CONTINUOUS PASSIVE FOOT JOINT MOBILIZATION DEVICE

Abstract

Joint mobilization. The device is characterized in that: . the articulated system I is mounted on a column 104 by a pivot 103 along the abduction-adduction axis CC'; . the motor organ II is associated with a movement transformation mechanism 108 with angular displacement, carrying adjustable sliders 114 to 116; . the connecting rods are mounted on the articulated sole system and on the sliders. Application to orthopedic correction of the foot.

Description

CONTINUOUS PASSIVE FOOT JOINT MOBILIZATION DEVICE This addition relates to improvements made to the mobility device characterized according to claim 1 of the main patent, in that it comprises a drive unit supported by the base, a carriage driven in reciprocating motion by the motor, and an articulated base system. orientacle and levers connecting the carriage to the system. The device according to the main patent allows, by its structure, continuous passive joint mobilization of the foot, with a view to its orthopedic correction, by mobilizing the entire osteoarticular system in the three planes perpendicular to space, allowing flexion-extension of the ankle, varus-valgus displacement of the talocalcaneal joint. and an abduction-adduction movement. In the proposed structure, the device includes an articulated sole system directly supported by the base at the mcyen of various also articulated supports, one of these The latter being responsible for fixing the sole. The aductor-adductor drive of the sole is achieved by directly attaching the sole through the support, resulting in a delicate and relatively bulky design that limits the sensitivity of the adjustment. With such a design, it is generally difficult, if not impossible, to create a two-part sole that could be controlled, if necessary, by independent relative pivoting. Therefore, such a device does not allow... a mobilization of the forefoot in metatarsus-varus. The fact that the sole is directly mounted on an articulated system which is itself supported by the base results in a mechanically fragile system offering little possibility of quickly changing the sole to adapt to the morphology. or a topic to be mobilized. Furthermore, in the proposed structure, the actuation of the articulated sole system on the three axes, BAD ORIGINAL around which the three movements mentioned above develop, is ensured by means of a sliding mechanism. The slides are carried by the base and connect to the various supports of the articulated system. os05 Such an assembly is cumbersome, even dangerous, due to the presence of moving parts that are difficult to conceal and, moreover, hinder maintenance and adjustment. This type of sliding system also does not allow for precise and individual adjustment of each movement to adapt the amzlitude depending on the correction that needs to be made. The object of the invention is to provide improvements to the mobilization device according to the main patent. These improvements, while respecting the basic structural organization of the device, aim to give it a smaller size, greater compactness, better mechanical resistance, and a greater possibility of adjusting the individual amplitude of each movement that can be imposed on the articulated system along the axes of mobilization in flexion-extension, varus-valgus, and... acuction-adduction. To achieve the above objectives, the mobilization device, according to this addition, is characterized in that: - the articulated system is mounted on a column by a pivot along the abduction-adduction axis, - the motor element is associated with a movement transformation mechanism with angular occlusion, carrying adjustable sliders, the connecting rods are mounted on the base system articulated and on the sliders. Several other characteristics emerge from the The description below refers to the accompanying drawings which show, as non-exhaustive examples, forms of realization of the object of the invention. Fig. 1 is a perspective of the addition. BAD ORIGINAL Fig. 2 is a plan view corresponding to Fig. 1. Figures 3 and 4 are schematic plan views showing two characteristic operating positions of the object of the addition. OS Fig. 5 is a partial perspective illustrating a variant implementation of some of the constituent elements of the object of the addition. Fig. 6 is a side view highlighting a construction detail according to fig. 5. Fig. 7 is a partial perspective of another shape of partial realization of the purpose of the additicn. Fig. 8 is a partial side view showing evident a constructive detail according to fig. 7. As in the main patent, the joint mobilization device according to the addition, as illustrated by Figs. 1 and 2, is intended to allow joint mobilization for the purpose of orthopedic correction of the foot by mobilization in flexion-extension on the AA' axis, in varus-valgus on the BB' axis and in abduction-adduction on the CC' axis. To this end, the bracket according to the addition comprises, as in the main patent, a support base S on which are mounted an articulated sole system I, a motorization assembly II and an interposed transmission system III the articulated sole system and the motorization assembly. As in the main patent, the articulated system I comprises a sole 1 capable of receiving, for example by resting on a heel pad (not shown), a foot to be mobilized, held in place by means of suitable removable fastening straps. The sole 1 is rigidly but removably supported by a sole holder 2 fixed to a base bracket 3, which is articulated by trunnions forming the axis AA' on an intermediate bracket 4 capable of rotating by means of a pivot 13 on the BB' axis. According to an example of an embodiment based on addition, the pivot 13 is supported by a suspension piece 100 BAD ORIGINAL- advantageously made in the form of a right angle, the arm 101 of which carries the trunnion 13. The arm 102 of the right angle 100 is suspended by a pivot 103 from the upper end of a column 104 rising from the base 1. The pivot 103 is coaxial with the axis CC' and is preferably formed by a rotating shaft passing through the upper part of the column 104. The arm 102 is fixed to the shaft of the pivot 103 in any suitable manner to be angularly immobilized on the latter, while being easily detachable. The base 1 is fitted onto the base plate 2, so that, in the rest state of the apparatus, the pivot 103 or the axis CC' coincides with the center of the physiological articulation of the foot. The motor assembly II consists of a geared unit 105, with two directions of rotation, preferably of the electric type, whose output shaft is provided with a pinion driving a belt 106 surrounding a reduction pulley or wheel 107 supported by the base S, preferably by means of a rotation axis DD' perpendicular to said base and parallel to the axis BB'. The wheel 107 supports a motion transformation mechanism 108 comprising a support 109 fixed to the wheel or pulley 107, so as to be driven by the latter with an alternating angular displacement about the pulley's rotation axis. The support 109 carries three threaded rods 110, 111, and 112, each of which is driven in rotation about its axis by a button 113, which may be manually or otherwise operated. The screws, 111 and 112, extend parallel to each other in a general direction parallel to the axis AA' and are made at the micrometric screw type. The threaded rods 110, 111 and 112 cooperate respectively with a slider 114, 115 and 116 in the form of a threaded ring capable of being moved along the corresponding threaded rod by the rotation imparted to the latter. via control button 113. Transmission system III consists of BAD ORIGINAL Rigid connecting rods 120, 121, and 122 are mounted by pivot pins 123, 124, and 125 on the corresponding sliders 114 and 116. The connecting rods 120, 121, and 122 are also mounted by their opposite end portions, respectively, on the base carrier 2 or the base bracket 3, on the intermediate bracket 4, and on the pivot pin 103. According to a preferred design, the connecting rod 121 is linked to a crank 126 fixed to a shaft 127 carried by the column 104 and provided with a pinion 128 cooperating with a complementary pinion 129 adapted to the end portion of the shaft constituting the pivot pin 103 opposite the base 1. The pinions 128 and 129 constitute, in In this case, an angle return. The construction of the device according to the addition method described above allows for a particularly compact and resistant articulated sole system I, since it is supported by a suspended part attached to the through shaft of the articulation pivot 103. The sole 2 is then devoid of any connection with the axis CC', and its adaptation to the sole holder 2 can thus be changed very quickly whenever it is necessary to adapt the device to the morphological conformation of the subject to be treated. The suspension of the articulated sole system I makes it possible to create a compact but robust articulated assembly by adopting, for the construction of the pivot 13 and the pivot 103, mechanical means well known for their sensitivity, precision, and concentricity, such as needle bearings. or roller-type. The use of a motion transformation mechanism 108 with angular displacement allows the use of micrometric screws 110, 111, 112 offering a wide range of fine adjustment possibilities for each movement transmitted by the connecting rods 120. 121 and 122 along axes AA', CC' and BB' respectively. Indeed, Fig. 3 shows a state in which, by rotating screws 110 to 112, sliders 114 to 116 have been aligned. with the axis DD' of partial angular rotation of pulley 107. In such a state, adapted to the mobilization of a right foot as BAD ORIGINAL This is represented by the fact that any angular displacement of this pulley, for example in the direction of arrow f1, via motor 105, does not produce any movement of the articulated sole system I. The points of application of the various connecting rods centered on the axis DD' are, in fact, not modified by the rotation, regardless of its angular amplitude. Such operation is made possible, in particular, by the connecting axes 123 to 125 between the connecting rods. and the cursors. Conversely, when the sliders have been moved to their maximum displacement in the direction corresponding to the possible active adjustment stroke from the neutral point in alignment with the axis DD', as illustrated by Fig. 4, a rotation in the direction of the arrow f1 of the wheel or pulley 107 results in a simultaneous actuation of the connecting rods 120, 121 and 122, each respectively controlling the dorsiflexion movement of the sole 1 via the base bracket 3, the abduction movement by rotation of the suspension piece 100 on the axis CC' via the angle drive 128, 129 and the valgus movement by the rotational drive of the bracket intermediate 4 on axis BB'. A rotational drive of pulley 107 in the opposite direction to that of arrow f1 produces the bending movements plantar, adduction and simultaneous varus. By means of the mechanisms described above, it becomes possible to individually adjust the amplitude of each mobilization movement to be imposed on the foot, for example by manually adjusting button 113 of the corresponding micrometer screw. Such an adjustment can be made easily and precisely, due to the accessibility of the mechanism 108 and the fine-tuning precision that can be achieved by adjusting the respective positions of the sliders 114 to 116. precisely between the two positions above. It should be noted that it appears advantageous to make the Gorter screw 110 a thread extending along its entire length BAD ORIGINAL useful, whereas a thread on only half the length of screws 111, 112 can be provided. Thus, as can be seen from the description and drawings, the same device can then be used for a left or right foot by simply moving the slider 114 to one or the other of the useful ranges of the screw on either side of the axis DD' and reversing the direction of rotation of the motor 105, so that the previously described valgus and abduction movements of a right foot become varus and adduction movements of the left foot. Another advantage of the above structure lies in the simplicity of the motion transmission ensured by the assembly of these connecting rods controlled by the transformation mechanism 108. The above means consequently allow the mobilization device to be easily adapted to the treatment at to guide and, also, to the patient's microbiology. The particular construction of the device according to this addition offers the additional possibility of allowing passive mobilization of the forefoot in order to correct the metatarsus-adcuctus deformation. To this end, as illustrated in Fig. 5, the articulated sole assembly I comprises a sole 1 consisting of a posterior portion 130 immobilized by any appropriate means on the base stirrup 3. The posterior portion 130 supports an anterior portion 131 via a pivot axis 132, which is offset towards the external lateral edge so as to be, in all cases, coaxially positioned with the pivot 103 centered on the axis CC'. As illustrated in Fig. 6, the posterior portion has a postero-internal rim 133, while the anterior portion 131 has an antero-internal rim 134 and a external median border 135. The edges 133, 134, and 135 allow a foot to be held in place in a static immobilization position, but also potentially in a dynamic position tending to mobilize the anterior part of the foot. Indeed, as illustrated by the BAD ORIGINAL Fig. 5, the rear part 131 can be angularly locked by means of a bar 136 adapted in an adjustable manner to the column 104 or to a telescopic extension 137 thereof, so as to engage a complementary stop 138 carried by the front part 131. In this way, after adjustment of the transformation mechanism 108 to neutralize the controls in plantar-dorsal flexion and varus-valgus by means of the connecting rods 120 and 122, an angular rotation of the pulley or wheel 107 rotates the suspension piece 102 on the axis CC'. The suspension piece 102 drives the rear part 130, while the front part 131 remains immobilized by means of the bar 136. In this way, as illustrated by Fig. 6, it becomes possible to mobilize angularly and alternately, for example on beach a, the posterior part 130 of Ca sole 1 and to mobilize the foot in metatarsus-adductus. An alternative embodiment is illustrated by Figs. 7 and 8, showing a sole 1 made as previously stated to comprise a rear part 130 and an anterior part 131 provided with the same internal and external edges as those described in Reference to fig. 6. In the illustrated example, the anterior part 131 is adapted to be angularly immobilized on the through shaft of the pivot 103, while the posterior part 130 can be angularly immobilized by means of a bar 139 engaging the column 104. In this embodiment, mobilization of the forefoot in metatarsus adductus is then ensured by subjecting the anterior part 131 to angular displacement relative to the immobilized posterior part 130, to which the anterior part is also articulated. via axis 132. The addition is not limited to the examples described and cited, as various modifications can be made to them. without stepping outside its framework. BAD ORIGINAL j

Claims

CLAIMS 1 - ApoareiL of passive joint mobilization of the foot, of the type comprising according to claim 1 of the main patent, on the one hand, an articulated sole system (I) OS comoortant a sole (1) carried by articulated supports (3, 4 ) to give said sole three degrees of adjustable orientation on the orthogonal axes of flexion (AA'), abduction-adducticn (CC') and varus-valgus (BB'), on the other hand, a motor organ (II) of the rotary type and, moreover, a transmission system (III) with adjustable rods connecting the motor member to the articulated sole system, characterized in that: - the articulated system (I) is mounted on a column (104) by an articulation pivot (103) along the abduction-adduction axis (CC'), - the motor oraane (II) is associated with a motion transformation mechanism (108) with angular displacement, carrying adjustable sliders (114 to 116), - the rods are mounted on the system of articulated sole and on the sliders. 2 - Apparatus according to claim 1, characterized in that the articulated sole system (I) comprises: - a part (100) for suspension on the column (104) by the articulation pivot (103), - an intermediate stirrup (4) mounted on the part (100) by an articulation pivot (13) along the varus-valgus axis (BB'), - a base stirrup (3) mounted on the intermediate stirrup by an articulation along the axis of flexion (AA'), - and a sole (1) removably fixed to the base stirrup so that its part corresponding to the center of the complex articulation of the foot is centered on the axis BADORIGINA r of abducticn-adducticn (CC'). 3 - Apparatus according to claim 1 or 2, characterized in that the articulated sole system comprises a sole (1) consisting of a rear part (130) immobilized on the base stirrup (3), an anterior part (131) hinged on the rear part by a pin (132) coinciding with the pivot and a blocking bar (136) mounted adjustable in the column to be able to engage and immobilize the anterior part. 4 - Apparatus according to claim 1, characterized in that the articulated sole system comprises an anterior part (131) mounted integral with the articulation pivot (103) so that its part corresponding to the center of the articulation of the foot is centered on the pivot, a rear part (130) articulated on the front part by a pin (132) and a blocking bar (139) capable of being interposed between the rear part and the column. - Apparatus according to claim 3 or 4, characterized in that the axis (132) of articulation of the front and rear parts of the sole is offset towards the middle part outside. 6 - Apparatus according to one of claims 3 to 5, characterized in that the sole has a front part provided with an antero-internal rim (134) and an outer median rim (135) and a rear part provided with a rim postero-internal (133). 7 - Apparatus according to claim 1 or 2, characterized in that the articulation pivot (103) is constituted by a shaft carrying the articulated sole system (I) and passing through the column beyond which it is controlled in rotation by one connecting rod. 8 - Apparatus according to claim 7, characterized in that the shaft and the connecting rod are linked by a pair of pinions angle transmission (128, 129). 9 - Apparatus according to claim 1, characterized in that the rods (120, 1Z1, 122) are articulated respectively BAD ORIGINAL on the base stirrup (3) or on the sole (1), on the intermediate stirrup (4) and on a bevel gear control crank (126). - Apparatus according to claim 1, characterized in that the transmission mechanism (108) consists of a rotating support (109) on which are mounted three threaded rods (110, 111, 112) each provided with a button (113) rotation control and each cooperating with a slider (114, , 116) tapped on Leauel a connecting rod is articulated. BAD ORIGINAL