Patent Description:
In particular, the invention refers to a device for blocking a shoe designed to be used with a system for rehabilitating the walk, to allow a person to walk directly on the ground with his own shoe, in direct contact with the ground, also allowing the rotation of the phalanxes to obtain an absolutely natural walk.

The device for blocking a shoe is connected to a suitable structure, which is, in turn, connectable to a movement managing system. The system finds its application connected to an exoskeleton and to a system for walk on the ground or for walking on a conveyor belt, or to allow the movement of the foot in training activities. The fields of application of the invention therefore are those of the assistance and of the rehabilitation and of the sports activities.

The prior art has various types of devices to be connected to the shoes for different purposes; for example, patent <CIT> discloses a device which can be added to the shoes to improve their contact with the ground, to allow walking on a difficult ground and/or to avoid uncontrolled slippages.

Other known devices are used in ortheses of lower limbs and in robotized exoskeletons for rehabilitation purposes.

Examples of such latter use are contained in documents <CIT> and <CIT>, which disclose systems comprising robotized exoskeletons, connected to the tibia to produce the movement of the foot with actuators which generate the rotation of an equivalent ankle joint.

Active exoskeletons are further known for performing a walk, both in systems to allow walking on the ground for assistance, and in systems for performing exercises on a conveyor belt, which provide for devices to fasten the shoes, or directly the foot, to mechanical structures comprising rigid platforms or plates moved by the exoskeleton actuators.

Such known devices and systems have the problem that, since the connecting devices to the foot or to the shoe consist in rigid platforms or plates, they do not allow a natural movement of the foot, preventing the rotation of the phalanxes in the stpe of lifting the foot and the contact of the shoe directly with the ground, causing a big limitation of the walking quality.

In the field of the robotized rehabilitation of the walk, it is necessary to use apparatuses capable of moving the legs according to predefined motion laws, unburdening at the same time the legs from the weight of the patient, to prevent them from being excessively loaded, above all during the earlier phases of a therapeutic treatment.

The known art in the sector of robotized apparatuses for rehabilitating the walk comprises many models with different mechanisms and technologies for actuating the leg articulation, both of the type with fixed station, and of the mobile type on the ground. All devices perform the movements of hip and knee; only some of them also move the ankle, while other leave the foot free, entrusting it to the activation of the patient's muscles, or use simple recall systems, for example based on springs, to avoid stumbling during a walk. The unburdening of the weight occurs by supporting the body of the patient with a suitable harness connected to Body Weight Support, or BWS, devices.

Weight unburdening systems are known, suitable for rehabilitation systems which develop the walk on the ground, without an active exoskeleton, for example disclosed in documents <CIT> and <CIT>.

These systems have the problem of being very complex, heavy and costly.

Weight lifting and unburdening systems are further known, used for rehabilitation, both for walking on the ground, and for walking on conveyor belt, which use various devices for compensating the vertical body motion.

The main techniques used in these systems are: elastic springs, balancing masses, automatic systems with force measurement, pneumatic systems.

These prior art systems with springs are simple, but have in general limits for regulating the force and for keeping its value during the oscillation of the patient body two to the unavoidable variation of the spring length.

The systems with balancing masses, for example disclosed in patent application <CIT> (LOKOMAT System), have problems in the step of reversing the movement direction of the masses, with dynamic actions which disturb the patient.

As regards systems with closed loop ring:.

These known systems with closed loop control can be very accurate, but have the problem of requiring dedicated instruments, with a force sensor, and are in general rather complex.

As regards systems based on compressed air devices:.

<CIT> discloses a device according to the preamble of claim <NUM>.

All prior art systems have critical aspects as regards the movements of the feet and the weight unburdening, which must take into account the need of unburdening the weight by following the vertical movements of the body following the walk execution.

As regards the feet, known systems have the problem of not allowing the execution of the walk by moving the foot with imposed actuations, and making simultaneously the patient use his own shoe in direct contact with the ground and bending the phalanxes. Systems which have actuations to move the feet in fact use platform on which the same foot is abutted. Such platforms are for rigid needs or have predefined articulations, so that the contact with the ground is the one imposed bz platforms and not by a contact between shoe and ground. The devices which do not provide for the actuation of the foot can allow the use of the shoe of the patient, but have the problem of developing an incomplete rehabilitation action, since the imposed and correct movements of the foot are not present, and are necessary for getting back a complete functionality.

As regards the unburdening of the weight, this can be managed rather easily in known rehabilitation apparatuses with fixed station, though with some limits two to the choice of the technical solution; for example, if balancing counterweights are used, strong dynamic actions are generated, upon reversing the motion direction.

As regard weight unburdening systems suitable for rehabilitation systems which develop the walk on the ground, known prior art devices, developed for different fields of application (rehabilitation of the walk on the ground without active exoskeleton), are very complex, heavy and costly.

Object of the present invention is solving these problems, by providing an innovative device to stably connect the shoe of a patient to the exoskeleton, thereby allowing correct movements, leaving the shoe free of touching, in a practically natural way, the ground, and thereby reestablishing all physiologic conditions for perceiving the contact and transmission conditions of the forces between patient and ground.

The above and other objects and advantages of the invention, as will result from the following description, are obtained with a device for blocking a shoe as claimed in claim <NUM>. Preferred embodiments and non-trivial variations of the present invention are the subject matter of the dependent claims.

It is intended that all enclosed claims are an integral part of the present description.

It will be immediately obvious that numerous variations and modifications (for example related to shape, sizes, arrangements and parts with equivalent functionality) can be performed to what is described, without departing from the scope of the invention as appears from the enclosed claims.

The present invention will be better described by some preferred embodiments thereof, provided as a non-limiting example, with reference to the enclosed drawings, in which:.

With reference to the Figures, the device <NUM> for blocking a shoe <NUM> according to the invention is used for an exoskeleton <NUM> of a system <NUM> for rehabilitating the walk, andcomprises a structure <NUM> designed to externally wrap the heel of a patient <NUM>, allowing the contact between the sole of the shoe <NUM> and the ground, said structure <NUM> comprising a rear element <NUM> connectable to a bearing and moving structure of a foot <NUM>, a band assembly <NUM> connected to the structure <NUM> to strap up and tighten the shoe <NUM> of the patient <NUM>, in order to make it integral to the device <NUM>, said structure <NUM> being further shaped in such a way as to comprise a reference <NUM> to arrange the device <NUM> in the correct position, centring the reference <NUM> with the ankle of the patient <NUM>.

Preferably, the band assembly <NUM> to connect the shoe <NUM> to the device <NUM>, in particular to the structure <NUM>, comprises: a band or a portion of band 14A connected to the structure <NUM>, for example inserted inside slits <NUM> obtained in the structure <NUM>, designed to wrap the heel passing below the heel <NUM> of the shoe <NUM> and opening, closing and adjusting elements <NUM> of a known type to adjust its length in order to guarantee the vertical position of the device <NUM>, making the reference <NUM> coincide with the centre of the ankle of the patient <NUM>; a band or a portion of band 14B connected to the structure <NUM>, for example inserted inside slits <NUM> obtained in the structure <NUM>, designed to pass on the neck of the foot of the patient <NUM>, preferably using an abutment bearing <NUM> to distribute the load on the neck of the foot, and comprising opening, closing and adjusting elements <NUM> of a known type to adjust its length in order to obtain an adequate closure on the foot; a band or a portion of band 14C connected to the structure <NUM>, preferably in its rear part, for example inserted inside slits <NUM> obtained in the structure <NUM>, having two ends <NUM> placed towards the tip of the foot; a ring-shaped band or a portion of band 14D to which the ends <NUM> are connected, designed to tighten the foot next to the phalanxes and comprising opening, closing and adjusting elements <NUM> to adjust its length, said ends <NUM> can also be adjusted in their length through opening, closing and adjusting elements <NUM> in order to allow a correct positioning of the ring-shaped band or portion of band 14D immediately downstream of the phalanxes on the metatarsus.

Preferably, the structure <NUM> comprises a reference of the centre of the heel obtained by shaping the upper profile of the structure <NUM> next to the heel.

According to the invention, the rear element <NUM> for connecting to the bearing and moving structure of a foot <NUM> is obtained through a tubular element or a rod <NUM>, built in such a way as not to have an axial symmetry, in order to locate an accurate angular position with the bearing and moving structure of a foot <NUM>, for example by being inserted into a corresponding hollow element <NUM> with a suitable length, which has inside a hole without axial symmetry capable of being coupled to the element <NUM>, obtained on an oscillating lever <NUM> of the bearing and moving structure of a foot <NUM>, preferably shaped as a "U", which wraps on the rear the foot and is connected to the structure <NUM> of the device for blocking a shoe <NUM>; the sliding of the rod <NUM> inside the hollow element <NUM> allows recording the position of the shoe in the sagittal plan with respect to the bearing and moving structure of a foot <NUM>; the rear element <NUM> is further equipped with a fastening system which avoids its spontaneous withdrawal, for example through pins or screws inserted inside a hole, of a group of holes <NUM> obtained in the rear element <NUM>, which coincides with a locking hole obtained in the hollow element <NUM> in the chosen position.

With reference to the Figures, the system <NUM> for rehabilitating the walk shown therein comprises an active exoskeleton <NUM> with six degrees of freedom to move the two hips, the two knees and the two ankles of the patient <NUM>, comprising a supporting structure <NUM> for the right leg and left leg, preferably a supporting structure <NUM> for regulating the distance between right leg and left leg, a bearing and moving structure <NUM> of a femur of the patient <NUM> connected in a rotary way to the supporting structure <NUM>, a bearing and moving structure <NUM> of a tibia of the patient <NUM>, with respect to the femur, connected in a rotary way to the bearing and moving structure of a femur <NUM>, the bearing and moving structure of a foot <NUM> of the patient <NUM>, with respect to the tibia, connected in a rotary way to the bearing and moving structure of a tibia <NUM>, and designed to be connected and disconnected to and from the device <NUM> for blocking a shoe of the invention, which allows the patient <NUM> to walk with his own shoes.

In a known way, the bearing and moving structures <NUM>, <NUM>, <NUM> comprise supporting means, composed for example of metallic guides and/or of sliders made of platesd made of harmonic steel, and handling means composed for example of pneumatic cylinders.

The active exoskeleton <NUM> of the system <NUM> for rehabilitating the walk comprises the bearing and moving structures of a femur <NUM> and of a tibia <NUM> preferably comprising elastic plates <NUM>, <NUM> connected to respective electromechanical actuating means <NUM>, <NUM>, <NUM> and <NUM>, <NUM>, <NUM> for regulating the lengths of the femur and tibia sections, in order to allow movements on the front plane to enable adapting the active exoskeleton <NUM> to patients with different configurations.

Preferably, the active exoskeleton <NUM> further comprises means for electronically acquiring data about the lengths of the femur and tibia sections, associated with the electromechanical actuating means <NUM>, <NUM>, <NUM> and <NUM>, <NUM>, <NUM> for regulating the lengths of the femur and tibia sections and consequently electronically acquiring the data, and electronic inclination sensors for adjusting the attitude of the exoskeleton <NUM> and for acquiring related data in a computerized way.

In a preferred embodiment of the invention, the active exoskeleton <NUM> comprises the bearing and moving structures of a femur <NUM> and of a tibia <NUM>, schematically shown in <FIG> and in turn comprising respective elastic plates <NUM>, <NUM>, each connected to a respective ball carriage <NUM>, <NUM>.

In particular, in an embodiment which provides for the electric adjustment of the lengths of the bearing and moving structures of a femur <NUM> and of a tibia <NUM>, <FIG> shows the principle diagram in case of an adjustment of the femur section, while <FIG> shows the tibia section.

The bearing and moving structures of a femur <NUM> and of a tibia <NUM> each comprise a rigid guide <NUM>, <NUM> connected to a respective ball carriage <NUM>, <NUM>; such ball carriage <NUM>, <NUM> being fastened to the end of an elastic plate <NUM>, <NUM> and to a nut <NUM>, <NUM>, through connecting elements of a known type. The other end of the elastic plate <NUM>, <NUM> is fastened to a joint o the exoskeleton, respectively a hip joint <NUM> or an ankle joint <NUM>, while the rigid guide <NUM>, <NUM> is fastened to a knee joint <NUM>.

The bearing and moving structures of a femur <NUM> and of a tibia <NUM> each comprise an electric motor-reducer <NUM>, <NUM> fastened to the rigid guide <NUM>, <NUM>, connected to a screw <NUM>, <NUM> and designed to rotate it to perform the adjustment of the length of the bearing and moving structures of a femur <NUM> and of a tibia <NUM>. The screw <NUM>, <NUM>, when rotating, linearly moves the nut <NUM>, <NUM>, integral with the ball carriage <NUM>, <NUM>. For example, in the relative movement between screw <NUM> and nut <NUM>, when the nut <NUM> moves far away from the electric motor-reducer <NUM> (<FIG>) tutto the gruppo formato da electric motor-reducer <NUM>, rigid guide <NUM> and knee joint <NUM> are lifted, reducing the length of the bearing and moving structure of a femur <NUM>.

Preferably, the active exoskeleton <NUM> comprises the bearing and moving structure of a foot <NUM> comprising two pneumatic cylinders <NUM> in parallel, for moving the foot and the ankle, which are placed on the rear to the heel and connected, preferably hinged, to a lever <NUM> and to the oscillating lever <NUM> which wraps the foot on the rear and is connected to the removable device for blocking a shoe <NUM>, in particular to the structure <NUM>, through the rear element <NUM>.

In a preferred way, the pneumatic cylinders <NUM> comprise an axially moving shaft <NUM> having an end connected, preferably hinged, to the oscillating lever <NUM> and a head <NUM> connected, preferably hinged, to the lever <NUM>; in a preferred way, the oscillating lever <NUM> is shaped as a "U" and comprises two first arms <NUM> connected, preferably hinged, to the lever <NUM>, and two second arms <NUM> connected, preferably hinged, to the shafts <NUM> of the pneumatic cylinders <NUM>.

Preferably, the lever <NUM> is shaped as a "U" and comprises two first arms <NUM> connected, preferably hinged, to the oscillating lever <NUM>, in a preferred way to the first arms <NUM>, and comprises two second arms <NUM> connected, preferably hinged, to the heads <NUM> of the pneumatic cylinders <NUM>.

Preferably, the bearing and moving structure of a foot <NUM> further comprises the elastic plate <NUM> having an end connected, preferably fastened, to the ball carriage <NUM> of the bearing and moving structure of a tibia <NUM>.

The other end of the elastic plate <NUM> is connected, preferably fastened, to the lever <NUM>, in a preferred way to a first arm <NUM>.

Preferably, the system <NUM> for rehabilitating the walk comprises the active exoskeleton <NUM>, a weight supporting device (BWS) <NUM> which allows lifting or lowering the patient <NUM> and the active exoskeleton <NUM> to which he is associated, in order to place the patient <NUM> in contact with the ground in a suitable position to allow walking exercises, said BWS <NUM> ending with a structure connected to means <NUM> for supporting the exoskeleton and the patient, comprising a harness for the exoskeleton <NUM> which allows supporting its weight without discharging it onto the patient, a wearable and adjustable harness for supporting the patient, preferably with bands for supporting the groins and a corsage for supporting the torso of the patient, said harness being suitably arranged to be connected to the active exoskeleton <NUM> and to the BWS <NUM>; handling means <NUM> connected to the BWS <NUM>, to allow its movement; means <NUM> for transmitting electric and pneumatic supplies, electric signals for managing, controlling, monitoring and diagnosing the whole system, to the BWS <NUM>; a managing system <NUM> comprising a microprocessor, for example of a computer, for acquiring and processing data, and managing a session of neuro-rehabilitation motion.

Preferably, the managing system <NUM>, for example a box on the ground, comprises the general pneumatic <NUM> and electric <NUM> supplies, electropneumatic circuits, a computer comprising electronic cards, memories of a known type, preferably a touch-screen <NUM> for managing and monitoring the walking exercises; an electropneumatic system for the actuations of the exoskeleton joints and of the oscillation system of the patient's torso in the walk on the ground; an electronic system for managing, controlling, acquiring data, monitoring and locally and remotely diagnosing, preferably comprising hardware emergency systems, backup battery, hanging pushbutton panel from BWS, controlling pushbutton panel for local actuations, touch-screen, electronic cards, power supplies and data transmission lines, with distributed hardware between box <NUM>, exoskeleton <NUM>, BWS <NUM>, an assembly <NUM> for managing the BWS movement and electric and pneumatic interconnection lines <NUM>; the system <NUM> for rehabilitating the walk further comprises a managing software.

Preferably, the handling means <NUM> comprise guiding means <NUM>, for example a track, preferably fastened to a ceiling, and the BWS <NUM> is associated with the guiding means <NUM> in a sliding way to allow its movement, for example by means of small sliding carriages; the means for transmitting electric and pneumatic supplies and electric signals <NUM> are for example a known cable-holder chain, containing the connection cables of the BWS <NUM> at an end of the guide track; in a preferred way, the system <NUM> for rehabilitating the walk further comprises dragging means <NUM> for the automatic movement of the BWS <NUM> with known speed and/or thrust force control, comprising for example a metallic wire tensioned by springs, with a free returning pulley, a driving pulley actuated by an electric motor-reducer, preferably of the torque-controlled type; means for measuring the position of the exoskeleton <NUM>, for example a laser measure sensor, to know the position of the exoskeleton <NUM> at the beginning and when performing the walking exercises, in order to correctly manage the number of footsteps to be walked before arriving at the end of the guide track <NUM> of the exoskeleton <NUM>; a second, auxiliary BWS <NUM> of the prior art, for example comprising a handle for lifting the patient <NUM>, which allows harnessing the standing patient <NUM>, dressing the device <NUM> for blocking a shoe or lifting the patient <NUM> once harnessed and having worn the device <NUM> for blocking a shoe when sitting or on a carriage, to then transfer the patient <NUM> to the BWS <NUM> which already supports the exoskeleton <NUM>, perform the necessary adjustments of the femur and tibia sections and connect the patient <NUM> to the exoskeleton <NUM> to perform the walking exercises.

In a preferred embodiment, the system <NUM> for rehabilitating the walk comprises a weight supporting device (BWS) <NUM> with a double electric and pneumatic actuation which allows lifting or lowering the patient <NUM> and the active exoskeleton <NUM> to which he is associated, in order to place the patient <NUM> in contact with the ground in a position suitable to allow walking exercises with a predefined weight unburdening value and with the natural torso oscillation, or to lift him completely from the ground for walking exercises in air, or to allow the rotation of the patient by <NUM>° at the end of a path on the ground and begin a new walking exercise.

Advantageously, the system <NUM> for rehabilitating the walk allows performing exercise capable of positively dealing with different situations and different rehabilitation stages.

In particular, it allows performing exercises in a complete suspension, to enable re-ordering the walk mechanisms, and walking exercises on the ground, with a physiologic walk and with partial weight unburdening, improving the movement perception and progressively loading the muscles; it further allows performing prolonged exercises, if associated with the use of a conveyor belt.

The weight supporting device, or BWS <NUM> of the system <NUM> for rehabilitating the walk uses a double electric and pneumatic actuation and, to lift or lower the patient <NUM> and the exoskeleton <NUM>, it comprises a suspension element <NUM> connected to a side through the means <NUM>, comprising for example suitable bands and harnesses, to the exoskeleton <NUM> and to the patient <NUM> and connected on the other side to a lifting band <NUM>; the BWS <NUM> further comprises a band collecting pulley <NUM>, actuated by actuating means, for example composed of an electric motor <NUM> connected to a reducer <NUM>, around which the lifting band <NUM> is wound to change its length till the final blocking in the desired position.

In order to allow a good performance of the walking exercises on the ground, allowing the natural vertical movement of the patient's body, the BWS <NUM> also comprises a second device <NUM> of a pneumatic type, for example a pneumatic cylinder <NUM> having an axially moving shaft <NUM>, connected to a moving pulley <NUM> around which the lifting band <NUM> is wound before arriving at the collecting pulley <NUM>, which allows the free vertical movement of the patient <NUM> starting from a starting position, with a constant weight unburdening force.

Advantageously, such device <NUM> of a pneumatic type, for example due to the use of the pneumatic cylinder <NUM> which works at a constant pressure, allows applying an absolutely constant unburdening force and, due to the yield of the pneumatic system, allows a comfortable actuation for the patient <NUM>, avoiding vibrations or sudden movements, in particular in the motion reversal step.

In the walk in air, instead, only the movement of the actuating means <NUM>, <NUM> of the band collecting pulley <NUM> is used, for example of the electric motor <NUM>, to lift from the ground exoskeleton <NUM> and patient <NUM> in a certain position which is not modified during the exercises.

The weight supporting device (BWS) <NUM> preferably comprises the electric motor <NUM> which actuates the reducer <NUM>, for example of the irreversible type, connected through an output shaft <NUM> to the collecting pulley of the band <NUM>. The lifting band <NUM> going out of the collecting pulley of the band <NUM> passes through two returning pulleys <NUM>, in order to always be horizontal, before being wound on the moving pulley <NUM> moved by a shaft <NUM> connected to the shaft <NUM> of the pneumatic cylinder <NUM>, to be then rotated, through two further returning pulleys <NUM>, from an horizontal to a vertical direction and be connected to the active exoskeleton <NUM> and to the patient <NUM>. The pneumatic cylinder <NUM> comprises a rear chamber <NUM> which is constantly at the atmospheric pressure, and a front chamber <NUM> which is pressurized, at an adequate level to provide, on the end of the lifting band <NUM> connected to the exoskeleton <NUM> and to the patient <NUM>, a force equal to the weight of the exoskeleton <NUM> and to the amount of weight of the patient <NUM> which must be unburdened. Given the configuration with moving pulley <NUM>, the value of the force produced by the pneumatic cylinder <NUM> is double what is required and its stroke is half of the vertical stroke necessary to oscillate the patient <NUM> in his walk on the ground.

<FIG> shows an example of an electropneumatic circuit <NUM> for controlling the cylinder <NUM>. For regulating the pressure, the front chamber <NUM> of the cylinder is connected to a proportional solenoid valve <NUM> which changes the pressure according to what is required.

Preferably, the front chamber <NUM> of the cylinder can be connected to a tank <NUM> with ad adequate volume according to the prior art, for an operation under energy saving conditions, which avoids filling and emptying the front chamber 53during every walking cycle, and obtaining a neglected pressure variation in the front chamber <NUM> of the cylinder when the patient <NUM> walks. Optionally, a solenoid valve <NUM> can be added (for example having two mouths and two positions, mono-stable, normally open) with a load resistance <NUM> to empty the pneumatic circuit <NUM> under emergency conditions.

Advantageously, the lifting and weight unburdening cylinder <NUM> can be used to lift the patient <NUM> from the ground at the end of the path allowed by the track, without requiring the addition of other control elements which would be necessary in case of intervention of the electric motor <NUM>, in order to allow the <NUM>° rotation of the patient <NUM>, and to take him back afterwards to the ground in the same vertical position before his lifting, to start a new walking exercise. This is obtained in a simple way, dimensioning the lifting and weight unburdening cylinder <NUM> with a longer stroke that a strictly necessary one to allow an oscillation during the walk to the ground and increasing the pressure in the front chamber <NUM> for his lifting. Following this solution, a solenoid valve <NUM> can be advantageously added (for example having two mouths and two positions, mono-stable, normally open) to avoid filling the tank <NUM> with compressed air, when the lifting operation of the patient <NUM> has been performed at the end of the path.

Advantageously, the weight supporting device (BWS) <NUM> of the invention, due to the use of the second pneumatic device <NUM> which works at a certain pressure and due to the compressed air yield, allows applying a constant unburdening force in a way which is always comfortable for the patient <NUM>, avoiding vibrations or sudden movements, in particular in the motion reversal stage.

Advantageously, the rehabilitation is greatly improved, since it allows not only assigning the correct motion law to the ankle movement, but also the perceptions of the contact, useful to make the patient acquire again his capability of improving his own walk with a correct and quick rehabilitation.

The use of a pneumatic device further generates a comfortable movement for the patient, increasing his appreciation towards the rehabilitation treatment.

The device <NUM> for blocking a shoe allows the patient to perform walking exercises with his own shoes, keeping the perception of the contact indispensable for a correct rehabilitation and allowing to naturally bend the shoes at the height of his phalanxes, thereby providing a substantial advantage with respect to other prior art solutions, which place the shoes on rigid platforms.

A further and important advantage is being able to fasten the device <NUM> for blocking a shoe to the shoes before wearing the exoskeleton, in a seated position or on a carriage, guaranteeing both a perfect positioning and an absolutely better comfort for the patient.

Claim 1:
Device (<NUM>) for blocking a shoe (<NUM>) for an exoskeleton (<NUM>) of a system (<NUM>) for rehabilitating the walk, comprising:
- a structure (<NUM>) designed to externally wrap the heel of a patient (<NUM>), allowing, in use, the contact between a sole of the shoe (<NUM>) and a ground, said structure (<NUM>) comprising a rear element (<NUM>) connectable to a bearing and moving structure of a foot (<NUM>);
- a band assembly (<NUM>) connected to the structure (<NUM>) and configured to strap up and tighten the shoe (<NUM>) of the patient (<NUM>) in order to make it integral to the device (<NUM>);
characterized in that the band assembly (<NUM>) comprises: a band or a portion of band (14A) connected to the structure (<NUM>) and designed to wrap the heel passing below the heel (<NUM>) of the shoe (<NUM>); a band or a portion of band (14B) connected to the structure (<NUM>) and designed to pass on the neck of the foot of the patient (<NUM>); a band or a portion of band (14C) connected to the structure (<NUM>) and having two ends (<NUM>) placed towards the tip of the foot; a ring-shaped band or a portion of band (14D) to which the ends (<NUM>) are connected, designed to tighten the foot next to the phalanxes; and
in that the rear element (<NUM>) for connecting to the bearing and moving structure of a foot (<NUM>) is obtained through a tubular element or a rod (<NUM>) built in such a way as not to have a axial symmetry, in order to locate an accurate angular position with the bearing and moving structure of a foot (<NUM>).