Abstract:
The invention relates to an orthopedic orthosis for the purpose of bracing a body region of a patient, which may include at least one sensor contrivance provided for detection of movements of said body region. According to the present invention, provision is made, in particular, for the orthosis to have at least one resiliently deformable sensor portion, which is disposed on the orthosis such that a movement of the body region causes resilient deformation of said sensor portion, that the sensor contrivance has at least one actor for coupling waves into the sensor portion and at least one sensor for sensing the waves coupled into the sensor portion, and that the actor and the sensor of the sensor contrivance are disposed on the sensor portion such that the sensor can sense the wave coupled into the sensor portion by the actor and changed according to the deformation of the sensor portion. The use thereof is for the detection of orthopedically detrimental movements of a patient.

Description:
CROSS REFERENCE TO RELATED APPLICATIONS 
       [0001]    This application claims priority under 35 U.S.C. §119 of German Patent Application No. 10 2009 049 542.8, filed Oct. 6, 2009, the entire disclosure of which is hereby incorporated by reference into this application. 
       FIELD OF THE INVENTION 
       [0002]    The invention relates to an orthopedic orthosis for bracing a body region of a patient. A generic orthosis comprises at least one sensor contrivance for the purpose of detecting the movement of said body region. 
       BACKGROUND OF THE INVENTION 
       [0003]    Orthopedic orthoses particularly serve to restore or maintain the functionality of damaged or highly stressed parts and regions of the body. They can be in the form of bandages that are predominantly made of a material of a flexible nature such as a textile material. Another variant of such orthopedic orthoses involves orthoses that are made, at least partly, of rigid components that are deformable only to a limited extent. 
         [0004]    It is known, for example from DE 10 2007 003 515 A1, to provide sensors on an orthopedic orthosis for the purpose of detecting the movement of the body part to be braced and of indicating an orthopedically detrimental movement to the patient, optionally by means of a signal. 
       SUMMARY OF THE INVENTION 
       [0005]    It is an object of the invention to develop an orthosis of the generic kind, particularly a spinal orthosis, to the effect that the movement of the body region braced by the orthosis can be detected in a particularly reliable manner. 
         [0006]    This object may be achieved according to the invention in that the orthosis may include at least one resiliently deformable sensor portion that is disposed on the orthosis in such a way that a movement of the body region causes a resilient deformation of this sensor portion. The sensor contrivance further comprises at least one actor for coupling waves into the sensor portion and at least one sensor for detecting the waves that have been coupled into the sensor portion. The actor and the sensor in the sensor contrivance are disposed on the sensor portion in such a way that the sensor can sense the wave that is coupled by the actor into the sensor portion and altered to an extent depending on the degree of deformation of the sensor portion. 
         [0007]    Thus, in the orthosis of the invention, provision is made for a preferably flat sensor portion made of a resiliently deformable material to be positioned such that it undergoes deformation as a result of the movement of the body region. This deformation of the sensor portion causes a state of stress in the sensor portion depending on the type and extent of the movement of the body region. The actor and the sensor in the sensor contrivance are provided for detecting this state of stress. The actor couples a wave into the sensor portion, which wave propagates in the sensor portion until it reaches the sensor in the sensor contrivance. For this purpose, the actor is formed such that it can be caused to oscillate when excited by an electronic system. The wave coupled into the sensor portion undergoes a change, particularly with regard to its amplitude, that is governed by the extent of deformation of the sensor portion, that is to say, by the nature of the state of stress prevailing in the sensor portion. The change in the wave can be detected by an electronic system in the bandage in that the wave produced by the actor is sensed by means of the sensor adapted to detect oscillations. 
         [0008]    It is possible, in principle, to utilize all forms of wave propagations in the sensor portion, for example, also bulk waves that penetrate the sensor portion. However, it is also regarded as being advantageous when the actor is adapted to couple surface waves into the sensor portion, and when the sensor is adapted to record these surface waves. The advantage of the use of these surface waves is that they require less excitation energy for generation thereof together with a low operating voltage for the actors and thus alleviate the hazard posed to the patient by the electric current used. Furthermore, the lower energy required for coupling surface waves into the sensor portion is advantageous with regard to the battery operating time. The use of surface waves additionally allows the actor and the sensor to be disposed on the same side of the sensor portion, which can give rise to advantages in terms of design. 
         [0009]    The actor and the sensor are functional terms for the purposes of the present invention. Apart from an embodiment in which the actor and the sensor are in the form of separate structural components, an embodiment comprising only one structural component suitable both for the emission and reception of waves is also feasible. Such structural components are referred to as transceivers. 
         [0010]    Those components can be used as actor and sensor that are suitable for converting an electrical voltage, more particularly an alternating voltage, to mechanical oscillations and, respectively, mechanical oscillations to a signal that can be evaluated by an electronic system. In particular, the actor and/or the sensor can be in the form of a piezoelectric actor and a piezoelectric sensor respectively. 
         [0011]    Due to the arrangement of the sensor portion and the integration of the sensor portion in the orthopedic orthosis, it is possible to predefine the type of movement of the body region that leads to a change in the wave and thus to a recording of a movement. Different body regions can be monitored by the use of a plurality of sensor contrivances comprising different sensor portions so that the evaluation allows for precise assessment of the movement of the patient. 
         [0012]    Preferably, the sensor contrivances are evaluated continuously. In such a case, the transmitter of the sensor contrivance continuously couples waves into the sensor portion. However, it is also feasible to monitor the movement of the body region at intervals of a few hundredths or tenths of a second by means of wave pulses generated at specific intervals in time. 
         [0013]    According to a development of the invention, the orthosis comprises at least one main portion that surrounds the body region such that a movement of the body region causes deformation of the main portion. The sensor portion is in the form, at least in portions, of an integral part of the main portion, and the sensor portion is in the form, at least in portions, of a supplementary portion attached to the main portion. 
         [0014]    The main portion is preferably in the form of a single piece that surrounds the relevant part of the body such that movement of that region of the body results in deformation of the main portion. In the case of an orthosis, such a main portion can be in the form of a rigid component, but one that is resiliently deformable to a limited extent. In the case of a bandage, the main portion can also be non-resiliently flexible. A mainly rigid main portion is preferably supplemented by a covering, for example, a preferably padded textile covering in order to enhance wearing comfort. 
         [0015]    In the case of a rigid but resiliently deformable main portion, a part of this main portion can directly form the sensor portion of the at least one sensor contrivance. This results in a very simple design. 
         [0016]    However, the use of an additional portion that is attached to the main portion non-positively, positively or adhesively and is thus deformed along with a deformation of the main portion is regarded as being advantageous. The use of bonded and/or positive fasteners, particularly the use of rivets, for attaching the additional portion to the main portion is regarded as being particularly advantageous. The use of an additional portion that is separate from the main portion makes it possible to employ optimal materials for the main portion and the additional portion. Thus, for example, the main portion can be in the form of a component made of plastics material, more particularly one that is made of polyethylene, thereby keeping down the production costs. However, the additional portion comprising the sensor portion can be in a form such that it allows for perfectly resilient behavior, more particularly for behavior that is free from relaxation as far as possible, and can be made of a fiber composite component for this purpose. More particularly, carbon fiber reinforced plastics materials or carbon fiber reinforced epoxy resins are suitable for this purpose. When use is made of fiber-reinforced composites, the fibers must preferably be oriented such that they extend in the direction of the intended wave propagation from the actor to the sensor. 
         [0017]    In the case of an embodiment comprising a separate additional portion disposed on the main portion, it is regarded as being advantageous when the main portion is provided with a recess in which the sensor and/or the actor is disposed, at least in part. This embodiment makes for a particularly flat design of the orthopedic orthosis since the sensor and/or the actor can be disposed on that side of the supplementary portion that faces the main portion. The arrangement of the sensor and/or the actor in the recess can additionally be utilized for attaching the additional portion to the main portion by means of a preferably bonded connection of the actor or sensor to the edge of the recess. 
         [0018]    According to one variant of the relative arrangement of the actor and the sensor, provision is made for the actor and the sensor to be disposed at opposite ends of the sensor portion and to be connected to the same. It is regarded as being advantageous when a wave reflector is provided on the sensor portion, which wave reflector is adapted to reflect a wave coming from the actor such that it is directed toward the sensor. This makes it possible, in particular, to position the actor and the sensor in the sensor contrivance such that they are directly juxtaposed or even to use of an easy to handle single structural unit comprising both the actor and the sensor. 
         [0019]    The actor and the sensor in the sensor contrivance are preferably disposed on the sensor portion in such a way that the wave coupled into the sensor portion by the actor travels through a distance of at least 5 mm before it reaches the sensor. In the case of a sensor and an actor that form a combined structural unit, the wave reflector is preferably disposed at a distance of at least 2.5 mm from this structural unit. Greater wave propagation distances of at least 10 mm between the actor and the sensor are preferred. 
         [0020]    A boundary surface of the sensor portion that causes reflection of the wave is regarded as the wave reflector. Preferably, the wave reflector is in the form of a fastener such as a rivet that serves to attach the supplementary portion to the main portion and thus performs a dual function. 
         [0021]    An orthopedic orthosis of the invention can serve to brace various regions and parts of the body and can thus be adapted for use on the knee joint or ankle joint or on the elbow joint or wrist joint. A neck orthosis can also be provided in the manner proposed by the invention. It is regarded as being particularly advantageous when the orthopedic orthosis is in the form of a spinal orthosis, the sensor contrivance being preferably disposed in a back region of this orthosis. 
         [0022]    The detection of a state of stress in the sensor portion is preferably carried out by evaluating the wave attenuation caused by this state of stress. Accordingly, the excitation frequency of the actor can preferably be selected so as to prevent unduly strong attenuation and also an unintended increase in oscillation. It is regarded as being particularly advantageous when an electronic control system that is connected to the sensor contrivance is adapted to excite the actor at a frequency ranging from 10 kHz to 10 MHz. A particularly good signal-to-noise ratio is achieved at frequencies ranging from 25 kHz to 100 kHz and 220 kHz to 1 MHz. 
         [0023]    It is advantageous when an orthopedic orthosis of the invention comprises a plurality of sensor contrivances. It is particularly advantageous when the respective sensor portions of at least two of these sensor contrivances are in the form of a single-piece supplementary portion attached to the main portion. The use of a combined supplementary portion, on which a plurality of sensor contrivances and thus a plurality of sensor portions are provided, results in a simpler design and, in particular, in reduced effort for attaching the supplementary portion to the main portion. 
         [0024]    As a development of the aforementioned orthopedic orthosis, the invention also relates to a generic orthopedic orthosis that is in the form of a spinal orthosis comprising at least one back portion disposed in the region of the back of the patient and at least one pair of wing-like portions joined to the back portion, the pair of wing-like portions comprising two wing-like portions that are attached to the sides of the back portion and are disposed opposite each other and are bent around opposite sides of the body to extend to the chest and/or abdominal region of the patient. A plurality of sensor contrivances is provided that are adapted to detect elongations or states of stress in the orthopedic orthosis, at least one sensor contrivance of a first type being disposed on the back portion at the level of the pair of wing-like portions or on one of the wing-like portions, and at least one sensor contrivance of a second type being disposed on the back portion above or below the wing-like portions. 
         [0025]    The spinal orthosis of the invention comprises an immovable back portion that is resiliently deformable to a limited extent and starting from which the wing-like portions extend to the chest and abdominal side of the patient. The wing-like portions are preferably formed integrally as a single piece with the back portion, but are at least attached to the same. The wing-like portions firstly serve to fasten the spinal orthosis to the body of the patient, for which purpose, they can preferably be fastened to each other in front of the abdominal or chest region of the patient by means of detachable fasteners such as belts and/or hook-and-loop fasteners. Secondly, the wing-like portions serve to identify any movement of the torso of the patient. For this purpose, the sensor contrivances of the first and the second type are provided. 
         [0026]    When the patient turns the upper part of his body to the left or to the right, this movement results in a resilient displacement of the wing-like portions relatively to the back portion. This deformation can be ascertained by the detection of a corresponding elongation or a state of stress by the at least one sensor contrivance of the first type. For this purpose, the latter is disposed either on the wing-like portion itself or in a transition region between a wing-like portion and the back portion, which transition region is partially deformed in the case of a resilient displacement of the wing-like portion in relation to the back portion. For detecting a forward bending movement or a backward bending movement of the patient, the at least one sensor contrivance of the second type is provided such that it is disposed above or below the wing-like portion. When the patient bends forward or backward, a deformation of the back portion of the orthosis is caused, at least in part, by his back or his chest or abdomen via the wing-like portions, which deformation can be detected by said sensor contrivance of the second type. 
         [0027]    The aforementioned feature involving the attachment of the sensor contrivances makes it possible to effectively distinguish between a forward/backward bending movement and a torsional movement. A forward/backward bending movement hardly causes stresses or elongations in the region of the sensor contrivance of the first type due to the increased mechanical section modulus in the region of the sensor contrivance arising from the presence of the wing-like portions. Instead, such a movement is detected primarily by the sensor contrivance of the second type that is disposed above or below the wing-like portions. Conversely, a torsional movement of the upper body of the patient substantially causes only a state of stress or an elongation at the level of the wing-like portions and thus in the region of the sensor contrivance of the first type, while the sensor contrivance of the second type is hardly influenced thereby. 
         [0028]    Thus the sensor contrivance of the first type preferentially detects a bending deformation of the orthosis in the region of the wing-like portions, while the sensor contrivance of the second type preferentially detects a bending deformation in the region of the back portion. 
         [0029]    Instead of only one back portion, a plurality of back portions can be provided that are joined together by belts, for example. The back portion is preferably in the form of a single piece or it comprises a plurality of components that are rigidly attached to each other. 
         [0030]    The sensor contrivances are preferably sensor contrivances of the embodiment described above comprising an actor, a sensor, and a sensor portion into which the actor can couple a wave that can be detected by the sensor in an altered form depending on the degree of deformation. It is a particular advantageous that sensor contrivances of identical design can be used as sensor contrivances of the first and second types, since both the torsional movement of the patient and the forward/backward bending movements are each manifested as detectable states of stress. It is possible to operate the different actors of the sensor contrivances using either different frequencies or the same frequency. The latter makes it possible to connect the actors in parallel, which is particularly advantageous with regard to the conductor layout. 
         [0031]    Apart from sensor contrivances based on wave evaluation, it is also possible to use other sensors, particularly those adapted for distance measurement such as strain gauges or optical distance sensors. 
         [0032]    Preferably, two sensor contrivances of the first type are provided which are each assigned to a wing-like portion of a combined pair of wing-like portions. The sensor contrivances can be provided as described above either in the transition region between the back portion and the wing-like portion or on the wing-like portion itself. By means of the embodiment comprising two such sensor contrivances of the first type, it is possible to detect the direction in which a patient turns the upper part of his body. 
         [0033]    Furthermore, preferably two pairs of wing-like portions that are vertically spaced from each other are provided, and preferably at least two sensor contrivances of the first type and at least two pairs of sensor contrivances of the first type are provided, each of which is assigned to one of the pairs of wing-like portions. The use of two pairs of wing-like portions is advantageous, particularly since the at least one sensor contrivance of the second type can very reliably identify a forward bending movement of the patient, because the pairs of wing-like portions disposed at a distance from each other result in a bending deformation of the back portion when the patient bends forward. An embodiment comprising sensor contrivances of the first type that are each provided on the pairs of wing-like portions permits particularly reliable detection of a torsional movement of the upper part of a patient&#39;s body. 
         [0034]    Furthermore, it is regarded as being particularly advantageous when at least two sensor contrivances of the second type are provided on the back portion, of which a first sensor contrivance is disposed in the vertical direction between two pairs of wing-like portions and of which a second sensor contrivance is disposed above the top pair of wing-like portions or below the bottom pair of wing-like portions. This embodiment comprising at least two sensor contrivances of the second type that are offset from each other in the vertical direction is advantageous with regard to the ability to distinguish between a forward bending movement and a backward bending movement. While with a backward bending movement, all sensor contrivances of the second type detect an elongation or a state of stress due to the deformation of the back of the patient, this applies to the forward bending movements, when the sensor contrivances are disposed between the pairs of wing-like portions. The sensor contrivance of the second type that is disposed above the top pair of wing-like portions or below the bottom pair of wing-like portions experiences no influence or experiences a significantly weaker influence during the forward bending movement so that this second sensor contrivance thus disposed makes it possible to reliably distinguish between a forward bending movement and a backward bending movement. 
         [0035]    An orthosis of the invention preferably comprises an electronic evaluation unit that is connected to the at least one sensor contrivance or the at least two sensor contrivances and that indicates an orthopedically detrimental movement of the body region by way of an indicating means dependent on the signals arising from this sensor contrivance. For this purpose, the electronic evaluation unit evaluates the signals coming from the sensor contrivances and draws conclusions on the movement carried out by the patient on the basis of the signal or, in the case of a plurality of sensor contrivances, on the basis of the plurality of signals. In the simplest case, this movement is classified as being orthopedically permissible or orthopedically detrimental. An orthopedically detrimental movement gives rise to the emission of a patient information signal by the indicating means, for example in the form of a warning signal or a vibration. The electronic evaluation unit may be adapted to store some or all of the characteristics of the movements performed by the patient in a memory so that an orthopedist can subsequently evaluate these data. 
         [0036]    In the context of the sensor contrivances based on wave analysis, the evaluation preferably involves the analysis of wave attenuation and/or wave travel time. In order to facilitate the analysis of wave attenuation, a circuit can be disposed upstream of the electronic evaluation unit, which circuit converts the signal originating from the sensor contrivance to a transformed signal, the strength of which is governed by the amplitude of the signal originating from the sensor contrivance. Such a circuit can, for example, be of such a kind that it converts the signal originating from the sensor contrivance and then passes it through a low-pass filter. Such signal conversion reduces the complexity of the electronic evaluation unit, particularly the power required by a microprocessor in the electronic evaluation unit, since it is not the actual wave detected by the sensor but the amplitude thereof that is to be analyzed by the electronic evaluation unit. An analysis of the signal amplitude is sufficient for determining the respective attenuation of the wave as results from the state of stress in the sensor portion. 
         [0037]    The respective thresholds, based on which the electronic evaluation unit identifies an orthopedically detrimental state and optionally indicates the same by way of the indicating means, can be fixed or can be selectively adjustable. However, it is particularly advantageous when the electronic evaluation unit can be transferred to an initialization mode in which the thresholds are formed as a function of the signals coming from the sensor contrivance, the electronic evaluation unit being adapted to utilize these thresholds in a subsequent operating mode for identifying orthopedically detrimental movements of the relevant body region. The initialization mode, which can be started, for example, by depressing a special press-button disposed on the orthosis, makes it possible to customize the orthosis to the needs of each patient in a convenient manner. In the initialization mode, the patient moves, optionally as instructed by the operating manual delivered with the orthopedic orthosis, or under the supervision of an orthopedist or as directed by the control unit itself, in such a way that the electronic evaluation unit can detect the signals coming from the sensors as produced by predefined movements of the specific region or part of the body. The thresholds determined on this basis are thus individually customized to the patient. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0038]    Additional aspects and advantages of the invention are revealed in the claims and in the following-like description of a preferred exemplary embodiment of the invention explained with reference to the figures, in which: 
           [0039]      FIGS. 1 to 3  show a spinal orthosis in a back and front view and a sectional view taken from above, respectively, 
           [0040]      FIGS. 4   a  to  4   c  illustrate the mode of operation of the sensor contrivances of the spinal orthosis shown in  FIGS. 1 to 3 , and 
           [0041]      FIGS. 5   a  to  5   d  illustrate the use of the spinal orthosis shown in  FIGS. 1 to 3  and those influences on the sensor contrivances of the orthosis that accompany different movements of a patient. 
       
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
       [0042]      FIGS. 1 to 3  show a spinal orthosis  10  of the invention. 
         [0043]    The spinal orthosis  10  comprises a main portion  20  that is in the form of a single-piece flat plastics component made of polyethylene or some other plastics material. This main portion  20  comprises a back portion  22  on which a top pair of wing-like portions  24  comprising wing-like portions  24   a  and  24   b  and a bottom pair of wing-like portions  26  comprising wing-like portions  26   a  and  26   b  are provided at the sides. These wing-like portions  26   a ,  26   b ,  24   a , and  24   b  are molded onto the two opposite sides of the back portion  22  and they extend arcuately toward the front. 
         [0044]    The main portion  20  of the spinal orthosis  10  is completely surrounded by a textile covering  12  indicated by dashed lines in  FIGS. 1 to 3 . It serves, in particular, to enhance the wearing comfort. 
         [0045]    On the front side of the spinal orthosis  10 , the wing-like portions  24   b  and  26   b  are each attached to fastening belts  14 , on the free ends of which hook-and-loop surfaces  16   a  are provided that are each intended for cooperation with corresponding hook-and-loop surfaces  16   b  disposed on wing-like portions  24   a  and  26   a , thereby allowing-like the wing-like portions  24   a ,  24   b ,  26   a , and  26   b  to be joined together in front of the abdomen or chest of the patient. 
         [0046]    Two flat bars  40  that are made of carbon fiber reinforced plastics material and that extend substantially in the vertical direction are provided on each side of the back portion  22 , and these flat bars are joined to the main portion  20  by rivets  44 . These flat bars  40  are provided on the inside surface of the back portion  22 , but are covered by the textile covering  12  such that they are not visible to the patient. 
         [0047]    The flat bars  40  serve as supports for sensor contrivances  1 ,  2 ,  3 ,  4 ,  5 ,  6 ,  7 , and  8 . Referring to  FIG. 3 , in particular, and the portion A shown on an enlarged scale in  FIG. 3 , the sensor contrivances each comprise an actor  1   a  to  8   a  and a sensor  1   b  to  8   b . These actors  1   a  to  8   a  and sensors  1   b  to  8   b  are disposed such that they are directly juxtaposed. Furthermore, the actors  1   a  to  8   a  are directly attached to the flat bars  40 , for example by means of an adhesive bond. The actors  1   a  to  8   a  are in the form of piezoelectric actors that can oscillate at high frequencies when appropriately excited. The sensors  1   b  to  8   b  are in the form of piezoelectric sensors and are adapted to be capable of detecting oscillations and converting the same to an electrical signal that can be analyzed. 
         [0048]    As is evident from the detail A shown in  FIG. 3 , the actors  1   a  to  8   a  and the sensors  1   b  to  8   b  are disposed in recesses  23  of the back portion  22  of the main portions  20 . They are attached by means of an adhesive  30  so that the flat bars  40  are physically connected to the main portion  20  not only by means of the rivets  44  but also by means of the sensors  1   b  to  8   b  and the actors  1   a  to  8   a  and the adhesive  30 . 
         [0049]    An electronic control/evaluation unit  50  is further disposed on the back portion  22  on the inside surface thereof such that the electronic control/evaluation unit is hidden under the textile covering  12 . The electronic control/evaluation unit  50  is connected to the actors  1   a  to  8   a  and the sensors  1   b  to  8   b  by means of electrical conductors. This is shown merely by way of example for the sensor contrivance  5  in  FIG. 2 . The connection of the other sensor contrivances to the control unit  50  is similarly configured. 
         [0050]    The control unit  50  is adapted to supply the actors  1   a  to  8   a  with a high-frequency alternating voltage in order to cause the actors to oscillate. A frequency of 500 kHz is used for this purpose. Furthermore, the control unit  50  is adapted to evaluate the oscillations detected by the sensors  1   b  to  8   b.    
         [0051]    The mode of operation of the sensor contrivances  1  to  8  is explained below with reference to  FIGS. 4   a  to  4   c . The mode of operation is explained with reference to the sensor contrivances  1  to  4  shown on the left hand side in  FIG. 1 . 
         [0052]    As explained above, the sensor contrivances  1  to  4  are provided on one of the two flat bars  40  made of carbon fiber reinforced plastics material. A sensor portion  1   c ,  2   c ,  3   c , and  4   c  is assigned to each set comprising one actor of the actors la to  8   a  and one sensor of the sensors  1   b  to  8   b . These sensor portions  1   c ,  2   c ,  3   c , and  4   c  are each sub-portions of the flat bar  40 , each sensor portion being delimited on both sides by rivets  44 . The main portion  20  disposed above the flat bar  40  is not shown in  FIGS. 4   a  to  4   c.    
         [0053]    The mode of operation of the sensor contrivances  1  to  8  is explained with reference to  FIG. 4   a  and exemplified by the sensor contrivance  3 . The actor  3   a  is excited by the control unit  50  with an alternating voltage having the aforementioned frequency of 500 kHz. The resulting oscillation of the actor  3   a  leads to coupling of waves into the sensor portion  3   c . The waves propagate in both directions  90  until they are reflected by the rivets  44  in the direction  91 . The reflected waves are detected by the sensor  3   b  and transmitted to the control unit  50  in the form of a corresponding signal. The control unit  50  can compare the recorded wave with the wave coupled into the sensor portion and accordingly draw conclusions on the state of stress in the sensor portion  2   c , for example, on the basis of the attenuation of the waves. 
         [0054]    In the state shown in  FIG. 4   a , the flat bar  40  is in the relaxed state so that the attenuation is low. 
         [0055]    In the state shown in  FIG. 4   b , the sensor portion  3   c  of the sensor contrivance  3  is bent as a result of a force applied to the flat bar  40 , and the surface of sensor portion  3   c  is thus under tensile stress. The waves coupled into the sensor portion  3   c  by the actor  3   a  are attenuated to a greater degree before they are detected by the sensor  3   b , due to this state of stress. The control unit  50  is thus able to identify the state of stress and thus the deformation of the sensor portion  3   c  on the basis of the increased attenuation. 
         [0056]    The flat bar  40  is twisted in the region of sensor portion  4   c  in the state shown in  FIG. 4   c . This also leads to a state of stress that causes the wave coupled by the actor  4   a  into the sensor portion  4   c  to reach the sensor  4   b  at a degree of attenuation which is greater than that occurring in the stress-free state shown in  FIG. 4   a.    
         [0057]    Although the states of stress of the sensor portion  3   c  shown in  FIG. 4   b  and the sensor portion  4   c  shown in  FIG. 4   c  are caused by a bent flat bar and a twisted flat bar respectively, they can be identified by sensors/actors of identical design since both types of stress states bring about increased attenuation. 
         [0058]    The movement-specific deformation of the flat bars  40  in the case of a deformation of the main portion  22  is utilized to enable the control unit  50  to recognize and distinguish between various movements of the patient. The manner in which this takes place is explained below in a simplified manner with reference to  FIGS. 5   a  to  5   d.    
         [0059]      FIG. 5   a  shows an initial state of the spinal orthosis  10 . The patient  60  maintains an upright posture. In this state, the flat bars  40  are relaxed as shown in the illustration of  FIG. 4   a . As a result, the coupled wave shown on the right-hand side of  FIG. 5   a  reach the respective sensors  1   b  to  8   b  almost without any attenuation as is evident from the representations of oscillations shown in  FIG. 5   a . On the basis of this condition, the control unit can identify the upright posture of the patient  60 . 
         [0060]      FIG. 5   b  shows the patient  60  bent forward. Due to the wing-like portions  24   a ,  24   b ,  26   a , and  26   b , this posture causes the flat bars  40  to bend in the region of the sensor portions  3   c  and  7   c  of the sensor contrivances  3  and  7 , respectively. The remaining sensor portions  1   c ,  2   c ,  4   c ,  5   c ,  6   c , and  8   c  are not bent or are hardly bent. In the case of the sensor portions  1   c  and  5   c , this is due to the fact that they are provided above the top wing-like portions  24   a  and  24   b  so that the wing-like portions  24   a ,  24   b ,  26   a ,  26   b  cannot produce any bending moment at this location. The fact that the sensor portions  2   c ,  4   c ,  6   c , and  8   c  are not bent or are hardly bent is due to the increased mechanical section modulus of the back portion  22  relative to bending in the region of these sensor portions caused by the presence of the wing-like portions  24   a ,  24   b ,  26   a , and  26   b . As shown by the wave diagrams in  FIG. 5   b , an increased attenuation can therefore be observed only in the region of the sensor contrivances  3  and  7 . Such an attenuation confined to the sensor contrivances  3  and  7  can thus be clearly identified by the control unit  50  as being an indication of the fact that the patient is bending forward. 
         [0061]      FIG. 5   c  shows the patient  60  bending back. This posture also causes bending of the back portion  22  and thus of the flat bars  40 . However, this is caused, unlike the forward bending posture shown in  FIG. 5   b , by the posture of the back  60   a  of the patient so that in contrast to the forward bend shown in  FIG. 5   b , the sensor contrivances  1  and  5  record an increased degree of attenuation. On the other hand, the sensor contrivances  2 ,  4 ,  6 , and  8  remain largely unaffected due to the increased section modulus of the back portion  22  due to the presence of the wing-like portions  24   a ,  24   b ,  26   a , and  26   b . The attenuation detected can thus be clearly assigned by the control unit  50  to a backward bending movement. 
         [0062]      FIG. 5   d  shows a position of the patient, in which the latter has turned the upper part of his body toward the left. Such a movement causes the left-hand wing-like portions  24   b  and  26   b  to bend back in the direction of the arrows  25   a . At the same time, the right-hand wing-like portions  24   a  and  26   a  on the front side of the patient are pulled toward the left by means of the fastening belt  14  so that they are bent forward in the direction of the arrows  25   b . This bending stress of the wing-like portions  24   a ,  24   b ,  26   a , and  26   b  results in each of the flat bars  40  being partially twisted in the direction of the arrows drawn in the region of the sensor portions  2   c ,  4   c ,  6   c , and  8   c  so that the sensor contrivances  2 ,  4 ,  6 , and  8  record an increased degree of attenuation. Due to the fact that this torsion is stronger in the rotational direction, that is to say, toward the left rather than to the right, the control unit  50  can detect that the patient has moved his body toward the left. 
         [0063]    It is apparent from the explanation of  FIGS. 5   a  to  5   d  that the control unit  50  can reliably detect the movement of the patient. The attenuation factor enables a detection of not only the type but also the extent of the respective movements. The control unit  50  can compare the determined movement or posture of the patient with predefined thresholds in order to assess whether the movement or posture in question is one that is orthopedically detrimental. When this is the case, the control unit  50  can inform the patient by means of an integrated vibration signal transmitter  52  to the effect that his present movement or posture should be avoided.