Abstract:
An orthopedic support device with an upper body engaging portion and a lower body engaging portion connected by a hinge or pivot and including a spring assist device. The orthopedic support device configured to provide assistance to a user in returning the user&#39;s torso from a forward leaned position to a vertical position. The device may be selectively engaged to permit the user to sit normally while wearing the device. The spring assist device may include a coil spring. The spring may be changeable to adapt to the level of assistance an individual user requires. The spring assist device may include a preload adjustment.

Description:
CROSS-REFERENCE TO RELATED APPLICATION 
       [0001]    The present application claims priority to U.S. Provisional Application Ser. No. 61/254,287, filed on Oct. 23, 2009, the disclosure of which is incorporated herein by reference. 
     
    
       [0002]    This device is intended to assist patients with camptocormia but could be used for other conditions or illnesses which cause difficulty standing and walking erect. The device performs the following functions:
       1. Holds the patient erect while standing or walking   2. Allows patient freedom to bend at the waist and then provides assistance to resuming an upright position.   3. When disengaged, allows patient to assume seated position while holding the torso erect.       
 
         [0006]    The Torso Assist Othosis (TAO) of the present disclosure is similar to the Reciprocating Gait Othosis (RGO) in form and fit. Unlike the RGO, the TAO has no reciprocating mechanism, nor does it restrict dynamic axial extension of the spine. Instead, the hip joint may be fitted with a spring mechanism which is preferably sized to counterbalance the specific torso weight and muscle capability of each patient. This selection of spring characteristics allows the patient the freedom to bend at the waist and return to an upright standing position with minimal effort. 
         [0007]    The TAO design of the present disclosure employs a torsion coil spring to provide the counterbalancing force but other types could be used. Examples are spiral-wound torsion springs and torsion bars. Other types of restorative devices could also be used. Examples are spring struts, spring loaded cam followers, or even motorized linear actuators. 
         [0000]    Benefits that may be provided by the preferred torsion spring mechanism are: 
         [0008]    1. Adjustable torsion spring strength based on weight or needs of patient 
         [0009]    2. Adjustable spring pre-load 
         [0010]    3. High-strength cam action plunger latching pin 
         [0011]    4. Self latching feature 
         [0012]    5. Precision roller bearing movement 
         [0013]    In order to simplify use and implementation, the TAO was designed to be compatible with standard lightweight hip joint and spinal othosis components. This makes it possible to add the TAO mechanism to a standard RGO if both functions are needed by the patient. While the convention designs for similar othoses do not permit them to be used simultaneously, extensible links (either spring loaded or motorized) could be employed in a traditional RGO which would provide the additional degree of freedom afforded by the TAO. It is intended that such embodiments are within the scope of the present disclosure. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0014]    The accompanying drawing figures, which are incorporated in and constitute a part of the description, illustrate several aspects of the invention and together with the description, serve to explain the principles of the invention. A brief description of the figures is as follows: 
           [0015]      FIG. 1  is a side view of a torso assist othosis (TAO) according to the present disclosure, with a user of the device shown in a torso upright position. 
           [0016]      FIG. 2  is a side view of the TAO and user of  FIG. 1 , with the user shown in a forward-lean with the TAO supporting some of user&#39;s torso weight. 
           [0017]      FIG. 3  is a side view of the TAO and user of  FIG. 1 , with the user shown in a sitting position and a spring assist of the TAO disengaged. 
           [0018]      FIG. 4  is a front cross-sectional view of a right side pivot assembly for the TAO of  FIG. 1 . 
           [0019]      FIG. 5  is a closer side view of an upper anchor block of the pivot assembly of  FIG. 4 . 
           [0020]      FIG. 6  is a closer side view of a lower anchor block of the pivot assembly of  FIG. 4 . 
           [0021]      FIG. 7  is a closer view of a central fastener of the pivot assembly of  FIG. 4 . 
           [0022]      FIG. 8  is a side view of a main body of the pivot assembly of  FIG. 4 . 
           [0023]      FIG. 9  is a front cross-sectional view of the main body of  FIG. 8 . 
           [0024]      FIG. 10  is a side of the main body of  FIG. 8  with a spring cover in place. 
           [0025]      FIG. 11  is a side view of the spring cover of  FIG. 10 . 
           [0026]      FIG. 12  is a front view of a pair of springs for use with the TAO of  FIG. 1 . 
           [0027]      FIG. 13  is a side view of one of the springs of  FIG. 12 . 
           [0028]      FIG. 14  is a side view of an alternative embodiment of a main body for use with the pivot assembly of  FIG. 4 . 
           [0029]      FIG. 15  is a front cross-sectional view of the main body of  FIG. 14 . 
           [0030]      FIG. 16  is a side view of a second alternative embodiment of a main body for use in a TAO according to the present disclosure. 
           [0031]      FIG. 17  is a front cross-sectional view of the main body of  FIG. 16 . 
       
    
    
     DETAILED DESCRIPTION 
       [0032]      FIGS. 1 to 3  illustrate a preferred embodiment  100  of a TAO according to the present disclosure and will be referred to in the description as an illustrative and non-limiting example. Applicants anticipate that various options and alternatives will be apparent and it is not intended limit the present disclosure in any way. TAO  100  is illustrated as being worn or used by a user  25 . 
         [0033]    The main components of the TAO are as follows and illustrated in  FIG. 1  of the drawings: 
         [0034]    Shoulder harness  10   
         [0035]    Pelvic girdle and frame  12  providing an upper body engaging portion 
         [0036]    Hip joint pivot  14  with upper  16  and lower  18  attachment arms 
         [0037]    Counterbalance spring  24  (inside pivot  14  and shown on  FIG. 4 ) 
         [0038]    Engagement mechanism  20   
         [0039]    Thigh cuffs  22  providing a lower body engaging portion 
         [0040]      FIGS. 4 to 7  illustrate pivot  14  in greater detail and include a spring  24  mounted within pivot  14 . An anchor block  26  is positioned toward a top end of pivot  14  and engages an upper arm  16  while a lower arm  18  engages a main body  32  of pivot  14  via releasable latching anchor  28 . A central screw  30  extends through body  32  through spring  24  and also provides a pivot axis for pivot  14 . A spring loaded pin  19  may be included at a top of engagement mechanism  20 . Pin  19  may be selectively engaged (extended as shown) or disengaged (by retracting or moving downward with lower arm  18  and engagement mechanism  20 ) from a recess  21  in main body  32  to provide selective engagement or disengagement of the spring assist device of TAO  100 . 
         [0041]      FIGS. 8 to 11  illustrate main body  32  in more detail along with a mating cover  36 . Main body  32  may include an opening  38  for receiving screw  30  and possibly some form of a bearing to reduce friction and wear in rotation of the body about the screw. A recess  40  about the screw opening permits the insertion and anchoring of spring  24  within body  32 . A lower extension  42  of recess  40  permits a lower arm  60  (as shown in  FIG. 4 ) of spring  24  to be anchored to body  32  while an upper opening  44  in recess  40  permits an upper arm  62  (as shown in  FIG. 4 ) of spring  24  to extend outside body  32  to engage anchor block  26 . A preload adjustment screw  58  may be mounted within an opening  46  extending into lower extension  42 . Preload screw  58  may press forward against the lower arm of spring  24  and extension  42  may be configured to permit some movement of the lower arm in response to pressure from the preload screw. 
         [0042]    Moving the lower arm of spring  24  forward by pressing against it with the preload screw will serve to preload the spring with some tension so that with the latch engaged, there will be immediate resistance to forward movement of upper arm  16 . This will serve to provide a quicker response and halting of a forward collapse of the user&#39;s trunk. 
         [0043]    Alternatively, as shown in  FIGS. 14 and 15 , an alternative main body  132  may be configured without a means for providing a preload to spring  24 . With the exception of the preload screw provisions, main bodies  32  and  132  may otherwise be similarly configured. 
         [0044]      FIGS. 16 and 17  show another alternative main body  232  which is configured to utilize a conventional latching mechanism such as that incorporated into conventional RGO&#39;s and eliminates the need for an external latching pin. Use of main body  232  in a TAO according to the present disclosure may permit a simplified installation and may increase the overall ease of use of the TAO by a patient. 
         [0045]      FIG. 12  illustrates spring  24  for use in pivot  14  and a spring  24   a  for use in a left side or mirror image pivot  14   a . These springs are similarly configured with upper arms  62  and lower arms  60  and a central coil  64 . 
         [0046]    Camptocormia, a syndrome which is increasingly associated with Parkinson&#39;s Disease, causes patients to exhibit a severe, bent over posture when walking, standing or sitting. There is currently no recognized medical treatment or orthopedic device to mitigate this degenerative condition, and because of this, the TAO was developed. The TAO is designed to support the torso using a pelvic girdle and chest support while transferring the associated forces through stiff torsion springs to the legs with thigh cuffs. Each of these components should be custom-molded to fit the individual patient but it is anticipated that versions or embodiments with adjustment features may be provided in standard sizes so that TAOs according to the present disclosure may be more readily available and adaptable to users at a variety of price points. 
         [0047]    Fitted with a TAO, when a standing patient desires to bend over, all that&#39;s required is to lean forward and relax. The individually-sized (or adjusted) torsion springs will preferably match the weight of the patient so that the torso is essentially weightless. Once the task in the bent over position is completed, the patient is free to resume an erect position with only minimal muscle effort. Alternatively, it is anticipated that the assist provided by TAO  100  may be adjusted to match the muscular capabilities of the user. A patient may have some muscular strength to perform some of the lifting of the weight of their own torso and may only require a lesser assistance from TAO  100 . Other patients or users may have lost all or substantially all of their muscular ability to raise their trunk and may require TAO  100  to be able to assist in moving substantially all of the weight of their torso to an upright position. 
         [0048]    Since the springs assert little resistance near the vertical position, the TAO only minimally impedes normal walking. However, a fully relaxed spring also has no restorative force, so a small amount of spring preload may be desired to ensure that the patient is held fully erect. For this reason, the device incorporates a feature that permits adding varying amounts of preload to the torsion spring with an internal adjustment screw. However, the amount of preload is kept to a minimum to minimize pressure on the thigh cuffs when walking 
         [0049]    The current spring mechanism may be selectively engaged and disengaged with a cam operated, spring-loaded indexing pin  19  which may selectively engage or disengage recess  21 . Engagement/disengagement of pin  19  from recess  21  may be accomplished with a convenient paddle switch allowing easy access by the user, but other latching mechanisms are possible, including the utilization of existing RGO latching mechanisms. All moving parts may be mated with precision roller bearings to ensure reliability and smooth operation. It is anticipated that other suitable bearings, bushings or similar pivot schemes may be used within the scope of the present disclosure and it is not intended to limit the disclosure to any particular rotational bearing or support arrangement. The pivot mechanism may be fitted with stops and designed to snap into a locked position by simply standing erect. 
         [0050]    In order to assume a seated position, such as illustrated in  FIG. 3 , the spring mechanism must be disengaged. An additional set of stops ensure that the patient cannot fall forward in the seated position. 
         [0051]    While TAO  100  as illustrated herein is passive and does not assist the patient in transitioning from a seated to standing position, it is anticipated that a powered version could be developed within the scope of the present disclosure which would perform that function. Such an alternative embodiment might include a secondary means of assisting the user in moving from a seated to a standing position to permit the pivots of the TAO to be re-engaged. 
         [0052]    The TAO has shown in patient testing to provide the assistance needed for patients with advanced camptocormia to stand erect, walk normally, bend and reach, and return to a normal standing position. Prior to this, posture was bent over characteristic of the syndrome and mobility was restricted to a walker. Patients in the early stages of camptocormia will also find relief since they are easily fatigued and can only stand erect for limited periods. For those patients, the TAO springs can be sized to provide less assistance and be less intrusive. Over time, the spring sizes and/or preload can be adjusted as needed. 
         [0053]    TAO  100  is not intended to be used exclusively to assist camptocormia patients. Others afflicted with an inability to stand erect unassisted may be aided by the device. The main qualifier is an individual&#39;s ability to lie on flat surface with the spine straightened and then also be able to stand and bend at the waist without discomfort. 
         [0054]    While the invention has been described with reference to preferred embodiments, it is to be understood that the invention is not intended to be limited to the specific embodiments set forth above. Thus, it is recognized that those skilled in the art will appreciate that certain substitutions, alterations, modifications, and omissions may be made without departing from the spirit or intent of the invention. Accordingly, the foregoing description is meant to be exemplary only, the invention is to be taken as including all reasonable equivalents to the subject matter of the invention, and should not limit the scope of the invention set forth in the following claims.