dorsal direction via the harness system, based on the movement.Another side effect of the tightly fitting lap belt of the back support belt system is that it gives the wearer of the system a feeling of security and stability.

[0046] In a special version, the back support belt system is therefore mounted on an elastic vest or jacket, with the shoulder straps and / or the lap belt being fixed to the vest or jacket at least in sections.

[0047] The present invention also solves the underlying technical problem by a garment comprising a stretchable vest or jacket and a back brace according to one of claims 1 to 11, wherein the shoulder straps and lap belt are mounted at least partially on a vest or jacket and firmly connected thereto. The garment according to the invention can be, for example, protective workwear.

[0048] In the simplest case, the back support harness system is sewn to the vest or jacket. In an alternative variant, the support straps are guided in tabs on the vest or jacket. Attaching the support harness to a vest or jacket allows for simplified donning and doffing, which is particularly useful for short-term and recurring use of the back support harness system by a wearer, for example, in the field of occupational safety. The vest or jacket used is made of elastic fabric or knit. Alternatively, flexible vests, such as those known as high-visibility vests, can be equipped with the back support harness system.

[0049] In this context, a "wearer" is understood to mean a person who, for example, puts on and uses the harness system as part of occupational safety measures, i.e., wears it, to prevent excessive strain or poor posture, for example, while working, especially when carrying loads. Furthermore, it is understood to mean a patient who, for example, puts on and uses the harness system as part of therapeutic measures, i.e., wears it, to counteract excessive strain or poor posture of a previously damaged, diseased musculoskeletal system, or to enable targeted movement guidance as part of therapy for the diseased musculoskeletal system.

[0050] The present invention also solves the technical problem underlying it by using a back orthosis according to the invention or a garment according to the invention for protection against adverse loads on the back.

[0051] In particular, this includes a non-medical use in which the back orthosis according to the invention is worn as protection, in particular as occupational protection, i.e. in particular is worn prophylactically.

[0052] The invention is further illustrated by the following specific embodiments, without these being understood as limiting. LIST OF REFERENCE SYMBOLS 10 back orthosis 11 Back orthosis 12 right shoulder strap 22a first section of the right shoulder strap 22b second section of the right shoulder strap 23 second end of the right shoulder strap 24 left shoulder strap 24a first section of the left shoulder strap 24b second section of the left shoulder strap 25 second end of the left shoulder strap 26 first end of the right shoulder strap 27 first end of the left shoulder strap 28 Deflection element on the right shoulder strap 29 Deflection element on the left shoulder strap 30 lap belt 31 Middle section 32 left side section 33 left lap belt end 34 right side section 35 right lap belt end 36a Velcro element 36b Velcro element 36 Velcro fastener 41 central upper intersection point 42 left lateral crossing point 43 central lower intersection point 44 right lateral crossing point 86 elastic strap section of the right shoulder strap 87 elastic strap section of the left shoulder strap 100 leadership module 101 first guide element 102 Guide element 103 second third guide element 104 fourth guide element 105 fifth guide element 106 sixth guide element 141 first connecting element 142 second connecting element 143 third connecting element 144 fourth connecting element 145 fifth connecting element 146 sixth connecting element 147 seventh connecting element 151 Passage opening of the first connecting element 151a first through-opening of the first connecting element 151b second through-opening of the first connecting element 152 Passage opening of the second connecting element 152a first through-opening of the second connecting element 152b second through-opening of the second connecting element 153 Opening of the third connecting element 153a first through-opening of the third connecting element 153b second through-opening of the third connecting element 154 Force introduction belt on the fourth connecting element 155 Force introduction belt on the fifth connecting element 163 Deflection element of the third guide element 164 Deflection element of the fourth guide element 200 jacket Fig. 1 shows a first embodiment of the back orthosis according to the invention in two different positions. Fig. 2 shows the back orthosis of Fig. 1 for a standing person. Fig. 3 shows the back orthosis of Fig. 1 for a seated person. Fig. 4 shows the rear view of the back orthosis of Fig. 1. Fig. 5 shows the side view of the back orthosis of Fig. 1. Fig. 6 shows the front view of the back orthosis of Fig. 1. Fig. 7 shows the guidance module of the back orthosis of Fig. 1. Fig. Figure 8 shows schematically the course of the guide module in the back orthosis of Fig. 1. Fig. 9 shows a second embodiment of the back orthosis according to the invention. Fig. 10 shows the rear view of the back orthosis of Fig. 9. Fig. 11 shows the side view of the back orthosis of Fig. 9. Fig. 12 shows part of the back orthosis of Fig. 9 in oblique front view. Fig. 13 shows the rear view of the back orthosis of Fig. 9 when tightening the shoulder straps. Fig. 14 shows a jacket / vest with a back orthosis according to the invention.

[0053] Fig. 1 shows a first embodiment of the back orthosis (10) according to the invention. Fig. 1a and Fig. Figure 1b shows the back orthosis (10) in various positions. The back orthosis (10) comprises a lap belt (30), a right shoulder strap (22) that encloses the right shoulder when worn, a left shoulder strap (24) that encloses the wearer's left shoulder when worn, and a guide module (100) located beneath the shoulder straps.

[0054] The lap belt (30) has a central section (31), a left side section (32) with a left lap belt end (33), and a right side section (34) with a right lap belt end (35). The left side section (32) and the right side section (34) can be connected to one another via hook-and-loop elements (36a, 36b) of a hook-and-loop fastener. The right shoulder strap (22) is connected to the left side section (32) of the lap belt (30) via its first end (26), and the left shoulder strap (24) is connected to the right side section (34) of the lap belt (30) via its first end (27).In the present embodiment, the two shoulder straps (22, 24) are each designed in two parts (22a, 22b, 24a, 24b), wherein the two parts (22a, 22b, 24a, 24b) of the shoulder straps (22, 24) are each connected to one another via deflection eyes (28, 29) so that a length adjustability is provided, wherein the parts (22b, 24b) attached to the lap belt (30) can be Velcroed to themselves after the deflection for fixing.

[0055] The right shoulder strap (22) and the left shoulder strap (24) cross a total of four times, namely at a central upper crossing point (41), at a left lateral crossing point (42), at a central lower crossing point (43), and at a right lateral crossing point (44). The guide module (100) with its various elements is located in the area between these crossing points (41, 42, 43, 44) and also up to the middle section (31) of the lap belt (30). The first connecting element (141) of the module (100) can be seen at the central upper crossing point (41). The second connecting element (142) is located at the left lateral crossing point (42), and the third connecting element (143) is located at the right lateral crossing point (44). Of these three connecting elements (141, 142, 143), the openings (151, 152, 153) for the shoulder straps (22, 24) can be seen.Also partially visible among the straps are the first guide element (101), the second guide element (102), the third guide element (103), and the fourth guide element (104). The third guide element (103) is movably attached to the central section (31) of the lap belt (30) via a fourth connecting element (144), and the fourth guide element (104) is movably attached to the central section (31) of the lap belt (30) via a fifth connecting element (145). The third guide element (103) and the fourth guide element (104) each have a deflection element (163, 164) through which the second end (23) of the right shoulder strap (22) and the second end (25) of the left shoulder strap (24) are respectively guided, so that the second end (23, 25) can be reversibly and variably fastened to the shoulder straps (22, 24) via a hook-and-loop fastener, so that here too there is a possibility of tensioning the shoulder straps (22, 24).

[0056] Fig. 2 shows the back orthosis (10) on a standing support, Fig. Figure 3 shows the same back orthosis (10) on a seated wearer. The diamond shape formed by the right shoulder strap (22) and the left shoulder strap (24) through the guide module (100) between the four intersection points (41, 42, 43, 44) is clearly visible. Also visible is a half diamond shape below, formed by the central lower intersection point (43), where the two shoulder straps (22, 24) intersect, and the fourth connecting element (144) and the fifth connecting element (145).

[0057] Comparing the diamond shape of the upper closed diamond and the half diamond below it, it can be seen that the leg length of the upper diamond lengthens when the wearer sits down, while the leg length of the lower open half diamond shortens. The lap belt (30) is not displaced upward and thus remains in its position for optimal, indication-appropriate treatment.

[0058] Fig. 4 shows the rear view of the back orthosis (10) in the embodiment according to Fig. 1. Located beneath the two shoulder straps (22, 24) is the guide module (100), which is formed from the first guide element, second guide element, first connecting element, second connecting element, and third connecting element (not visible here), as well as from the at least partially visible parts: third guide element (103), fourth guide element (104), fourth connecting element (144), and fifth connecting element (145). The two lower guide elements (103, 104) are rotatably attached to the central section (31) of the lap belt (30) via the two lower connecting elements (144, 145).A guide element (151) is attached to the first connecting element in the central upper crossing point (41) of the two shoulder straps (22, 24), which has a first opening (151a) for the right shoulder strap (22) and a second opening (151b) for the left shoulder strap (24), so that the two shoulder straps (22, 24) are guided in the crossing point (41) but can slide against each other, which allows a change in the length and angle of these strap sections to each other.

[0059] Fig. 5 shows the side view of the back orthosis (10) of Fig. 4. On the second connecting element (not visible), a pass-through element (152) with a first pass-through opening (152a) for the right shoulder strap (22) and a second pass-through opening (152b) for the left shoulder strap (24) is visible. The first end (26) of the right shoulder strap (22) is connected to the left side section (32) of the lap belt (30) via a hook-and-loop fastener.

[0060] Fig. 6 shows the back orthosis (10) of the Fig. 4 and Fig. 5 in front view. The course of the right shoulder strap (22) around the right shoulder and the left shoulder strap (24) around the left shoulder of the wearer can be seen. The left side section (32) with the left lap belt end (33) and the right side section (34) with the right lap belt end (35) of the lap belt (30) are reversibly connected to one another via a hook and loop fastener (36) consisting of a first hook and loop element (36a) on the left side section (32) and a second hook and loop element (36b) on the inside on the right side section (34) for tightening the lap belt (30). The first end (27) of the left shoulder strap (24) is reversibly and adjustably attached to the right side section (34) of the lap belt (30) by means of hook and loop fasteners, the first end (26) of the right shoulder strap (22) is reversibly and adjustably attached to the left side section (32).

[0061] Fig. 7 shows the guide module (100) of the back orthosis from the Fig. 1 to 6. The guide module (100) comprises a first guide element (101) and a second guide element (102), which are rotatably connected to one another via a first connecting element (141) designed as a rivet. The first guide element (101) is rotatably connected to the third guide element (103) via the second connecting element (142), and the second guide element (102) is rotatably connected to the fourth guide element (104) via a third connecting element (143). The third guide element (103) and the fourth guide element (104) intersect in the lower region and have holes at the lower end through which a fourth connecting element (not shown) and a fifth connecting element (not shown) can pass in the form of rivets, thus movably connecting the third guide element (103) and the fourth guide element (104) to the lap belt. The three connecting elements (141, 142, 143) each have feedthrough elements (151, 152, 153).These through-opening elements (151, 152, 153) each have a first through-opening (151a, 152a, 153a) and a second through-opening (151b, 152b, 153b) through which the shoulder straps of the back orthosis can be slidably guided, so that the central upper crossing point, the left lateral crossing point and the central lower crossing point are defined and positioned by the three connecting elements (141, 142, 143).

[0062] The guide elements (101, 102, 103, 104) are made of a flexible plastic which is essentially inelastic in the tensile direction, but can also be made of metal, for example a spring steel strip.

[0063] In Fig. Figure 8 schematically shows the positioning of the guide module (100) on the ventral region of the back orthosis (10). This shows that the right shoulder strap (22) follows the path of the first guide element (101) and the fourth guide element (104), and the left shoulder strap (24) follows the path of the second guide element (102) and the third guide element (103). Furthermore, it can be seen that the first connecting element (141) is located in the region of the central upper intersection point, the second connecting element (142) is located in the region of the left lateral intersection point, and the third connecting element (143) is located in the region of the right lateral intersection point.

[0064] Fig. Figure 9 shows a second embodiment of the back orthosis (11) according to the invention. The course of the shoulder straps (22, 24) and the structure of the lap belt (30) are the same as in the embodiment of Fig. 1. In the present embodiment (11), however, the third guide element (103) and the fourth guide element (104) are not directly connected to the bandage (30) via the fourth connecting element (144) and the fifth connecting element (145). Instead, the third guide element (103) is articulated to a fifth guide element (105), and the fourth guide element (104) is articulated to a sixth guide element (106). Only the fifth guide element (105) and the sixth guide element (106) are articulated to the central section (31) of the lap belt (30) via the additional sixth connecting element (146) and seventh connecting element (147).Furthermore, force introduction belts are provided in this embodiment, wherein a first force introduction belt (154) reversibly connects the fourth connecting element (144) to the right side section (34) of the bandage (30) via a hook-and-loop fastener and a second force introduction belt (155) reversibly connects the fifth connecting element (145) to the left side section (32) of the lap belt (30) via a hook-and-loop fastener.

[0065] In this embodiment, the guide module (100) forms not one and a half diamonds, but almost two diamonds by means of the additional connecting elements (105, 106).

[0066] It is not excluded to supplement the guide module (100) with further guide elements and connecting elements and thus further diamonds, for example with one further diamond, two further diamonds, three further diamonds, four further diamonds, five further diamonds or more.

[0067] Fig. 10 shows the back orthosis (11) from Fig. 9 in rear view. Compared to Fig. 4 the additional guide elements (105, 106) and the additional connecting elements (146, 147) can be seen. The course of the two shoulder straps (22, 24) is the same as in Fig. 4, since the shoulder straps (22, 24) already end at the third or fourth guide element and are reversibly and tensionably coupled to it.

[0068] Fig. 11 shows the back orthosis (11) of Fig. 9 in the right side view. The structural design can be seen, in which the third guide element (103) is movably coupled to the fifth guide element (105) via the fourth connecting element (144), wherein the fifth guide element (105) is movably connected to the lap belt (30) via a sixth connecting element (146). The fourth connecting element (144) simultaneously couples the fifth guide element (105) and the third guide element (103) to the right force introduction belt (154), which is reversibly and tensionably connected to the right side section (34) of the lap belt (30) via a hook-and-loop fastener.

[0069] The left shoulder strap (24) has an additional elastic strap section (87).

[0070] Fig. 12 shows the back orthosis (11) from Fig. 9 in the left side view obliquely from the front. It can be seen how both the first end (26) of the right shoulder belt (22) and the second force introduction belt (155), which is movably attached to the fifth connecting element (145), are reversibly, positionably, and thus tensionably attached to the left side section (32) of the lap belt (30) by means of a hook-and-loop connection.

[0071] The right shoulder strap (22) has an additional elastic strap section (86).

[0072] Fig. 13 shows the back orthosis (11) from behind, as in Fig. 10, wherein, however, the two force introduction belts (154, 155) are detached from the lap belt (30). The force introduction belts (154, 155) can be tensioned in this way and then, in a tensioned state, attached to the lap belt (30) via hook-and-loop fasteners, which allows the wearer to easily tension the belt system comprising the two shoulder straps (22, 24).

[0073] Fig. Figure 14 shows a jacket or vest (200) equipped with a back orthosis (10) according to the invention. The right and left shoulder straps (22, 24) and the lap belt (30) are firmly connected to the vest (200) at least in sections. The back orthosis (10) can thus be put on directly and immediately together with the vest (200). Such a vest is suitable, for example, as protective workwear.

Claims

[1] Back brace (10,11), containing: - a pelvic belt (30) for application to the pelvis of a wearer, with a central section (31) that can be positioned lumbosacrally and a left side section (32) extending laterally from it with a left pelvic belt end (33) and a right side section (34) with a right pelvic belt end (35), wherein the pelvic belt ends (33, 35) can be connected to each other under tension for application, - a right shoulder strap (22) for putting on over the wearer's right shoulder, which is connected via its first end (26) to the left side section (32) of the waist belt (30), and - a left shoulder strap (24) for putting on over the wearer's left shoulder, which is connected via its first end (27) to the right side section (34) of the waist belt (30), wherein the right shoulder strap (22) and left shoulder strap (24) intersect at a dorsal central upper crossing point (41) when worn, a dorsal central lower crossing point (43) when worn and at two lateral crossing points (42,44) when worn, characterized by , that the back orthosis has a guide module (100) associated with the shoulder straps (22,24), the guide module (100) comprising: - a first guiding element (101), - a second guide element (102) - a third guiding element (103) - a fourth guiding element (104) - a first connecting element (141) - a second connecting element (142) - a third connecting element (143) - a fourth connecting element (144) - a fifth connecting element (145), wherein the first connecting element (141) is positioned at the dorsal central upper intersection point (41) and connects the first guide element (101) and the second guide element (102) as a hinge, wherein the second connecting element (142) is positioned at the first lateral intersection point (42) and connects the first guide element (101) and the third guide element (103) as a hinge, wherein the third connecting element (143) is positioned at the second lateral intersection point (44) and connects the second guide element (102) and the fourth guide element (104) as a hinge, wherein the third guide element (103) and the fourth guide element (104) cross in the region of the dorsal central lower intersection point (43), wherein the right shoulder strap (22) is connected to the guide module (100) via its second end (23) and the left shoulder strap (24) is connected to the guide module (100) via its second end (25). [2] Back orthosis (10) according to claim 1, characterized by , that the third guide element (103) is connected via the fourth connecting element (144) as a joint and the fourth guide element (104) is connected via the fifth connecting element (145) as a joint directly to the central section (31) of the pelvic belt (30). [3] Back orthosis (11) according to claim 1, characterized by , that the fourth connecting element (144) connects the third guide element (103) and a fifth guide element (105) as a joint, wherein the fifth connecting element (145) connects the fourth guide element (104) and a sixth guide element (106) as a joint, wherein the fifth guide element (105) is connected to the central section (31) of the pelvic belt (30) via a sixth connecting element (146) as a joint and the sixth guide element (106) is connected to the central section (31) of the pelvic belt (30) via a seventh connecting element (147) as a joint. [4] Back brace according to one of the preceding claims, characterized by, that the first connecting element (141), the second connecting element (142) and / or the third connecting element (143) have through-openings (151, 152, 153) through which the right shoulder strap (22) and the left shoulder strap (24) are slidably guided. [5] Back orthosis according to claim 4, characterized by , that the first connecting element (141), the second connecting element (142) and the third connecting element (143) each have a first through-opening (151a, 152a, 153a) through which the right shoulder strap (22) is slidably guided and each have a second through-opening (151b, 152b, 153b) through which the left shoulder strap (24) is slidably guided. [6] Back brace according to one of the preceding claims, characterized by, that the guide elements (101,102,103,104,105,106) are made of a flexible and inelastic material in the tensile direction, for example plastic, leather or metal, in particular spring steel. [7] Back orthosis according to one of the preceding claims, wherein an elastic strap section (86, 87) is formed between the first end of the shoulder strap (26, 27) and the lateral crossing point (42, 44), the elasticity of which is equal to or higher than that of the shoulder strap (22, 24) itself. [8] Back orthosis according to one of the preceding claims, wherein the first ends (26, 27) of the shoulder straps (22, 24) are reversibly connected to the pelvic strap (30), in particular via a Velcro fastener. [9] Back orthosis according to one of the preceding claims, wherein the second ends (23, 25) of the shoulder straps (22, 24) are variably adjustable on the associated guide elements (104, 103) or the fourth and third guide elements (104, 103) each have at least one deflection element (164, 163) through which the associated shoulder strap (22, 24) is passed and the second end (23, 25) can be reversibly and variably attached to the shoulder strap (22, 24). [10] Back orthosis according to claim 3 or one of claims 4 to 9 in conjunction with claim 3, wherein a force transmission belt (154, 155) is attached to the fourth connecting element (144) and to the fifth connecting element (145), respectively, and wherein the force transmission belts (154, 155) are reversibly connected to the pelvic belt. [11] Back orthosis according to one of the preceding claims, wherein the shoulder straps and / or the force transmission straps are formed by a cable pulley system. [12] Article of clothing comprising a stretchable vest or jacket (200) and a back brace as characterized in one of the preceding claims, wherein shoulder straps (22, 24) and pelvic belt (30) are at least partially mounted on a vest or jacket (200) and are firmly connected to it.

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