THERAPEUTIC METHOD AND DEVICE FOR REHABILITATION

• US 20090306548A1
• Filed: 06/05/2008
• Published: 12/10/2009
• Est. Priority Date: 06/05/2008
• Status: Abandoned Application

• Current Assignee: Tibion Corporation (AlterG, Inc.)
• Original Assignee: Tibion Corporation (AlterG, Inc.)
• Inventors: BHUGRA, Kern S., Jardine, Robert L., Horst, Robert W.
• Application Number:
  US12/134,095
• Publication Number:
  US 20090306548A1
• Time in Patent Office: Days
• US Class Current: 600/587
• CPC Class Codes: A61H 1/008 Apparatus for applying pressure or blows almost perpendicular to the body or limb axis, e.g. chiropractic devices for repositioning vertebrae, correcting deformation
• CPC Class Codes: A61H 1/024 Knee A61H1/0255 takes precedence
• CPC Class Codes: A61H 1/0266 Foot
• CPC Class Codes: A61H 2201/165 Wearable interfaces
• CPC Class Codes: A61H 2201/5015 using specific interfaces or standards, e.g. USB, serial, parallel
• CPC Class Codes: A61H 2201/5038 freely programmable by the user
• CPC Class Codes: A61H 2201/5061 Force sensors
• CPC Class Codes: A61H 2201/5064 Position sensors
• CPC Class Codes: A61H 2201/5069 Angle sensors
• CPC Class Codes: A61H 2230/65 Impedance, e.g. skin conductivity; capacitance, e.g. galvanic skin response [GSR]
• CPC Class Codes: A63B 21/00181 comprising additional means assisting the user to overcome part of the resisting force, i.e. assisted-active exercising
• CPC Class Codes: A63B 21/0054 for charging a battery

Abstract

The invention relates to embodiments of methods for extending a subject-controllable range of joint motion, and for increasing subject control of joint movement within a range of motion. Embodiments include fastening a powered device around a joint so as to be able to control the joint, allowing the subject to move the joint within a range of volitional motion, and then engaging the powered device to support movement of the joint into an expanded, rehabilitative range. In some embodiments, the device supports joint movement by substantially providing the force to move the joint beyond the volitional boundary. In other embodiments, supporting movement includes the subject substantially providing the force, and the device allowing movement only in a desired direction. The invention further relates to a system for increasing the functional capability of a joint by implementing embodiments of the method. By such methods and system, rehabilitation is accomplished both by building strength, and training neural pathways.

Claims

1. A method for extending a subject-controllable range of motion of a joint comprising:

fastening a powered device at sites above and below a joint of a subject;

moving the joint volitionally from a starting position to a volitional boundary of the subject'"'"'s range of motion substantially through the effort of the subject, the range of motion being any of extension or flexion; and

moving the joint beyond the volitional boundary with the assistance of the powered device.

2. The method of claim 1 further comprising determining joint angle while the joint is moving volitionally within the subject'"'"'s range of motion to determine the volitional boundary of the subject'"'"'s range of motion.

3. The method of claim 1 wherein moving a joint to the volitional boundary is repeated one or more times prior to moving the joint beyond the volitional boundary.

4. The method of claim 1 wherein moving a joint beyond the volitional boundary further includes moving the joint toward an expanded boundary of range of motion.

5. The method of claim 4 further comprising setting the expanded range of motion by an operator entering a value for the boundary of the expanded range of motion.

6. The method of claim 4 further comprising setting the expanded range of motion by applying an algorithm.

7. The method of claim 1 wherein moving to the volitional boundary occurs without assistance from the powered device.

8. The method of claim 1 wherein moving to the volitional boundary occurs with an amount of assistance from the powered device that counteracts at least a portion of gravitational force on the joint without exceeding the force of gravity on the joint.

9. The method of claim 1 further comprising, if the joint has not reached the volitional boundary before the lapse of a predetermined amount of time, continuing the volitional movement step.

10. The method of claim 1 further comprising, if the joint has not reached the volitional boundary after the lapse of a predetermined amount of time, proceeding with the step of moving the joint with the assistance of the powered device.

11. The method of claim 10 further comprising adjusting the volitional boundary to decrease the range.

12. The method of claim 1 further comprising, if the joint has reached the volitional boundary, proceeding with the step of moving the joint with the assistance of the powered device.

13. The method of claim 1 further comprising determining if the joint has reached the volitional boundary, and if the joint has reached the volitional boundary, then determining joint velocity, and if the velocity is greater than a preset limit, continuing with the step of moving the joint volitionally.

14. The method of claim 1 further comprising determining if the joint has reached the volitional boundary, and if the joint has reached the volitional boundary, then determining joint velocity, and if the velocity is less than a preset limit, then proceeding to the step of moving the joint with the assistance of the powered device.

15. The method of claim 14 further comprising adjusting the volitional boundary to increase the range.

16. The method of claim 1 after the step of the joint moving beyond the volitional boundary, one of flexion or extension, the method further comprising:

moving the joint to the boundary of an expanded range of flexion or extension beyond the volitional boundary; and

moving the joint to the boundary of an expanded range, the other of flexion or extension.

17. The method of claim 16 wherein the moving steps further include returning to the starting position, the return marking a conclusion of a movement cycle, the method further including repeating the cycle one or more times

18. The method of claim 17 wherein returning to the starting position may be completed volitionally.

19. The method of claim 17 wherein returning to the starting position may be completed with assistance from the powered device.

20. The method of claim 17 wherein returning to the starting position may be partially completed volitionally and partially completed with assistance from the powered device.

21. The method of claim 16 wherein the movement cycle is repeated for a predetermined number of times.

22. The method of claim 16 wherein the movement cycle is repeated at a predetermined rate of cycles per unit time.

23. The method of claim 1 wherein the joint includes any one or more of an ankle, knee, shoulder, hip, elbow, wrist, or finger.

24. The method of claim 1 further comprising sensing the status of a joint with a myoelectric sensor, such status including any of joint position, rate of joint movement, or indication of electrical activity in a muscle that can move the joint.

25. A method for increasing a subject'"'"'s control of movement of a joint within a range of motion comprising:

fastening a powered device at sites above and below the joint;

moving the joint volitionally from a starting position toward a volitional boundary of the subject'"'"'s range of motion substantially through the effort of the subject, the range of motion being toward a goal direction of any of extension or flexion; and

permitting movement only in the direction with the powered device.

26. The method of claim 25 further comprising:

selecting the goal direction;

allowing volitional movements in the goal direction; and

disallowing volitional movements away from the goal direction.

27. The method of claim 25 wherein movement toward a volitional boundary is in a first of opposite directions of flexion or extension, the method further comprising:

moving the joint volitionally to a volitional boundary in the first direction, and moving the joint back to the start position;

moving the joint volitionally to a volitional boundary in a second direction opposite to the first direction; and

moving the joint to return to the starting position, the return marking the conclusion of a movement cycle.

28. The method of claim 27 further comprising repeating the cycle one or more times.

29. The method of claim 28 further comprising setting the number of repeat cycles by an operator entering a value for the number of repeat cycles.

30. The method of claim 28 further comprising setting the number of repeat cycles by applying an algorithm.

31. The method of claim 28 further comprising setting the rate of cycles per unit time by an operator entering a value for the rate of cycles per unit time.

32. The method of claim 28 further comprising setting the rate of cycles per unit time by applying an algorithm.

33. The method of claim 25 wherein the joint includes any one or more of an ankle, a knee, a shoulder, a hip, an elbow, a wrist, or a finger.

34. A method for improving the ability to volitionally control movement of a joint comprising:

fastening a powered device at sites above and below a joint of a subject;

moving the joint volitionally within a range of motion substantially without assistance of the device; and

moving the joint beyond the range of motion substantially with support of the powered device.

35. The method of claim 34 wherein moving the joint volitionally within a range of motion substantially without assistance of the device includes moving the joint from a starting position to a volitional boundary of the subject'"'"'s range of motion;

and

wherein moving the joint with the support of the powered device includes moving the joint beyond the volitional boundary with the assistance of the device.

36. The method of claim 34 wherein moving the joint volitionally includes volitionally within a range of motion substantially without assistance of the device, includes moving the joint solely through the effort of the subject.

37. The method of claim 34 wherein moving the joint volitionally within a range of motion substantially without assistance of the device includes moving the joint with assistance from the powered device providing an assistance amount sufficient to partially counteract the effect of gravity.

38. The method of claim 34 wherein moving the joint volitionally includes moving the joint from a starting position in a direction toward a volitional boundary of a range of motion;

and wherein moving the joint with the support of the powered device includes permitting only movement in that direction.

39. A system to increase the functional capability of a joint of a patient comprising:

an actuator coupled to an orthotic attached to both sides of a joint, the actuator configured to activate the orthotic to support movement of the joint;

at least one sensor adapted to determine an angle of the joint; and

a controller operably connected to the actuator and the sensor, the controller to operate the actuator and the orthotic to support movement of the joint based on the angle of the joint;

the controller configured to determine when the patient'"'"'s joint has reached a volitional boundary of extension or flexion based on sensor input, and to activate the actuator to support movement of the joint beyond the volitional boundary.

40. The system of claim 39 wherein the controller is configured to differentiate the angle of the joint with respect time, thereby being able to determine a rate of movement of a joint.

41. The system of claim 40 wherein the system is able to determine when a volitional movement of the joint has come to a stop, the stop indicating a volitional boundary of movement.

42. The system of claim 39 wherein the controller is configured to operate the actuator and the orthotic to allow volitional movement of the joint to occur substantially without the assistance of the device, and wherein to support movement of the joint includes to assist movement when the joint has moved to a boundary of volitional movement.

43. The system of claim 39 wherein the controller is configured to operate the actuator and the orthotic to allow volitional movement of the joint to occur substantially without the assistance of the device when the joint is moving in a direction of flexion or extension, and wherein to support movement of the joint includes permitting movement only in the respective direction of flexion or extension.

44. The system of claim 39 wherein the controller is configured to activate the actuator to move the joint beyond the volitional boundary and then to an expanded boundary of a range of motion.

45. The system of claim 39 wherein the controller is configured to have the actuator counteract at least in part the effect of gravity on movement of the joint.

46. The system of claim 39 further comprising an actuator force sensor operably connected to the controller and providing input thereto, the controller capable of limiting the maximal force applied to the actuator.