Modular residual force-enhancing arm brace

Abstract

Modular, residual force-enhancing arm orthosis RVA (1) for supporting the lifting of at least one arm by the muscle power of a patient using modules of a modular system, which comprises: - at least one cable guide module (5) with a Bowden tube (20) with cable outlets (22, 22') for guiding a traction cable (10) with first hand loops (6, 6') arranged at the ends of the traction cable (10) that are accessible to the patient, - at least one support module (3) for holding the cable guide module (5), and - at least one base module (2) which is detachably arranged on the patient's body in the area of ​​the back and supports the support module (3), wherein the cable outlets (22, 22') of the base tube (10) are arranged in the area of ​​the front of the body at a height above the patient's clavicles.

Description

In patients with unilateral or bilateral arm raising weakness, the residual force-enhancing arm orthosis (RVA) is intended to at least partially compensate for the weight force of at least one arm and thus reduce the load on the respective shoulder girdle. The RVA (Residual Strength Assisted Reflexology) is modular, and by selecting just a few modules from a modular system, it can be cost-effectively adapted to the needs of a patient with arm lift weakness. The residual strength-enhancing arm orthosis comprises a base module, a support module, and a rope guidance module with at least one guide device for a rope. The rope has hand loops at its ends, which the patient grasps with their hands, using the strength of one arm to assist the remaining strength needed to lift the other arm. Patients who, for example, are unable to lift an arm independently due to paralysis or partial paralysis, often still have limited grasping function in the hand of the affected arm. Such patients can, for instance, use the hand of the unaffected arm to position the hand of the affected arm, for example, on a tabletop or doorknob, in which position the limited hand function can then be utilized. Furthermore, using RVA (Reflexive Acupressure), a patient can be enabled to bring one hand, or both hands alternately, to their mouth to allow for independent drinking or eating. European patent EP3522838B1 discloses an arm lifting device with an artificial tendon and a motorized cable pulley device. A disadvantage of the arm lifting device known from EP3522838B1 is that, in addition to the motor drive, measuring and control devices are needed to fulfill the arm lifting task. The purpose of the innovation is to create a cost-effective arm orthosis to support an arm lifting movement using the patient's own strength, in which the weakened arm can be selectively raised and lowered under visual control by exerting force from the healthy arm. The problem is solved by the features of the main claim. Further elaborations of the novelty are found in the dependent claims. The new feature will be explained in more detail using the figures. Figure 1 illustrates the operating principle of the modular, residual force-enhancing arm orthosis RVA. A Bowden tube 20 with cable outlets 22, 22' is arranged around the patient's neck. A non-stretchable traction cable 10, preferably a steel cable, is guided through this tube. First hand loops 6, 6 are arranged at the ends of the traction cable 10, which the patient grasps with their hands. Due to the cable deflection, a downward arm movement 60 of one arm exerts a force on the other arm, causing an upward arm movement 61. The Bowden tube 20 is held by a bracket 4, which is part of a support module. The forces and torques caused by the traction cable movement are transmitted to the bracket 4 via the support module to a base module in the area of ​​the patient's back. In Fig. 2 a, a Bowden tube 20 is shown in a top view, guided around the neck of the patient and held by a bracket 4, with a pull rope 10 and rope outlets 22, 22'. Figures 2b and 2c show a Bowden tube 20 held by a rigid chalice collar 51. Figure 3 shows a schematic side view of a modular RVA (Reflexive Traction Device) attached to a patient's body. The modular RVA comprises a cable guide module 5 with a Bowden tube 20 and cable outlets 22, 22', as well as a guide device with outlets 24, 24' for at least one elastic band 12, 12', 13, 13'. First hand loops 6, 6' are arranged at the ends of the traction cable 10 guided in the Bowden tube 20. The ends of the elastic bands 12, 12', 13, 13' bear second hand loops 7, 7' and third hand loops 8, 8'. In contrast to the traction cable 10, which is freely movable in the Bowden tube, the elastic bands 12, 12', 13, 13' are secured against displacement at a cable attachment point 15. This allows a relieving traction force to be applied to one or both of the patient's arms, compensating for part of the weight of the respective arm, regardless of the support provided by the other arm. The modular RVA further comprises a support module 3 with a support arm 50 and a bracket 4, wherein the support arm is attached to a base module 2, which in the example of Fig. 3 consists of a trunk orthosis 40 which is detachably held on the patient's trunk by means of waist belts 31, 32 and a shoulder strap 34. Figure 4a schematically depicts a modular RVA 1 with cable guide module 5, support module 3, and base module 2. Figures 4b to 4h show examples of components from a modular kit for a modular RVA. For the support module 3 and the base module 2, components that were previously fitted to the patient during a previous prescription can be used, if suitable, resulting in cost savings in many cases when providing the patient with an RVA. In Fig. 2a, a Bowden tube 20, guided around the neck of the patient and held by a bracket 4, with a pull rope 10 and rope outlets 22, 22', is shown in a top view. Figures 2b and 2c show a Bowden tube 20 held by a rigid chalice collar 51. Figure 3 shows a schematic side view of a modular RVA (Reflexive Traction Device) attached to a patient's body. The modular RVA comprises a cable guide module 5 with a Bowden tube 20 and cable outlets 22, 22', as well as a guide device with outlets 24, 24' for at least one elastic band 12, 12', 13, 13'. First hand loops 6, 6' are arranged at the ends of the traction cable 10 guided in the Bowden tube 20. The ends of the elastic bands 12, 12', 13, 13' bear second hand loops 7, 7' and third hand loops 8, 8'. In contrast to the traction cable 10, which is freely movable in the Bowden tube, the elastic bands 12, 12', 13, 13' are secured against displacement at a cable attachment point 15. This allows a relieving traction force to be applied to one or both of the patient's arms, compensating for part of the weight of the respective arm, regardless of the support provided by the other arm. The modular RVA further comprises a support module 3 with a support arm 50 and a bracket 4, the support arm being attached to a base module 2, which in the example of Fig. 3 consists of a trunk orthosis 40 detachably held on the patient's torso by waist straps 31, 32 and a shoulder strap 34. The bracket 4 is advantageously adjustable, for example as a tube clamp connection, so that the position of the outlets 22, 22' and 24, 24' can be adapted to the height of the patient's chin. Figure 4a schematically depicts a modular RVA 1 with cable guide module 5, support module 3, and base module 2. Figures 4b to 4i show examples of components from a modular kit for a modular RVA 1. For the support module 3 and the base module 2, components that were previously fitted to the patient during a previous prescription can be used, provided they are suitable. This often results in cost savings when providing the patient with an RVA. The cable guide modules 5 shown schematically in Figs. 4b to 4d show in Fig. 4b a Bowden tube 20, in Fig. 4c a Bowden tube 20 with a band guide 21, 21' for guiding elastic bands and in Fig. 4d a Bowden tube 20 designed as a rigid, bent tube. A flexible tube is also provided as a Bowden tube 20 to guide the traction cable 10, provided that the associated holding module 3 holds the Bowden tube 20 in such a way that the cable outlets 20, 20' are fixed opposite the patient's shoulder area. The position of the cable outlets 22, 22' is determined depending on the planned arm trajectories. For example, if an arm movement is to be supported that brings a hand to the patient's mouth, the cable outlets are positioned in the area of ​​the patient's chin. The cable guide module 5 is attached to the support module 3 by means of force-fit or form-fit connections. Figures 4e and 4f show two exemplary support modules 3. In Figure 4e, the support module 3 consists of a support arm 50 with a cable guide bracket 4. The support arm 50 is arranged on a base module at its base module end. The connection between the support module 3 and the base module 2 can be rigid or articulated. If a trunk orthosis 40 is to be used as the base module 2, an articulated arrangement of the support arm 50 is advantageous, as it can follow a lateral movement of the upper back. Figure 4f schematically shows a collar 51 as a support module 3, which rests against the patient's shoulders and neck. The collar 51 is preferably designed as a padded molded plastic part and can be held in place on the patient by shoulder straps if necessary. Figures 4g to 4i schematically illustrate examples of basic modules 2 from a modular system. In Figure 4g, the basic module 2 consists of a trunk orthosis 40, which is held to the patient's body by means of straps. The length of the straps can be adjusted to the patient's needs by using buckles or hook-and-loop fasteners. Figure 4h shows an example of a basic module 2: a back brace 41 similar to a back protector. The back brace 41 is held to the upper body by means of preferably adjustable waist and shoulder straps. Figure 4i schematically illustrates a backpack with a carrying frame 42 as an example of a basic module 2.The use of a backpack with carrying frame 42 as a base module 2 for attaching a carrying module 3 and a rope guide module 5 is advantageous when the patient walks with the support of walking sticks and the pull rope and the elastic bands support the arm movement during walking by partially compensating the weight of the arms. List of illustrations Fig. 1: Cable guide of a residual force-enhancing arm orthosis (RVA). Fig. 2: Support module with a collar. Fig. 3: Modular RVA with arm weight relief device. Fig. 4: Modular system for a modular RVA. Reference symbol list 1 Modular residual force-enhancing arm orthosis (RVA) 2 Base module 3 Support module 4 Bracket 5 Rope guide module 6, 6' First hand loop 7, 7' Second hand loop 8, 8' Third hand loop 10 Pull rope 12 First elastic band 13 Second elastic band 15 Band attachment point 20 Bowden tube 21, 21' Band guide 22, 22' Rope outlet 24, 24' Outlet for elastic band 31 Waist belt 32 Waist belt 34, 34' Shoulder strap 40 Trunk orthosis 41 Back corset 42 Backpack with carrying frame 50 Support arm 51 Chalice collar 60 Downward arm movement 61 Upward arm movement QUOTES INCLUDED IN THE DESCRIPTION This list of documents cited by the applicant was automatically generated and is included solely for the reader's convenience. The list is not part of the German patent or utility model application. The DPMA accepts no liability for any errors or omissions. Cited patent literature EP 3522838B1 [0004, 0005]

Claims

Modular, residual force-enhancing arm orthosis RVA (1) for supporting the lifting of at least one arm by the muscle power of a patient using modules of a modular system, which comprises: - at least one cable guide module (5) with a Bowden tube (20) with cable outlets (22, 22') for guiding a traction cable (10) with first hand loops (6, 6') arranged at the ends of the traction cable (10) that are accessible to the patient, - at least one support module (3) for holding the cable guide module (5), and - at least one base module (2) which is detachably arranged on the patient's body in the area of ​​the back and supports the support module (3), wherein the cable outlets (22, 22') of the base tube (10) are arranged in the area of ​​the front of the body at a height above the patient's clavicles. Modular RVA according to claim 1, characterized in that a guide (21, 21') with outlets (24, 24') for at least one elastic band (12, 12', 13, 13') is further arranged on the Bowden tube (10), wherein one end of the elastic bands (12, 12', 13, 13') is secured against displacement at a band attachment point (15) on the cable guide module (5) and the ends of the elastic bands (12, 12', 13, 13') facing away from the outlets (24, 24') carry hand loops (7, 7', 8, 8') which are accessible to the patient's hands. Modular RVA according to one of claims 1 - 2, characterized in that the rope outlets (22, 22') and / or the outlets (24, 24') are arranged in a plane at the level of the patient's chin. Modular RVA according to one of claims 1 - 2, characterized in that the rope outlets (22, 22') and / or the outlets (24, 24') are arranged in a plane at a height above the skull roof of the patient. Modular RVA according to one of claims 1 - 4, characterized in that the first hand loops (6, 6') arranged at the ends of the traction rope (10) and which are accessible to the patient, and the hand loops (7, 7', 8, 8') arranged on the elastic bands (12, 12', 13, 13') are variably attachable in their positions with respect to the traction rope (10) and the elastic bands (12, 12', 13, 13'), respectively. Modular RVA according to one of claims 1 - 5, characterized in that a further hand loop, which can be grasped by the patient, is provided in the area of ​​one end of the traction rope (10).

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