Hand orthosis or hand prosthesis, and system consisting of a hand orthosis or hand prosthesis and counter element

Abstract

The invention relates to a hand orthosis or hand prosthesis comprising a support part (20) and at least one finger portion (30) which is arranged distally on the support part (20) and mounted so as to be pivotable relative to the support part (20), the finger portion (30) being formed in multiple parts by a plurality of finger parts (34, 36, 38) which are articulatedly mounted on one another, a coupling rod (80) being coupled to a distal finger part (36, 38) and a proximal finger part (34, 36) or the support part (20) so as to overlap two joints and so as to transmit force, the coupling rod (80) being mounted once palmarly and once dorsally with respect to the relevant pivot pin (35, 37) of the joints.

Description

[0001] Hand orthosis or hand prosthesis and system consisting of hand orthosis or hand prosthesis and counter element

[0002] The invention relates to a hand orthosis or hand prosthesis with a support part and at least one finger section which is arranged distally on the support part and is pivotably mounted relative to the support part, wherein the finger section is formed in several parts from several finger parts which are hinged to one another, and to a system comprising such a hand orthosis or hand prosthesis and a counter element.

[0003] Hand orthoses are orthoses that are at least partially attached to the hand and that make it possible to influence movements of the entire hand relative to the forearm and / or finger movements. This can be achieved, for example, by supporting certain movements or resisting certain movements. Likewise, certain movements can be blocked or the finger joints or limbs can be guided relative to each other using an orthosis.

[0004] Hand prostheses replace hands that are no longer present or no longer exist and are intended not only to have a purely cosmetic effect but also to partially replace the functions of a natural hand. Hand prostheses or prosthetic hands have a base body or a support part on which at least one artificial finger or finger section is arranged distally. A thumb element is often arranged on the base body and provides a component opposite the finger element or the artificial fingers. A finger section or prosthetic finger can be movable, in particular articulated, on the support part and can be moved via an actuator. There are motor-driven prosthetic hands in which the drive is arranged as an electric motor within the support part or the base body. There are also prosthetic hands driven by a cable pull and with a gripping function, in which the cable pull is attached, for example, to the patient's shoulder.

[0005] DE 202015 008 342 U1 relates to a hand orthosis with a forearm brace and a metacarpal span connected to the forearm span via a connecting piece. It has at least one flexible, elastic element attached to the metacarpal brace, extending essentially in a distal-proximal direction, and a fastening element arranged in the region of the distal end of each elastic element for fastening a finger. Due to the flexible, elastic element extending along the finger, such a hand orthosis creates a restoring force acting on the finger when the finger is deflected from a predetermined rest position by flexion or extension. Such an orthosis can be particularly advantageous in cases of partial paresis, which can arise, for example, from injuries or a stroke.

[0006] US Pat. No. 9,861,500 B2 discloses a prosthetic gripping unit comprising a base body and two finger parts mounted on the base body so that they can pivot relative to each other. An electric motor is arranged within the base body to drive one of the two finger parts. An actuating lever is also arranged on the base body and is actuated via a Bowden cable.

[0007] DE 10 2017 130 082 B4 discloses a prosthetic hand with a thumb element and at least one finger element. The thumb element is displaced relative to the one finger element by a control force and is movable along a first trajectory in a first mode and along a second trajectory in a second mode. The prosthetic hand has a force application element that applies a restoring force to the thumb element that is opposite to the control force. The control force is applied via a tension element that is arranged on a shoulder or torso of the wearer of the prosthetic hand.

[0008] EP 2 512 758 B1 relates to a device having a first link and a second link, wherein the first link is coupled between a first and a second joint. The first joint is adapted for coupling to a base element to enable articulated mobility of the first element relative to the base element. A first differential is configured to receive torque and transmit torque to the first and second joints. A stop limits the rotation of the second joint. A stop connecting piece is arranged between the first joint and the stop to move the stop based on the degree of twist of the first joint. In order to be able to displace the first link, a drive is provided which pivots a pivoting part pivotally arranged on the first link via a first connecting rod.On the opposite side of the pivoting part, a second connecting rod is arranged, which is fastened to the second link and pivots the second link relative to the first link when the pivoting part is displaced.

[0009] The object of the present invention is to provide an improved hand orthosis or hand prosthesis that facilitates daily tasks.

[0010] This object is achieved by a hand orthosis or hand prosthesis having the features of the main claim. Advantageous embodiments and further developments of the invention are disclosed in the subclaims, the description, and the figures.

[0011] The hand orthosis or hand prosthesis with a support part and at least one finger section which is arranged distally on the support part, wherein the finger section is pivotally mounted relative to the support part and is formed from several finger parts which are articulated to one another, is characterized in that a coupling rod is coupled to a distal finger part and a proximal finger part or to the support part across two joints and in a force-transmitting manner, wherein the coupling rod is mounted once palmar and once dorsal to the respective pivot axis of the joints. As a result, during a flexion movement, for example around the metacarpophalangeal joint, a flexion movement of the middle joint and possibly also of the end joint of the finger will occur simultaneously. A corresponding displacement or movement is carried out on the thumb part if necessary.This has the advantage that not all finger parts or components of the thumb part have to be subjected to a separate restoring force or adjustment force. In addition, the movements of the individual finger parts and, if applicable, the components of the thumb part are coordinated in a simple manner. For example, the coupling rod is coupled to a distal finger part or a distal component and a proximal finger part or proximal component or the support part across two joints, whereby no adjustment force for adjusting the proximal joint component is applied directly to it via the coupling rod. Adjustment takes place via a different force introduction point, whereby the proximal joint component can also be adjusted.Due to the arrangement of the bearing points of the coupling rod on opposite sides of a connecting line between the joint axes, when the proximal phalanx is pivoted relative to the support part, the medial phalanx can simultaneously pivot relative to the proximal phalanx, so that a closing hand with curling fingers can be achieved with only one drive, e.g. motor or spring, or a displacement of the proximal phalanx, e.g. by a muscle.

[0012] In one embodiment, the hand orthosis or hand prosthesis comprises an actuator whose distal end is coupled to the finger portion and which displaces the finger portion from an initial position, possibly counteracting the elastic restoring force, into a use position. In one embodiment, the actuator is coupled proximally to the support part to a form-locking element that can be reversibly engaged with a correspondingly designed counter-element, wherein the counter-element advantageously comprises a fastening device for securing it to the torso, shoulder, or a limb of the user. The initial position of the finger portion can be flexed or extended, i.e., it can have bent or stretched fingers.

[0013] In one embodiment, the finger parts are resiliently mounted on one another and / or on the support part in the starting position, so that after an adjustment from the starting position to a use position, they are automatically reset once the adjusting force is removed. By designing the finger section with multiple finger parts, a use with the hand orthosis that approximates natural hand movement and finger movements is possible. In one embodiment, the thumb part is also made of several parts, the individual components of the thumb part are preferably articulated to one another, in particular articulated to one another in a starting position against a spring force. From this starting position, the finger section or thumb section is moved into the desired use position with an elastic bearing against the elastic restoring force.If the finger section and, in the case of a hand orthosis with fingers attached to the finger section, also the finger or fingers of the hand are in the fully extended position in the starting position, the position of use is a flexed position. If the finger section is not fully or maximally flexed, the position of use can be assumed either extended or flexed to the starting position. The actuator enables the finger section to be adjusted from the starting position to the position of use, whereby the actuator is any device with which the transition from the starting position to the position of use is enabled or carried out. If, for example, a patient has paralysis or a weakening of the muscles that cause extension of the finger, the actuator acts in such a way that extension is caused.In the starting position, for example, the finger section will be slightly curved and will be moved by the actuator against the elastic restoring force into a stretched or extended position. In this position, the hand can be placed on an object and the actuator decoupled or deactivated so that the elastic restoring force moves the finger section back to its starting position. The object can be held in this starting position. Alternatively, the starting position can also be a substantially extended finger position relative to the back of the hand and the actuator can cause flexion, which causes the finger section and thus also the finger attached to it to be moved into a flexed position and held in this position. The flexed position is then the position of use, for example to hold an object.If the actuator is uncoupled or deactivated, the finger section returns to its original position together with the finger attached to it.

[0014] The hand orthosis or hand prosthesis is actuated, for example, by coupling the actuator to the counter element via the form-fitting element. For this purpose, the form-fitting element, which is attached to the proximal end of the actuator or forms the proximal end, is brought into positive engagement with the counter element. This is done, for example, by hooking a loop into a hook. The counter element is attached to the torso, shoulder, or a limb of the user or patient and forms an abutment for the form-fitting element and the actuator. In its simplest form, the actuator is a cable pull whose rear, proximal end is provided with a loop or similar device. This loop is then freely arranged and displaceable on the forearm or forearm part of a prosthesis and can be fixed to the torso, shoulder, or a limb.To actuate the actuator, the form-fitting element or loop is engaged with the counter-element and then the hand is moved forward or away from the torso, shoulder or a limb and the counter-element so that a tensile force is transmitted via the form-fitting element and, if applicable, the force transmission device or the force transmission element to the actuator, which then displaces the finger section and / or, if applicable, a part of the thumb due to the tensile force or a resulting force or moment. To decouple the actuator, the form-fitting element is disengaged from the counter-element so that the user can once again freely move the hand orthosis or hand prosthesis without being connected to the torso, shoulder or limb on the counter-element. This restores the free mobility of the hand orthosis or hand prosthesis.

[0015] In addition to a finger section, in one embodiment a thumb part is arranged on the support part, which in one embodiment is adjustably arranged on the support part. This not only allows fingers to be received and supported or fingers to be replicated using prosthetic fingers, but also the thumb to be supported or a thumb to be replicated. The support part can extend over the forearm so that the thumb part can be attached to a forearm shell or a wrist mechanism. The thumb part, which in one embodiment as a hand orthosis has a thumb receptacle, can be mounted on the support part so that it can be fixated in a use position, for example in order to be able to permanently adjust different grip types. This makes it possible, for example, to realize the pincer grip or tweezer grip or even a fist with the involvement of the thumb.The displacement of the components of the thumb part relative to each other and, if applicable, relative to the support part is carried out in particular via the actuator.

[0016] In one embodiment, the thumb part is spring-loaded or elastic, for example when it is formed integrally with the support part or rigidly attached thereto, or is spring-loaded on the support part. Spring-loaded mounting can be achieved, for example, by an articulated mounting with an associated spring element. The spring-loaded or spring-loaded thumb part is coupled to the actuator in one embodiment and, analogous to the finger section, can be displaced from an initial position to a use position and fixed therein. The displacement against the elastic restoring force enables the return to the respective initial position. Due to the adjustable mounting of the thumb part on the support part, the initial position can be varied.

[0017] In one embodiment of the orthosis, one or more of the receptacles are arranged or formed on the finger section. This makes it possible to couple one, two, three or all fingers to the finger section. In a design as a prosthesis, one or more finger parts or prosthetic fingers are arranged on the support part. Analogous to the thumb part, which is designed to be resilient or is mounted resiliently on the support part, in one embodiment the at least one finger section is designed to be resilient or is mounted resiliently on the support part and coupled to the actuator. In one embodiment, the finger section is also adjustably arranged on the support part and, in another embodiment, can be fixed in any starting position. Thus, different and freely selectable starting positions can be set not only for the thumb part, but also for the finger section.

[0018] A further development provides that an adjustment device for adjusting the elastic restoring force is assigned to the finger section and / or the thumb section in order to be able to adapt it to the respective patient or the respective intended use.

[0019] In one embodiment, the finger section and / or the thumb part are designed as a leaf spring and / or are resiliently mounted on the support part via a spring, for example, a leaf spring, a torsion spring, a coil spring, a spiral spring, or an elastomer element. The leaf spring can be made of steel, a plastic, or a fiber composite material, or a combination thereof.

[0020] The coupling rod is spring-mounted or spring-loaded in one embodiment, which enables independent displacement of the finger parts or thumb components under external loads. This prevents injuries and protects the materials in the hand orthosis or hand prosthesis. The spring-loaded or elastic mounting and / or design of the coupling rod can be effective in the direction of compression and / or tension, so that the effective length of the coupling rod can be reversibly increased or decreased. The special design as a flexible coupling rod, which, for example, is spring-loaded and / or has a length that can be adjusted in a controlled manner, enables an adaptive gripping movement. The key behavior is the coupling rod's length-flexing properties, which compensate for the disadvantage of a rigid coupling.With a rigid coupling rod, the rotational movements of the metacarpophalangeal joint (MCP) and the proximal interphalangeal joint (PIP) are coupled. If the MCP is blocked and the proximal part of the finger encounters an object, this also suppresses further movement of the PIP and thus the displacement of the distal part of the finger. A flexible coupling rod with simultaneous drive and a moment around the PIP axis allows the distal part of the finger to continue moving, even if the proximal part of the finger is blocked in its movement by contact with a (grasped) object. Possible embodiments for an elastic coupling rod include a curved or curved design (e.g.

[0021] Sinusoidal) or a correspondingly small-sized linear hydraulic or pneumatic system. By using a length limiter, for example, a rope or cable along the coupling rod, or a linear hydraulic or pneumatic system with a stop, further elongation of the coupling rod can be prevented from a defined elongation, starting from an unloaded initial position. Conversely, a minimum length can also be guaranteed using a stop, so that from this point on, the coupling rod behaves like a rigid coupling rod.

[0022] In one embodiment, the coupling rod has a length limiter or a linear actuator, so that it is possible to limit the maximum elongation or shortening of the coupling rod in an elastic or length-variable design. The length limiter can be designed, for example, as a tensile-rigid, flexible, or optionally elastic element that is arranged, in particular fastened, to the coupling rod. The length limiter can be, for example, a rope, cable, or even an articulated hinge construction that prevents a pulling movement from causing excessive lengthening of the coupling rod. As soon as the maximum desired length of the coupling rod is reached, the length limiter takes effect, so that from this point in time or from this state, the elastic or spring-loaded or mounted coupling rod acts as a rigid coupling rod.The same can also be achieved using a linear actuator, which can be designed, for example, as a linear pneumatic or linear hydraulic system, optionally with spring elements arranged thereon. The coupling rod is then designed as a linearly displaceable component consisting of at least two components, each of which rests against a stop in its end position, thus preventing further displacement relative to each other. The coupling rod can be designed in several parts, so that different elastomer elements, spring elements, or similar elements can be arranged on the mounts to achieve the desired spring behavior of the coupling rod.

[0023] In one embodiment, the coupling rod is curved or wave-shaped at least in some areas to achieve the springy or elastic behavior, so that a simple realization of the reversible deformation can be achieved.

[0024] In a further embodiment, at least one deformation element is assigned to the coupling rod, which is arranged on a finger part and / or the support part. When the finger parts are displaced relative to one another or relative to the support part, the deformation element engages with the coupling rod and deforms it due to the displacement of the coupling rod relative to the deformation element. This makes it possible to achieve adapted spring behavior due to the deformation of the coupling rod depending on the displacement of the individual components relative to one another. The actuator can be arranged or mounted on the hand orthosis, in particular the support part or a forearm holder, in a rotatable or displaceable manner. The actuators can be manually operable and, for example, have a grip element or a form-fitting element via which a tensile force, a compressive force, or a moment can be applied.The actuator is coupled to the finger section and, if applicable, to the thumb section, for example, via a pulling element, pushing element or other force transmission device or another force transmission element connected to the finger section or thumb section and enables a displacement from the starting position to the use position.

[0025] In a further development, a damper is integrated into the actuator to dampen the return movement from the operating position to the starting position. The damper can be arranged directly on the actuator, for example, as a brake, a hydraulic damper, a friction clutch, or similar. In one variant, the damper's damping rate is adjustable to adapt to the specific user and intended use.

[0026] In one embodiment, the actuator is coupled to a clutch and a force accumulator, in particular a spring, to facilitate actuation, in particular to easily effect locking and release. The actuator can be coupled to a winding mechanism or a tensioning device that can be released to release a stored force and effect a displacement of the finger section or thumb part.

[0027] In one embodiment, the actuator is designed as an interchangeable module, allowing different actuators to be easily attached to the hand orthosis or hand prosthesis. This modular design makes it possible to retrofit a conventional hand orthosis or hand prosthesis with an actuator and a fixation device, allowing for easy replacement of components and adaptation to the respective intended use.

[0028] In order to enable the actuator to be spatially independent of the finger section, the actuator in one embodiment has a force transmission element which transmits tensile forces and / or compressive forces from the actuator to the component to be moved or to which a force is to be applied.

[0029] In one embodiment, a deformation element is assigned to the force transmission element, which is arranged on the finger part and / or the support part. The deformation element, which is designed, for example, as a cam disk, influences the course and displacement of the force transmission element depending on the displacement of the finger parts relative to one another or to the support pillar. This makes it possible, for example, for a distal finger part to be pivoted more strongly about the pivot axis on the proximal finger part when the proximal finger part is displaced relative to the support part.

[0030] In a further development, a fixing device is coupled to the actuator or the finger section or thumb part, with which the finger section or thumb part is held in the position of use. The starting position can be flexed or extended, i.e. have bent or stretched fingers. From this starting position, the finger section or thumb part, and when applied, thus also the finger attached to it, is moved against the elastic restoring force into the desired position of use. In the respective position of use, the desired activity can then be carried out or the hand can be placed on an object and the fixing device deactivated, so that the elastic restoring force moves the finger section or thumb part back to its starting position.Thus, the locking device holds the finger section and, if applicable, the thumb section in the extended position without the actuator having to remain attached to the counter element and in contact with the positive-locking element. As explained above, an extended position can also be the starting position; the finger section or thumb section is flexed by the actuator and held in this position by the locking device. The flexed position is then the position of use, for example, for holding an object. If the locking device is released, the finger section or thumb section, possibly together with the attached fingers, returns to the starting position.

[0031] In one embodiment, the actuator is coupled to the form-locking element to effect manual displacement of the finger portion or thumb portion. The form-locking element is designed, for example, as a ring, loop, hook-and-loop fastener, or hook. In particular, a form-locking part with a rigid actuator portion is arranged or configured proximal to the support part and thus also proximal to the finger portion and thumb portion to facilitate actuation of the form-locking element and facilitate accessibility.

[0032] In a hand orthosis design, the support part rests against the back of the hand when the hand orthosis is in place. In particular, the support part extends above the back of the hand when the hand orthosis is in place, allowing the finger section or sections to be guided dorsally to the fingers to keep the palm free for the desired activities or tasks. Alternatively, the support part can extend around the ball of the hand or along the edge of the hand, so that the support part extends laterally next to the hand. Even with such embodiments, it is possible to support a finger section relative to proximal hand sections or arm sections.

[0033] In one embodiment, the support element is designed as a hand orthosis and extends proximally beyond the wrist when in place. The support element on the forearm enables secure fixation and effective support of the finger portion relative to the support element, ensuring a large-area distribution of force. In the case of a hand prosthesis, support is provided via the forearm shaft or the forearm tube.

[0034] The invention also relates to a system comprising a hand orthosis or hand prosthesis as described above and the counter-element, which can be fastened to the torso, shoulder or a limb of the user of the hand orthosis or hand prosthesis and has a fastening device for securing it to the torso, shoulder or a limb, e.g. the upper arm. The fastening device can be designed, for example, as a strap; likewise, the fastening device can have a clasp or a clamp as well as hooks, buttons, screw connections or the like, or can be designed as such in order to either provide direct fastening and securing to the body or to be able to provide fastening to fastening devices such as belts, clasps, shells, cuffs or the like.

[0035] Exemplary embodiments of the invention are explained in more detail below with reference to the figures. They show:

[0036] Figure 1 - Views of two embodiments of a hand orthosis;

[0037] Figure 2 - two views of a variant of a hand orthosis;

[0038] Figure 3 - a side view of the hand orthosis according to Figure 2 in two states;

[0039] Figure 4 - a variant without thumb part;

[0040] Figure 5 - a variant of Figure 1;

[0041] Figure 6 - Application examples of a hand orthosis with actuator;

[0042] Figure 7 - Illustrations of the use of a hand orthosis according to Figure 5;

[0043] Figure 8 - a detailed view of a hand orthosis with a multi-part finger section;

[0044] Figure 9 - a complete representation with a finger section according to Figure 7;

[0045] Figure 10 - a variant with three finger parts;

[0046] Figure 11 - a variant with a damped actuator;

[0047] Figure 12 - Progressive representations of the use of an orthosis;

[0048] Figure 13 - a variant with an adjustable thumb section;

[0049] Figure 14 - a variant with a configurable actuator; Figure 15 - illustrations of an embodiment;

[0050] Figure 16 - a variant of Figure 15;

[0051] Figure 17 - a variant of Figure 16;

[0052] Figure 18 - a detailed sectional view of a trigger mechanism;

[0053] Figure 19 - a support part with a multi-part finger section and coupling rod;

[0054] Figure 20 - a schematic representation of an embodiment with a deformation element;

[0055] Figure 21 - a variant of Figure 20 in a flexed position;

[0056] Figure 22 - a representation of Figure 20 in use;

[0057] Figure 23 - a coupling rod in detailed view;

[0058] Figure 24 - perspective views of a hand orthosis with a coupling rod according to Figure 23;

[0059] Figure 25 - Variants of the coupling rod;

[0060] Figure 26 - Representations of a coupling rod with linear actuators;

[0061] Figure 27 - Representations of a coupling rod with a length limitation;

[0062] Figure 28 - Concept comparison to object adaptivity;

[0063] Figures 29 and 30 - Fingertip trajectories;

[0064] Figure 31 - a representation of a deformation element on a coupling rod; and Figure 32 - different positions of the deformation element.

[0065] Figure 1 shows a hand orthosis 10 in the applied state with a support part 20 arranged above the back of the hand. Extending from the support part 20 in the proximal direction along the forearm is a forearm receptacle 60, which extends spirally from the back of the hand to the inside of the forearm. The forearm receptacle 60 is secured to the forearm via fastening means, for example via cuffs, straps or the like, which are secured to the forearm, for example, via a hook-and-loop fastener, a buckle or a clasp. In the illustrated embodiment, the support part 20 and the forearm receptacle 60 are formed as a single piece and are made in particular from a plastic, a fiber composite material or, if appropriate, from a light metal. It is also possible for the support part 20 and the forearm receptacle 60 to be manufactured separately and connected and secured to one another.A finger section 30 is formed distally on the support part 20 and extends from the end of the back of the hand over the metacarpophalangeal joints to the fingertip region. The finger section 30 in the illustrated embodiment is formed as a single piece and is formed integrally with the support part 20. The finger section 30 does not extend across the entire width of the fingers, but converges obliquely in the distal direction, as can be seen in the middle illustration in Figure 1. A finger receptacle 32 is formed at the distal end region of the finger section 30, via which the fingers are coupled to the finger section 30. The finger receptacle 32 enables the fingers to follow a deformation movement in the extension direction. Since the finger section 30 is arranged dorsally or on the upper side of the fingers, a flexion movement of the finger section 30 also leads to flexion of the fingers due to the transmission of compressive forces.The finger receptacle 32 can be designed, for example, as one or more pockets, as a loop or loops, clasps, straps, or other fastening elements that allow the finger(s) to be secured to the finger section 30. A thumb receptacle 33, which is formed on a thumb section, is also arranged on the support part 20. The thumb section can also be formed separately and fastened to the support part 30. The thumb receptacle 33 also secures the thumb to the thumb section, which can, for example, be formed integrally with the support part 20, analogous to the finger section 30. A leaf spring 160 is displaceably mounted on the upper side of the support part 20. The leaf spring 160 is mounted for longitudinal displacement on the upper side of the support part 20 on a guide element, which simultaneously represents a fixing device 50.The guide element and the fixing device 50 are arranged in a slot or a slit of the leaf spring 160. The leaf spring 160 is a curved spring element and is displaced in the proximal or distal direction and secured in the desired position by the fixing device 50. When the leaf spring 160 is in the most distally advanced position, the distal regions of the finger section 30 are subjected to the least spring force. In the normal position, without the application of force by an actuator 40, the finger section 30 has a substantially flexed position.

[0066] The left and right views of Figure 1 show a variant in which the actuator 40 is arranged at the proximal end of the forearm holder 60. The actuator 40 is connected to the finger section 30 or the leaf spring 160 via a force transmission device in the form of a force transmission element 110, which in the illustrated embodiment is designed as a cable pull or a belt. If the actuator 40, which is designed as a lever, is moved backwards, for example, the force transmission device or the force transmission element 110 is tensioned. Depending on where the force transmission device or the force transmission element 110 is attached, either the distal region of the finger section 30 is pulled upwards and extended, or the leaf spring 160 is moved in the proximal direction. If the force transmission device orOnce the force transmission element 110 is attached to the receiver section 30, the desired position is determined via the fixing device 50. Due to the elastic design of the finger section 30 or the leaf spring 160, a flexion movement then occurs automatically when the fixing device 50 is released. The actuator 40 can also be displaced between two dead-center positions, so that a fixing device 50 can be omitted if only two positions of the finger section 30 are to be assumed.

[0067] If the force transmission device or force transmission element is mounted on the displaceably mounted leaf spring 160, the latter slides along the curvature into a forward, distally displaced position upon release of the actuator 40. This exerts a force on the distal region of the finger portion 30, causing flexion. If the leaf spring 160 is retracted, i.e., moved toward the forearm receptacle 60, the leaf spring 160 slides along the upper side of the support part 20 and is stretched because, during a backward displacement movement, the leaf spring 160 is upwardly limited by the guide element and the fixing device 50, and the force application point of the leaf spring 160 moves proximally. The actuator 40, and thus also the deformed leaf spring 160, is secured in the desired position by the fixing device 50.The fixing device 50 can effect locking in discrete steps, for example by means of latching elements with a positive locking action, when the fixing device 50 is displaced, for example, downwards in the direction of the support part 20. A rotation of the fixing device 50 for positive locking or a clamping locking action are also realized in embodiments. The actuator 40 is actuated manually; the displacement of the leaf spring 160 can also occur directly without a lever as an actuator; the leaf spring 160 then simultaneously serves as the actuator. To facilitate actuation, in one embodiment, gripping elements, positive locking elements, or the like (not shown) are arranged on the rear side of the leaf spring 160 to facilitate the displacement and movement of the leaf spring 160 in the distal or proximal direction.If the leaf spring 160 is moved backward, the finger section 30 and thus also the finger in the finger receptacle 32 are extended; conversely, a displacement movement in the distal direction causes flexion.

[0068] The right-hand illustration of Figure 1 shows a variant in which the actuator 40 has an actuating element in the form of a lever, which is arranged at the proximal end of the forearm support 60. The actuating element is coupled to the leaf spring 160 or the finger section 30, and in particular to the finger support 32, via a force transmission device or force transmission element 110, which in the illustrated embodiment is designed as a cable pull or a belt, and extends the finger section 30 when the force transmission device 110 is tensioned. In the middle illustration, no actuating element or force transmission device is attached to the forearm support 60. The actuator is then, for example, the leaf spring element 160 on the support part 20.

[0069] Figure 2 shows a variant of Figure 1 in which a damper 90 is arranged on the force transmission element 110 and the fixing device 50 at the bottom of the actuator 40 fixes the actuator 40 in the desired position. In the embodiment according to Figure 2, the finger receptacle 32 is designed as a pocket or cap in which all fingers, except the thumb, can be accommodated. The force transmission element 110 runs from the back of the hand in the support part 20 in a channel through the damper 90 to the actuating element of the actuator 40 at the proximal end region of the lower receptacle 60. The damper 90 prevents spontaneous displacement of the actuator 40 upon release of the force transmission element 110 or a snapping back of the extended finger section 30 upon release of the leaf spring 160 with a released fixing device.In the right-hand illustration of Figure 2, it can be seen that the force transmission element 110 is attached to the actuating element of the actuator 40. In the illustrated position, the actuator 40 is in an almost maximally distal position with a relaxed force transmission element 110 and holds the hand orthosis 10 in the desired basic position. To achieve an extended position, the actuating element is displaced; in the illustrated embodiment, the lever is moved backward in the proximal direction. This tensions the force transmission element 110 attached to the distal end of the finger section 30, and the finger section 30 is extended. The fingers extend and can be held in the desired position by the fixing device 50.Since the force transmission element 110 is attached to the displaceably mounted leaf spring 160, the leaf spring 160 is displaced rearward upon actuation of the actuator 40, and either the leaf spring 160 is stretched, causing an extension, or, in the case of a rigid leaf spring 160, the receiver section 30 is bent, causing a flexion. The hand orthosis 10 according to Figure 2 also contains a thumb receptacle 33, which is movably arranged on the support part 20 and can be fixed in the desired position. The thumb is then in the set position of the thumb receptacle 33 relative to the support part 20, so that the desired type of grip can be realized during a flexion or extension movement of the finger section 30.

[0070] The finger section 30 itself can be designed to be elastic in order to be able to return to the respectively set starting position when external forces, which are applied, for example, via the actuator 40, are removed. This results in a spring effect for the springs via the finger section 30. The spring effect is adjustable; for example, a displacement of the leaf spring 160 towards the finger section 30 or away from the finger section 30 can be effected, which can be achieved by an adjustment mechanism. As soon as the fixation device 50 has released the preloaded state, the orthosis returns to the starting state. The damper 90 prevents an excessively rapid flexion movement or, in the opposite case, an excessively rapid extension movement, whereby the damping rate can be adjustable. The damper 90 can be designed as a brake or other resistance device to influence the return movement.

[0071] Figure 3 shows a side view of another variant of the orthosis 10. Here, too, actuation is achieved via the actuator 40 in the form of a lever, which is arranged on the underside of the forearm holder 60 and coupled to the finger section 30 via the force transmission element 110. The leaf spring 160 on the side of the finger section 30 is shown detached from the finger section 30. The curvature, which causes a flexion movement, can be seen. The finger holder 32 secures the fingers to the finger section 30, wherein the finger holder 32 is designed such that the leaf spring 160 has no negative influence on the haptics or gripping.The damper 90 (not shown) initiates the return movement upon release of the fixation device 50, for example, when the actuator 40 is moved from the tensioned, extended position, in which it is in a dead position, to the illustrated forward position for assuming the home position. The actuator 40 is actuated by the contralateral hand, so that a purely manually operable hand orthosis 10 can be provided. The finger section 30, together with the support part 20, is elastically designed, and the thumb receptacle 33 is attached thereto so as to be adjustable relative to the support part 20.

[0072] Figure 4 shows a variant of the hand orthosis without the thumb section 33. Fixation to the forearm is achieved via a spiral guide of the forearm support 60 around the forearm and secured via a strap. A guide for the force transmission element 110 is incorporated within the forearm support 60 or attached thereto.

[0073] Figure 5 shows a variant of the orthosis 10 which has a thumb receptacle 33 which can be passively positioned. In contrast to the embodiment according to Figure 4, the forearm receptacle 60 is guided laterally around the forearm in a proximal direction from the support part 20; in Figure 4, the forearm receptacle 60 is guided medially on the side of the thumb to the underside of the forearm. A bendable or flexible, optionally elastic region can be formed within the forearm receptacle 60, which enables bending of the forearm receptacle 60 in the region of the transition from the back of the hand to the underside of the forearm, thus enabling adaptation to different diameters, as shown in the upper right illustration of Figure 5. This allows the radii of curvature of the forearm receptacle 60 to be adjusted.

[0074] A hand orthosis as shown in Figures 1 to 5 requires no electronic control or energy storage device. Due to its design from plastic and / or a fiber composite material, it is highly resilient yet lightweight. The hand orthosis 10 is easily adaptable to different patients and allows the hand to be positioned in the desired position. By adjusting the elastic return force, it is possible to preset a closing force if, for example, the basic position should be the closed position. The damper 90 or the damper system regulates the speed of the return movement and prevents the hand orthosis from spontaneously opening or snapping shut. The starting position of the fingers relative to the back of the hand orof the finger portion 30 to the support part 20 can be either open or closed, wherein the elastic configuration is achieved either by manufacturing the support part 20 together with the finger portion 30 and / or by a corresponding.

[0075] A separate spring mechanism or spring is mounted and attached. After the finger section 30 has been moved from its initial position, the use position is held by the fixing device 50. Only when the fixing device 50 is deactivated, for example, by a mechanical trigger mounted at an ergonomically sensible position, does the finger section 30, and thus the hand, close or open again. The respective use position can be freely selected and can lie either between two discrete states that define an open or closed position, or in discrete or continuous steps in between. Fixation is achieved, for example, by a ratchet mechanism or a clamping mechanism.If a thumb holder is provided, this can be fixed in a predefined position relative to the other fingers or the hand on the support part 20; alternatively, the thumb holder is passively adjustable and can be fixed in different, adjustable positions.

[0076] A variant is shown in Figure 6, which shows various possible uses of the hand orthosis. In the left-hand illustration of Figure 6, the hand orthosis 10 is in the open position, for example in the starting position, and can be used to grasp objects without closing the hand. The right-hand illustration of Figure 6 shows a state in which the hand orthosis 10 is in a closed position of use. In order to achieve this position of use, a form-locking element 130 is provided as part of the actuator 40, which is designed or arranged in the form of a loop at the proximal end of a comparatively stiff proximal actuator section 150. The form-locking element 130 or the loop engages with a counter-element 230 that is attached to the user's torso.In the illustrated embodiment, the counter element 230 is designed as a hook or a projection that is attached to the hip, for example, to a belt. To actuate the hand orthosis 10, the form-fitting element 130 is brought up to the counter element 230, hooked there, and the hand with the hand orthosis 10 is moved forward. This exerts a tensile force via the actuator 40 and moves the hand orthosis from the open starting position into the closed use position, allowing an object to be held in the closed hand. The closed hand position is then maintained by activating a fixation device.If no fixation device is activated, the hand opens when the hand with the hand orthosis 10 moves toward the counter element 230, since the tensile force of the actuator 40 is eliminated and the initial position is resumed due to the elastic mounting or the elastic design of the finger section 30. Here, too, a damping device is advantageously arranged in the hand orthosis 10 or in the forearm support 60 to slow down or stop the return movement.

[0077] Figure ? shows the process of hooking the form-locking element 130. A loop held open is inserted into the counter-element 230 designed as a hook, and the hand is moved forward. This is indicated by the arrow in the right-hand illustration of Figure 7. By applying a pulling force, the hand orthosis 10 is closed, which is indicated by the curved arrow on the hand orthosis 10. A corresponding reverse movement occurs when the form-locking element 130 is unlocked. Such an actuating device or such an actuating mechanism enables the grasping and fixation of objects in a hand provided with the hand orthosis 10, particularly during activities while standing, when people with hand paresis but otherwise good mobility in the arm and shoulder as well as in the torso want to perform activities.Other means for producing an abutment for the actuator via the form-locking element on the fuselage are possible, for example by a hook on the form-locking element 130, by a ball which is arranged at the end of a cord or a rod and can be inserted into a corresponding dome-shaped ball receptacle or by other form-locking devices.

[0078] A further embodiment of the hand orthosis is shown in Figures 8 and 9. Figure 8 shows a detailed view of a hand orthosis 10 with the support part 20 and finger parts 34, 36 arranged distally thereto, which are pivotally mounted on one another about pivot axes 31, 35. The support part 20 is attached, for example, to the upper side of the back of the hand and is secured thereto by a strap that extends around the wrist or the forearm. Distal to the support part 20, a first, disc-shaped receptacle is pivotally mounted as the first finger part 34. The pivoting takes place about a pivot axis 31, which essentially corresponds or should correspond to a compromise axis of rotation of the metacarpal joints. The proximal finger part 34 extends from the metacarpal bone in a distal direction over the first phalanx or the proximal phalanx of a natural hand.The second, distal part of the finger 36 extends over the other two phalanxes, i.e. the medial phalanx and the distal phalanx.

[0079] Instead of a one-piece design of the finger section 30, as described above, a multi-piece design of the finger part 30 is provided, a two-piece design in the illustrated embodiment. The actuator or the force transmission device is connected dorsally. For example, a cable pull is attached to the distal finger part 36, which is guided via the proximal finger part 34 and via the support part 20 to the actuator and extends the finger part 30 when the actuator is actuated. The basic position is set and maintained via spring elements that act about the pivot axes 31, 35, for example in the form of torsion springs or coil springs; alternatively, a leaf spring can be arranged on the back of the hand, similar to that in Figures 1-5.Figure 9 shows the hand orthosis in a worn state; the support part 20 has a forearm receptacle 60 that is fixed to the underside of the wrist via a strap or Velcro fastener. The finger section 30 has two finger parts 34, 36 that are hingedly connected to one another via the corresponding axes 31, 35. The cable pull system via the actuator can be provided with a spring preload and, if necessary, with a damper. Figure 9 shows the torsion springs 163 that act about the hinge axes 31, 35; the torsion springs 163 can also be designed as elastomer elements. As an alternative to the design with two pivot axes 31, 35, the finger section 30 can also be designed with three finger parts that can be displaced about three pivot axes relative to the support part 20.

[0080] Such a design is shown in Figure 10, in which the individual finger parts 34, 36, 38 are connected to one another via film hinges or leaf springs to form joint axes 31, 35, 37. The force transmission element 110 in the form of a belt is guided along the back of the hand, as can be seen in the right-hand illustration in Figure 10. The individual finger parts 34, 36, 38 correspond to the finger joints; the film hinges can be elastically prestressed or designed as leaf spring elements and, in addition to providing the pivot axes 31, 35, 37, also simultaneously ensure the elastic mounting of the finger elements 34, 36, 38 on one another. Depending on the design of the connecting elements between the finger parts 34, 36, 38, the basic position can be an extended or open hand position, or a flexed or closed hand position.The right-hand illustration of Figure 10 shows the thumb holder 33, to which the thumb can be secured. The thumb holder 33 is passively adjustable, allowing different grip types to be realized. If a tensile force is applied by the actuator via the force transmission element 110 from the starting position according to Figure 10, the spring elements between the finger parts 34, 36, 38 are tensioned and force is stored therein. To prevent an unwanted closing movement, the force transmission element 110 is fixed in the desired position. To effect a return movement to the starting position, the fixing device is deactivated so that the hand orthosis closes again, with a damper slowing the closing movement in the desired manner. The damper advantageously acts on the force transmission element 110.

[0081] Figure 11 shows a perspective view of a configuration with a damper 90. The actuator 40, for example as a slider with a gripping element, is arranged on the forearm receptacle 60. Projections or form-fitting elements into which a fixing device 50 can engage in a form-fitting manner can be formed on the slider. For example, a clamping movement can always be possible, which is mechanically simple to achieve by appropriately orienting sawtooth elements. The fixing device 50 is pre-tensioned in the direction of a closing movement, so that when the actuator 40 is retracted and the spring elements between the finger parts are tensioned, the respective proximal position of the actuator 40 is fixed. If the actuator 40 is not moved any further in the proximal direction, the tensile stress remains within the force-transmitting element due to the restoring effect of the spring elements.If the fixing device 50 is deactivated, for example by unlocking the elastically mounted fixing element 50, it is released so that the actuator 40 can be moved back in the distal direction. This return movement is influenced and slowed down by the damper 90, which is shown schematically, in order to prevent rapid snapping shut during the closing movement. The closing movement caused by the release of the fixing device 50 is shown by the arrow movement, so that the thumb receptacle 33 and finger receptacles 32 move towards one another. The position of the thumb receptacle 33 can be freely selected. Figure 12 shows different positions of the hand orthosis. The upper left illustration shows the starting position with a closed hand and the corresponding hand orthosis. If the actuator is actuated and the force transmission device orIf the force transmission element 110 is moved backward, the finger section 30 is extended and the hand is opened. In the lower left illustration, the hand is in the extended position with spring preload. The lower right illustration shows a slow, damped return movement via the damper 90 upon release of the fixing device and a return movement due to the relaxation of the springs. The springs are charged in the left illustration by a linear movement of the actuator, while in the right illustration, by a tilting movement of a lever.

[0082] Figure 13 shows the different positions of the thumb receptacle 33 relative to the finger part or the finger receptacle 32. In the left-hand illustration, the thumb is in a spread-out position, so that in the closed position a pincer grip takes place. The adjustment is carried out passively via a thumb section joint 330. In the right-hand illustration, the thumb is parallel to the proximal phalanx of the index finger in order to enable a so-called power grip. Figure 14 shows a variant of Figure 9, in which two finger parts 34, 36 are also designed as a finger section 30 with finger receptacles 32. In addition, the thumb receptacle 33 is articulated and pivotally mounted on the support part 20. The elastic mounting is provided by a spiral spring 162. The elastic mounting of the finger parts 34, 36 orThe finger section 30 is bent via a coil spring 162 as a tension spring element, which is arranged at the distal end of the distal finger part 36 and secured to the support part 20 via a tension element. Bending of the finger section 30 or the finger parts 34, 36 is carried out via the actuator 40, which is secured to the support part 20, via the force transmission device or force transmission element 110, the structure and mode of operation of which are explained in more detail. The actuator 40 can be replaced and freely configured and attached to the support part 20 or the forearm holder 60, which is not shown. The modular design of the actuator 40 and its interchangeability make it possible to adapt the orthosis to the respective user and the respective usage situations. Furthermore, it is possible to define different starting positions, for example, the closed position or the open position as the starting position.The actuator 40 can also incorporate locking and release devices, as well as a damper to influence the movement when the preloaded springs are released. The actuator itself, for example, if it is designed as an electric motor, can act as a damper in generator mode.

[0083] The actuator 40 can be designed to be either motorized or purely manually operated. When the actuator 40 is activated, the cable pull or the force transmission element 110 is pulled in the proximal direction, thereby causing the finger portions 34, 36 to bend around the respective pivot axes and thus flex and close the hand. The thumb with the thumb receptacle 33 can either be held fixed in the respectively set position or can be activated via other actuating devices or the actuator 40. The cable pull or the force transmission element 110 is tensioned against the elastic restoring force of the coil spring 162. If the fixing device is deactivated, the tensioned spring 162 relaxes and the finger portion 30 returns to its original position.

[0084] The actuator 40 is shown schematically in Figure 15. The actuator 40 has two clutches 100, which are coupled to a force accumulator 105 and connected to the distal finger part 36 and the thumb receptacle 33 via force transmission elements 110. The clutches 100 are thus part of the fixing device 50 and ensure that, after actuation of the actuator 40 and displacement from the starting position to the use position, the finger parts 34, 36 and the thumb receptacle 33 are held in the desired position. A release element 501 is arranged on the fixing device 50 and can deactivate the fixing device 50. The detailed structure will be explained with reference to Figure 18. The actuators 40 roll up the respective cable pulls or force transmission elements 110, a coil spring 161 as a force accumulator 105 is assigned to the respective rollers and is tensioned when rolled up and thus when the springs 161, 62 are tensioned.In the desired position, the actuator is blocked by the locking device 50 and secured against reversing. Actuating the release element 101 unlocks a freewheel, releasing both the spiral spring 161 and the coil springs 162.

[0085] In Figure 16, the drive 40 is designed as an electric motor. Upon activation of the actuator 40, the hand orthosis 10 is closed against the elastic restoring force of the springs 162. The electric motor, as a drive or actuator 40, is arranged directly on the fixation device 50 with the clutches.

[0086] In Figure 17, an actuator is provided remote from the fingers. This actuator is not located directly on the support part 20, but is positioned, for example, as a motor on the forearm support. The actuator can also be designed as a lever, slider, sliding element, rotary element, or the like and can be coupled to the fixing device 50 via a force transmission device or force transmission element 110.

[0087] The fixing device 50 is shown in detail in Figure 18. The coil spring 161, two coil disks 502, and a freewheel 504 are mounted on a common axis. A locking ring 503 is arranged on the outer circumference of the freewheel 504 and is rigidly coupled to the outer ring of the freewheel 504. The coil spring 161 is secured to both the housing and the axis. The coil disks 502 accommodate the force transmission element 110, in particular designed as a cable or Bowden cable. The fixing device 50 enables the finger parts 34, 36 and the thumb receptacle 33 to be moved in one direction of movement, i.e., flexion or extension. The force transmission elements 110 are wound up by the coil spring 161. The release element 501, which can be inserted into recesses in the locking ring 503, ensures that the winding discs 502 remain in the set position.Only when the locking ring 503 is released by actuating the release element 501, the spring 161 relaxes together with the springs 162 and the thumb receptacle 33 as well as the finger parts 34, 36 are moved back to the starting position.

[0088] A further embodiment of the orthosis with a support part 20 and a multi-link section 30 is shown in Figures 19 to 24. Figure 19 shows a shell-colored support part 20 with two articulated finger parts 34, 36, which are designed analogously to the embodiment according to Figures 8 and 9. In addition to or in addition to the torsion springs, which provide the finger parts 34, 36 with a spring preload relative to one another and to the support part 20, a coupling rod 80 is arranged between the support part 20 and the distal finger part 36. In the illustrated embodiment, the distal bearing point 83 of the coupling rod 80 is arranged dorsally on the distal finger element 34, i.e., on the upper side and thus above the pivot axis 35. The proximal bearing point 81 of the coupling rod 80 on the support part 20 is located below the pivot axis 31, i.e. closer to the hand than the pivot axis 31.The coupling rod 80 thus spans the proximal finger part 34 and two joint axes 31, 35. In the illustrated embodiment of Figure 19, only one coupling rod 80 is shown on the medial side, but corresponding receptacles in the form of bolts or projections are also arranged or formed on the lateral side on the support part 20 and the distal finger part 36 in order to attach a second coupling rod 80 there.

[0089] Figure 20 shows a schematic side view of the individual components. Also shown is the force transmission element 110, which is guided by the proximal pivot axis 31 and secured to the distal finger part 36 below the distal pivot axis 35. By connecting the finger parts 34, 36 via the coupling rod 80, it is possible to ensure physiological movement of the fingers. In particular, physiological finger flexion as well as finger extension can be achieved with only one force application. The coupling rod 80 is elastically designed, so that in addition to its function as a force transmission between the support part 20 and the distal finger part 36, the coupling rod 80 has the ability to be stretched and compressed. This provides increased functionality for the hand orthosis 10.Because the coupling rod 80 can be adjusted to different lengths, the individual finger parts 34, 36 can be moved independently of one another. The distal finger parts can also yield separately under distal loads, which protects the components. This allows for natural movement of the fingers coupled to the finger parts 34, 36, preventing damage to the joints, muscles, and tendons caused by inappropriate guidance. In particular, adaptive gripping is possible with such a design. Figure 21 shows the relative positions of the individual components, with a deformation element 310 in the form of a cam disk being arranged on the proximal finger part 34, which acts on the force transmission element 110. The deformation element 310 in the form of the cam disk can be used to manipulate the path of the force transmission element 110.In the illustration according to Figure 21, the force transmission element 110 or the cable pull runs through the proximal joint axis 31 and generates only a moment about the distal pivot axis 35, so that only the distal finger part 36 flexes. In Figure 22, the deformation element 310 is rotated such that it acts on the force transmission element 110. It thus runs at a greater distance below the pivot axis 31 or the pivot point about the pivot axis 31 and thus generates not only a moment about the distal pivot axis 35, but also about the proximal pivot axis 31.

[0090] A detailed view of the coupling rod 80 used in the embodiments of Figures 21 and 22 is shown in Figure 23. The coupling rod 80 has an S-shaped, sine-wave-like central region arranged between the proximal and distal bearing points 81, 83, which are designed as axle mounts. The coupling rod 80 can be made of a plastic or another elastic material and enables the transmission of both tensile and compressive forces, as well as elongation or compression with simultaneous force transmission.

[0091] The mounted coupling rod 80 on the support part 20 as well as the distal finger part 36 with the finger receptacle 32 is shown in Figure 24.

[0092] Figure 25 shows two coupling rods 80 which are designed similarly to that in Figure 23. The coupling rods 80 also have two bearing points in order to be able to attach the coupling rod 80 to one of the components of the hand orthosis or hand prosthesis, for example distally to the PIP and proximally to the MCP. The coupling rod 80 of Figure 25 is designed in several parts, wherein the springy or elastic central region is designed as a separate component which is replaceably attached to the bearing points at the straight end regions. The right-hand coupling rod 80 has a reinforced central region, thus providing greater spring resistance against deformation. In the illustrated embodiments, the elastic region is wave-shaped, in particular in the form of a sinusoidal wave.

[0093] Figure 26 shows two states of a coupling rod 80 with a linear actuator 82. In the left-hand illustration of Figure 26, the linear actuator is in a central position, which allows the two bearing points to be moved both away from and towards each other. The linear actuator 82 is designed similarly to a hydraulic damper or a pneumatic spring and has a housing as a receptacle for a piston-like end piece. A linear displacement of the piston-like end piece is possible within the housing, so that an effective shortening or lengthening of the piston rod 80 can occur. If the linear actuator is designed as a pneumatic spring, the end piece divides the cylinder-like housing into two chambers, so that compression in one chamber occurs both when the coupling rod 80 is compressed and when it is extended.Alternatively or additionally, at least one spring is arranged in or on the linear actuator to return the two components of the coupling rod 80 to their original position after they have been displaced relative to one another once an external load is removed. In the right-hand illustration, the linear actuator 82 is in its fully extended position, from which it then returns when the external force is removed.

[0094] Figure 27 shows an embodiment of the coupling rod 80 with a length limiter 84. In the left-hand illustration of Figure 27, the coupling rod 80 is in a relaxed state or in a compressed state, in which the length limiter 84, which is designed, for example, as a cable that engages over the elastically deformable region of the coupling rod 80, is relaxed. The cable or the length limiter 84 is, in particular, tensile-rigid and at least flexible, so that after an elongation of the coupling rod due to a tensile force, the length limiter is tensioned, which is shown in the right-hand illustration in Figure 27. If the coupling rod 80 is in the state shown in the right-hand illustration of Figure 27, it acts like a rigid coupling rod.After the removal of a tensile force between the bearing points, the coupling rod returns to its initial state due to the springback of the elastic area, for example to the state shown on the left in Figure 27.

[0095] Figure 28 shows four schematic representations of the object adaptability of the individual prosthetic fingers or orthotic fingers. The upper left representation of Figure 28 shows a support part 20 with a proximal phalanx 34, a medial phalanx 36, and a distal phalanx 38. A rigid coupling rod 80 is arranged between the support part 20 and the medial phalanx 36. When the proximal finger part 34 is bent about the pivot axis 31, the coupling rod 80 forces it to bend about the pivot axis 35 of the PIP. This configuration makes it relatively easy to grasp a cylindrical object. In the upper right representation of Figure 28, the object to be grasped is not cylindrical, but has an oval cross-section.The entire joint system is blocked because there is direct contact of the object with the proximal finger part 34, so that further bending and flexion about the pivot axis 35 cannot occur despite the coupling rod 80.

[0096] The lower left illustration of Figure 28 shows object adaptability without a coupling mechanism via a coupling rod; in comparison, the lower right illustration shows an orthotic finger or prosthetic finger with a coupling mechanism and a coupling rod 80. The coupling rod 80 is variable in length, namely by the length AL, resulting in an automatic and improved application of the medial phalanx 36 and an improved grip by the distal finger part 38.

[0097] Figures 29 and 30 show physiological trajectories for the fingertips. In Figure 29, the finger is in the extended position, while in Figure 30, it is in the 90° bent position, in which the proximal finger part 34 is bent 90° around the pivot axis 31. The coupling rod 80 pivots the medial finger part 34 about the pivot axis 35, while the distal finger part 38 remains extended and does not pivot about the pivot axis 37. The trajectory of the fingertip of the orthosis or prosthesis approximates the natural trajectory of a fingertip. Figure 31 shows a schematic representation of a prosthetic finger or an orthotic element with a support part 20, a proximal finger part 34, and a distal finger part 36. The individual finger parts 34, 36 are articulated about pivot axes 31, 35 on the respective proximal component.In the illustrated embodiment, a deformation element 86 is arranged on the proximal finger part 34, which can be pivoted together with the proximal finger part 34 about the pivot axis 31 during a displacement. The deformation element 86 is arranged on the proximal finger part 34 in a rotationally fixed manner. The coupling rod 80 is arranged, as shown in Figures 22 and 24, across the joints on the support part 20 and the distal finger part 36. The bearing points of the coupling rod 80 are located on different sides of a connecting plane between the pivot axes 31, 35. The coupling rod 80 or the coupling element is resilient and has a wave-like shape. When the proximal finger part 34 is pivoted, the deformation element 86 acts on the coupling rod 80 and causes or reinforces a deformation of the coupling rod 80, so that a change in the spring stiffness or a change in the effective length orThe distance between the bearing points can be shortened or lengthened. In the embodiment of Figure 31, the coupling rod 80 is solid, and the deformation element 86 is designed as a cam that slides along the surface of the coupling rod 80.

[0098] Figure 32 shows a variant of the deformable coupling rod 80 coupled to a deformation element 86. The coupling rod 80 also has a wave shape and is designed in multiple layers. In the left-hand illustration in Figure 32, the deformation element 86, which can have multiple areas of action, is positioned out of engagement with two spring layers of the coupling rod, so that only one spring or one spring layer of the coupling rod 80 is effective. The spring is correspondingly soft or flexible, respectively. In the right-hand illustration in Figure 32, the coupling element 86 is engaged with the individual spring layers and presses them against one another, so that a total of three springs are effective, since the wave shape transmits a compressive or tensile movement that is applied to the bearing points of the coupling rod 80.The effective areas of the deformation element 86 bring the three spring layers in the coupling rod 80 into contact with each other, thereby increasing the overall spring stiffness, so that the spring stiffness is influenced by the deformation element.

[0099] The design of the force transmission with the coupling rod, as shown and described in the figures, is not limited to the use of hand orthoses. Such a design can be used for prosthetic applications or even in robotics. Instead of the support part 20, a prosthetic hand then has a base body corresponding to the metacarpal, in which drive devices are generally arranged. Instead of the finger parts 34, 36, prosthetic fingers with corresponding joints and components and prosthetic finger parts are pivotably mounted on this base body. Likewise, in one embodiment, three finger parts are arranged in an articulated manner, as shown in Figure 10.The finger parts are then each coupled via the coupling rod 80, which is arranged across two joints with different positioning of the respective attachment points on different sides of the joint axes, opposite each other. The coupling rod 80 spans the finger joint located between the joint axes, for example, the proximal finger joint between the support part and a distal finger joint, thus providing a direct, one-piece connection between the support part and the distal finger joint. The coupling rod 80 is not driven in the illustrated embodiments; in principle, the coupling rod 80 can also be coupled to a drive.

[0100] List of reference symbols

[0101] 10 Hand orthosis

[0102] 20 support part

[0103] 30 finger section

[0104] 31 Swivel axis

[0105] 32 Finger recording

[0106] 33 Thumb part

[0107] 34 Finger part

[0108] 35 swivel axis

[0109] 36 Finger part

[0110] 37 Swivel axis

[0111] 38 Finger part

[0112] 40 Actuator

[0113] 44 Actuating element

[0114] 50 Fixing device

[0115] 60 Forearm radiograph

[0116] 70 Adjustment device

[0117] 80 coupling rod

[0118] 81 proximal storage site

[0119] 82 Linear actuators

[0120] 83 distal storage site

[0121] 84 Length limitation

[0122] 86 Deformation element

[0123] 90 dampers

[0124] 100 clutch

[0125] 105 energy storage

[0126] 110 Power transmission element

[0127] 120 engine

[0128] 130 Form-locking element

[0129] 140 handle element

[0130] 150 actuator section

[0131] 160 leaf spring

[0132] 161 Spiral spring - spiral spring - torsion spring - counter element - fastening device - deformation element - release element - winding disc - locking ring - freewheel

Claims

Patent claims 1. Hand orthosis or hand prosthesis with a support part (20) and with at least one finger section (30) which is arranged distally on the support part (20) and is pivotally mounted relative to the support part (20), wherein the finger section (30) is formed in several parts from a plurality of finger parts (34, 36, 38) which are pivotally mounted to one another, characterized in that a coupling rod (80) is coupled to a distal finger part (36, 38) and a proximal finger part (34, 36) or to the support part (20) across two joints and in a force-transmitting manner, wherein the coupling rod (80) is mounted once palmarly and once dorsally to the respective pivot axis (35, 37) of the joints.

2. Hand orthosis or hand prosthesis according to claim 1, characterized by an actuator (40) which is coupled with its distal end to the finger portion (30) and displaces the finger portion (30) from an initial position into a use position.

3. Hand orthosis or hand prosthesis according to claim 1 or 2, characterized in that a thumb part (33) is arranged on the support part (20).

4. Hand orthosis or hand prosthesis according to claim 3, characterized in that the thumb part (33) is adjustably arranged on the support part (20).

5. Hand orthosis or hand prosthesis according to claim 3 or 4, characterized in that the thumb part (33) is mounted on the support part (20) so as to be fixable in a position of use.

6. Hand orthosis or hand prosthesis according to one of claims 3 to 5, characterized in that the thumb part (33) is elastically designed or is elastically mounted on the support part (20).

7. Hand orthosis or hand prosthesis according to one of the preceding claims, characterized in that the finger portion (30) is elastically formed or is elastically mounted on the support part (20).

8. Hand orthosis or hand prosthesis according to claim 6 or 7, characterized in that an adjusting device (70) for adjusting the spring force is assigned to the finger portion (30) and / or the thumb part (33).

9. Hand orthosis or hand prosthesis according to one of the preceding claims, characterized in that the finger section (30) and / or the thumb part (33) is designed as a leaf spring and / or is elastically mounted on the support part (20) via a leaf spring, torsion spring, spiral spring, helical spring or an elastomer element.

10. Hand orthosis according to one of claims 2 to 9, characterized in that the actuator (40) is coupled proximally to the support part (20) with a form-locking element (130) which can be reversibly engaged with a correspondingly designed counter-element (230).

11. Hand orthosis or hand prosthesis according to claim 10, characterized in that the form-fitting element (130) is designed as a ring, loop, Velcro fastener part and hook.

12. Hand orthosis or hand prosthesis according to one of the preceding claims, characterized in that the finger parts (34, 36, 38) are elastically mounted in the starting position.

13. Hand orthosis or hand prosthesis according to one of the preceding claims, characterized in that the coupling rod (80) is elastically mounted or designed.

14. Hand orthosis or hand prosthesis according to one of the preceding claims, characterized in that the coupling rod (80) has a length limitation (84) or a linear actuator (82).

15. Hand orthosis or hand prosthesis according to one of the preceding claims, characterized in that the coupling rod (80) is curved or wave-shaped at least in some regions.

16. Hand orthosis or hand prosthesis according to one of the preceding claims, characterized in that the coupling rod (80) is assigned at least one deformation element (86) which is arranged on a finger part (34, 36, 38) and / or the support part (20).

17. Hand orthosis or hand prosthesis according to one of claims 2 to 16, characterized in that the actuator (40) is arranged or mounted on the support part (20) in a rotatable or displaceable manner.

18. Hand orthosis or hand prosthesis according to one of claims 2 to 17, characterized in that the actuator (40) is coupled to a clutch (100) and a force accumulator (105).

19. Hand orthosis or hand prosthesis according to one of claims 2 to 18, characterized in that the actuator (40) is designed as an exchangeable module.

20. Hand orthosis or hand prosthesis according to one of claims 2 to 19, characterized in that the actuator (40) has a force transmission element (110) transmitting tensile forces or is designed as such.

21. Hand orthosis or hand prosthesis according to claim 20, characterized in that the force transmission element (110) is assigned a deformation element (310) which is arranged on a finger part (34, 36, 38) and / or the support part (20).

22. Hand orthosis or hand prosthesis according to one of claims 2 to 21, characterized in that a fixing device (50) is connected to the actuator (40) or the Finger section (30) is coupled, with which the finger section (30) is held in the position of use.

23. Hand orthosis or hand prosthesis according to claim 22, characterized in that the form-fitting element (130) is arranged or formed on a rigid actuator section (150) proximal to the support part (20).

24. Hand orthosis or hand prosthesis according to one of the claims, characterized in that the actuator (40) is assigned a damper (90) for damping the return movement from the use position to the starting position.

25. Hand orthosis or hand prosthesis according to claim 24, characterized in that the damping rate of the damper (90) is adjustable.

26. Hand orthosis according to one of the preceding claims, characterized in that the finger section (30) has at least one finger receptacle (32) for receiving at least one finger, in particular that one or more finger receptacles (32) are arranged or formed on the finger section (30).

27. Hand orthosis according to one of claims 3 to 26, characterized in that the thumb part (33) has a thumb receptacle for receiving a thumb.

28. Hand orthosis according to one of the preceding claims, characterized in that the support part (20) extends above the back of the hand in the applied state, in particular rests against the back of the hand in the applied state.

29. Hand orthosis according to one of the preceding claims, characterized in that the support part (20) projects proximally beyond the wrist when applied and has a forearm receptacle (60).

0. System comprising a hand orthosis or hand prosthesis according to one of the preceding claims and a counter element (230) according to claim 10, characterized in that the counter element (230) has a fastening device (235) for fixing to the torso or a limb of the user.

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