Abstract:
An orthosis for supination and/or pronation of a forearm of a wearer, the orthosis including a base, an upper arm support coupled to the base and configured to secure an upper arm of the wearer, a rotation assembly coupled to the base and including an output member rotatable relative to the base within a rotation plane, and a forearm support member coupled to the output member of the rotation assembly and configured to releasably engage a wrist and the forearm of the wearer, wherein the forearm support member is contoured to receive a thumb of the wearer.

Description:
CROSS REFERENCE TO RELATED APPLICATIONS 
       [0001]    This application is a continuation application of U.S. patent application Ser. No. 13/232,337, filed Sep. 14, 2011, which is incorporated herein by reference in its entirety. 
     
    
     BACKGROUND 
       [0002]    The field of the disclosure relates generally to a hand and forearm orthosis. When a joint is injured either by trauma or by surgery, scar tissue can form, often resulting in contractures. Such conditions can limit the range of motion of the joint. It is often possible to treat this condition by use of a range-of-motion (ROM) orthosis. ROM orthoses are devices commonly used during physical rehabilitative therapy to increase the range-of-motion over which the wearer can move the joint. 
       BRIEF DESCRIPTION 
       [0003]    An orthosis for supination and/or pronation of a forearm of a wearer is provided. The orthosis includes a base, an upper arm support coupled to the base and configured to secure an upper arm of the wearer, a rotation assembly coupled to the base and including an output member rotatable relative to the base within a rotation plane, and a forearm support member coupled to the output member of the rotation assembly and configured to releasably engage a wrist and the forearm of the wearer, wherein the forearm support member is contoured to receive a thumb of the wearer. 
         [0004]    A method of using an orthosis for supination and/or pronation of a forearm of a wearer is provided. The method includes coupling an upper arm of the wearer to the orthosis, and coupling a wrist and the forearm of the wearer to a forearm support member of the orthosis such that a styloid process of the wearer is substantially aligned with a rotation plane of a rotation assembly and a base of a thumb of the wearer is distal to the rotational plate of the rotation assembly. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0005]      FIG. 1  is an illustration of a right anterior arm of a wearer. 
           [0006]      FIG. 2  is side perspective view of an exemplary orthosis for providing supination and pronation rotation. 
           [0007]      FIG. 3  is an alternative side perspective view of the orthosis of  FIG. 2 . 
           [0008]      FIG. 4  is a fragmentary sectional view of the orthosis of  FIG. 2 . 
       
    
    
     DETAILED DESCRIPTION 
       [0009]    This disclosure relates generally to an orthosis for providing supination and pronation rotation of a forearm of a wearer. The orthosis provides rotation such that an upper arm portion of the wearer is secured in a position relative to the rotation of a forearm of the wearer. 
         [0010]      FIG. 1  is an illustration of an arm of a wearer for use with an orthosis. Although the orthosis could be utilized with either a right or left arm of the wearer, a right arm  10  of the wearer is illustrated in  FIG. 1 . Arm  10  of the wearer extends between a hand  12  and a shoulder  14  of the wearer. Right arm  10  of the wearer includes a wrist  16 , a lower portion or forearm  18 , an elbow  20 , and an upper portion  22 . Wrist  16  includes carpals  17  is the region where hand  12  is joined with lower portion  18  of arm  10  of the wearer. Elbow  20  is the region where lower portion  18  of arm  10  and upper portion  22  of arm  10  are joined. 
         [0011]    Lower portion  18  of arm  10  includes a radius bone  30  and an ulna bone  32 . Radius  30  has a distal end portion  40  at the end of which a radius styloid process  42  is formed. Radius  30  has a proximal end portion  44  or head of radius  30  at elbow  20 . Similarly, ulna  32  has a distal end portion  46  at the end of which an ulna styloid process  48  is formed. Ulna  32  has a proximal end portion or olecranon  50  at elbow  20 . Lower portion  18  of arm  10  also includes a proximal radioulnar joint  52  and a distal radioulnar joint  54 . The location of radius styloid process  42  and ulna styloid process  48  is substantially at the wrist joint or the location of wrist  16  at which flexion, extension, adduction, abduction, and circumduction occur with hand  12 . 
         [0012]    Upper portion  22  of arm  10  extends between shoulder  14  and elbow  20 . Upper portion  22  of arm  10  includes a humerus bone  60 . Humerus  60  has a distal end portion or trochlea and capitulum  62 , which cooperates with proximal end portions  44  and  50  of radius  30  and ulna  32  respectively. Additionally, humerus  60  has a proximal end portion  64 , which cooperates with shoulder  14 . 
         [0013]    Pronation of forearm  18  occurs when hand  12  is turned so that the palmar or anterior side of hand  12  and wrist  16  faces downward and the opposite or posterior side of hand  12  and wrist  16  face upward. Supination of forearm  18  occurs when hand  12  is turned so that the palmar or anterior side of hand  12  and wrist  16  faces upward and the opposite or posterior side of hand  12  and wrist  16  face downward. During pronation of forearm  18 , radius  30  crosses ulna  32  by revolving about proximal and distal radioulnar joints  52  and  54 . The orthosis couples to wrist  16 , at least a portion of forearm  18 , and upper portion  22  of arm  10  of the wearer to isolate movement to radius  30  and ulna  32  during pronation and/or supination of hand  12 . 
         [0014]      FIGS. 2 and 3  are side perspective views of an exemplary orthosis for providing supination and pronation rotation of an arm  10  of a wearer shown in  FIG. 1 . In the exemplary embodiment, an orthosis  100  includes a base  102  that may be releasably coupled to an upper arm support  104  and rotation assembly  106  having a central axis  108  extending longitudinally through the device with respect to base  102 . Base  102  may be releasably coupled to an upper arm support  104  via a retention device  110  and in the exemplary embodiment, base  102  may be formed from a rigid plastic material but may be formed from any suitable material. Retention device  110  may be a locking device in the exemplary embodiment and may be in the form of a bolt and knob  111 , which facilitates selective locking and unlocking of upper arm support  104  to base  102 . Upper arm support  104  includes an arm member  112  positionable over base  102  such that a slot  114  may be formed within arm member  112  to enable upper arm support  104  to couple to base  102 . Arm member  112  may be formed from a rigid plastic material but may be formed from any suitable material. In one embodiment, slot  114  may be substantially arcuate to allow upper arm support  104  to provide adjustment of an angle formed between upper arm support  104  and base  102 . Base  102  includes a retention slot  116  substantially aligned with a longitudinal axis of base  102  and substantially parallel with central axis  108  such that upper arm support  104  may be slidably coupled to base  102 , to accommodate wearers of orthosis  100  having forearms  18  of various lengths. 
         [0015]    Upper arm support  104  also includes an upper arm cuff  118  configured to secure upper arm  22  to orthosis  100 . Upper arm support  104  substantially secures upper arm portion  22  of the wearer in a fixed position relative to hand  12  of the wearer during rotation. Upper arm cuff  118  may be releasably coupled to arm member  112 , through cuff slot  120 , via cuff retainer  122 . In one embodiment, cuff retainer  122  includes a bolt (not shown) extending through upper arm cuff  118  and cuff slot  120  that may be tightened and secured by cuff knob  124 . Alternatively, upper arm cuff  118  may be coupled to arm member  112  by a any suitable retention means. In the exemplary embodiment, upper arm cuff  118  may be fabricated from a resilient material, such as plastic, and includes upper arm straps  126  coupled to upper arm cuff  118  that may be configured to allow upper arm cuff  118  to releasably secure an upper arm of the wearer within upper arm support  104 . In an alternative embodiment, upper arm cuff  118  may be fabricated from a relatively rigid material that substantially prevents movement of upper arm cuff  118 . Upper arm straps  126  include a releasable fastening component, such as hook and loop components, to adjustably tighten strap  126  and releasably secure upper arm  22  to upper arm support  104 . 
         [0016]    Similar to upper arm support  104 , rotation assembly  106  may be slidably coupled to base  102  such that rotation assembly  106  may be positioned over base  102 . Rotation assembly  106  may be formed from a rigid plastic material or from another suitable material. In the exemplary embodiment, rotation assembly  106  may be coupled to base  102  via a retention device  130 . Retention device  130  extends through a slot  132  formed in rotation assembly  106  and a hole  134  formed within base  102 . In the exemplary embodiment, retention device may be a locking device, which may be in the form of a bolt and knob  131  that facilitates selective locking and unlocking of rotation assembly  106  to base  102 . Slot  132  may be oriented perpendicular to the longitudinal axis of base  102  to provide vertical adjustment of a hand  12  and/or a wrist  16  with respect to base  102 . 
         [0017]    Rotation assembly  106  may be configured to rotate forearm  18  about axis  108 , which extends substantially within a central or mediolateral axis of forearm  18  of the wearer, when positioned within orthosis  100 . In the exemplary embodiment, rotation assembly  106  may be coupled to a forearm support member  140 , which includes an anterior forearm support member  142  and a posterior forearm support member  144 . Forearm support member  140  may be configured to extend proximal radius styloid process  42 , ulna styloid process  48 , and the wrist joint of the wearer to provide relative stability and to ensure forearm  18  and wrist  16  may be substantially maintained within axis  108 . Forearm support member  140  may be configured to substantially prevent a torsional load from being applied to carpals  17  of wrist  16  and to substantially prevent wrist  16  from extending and/or flexing during rotation of forearm  18  within orthosis  100 . Substantially preventing wrist  16  from extending and/or flexing during rotation of forearm  18  facilitates a reduction of a higher load to be placed on wrist  16  and hand  12  than forearm  18 . 
         [0018]    In the exemplary embodiment, anterior forearm support member  142  and posterior forearm support member  144  may be coupled together via lower arm straps  141 , which loop through slots  143  formed within anterior forearm support member  142 , such that forearm support member may be configured to secure forearm  18  within forearm support member  140  during rotation of forearm  18 . In the exemplary embodiment, lower arm straps  141  may be coupled to forearm support member  140  proximal radius styloid process  42 , ulna styloid process  48 , and the wrist joint. Coupling forearm support member  140  proximal radius styloid process  42 , ulna styloid process  48 , and the wrist joint facilitates substantially preventing wrist  16  from extending and/or flexing during rotation of hand  12 . 
         [0019]    In one embodiment, lower arm straps  141  include fastening components, such as hook and loop components, such that straps  141  may be adjustable and may be tightened over hand  12  and forearm  18 . In the exemplary embodiment, forearm support member  140  may be formed from plastic or other material and includes a cushioning material lining the inner walls of each of anterior forearm support member  142  and posterior forearm support member  144  to provide comfort to the wearer. 
         [0020]    Rotation assembly  106  may be coupled to forearm support member  140  by coupling forearm support member  140  to an inner wall  150  formed within a rotation gear  152 . In the exemplary embodiment, rotation gear  152  has a substantially arcuate cross-sectional shape to provide rotation to forearm  18 . In the exemplary embodiment, forearm support member  140  may be coupled to inner wall  150  with a screw and nut securing system, however, any coupling means can be used to couple forearm support member  140  to inner wall  150 . Alternatively, forearm support member  140  may be integrally formed on rotation gear  152 . 
         [0021]    Rotation gear  152  includes an arcuate array  156  of gear teeth having a configuration of a portion of a circle. Forearm support member  140  extends upward between opposite ends  155  of arcuate array  156  of gear teeth and through a portion of an opening  158  formed in rotation gear  152 . Arcuate array  156  of gear teeth defines a rotational plane  160 , which may be perpendicular and/or orthogonal to axis  108 . Forearm support member  140  may be coupled to rotation assembly  106  such that, when in use, the wearer&#39;s radius styloid process  42  and/or ulna styloid process  48  lie within rotational plane  160 . Aligning radius styloid process  42  and/or ulna styloid process  48  with rotational plane  160  facilitates substantially preventing wrist  16  from extending and/or flexing during rotation of forearm  18 . 
         [0022]    Rotation gear  152  may be coupled to a drive gear  162  (shown in  FIG. 4 ) that may be fixedly coupled with a drive shaft  164  and drive knob  166 , such that drive gear  162  may be engaged with arcuate array  156  of teeth on rotation gear  152 . In the exemplary embodiment, drive gear  162  may be a worm gear. In an alternative embodiment, drive gear  162  may be a motor. Alternatively, drive gear  162  may be any gear that affects rotation of forearm  18  of the wearer. Upon rotation of drive knob  166 , drive gear  162  may be rotated to affect pronation and/or supination of forearm  18 . 
         [0023]    During operation, in the exemplary embodiment, viscoelastic body tissue connecting proximal end portions  44  and  50  of radius  30  and ulna  32  with humerus  60  in arm  10  of the wearer may require stretching to enable forearm  18  of the wearer to move through a desired range of motion in supination and/or pronation. When the viscoelastic body tissue connected with proximal end portions  44  and  50  of radius  30  and ulna  32  is to be stretched, upper portion  22  of arm  10  of the wearer is positioned in upper arm cuff  118  of orthosis  100 . Straps  126  may be tightened around upper portion  22  of arm  10  to position arm member  112  relative to upper portion  22  of wearer&#39;s arm  10 . 
         [0024]    Hand  12  may be positioned in forearm support member  140  by moving hand  12  through opening  158  in forearm support member  140 . Straps  141  may be then tightened and secured proximal the wrist joint to press the sidewalls of forearm support member  140  against the palmar and back sides of hand  12 , wrist  16 , and forearm  18 , such that at least one of the radius styloid process  42  and ulna styloid process  48  may be substantially aligned with rotational plane  160 . Once hand  12 , wrist  16 , and forearm  18  may be positioned within forearm support member  140 , flexion and/or extension of wrist  16  may be substantially prevented. 
         [0025]    Until rotation assembly  106  is actuated or initiated, lower portion  18  and upper portion  22  of wearer&#39;s arm  10  may be held against movement relative to each other. Thus, lower portion  18  of arm  10  may be held against movement relative to base  102  by forearm support member  140 . Upper portion  22  of arm  10  may be held against movement relative to arm member  112  by upper arm cuff  118 . 
         [0026]    To affect pronation of forearm  18 , knob  166  of rotation assembly  106  may be rotated in a counterclockwise direction. Counterclockwise rotation of knob  166  causes drive gear  162  to rotate rotation gear  152  about axis  108 . As rotation occurs, anterior forearm support member  142  and a posterior forearm support member  144  of forearm support member  140  secure hand  12 , wrist  16 , and forearm  18  to substantially prevent a torsional load from being placed on carpals  17  and to substantially prevent flexion and/or extension of the wrist joint and allow distal end portions  40  and  46  of radius  30  and ulna  32  to rotate with forearm support member  140  about axis  108 . 
         [0027]    As forearm support member  140  is rotated about axis  108 , proximal end portions  44  and  50  of radius  30  and ulna  32  move relative to distal end portion  102  of humerus  60 . Proximal end portion  50  of ulna  32  articulates with distal end portion  102  of humerus  60 . The rotational motion imparted by forearm support member  140  to distal end portions  40  and  46  of radius  30  and ulna  32  may be isolated to the region between elbow  20  and wrist  16  in arm  10  of the wearer. As drive gear  162  is rotated, rotation gear  152  and forearm support member  140  may be rotated together in a clockwise direction about axis  108  and the extent of pronation of forearm  18  may be increased. 
         [0028]    Reversing the direction of rotation of knob  166  rotates drive gear  162  and rotation gear  152  to move forearm support member  140  such that the extent of pronation of forearm  18  may be decreased. Rotation assembly  106  may be operated to increase the extent of supination of forearm  18  by rotating knob  166  in a clockwise direction. As forearm support member  140  and rotation gear  152  may be rotated in a counterclockwise direction, the extent of supination of forearm  18  may be increased. As forearm  18  is rotated, anterior forearm support member  142  and posterior forearm support member  144  of forearm support member  140  secure hand  12 , wrist  16 , and forearm  18  to substantially prevent a torsional load from being placed on carpals  17  and to substantially prevent flexion and/or extension of the wrist joint. Rotating forearm  18 , anterior forearm support member  142 , and posterior forearm support member  144  allows distal end portions  40  and  46  of radius  30  and ulna  32  to rotate with forearm support member  140  about axis  108  and results in radius  30  and ulna  32  bones being moved relative to humerus  60  at elbow  20 . 
         [0029]    This written description uses examples to disclose embodiments of the invention, including the best mode, and also to enable any person skilled in the art to practice embodiments of the invention, including making and using any devices or systems and performing any incorporated methods. The patentable scope of this disclosure is defined by the claims, and may include other examples that occur to those skilled in the art. Such other examples are intended to be within the scope of the claims if they have structural elements that do not differ from the literal language of the claims, or if they include equivalent structural elements with insubstantial differences from the literal languages of the claims.