Device for measuring, diagnosing and / or treating the strength of the human fingers, hand, arm and / or shoulder and its use for measurement and / or training

Description

[0001] The present invention relates to the field of medical technology, medical diagnostics, physiotherapy and medical rehabilitation and concerns a device for measuring, diagnosing and / or treating the forces of the human fingers, hand, arm and / or shoulder, as it can be used, for example, to measure the bending forces of the hand or arm, to detect problems in bending the hand or arm and to remedy these problems.

[0002] A device for measuring the flexion forces of the human hand or of the second to fifth fingers and the various flexion angles is known from DD-PS 204 206. These forces are measured by freely selecting the gripping parts on perpendicular lines, and by a gripping part, gripped by the second to fifth fingers and vertically adjustable to the height of each finger, in operative engagement with a force transducer. The movable gripping part is connected to a tension bolt, which has a flange at its opposite end. Under the force of a compression spring, this flange rests against the central region of the load cell, which coaxially surrounds the tension bolt without tilting. However, an accurate measurement of the flexion force of the thumb is not possible with this device.

[0003] The measurement of the flexion forces of the thumb is made possible by a device according to DE-PS 36 34 940, in which, using the construction described above, the horizontal and vertical angle of the longitudinal axis of a handle with abutment to the longitudinal axis of the tension bolt in operative engagement with the measuring transducer and its inclination relative to the horizontal plane in a second vertical plane perpendicular to the first by means of a rotating stand and two swivel joints, as well as the longitudinal and transverse distance of the handle to the finger pull handle connected to the tension bolt can be freely adjusted by means of a longitudinal and a transverse support.

[0004] Although the known devices enable precise measurements of the flexion forces of the human hand or of individual fingers in the direction of action of the force under biomechanically identical conditions, for hands of different sizes and at different flexion angles of the fingers of one and the same hand, they do not allow the measurement of the extension forces of the human hand or of its individual fingers, which are important for various fields of medicine.

[0005] From US 3 680 386 A a measuring device is known with which the magnitude of an impact force and also a tensile force can be measured for body parts.

[0006] Also known from EP 0 495 461 A1 is a device for measuring the forces of the human hand or its individual fingers by means of a force measuring transducer, in which the force measuring transducer comprises a tension bolt penetrating it and is surrounded by a housing, wherein a reversing disc is provided which is supported on the housing in the case of bending forces or tensile forces applied by an actuating part and a reversing disc is provided which is supported on the force measuring transducer in the case of extension forces or compressive forces applied by an actuating part.

[0007] Force transducers are force transducers with a measuring function. Force transducers are also called force sensors, where the force acting on a sensor is measured. Common force transducers include spring element force transducers, piezo force transducers, force transducers with oscillating elements, force transducers with electromagnetic compensation, and resistive force transducers (see Wikipedia for "force transducer").

[0008] Furthermore, from US 2012 / 255355 A1 a device for measuring the forces and dexterity of the hand is known, which contains a force sensor positioned in a front handle.

[0009] US Pat. No. 8,082,786 B1 discloses a portable device for testing work capacity. It includes a portable computer detachably connected to a dynamic force measuring and lifting device via a hub. A number of other devices and testing devices can be detachably connected to the hub. These additional devices and testing devices can be devices for testing finger clamp strength, finger flexion strength, handgrip strength, forearm strength, wrist strength, and even for testing whole-body coordination.

[0010] The disadvantage of the known technical solutions is that no multifunctional measurement, diagnostics and / or therapy of the forces of the human fingers, hand, arm and / or shoulder is possible with one device.

[0011] The object of the invention is to provide a device for measuring, diagnosing and / or treating the forces of the human fingers, hand, arm and / or shoulder, with the aid of which a multifunctional measurement, diagnosing and / or treating the forces of the human fingers, hand, arm and / or shoulder is possible on one device.

[0012] This object is achieved by the invention defined in the claims. Advantageous embodiments are the subject of the dependent claims, whereby the invention also includes combinations of the individual dependent claims in the sense of an AND connection, as long as they are not mutually exclusive.

[0013] The device according to the invention for measuring, diagnosing and / or treating the forces of the human fingers, hand, arm and / or shoulder consists of at least a base plate and force measuring transducers, at least one of which has a tension bolt penetrating it and this force measuring transducer is fixedly positioned on one side of the base plate and this force measuring transducer is non-positively connected to an actuating part via the tension bolt, furthermore on the side of the base plate opposite the fixedly positioned force measuring transducer and at least partially in the area of ​​the sides of the base plate adjoining this side there is a guide on or at which at least one movable force measuring transducer is positioned.

[0014] Advantageously, the force transducers of the device according to the invention are spring body force transducers, piezo force transducers, force transducers with oscillating elements, force transducers with electromagnetic compensation or strain gauge force transducers.

[0015] Also advantageously provided as the actuating part of the device according to the invention is a finger grip part, a hand grip part, a hand support, a thumb support or an elbow shell, wherein these actuating parts for the individual fingers are shaped for the right or left hand, arm or shoulder.

[0016] Even more advantageously, the handle part has device elements that realize the fixed positioning of the fingers during the measurement and / or therapy.

[0017] Advantageously, detachable connecting elements, bolts, locking screws or recessed grips are provided as device elements.

[0018] The force-locking connection between the tension bolt and the actuating part is advantageously realized via a quick-release fastener or locking screw.

[0019] It is also advantageous to use a rectangular plate made of wood, plastic or metal with or without upholstery elements as the base plate.

[0020] Even more advantageously, the base plate is adapted or adaptable in cross-section over its length to the shape of a forearm or hand.

[0021] Furthermore, the guide in the form of a U-shaped metal rail on the edge of the base plate or in the form of a groove on the outer edge of the base plate is advantageously provided on the side of the base plate opposite the stationary force measuring transducer.

[0022] And also advantageously, the guide serves to accommodate a fastening device for one or more force measuring transducers, which are arranged displaceably and fixably on or at the guide.

[0023] Also advantageously, axially and / or radially movable auxiliary devices are provided on and / or on the base plate, which serve to position the fingers, the hand and / or the arm and / or as abutments.

[0024] Advantageously, the axially movable auxiliary devices are provided for positioning or as abutments for the measurement and / or training of the fingers, hand and / or arm.

[0025] Also advantageously, the radially movable auxiliary devices are provided for positioning or as abutments for the measurement and / or training of the fingers, hand, arm or shoulder.

[0026] Also advantageously provided as auxiliary devices are a hand rest, a thumb rest or an elbow rest, said auxiliary devices being shaped for the right or left hand, right or left thumb or right or left elbow.

[0027] Advantageously, fixing elements for the fingers, hand, arm or elbow are provided as auxiliary devices.

[0028] Also advantageously positioned as an auxiliary device is a holding device for a further force measuring transducer, which is fixed in the area of ​​the stationary force measuring transducer, said holding device positioning a further force measuring transducer to the right and / or left of the base plate in the area of ​​the thumb or hand and is designed to absorb thumb forces or rotational forces of the hand or forearm.

[0029] The inventive use of the inventive device for measuring and training, or training the flexion, tensile, extension, rotation and / or compression forces of the human fingers, hand, arm or shoulder, wherein advantageously the strength of the muscles of the finger, hand, arm or shoulder is measured and trained or trained, and wherein advantageously the strength of the biceps, triceps or deltoid muscle is measured and trained or trained.

[0030] With the present invention, it is possible for the first time to provide a device in which the measurement, diagnosis and / or therapy of the forces of the human fingers, hand, arm and / or shoulder is possible on one device.

[0031] Starting from the known device for measuring the forces of the human hand or its individual fingers according to EP 0 495 461 A1, the device has been expanded according to the invention in such a way that it can be used not only for measuring, but also for diagnosing and / or treating the forces, but also for measuring, diagnosing and / or treating the forces of the arm and / or shoulder.

[0032] The device known per se consists of a force transducer which comprises a tension bolt penetrating it and is surrounded by a housing, wherein an actuating part for applying flexion forces or tensile forces is non-positively connected to the tension bolt, wherein a hand support is provided as an abutment for applying flexion forces and tensile forces, wherein an actuating part for applying extension forces or compressive forces is non-positively connected to a reversing disc, wherein an elbow abutment is provided for applying extension forces or compressive forces, wherein the reversing disc is supported on the housing when flexion forces or tensile forces are applied, wherein the tension bolt is displaceable in the axial direction relative to the reversing disc and the force transducer, and wherein when extension forces or compressive forces are applied,wherein the reversing disc and the force transducer are displaceable relative to the tension bolt and the housing.,

[0033] Based on this, the device according to the invention can now be used to measure the forces of the entire arm, including the shoulder, in various radial or axial directions on both the right and left arm, and to diagnose problems and then treat them.

[0034] The strength values ​​obtained, in conjunction with anthropometric measurements, can provide insights into people's physical development. They can be used as a normative basis for assessing the performance and health status of people suffering from diseases that impair the function of the shoulder joint.

[0035] The increase in shoulder strength is the origin of further improvements in shoulder performance. Targeted training leads to an increase in the strength of the shoulder muscles. The strengthened muscles can then relieve the strain on the joint socket and capsule. This reduces subsequent wear and tear and eliminates any causes or sources of inflammation. This, in turn, promotes mobility and enables even better training. Strength continues to increase, and the mobility of the shoulder, as well as the entire arm and hand, gradually improves. Training success is thus triggered by the increase in strength. The result is a regained quality of life, which is a consequence of the increased range of use of the arm.

[0036] With the solution according to the invention, both tensile and compressive forces, and thus both the flexion and extension, rotation, and compressive forces of the human hand or individual fingers, arm, or shoulder, can be measured, diagnosed, treated, and thus trained precisely and with comparatively little effort. The application of the device is not limited to medical tasks. The device can also be used in other technical systems where forces in opposite directions need to be measured.

[0037] A particularly advantageous feature of the device according to the invention is that the device can be adapted to the anatomy of the respective human body with little effort and that the various specified measuring, diagnostic and therapeutic options can be implemented.

[0038] In order to ensure that the most accurate measurement possible, the force transducers are designed as sensors with the smallest possible contact surfaces, and their positioning on the device according to the invention keeps measurement inaccuracies caused by friction to a minimum.

[0039] The device according to the invention consists of at least one base plate, which is advantageously rectangular in shape and made of wood, plastic, or metal, with or without padding for the resting parts of the human arm or hand. This base plate can also be adapted in cross-section along its length to the forearm and / or hand shape of the human body, or can be adapted to the specific forearm or hand shape of the patient.

[0040] Auxiliary devices can also be attached to or on the base plate. Such as a hand rest, a thumb rest, or an elbow rest, these auxiliary devices can be shaped for the right or left hand, right or left thumb, or right or left elbow. These auxiliary devices serve as fixation elements for the fingers, hand, arm, or elbow, or as abutments.

[0041] These auxiliary devices which can be used according to the invention can be anatomically shaped elements which serve for positioning or fixation or as abutments during measurement, diagnostics and / or therapy.

[0042] The auxiliary devices are attached using detachable connections, bolts, locking screws or a quick-release fastener.

[0043] The force transducers of the device according to the invention can be spring body force transducers, piezo force transducers, force transducers with oscillating elements, force transducers with electromagnetic compensation or strain gauge force transducers.

[0044] The device according to the invention further comprises at least one force measuring transducer which is fixedly positioned on one side of the base plate and a tension bolt penetrating it, which in turn is connected in a force-locking manner to an actuating part.

[0045] The actuating part can be a finger grip part, a hand grip part, a hand rest, a thumb rest or an elbow shell, whereby the shape of the actuating parts can be anatomically adapted to the human body, for example for the individual fingers for the right or left hand, arm or shoulder.

[0046] The actuating part can be a finger grip part, a hand grip part, a hand rest, a thumb rest or an elbow cup.

[0047] The actuating part can also be attached using detachable connections, bolts, locking screws or a quick-release fastener.

[0048] The actuating part can advantageously be combined with a finger grip and used with a hand rest as an auxiliary device. The hand rest ensures that the force originates only from the finger, and other forces from the hand, arm, or the entire human body are not measured.

[0049] Likewise, a hand rest in combination with an elbow rest can be used as an auxiliary device to hold the forearm in position for measuring shoulder strength.

[0050] If the strength of the hand is measured, diagnosed and / or treated, it is advantageous to use a handle that positions the fingers of the hand in a fixed position so that the fingers cannot slip together and press against each other during the measurement, diagnosis and / or therapy.

[0051] To enable this fixed positioning of the fingers on the handle, detachable fasteners, bolts, locking screws or grip recesses may be present, or the handle may have a curve that resembles the shape of a hand with bent fingers, or the handle may be fixedly adjustable from both sides of the fingers (on the side of the index finger and the little finger) with limiting devices to the width of the entire fingers.

[0052] The device according to the invention also makes it possible to measure thumb strength. The handle can also advantageously be fixed at an angle, allowing measurements, diagnostics, and / or therapy to be performed even on people with limited thumb, hand, or arm movement.

[0053] Furthermore, according to the invention, the base plate has a guide for at least one further force measuring transducer in order to be able to carry out the multifunctional measurement, diagnostics and / or therapy of the various forces on the finger, hand, arm or shoulder.

[0054] The guide is located on the side of the base plate opposite the stationary force transducer and at least partially in the area of ​​the sides of the base plate adjacent to this side.

[0055] The guide can be implemented by a U-shaped metal rail or groove on the outer edge of the base plate. This guide accommodates a fastening device for at least one additional force transducer, which, according to the invention, can be moved and fixed on or to the base plate. The force transducer is thus guided on and / or to the base plate and can be moved and fixed at multiple positions along the U-shaped metal rail or groove to measure the various forces on the finger, hand, arm, or shoulder.

[0056] This allows the force transducer to be guided around the forearm. More precisely, this means that the device does not need to be rotated, nor does the patient need to change their sitting position when measuring all shoulder forces on one arm. To avoid the problem of force dissipation during anteversion force measurements, the previously used knob can be replaced with an ergonomically optimized wooden handle, which can be attached to a holder, allowing direct, straight-line force application to the force transducer. The new wooden handle is available in various sizes, allowing the use of wooden handles of different sizes for hands of different sizes. This allows for more precise measurements, as almost the entire force can now be transmitted undivided to the force transducer. The second force transducer is used for retroversion and abduction force measurements.During abduction measurements, the torque acting on the forearm on the upper arm is eliminated because the force transducer is precisely positioned at the desired measurement point on the upper arm, the radial epicondyle. During retroversion, instead of the previous semicircular, concave wooden elbow shell, a wooden shell ergonomically adapted to the distal end of the upper arm is used as an auxiliary device, allowing force to be applied in the area of ​​the epicondyles (radial epicondyle and ulnar epicondyle). The device according to the invention achieves precise, direct force application to the two force transducers.

[0057] Standardized force application for different arm sizes is enabled, firstly, by the fact that the position of the movable force transducer can be adjusted once vertically and twice horizontally. Secondly, further ergonomic adaptation is achieved by using force transducer elements in different arm sizes that are much more closely adapted to the arm shape than before for measuring forces during abduction and retroversion. Furthermore, different grip sizes are available for different hand sizes for measuring forces during anteversion.

[0058] To standardize the measurement, biomechanically identical measurement conditions must be created for arms of different lengths by transferring the force to the measuring system at the same anatomical point, in contrast to the previous procedure. The radial epicondyle was selected as the anatomical reference point for force transmission when measuring arm forces during abduction. For measuring arm forces during retroversion, the outer line on the upper arm from the radial epicondyle to the ulnar epicondyle is the anatomical reference line for force transmission.

[0059] The positioning of the movable force transducer consists of a U-shaped guide with a horizontally continuously movable carriage. Vertical adjustability is achieved by the carriage consisting of two metal strips connected at right angles, with the force transducer movably connected to the vertical leg of the slide. The carrier can be fixed to the U-shaped guide with the help of a bolt, allowing it to be guided continuously around the supported arm and secured. The movable force transducer can be screwed firmly into any freely selectable position on either side and at the end of the base plate behind the elbow. In this way, the force transducer can be adjusted twice in the horizontal direction and once in the vertical direction.

[0060] Another movable force transducer can be positioned on a holding device fixed in the area of ​​the stationary force transducer. The holding device can be designed with a double angle and can be pivoted from the left to the right side of the base plate. With this holding device, the additional movable force transducer can be used for the measurement, diagnosis, and / or therapy of thumb forces of the right or left hand. Likewise, the measurement, diagnosis, and / or therapy of the rotational forces of the hand or forearm is possible with the help of a handle used as an additional auxiliary device, which positions the hand or forearm at different angles and exerts forces on the force transducer.

[0061] The device according to the invention for measuring, diagnosing and / or treating the forces of the human fingers, hand, arm or shoulder is used for measuring and training or training the flexion, tensile, extensile, rotational or compressive forces of the human fingers, hand, arm or shoulder.

[0062] The device is ideally used on a patient in two large phases. Each phase is characterized by repeated alternations between exertion of force and rest, with the rest periods in the second large phase being significantly shorter than in the first. As strength increases, the rest periods are shortened over the further course of treatment. Before beginning the entire training or exercise treatment, the starting level of hand closure strength on the left and right sides is documented in order to determine the initial state of strength performance. If only one hand is paralyzed, the performance of the healthy hand can serve as a target for the affected hand. It is important to note whether the patient is left- or right-handed. The primary hand must have approximately five to ten percent higher hand closure strength than the secondary hand. This must be taken into account when setting training goals.Depending on the strength deficits, all individual fingers or just a portion of the middle and distal phalanges are treated. However, in combination with a focus on individual fingers, the hand closure strength of the middle and often also the distal phalanges is almost always trained. It should be noted that treatment is specifically tailored to each patient according to the type of injury. Training usually takes place twice a week, with a total duration of 45 to 60 minutes each time, with exercises or training of five to six individual functions. The training intensity is always adapted to the patient's level of performance. To ensure optimal strength development, the device is secured to the table with screw clamps. The patient sits parallel to the device in an upright posture on a non-rolling, height-adjustable chair.This chair is adjusted so that the patient has his arm in the forearm rest almost in the neutral position and can grasp the handles.

[0063] Advantageously, the strength of the muscles of the finger, hand, arm or shoulder is measured and trained or trained, whereby advantageously the measurement and training or training of the strength of biceps, triceps and / or deltoid muscles takes place.

[0064] The device according to the invention with the actuating parts enables an accurate measurement of the forces in the individual fingers, the hand, the arm and / or the shoulder, in particular through the use of the extended device components and auxiliary devices.

[0065] With regard to the measurement of forces in the shoulder joint, an accurate measurement of the forces on the arm in the three directions of movement anteversion, retroversion and abduction is now possible with the device according to the invention.

[0066] The device according to the invention can be used to treat the strength and mobility of individual fingers, the hand, the arm or the shoulder.

[0067] The device according to the invention is described in more detail below using several exemplary embodiments.

[0068] This shows Fig. 1 a schematic overall view of the device according to the invention with a handle part as an actuating part Fig. 2 a schematic detailed view of the advantageous handle part as an actuating part Fig. 3 schematic detailed view of the advantageous arrangement with a further force measuring transducer for the measurement, diagnosis and / or therapy of thumb forces of the right or left hand and / or the rotational forces of the hand and / or the forearm with the aid of a handle used as a further auxiliary device Example 1

[0069] The device according to Figure 1has a rectangular wooden base plate 1 with the dimensions W x L x H = 60 x 20 x 3 cm, with two force transducers 2 and 3 arranged on the base plate 1. One force transducer 2 is fixedly positioned on one short side of the rectangular base plate 1 via a metal connection and has a metal tension bolt 4 penetrating it. The other force transducer 3 is arranged with a metal connection on the U-shaped guide 6 and can be moved both axially and radially relative to the base plate 1. The U-shaped guide 6 is made of metal and is guided along the long sides of the rectangular base plate 1 every 30 cm and is fastened to the base plate 1.

[0070] The tension bolt 4 penetrating the stationary force transducer 2 is force-locked to an actuating part 5 in the form of a handle.

[0071] A forearm pad is attached to base plate 1 as an auxiliary device, on which the forearm is supported. The padding also serves to immobilize the forearm. Additionally, a fixation device consisting of adjustable rods and screws is attached to base plate 1 at wrist level. This fixes the forearm as immobile as possible during measurement / diagnosis / therapy, allowing the force along the forearm axis to be measured when the hand exerts its force on the handle.

[0072] Instead of the handle portion, a finger grip portion can be provided. In this case, a hand support, such as a bolt, is advantageously provided to perform measurement, diagnostics, and / or therapy for the finger and minimize forces emanating from the hand, arm, or the entire human body. Example 2

[0073] On the base plate 1 according to Example 1, an elbow shell is additionally mounted on the opposite side of the stationary force transducer 2 as an auxiliary device, which is displaceable in the axial direction on the base plate 1 and serves as a fixation of the elbow and as an abutment.

[0074] After positioning the forearm on base plate 1 and securing the wrist and elbow, shoulder abduction is measured by measuring the force exerted on the side of the elbow using force transducer 3 positioned on guide 6. Force transducer 3 has previously been moved to the position of the elbow. A forearm pad and a wrist rest are located on base plate 1, which secure the wrist. The forearm is positioned on the forearm rest, and the hand grasps the wrist rest. The force transducer then measures the shoulder force when a force is exerted on the force transducer with the elbow. List of reference symbols

[0075] 1Base plate 2Force sensor 3Force sensor 4Tension bolt 5Actuator 6Guide 7Carrier 8Holding device 9Movable force sensor 10Handle as auxiliary device

Claims

1. Device for measuring, diagnosing, and / or therapy of the forces of human fingers, hand, arm, and / or shoulder, comprising at least a base plate (1) and force sensors (2, 3, 9), of which at least one has a tension bolt (4) passing through it, and this force sensor (2) is fixedly positioned on one side of the base plate (1) and is connected friction-locked to an actuating part (5) via the tension bolt (4). Furthermore, on the side of the base plate (1) opposite the fixed force sensor (2) and at least partially in the area of the adjoining sides of the base plate (1), a guide (6) is provided on or in which at least one movable force sensor (3) is positioned.

2. Device according to Claim 1, wherein the force sensors (2, 3, 9) are spring-body force sensors, piezoelectric force sensors, force sensors with oscillating elements, force sensors with electromagnetic compensation, or strain gauge force sensors.

3. Device according to Claim 1, wherein the actuating part (5) is a finger grip part, a hand grip part, a hand support, a thumb support, or an elbow shell, and these actuating parts (5) are shaped for the individual fingers, for the right or left hand, arm, or shoulder, and wherein the hand grip part includes device elements that enable the fixed positioning of the fingers during measurement and / or therapy, and wherein the device elements include detachable connecting elements, bolts, locking screws, or grip recesses.

4. Device according to Claim 1, wherein the force-transmitting connection between the tension bolt (4) and the actuating part (5) is achieved via a quick-release mechanism or a locking screw.

5. Device according to Claim 1, wherein the base plate (1) is a rectangular plate made of wood, plastic, or metal, with or without cushioning elements.

6. Device according to Claim 1, wherein the base plate (1) is adapted or adaptable in cross-section along its length to the shape of a forearm or hand.

7. Device according to Claim 1, wherein on the side of the base plate (1) opposite the fixed force sensor (2), the guide (6) is in the form of a U-shaped metal rail at the edge of the base plate (1) or in the form of a groove at the outer edge of the base plate (1).

8. Device according to Claim 1, wherein the guide (6) serves to accommodate a fixing device for one or more force sensors (3), which are arranged movably and fixably on or in the guide (6).

9. Device according to Claim 1, wherein axially and / or radially movable auxiliary devices are provided on and / or in the base plate (1), which serve for positioning the fingers, hand, arm, or as abutments.

10. Device according to Claim 9, wherein the axially movable auxiliary devices are provided for positioning or as abutments for the measurement and / or training of the fingers, hand, and / or arm.

11. Device according to Claim 9, wherein the radially movable auxiliary devices are provided for positioning or as abutments for the measurement and / or training of the fingers, hand, arm, or shoulder.

12. Device according to Claim 9, wherein the auxiliary devices include a hand support, a thumb support, or an elbow shell, and these auxiliary devices are shaped for the right or left hand, right or left thumb, or right or left elbow, or wherein the auxiliary devices include fixing elements for the fingers, hand, arm, or elbow.

13. Device according to Claim 9, wherein the auxiliary devices include a holding device fixed in the area of the fixed force sensor for an additional force sensor, and this holding device positions an additional force sensor to the right and / or left of the base plate in the area of the thumb or hand and is designed for measuring the forces of the thumb or rotational forces of the hand or forearm.

14. Use of a device according to Claim 1 for measuring and training, or for training the flexion, tension, extension, rotational, or pressure forces of the human fingers, hand, arm, or shoulder, wherein advantageously the force of the muscles of the fingers, hand, arm, or shoulder is measured and trained or trained, and wherein advantageously the force of the biceps, triceps, or deltoid muscle is measured and trained or trained.