Patent Publication Number: US-9895282-B2

Title: Exercise and gait-training apparatus

Description:
CROSS-REFERENCE TO RELATED U.S. APPLICATIONS 
     Not applicable. 
     STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT 
     Not applicable. 
     NAMES OF PARTIES TO A JOINT RESEARCH AGREEMENT 
     Not applicable. 
     REFERENCE TO AN APPENDIX SUBMITTED ON COMPACT DISC 
     Not applicable. 
     BACKGROUND OF THE INVENTION 
     1. Field of the Invention 
     The present invention relates to an exercise and gait-training apparatus primarily but not exclusively for use in the rehabilitation of disabled persons, such as the victims of strokes, spinal injuries or the like who suffer from impaired mobility. However, it is expected that sonic embodiments of the apparatus may also be suitable for use by sportspersons who wish to correct or alter their gait to improve their performance. 
     2. Description of Related Art Including Information Disclosed Under 37 CFR 1.97 and 37 CFR 1.98 
     Persons who have suffered spinal injuries or strokes or who have undergone surgery such as arthroplasty may require intensive therapy to enable them to stand, balance, walk and sit down. This type of rehabilitation is usually provided in healthcare institutions. Conventional apparatus for use in the rehabilitation of such persons is designed to exercise muscles and to aid a person to walk. However, it does not always require the user&#39;s legs to follow a pathway simulating a natural movement of the leg during walking. This can result in the user adopting a poor gait. 
     It is an object of the present invention to provide an exercise and gait-training apparatus which overcomes this disadvantage. 
     BRIEF SUMMARY OF THE INVENTION 
     According to the present invention there is provided an exercise and gait-training apparatus comprising: 
     a framework adapted for location above a surface; 
     a harness adapted to support a person relative to the framework; 
     an orthosis adapted for attachment to a lower leg or a foot of one leg of said person; 
     a first pair of first actuators connected to the framework and to the harness whereby one side of the harness is moved, to move a hip or a thigh of said one leg of said supported person relative to the framework; 
     a second pair of first actuators connected to the framework and to the orthosis whereby the orthosis is moved relative to the framework; and 
     control means adapted to control and to synchronize operation of the actuators such that the first leg is moved in a pathway simulating a natural movement of the leg during one of a walking, a running or a sporting activity. 
     It will be appreciated that an apparatus in accordance with the present invention may be used not only by persons with impaired mobility to exercise and to improve their gait but also by sportspersons who wish to train their legs to follow predetermined pathways to improve their performance. 
     Preferably, the framework is provided with wheels in order that it can roll over a floor surface. However, in a first alternative embodiment the framework is connected to a machine comprising an endless conveyor surface on which the person can practise movement while supported by the support means, the control means being adapted to synchronize movement of the conveyor surface relative to operation of the actuators. In a second alternative embodiment, the harness is adapted to suspend the person above floor level whereby the first leg is moved in the pathway either without the foot touching the floor or with the foot gliding over the floor. 
     Preferably also, the framework is provided with rear wheels, each driven by a first motor controlled by the control means. Advantageously, a feedback system is linked to the control means whereby control of the actuators and any driven wheels is responsive to movement of said person using the apparatus and/or the floor surface. 
     Preferably also, a second orthosis is provided for attachment to a lower leg or foot of the other leg of said person and pairs of second actuators identical to the first and second pairs of the first actuators are provided to move the other side of the harness and the second orthosis relative to the framework, the control means being adapted to control and to synchronize operation of all the actuators such that both legs of the person are moved in pathways simulating their natural movement during one of a walking, a running or a sporting activity. 
     Preferably also, a lever is connected to the control means and operable by said person to control the speed of operation of the actuators. 
     Preferably also, the lever comprises a joystick that controls the speed and direction of the wheels. 
     Preferably also, the actuators in each second pair of actuators are pivotally connected to their respective orthosis along a common pivot axis. 
     Preferably also, the harness is detachable from each first pair of actuators so that it can be fitted to said person prior to connection of each first pair of actuators thereto and said control means is adapted to move each first pair of actuators after connection to the harness to move said person from a seated into a standing position along a pathway simulating a natural standing movement prior to operation of the actuators to simulate natural movement of one or both legs during said walking, running or sporting activity. 
     Further preferred but non-essential features of the various aspects of the present invention are further described in the dependent claims appended hereto. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       Embodiments of the present invention will now be described by way of example with reference to the accompanying drawings, in which: 
         FIG. 1  is a perspective view from the rear and one side of a first embodiment of an exercise and gait-training apparatus in accordance with the present invention; 
         FIG. 2  is a side elevation of the apparatus shown in  FIG. 1 ; 
         FIG. 3  is a perspective view from the front and one side of the apparatus shown in  FIGS. 1 and 2 ; 
         FIG. 4  is a block diagram showing operation of the apparatus shown in  FIGS. 1 to 3  by a control means of the apparatus; and 
         FIG. 5  is a side elevation similar to  FIG. 2  but of a second embodiment of the apparatus in accordance with the present invention and showing a user of the apparatus attached to it. 
     
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
     The embodiments of apparatus  1 A and  1 B shown in the drawings comprise exercise and gait-training apparatus suitable for use in the rehabilitation of disabled persons. The first embodiment  1 A shown in  FIGS. 1 to 4  provides both a means of exercising the legs and a limited form of mobility to enable a user to move around in a controlled environment inside a building and possibly also, to a more limited extent, outside. The second embodiment of apparatus  1 B shown in  FIG. 5  is similar to the first embodiment but is static. In the drawings the parts of both apparatus that are identical or that have similar functions have been given the same reference number. 
     In both embodiments the apparatus  1 A,  1 B comprises a framework  2 . The apparatus  1 A is provided with front and rear pairs of wheels  3 ,  4 , the front wheels  3  being caster wheels and the rear wheels  4  being drivable by adjacent motors  5  under the control of a control means  6 . The motors  5  are fined with a brake system for safety. In the apparatus  1 B, there are no wheels but a control means  6  is still provided as this control the operation of the apparatus  1 A,  1 B as a whole. The control means  6  is located at the front of the framework  2  in combination with a user interface means  7 , as is described in more detail below. 
     The framework  2  comprises two vertical side frames  8   a  and  8   b  respectively alai are connected at the front of the apparatus  1  by crosspieces  9   a  and  9   b  at top and bottom respectively. The rear of the framework  2  is left open so that it can be positioned around a prospective user of the apparatus, who is likely to be seated, for example in a wheelchair. 
     In the first embodiment of apparatus  1 A, the front caster wheels  3  are located at the joint between the crosspiece  9   b  and the side frames  8   a ,  8   b . The rear wheels  4  and their motors  5  are secured to small framework extensions at the bottom, rear of the frames  8   a  and  8   b  respectively. In the second embodiment of apparatus  1 B, the framework  2  is provided with adjustable feet  10  instead of but in the same positions as the wheels  3 ,  4 . 
     Secured between the frames  8   a  and  8   b  to the upper crosspiece  9   a , which in the present embodiments is integrally formed with parts of the side frames  8   a  and  8   b  in a U-shaped arrangement, is the control means  6  and the user interface means  7 . The crosspiece  9   b  forms a tray on which is located a rechargeable battery pack  11  and a transformer  12  beneath a cover  13 . The battery pack  1  powers the apparatus  1  and the transformer  12  enables it to be recharged via a mains electricity supply. The battery pack  11  and the transformer  12  are mounted low down at the front of the apparatus  1  to provide provides stability and to counterbalance the apparatus  1  when the user is being raised and lowered, as described below, or if the user should stumble or lean over during use. In some embodiments, the apparatus  1  may be powered directly, via the transformer  12 , by mains electricity. This method of providing power is more appropriate for static embodiments of the apparatus  1 B as shown in  FIG. 5 . 
     As the illustrated embodiments of the apparatus  1 A and  1 B are designed to exercise either or both legs of a user, they are symmetrical about a central, front-rear axis. Hence, in the following description where two pairs of actuators are described, it is to be understood that one of the pairs is located on one side of the apparatus  1 A,  1 B and the other of the pairs is located on the opposite side of the apparatus  1 A,  1 B. Both pairs have the same configuration and carry out the sane function. The actuators themselves are provided in pairs so that by coordinating operation of the actuators, movement of the parts of the apparatus  1 A,  1 B to which they are connected (as described below) can follow an arcing rather than a linear pathway. This is important as it enables the apparatus  1 A,  1 B to mimic a natural gait wherein movement of the hips and upper and lower legs of a user of the apparatus  1  follow a normal biomechanical pathway. In this regard, the control means  6  may be programmed to operate and to synchronize the pairs of actuators to suit individual users of the apparatus  1 . The location and operation of the various pairs of actuators in the apparatus  1 A,  1 B will now be described. 
     Mounted between the side frames  8   a  and  8   b  at the rear of the apparatus  1 A,  1 B by two pairs of first actuators  14   a ,  14   b  is a harness  15  for supporting a user of the apparatus  1 . The pairs of actuators  14   a ,  14   b  are respectively located, at the sides of the harness  15  and their operation is controlled by the control means  6  so that they move their respective side of the harness  15  and thereby a hip or a thigh of one leg of a person supported by the harness  15  relative to the framework  2  in such a way as to assist the user&#39;s pelvis to assume the correct position when standing up, balancing, walking, stepping and sitting down. To accomplish this the harness  15  comprises a waist belt  16 , a gluteal belt  17  and leg straps  18 . The waist belt  16  is preferably a semi-rigid padded construction and can be fashioned to provide additional front, rear or side support (not shown) if required. This additional support may be formed integrally with the waist belt  6  or be attachable as one or more separate parts. The gluteal belt  17  has a concave inner form and is also a semi-rigid padded construction. The concave inner form is designed to fit snugly to the user&#39;s posterior so that it does not slide out of position during standing or sitting movements. The leg straps  18  are again semi-rigid padded constructions and are designed to prevent a user from slipping out of the harness when they are being supported in an upright position. All the parts of the harness  15  are adjustable so that they can be tightened around the user to fit snugly by means of suitable devices such as clips, buckles, and book and loop strips. 
     The harness  15  is detachably secured to the ends of the two pairs of first actuators  14   a ,  14   b  by quick release fasteners  19  to connection tabs  20  located at each side of the harness  15  adjacent the waist belt  16  and thereby above the level of the user&#39;s hips. The connection tabs  20  enable the actuators  14   a  and  14   b  to be connected to the harness  15  in close proximity to one another at this location. When not under load, the fasteners  19  allow the harness  15  to be readily and quickly detached from the rest of the apparatus  1 . However, when under load the listeners  19  are preferably arranged to be more difficult to release in order to prevent an accidental separation during use of the apparatus  1 . The fasteners  19  also allow the actuators  14   a ,  14   b  to pivot relative to the harness  15 . The actuators  14   a ,  14   b  of the each pair are angled with respect to one another and are also connected intermediate their length to different parts of their respective frame  8   a ,  8   b  by pivotally mounted brackets  21   a  and  21   b  respectively. The brackets  21   a  are attached to a crosspiece  22  that is secured at its ends to the two frames  8   a  and  8   b  and that is located immediately in front of a user of the apparatus  1  when in a standing position. 
     Located beneath the harness  15  is a pair of orthoses  23  that are adapted for respective attachment to the lower legs of a user of the apparatus  1 . Each orthosis  23  comprises a pad  24  designed to be connected to the lower leg by straps or other securing method and a footplate  25  that locates beneath the foot. The connection between the footplate  25  and the pad  24  may be hinged and the footplate  25  may be flexible so that it can flex to allow a user to bend their toes relative to the rest of the foot. Each orthosis  23  is mounted to the framework  2  by a second pair of actuators  26   a ,  26   b . Ends of the actuators  26   a ,  26   b  are pivotally connected to their respective orthosis  23  by a common pivot pin  27  that permits rotation of the actuators  14   a ,  14   b  relative to the orthosis  23  about a common pivot axis. This is important as if ensures that movement of the orthosis  23  by the actuators  26   a ,  26   b  follows a natural pathway around a closed loop, which mirrors the pathway followed by an ankle of a healthy person when walking. The actuators  26   a ,  26   b  are angled with respect to one another and their other ends are pivotally mounted to different parts of the adjacent frame  8   a  or  8   b  by brackets  28 . Operation of both pairs of actuators  26   a ,  26   b  is also controlled by the control means  6  in such a way that the user&#39;s legs and feet will move along a pathway simulating a natural movement during one of a walking, a running or a sporting activity. It will be appreciated that operation of all the actuators  14   a ,  14   b ,  26   a  and  26   b  on both sides of the apparatus  1  is controlled and synchronized by the control means  6  so that a user&#39;s hips, legs and feet are moved in harmony with one another along natural pathways. This exercises the patient&#39;s muscles and trains the body to move in a natural way. 
     At the same time as controlling operation of all the actuators, in the mobile first embodiment of the apparatus  1 A, the control means  6  also drives the rear wheels  4  via the motors  5  either in unison or differentially to enable the apparatus  1  to move forwards, backwards and to turn. Operation of the motors  5  is synchronized with that of all of the actuators  14 ,  14   b ,  26   a ,  26   b  on both sides of the apparatus  1 A by the control means  6  to assist the user to move relative to the ground in a natural way. 
     The user interface means  7  allows the user to control operation of the control means  6  and thereby the apparatus  1 A,  1 B as a whole. It comprises instrumentation and user input controls via a display screen  28  and user input buttons  29 . In a modification, the screen  28  comprises a touch screen incorporating the functions of the buttons  29 . The display screen  28  is adapted to display information concerned with the way the apparatus  1 A,  1 B is operating and operational settings. For safety reasons, an isolator button  30  allows the user or another person to switch off the power supply to the apparatus  1 A,  1 B quickly if necessary by instantly disconnecting the battery pack  11  and/or or transformer  12  from the control means  6 . Preferably, the interface means  7  duplicates all buttons  29 ,  30  and on each side of the apparatus  1 A,  1 B so that they can be readily operated by a left or a right hand of the user so that the apparatus  1 A,  1 B can be readily used by stroke victims or other persons who have lost the use of limbs down one side of the body. In addition to the interface means  7 , levers  31  are provided on each side of the apparatus  1 A,  1 B and linked to the control means  6  in order to provide the user control over the speed of operation of the actuators  14   a ,  14   b ,  26   a ,  26   b , in mobile embodiments of the apparatus  1 A, the levers  31  take the form of joysticks to enable the user to control the direction and speed of the rear wheels  4 , which are operated in synchronism with the speed of the actuators  14   a ,  14   b ,  26   a ,  26  by the control means  6 . 
     The levers or joysticks  31  are duplicated for the same reason as the buttons  29 ,  30  and are mounted on the frames  8   a .  8   b  adjacent a hand grip  32  and arm rest  33  and close to the harness  15  for the convenience of the user. For safety and to prevent confusion, a user must decide prior to use of the apparatus  1 A,  1 B whether to use the buttons  29  and the lever or joystick  31  on the left or on the right of the apparatus  1 A,  1 B. This information is communicated to the control means  6  via the interface means  7  and the control means  6  then disables signals from the buttons  29  and the lever or joystick  31  on the other side of the apparatus  1 A,  1 B. 
     Preferably, the apparatus  1 A,  1 B incorporates a feedback system comprising, force sensors  34  mounted in the orthoses  23 , preferably on the footplates  25 , and in the actuators  14   a ,  14   b ,  26   a  and  26   b  on both sides of the apparatus  1 . The force sensors  34  relay information relating to the pressure exerted by the user on the footplates  25  and the degree of resistance being offered by the user to the actuators  14   a ,  14   b ,  26   a  and  26   b  hack to the control means  6 . This allows the control means  6  to respond to the movement of the user and to control all the actuators and, where applicable, the motors  5  appropriately, for example by reducing the speed of the motors  5  if the user starts walking well or by offering resistance to the user via the actuators  14   a ,  14   b ,  26   a  and  26   b  to force the user to use more muscle power to move. More generally, the feedback system allows the control means  6  to control operation of the apparatus  1 A,  1 B within a predetermined set of parameters, which may be programmed into the control means  6  via the interface means  7  for any individual user. The control means  6  may also record data relating to individual therapy sessions for analysis and evaluation by healthcare professionals. The control means  6  may also be programmed to act appropriately, for example to brake the motors  5  or to stop operation of the actuators  14   a ,  14   b ,  26   a  and  26   b  in certain circumstances, for example in the case of collision. 
     In use, the harness  15  is first fitted to the user and then the apparatus  1 A,  1 B is moved into position around the user, who is likely to be seated. The harness  15  is then secured to the ends of the two pairs of first actuators  14   a ,  14   b  by the quick release fasteners  19  at each side of the harness  15 . The orthoses  23  are also secured to the user&#39;s lower legs. When the user is ready, the apparatus  1  can be switched on via the interface means  7  and the apparatus  1 A,  1 B activated, to raise the user into a standing position by the pairs of actuators  14   a ,  14   b . The shape of the harness  15  and the location of the connection tabs  20  relative thereto, namely above the hips, enables this to be accomplished in a natural fashion, the harness  15  enabling the user&#39;s pelvis to following a natural trajectory wherein each hip is raised along, with the leg as the user picks up each foot from the floor prior to striding forward. During this part of the operation, in mobile embodiments of the apparatus  1 A the control means  6  ensures that the rear wheels  4  are braked to prevent the framework  2  from rolling forwards. 
     Once the user is standing, the control means  6  can be signalled via the interface means  7  to commence a pre-programmed operation of all of the actuators  14   a ,  14   b ,  26   a ,  26   b  and, in mobile embodiments of the apparatus  1 A, the motors  5  to move the user&#39;s legs along pathways simulating natural movement of the legs during one of a walking, a running or a sporting activity. As the user moves, the pairs of actuators  41   a ,  14   b  move in sequence under control of the control means  6  to move the user&#39;s pelvis and hips along a natural biomechanical pathway. Similarly the pairs of actuators  26   a ,  26   b  connected to the orthoses  23  are controlled in sequence with each other and synchronized with operation of the actuators  14   a ,  14   b  to move the users legs and feet in harmony with the pelvis and hips. In mobile embodiments of the apparatus  1 A, the control means  6  also controls operation of the motors  5  to drive the wheels  4  either in unison or differentially to enable the apparatus  1 A to move forwards, backwards and to turn. The user can control this and the acceleration and the speed of operation of the actuators  14   a ,  14   b ,  26   a ,  26   b  via the lever or joystick  31 . Alternatively, the control means  6  can be programmed to follow a predetermined routine. This is particularly appropriate in static embodiments of the apparatus  1 B. 
     In an alternative static embodiment of the apparatus, the framework may be arranged above the surface of an endless conveyor on which the user can practise walking. The speed and acceleration of the conveyor surface may be controlled by the lever  31  via the control means  6  or the control means  6  may be pre-programmed to follow a predetermined routine. In either case, the control means  6  synchronizes the movement and speed of the conveyor surface with operation of the actuators. Such an embodiment is particularly suited for training sportspersons as the conveyor may be accelerated up to appropriate running speeds, with the actuators  14   a ,  14   b ,  23   a ,  23   b  adjusting their operation in synchronism therewith. Such sportspersons may use the apparatus to correct their gait and to force their body to exercise in a particular way that they can then train themselves more to use. The control means  6  may also be programmed to move the actuators  14   a ,  14   b ,  23   a ,  23   b  to simulate appropriate pathways followed by the legs in various sporting manoeuvres, again for training purposes. 
     In the illustrated, static embodiment of the apparatus  1 B shown in  FIG. 5 , the harness  15  substantially supports the weight of the user so that the user&#39;s feet either do not touch the floor or barely touch the floor so that they slide over it during use of the apparatus  1 B. The footplates  25  of the orthoses  23  are therefore preferably provided with a smooth, undersurface in contrast to the surface use for mobile embodiments of the apparatus  1 A where a rougher undersurface provides a better grip on the floor. Preferably, the floor surface  35  beneath the apparatus  1 B is polished to offer less resistance to the sliding motion of the footplates  25 . It will be appreciated that this embodiment is particularly suitable for use by disabled persons as the user does not have to support his or her own weight. However, it may also be used by sportspersons who want to exercise or correct the gait of only one leg or foot. 
     With regard to the latter comment, whilst in most cases it is expected that a user of the apparatus  1 A,  1 B will connect both legs to the orthoses  23 . However, it is possible to adapt the apparatus  1 A,  1 B to operate on only one side of the body to assist movement of one leg only. This can be done by appropriate programming of the control means  6 .