JP2024083181A - Function recovery support device - Google Patents

Abstract

To provide a function recovery support device for allowing muscles responsible for dorsiflexion of an ankle joint to be concretely recognized and to function so as to contribute to efficient recovery of a voluntary motion of an ankle.SOLUTION: A function recovery support device includes: step boards 1 to place feet of a trainee; and a base plate 2 for swingably supporting the step boards 1 in a front and rear direction. Each one of the step boards 1, 1 includes holding means 3 in a toe part to hold a toe of the trainee, has a fulcrum of a swing of the step board 1 beneath an arch part, and includes an extendable load member 4 arranged on a lower side of a heel part and to return to an extension state when no load is applied. Thus, front surfaces of the device change a direction so as to move between a forward inclination state and a backward inclination state by the swing.SELECTED DRAWING: Figure 1

Description

The present invention relates to a device that assists in functional recovery in cases where the lower limbs have been injured due to aging, locomotive syndrome, or trauma, etc.

Locomotive syndrome refers to a condition in which the physical ability to stand and walk (mobility function) is reduced in both men and women due to disorders of the musculoskeletal system caused by aging, stroke, etc.
Lower limb disorders are often accompanied by a condition known as "foot drop," in which the person cannot control the muscles that lift the toes.
When a person has "drop foot," it becomes difficult to walk normally because the person is unable to land on their heels, and the person may scrape and catch the toes, or the person's ability to control balance in the feet may decrease, leading to more frequent falls.
Conventionally, in order to allow people to live a safe life despite such symptoms, various braces for supporting the function of the feet and devices for assisting walking have been provided.
In addition, various functional recovery trainings are being carried out to improve such symptoms.

Conventional orthoses include, for example, a drop foot correction device (see Patent Document 1 below) that includes a crus support for tightening the crus, crus extensions extending downward from both lower ends of the support, a sole support for supporting and placing the front end of the sole of the foot, a sole extension extending from the rear end of the sole support, a pivot that allows the tips of the crus extension and sole extension to be bent freely together, and an adjustment band member disposed between the crus support and the sole support; Provided is a short lower limb orthosis (see Patent Document 2 below) which comprises an ankle band having holder parts located on the inside and outside of the neck, a connecting belt connecting the holder part side located on the inside of the toes when the orthosis is worn to the holder part side located on the inside of the ankle when the orthosis is worn, and a connecting belt connecting the holder part side located on the outside of the toes when the orthosis is worn to the holder part side located on the outside of the ankle when the orthosis is worn, and which can adjust the movable angle between the wearer's foot (or shoe) and shin by adjusting the length of the connecting belt by gluing together the hook-and-loop fasteners.
These braces can promote normal walking by physically supporting the ankle and preventing "foot drop," but because wearing the brace reduces voluntary use of the foot, there is a risk that the patient will forget how to use their toes.

Restorative training, the process of relearning muscle control with the brain, is extremely useful as a treatment for "foot drop" and other disorders of the lower limbs.
For example, Functional Electrical Stimulation (FES) is known as one of the methods for restoring the function of paralyzed limbs, and uses a device (see Patent Document 3 below) that includes a walking phase detection unit that detects the walking phase by attaching a switch for detecting the walking phase to the sole of the healthy side, a control signal generation unit that generates a control signal that replaces the signal descending from the central nervous system of a patient paralyzed by stroke or spinal cord injury based on the detected walking phase, and an FES system that applies electrical stimulation to the nerves controlling the paralyzed muscles based on this control signal.

Functional electrical stimulation (FES) is also used to assist leg movements, such as walking, by sending small electrical pulses to the nerves in paralyzed muscles, which then activate the muscles with the electricity passed through them.
For example, there is an assist device (see Patent Document 4 below) that assists a patient with a paralyzed lower limb in walking, the assist device comprising a first sensor for detecting first information indicating forward movement of the lower end of the paralyzed lower limb, a second sensor for detecting second information indicating vertical movement of the lower end, and a control unit that controls electrical stimulation applied to the muscles of the paralyzed lower limb based on the first information and the second information.
If elderly people or others wear such a device, it may be possible to prevent falls while standing or walking. However, since moving the muscles that control the desired movement by applying electrical pulses to the muscles can easily lead to involuntary movements that involve little of the trainee's will, depending on how it is used, it may also hinder the trainee's ability to express voluntary movements.

As an exercise machine for not only activating voluntary movement of the feet whose function has been reduced due to locomotive syndrome, etc., but also for increasing muscle strength in the feet, there is a bouncy rocking foot exercise machine (see Patent Document 5 below) in which two foot plates arranged in parallel are supported on a base plate so that they can be rocked, and springs are arranged to constantly apply a spring force to each foot plate in the direction of spreading relative to the base plate; a foot rest is attached to the front half of the base, and a shaft having a convex arc-shaped top is attached to the center of the rear half of the base in a direction perpendicular to the rear edge of the foot rest, and a heel rest with an arc-shaped concave cutout in the center of the bottom surface is placed on the shaft, and a person places the toes on the foot rest and the heels Other examples include a heel lift exerciser in which the left and right legs are placed on a heel rest and alternately pressed downward in a seesaw shape by applying force to the left and right legs (see Patent Document 6 below); an exercise machine equipped with a base plate placed on the floor, an attachment plate fixed to the upper front side of the base plate, and right and left step plates that are held by the attachment plate and can swing or move up and down (see Patent Document 7 below); and a foot exerciser in which the sole of the foot is placed on the top plate and the ankle is moved by moving the toes up and down, with the curved surface of the curved plate acting as a support, causing the foot exerciser to swing like a seesaw, making it easy to move the ankle, and the thighs also move up and down as the ankle moves, promoting blood circulation in the legs (see Patent Document 8 below).

JP 2022-134743 A Utility Model Registration No. 3217189 JP 2002-331007 A JP 2015-085034 A Japanese Utility Model Application Publication No. 56-113560 Japanese Utility Model Application Publication No. 61-016170 Utility Model Registration No. 3229703 JP 2002-224191 A

However, "foot drop" is a condition in which muscle strength or voluntariness of the tibialis anterior and other muscles has decreased, making it impossible to dorsiflex the ankle (raising the toes), and all exercise equipment only allows for extremely abstract extension and contraction, making it difficult to provide functional recovery training that specifically focuses on and activates the muscles that control dorsiflexion of the ankle, resulting in the problem that it is difficult to achieve the effect of efficiently activating both muscle strength and voluntariness.

The present invention was made in consideration of the above-mentioned circumstances, and aims to provide a functional recovery support device that specifically focuses on and activates the muscles that control dorsiflexion of the ankle joint, contributing to the efficient recovery of voluntary ankle movement.

The functional recovery support device of the present invention, which has been made to solve the above-mentioned problems, comprises footboards on which the trainee's feet rest and a base plate that supports the footboards so that they can swing back and forth, and each footboard has a holding means for holding the trainee's toes at the toe portion, a fulcrum for the swinging movement of the footboard under the arch portion, and an expandable load member under the heel portion that returns to an extended state when no load is applied, and is characterized in that the swinging movement causes the surface to change direction so as to go back and forth from a forward-leaning state to a backward-leaning state.
The functional recovery support device can also be configured to include a pair of footboards on which the trainee places his/her feet, spaced approximately waist-width to shoulder-width apart, and a base plate that supports the pair of footboards so that they can swing back and forth.

In order to avoid a sudden change from dorsiflexion to plantar flexion (toes extended) during return and to avoid placing excessive strain on the ankle, it is desirable for the elastic load-bearing member to be a cushioning material with a porous structure that is soft to the touch.

The functional recovery support device of the present invention is provided with a holding means for holding the toes of the trainee at the toes, a fulcrum for the swinging of the foot plate is placed under the arch, and an elastic load member that returns to an extended state when no load is applied is placed under the heel. By placing one's own weight on the heel, it becomes difficult to dorsiflex the ankle, and dorsiflexion and plantar flexion are forced while being specifically aware of the stretching of the tibialis anterior, gastrocnemius, soleus, etc., thereby obtaining the effect of efficiently activating both muscle strength and volition.

In addition, by using a porous cushioning material such as memory foam, which is soft to the touch, as the elastic load-bearing member, the problem of excessive pressure caused by the sudden return action of a spring or leaf spring when the ankle changes from dorsiflexion to plantar flexion is eliminated, allowing training to be performed while slowly focusing on muscle stretching and contraction without placing unnecessary strain on the ankle.
In this way, the functional recovery assistance device according to the present invention allows the patient to specifically become aware of and function the muscles that control dorsiflexion of the ankle joint, thereby contributing to the efficient recovery of voluntary ankle movement.

1A is a front view, FIG. 1B is a side view of an embodiment of a functional recovery support device according to the present invention, FIG. 1C is a rear view, FIG. 1A is a front view, FIG. 1B is a side view of an embodiment of a functional recovery support device according to the present invention, FIG. 1C is a rear view, FIG. 1 is a perspective view showing an example of a functional recovery support device according to the present invention.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, an embodiment of a functional recovery support device according to the present invention will be described in detail with reference to the drawings.
FIG. 3 shows an example of a functional recovery support device (hereinafter, referred to as "device") according to the present invention.
This example comprises a footboard 1 on which a trainee places his/her feet, and a base plate 2 that supports the footboard 1 so that it can swing back and forth.

The base plate 2 in this example is a rectangular plate, but any shape that can stably support the foot boards 1 will suffice, and as long as sufficient strength and stability for use is obtained, a configuration in which the center of the base plate 2 where the foot boards 1, 1 are not located is hollowed out in order to reduce the total weight, etc., can be adopted.
In order to absorb vibrations and rattles, a configuration can be adopted in which a mat is provided over the entire back surface of the base plate 2, or legs are provided protruding from the back surface of the four corners of the base plate 2.
The footboards 1, 1 are respectively positioned so as to swing back and forth in a left area 2L and a right area 2R, which are set at a position on the platform 2 where the trainee's feet are spread approximately between waist width and shoulder width.

Each footboard 1, 1 is a rectangular plate having an area large enough for the entire sole of the trainee to rest on.
Each foot plate 1, 1 of this device has a holding means 3 fixed to the toe portion for holding the toes of the trainee, a leg portion 5 which serves as the fulcrum for back and forth swinging is fixed below the arch, an expandable load member (hereinafter referred to as the "load member") 4 which returns to an extended state when no load is applied is replaceably fixed below the heel, and a heel stopper 6 which supports the heel is protruded from the rear end.
A mat 7 may be attached to the surface of each footboard 1, 1 for the purpose of preventing contamination, preventing slipping and protecting the soles of the feet, or a curved surface may be formed to follow the contours of the soles of the feet.

The retaining means 3 is an instep strap that restrains the toes of the trainee to the surface of the footboard 1, and is fixed to the toe portion of each footboard 1, 1 in a ring-shaped form whose circumference can be adjusted.
The leg portion 5 is formed by a pair of leg plates 5a, 5a cut into the same triangular shape and arranged in parallel with a gap capable of accommodating the load member 4 therebetween.
A pair of leg plates 5a, 5a are integrated by fixing either the front or rear surface of the top of each to one of the wings of a hinge 8, and the other wing of the hinge 8 is fixed to the center of the front-to-rear direction of the left region 2L and right region 2R of the base plate 2, with the pivot pin of the hinge 8 facing in the left-to-right direction of the base plate 2. By doing so, each foot plate 1, 1 is pivoted so as to be able to swing back and forth relative to the base plate 2 via the hinge 8.

The back and forth swing of each footboard 1, 1 is a seesaw motion in which the surface of the footboard 1 changes direction from a forward tilted state to a backward tilted state.
In this example, the amount of swing of each footboard 1, 1 is adjusted by adjusting the height of the leg 5 and the shape and properties of the load member 4 so that dorsiflexion due to contraction of the tibialis anterior muscle, etc.: approximately 0 to 20°, and plantar flexion due to contraction of the gastrocnemius, soleus muscle, etc.: approximately 0 to 45° is possible.

A variety of materials can be used as the expansion/contraction load member 4, but in this example, a porous cushioning material is used, which has a variety of shapes that allow it to recover after compression and disperse the pressure during recovery without concentrating it in one area.
In order to obtain the appropriate load and resilience to allow for voluntary muscle extension and contraction to provide active dorsiflexion and plantar flexion to the foot, it is desirable to use soft urethane foam that has both elasticity and viscoelasticity (slow resilience) as a porous cushioning material.
In particular, by using low-resilience foam, which is a foam with open cells made of polyurethane resin, it is possible to obtain slow recovery, that is, a slow return to the original state after compression, making it possible to create a delicate training device that is gentle on the trainee's feet.

The load member 4 in this example is formed in a roughly fan-like shape following the path of the swinging motion of the footboard 1 .
The load member 4 is fixed by fitting both ends of the load member 4 into retaining portions (not shown) provided on the rear surfaces of the heels of the foot plates 1, 1 and the rear surfaces of the left and right regions 2L and 2R. In this example, a part of the load member 4 is loaded into the rear of the gap between the pair of leg plates 5a, 5a.
The holding portions provided on the underside of the footboard 1 and the surface of the base plate 2 are, for example, frames or the like having recesses that match the shapes of both ends of the load member 4 .
In this way, by arranging frames capable of holding both ends of the load member 4 on both sides of the load member 4 in the extension/contraction direction, combined with the presence of leg plates 5a, 5a arranged on the sides, the load member 4 can be stably held in a fixed position without the need for any adhesives or screws, and load members 4 with different rebound elasticity moduli can be easily replaced depending on the symptoms of the trainee.

Training using the device configured as described above mainly involves placing the device in front of a chair and repeating dorsiflexion and plantar flexion.
When the trainee sits on a chair and puts the toes through the instep belt (retaining means 3) and fits the foot plate 1, it becomes difficult to move the center of gravity forward and backward around the arch of the foot. As a result, it becomes difficult for the trainee to put his/her own weight on the foot plate (especially the heel) 1, and he/she is forced to perform dorsiflexion solely by muscle strength, so that the trainee can train the dorsiflexion and plantarflexion of the ankle while being conscious of the stretching and contraction of the muscles involved.
The amount of dorsiflexion and plantar flexion of the ankle, the strength and properties of the load member 4, and the training menu are adjusted by the trainee according to the trainee's symptoms, and the training is carried out.
In terms of functionality, the porous cushioning material is lightweight and has good shock absorption, vibration damping, pressure dispersion, and sound absorption properties, so it does not burden housemates when training at home, and if placed in the toilet, it has the secondary effect of improving bowel movements due to the leg movement of the trainee.
In addition, from a design perspective, porous cushioning materials allow for a wide range of coloring options, which helps avoid spoiling the aesthetic look of the room.

1 footboard,
2 base plate, 2L left area, 2R right area,
3 holding means, 4 load member, 5 foot, 6 heel stop, 7 mat, 8 hinge,

Claims (3)

The training device is provided with a footboard on which the trainee places his/her feet, and a base plate that supports the footboard so that the footboard can swing back and forth.
This functional recovery support device is characterized in that each foot plate has a holding means at the toe portion for holding the toes of the trainee, a fulcrum for the swinging movement of the foot plate under the arch portion, and an elastic load member under the heel portion which returns to an extended state when no load is applied, and the swinging movement causes the surface to change direction from a forward-leaning state to a backward-leaning state. The training device is provided with a pair of footboards on which the trainee places his/her feet with the feet spaced approximately from waist width to shoulder width, and a base plate that supports the pair of footboards so that the pair of footboards can swing back and forth.
This functional recovery support device is characterized in that each foot plate has a holding means at the toe portion for holding the toes of the trainee, a fulcrum for the swinging movement of the foot plate under the arch portion, and an elastic load member under the heel portion which returns to an extended state when no load is applied, and the swinging movement causes the surface to change direction from a forward-leaning state to a backward-leaning state. 3. The mask according to claim 1, wherein the elastic load member is a buffer material having a porous structure.

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