Individually adjustable cervical orthosis

Abstract

An arrangement in the form of a cervical orthosis comprising a back part (1) with two upper ends (13) and two lower ends (14), a front part (2) and a forehead part (3), wherein the front part (2) is connected to the lower part of the back part (1) and the forehead part (3) is connected to the upper part of the back part (1) by hook and loop fasteners, characterized in that the back section (1) is individually adapted to a patient anatomically, is provided between the two upper ends (13) and the two lower ends (14) with a central cutout (11) for a cervical spine and round perforations (12) for sufficient air circulation, wherein the two upper and the two lower ends (13 and 14) of the back part (1) are designed as two anatomically shaped tab receptacles (15) of individual length and as two anatomically shaped tabs (16) of individual length, and the tab receptacles (15) at the two upper ends (13) serve for the corresponding receptacles (31) of the forehead part (3), and the tabs (16) at the two lower ends (14) serve for the corresponding connection to tab receptacles (23) of the front part (2), the front part (2) is individually adapted to a patient's anatomy, is provided centrally with an individually adapted cutout (21) for a tracheostomy tube and below the cutout (21) with round perforations (22) for sufficient air circulation, wherein the two upper ends (23) of the front part (2) are designed as anatomically individually adapted tab receptacles (23) for the tabs (16) of the back part (1) in order to ensure a mechanically stable connection between the back part (1) and the front part (2) in the shoulder-chest area of ​​the patient, and The forehead section (3) is individually anatomically adapted to a patient, has anatomically adapted tabs (31) of individual length on both sides, and is provided in the lower part with laterally widened supports (32) which correspond to the shape of the two upper ends (13) of the back section (1) in order to ensure optimal hold and fit of the orthosis on the patient, the tabs (31) serving to be received in the tab receptacles (15) at the two upper ends (13) of the back section (1). wherein the back part (1), the front part (2) and the forehead part (3) are firmly and releasably connected to each other by means of the tabs (16 and 31) and the tab receptacles (15 and 23) and the Velcro straps with the Velcro fasteners.

Description

[0001] The invention relates to an individually adjustable cervical orthosis, particularly for ALS patients.

[0002] Amyotrophic lateral sclerosis (ALS for short; from "amyotroph" [Greek] = not sufficiently nourished muscles, and from "lateral" [Latin] = sideways, sclerosis [Greek] = hardening) belongs to the group of motor neuron diseases and is an incurable degenerative disease of the motor nervous system. The degeneration of the first motor neurons leads to increased muscle tone (spastic paralysis). Damage to the second motor neurons leads to increasing muscle weakness (paresis to plegia), which is accompanied by muscle atrophy. This leads to progressive limitations in activities of daily living. The world’s most famous ALS patient was the astrophysicist Stephen Hawking. https: / / de.wikipedia.org / wiki / Amyotrophic lateral sclerosis

[0003] Aids for ALS patients include a neck brace or neck cushion on the wheelchair, the latter possibly with a headband if the neck muscles are severely weakened.

[0004] Devices for supporting a neck and / or head are available today in a wide variety of shapes and designs, mostly in the form of inflatable U-shaped neck pillows or neck cushions. DE 297 097 60 U1, for example, describes a neck pillow for maintaining a comfortable posture in the cervical spine area (e.g. while driving a car).

[0005] DE 10 2016 111 768 A1 discloses a device for protecting and / or supporting a neck and / or head of a person with a support element that at least partially adapts to the neck and / or head, wherein the support element is provided in a scarf, has at least one hollow space whose volume is variable (e.g. by inflation) and is incorporated into the scarf or placed on the scarf. The disadvantage of this technical solution is that although the support device can be individually adjusted to the patient by inflation, it becomes slack over longer periods due to leaks, which leads to spatial changes in the supporting shape and thus the ALS patient gradually loses the necessary head support.

[0006] DE 20 2015 103 834 U1 discloses a device for supporting the neck and head of a patient, comprising a rear wall and exactly one pair of two legs that are substantially symmetrical to one another, wherein the rear wall has a lower end and an upper end, wherein the pair of symmetrical legs is located at the lower end of the rear wall, wherein the rear wall has one or more head support elements that taper towards its upper end, wherein the head support element(s) of the rear wall define a first plane, wherein the pair of symmetrical legs defines an empty space located between the legs for receiving the neck of the patient, wherein the pair of legs defines a second plane that is at an angle of approximately 70 degrees to approximately 100 degrees to the first plane. The upper end of the rear wall has a depression, wherein • the trough in the first level defines a passage open at the upper end of the rear wall, each of the legs having a peripheral outer wall facing away from the empty space and the rear wall having a peripheral outer wall facing away from the empty space, the peripheral outer walls and the peripheral outer wall defining a continuous circumferential outer wall of the device, • the pair of symmetrical legs defines a substantially U-shaped base with the area of ​​the rear wall located in the first plane, • the two symmetrical legs have a length that exceeds the height of the rear wall, • the rear wall has a plurality of mutually symmetrical headrest elements, • the legs have a substantially uniform thickness, • the rear wall is U-shaped in the first level and has a fastening device, • each end of the legs has a fastening means, whereby the two fastening means at the two leg ends can be releasably connected to one another so that the two leg ends can be fixed to one another, e.g. in the form of a Velcro fastener.

[0007] The outer shell can be made of one or more textile materials and / or leather.

[0008] The textile material may, for example, comprise cotton or a nonwoven fabric which may contain cotton, flax fibres, wool fibres, viscose fibres, polyester fibres, polyethylene terephthalate fibres, polybutylene terephthalate fibres, polypropylene, polyamide, polyethylene fibres, aramid fibres, glass fibres, carbon fibres.

[0009] An outer shell may also contain a polymer referred to as "plastic" or consist of one or more polymers. Illustrative examples of suitable outer shell materials include polyvinyl chloride (PVC), polyethylene (PE), polypropylene (PP), ethylene-vinyl acetate (EVA), polystyrene (PS), polyethylene terephthalate (PET), polyacrylonitrile ("acrylic"), polymethyl methacrylate, and mixtures of two or more of the aforementioned polymers.

[0010] The filling can contain or consist of any material suitable for neck pillows or pillows. Suitable examples of fillings include, but are not limited to, feathers, wool, cotton, polyurethane foam, viscoelastic foam, textile fiber beads, polystyrene beads, kapok fibers (the hollow fiber of the kapok tree), or kernels or seeds of fruits, including legumes, as well as a mixture of one or more of the aforementioned materials. Examples of suitable kernel or seed fillings include, but are not limited to, spelt husks, cherry stones, grape seeds, linseed, rapeseed, millet grains, wheat grains, rye grains, wheat kernels, or a mixture of one or more of the aforementioned kernels. Textile fiber beads can be made of the aforementioned materials, such as polyester, polyethylene terephthalate, polybutylene terephthalate, polypropylene, or polyamide.

[0011] DE 20 2015 103 834 U1 teaches, in some embodiments, particularly where the outer shell is made of one or more plastics, that the device is filled with a fluid. A suitable fluid can be, for example, a gas, a gas mixture such as air, or a liquid such as water.

[0012] The disadvantage of this technical solution is that although the support device can be individually adapted to the patient thanks to the outer shell and the filling, there is a risk of leaks due to the mandatory seams and / or openable and resealable openings in the outer shell, which over a shorter or longer period of time lead to the filling escaping from the outer shell and thus to the slackening of the orthosis, which leads to spatial changes in the supporting shape and thus the ALS patient temporarily or gradually losing the necessary support of the head.

[0013] The object of the present invention is to avoid the disadvantages of the prior art and to provide an individually adjustable cervical orthosis (particularly for ALS patients) which avoids the aforementioned disadvantages of the prior art, in particular enabling permanent individual support of the head of an ALS patient and is easy to handle.

[0014] This task is solved by an arrangement according to the first claim in the form of an individually adjustable cervical orthosis [hereinafter also referred to as RaCko, as the product name for (Reha aktiv Cervical cranial orthosis)].

[0015] Advantageous embodiments of the invention are specified in the subordinate claims.

[0016] The RaCko consists of 3 individually manufactured parts: the front part (chest), the back part (back + head) and the forehead part.

[0017] Alternatively, it can also consist of 4 individually manufactured parts: the front part (chest), the back part (back + head), the forehead part (forehead) and the chin part (chin), whereby the chin part is optionally removable.

[0018] The design and manufacture of these 3 parts (alternatively 4 parts) is based on a 3D scan in which the individual head of a patient is scanned in a corrected yet relaxed position.

[0019] After this individual 3D scan, the front part, the back part and the forehead part, or alternatively the front part, the back part, the forehead part and the chin part, are manufactured based on the individual patient data recorded during the scan. During this production process, they are also provided with special holding and locking devices for the overlapping connection of the three individual parts.

[0020] The individual parts can be cut and permanently deformed using a known process or manufactured using a known 3D printing process.

[0021] It is important that the three parts are provided with special holding and locking means that correspond to one another. These are inserted into one another in an overlapping manner and are firmly but still releasably connected to one another in their final position, so that the front part, the back part and the forehead part can be firmly and releasably connected to one another.

[0022] Alternatively, it can also be provided that the special holding and locking means are provided on the 4 parts corresponding to one another, which are inserted into one another in an overlapping manner and are firmly but nevertheless releasably connected to one another in their final position, so that the front part, the back part, the optional chin part and the forehead part can be firmly and releasably connected to one another.

[0023] The specific purpose of the special holding and locking devices provided is to create force-fitting yet detachable connections between the front, back, and forehead sections, or alternatively between the front, back, chin, and forehead sections, which can absorb forces resulting from patient movements and transmit them to the adjacent sections without the assembly of the three parts (or alternatively four parts) shifting against each other or even coming loose (which is a major disadvantage in the current state of the art, as these only provide connections in the form of fastening devices such as hook-and-loop fasteners at the free ends or in the form of straps with buckles, coupling buckles, hooks, or D-rings at the free ends as closures, which means that the forces resulting from patient movements cannot be effectively absorbed or transmitted to the adjacent sections).

[0024] Thanks to the patient-specific design of the back section in conjunction with the front section, the load is distributed almost evenly across the patient's upper body and shoulders. This technical solution allows the back and front sections to be shorter than before, which offers the advantage for the patient of being able to move freely and lean comfortably while sitting, despite the tight fit of the RaCko.

[0025] The special holding and locking means provided for the connection system can also be supplemented with fastening means in the form of Velcro fasteners or straps with buckles, belt buckles, hooks or D-rings at the free ends as closures in order to ensure special security when connecting the 3 parts or alternatively 4 parts to each other.

[0026] The special holding and locking means are each an integral part of the front, back and forehead parts and are designed as a tab and tab receptacle corresponding to one another, with a tab on each of the two free ends of the forehead part, which correspond to two tab receptacles on the upper part of the back part and a tab on each of the lower parts of the back part on each side, which is designed to correspond to two tab receptacles on the upper end of the side of the chest part facing the chest.

[0027] As already explained, it is important that the special holding and locking means can be inserted into each other in an overlapping manner and can be firmly but still releasably connected to each other in their final position, so that the front part, the back part and the forehead part can be firmly and releasably connected to each other. The locking devices are adapted to the scanning surface and therefore have minimal bulk while still being mechanically extremely stable.

[0028] The length of the tabs is adjusted so that under normal circumstances the two parts, including 3 mm of padding, fit together in a form-fitting manner.

[0029] A reserve of 10 - 20 mm is added to the flap length in case additional padding is required or the patient is wearing a winter jacket, for example.

[0030] The tab and tab holder have a clearance of 0.75 mm to ensure easy sliding into each other.

[0031] The round air holes on the chest part and their special arrangement ensure good air circulation and allow the padding to be well fixed via the bars located between the air hole positions.

[0032] In addition, the special holding and locking devices (= the tab system) that are locked together can be secured in any position with a Velcro fastener.

[0033] In particular, the use of the well-known MJF 3D printing process with PA12 material to produce the 3 parts (chest, forehead and back sections) or alternatively 4 parts (chest, forehead, chin and back sections) enables a stable, flexible and also super lightweight orthosis with the special holding and locking devices to ensure optimal support and weight distribution for each individual patient.

[0034] This can be further supported by the addition of individual reinforcement elements, particularly in the chest and back sections, which are precisely and individually adapted to the position of the head of the respective patient and provide the necessary stability at critical points so that the weight of the head is held specifically and predominantly via the forehead section.

[0035] By holding the head above the forehead, this technical solution provides enormous relief in the jaw area compared to the current state of the art, as the weight of the head is not solely on this area. This relief of pressure on the jaw and chin area makes speaking and eating easier for the ALS patient, leading to a significant improvement in their quality of life.

[0036] The invention is explained in more detail below with reference to a preferred embodiment and an alternative embodiment of the individually adjustable cervical orthosis and the figures, without being limited to these.

[0037] It shows: Fig. 1: a schematic representation of an embodiment of a back part, Fig. 2: a schematic representation of a first embodiment of a front part, Fig. 3: a schematic representation of an embodiment of a head / front part, Fig. 4: a schematic representation of a first embodiment of the complete cervical orthosis with the components according to the Fig. 1 to 3, Fig. 5: a schematic representation of a second embodiment of a front part, Fig. 6: a schematic representation of a chin part and Fig. 7: a schematic representation of the second embodiment of the complete cervical orthosis with the components according to the Fig. 1, Fig. 3, Fig. 5 and Fig. 6, wherein the component according to Fig. 6 is removable.

[0038] The individually adjustable cervical orthosis (RaCko) consists of three Fig. 1, Fig. 2 and Fig. 3 shown components and is in Fig. 4 shown in the fully assembled state.

[0039] Alternatively, an adjustable cervical orthosis (RaCko) can also be made from four Fig. 1, Fig. 3, and Fig. 6 shown components and as shown in Fig. 7 shown must be completely assembled.

[0040] The Fig. The back part (1) [back side] shown in Figure 1, which is individually anatomically adapted to a patient, is provided with a central cutout (11) for the cervical spine (C-spine) and round perforations (12) for sufficient air circulation, which ensures a comfortable wearing feeling for the patient.

[0041] The two upper and the two lower ends (13 and 14) of the back part (1) are designed as two anatomically shaped tab holders (15) of individual length and as two anatomically shaped tabs (16) of individual length, wherein the tab holders (15) at the two upper ends (13) serve for the corresponding reception of tabs (31) of the front part (3) and the tabs (16) at the two lower ends (14) serve for the corresponding connection to tab holders (23) of the front part (2), wherein the back part (1) on its side opposite the cutout (11) has areas running along the cervical spine with individual reinforcement elements (17) for sufficient mechanical stability and the back part (1) on its lower side, which carries the perforations (12) and the lower part of the cutout (11), also runs below the two lower ends (14) in order to ensure the largest possible,to ensure a ventilated support surface of the back part (1) on the shoulder and back area of ​​the patient (which may be provided with the manufacturer's logo and information in accordance with the MDR for information purposes only).

[0042] In addition, the two upper and two lower ends (13 and 14) of the back part (1) are provided with four deflectors (18) for locking the orthosis parts with Velcro fasteners (in Fig. 1 not shown).

[0043] For the alternative embodiment according to Fig. 6, the previously described back part (1) also has the described receptacles and flaps for a Fig. 4 shown, optionally removable chin part (4).

[0044] The Fig. The front part (2) [chest side] shown in Figure 2, which is individually anatomically adapted to a patient, is provided with a centrally adapted cutout (21) for the tracheostomy tube and round holes (22) for sufficient air circulation, which ensures a comfortable wearing experience for the patient.

[0045] The two upper ends (23) of the front part (2) are designed as anatomically individually adapted tab holders (23) for the tabs (16) of the back part (1) in order to ensure a mechanically stable connection of the back part (1) and the front part (2) in the shoulder-chest area of ​​the patient.

[0046] The corresponding receptacles of the tabs (16) of the back part (1) in the tab receptacles (23) of the front part (2) are designed in the example with a 0.75mm tolerance so that these two components can slide optimally into each other and ensure good force absorption.

[0047] The holes (22) in the front part (2) are located in the middle to lower part of the front part (2) in order to ensure not only good ventilation through optimal air circulation but also good flexibility in the area of ​​the contact surfaces of the front part.

[0048] In addition, the two upper ends of the front part (2) in the chest-shoulder area of ​​the patient are each provided with a Velcro strip with Velcro fastener, whereby the two Velcro strips can be guided through the two lower deflectors (18) of the back part (1) to lock the orthosis parts.

[0049] The Fig. The forehead part (3) shown in Figure 3, which is individually anatomically adapted to a patient, has anatomically adapted tabs (31) of individual length on both sides and is provided in the lower part with slightly wider supports (32) on the sides, which correspond to the shape of the two upper ends (13) of the back part (1), in order to ensure optimal hold and fit of the orthosis on the patient, wherein the tabs (31) serve to be received in the tab receptacles (15) on the two upper ends (13) of the back part (1).

[0050] The corresponding receptacles of the tabs (31) of the front part (3) in the tab receptacles (15) of the back part (1) are designed in the example with a 0.75 mm tolerance so that these two components can slide optimally into each other and ensure good force absorption.

[0051] It is important that the forehead part (3) is manufactured exactly according to the digital 3D scan of the individual patient data for optimal hold.

[0052] In addition, the two upper ends of the forehead part (3) in the patient's head area are each provided with a Velcro strip with a Velcro fastener, whereby the two Velcro strips can be guided through the two upper deflectors (18) of the back part (1) to lock the orthosis parts.

[0053] The Fig. The second embodiment of the front part (2) shown in Figure 5 has [as an alternative embodiment to the first embodiment of the front part (2) according to Fig. 2] two tab receptacles (24) which are provided to releasably receive a removable chin part (4) in order to be able to attach the entire front part according to the received chin part (4) in the assembled state of the arrangement Fig. 2. This technical solution provides a more efficient solution than the technical solution according to Fig. 2 enables easy and quick removal and insertion of the chin part (4).

[0054] The Fig. The chin part (4) shown in Figure 6 has two individually shaped tabs (42) and two widened supports (41).

[0055] The two individually formed tabs (42) are aligned with the tab holders (24) in the front part according to Fig. 5 are designed to correspond in shape and, together with the two widened supports (41), which are connected to the two ends of the tab holders (24) in the front part [+ the tab holders (24) = total width] according to Fig. 5 are designed to correspond in shape, ensuring a secure hold of the chin guard (4) when assembled, even under load. The anatomically adapted (based on a 3D scan) closure consisting of the tab (42) and tab holder (24) allows for easy and quick removal and insertion of the chin guard.

[0056] The removable chin guard (4) allows the patient to facilitate feeding (depending on the progression of the disease). Furthermore, caregivers or relatives of the patient can more easily insert the tracheostomy tube and subsequently reinsert the chin guard (4).

[0057] As in Fig. As shown in Figure 4, the back part (1), the front part (2) and the forehead part (3) can be firmly and releasably connected to one another using the tabs (16 and 31), the tab holders (15 and 23) and the Velcro strips with the Velcro fasteners.

[0058] Alternatively, as in Fig. 7 also shows the optionally removable chin part (4) with the parts according to Fig. 5 should be added.

[0059] The individually adjustable cervical orthosis is manufactured after contactless measurement of the patient's head using conventional 3D scanning techniques. The acquired scan data is then used to construct the three individually adapted components of the cervical orthosis (chest, forehead, and back sections), including the individual reinforcement elements and the anatomically shaped flap holders in individually positioned positions, using a conventional 3D printing process. These are then supplemented with the additional components (anatomically shaped flaps in individual lengths, hook-and-loop fasteners, and deflectors for locking the three orthosis components together using the hook-and-loop fasteners).

[0060] The printing is carried out, for example, using HP-MJF (MultiJetFusion) / SLS 3D printing processes from the material PA12 or PA11, whereby the printing takes place in three individual parts, which are then connected to one another via the corresponding special holding and locking means in the form of the anatomically shaped tabs and tab holders as well as deflectors and Velcro fasteners.

[0061] The padding of the three or alternatively four individually printed cervical orthosis parts is made with a breathable padding material (e.g. ComforTexAir material), which ensures a high level of comfort.

[0062] The technical solution provided in the form of the cervical orthosis has the advantage of being patient-specific and durable, easy to handle by both nursing staff and the patient, and provides enormous relief in the jaw and chin area, as the weight of the head is not solely on this area, making speaking and eating easier for the ALS patient compared to previously known technical solutions.

[0063] The optionally removable chin guard allows for easier feeding and easier tracheostomy tube changes, which is also an advantage.

[0064] All features presented in the description, the embodiments and the following claims can be essential to the invention both individually and in any combination with one another. Reference symbol 1 back part 11 Cutout for a cervical spine 12 holes 13 two upper ends 14 two lower ends 15 tab holders 16 tabs 17 Reinforcing element / stiffening element 18 deflectors 2 front part 21 Cutout for a tracheostomy tube 22 holes 23 upper ends 24 tab holders 25 recess 26 Reinforcing element / stiffening element 3 Headboard / forehead section 31 tabs 32 editions 4 Chin part 41 widened support surface 42 tab QUOTES CONTAINED IN THE DESCRIPTION

[0000] This list of documents submitted by the applicant was generated automatically and is included solely for the convenience of the reader. This list is not part of the German patent or utility model application. The DPMA assumes no liability for any errors or omissions. Cited patent literature

[0000] DE 297 097 60 U1

[0004] DE 10 2016 111 768 A1

[0005] DE 20 2015 103 834 U1 [0006, 0011]

Claims

[1] Arrangement in the form of a cervical orthosis comprising a back part (1) with two upper ends (13) and two lower ends (14), a front part (2) and a forehead part (3), wherein the front part (2) is connected to the lower part of the back part (1) and the forehead part (3) is connected to the upper part of the back part (1) by means of hook-and-loop fasteners, characterized by , that the back part (1) is individually anatomically adapted to a patient, is provided centrally between the two upper ends (13) and the two lower ends (14) with a cutout (11) for a cervical spine and round holes (12) for sufficient air circulation, wherein the two upper and the two lower ends (13 and 14) of the back part (1) are designed as two anatomically shaped tab receptacles (15) of individual length and as two anatomically shaped tabs (16) of individual length, and the tab receptacles (15) at the two upper ends (13) serve for the corresponding reception of tabs (31) of the front part (3) and the tabs (16) at the two lower ends (14) serve for the corresponding connection to tab receptacles (23) of the front part (2), the front part (2) is individually anatomically adapted to a patient, is provided centrally with an individually adapted cutout (21) for a tracheostomy tube and below the cutout (21) with round perforations (22) for sufficient air circulation, wherein the two upper ends (23) of the front part (2) are designed as anatomically individually adapted tab receptacles (23) for the tabs (16) of the back part (1) in order to ensure a mechanically stable connection of the back part (1) and the front part (2) in the shoulder-chest area of ​​the patient, and the forehead part (3) is individually anatomically adapted to a patient, has anatomically adapted tabs (31) of individual length on both sides and is provided in the lower part with laterally widened supports (32) which correspond to the shape of the two upper ends (13) of the back part (1), in order to ensure optimal hold and fit of the orthosis on the patient, wherein the tabs (31) serve to be received in the tab receptacles (15) at the two upper ends (13) of the back part (1), wherein the back part (1), the front part (2) and the forehead part (3) are firmly and releasably connected to one another by means of the tabs (16 and 31) and the tab holders (15 and 23) as well as the Velcro strips with the Velcro fasteners. [2] Arrangement according to claim 1, characterized bythat the back part (1) has, on its side opposite the cutout (11), areas running along the patient's cervical spine with individual reinforcement elements (17) for sufficient mechanical stability and the back part (1) on its lower side, which carries the perforations (12) and the lower part of the cutout (11), also runs below the two lower ends (14) in order to ensure the largest possible ventilated contact surface of the back part (1) on the shoulder and back area of ​​the patient. [3] Arrangement according to claim 1 or 2, characterized by that the holes (22) are located in the middle to lower part of the front part (2) in order to ensure not only good ventilation through optimal air circulation but also good flexibility in the area of ​​the contact surfaces of the front part (2). [4] Arrangement according to claim 1, 2 or 3, characterized bythat the corresponding receptacles of the tabs (16) of the back part (1) in the tab receptacles (23) of the front part (2) are designed with a 0.75 mm tolerance so that these two components can slide optimally into each other and ensure good force absorption. [5] Arrangement according to claim 1, 2 or 3, characterized by that the corresponding receptacle of the tabs (31) of the front part (3) in the tab receptacles (15) of the back part (1) is designed with a 0.75 mm tolerance so that these two components can slide exactly into each other and ensure good force absorption for optimal hold. [6] Arrangement according to claim 4 and claim 5, characterized bythat the two upper ends of the front part (2) in the chest and shoulder area of ​​the patient are each provided with a hook and loop fastener and the two hook and loop fasteners can be guided through two lower deflectors (18) of the back part (1) to lock the orthosis parts, and that the two upper ends of the forehead part (3) in the head area of ​​the patient are each provided with a hook and loop fastener and the two hook and loop fasteners can be guided through the two upper deflectors (18) of the back part (1) to lock the orthosis parts. so that the back part (1), the front part (2) and the forehead part (3) can be firmly and releasably connected to one another in their final position by means of the corresponding tabs (16 and 31) and the tab receptacles (15 and 23) as well as the deflectors (18) with the hook and loop fasteners and their hook and loop fasteners. [7] Arrangement according to one or more of claims 1 to 6, characterized bythat the back part (1), the front part (2) and the forehead part (3) are padded with breathable material. [8] Arrangement according to one or more of claims 1 to 7, characterized by that a chin part (4) is additionally provided, which has two individually molded tabs (42) and two widened supports (41) and, by means of the widened molded tabs (42), which correspond to the tab receptacles (24) in the front part (2), together with the two widened supports (41), ensure that the chin part (4) is held securely even under load, wherein an anatomically adapted closure consisting of the tab (42) and the tab receptacle (24) is formed, whereby simple and quick removal or simple and quick insertion of the chin part (4), which is optionally removable from the front part (2), is ensured.

Images