Walking rehabilitation apparatus for persons limited in their mobility

Abstract

The invention relates to a walking rehabilitation apparatus (10; 100) for persons limited in their mobility. The apparatus (10; 100) comprises a treadmill (12; 112) on which a user can walk, a support (14; 114), and a first and a second supporting bar (16a, 16b; 116) or a first and a second handle that are connected to the support (14; 114) in order to allow a forward and backward movement of the first and second supporting bars (16a, 16b; 116) or of the first or second handles; the first and second supporting bars (16a, 16b; 116) or the first or second handles are to be pushed or pulled by the user. The apparatus further comprises means (18; 118) for applying to each supporting bar (16a, 16b; 116) or to each handle a driving force or a resistance against the movements induced by the user, and a control device configured to control said means (18; 118) and the speed of movement of the treadmill (12; 112) according to one or more parameters.

Description

Device for gait rehabilitation for people with limited mobility Technical field

[0001] The present invention relates to an apparatus for gait rehabilitation for persons with limited mobility. The present invention also relates to a method for gait rehabilitation using this apparatus. State of the art

[0002] There are already gait rehabilitation devices for people with limited mobility, including treadmills, which are generally used so that a therapist can make dynamic corrections to posture and gait. People can be secured or even supported using a harness. The treadmill's speed is usually set by the therapist. However, the chosen speed may not be adapted to the person's motor abilities. Furthermore, these devices generally do not allow for synchronization between arm and leg movements. Many devices are suitable for running, but not for exercise or gait rehabilitation. Brief summary of the invention

[0003] An aim of the present invention is therefore to propose an apparatus for gait rehabilitation comprising a treadmill whose movement speed is adapted to preserve the balance and dynamics of gait specific to the person.

[0004] Another object of the present invention is to provide an apparatus for actively correcting the gait of this person.

[0005] Another object of the present invention is to propose a method for gait rehabilitation using the above-mentioned apparatus.

[0006] These aims are achieved in particular by an apparatus for gait rehabilitation for people with limited mobility. The apparatus comprises a treadmill on which a user can walk, a support, a first and a second support bar or a first and a second handle connected to the support in order to allow forward and backward movement of the first and second support bars or of the first or second handles. The first and second support bars or the first or second handles are intended to be pushed or pulled by the user. The apparatus further comprises means for applying to each support bar and / or to each handle a driving force or resistance against the movements induced by the user, and a control device configured to control said means and the speed of movement of the treadmill according to one or more parameters.

[0007] According to one embodiment, the first and second support bars are parallel to the direction of travel of the treadmill and are connected to the support so that their respective movements are constrained in the direction of travel in two opposite directions.

[0008] According to one embodiment, the first and second support bars each comprise a sensor, preferably a strain gauge, oriented so as to measure a force in the direction of the longitudinal axis of the support bar.

[0009] According to one embodiment, the first and second support bars are each connected to the support by at least one connecting bar comprising a sensor, preferably a strain gauge, oriented so as to measure a force in the direction of the longitudinal axis of the connecting bar.

[0010] According to one embodiment, the first and second support bars are each connected to the support by two connecting bars, preferably connected to each end of the respective support bar. Each connecting bar comprises a sensor, preferably a strain gauge, oriented so as to measure a force in the direction of the longitudinal axis of the connecting bar.

[0011] According to one embodiment, the parameter or one of the parameters is calculated based on one of the following data or a combination of at least two of these data: - the force applied to each support bar by the user in the direction of travel or the opposite direction, - the speed of movement of each support bar, and - the placement distance (range of movement) of each support bar.

[0012] According to one embodiment, the user is equipped with several sensors placed on different regions of interest, the parameter or one of the parameters is calculated according to the movement of the user measured by the sensors.

[0013] According to one embodiment, the apparatus further comprises a link winch for attaching a limb of the user. The control device is configured to further actuate the winch depending on the movement of one of the two support bars.

[0014] According to one embodiment, the apparatus further comprises a link winch for attaching a body support system and force sensors for measuring the vertical force applied by the user to the support bars. The controller is further configured to control the winch based on the force measured on the support bars to relieve the user's arms.

[0015] Another aspect of the invention relates to a method for gait rehabilitation using the apparatus according to one of the aforementioned embodiments. The method comprises a step of previously equipping the user with the apparatus with several sensors and controlling the control device so that it performs the following steps: i) collecting in real time the measurements of the sensors when the user walks on the treadmill; ii) calculating in real time the position of the center of gravity of the user according to the measurements of the sensors, and iii) controlling in real time the movement of the treadmill according to the position of the center of gravity of the user.

[0016] According to one embodiment, the control device calculates in real time a value relating to the phase shift of the movement of the user's arms and legs based on the measurements from the sensors and modifies the speed of movement of the treadmill based on said value.

[0017] In one embodiment, one of the user's legs is attached to a tether, for example at the knee, the tether being connected to a winch. The method further comprises controlling the control device to operate the winch to pull the leg forward in accordance with the rearward movement of one of the two support bars.

[0018] According to one embodiment, the user is supported by a body support connected to a winch. The control device actuates, according to the method, the winch to raise or lower the body support depending on the vertical force applied by the user to the support bars.

[0019] An additional aspect of the invention relates to an alternative method of gait rehabilitation using the apparatus according to one of the aforementioned embodiments. This method consists of controlling the control device to actuate said means in order to apply to each support bar a driving force or a resistance against the movements induced by the user according to one of the data following or a combination of at least two of these data: - the force applied by the user to each support bar in the direction of the longitudinal axis of said bar, - the speed of movement of each support bar, and - the travel distance (range of travel) of each support bar, or

[0020] In one embodiment, the means are in the form of an electric motor. The control device drives the motor so that it generates said resistance. The intensity of the resistance is controlled as a function of the force exerted by the user on the support bars in the direction of the longitudinal axis of said support bars. Brief description of the figures

[0021] Examples of implementation of the invention are indicated in the description illustrated by the appended figures in which: - figure 1 represents a schematic perspective view of the apparatus for gait rehabilitation according to one embodiment of the invention; - Figure 2 represents a perspective view of a more advanced apparatus for gait rehabilitation, according to one embodiment; - Figure 3 illustrates a perspective view at the level of the installation of the motors on the upper part of the bar support; Figure 4 represents a detailed view of a motor mounted on a tie bar, which is mounted on the cross bars of the upper part of the bar support of Figure 3; - Figure 5 shows a perspective view of a support bar of the apparatus of Figure 2 mounted close to one end of each connecting bar; - Figure 6 shows an exploded view of the support bar of Figure 5; - figures 7a) to 7c) respectively represent an upper part of the connecting bar connecting the support bar to the attachment bar, a longitudinal sectional view of the connecting bar and a view of the lower part of this connecting bar; - Figure 8 represents a user of the device equipped with sensors, and - Figures 9a to 9d illustrate different methods for operating the apparatus of Figure 1 or Figure 2. Examples of embodiments of the invention

[0022] According to Figure 1, the apparatus 10 for the rehabilitation of walking for people with limited mobility, comprises a treadmill 12, a bar support 13, as well as a first and a second support bar 16a, 16b parallel to the direction of movement of the treadmill 12 and pivotally mounted on the support 13 so that their respective movements are constrained in the direction of walking in two opposite directions.

[0023] More particularly, the support 13 comprises an upper part 14 arranged above the conveyor belt 12 and held for example by four posts 15 arranged at the four corners of the structure and resting on the ground or on a frame. According to a variant, the upper part 14 can be fixed to a ceiling. The upper part 14 of the support 13 is intended to support the two support bars 16a, 16. For this purpose, this upper part comprises a first and a second transverse bar 23 which are oriented perpendicular to the support bars 16a, 16b. Each transverse bar 23 can be actuated around its respective axis by an electric linear actuator 18, for example a jack or a linear motor. According to an alternative embodiment, the actuator may be in the form of a spring.

[0024] The two ends of each support bar 16a, 16b are connected respectively to the first and second crossbars 23 by two connecting bars 24.

[0025] The first and second support bars 16a, 16b are intended to be pushed in the direction of travel or pulled in the opposite direction by the user. The actuator 18 is configured to be able to apply to each support bar 16a, 16b a driving force or resistance against the movements induced by the user.

[0026] The apparatus 10 further comprises a control device configured to control, on the one hand, the actuator 18 of each support bar 16a, 16b and, on the other hand, one or more motors of the treadmill 12 as a function of one or more parameters. For this purpose, the control device comprises an acquisition module for collecting data measured by different sensors, an analysis module for processing this data and deducing therefrom in particular the intention of the user and a control module configured to operate the actuator 18 of each support bar 16a, 16b and the motor or each motor of the treadmill as a function for example of the intention of the user. The control device can be controlled by control software executed by a processor.

[0027] A parameter can for example be calculated as a function of the force applied to each support bar 16a, 16b by the user, in particular in the direction of walking, the speed of movement each grab bar, the distance / range of travel of each grab bar, or a combination of all three (Figure 9a).

[0028] According to the embodiment illustrated by figures 2 to 7, the apparatus 100 comprises a treadmill 112, a bar support 113 similar to the first embodiment to constrain the movements of two support bars 116 in the direction of the user's walking in two opposite directions.

[0029] Referring to Figure 3, the upper part 114 of the bar support comprises two transverse bars 123a whose ends are fixed to two longitudinal bars 123b extending in the direction of walking of the user. Two attachment bars 127 are fixed to the transverse bars 123a so as to also extend in the direction of walking of the user. Two connecting bars 124 arranged respectively at the front and at the rear of the user during a rehabilitation session are pivotally mounted at the ends of each attachment bar 127 by means of a first fixing support 126 fixed to an upper part 124a of the connecting bar 124. These two connecting bars 124 will be referred to hereinafter as front and rear connecting bars.

[0030] According to another embodiment not illustrated, the two connecting bars arranged respectively at the front and at the rear of the user are pivotally mounted on a first and a second support resting on the ground on either side of the treadmill.

[0031] According to another embodiment not illustrated, the first and second support bars are each connected to the support by a single connecting bar. More particularly, one end thereof is connected to the corresponding support bar substantially midway between its two ends, the other end of the connecting bar being pivotally mounted to the support.

[0032] A first and a second actuator 118, which are for example each in the form of an electric motor of the linear type or of the rotary linear type, are mounted to be connected to the corresponding tie bar 127 on the one hand, and to the upper part 124a of the corresponding rear connecting bar 124 on the other hand. More particularly, with reference to FIGS. 2 and 3, one end of the housing 118a of the mounter 118 is pivotally mounted by means of a first fixing support 128a to a second fixing support 128b, which is fixed to the corresponding tie bar 127. The motor 118 comprises a slider 119 movable along its longitudinal axis and the distal end of which comprises a fixing member 119a connected to a second fixing support 129 mounted on the upper part 124a of the corresponding rear connecting bar 124.

[0033] The two attachment bars 217 are connected to the two crossbars 123a so as to be able to slide along them in order to be able to adjust the distance between these two bars to adjust the spacing between the two support bars 116 so that it is adapted to the size of the user and in particular the span of his arms.

[0034] Referring to Figure 5, a connecting piece 130a, 130b is pivotally mounted at each end of each support bar 116. The connecting piece 130a, 130b comprises a channel passing right through the piece and inside which is arranged a segment of a lower part 124b respectively of the rear and front connecting bar. This lower part 124b is preferably in the form of a tube and comprises a plurality of orifices 125 along its longitudinal axis (see Figure 7c) while each connecting piece 130a, 130b comprises at least two orifices located on two opposite sides of the piece in order to be able to adjust the height of the support bars 116 also according to the size of the user, then to secure them at the chosen height for example by means of a pin passing through one of the holes 125 of the lower part 124b of the connecting bar 124 and the two holes of the connecting piece 130a, 130b.

[0035] According to an embodiment illustrated in particular by Figure 6, each support bar 116 incorporates a sensor 140 in order to measure the force exerted by the user when the latter pushes each support bar in the direction of walking or pulls on it in the opposite direction by reproducing the natural swinging movement of the arms during walking. The support bar 116 comprises a linear bearing 142, for example of cylindrical shape, connected to one end of this bar and mounted inside a bearing support 144, for example of tubular shape, in order to be able to move relative thereto.

[0036] The sensor is, for example, a strain gauge 140 on which two fixing rods 146 are mounted on two opposite sides. One of these fixing rods is connected to the linear bearing 142 secured to the support bar 116 while the other end is fixed to a fixed part inside the bearing support 144 close to one end of this support. More precisely, the bearing 142 is mounted inside the bearing support 144 so that this fixed part, the strain gauge 140 and the bearing 142 are arranged side by side in the bearing support 144.

[0037] Thus, the fixing rods 146 apply two opposite forces to the strain gauge 140 tending to extend the latter along the axis of the corresponding support bar 116 when the user pulls alternately on the two support bars 116, while the fixing rods 146 apply two forces in the opposite direction to the strain gauge 140 tending to compress the latter along the axis when the user pushes alternately on the two support bars 116.

[0038] According to an embodiment, the force exerted by the user when he pushes each support bar in the direction of travel or pulls on each bar in the opposite direction, reproducing the movement natural arm swing during walking can be measured based on data provided by each motor.

[0039] The apparatus 100 also makes it possible to measure the vertical force applied to the support bars 116 by the user during a rehabilitation session. According to one embodiment, a sensor 150 is integrated for this purpose in the front and rear connecting bars 124 connecting each support bar 116 to the respective attachment bars 127. More particularly, according to FIGS. 7a to 7c, each connecting bar comprises two distinct parts, namely the upper part 124a comprising a tubular segment and the lower part 124b in the form of a tube, previously described, partially mounted in two linear bearings 160 arranged at a distance from each other in the tubular segment of the upper part 124a. The sensor 150 is mounted in a housing 126a forming an integral part of the first and second fixing parts 126, 129 of each connecting bar 124.

[0040] Like the sensor integrated in the support bars 116, the sensor 150 is for example a strain gauge on which two fixing rods 156 are mounted on two opposite sides. One of these fixing rods is connected to the housing 126a while the other fixing rod is fixed to one end of the tube 124b. Thus, the measurement of the vertical force applied to the support bars by the user during a rehabilitation session can be determined based on the combination of the measurements obtained by the four sensors 150.

[0041] Each motor 118 is configured to be able to be controlled to apply to each support bar 16a, 16b a driving force or resistance against the movements induced by the user according to different intensities.

[0042] Like the first embodiment, the apparatus 100 further comprises a control device configured to control, on the one hand, each motor 118 of each support bar 116 and, on the other hand, one or more motors of the treadmill 112 as a function of one or more parameters, in particular a parameter calculated as a function of the force applied to each support bar 116 by the user, in particular in the direction of walking, the speed of movement of each support bar, the distance / amplitude of movement of each support bar or a combination of the three as already mentioned. The control device comprises for this purpose an acquisition module for collecting data measured by different sensors, an analysis module for processing this data and deducing therefrom in particular the intention of the user and a control module configured to operate each motor 118 of each support bar 16a, 16b and the motor or each motor of the treadmill as a function, for example, of the intention of the user.

[0043] The speed of each support bar can be determined based on the data provided by each motor. The intensity of the driving force or resistance mentioned above can be calculated based on this parameter.

[0044] Each 118 motor shown in Figure 3 can be programmed to: - pushing and pulling the second fixing bracket 129 of the upper part 124a of the rear connecting bar in order to impart a driving force to each support bar 116 respectively towards the rear and the front, or - perform the function of a spring in order to exert resistance on the fixing support 129 of the upper part 124a of the connecting bar when the user pulls on the support bar and to assist the movement of the support bar forward.

[0045] Using the motor as a spring has the advantage of allowing the variation of different parameters, in particular the intensity of the resistance dynamically and the amplitude of the stroke. The stroke is therefore known which makes it possible to know the amplitude of movement of the support bars.

[0046] It goes without saying that the engines can be mounted differently to act on the front tie rods and not on the rear tie rods.

[0047] According to one embodiment, the user is equipped with several sensors which may be, for example, inertial measurement units (IMUs) 30 placed on different regions of interest as illustrated in FIG. 8. The sensors 30 may, for example, be attached to the user's feet, hands, shoulders and hips. The user's various movements during walking are measured. The parameters relating to the user's movements may be used to control the motor or motors moving the treadmill 12, 112 forward (Figure 9b).For example, the user's center of gravity may be calculated in real time by the analysis module of the control device based on sensor data to detect, for example, a forward movement of the center of gravity, in which case the control module is configured to control the or each motor of the treadmill 12, 112 and / or the resistance on the bars 16a, 16b, 116 so as to reconfigure the position of the center of gravity.

[0048] The apparatus according to one of the aforementioned embodiments may further comprise at least one winch 20, 120. A lower limb and / or the pelvis of the user may be attached to a link, in particular by a rope or a cable connected to the winch 20, 120. The control device is configured to actuate the winch 20, 120 in order to pull a lower limb forward as a function of the rearward movement of one of the two support bars 16a, 16b, 116 (figure 9c).

[0049] For example, for a user who has difficulty controlling their right leg to move forward, the rope or cable can be attached to the knee of the right leg. The winch 120 is actuated by the controller when the user pulls the support bar 16b rearward with their left hand to bring the right leg forward.

[0050] For a user who has difficulty controlling both legs, two independent winches may be provided. The rope or cable of each winch may be attached to the knee of each leg. The two winches are operated alternately by the control device when the user alternately pulls the support bars 16a, 16b backward with his right hand and left hand respectively in order to bring his left leg and right leg forward so as to reproduce the natural movements of walking. The winches may be controlled independently of each other so as to control the movement of each leg. The force applied to each leg as well as the amplitude of the controlled movement may be different.

[0051] The winches can be controlled in synchronization with the movement of the bars 16a, 16b, 116. It is thus possible to exercise the synchronization of the arms and legs, and the rotation of the pelvis, when walking.

[0052] The use of one or more cables to assist the forward movement of one or both of the user's legs, as well as the use of bars to coordinate the movements of the user's arms, thus makes it possible to stimulate the spinal locomotor network.

[0053] According to one embodiment, the structure 14, 114 of the apparatus 10, 100 may comprise an additional winch 22, 122 for attaching a body support system, for example a harness. The sensors 150 of the apparatus 100 make it possible to measure the force applied by the user to the support bars 16a, 16b, 116. The control device is configured to operate the winch 22, 122 to raise or lower the body support depending on the force applied by the user to the support bars 16a, 16b (Figure 9d). This prevents overloading of the user's arms.

[0054] It will be understood that various modifications and / or improvements obvious to a person skilled in the art may be made to the rehabilitation apparatus which is the subject of the above description without departing from the scope of the present invention defined by the appended claims. For example, the support bars may be replaced by simple handles which are each connected to the upper part of the support by a single connecting bar or to a first and a second support which are arranged on either side of the treadmill. Furthermore, the support bars are not necessarily parallel but may be oblique in a plane coinciding or parallel to the transverse plane of the patient.

Claims

Claims 1. Apparatus (10; 100) for gait rehabilitation for persons with limited mobility, comprising a treadmill (12; 112) on which a user can walk, a support (14; 114), a first and a second support bar (16a, 16b; 116) or a first and a second handle connected to the support (14; 114) in order to allow forward and backward movement of the first and second support bars (16a, 16b; 116) or of the first or second handles, said first and second support bars (16a, 16b; 116) or said first or second handles being intended to be pushed or pulled by the user, the apparatus further comprising means (18; 118) for applying to each support bar (16a, 16b; 116) or to each handle a driving force or a resistance against movements induced by the user, and a control device configured to control said means (18;118) and the speed of movement of the conveyor belt (12; 112) as a function of one or more parameters.; 2. Apparatus (10; 100) according to claim 1, wherein the first and second support bars (16a, 16b; 116) are parallel to the direction of travel of the treadmill (12; 112) and are connected to the support (14; 114) so ​​that their respective movements are constrained in the direction of travel in two opposite directions.

3. Apparatus (100) according to one of the preceding claims, wherein the first and second support bars (116) each comprise a sensor (140), preferably a strain gauge, oriented so as to measure a force in the direction of the longitudinal axis of the support bar (116).

4. Apparatus (100) according to one of the preceding claims, wherein the first and second support bars (116) are each connected to the support (114) by at least one connecting bar (124) comprising a sensor (150), preferably a strain gauge, oriented so as to measure a force in the direction of the longitudinal axis of the connecting bar (124).

5. Apparatus (100) according to the preceding claim, wherein the first and second support bars (116) are each connected to the support (114) by two connecting bars (124), preferably connected to each end of the respective support bar (116), each connecting bar (124) comprising a sensor (150), preferably a strain gauge, oriented so as to measure a force in the direction of the longitudinal axis of the connecting bar (124).

6. Apparatus (10; 100) according to one of the preceding claims, wherein said parameter or one of the parameters is calculated as a function of the force applied to each support bar (16a, 16b; 116) by the user in the direction of travel or the opposite direction, the speed of movement of each support bar or the distance of movement of each support bar.

7. Apparatus (10; 100) according to one of the preceding claims, in which the user is equipped with several sensors (30) placed on different regions of interest, and in which said parameter or one of the parameters is calculated as a function of the movement of the user measured by the sensors.

8. Apparatus (10; 100) according to one of the preceding claims, further comprising a link winch (20; 120) for attaching a limb of the user, the control device being configured to further actuate the winch (20; 120) as a function of the movement of one of the two support bars (16a, 16b; 116).

9. Apparatus (10; 100) according to one of the preceding claims, further comprising a link winch (22; 122) for attaching a body support system as well as force sensors for measuring the force applied by the user to the support bars (16a, 16b; 116) and wherein the control device is further configured to control the winch (22; 122) as a function of the force measured on the support bars.

10. Method for rehabilitating walking using the apparatus according to one of the preceding claims, comprising a step consisting of equipping the user of the apparatus (10; 100) with several sensors, the control device carrying out the following steps: - collect sensor measurements in real time when the user walks on the treadmill (12; 112), - calculate in real time the position of the user's center of gravity based on sensor measurements, and - control in real time the movement of the treadmill (12; 112) according to the position of the user's center of gravity.

11. Method according to the preceding claim, in which the control device calculates in real time a value relating to the phase shift of the movement of the arms and legs of the user according to the measurements of the sensors and modifies the speed of movement of the treadmill (12; 112) according to said value.

12. A method according to either of claims 10 or 11, wherein one of the user's legs is attached to a link, for example at the knee, the link being connected to a winch (20; 120), the method comprising controlling the control device to operate the winch (20; 120) to pull the leg forward as a function of the rearward movement of one of the two support bars (16a, 16b; 116).

13. A method according to any one of claims 10 to 12, wherein the user is supported by a body support connected to a winch (22; 122), the method comprising controlling the control device to operate the winch (22; 122) to raise or lower the body support depending on the force applied by the user to the support bars (16a, 16b; 116).

14. A method of rehabilitating walking using the apparatus according to one of claims 1 to 9, wherein the method consists of controlling the control device to actuate said means (18; 118) in order to apply to each support bar (16a, 16b; 116) a driving force or resistance against the movements induced by the user in 15. Method according to the preceding claim, wherein said means are in the form of an electric motor (118), the control device driving the motor so that it generates said resistance, the intensity of the resistance being controlled as a function of the force exerted by the user on the support bars in the direction of the longitudinal axis of said bars.

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