Orthopedic joint devices and methods for their manufacture

Description

[0001] The invention relates to a method according to claim 1.

[0002] The invention also relates to an orthopaedic joint device according to claim 15.

[0003] The orthopaedic joint device is designed in particular as a prosthesis, orthosis or exoskeleton of the upper or lower extremity, especially for artificial ankle joints, artificial knee joints, artificial hip joints, artificial shoulder joints or artificial elbow joints.

[0004] Orthopedic joint devices such as prostheses, orthoses, or exoskeletons allow at least two components to pivot around a common axis, enabling an upper part to pivot relative to a lower part. In a prosthesis, the upper part of the joint can be connected to a prosthetic socket or an end-exoskeleton implant to fix a lower part and, if necessary, other prosthetic components to a limb stump. For example, in a lower extremity prosthesis, the socket is designed as a femoral socket connected to the upper part of a prosthetic knee joint, to which a lower leg section with a prosthetic foot is pivotally mounted. An actuator is positioned between the upper and lower parts to control the relative pivoting motion.Passive actuators influence or modify the pivoting motion by applying resistance in the opposite direction. This resistance is adjustable to create a customized pivoting behavior. This adjustment is based, for example, on sensor data, specific loads, accelerations, movements, or even external conditions. Passive actuators include pneumatic or hydraulic resistors, magnetorheological resistors, and other braking devices that convert kinetic energy into heat energy. Active actuators also exist, which can likewise influence the pivoting motion of the upper part relative to the lower part. Drives, such as motors or energy storage devices, can act as brakes during generator or charging operations.It is also possible to influence a pivoting movement via an active actuator in such a way that a pivoting movement occurs from a rest position or that a pivoting movement is supported. Activating the actuator can also counteract a pivoting movement without reversing it. An active actuator then also acts as a brake and modulates the pivoting movement.

[0005] Modern control systems use sensor data to influence the pivoting motion via the actuator, as the sensors capture status or motion data of the joint. Based on these sensor values, the actuator is activated, deactivated, or modulated, for example, to provide appropriate resistance after reaching a specific position, joint angle, or load, or to initiate or assist a pivoting movement. Furthermore, actuators are activated, deactivated, or modulated based on biosignals. Biosignals are signals captured by at least one biosignal sensor and transmitted to the control system.Biosignals are, in particular, signals that detect or represent muscle activity, the activation of a muscle, or the intention to activate it. This can be achieved, for example, through the mechanical detection of changes using a pressure cuff or similar device, through electromagnetic sensors that detect myoelectric or nerve signals, or through electromechanical sensors that detect the activities of a patient or user of the orthotic joint device via ultrasound or changes in length. The sensors for the direct or indirect detection of muscle activity or activation are the biosignal sensors. Based on the biosignals transmitted to the control unit, the actuator is activated, deactivated, or modulated to influence the pivoting movement.

[0006] WO 2021 / 124060 A1 concerns, among other things, a method for controlling an upper extremity prosthesis that is controlled via EMG data based on muscle contractions. In addition, data from an IMU or magnetic field data are acquired. The control signal for controlling the prosthetic device is generated based on the EMG data and at least data from one of the other two sensor types mentioned.

[0007] EP 3 285 694 B1 relates to a system for controlling a prosthetic or orthotic device comprising a first part and a second part connected by a joint. The joint has a neutral position, which is used during a gait cycle to set an angle between the two parts. A first sensor, designed as an EMG sensor, transmits signals from a first muscle to a controller. An actuator is connected to the controller and modifies the neutral position. Additional EMG sensors, as well as implanted sensors or accelerometers, gyroscopes, magnetometers, pressure sensors, angle sensors, or the like, are connected to the controller and modify the level of support provided by the actuator.

[0008] Certain adjustments to the orthotic joint device based on sensor data require the user to maintain specific states or positions for extended periods. If a joint device is to be locked in a particular position, for example, to provide a standing or holding function, the corresponding orthotic device must be held motionless or nearly motionless in a specific position for a certain period. The control system then recognizes that no further movement is expected and locks the joint device. This can be time-consuming and difficult.

[0009] The object of the present invention is to provide an orthopaedic joint device and a method for controlling it, which can make the use of the orthopaedic joint device easier and safer for the patient.

[0010] According to the invention, this problem is solved by a method with the features of the main claim and an orthopaedic joint device with the features of the dependent claim. Advantageous embodiments and further developments of the invention are disclosed in the dependent claims, the description, and the figures.

[0011] The method for controlling an orthopaedic joint device comprising an upper and a lower part, which are pivotally mounted to one another about a pivot axis, with an actuator coupled to the upper and lower parts and which influences a pivoting movement of the upper part relative to the lower part, wherein the actuator is coupled to a control device coupled to at least one sensor for acquiring status data of the joint device and which activates, deactivates, or modulates the actuator based on sensor values ​​of the at least one sensor, and with at least one biosignal sensor that detects muscle activity or the activation of one or more muscles as a biosignal and transmits it to the control device, wherein the actuator is activated, deactivated, or modulated based on the biosignal(s), provides thatThe actuator's influence on the pivoting movement against flexion, i.e., a change in flexion resistance, is increased based on a biosignal, and subsequently, this increased resistance to flexion is reduced based on sensor readings. This increase in flexion resistance, or the enhanced influence of the actuator on the pivoting movement against flexion, is based on a biosignal, for example, through the detection of a contraction or co-contraction, by recording nerve signals, or electromechanically by detecting a change in length, such as that of an attached sensor or liner. Thus, it is possible, for example, to lock a joint through a contraction or co-contraction. If the biosignal is absent, for example, due to a decrease in muscle tension,However, there is no reduction in flexion resistance, or at least not necessarily; rather, the increased resistance to flexion is reduced based on sensor readings—that is, sensor readings designed and intended to capture state data of the joint mechanism. The increased flexion resistance is maintained, regardless of any changes in the biosignal, until at least one sensor detects a movement or change in state of a defined magnitude. Thus, a threshold is set to trigger a reduction in flexion resistance, and the reduction is triggered by reaching, exceeding, or falling below this threshold. For example, the upper and / or lower part must be moved at a certain speed, such as pivoting.before the flexion resistance is reduced again. Certain load limits may also need to be exceeded or fallen below to trigger the reduction in flexion resistance. It is also possible for multiple limits to be exceeded or fallen below simultaneously. Furthermore, auxiliary variables can be calculated from multiple input signals, which are then compared with one or more threshold values ​​or limits to trigger a reduction in flexion resistance. In addition to control via limit values, the flexion resistance can be continuously and / or in several discrete steps based on sensor values. Alternatively or additionally, algorithms from signal processing, statistics, classification, machine learning, and / or artificial intelligence can be used for control via biosignals and / or sensors. Model-based methods can also be employed for control.

[0012] In one implementation, the increased flexion resistance is reduced solely based on sensor readings or a combination of sensor readings and a biosignal. Thus, even with continued muscle activation, a reduction in flexion resistance and, if necessary, assistance with flexion can only occur when corresponding state data such as acceleration, angular positions, spatial orientation, relative or absolute positions, changes in position, or loads are present, possibly in conjunction with a corresponding biosignal. Loads can include forces, moments, pressures, points of force application, and / or lever arms. The temporal derivatives and trends of state data can also be used for control.

[0013] In one embodiment, the sensors detect, in particular, a movement of the upper part or the lower part relative to each other or absolutely.

[0014] In one embodiment, at least one biosignal triggers an increase in flexion resistance, independent of the state of the orthotic joint device, and in particular independent of the position, load, and / or movement of the joint device, its upper part, or its lower part. Thus, a flexion lock or an increase in flexion resistance can be implemented in any state of the orthotic joint device. This is particularly advantageous for achieving rapid locking or a rapid increase in flexion resistance in emergency situations. A natural reflex in unforeseen situations, such as stumbling, is muscle tension, especially co-contraction. Such an involuntary co-contraction emits a strong biosignal that can be interpreted as an emergency locking mechanism or emergency response and always triggers an increase in flexion resistance.

[0015] Alternatively, the biosignal triggers the increase in flexion resistance only if no movement or change in state of the upper and / or lower part is detected by at least one sensor, or only movement or change in state below a threshold. Alternatively or additionally, the biosignal triggers the increase in flexion resistance only within a certain positional, absolute, and / or relative angular range, for example, a certain degree of inclination of the lower leg relative to the thigh or an external reference orientation, such as gravity, or within a certain knee angle range. Another alternative condition is, for example, a load, particularly an axial load against the direction of gravity of the upper and / or lower part, which must be detected before the increase in flexion resistance is implemented.This allows, for example, an increase in flexion resistance or a locking of the orthotic joint device only in certain situations, such as when a prosthesis, orthosis or exoskeleton is under load.

[0016] Sensor values ​​are provided in a configuration with one or more threshold values, which must each be exceeded or fallen below before the control device reduces the flexion resistance after an increase has occurred.

[0017] The orthopaedic joint device comprises an upper part and a lower part, which are pivotally mounted to each other about a pivot axis, with an actuator coupled to the upper part and the lower part, which influences a pivoting movement of the upper part relative to the lower part, wherein the actuator is coupled to a control device coupled to at least one sensor for acquiring status data of the joint device and which, based on sensor values ​​of the at least one sensor, activates, deactivates, or modulates the actuator, and with at least one biosignal sensor that acquires biosignals and transmits them to the control device, wherein, based on the biosignals, the actuator is activated, deactivated, or modulated, and the control device is configured as follows:to increase the influence of the actuator against flexion based on a biosignal and to decrease the increased flexion resistance based on sensor values, wherein the increased flexion resistance is maintained independently of a change in the biosignal until at least one sensor signal is detected by the at least one sensor (50) due to a movement, load and / or change of state of a defined magnitude. The actuator is configured as an active actuator with a drive, for example in the form of an electric motor or an energy storage device, or as a passive actuator that acts as a brake or damper.

[0018] The joint device may be arranged or formed on a lower or upper extremity, in particular as an artificial ankle joint, an artificial knee joint, an artificial hip joint, an artificial elbow joint, or an artificial shoulder joint.

[0019] The at least one sensor for recording status data or movement data of the orthopaedic joint device is arranged on the upper part and / or the lower part and records in particular positions in space, positions of the upper part and lower part relative to each other, forces, moments, accelerations, velocities and changes in state.

[0020] Biosignals are any biologically generated signals that enable the voluntary or involuntary control of an orthotic joint device. Biosignals can indicate the activation of one or more muscles. This activation can also refer to the intention to activate one or more muscles, particularly when the targeted muscle is no longer present or controllable, for example, due to paralysis. A biosignal can be an electrical signal, such as nerve signals from peripheral nerves, electrical signals during muscle contraction (EMG, electromyography), or signals from the central nervous system. Electrical signals can be recorded using electrodes. If information is encoded in a signal, it can first be decoded before being used for control.A biosignal can be a chemical or electrochemical signal, such as the concentration of a substance, the interaction of molecules, or an electrochemical gradient. These quantities can be determined, for example, via interaction with light, such as absorption or excitation by light followed by emission. Biosignals can also be the conductivity of tissues and / or body parts. Biosignals can also be mechanical parameters such as force, pressure, length, and / or their changes over time, for example, the pulse or the change in length of a muscle or structures within the muscle. These quantities can be determined, for example, by pressure sensors in a shaft or cuffs that detect the thickening of a muscle during contraction. Changes in length and geometry can also be determined using ultrasound. Biosignals can be acquired invasively or non-invasively.Invasive sensors include, for example, implanted myoelectric electrodes, electrodes placed around a nerve, or needle electrodes in the brain or spinal cord. Signals from invasive sensors can be transmitted wirelessly to avoid skin penetration. Power can also be supplied wirelessly via inductive power. In osseointegrative restorations using an end-exo implant, the sensors can be connected via the implant. Biosensors can also be partially invasive. For example, magnetic bodies can be invasively inserted into tissue, such as muscle or tendon, and the displacement of the magnets relative to each other during movement or muscle contraction can be detected by external sensors. Multiple methods can also be combined, or different biosignals can be detected, particularly to achieve greater robustness against interference and false detections. InIn one design, the control of the orthotic device is based on at least one biosignal associated with physical or intentional muscle tension, contraction, and / or activation of the musculoskeletal system, particularly via electromyography. Such a biosignal allows the wearer to influence the control. Various filters and signal processing algorithms can be applied to the acquired biosignals, and the resulting parameters can be used for control. This makes it possible, for example, to control the device via a biosignal only if the signal meets certain criteria, such as exhibiting a specific spectrum or temporal profile. For instance, a high-frequency alternating signal can be low-pass filtered and rectified, and this signal can then be used for control.In addition to the biosignal, calculated quantities such as time derivatives, integral quantities, statistical quantities or properties in the frequency domain can also be used for control.

[0021] In one implementation, the activation of one or more muscles is detected and used for control. For example, in a knee prosthesis or orthosis, a recording electrode can be placed on the front of the thigh to detect the contraction of the quadriceps femur or biceps femur, and this biosignal can be used for control. Control via a single muscle is particularly simple and cost-effective. It is also possible to detect the contraction of several muscles, but only use the contraction of one muscle or a subset of muscles for control. In multi-muscle control, co-contraction—the simultaneous contraction of two or more muscles—can be detected and used for control. A co-contraction does not necessarily have to involve the contraction of both an agonist and antagonist muscles.However, it is also possible to use different muscle activations or different muscles and / or muscle groups for control in different situations, movement phases, or modes. In some movement situations, certain muscles are involuntarily tensed, making it difficult to determine whether an increase in resistance is intended based solely on muscle activation. Furthermore, some muscles extend across joints, for example, simultaneously extending the hip and flexing the knee, which inevitably results in a knee extension moment during hip extension. This synergy can be used for particularly intuitive control.

[0022] In one implementation, machine learning and / or artificial intelligence methods are applied to the biosignals, and the resulting continuous or discrete information, such as classes, is used for control. Using pattern recognition techniques, different signal characteristics of one or more biosignals can be used to infer a specific activation response, for example, a specific activation pattern of multiple muscles or the distinction between voluntary and involuntary muscle contraction. This makes it possible to increase and / or decrease resistance only when a specific signal pattern is present. Alternatively or additionally, machine learning and / or artificial intelligence algorithms can also be applied to modify resistance and thus also to other sensor values.

[0023] InIn one configuration, control via at least one biosignal depends on a situation, a movement pattern, a movement phase, and / or a mode of the orthotic device. For example, the biosignal control can be configured differently in a special mode for cycling than in a mode for walking. It is also possible for the control to depend on the current movement pattern, for example, that a different control is active when walking straight ahead than when walking around a curve, or that a different control is active when walking quickly than when walking slowly. The control can also be modified depending on the movement phase. For example, a different control can be used in the terminal stance phase than in the early swing phase. The movement phases can be determined via the sensors.It is also possible that biosignal control is not active in specific modes, movement patterns, or phases of movement. Furthermore, the user can temporarily or permanently activate and / or deactivate biosignal control via interfaces such as controls or an app. Adjustments based on the situation, movement pattern, phase, and / or mode can affect both the criteria for increasing and / or decreasing resistance based on the biosignal and the parameters of this resistance increase and / or decrease, such as sensitivity or amplification of the resistance adjustment in relation to the biosignal, the extent of the resistance adjustment, or the type of resistance adjustment, such as a change in damping, stiffness, equilibrium position, and / or moment.

[0024] InIn one configuration, in addition to flexion resistance, at least one extension resistance is also increased based on at least one biosignal, possibly up to a complete lock. The criteria for increasing and decreasing the extension resistance, as well as the affected control parameters, may differ from those for flexion resistance.

[0025] InIn one configuration, flexion resistance remains elevated when controlled by a biosignal. This increase in flexion resistance refers to the resistance that would be present without biosignal control. For example, in a conventional standing function of a prosthetic knee joint, where flexion is completely restricted while standing, flexion resistance is reduced when the prosthesis is unloaded, the knee joint is extended, or the leg is rapidly rotated forward or backward. While this behavior is advantageous in many situations, it can be disadvantageous in others. Accordingly, in one configuration, when controlled by a biosignal, the resistance may remain elevated or, if necessary, restricted, even though other sensors would indicate a reduction in flexion resistance. In this case, the biosignal overrides or overrules the other sensors.

[0026] In one embodiment, the increase and / or decrease of flexion resistance is time-controlled and / or limited in its rate of change. Particularly when reducing flexion resistance based on at least one biosignal and / or other sensors, an abrupt reduction in resistance can be perceived as unpleasant or even unsafe. Accordingly, it is advantageous not to increase or decrease resistance abruptly, but rather continuously at a reduced or limited rate of change, even if the underlying biosignals change very rapidly or abruptly. For example, a time-dependent profile for the changes between the increased and normal flexion resistance can be stored and applied in the control system, or a low-pass filter can be applied.

[0027] In one embodiment, the change in flexion resistance, in particular the extent of the increase and / or reduction of the resistance, also depends on other parameters, which are detected, for example, by sensors, especially relative and segment angles, loads and / or their time derivatives and / or profiles. For example, the increase in flexion resistance can depend on a knee angle, a lower leg angle, a pivoting speed, or even an ankle or knee moment.

[0028] The described control methods can also be applied to a foot with a movable ankle joint or a hip joint. Multiple axes of a joint can also be controlled, for example, both flexion and extension as well as adduction and abduction of a hip joint. In the case of a foot, increasing resistance to dorsiflexion for standing is particularly useful. Based on one or more biosignals, resistance to dorsiflexion can be increased. If the biosignal is absent, the resistance to dorsiflexion is not necessarily reduced; instead, this occurs based on sensor values—that is, sensor values ​​designed to acquire state data of the joint mechanism. In the case of a hip joint, increasing resistance to hip flexion for standing is especially advantageous. The resistances of several joints can also be controlled simultaneously.

[0029] InIn one configuration, the flexion resistance is increased by one or more pulses of at least one biosignal. Only a brief activation via the biosignal occurs, whereby the flexion resistance initially remains constant after the biosignal ceases, and the subsequent reduction of the flexion resistance is based on sensor values.

[0030] In In one design, the flexion resistance of the orthotic device is increased in an unloaded state based on at least one biosignal. This can be useful, for example, to reposition a leg with an artificial knee joint, such as when getting into a car. Without the increased flexion resistance, the knee joint would be bent by the force of gravity acting on the lower leg and foot when the leg is lifted forward.

[0031] InIn one design, the flexion resistance increased by the biosignal is reduced again when a certain range of angular position, load, and / or speed is exceeded, or after a defined time. For example, with a leg prosthesis or orthosis, it is advisable for safety reasons to reduce the flexion resistance in a knee joint if a particularly strong backward or forward bending of the leg is detected, or if the leg rotates particularly quickly forward or backward. Reducing the flexion resistance can also be beneficial for safety reasons under particularly high loads to prevent overloading of the connection to the body or the body itself. In In such situations, involuntary activation via the biosignal by the user may occur, which necessitates reduction via sensor signals.

[0032] InIn one configuration, the increased flexion resistance is only partially reduced when the biosignal-based control is maintained. Only when the biosignal control is also reduced does the flexion resistance fully decrease to a corresponding resistance level. With such a control method, the flexion resistance can remain partially elevated due to the biosignal control, even though a greater reduction in resistance would occur based on the other sensors.

[0033] Increasing flexion resistance can start from a high, non-locking resistance, as is advantageous, for example, for a leg prosthesis to ensure stable, upright standing or during the stance phase of walking on varying surfaces and inclines. It is also possible to increase resistance from a very low or minimal level, such as during the swing phase of a leg prosthesis or when the prosthesis is unweighted. If the flexion resistance is increased by a biosignal, it can be reduced back to its initial level based on sensor data. Alternatively or additionally, it can be reduced to a minimal level. This is particularly beneficial for a leg prosthesis or orthosis during the terminal stance phase or when unweighted, to facilitate a smooth initiation of the swing phase or to actively support flexion.Despite continued activation by the biosignal, the reduction can be achieved based on status data of the prosthesis or orthosis, which are determined via sensors, for example based on a forward tilt of a lower leg and a load on the forefoot.

[0034] Exemplary embodiments of the invention are explained in more detail below with reference to the figures. The figures show: Figure 1 a schematic representation of an orthopaedic joint device; Figures 2 to 6 -different usage situations; Figure 7 - a schematic representation of the control function; Figures 8 to 12 - different control schemes; Figure 13 - Correlations between biosignal and resistance parameters; Figure 14 - schematic representations of an increase in resistance; as well as Figure 15 - another usage scenario.

[0035] In the Figure 1Figure 1 shows a schematic representation of an orthopaedic joint device in the form of a lower extremity prosthesis. The orthopaedic joint device comprises an upper part 10 and a lower part 20, which are pivotably mounted to one another about a pivot axis 15. To influence the relative pivoting of the upper part 10 to the lower part 20 about the pivot axis 15, an actuator 30 is arranged on both the upper part 10 and the lower part 20. In the illustrated embodiment, this actuator is designed as a hydraulic damper. In In alternative configurations, the actuator 30 can be equipped as an active actuator with a drive, for example an electric motor, a power storage device or another type of drive, to influence a pivoting movement of the upper part 10 relative to the lower part 20. InIn the illustrated embodiment, the actuator 30 is designed as a passive actuator and provides resistance to flexion and, if applicable, extension movements. The actuator 30 is coupled to a control unit 40, which in the illustrated embodiment is arranged on the lower part 20. The control unit 40 is coupled to sensors 50, which are arranged on the upper part 10 and / or the lower part 20. The sensors 50 detect state variables of the joint device, e.g., positions, orientations, forces, moments, accelerations, or orientations of components in space or relative to each other. A plurality of sensors can be used to detect the desired state variables of the orthotic joint device.The sensors 50 are coupled to the control unit 40 and transmit corresponding sensor data or sensor signals to the control unit 40. Based on the sensor values ​​or sensor data, the actuator 30 is modified with respect to its ability to influence the pivoting movement or pivotability of the upper part 10 relative to the lower part 20. For example, the flexion resistance and / or extension resistance is changed depending on the sensor values. This is achieved by adjusting valves or throttles. In an alternative embodiment, magnetic fields can be changed to alter the viscosity of magnetorheological fluids. In a mechanical braking device, braking forces can be increased or decreased to generate a customized resistance behavior of the actuator 30.In an active drive system that includes at least one electromechanical actuator, resistance to movement can be applied via currents and voltages, or movements can be assisted. In addition to applying torques and torque profiles, control algorithms and sensor information about the pivoting movement of the upper and lower parts can be used to track trajectories or emulate system properties in the sense of impedance or admittance control. For example, the behavior of a linear or nonlinear spring, the behavior of a damper, or inertia can be emulated, or a combination of several properties, thereby influencing a pivoting movement against flexion. Such control offers a high degree of flexibility. Pivoting movements can also be actively assisted using such control systems.If a moment or force is applied via an actuator without a pivoting motion occurring, for example, because external and internal forces are in equilibrium, the pivoting movement is also met with resistance. Actuators can also be used to activate and deactivate energy storage devices, such as hydraulic spring accumulators, change the gear ratios of drives, and / or engage or disengage them. These types of actuation can also be used to influence the pivoting motion. Resistances are forces and moments applied by actuators to influence a pivoting motion. A resistance can oppose a pivoting motion, but it can also assist a pivoting motion, meaning it can act in the direction of the pivoting motion.

[0036] Biosignal sensors 60 are formed on or attached to the upper part 10, for example, to a prosthetic socket or a holder. These sensors are designed to detect muscle activity or to control a muscle or musculature and generate biosignals that are transmitted to the control unit 40. The biosignal sensors 60, which may be configured as electrodes, are coupled to the control unit 40 via a conductive connection or wirelessly and transmit corresponding signals to the control unit 40. The control unit 40 then activates, deactivates, or modulates the actuator 30 based on these biosignals in order to change its resistance or to influence the movement or displacement of the components relative to each other.

[0037] In contrast to the design of the orthotic joint device as a prosthesis, it can also be designed as an orthosis, in which case, instead of the lower leg section (lower part 20), a lower leg splint is attached to an artificial knee joint. The upper part 10 is then a thigh splint that can be secured to the thigh using appropriate fastening devices such as straps, shells, or cuffs. The biosignal sensors 60 are either attached separately to the thigh or to another muscle group and can also be located on the fastening device. The orthotic joint device can also be designed as an exoskeleton, a special form of orthosis.As an alternative to the embodiment shown as an orthopaedic joint device for the lower extremity, the orthopaedic joint device can also be designed for an upper extremity, for example as an artificial shoulder joint or artificial elbow joint for a prosthetic arm or as an orthosis or exoskeleton for an arm.

[0038] The activation, deactivation, and, if necessary, modulation of the actuator to influence a pivoting movement or the pivotability of the joint mechanism is based on at least one biosignal from the biosignal sensor, such that the influence on the pivoting movement or pivotability against flexion is increased when a corresponding biosignal is present. Influencing the pivoting movement also includes locking the pivoting movement, so that the lower part 20 is locked relative to the upper part 10 and no relative movement occurs or can occur between the two parts. The influence on the pivotability of the upper part 10 relative to the lower part 20 can therefore be achieved by locking the joint in the flexion direction or by increasing the flexion resistance. This influence is effected by either a passive or an active actuator.To reduce the increased flexion resistance of the joint device, this is done based on sensor values, i.e., values ​​transmitted by sensor 50 or sensors 50 to the control unit 40, possibly in conjunction with or depending on a biosignal. Such control of the orthotic joint device, for example of a lower extremity, is advantageous and useful for a standing function where flexion, for example of the knee joint, is to be made more difficult or blocked.

[0039] In the Figure 2Figure 1 shows a user of an orthotic joint device for a lower extremity, comprising an upper part 10 with a prosthetic socket and a lower part 20 in the form of a lower leg section with a prosthetic foot attached distally. The upper part 10 is pivotable relative to the lower part 20 about the pivot axis 15. The actuator, as shown in the Figure 1The device shown is located in the lower part 20 and attached to the upper part 10 at its upper end. The user of the orthotic joint device is in a deep squat with weight-bearing on both legs. It is known from the prior art that when standing flexed and still, as detected by monitoring the knee angle, the resistance to flexion is increased until a relaxed standing position is possible. This is achieved, for example, by locking the knee joint or by applying an extension moment. To signal to the control unit that a corresponding function should be activated, the user must exhibit a predefined standard behavior and maintain the orthotic joint device in a specific state, for example, by assuming a steady, balanced position.This requires an increased extension moment and, if necessary, partial unloading of the side fitted with the orthotic joint device. Assuming such a position is difficult or even impossible in some positions, such as the deep squat shown, when there is high stress on the fitted side, or when weight is placed on the forefoot. Therefore, it can sometimes be difficult for a user to even meet the necessary conditions to activate the standing function in the conventional way. This is particularly challenging, demanding in terms of coordination, and strenuous in unstable positions.

[0040] The proposed method involves the activation of the standing functions with increased resistance to flexion being detected by at least one biosignal, which is captured by the biosignal sensor(s) and transmitted to the control unit. This biosignal, or multiple biosignals, can stop or slow down the flexion movement in situations where a user is unable to maintain a necessary equilibrium position for a certain period. Activating or modulating the actuator based on at least one biosignal may be the only way to achieve a stable standing position or to facilitate the process of assuming a standing position. Once the desired position is reached, the increased resistance to flexion can remain active, even without the continued presence of at least one biosignal.A user can therefore stand and remain in the deep squat shown much more easily.

[0041] In the Figure 3Another usage scenario for an orthotic joint device is depicted, namely descending stairs. When placing the prosthetic foot on a lower step, it is particularly difficult, if not impossible, to stop this movement and maintain a stable standing position because a high flexion moment is applied around the pivot axis 15, and no stabilization can occur via the prosthetic foot, as it only rests on the front edge of the lower step with its heel. The prosthetic foot rolls over the edge of the step. Activating a standing function in this situation using conventional methods is either impossible or extremely difficult for a user. By activating a biosignal, such as a muscle contraction or co-contraction, corresponding sensor values ​​are recorded by the biosignal sensors or recording electrodes and transmitted to the control unit, resulting in knee flexion or...Further knee flexion is met with increased resistance, possibly leading to a locking of the joint. Such control and increased resistance to flexion can occur dynamically when walking on stairs, particularly when slowing down or stopping on a step or incline, or alternatively or additionally when simply standing on the edge or at a sloping point, for example, on a ledge, a stone, an elevated area, or a platform. The increase in resistance is shown in the right-hand diagram. Figure 3Once the activation process is complete, a renewed movement of the fitted side with the orthotic joint device allows this increased flexion resistance or joint locking to be released, enabling the orthotic joint device to operate in a different mode. If the biosignal activation is terminated before the fitted side is sufficiently at rest and the criteria for activating a conventional standing function are not met, the resistance will decrease again as the biosignal activation diminishes.

[0042] In the Figure 4 Another possible application is shown, in which a user of the orthopaedic joint device stands in a bent-over position, as shown in the left drawing of the Figure 4As illustrated, in some situations the body position changes without altering the knee angle, for example, by the user bending further forward. With conventional control methods, the already assumed standing function is initially deactivated, thereby reducing flexion resistance. This occurs based on specific sensor readings and other parameters, such as knee extension, rapid movement of the upper or lower section, or complete unloading. By controlling the actuator via biosignals, the standing function can remain active with increased resistance if deactivation or activation would otherwise occur due to sensor signals during upper body, upper, or lower section movement. As shown in the left figure, the user initially stands relaxed in a bent position.During a change in upper body position, the orthotic joint device is controlled via a biosignal, for example, a contraction of the thigh muscles. This contraction is detected as electrical signals by biosignal sensors or electrodes and transmitted to the control unit. The orthotic joint device remains in the standing position. After the thigh muscles relax, no biosignal is present at the control unit, but the resistance via the actuator remains high because the user is still in a standing, static position. Only when movement of the affected side occurs is the standing position released and the flexion resistance via the actuator reduced.

[0043] Another situation is in the Figure 5The diagram shows a user of the orthotic joint device pulling an object (not shown). Starting from a flexed position, as depicted in the left-hand drawing, the person steps back with their untreated, healthy side to pull an object in front of them. A conventional standing function would be deactivated here because the treated side rotates backward, meaning the lower part 20 pivots around the ankle joint axis in a posterior direction. However, if a biosignal is transmitted via the biosignal sensors of the control unit, it is possible to voluntarily maintain the standing function even during the backward movement or posterior pivoting of the lower part 20 around the ankle joint axis.The biosignal activation can also be maintained in the position shown on the right, for example, if the person wants to ensure that the standing function remains active despite movement of the joint components. Only when the biosignal is no longer applied and the person is no longer standing still is the increased resistance to flexion reduced. However, once the person is standing still again, the biosignal activation can be terminated to allow for relaxed standing. This relieves the person both cognitively and muscularly. It is also possible that the standing function is activated or remains activated by the biosignal activation, even though activation would not normally be possible in this position based on the other sensor data.For example, if a condition is that a lower leg section must be vertical or inclined forward in the direction of walking before a standing function with increased flexion resistance is activated, this would be an obstacle to the position shown in the right-hand illustration of the . Figure 5 to provide a standing function. With the claimed method, it is possible to override the other conditions via the biosignal and, due to a higher prioritization by the biosignal, to increase the resistance to flexion.

[0044] Another situation is in the Figure 6The illustration depicts a lateral movement occurring within the frontal plane. In this example, the person takes a step to the left while the right side, which is controlled by the device, remains stationary. Conventional control systems do not respond to movements within the frontal plane, so a biosignal can be used to set a standing function with increased flexion resistance even in such situations. Increasing flexion resistance during lateral movement via a biosignal is useful, for example, during a dynamic change of direction from forward movement to a combined forward and lateral movement, enabling the person to push off from the controlled side. In the terminal stance phase, despite control via the biosignal, the flexion resistance of the knee joint can be reduced based on other sensors to initiate a swing phase or to support flexion for the swing phase.

[0045] In the Figure 7The basic functional scheme of the control system is shown. Biosignals B and other information X provided by sensors or data sources, such as sensor signals about state variables, internal states, or external data, are processed by a controller C, which is stored and housed in a control unit. The controller C of the control unit then controls the actuator 40. The conventional information X typically includes kinematic quantities such as knee angles, segment angles, ranges of motion, distances, lengths and orientations of a leg tendon, velocities, accelerations, and the like, as well as kinetic quantities such as forces, moments, lever arms, points of force application, and the like. Furthermore, external information X can originate from adjustment devices, apps, other prosthetic components, or a data cloud.The biosignals B are, for example, data relating to muscle tension, which are derived or recorded via electromyographic sensors, ultrasound, magnets, pressure sensors, direct nerve sensors, and the like. The control unit C in the control device generates an input variable for the actuator 40 and thus a manipulated variable, for example, regarding the position of the joint, the position of a valve, the opening or closing of a valve, via velocities, torques, current, stiffnesses, damping, impedance, and the like.

[0046] In the Figure 8 An embodiment of a control system for increasing the flexion resistance is shown schematically. The input variable X for sensor values ​​of sensors 50 according to the Figure 1The upper group shows the activation or deactivation of actuator 40; the middle curve shows the activation signal A over time; the lower curve shows the biosignal B over time. The right-hand representation of the Figure 8Two of the actuator states and their conditions are shown. The first state, AL, denotes a state in which actuator 40 exhibits normal resistance behavior, i.e., it has a low flexion resistance or is open. Actuator state AH corresponds to the state with increased resistance, possibly a blocked actuator that prevents flexion. If the biosignal B is greater than a threshold value β1 and, in addition, the sensor values ​​or conventional quantities X are within a range that would normally lead to the activation of a standing function (symbolized by < ξ), the actuator switches from state AL with low flexion resistance to state AH with high flexion resistance.The control system is only activated when both the condition(s) for the sensor values ​​X of the state sensors 50 and the conditions for the biosignals B via the biosignal sensors 60 are simultaneously met. This means, for example, that the system is sufficiently at rest and under load, and that, furthermore, it is receiving a signal from the biosignal B. Deactivation, i.e., a switch from state AH to state AL, occurs when either of these conditions is not met. Therefore, if no biosignal B of sufficient magnitude or intensity is present, or if a limit value ξ for the sensor values ​​or state data X is exceeded, the flexion resistance is reduced again. Such an implementation can be useful, for example, when an accidental increase or maintenance of the resistance is particularly undesirable, such as in a special mode like cycling.Expressed in the curves, the orthotic joint device is at rest at time t1, and no biosignal B is present. The resistance of actuator 40 is therefore low, as shown in curve A. Between times t1 and t2, the biosignal B increases, for example, due to the contraction of the thigh muscle. Consequently, the resistance A provided by actuator 40 also increases, with the increase being proportional to the muscle signal. At time t3, a sufficient change in the state of the orthotic joint device occurs, indicated by the increase in the values ​​X. Therefore, the resistance of actuator 40 decreases, even though the biosignal B is still present.

[0047] In the embodiment according to the Figure 8 The biosignal B is overruled by the sensor values ​​X.

[0048] In the Figure 9 This shows a variant of the control system in which deactivation, i.e., a reduction in flexion resistance, only occurs when there is no activation by the biosignal B and the other conditions are no longer met by the state data X of the joint mechanism. Activation occurs as shown in the diagram above right. Figure 9 The activation of actuator 40 depends solely on the biosignal B; in the illustration below right, activation occurs when either the biosignal B is sufficient or the sensor values ​​X for status data of the orthopaedic joint device are of a magnitude that would result in activation of the standing function and an increase in flexion resistance.

[0049] At time t0, the orthotic joint device, in the form of a leg orthosis or prosthetic leg, is in a forward motion and is not being activated by biosignal B. Between times t0 and t1, the activation signal A is increased by biosignal B. Although the leg continues to rotate forward, which would not normally trigger a standing function based on the sensor values ​​of the state data X, the resistance is increased via the activation of actuator 40 according to curve A. This increase in flexion resistance reduces and stops the movement between the upper and lower parts, and the movement of the orthotic device is decelerated, as evidenced by the decrease in the sensor values ​​of the state data X.Biosignal B is reduced when the joint is braked and locked, for example, by muscle relaxation, so that the intensity of biosignal B decreases from time t2 onwards. The increased resistance to flexion persists, which is reflected in the consistently elevated curve A. The person can stand relaxed. If the joint is then moved again, which can be seen in the rising values ​​of the X-curve, the resistance to flexion decreases, which is indicated by the falling curve A.

[0050] The upper right diagram illustrates the conditions for switching from state AL to state AH, namely when the biosignal B is sufficiently large and of sufficient quality to trigger the actuator, switching it to an increased resistance. If the biosignal B is subsequently reduced or disappears (i.e., if the biosignal B is < β2), the state of increased flexion resistance persists. The same occurs if a biosignal B greater than β3 is present again, ensuring sufficient signal quality for activation.Only when the orthotic joint device moves again without simultaneous activation via the biosignal, i.e., when the state values ​​X > ξi (i.e., are outside a range that would normally lead to activation of a standing function with increased flexion resistance), is the flexion resistance reduced and state AL is assumed. In the lower right illustration, an increase in flexion resistance is executed when one of two conditions is met: either the biosignal B is greater than a threshold β that would justify activation of the actuator, or the sensor values ​​for the state variables are within a range that would normally lead to activation of the standing function and an increase in flexion resistance. Unlocking or...A reduction in flexion resistance only occurs when the sensor values ​​for the status data X for the joint device are outside a range that would normally lead to an increase in flexion resistance, for example, when the entire prosthesis is lifted and pivoted without simultaneous control via the biosignal.

[0051] In the Figure 10The control system for a special mode is shown. This special mode could, for example, be a special function for cycling, in which periodically recurring movements are performed. Within such a mode, it is possible for the resistance to increase solely due to the biosignal B. At time t1, the biosignal B is increased until time t2, for example, by increasing muscle contraction. The biosignal B remains at a higher level than at time t1. Along with the increase in biosignal B, the actuator is activated, resulting in an increase in flexion resistance, as shown in the middle curve A. Even after the reduction and maintenance of muscle tension at an elevated level above a threshold from time t2 to time t4, the flexion resistance remains at an elevated level.The increase in resistance can also be triggered by the quality of biosignal B, for example, by a significant impulse or by maintaining biosignal B for a certain period. The conditions for the quality of biosignal B serve to prevent an accidental increase in flexion resistance. Only when biosignal B occurs again at time t4 above a certain level, and possibly falls again, is the resistance reduced. The movements change accordingly, which can be detected by the values ​​of the state data X. This data can be used to activate a different control strategy or control mode. For example, when cycling, these switches can be used to stand up and stand on the pedals. Pedal movements or vibrations alone should not be decisive for activating or deactivating the increased resistance.

[0052] In the Figure 11 is a variant of the control according to the Figure 9The diagram shows that the locked position or increased flexion resistance is indicated by the high value of curve A. No activation occurs via biosignal B. For example, the person using the orthotic joint device is standing relaxed in a flexed position. Biosignal B can now anticipate a situation in which the resistance of a conventional control would be reduced, for example, if the state data X would result in unlocking or a reduction in flexion resistance.If, at time t0, an activation via biosignal B occurs when resistance is already elevated, and movement of the orthotic joint device is only subsequently performed (represented by the rising and falling curve in the period between t1 and t2 of the upper curve X), the resistance remains high during the movement in this period, as expressed by the constant curve A. When the movement ends at time t2, biosignal B can also be reduced, which occurs in the period between t2 and t3. Furthermore, from time t2 onwards, the conditions for a reduction in flexion resistance based on the sensor values ​​of the state data X are within a range where no unlocking would occur, so the locked position or standing function of the lower extremity orthotic joint device remains intact.The flexion resistance remains high; unlocking does not occur.

[0053] In the Figure 12 Another control variant is shown, in which a flexion movement is represented via the knee angle φk. The knee angle φk is shown in the upper diagram. At the beginning of the control, there is normal or low resistance for the actuator A. A biosignal B is not present, and the knee joint is in a sufficiently extended position. If the orthotic joint device, for example, in the form of a prosthesis as in the Figure 3The artificial knee joint is moved to the next lower stage and flexes in a controlled manner under load. This occurs between time points t0 and t1. To reduce the flexion, an initial biosignal B at an elevated level, for example, a moderate muscle activation, is applied to the control system from time point t1 onwards to achieve a moderate resistance. This resistance is built up from time point t1 and maintained until time point t2. This allows for a controlled deceleration of the flexion movement without abruptly stopping it. At time point t2, the movement is to be stopped. To achieve this, the biosignal B is increased in the period between time points t2 and t3, for example, by a maximal contraction of the corresponding muscle.This maximizes the resistance A provided by the actuator and slows the change in knee angle φk, so that the movement comes to a standstill at time t3. The biosignal B can be terminated at time t4, when the knee flexion has completely ceased and a standing function is established, meaning that muscle tension or muscle activation can be reduced. The resistance from the actuator remains high, however, until a corresponding cancellation signal is sent to the control system.

[0054] In addition to or as an alternative to control via simple threshold values, continuous transitions between the resistances can be implemented. For example, criteria can be partially met, leading to a partial increase or decrease in resistance.

[0055] In the Figure 13Different relationships between the biosignal B and the resistance parameter P are shown. Control via the biosignal B increases the actuator's resistance, thereby influencing different parameters P of the resistance. This is shown in the Figure 14 This will be explained in more detail. The type of influence can be continuous or proportional, meaning that increased activation of the muscles or biosignal B results in increased resistance, as shown in the left diagram. Figure 13 The relationship between the biosignal B and the resistance parameter P need not be linear. Alternatively, the adjustment can be binary, meaning that a fixed increase in resistance is implemented starting at a specific threshold or thresholds of the biosignal B. This is shown in the middle representation of the Figure 13The adjustment of the resistance parameter P can also exhibit saturation ranges, such that a further increase in the activation by the biosignal B does not lead to a further increase in resistance. This is shown in the right-hand diagram. Figure 13 The different types of adjustment can also be combined with each other, and they can also be applied differently in different situations; for example, a binary adjustment can be used when cycling, while a proportional adjustment is used when standing still.

[0056] In the Figure 14Different types of resistance increase are illustrated using the examples of spring-like and damping behavior, where a resistance modulus τ is plotted against the knee angle φi. The resistance modulus τ is applied against or with a movement to influence the pivoting motion. In spring-like behavior, an equilibrium position can be altered by the biosignal B. When generating a knee-extending moment, which is achieved by bending against a spring-like behavior, the equilibrium position of the spring can be shifted towards a smaller knee angle when controlled by the biosignal B. At the same knee angle φi, a higher knee-extending moment then occurs. The spring stiffness can also be changed, as shown in the middle illustration. Figure 14This is illustrated. In the case of damping behavior, the damping coefficient can be increased by controlling it via the biosignal B. For nonlinear characteristics, several coefficients must be changed accordingly, or the corresponding characteristic curve is shifted towards higher moments. Increasing and / or decreasing resistance can therefore also increase and / or decrease stiffness, an equilibrium point, damping, and / or the like. Other parameters of such characteristics can also be adjusted to change resistance, for example, the progressiveness. Several characteristics can also be combined, for example, a spring-like and a damping behavior.Alternatively or additionally to the knee angle, φ can represent another degree of freedom of rotation of the orthotic device, which is met with resistance or whose rotation is influenced by an actuator. Alternatively, it can also represent another state of the orthotic device detected by the sensors, such as the absolute angle of the upper or lower part or the load. The biosignal can, of course, also directly influence the torque or force applied by the actuator, either in opposition to or in conjunction with the rotation, particularly in a proportional relationship, which corresponds to a reduction and / or increase in resistance.

[0057] In the Figure 15Another usage scenario of an orthotic joint device is depicted, namely the repositioning of the fitted leg. In the starting position shown on the left, the user is in a slightly bent posture. A standing function of the orthotic device is active and provides corresponding resistance against knee flexion and dorsiflexion. For repositioning, the fitted side is unloaded, the leg is moved forward, in this case onto a heel edge, as shown in the right-hand illustration, and then weight is applied again. Unloading or pivoting the leg would deactivate a standard standing function and reduce the resistance in the knee or ankle.Assuming a position like the one shown on the right and bearing weight on the prosthesis would be extremely difficult, as it is a very unstable position and both the knee and ankle joints would experience a strong bending moment. However, if a biosignal is transmitted via the biosignal sensors, e.g., the electrodes of the control unit, it is possible to voluntarily maintain the standing function even during unloading and repositioning, in this case essentially a pivoting motion around the hip. After repositioning and weight-bearing, the control via the biosignal can be discontinued from this quasi-static situation, while the standing function remains active. This is possible because the reduction of resistance is based on sensor data, in particular sensor data about the state of the orthotic device.In the depicted case of repositioning, it is advantageous to increase not only the resistance to flexion, but also the resistance to extension at the knee and / or plantar flexion at the ankle joint based on the biosignal, possibly even to the point of complete locking. If the biosignal disappears after repositioning, the resistance to extension and / or plantar flexion can be reduced again.

Claims

1. A method for controlling an orthopedic joint device comprising an upper part (10) and a lower part (20), which are mounted articulated to one another so that they can pivot about a pivot axis (15), comprising an actuator (30), which is coupled to the upper part (10) and to the lower part (20) and influences a pivoting movement of the upper part (10) relative to the lower part (20), the actuator (30) being coupled to a control device (40), which is coupled to at least one sensor (50) for recording state data of the joint device and activates, deactivates or modulates the actuator (30) on the basis of sensor values of the at least one sensor (50) and comprising at least one biosignal sensor (60), which records a muscle activity or a stimulation of at least one muscle as a biosignal and transmits it to the control device (40), the actuator (30) being activated, deactivated or modulated on the basis of the biosignal or the biosignals, wherein the resistance to the pivoting movement by the actuator (30) against a flexion is increased on the basis of at least one biosignal, and the increased resistance against a flexion is subsequently reduced on the basis of sensor values, characterized in that the increased flexion resistance is maintained, independently of a variation of the biosignal, until at least one sensor signal due to a movement, load and / or state change of a defined size is detected by the at least one sensor (50).

2. The method as claimed in claim 1, characterized in that the increased flexion resistance is reduced only on the basis of sensor values or on the basis of a combination of sensor values and at least one biosignal.

3. The method as claimed in claim 1 or 2, characterized in that the sensors detect a movement of the upper part (10) or of the lower part (20) absolutely or relative to one another.

4. The method as claimed in one of the preceding claims, characterized in that the biosignal triggers the increase of the flexion resistance independently of the position, load and / or movement of the joint device or of the upper part (10) or of the lower part (20).

5. The method as claimed in one of claims 1 to 3, characterized in that the biosignal triggers the increase of the flexion resistance only if no position, movement or state change of the upper part (10) and / or lower part (20), or one that lies below a limit value, is detected by the at least one sensor (50) and / or a load above a limit value, in particular an axial load against the direction of gravity, of the upper part (10) and / or lower part (20) is detected.

6. The method as claimed in one of the preceding claims, characterized in that the sensor values must exceed or fall below a threshold value before a reduction of the flexion resistance is initiated.

7. The method as claimed in one of the preceding claims, characterized in that the flexion resistance is reduced despite stimulation via the at least one biosignal on the basis of the at least one sensor signal of the at least one sensor (50) due to a movement, load and / or state change of a defined size.

8. The method as claimed in one of the preceding claims, characterized in that the extent of the increase and / or of the flexion resistance is varied on the basis of the position, the movement, the load, the state change, the mode and / or the movement phase.

9. The method as claimed in one of the preceding claims, characterized in that the at least one biosignal is a myoelectrical signal, which is recorded in particular by implanted electrodes or electrodes fitted on the surface.

10. The method as claimed in one of the preceding claims, characterized in that the flexion resistance is increased to the extent of blocking.

11. The method as claimed in one of the preceding claims, characterized in that the flexion resistance is reduced on the basis of at least one sensor value to a level below the initial resistance before increasing the flexion resistance, particularly in a terminal stance phase.

12. The method as claimed in one of the preceding claims, characterized in that, in at least one mode or at least one movement phase, the stimulation of a muscle or a muscle group is recorded and employed for the control.

13. The method as claimed in one of the preceding claims, characterized in that, in at least one mode or at least one movement phase, the cocontraction of at least two muscles or muscle groups is recorded and employed for the control.

14. The method as claimed in one of the preceding claims, characterized in that the flexion resistance is increased continuously with increased activation of the musculature and / or reduced with reduced activation and / or the flexion resistance is controlled digitally by the activation of the musculature.

15. An orthopedic joint device comprising an upper part (10) and a lower part (20), which are mounted articulated to one another so that they can pivot about a pivot axis (15), comprising an actuator (30), which is coupled to the upper part (10) and to the lower part (20) and influences a pivoting movement of the upper part (10) relative to the lower part (20), the actuator (30) being coupled to a control device (40), which is coupled to at least one sensor (50) for recording state data of the joint device and activates, deactivates or modulates the actuator (30) on the basis of sensor values of the at least one sensor (50) and comprising at least one biosignal sensor (60), which records biosignals and transmits them to the control device (40), the actuator (30) being activated, deactivated or modulated on the basis of the biosignals, wherein the control device (40) is adapted to increase the influencing by the actuator (30) against a flexion on the basis of a biosignal and to reduce the increased flexion resistance on the basis of sensor values, characterized in that the increased flexion resistance is maintained, independently of a variation of the biosignal, until at least one sensor signal due to a movement, load and / or state change of a defined size is detected by the at least one sensor (50).

16. The orthopedic joint device as claimed in claim 15, characterized in that it is formed as a joint device of the lower extremity, in particular an orthotic hip joint, prosthetic hip joint, orthotic knee joint, prosthetic knee joint, orthotic ankle joint, prosthetic ankle joint or as a joint device of the upper extremity, in particular as an artificial elbow joint or artificial shoulder joint an orthosis, prosthesis or of an exoskeleton.

17. The orthopedic joint device as claimed in claim 15 or 16, characterized in that the at least one sensor (50) is arranged on the upper part (10) and / or on the lower part (20).