DE102018006519A1 - Device for night storage and to support the lifting of the foot of disabled patients - Google Patents

Abstract

The invention relates to a device for night storage and to support the lifting of a foot of handicapped patients, the device being used as a night support rail and foot lifting orthosis. The object of the invention is to develop a device that can be used both as a night storage rail and as a foot lifting orthosis can and does not create pressure points on the back of the patient's foot. This is achieved according to the invention in that the base part (1) is composed of three partial areas, wherein • the upper partial area (10) rests on the patient's shin and has a curved shape in cross section, • The cross section of the middle section (7) has an angular shape composed of straight sections, • The lower section (11) rests on the back of the patient's foot and, in cross section, again has a curved shape, whereby on the front of the base section (1) upper section ( 10) a rotatable ratchet tensioning system (2) is arranged, which is connected to a coated strand or a coated rope (3), that in a tunnel train - via a passage tunnel (4) - by one over all three sub-areas (10; 7; 11) extending, elongated recess (9) is guided around.

Description

The invention relates to a device for night storage and to support the lifting of a foot of patients with walking difficulties, the device being used as a night support rail and foot lifting orthosis.

Such devices are used to prevent the development of ulcers (decubitus) and to avoid shortening of the tendons and muscles due to insufficient movement of the limbs with inevitable stiffening in the joints (contractures).

A large number of differently designed splints (orthoses) are known both from orthopedics and from surgery, with which either misalignments are eliminated, injured limbs are relieved, or limbs or joints are supported during sporting activities. A large number of such devices are also known for immobilizing injured or damaged limbs.
However, due to their special training, these devices are not or only slightly suitable for solving the problem described at the outset.

From the DE 20 43 125 A1 A device is known which is intended to solve the task of protecting the leg muscles of a bedridden patient from a deterioration in mobility or even immobility. For this purpose, the leg is enclosed in an air chamber, the cyclical inflation and deflation of which is intended to provoke a periodic movement of the leg. However, no solutions can be found to the problem of preventing ulcers.

The DE 25 49 169 A1 describes storing corresponding limbs in a device which is made from a block of polyurethane foam. The soft foam should avoid pressure points and skin irritation. However, the material's extensive impermeability to air is likely to be problematic, particularly with regard to the occurrence of skin irritation. In addition, no attention is paid to the prominently excellent body parts, such as the heel.

From the DE 196 45 076 A1 a device for reducing stretching and flexion deficits of a distal limb compared to a proximal limb is known.

The DE 299 21 472 U1 describes a splint made up of at least two elements which are articulated to one another at an articulation point and are limitedly angularly movable with respect to one another about the articulation point, the inner surfaces of which are predominantly applied to body sections of the patient not lying on the lying surface, the first element being in contact with the distal end and the second Element is formed on the proximal side of a limb, wherein the elements can be fixed in different angular positions to each other within the restricted range of motion.

From the US 6,793,640 B1 a foot lifting orthosis is known in which the sole is relatively softly supported in relation to the support elements extending in the vertical direction. In order to fix an angle between the lower leg and the foot or to lift the foot, lateral flexible bands are provided which act on the one hand in the ankle area of the support elements and on the other hand on the sole in the area of the forefoot.

From the DE 91 00 531 U1 a foot lifting orthosis is also known. This has a cuff in the upper region of the support elements, through which the foot lifting orthosis can be firmly attached to a lower leg. A non-elastic band is provided between this cuff and the sole, by means of which a fixed angular position of the foot relative to the lower leg of 90 ° is set.

A variety of diseases, such as multiple sclerosis, polyneuropathy, amyotropic lateral sclerosis, traumatic peronaeous lesion, nerve root symptoms or apoplexy, can lead to weakness in the foot lifting, which requires wearing such foot lifting orthoses. These foot lifting orthoses are used to raise the toe, so that the toe does not get caught on the floor when walking or the foot does not drag over the floor. In addition, tripping over bumps or falling can at least be reduced. In addition, the signs of a so-called stork walk should at least be reduced.

In many affected people, however, not only is a motor impairment, i.e. the deliberate possibility of movement of the lower extremities, restricted, but also the arm of the affected side of the body, which is partly more or less or completely paralyzed. Such hemiparesis means for those affected that the foot lifting orthoses described above cannot be put on without additional support from third parties. In addition, the previously known foot lifting orthoses cannot be used for therapeutic purposes in order to provide therapeutic support if the foot lifting function is weakened enable and thus to achieve a partial or complete regeneration of damaged muscles.

The DE 87 01 648.6 describes an anti-supinatorial podorthesis (ASP) = orthopedic support and holding device for anti-supinatorial restraint and immobilization of the foot up to and including the upper ankle, for preventing sagebrush formation in the sense of the sagging foot, for reflex inhibition of pointed spastic impulse, whereby it consists of a multidimensional Shaped and L-shaped angled stability part, which consists in one piece of a sole part with a partial outer heel shell and a lateral metatarsal to forefoot and an integrated longer outer shaft portion with a recessed outer ankle area, the integrated 3 Leather / Velcro bandages fix the middle, inner and rear foot firmly in relation to the lower leg shaft so that the outer foot prevents the above-mentioned misalignments by firmly clamping it in the splint.
The L-shaped molded part is designed as an inner shoe-shaped orthosis (for wearing in suitable ready-made shoes) and has the property of a night or positioning aid (without a surrounding shoe shape), the physiological lower leg / foot shapes being characterized by 3 Sizes can be adjusted for right and left and are made of a flexible, unbreakable thermoplastic material.

• • Keine der genannten Vorrichtungen kann problemlos sowohl als Nachtlagerungsschiene als auch als Fußheberorthese eingesetzt werden,
• • Viele der bekannten Lösungen setzen sich aus mehreren Teilen (Fußschale und Deckblenden) zusammen, sind nicht flexibel an jede Fußform anpassbar und erzeugen Druckstellen am Fuß des Patienten,
• • Eine stufenlose Anpassung der Vorspannung und/oder des Winkels ist nicht möglich,
• • Alle bekannten Lösungen sind am Fußrücken weitestgehend vollflächig sowie gewölbt ausgeführt und sorgen für zusätzliche Druckstellen bei einer Bewegung des Fußes,
• • Eine einhändige Bedienung/Verstellung durch den Patienten ist nicht oder nur sehr eingeschränkt möglich,
• • Durch die benötigte Steifigkeit herkömmlicher Orthesen sind das Abrollverhalten des Fußes und die daraus resultierende Muskelbewegung eingeschränkt oder nicht ausreichend möglich.

The known prior art has the following disadvantages:

• • None of the devices mentioned can be used without problems both as a night support rail and as a foot lifting orthosis,
• Many of the known solutions consist of several parts (foot shell and cover panels), cannot be flexibly adapted to every foot shape and create pressure points on the patient's foot,
• • It is not possible to continuously adjust the preload and / or the angle,
• • All known solutions are largely full-surface and arched on the back of the foot and provide additional pressure points when the foot moves,
• • One-handed operation / adjustment by the patient is not possible or only possible to a very limited extent,
• • Due to the required stiffness of conventional orthoses, the rolling behavior of the foot and the resulting muscle movement are restricted or not sufficiently possible.

The invention is based on the object of developing a device which can be used both as a night support rail and as a foot lifting orthosis and which does not produce pressure points on the back of the patient's foot.

• • der obere Teilbereich am Schienbein des Patienten anliegt und im Querschnitt eine gewölbte Form aufweist,
• • der mittlere Teilbereich im Querschnitt eine aus geraden Abschnitten winkelförmig zusammengesetzte Form aufweist,
• • der untere Teilbereich auf dem Fußrücken des Patienten anliegt und im Querschnitt wiederum eine gewölbte Form aufweist,

wobei auf der Vorderseite des Grundteils im oberen Teilbereich ein drehbares Ratschenspannsystem angeordnet ist, welches mit einer beschichteten Litze oder einem beschichteten Seil verbunden ist, dass in einem Tunnelzug - über Durchgangstunnel - um eine über alle drei Teilbereiche sich ausstreckende, länglich ausgeführte Aussparung herumgeführt ist.According to the invention, this is solved in that
the basic part is composed of three sections, whereby

• The upper part lies against the patient's shin and has a curved shape in cross-section,
• The middle section has a cross-sectional shape composed of straight sections,
• The lower partial area rests on the back of the patient's foot and again has a curved shape in cross section,

a rotatable ratchet tensioning system is arranged on the front of the base part in the upper section, which is connected to a coated strand or a coated rope that is guided in a drawstring - via a tunnel - around an elongated recess extending over all three sections.

At the end of the rounded recess in the lower part of the base part, the drawstring is guided in a through tunnel, which is also rounded.

Between the ratchet tensioning system and the coated strand / rope there is a tension spring which can be adjusted to the strength of the patient. The tension spring is attached to the strand / cable pull circuit by means of an eyelet, loop or a ring in the upper part of the rail and has a pulling force of 100 g to 2 kg. The respective strength of the tension spring required is dependent on the weight of the patient's foot and can be adjusted thereon. It serves for safety and comfort, because the spring action creates a uniform lifting force and the spring compensates for overstretching when walking.

The ratchet tensioning system is carried out via a rotary wheel with an angle adjustment of 1 to 3 degrees, so that one-handed, almost stepless adjustment of the angle between the upper and the lower section is possible. Depending on the constitution, the wearer can adjust the splint to his needs by stretching or relaxing.

The strand / rope is surface-coated with polypropylene or PTFE, so that a easy and friction-free, almost sliding adjustment of the cable system is possible.

The coated strand / rope preferably has a thickness of 0.8 to 1.0 mm.

The elongated recess preferably has a width of 1.5 to 3 cm. This is to ensure that the entire length of the base part does not cause pressure points on the back of the foot.

The middle part of the base part has a taper on both sides on its respective outside in order to make the overstretched area as small as possible and to compensate for a torsional movement on the foot.

Markings for shortening the length of the splints are arranged on the upper part and on the lower part of the base part, so that they can be adapted to the physical conditions of the patient.

The Velcro fasteners have a fleece band and are fixed to the calf and foot (towards the toes). They are connected to the patient's leg / foot using a Velcro strap.

• • Durch die gerade Ausführung des mittleren Teilbereiches mit einer im Querschnitt sich darstellenden Winkelform, kann ein seitlicher Riss bei Überdehnung der Schiene verhindert werden, was bei einer durchgehend gewölbten Form der Fall wäre. Dadurch können Verletzungen beim Träger der Schiene verhindert und gerade in diesem wichtigen Bereich einerseits eine Flexibilität bedingt durch die Geometrie und andererseits eine erhöhte Festigkeit bedingt durch die Eigenschaften des Kunststoffes erreicht werden.
• • Durch die erfindungsgemäße Ausführung des Ratschenspannsystems in Verbindung mit der speziellen Ausführung des Tunnelzuges, der um die längliche Aussparung herumgeführt ist, kann der Träger mit einer Hand nahezu stufenlos die Schiene an seine Bedürfnisse anpassen, ohne dass diese am Fußrücken ein Drücken verursacht.
• • Die spezielle Ausführung der mittig in der Schiene angeordneten länglichen Aussparung, die sich über alle drei Teilbereiche erstreckt und im mittleren Teilbereich beidseitig an der Außenseite zusätzlich verjüngt ausgeführt ist, wird gewährleistet, dass die überdehnte Fläche so klein als möglich gehalten und eine Torsionsbewegung am Fuß ausgeglichen wird.
• • Durch die zusätzliche Anordnung einer anpassbaren Zugfeder zwischen dem Ratschenspannsystem und der/dem Litze/Seil, kann die Nachtlagerungsschiene problemlos auch als Fußheberorthese verwendet werden. Durch die Federwirkung kann eine gleichmäßige Hebekraft erzeugt werden, wodurch die Feder und die Überdehnung durch das Auftreten beim Gehen ausgeglichen werden.

Advantages of the invention:

• • Due to the straight design of the middle section with an angular shape in cross-section, a lateral crack when the rail is overstretched can be prevented, which would be the case with a continuously curved shape. This prevents injuries to the wearer of the rail and in this important area, on the one hand, flexibility due to the geometry and, on the other hand, increased strength due to the properties of the plastic can be achieved.
• • Due to the inventive design of the ratchet tensioning system in connection with the special design of the drawstring, which is guided around the elongated recess, the wearer can adapt the rail to his needs almost continuously with one hand, without causing a pressure on the back of the foot.
• • The special design of the elongated recess in the middle of the rail, which extends over all three sections and is additionally tapered on the outside on both sides, ensures that the overextended area is kept as small as possible and a torsional movement on the foot is balanced.
• • Due to the additional arrangement of an adjustable tension spring between the ratchet tensioning system and the strand / rope, the night storage rail can also be used as a foot lifting orthosis. The spring action can produce a uniform lifting force, which compensates for the spring and the overstretching caused by the occurrence when walking.

embodiment

The invention will be explained in more detail below using an exemplary embodiment.

• - 1 - die Schiene/das Grundteil in einer 3D-Darstellung von vorn
• - 2 - die Schiene/das Grundteil in einer seitlichen 3D-Darstellung
• - 3 - die Schiene/das Grundteil von vorn in der Draufsicht
• - 4 - die Schiene/das Grundteil im Querschnitt
• - 5 - die Schiene/das Grundteil im Querschnitt mit Klettverschlüssen
• - 6 - einen Schnitt durch den mittleren Teilbereich

Show:

• - 1 - The rail / base in a 3D view from the front
• - 2 - The rail / the base part in a side 3D representation
• - 3 - The rail / the base part from the front in plan view
• - 4 - The rail / base in cross section
• - 5 - The rail / base in cross section with Velcro fasteners
• - 6 - A section through the middle section

The rail has the molded base 1 on the front of which the ratchet tensioning system 2 is arranged in the form of a rotatable wheel ( 1 ; 2 ).
Through the ratchet tensioning system 2 is a coated strand or a coated rope 3 which is used as a drawstring system over a tunnel 4 around the elongated recess 9 is led ( 3 ).
The basic part 1 is made up of the three sub-areas 10 . 7 and 11 together, with the upper section 10 an arched cross-sectional shape, the middle section 7 an angular shape formed from straight sections and the lower part 11 again has a curved cross-sectional shape ( 4 ; 5 ).
Between the upper part 10 and the ratchet tensioning system 2 is the mainspring 8th arranged, which gives the patient the opportunity to use the night bed during the day as a foot lifting orthosis.
The mainspring 8th can be adapted to each patient in different strengths.
In the middle section 7 points the base part 1 the rejuvenation 12 on. To adapt to the patient's proportions are on the upper part 10 as well as in the lower part 11 different markings 5 to shorten the base part 1 ,
On the upper part 10 and at the bottom 11 are the Velcro fasteners 6 attached to the patient's foot / leg with a fleece band ( 5 ).

1 -

Grundteil

2 -

Ratschenspannsystem

3 -

Litze/Seil

4 -

Durchgangstunnel

5 -

Markierungen

6 -

Klettverschluss

7 -

mittlerer Teilbereich

8 -

Zugfeder

9 -

Aussparung

10 -

oberer Teilbereich

11 -

unterer Teilbereich

12 -

Verjüngung

List of the reference symbols used

1 -

base

2 -

Ratchet tensioning system

3 -

Strand / rope

4 -

Through tunnel

5 -

marks

6 -

velcro fastener

7 -

middle section

8th -

mainspring

9 -

recess

10 -

upper part

11 -

lower section

12 -

rejuvenation

QUOTES INCLUDE IN THE DESCRIPTION

This list of documents listed by the applicant has been generated automatically and is only included for the better information of the reader. The list is not part of the German patent or utility model application. The DPMA assumes no liability for any errors or omissions.

Patent literature cited

• DE 2043125 A1 [0004]
• DE 2549169 A1 [0005]
• DE 19645076 A1 [0006]
• DE 29921472 U1 [0007]
• US 6793640 B1 [0008]
• DE 9100531 U1 [0009]
• DE 8701648 [0012]

Claims (12)

Device for night storage and to support the lifting of a foot of disabled patients, the device being designed as a one-piece rail design from a base part and having at least two Velcro fasteners, characterized in that the base part (1) is composed of three partial areas, wherein The upper partial area (10) rests on the patient's shin and has a curved shape in cross section, • the central section (7) has a cross-sectional shape composed of straight sections, • The lower section (11) rests on the back of the patient's foot and in turn has a curved shape in cross section, a rotatable ratchet tensioning system (2) being arranged on the front of the base part (1) in the upper section (10) and coated with a A stranded wire or a coated rope (3) is connected that is guided in a tunnel pull - via a passage tunnel (4) - around an elongated recess (9) which extends over all three sub-areas (10; 7; 11). Device after Claim 1 , characterized in that between the ratchet tensioning system (2) and the coated strand / rope (3) there is a tension spring (8) which can be adjusted in strength to the patient. Device after Claim 2 , characterized in that the adjustable tension spring (8) is designed with a tensile force of 100 g to 2 kg. Device after Claim 1 and 2 , characterized in that the ratchet tensioning system (2) is designed in an angular adjustment per switching operation of 1 to 3 degrees. Device after Claim 1 , characterized in that the strand (s) / rope (3) is surface-coated by means of polypropylene or PTFE. Device after Claim 1 and 5 , characterized in that the coated strand / rope (3) has a thickness of 0.8 to 1.0 mm. Device after Claim 1 . 5 and 6 , characterized in that the strand / rope (3) is guided on the base part (1) in through tunnels (4). Device after Claim 1 , characterized in that at the end of the rounded recess (9) in the lower part area (11) of the base part (1) the drawstring is guided in a likewise rounded through tunnel (4). Device after Claim 1 , characterized in that the elongated recess (9) has a width of 1.5 to 3 cm. Device after Claim 1 , characterized in that the central portion (7) of the base part (1) has a taper (12) on both sides on its respective outside. Device after Claim 1 , characterized in that markings (5) for shortening the rail length are arranged on the upper partial region (10) and on the lower partial region (11) of the base part (1). Device after Claim 1 , characterized in that the Velcro fasteners (6) are provided with a fleece band.

Images