Orthosis with distraction through range of motion

• US 5,395,303 A
• Filed: 09/23/1993
• Issued: 03/07/1995
• Est. Priority Date: 07/30/1990
• Status: Expired due to Term

• Current Assignee: Bonutti Research Incorporated (Bonutti IP LLC)
• Original Assignee: Peter M. Bonutti
• Inventors: Bonutti, Peter M., Zitzmann, Gary E.
• Primary Examiner(s): Apley, Richard J.
• Assistant Examiner(s): DVORAK, LINDA C
• Application Number:
  US08/126,081
• Time in Patent Office: 530 Days
• Field of Search: 602/16, 602/20, 602/23, 602/36, 602/37, 601/23, 601/33, 601/34, 601/40
• US Class Current: 602/16
• CPC Class Codes: A61F 2005/0137 with two parallel pivots
• CPC Class Codes: A61F 2005/0139 geared
• CPC Class Codes: A61F 2005/0153 combining rotational and stretching movements
• CPC Class Codes: A61F 5/0102 specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations
• CPC Class Codes: A61F 5/0123 for the knees A61F5/0106 takes precedence
• CPC Class Codes: A61F 5/013 for the arms, hands or fingers A61F5/0118 takes precedence
• CPC Class Codes: A61H 1/024 Knee A61H1/0255 takes precedence
• CPC Class Codes: A61H 1/0277 Elbow
• CPC Class Codes: G04F 5/025 Electronic metronomes rhytem generation for electrophonic musical instruments G10H1/36
• CPC Class Codes: G04G 9/085 provided with date indication

Abstract

An orthosis for stretching tissue that limits compressive forces on the soft tissue around a joint during movement of the joint. The orthosis includes two relatively pivotable cuff arms with a cuff on each arm. The cuffs clamp onto the body portions on either side of the joint. The pivot axis of the cuff arms is spaced from the pivot axis of the joint, so that movement of the cuff arms to extend the joint results in distractive forces being applied to the joint. The cuffs are selectively moved on the cuff arms, during extension and flexion, to provide the proper amount of distractive forces to the joint and to limit compressive forces on the joint. A mechanical advantage is gained through the use of a gear drive mechanism for transmitting to the joint the force applied by the patient. This allows the orthosis to be relatively small and light weight. The orthosis also provides a portable system for continuous passive motion therapy for a joint. The orthosis may be operated by a manual plus electric drive cycling it between extremes of motion. Provision is made for monitoring the range of motion or the force applied.

Claims

1. An orthosis movable between first and second conditions for moving a joint which is located between first and second relatively movable body portions, comprising:

a first cuff arm;

a second cuff arm movably connected to said first cuff arm;

a first cuff on said first cuff arm for connecting said first cuff arm to the first body portion;

a second cuff on said second cuff arm for connecting said second cuff arm to the second body portion;

means for moving said first cuff arm relative to said second cuff arm about an axis intermediate said first and second cuffs; and

means for moving said first cuff along said first cuff arm upon relative movement between said first and second cuff arms, said means for moving said first cuff along said first cuff arm includes a motor and linkage means for transmitting force from said motor to said first cuff to move said first cuff along said first cuff arm through a distance which is a function of the extent of movement of said first cuff arm relative to said second cuff arm.

2. An orthosis as defined in claim 1 wherein said first cuff is slidably mounted on said first cuff arm.

3. An orthosis as defined in claim 2 wherein said first cuff arm comprises a track having at least one slot extending longitudinally along said track, said first cuff including means for extending through said slot and for guiding the sliding movement of said first cuff on said first cuff arm.

4. An orthosis as defined in claim 3 wherein said means for moving said first cuff upon relative movement between said ,first and second cuff arms comprises a cuff actuator block fixed to said first cuff and slidably mounted on said first cuff arm, said cuff actuator block being slidably driven by said means for moving said first cuff arm relative to said second cuff arm.

5. An orthosis for stretching tissue around a joint between first and second relatively pivotable body portions, comprising:

a first cuff arm, and a first cuff on said first cuff arm for connecting said first cuff arm to the first body portion;

a second cuff arm movably connected to said first cuff arm, and a second cuff on said second cuff arm for connecting said second cuff arm to the second body portion;

means for moving said first cuff arm relative to said second cuff arm;

means for moving said first cuff on said first cuff arm and for moving said second cuff on said second cuff arm upon relative movement between said first and second cuff arms; and

said means for moving said first cuff arm relative to said second cuff arm being selectively operable to provide incremental movement of said first cuff arm relative to said second cuff arm between a plurality of positions and to lock said arms at said positions.

6. An orthosis as defined in claim 5 wherein said means for moving said first cuff arm relative to said second cuff arm comprises ratchet drive means.

7. An orthosis as defined in claim 5 wherein said means for moving said first cuff arm relative to said second cuff arm comprises gear drive means.

8. An apparatus effecting relative movement between first and second body portions interconnected by a joint, said apparatus comprising a first cuff arm, first cuff means for connecting said first cuff arm with the first body portion, said first cuff means being movable along said first cuff arm, a second cuff arm, second cuff means for connecting said second cuff arm with the second body portion, means for interconnecting said first and second cuff arms and for enabling said first cuff arm to move relative to said second cuff arm, and fluid motor means operable under the influence of fluid pressure and connected with at least said first cuff arm for moving said first cuff arm relative to said second cuff arm and to simultaneously therewith move said first cuff means along said first cuff arm.

9. An apparatus as set forth in claim 8 wherein said second cuff means is movable along said second cuff arm, said fluid motor means being operable to move said second cuff arm and to simultaneously therewith move said second cuff means along said second cuff arm.

10. An apparatus as set forth in claim 9 further including a first lever having a first end portion connected with said fluid motor means and a second end portion connected with said first cuff means, said first lever being connected with said first cuff arm at a location between said first and second end portions of said first lever, said fluid motor means being operable to move said first end portion of said first lever to move said second end portion of said first lever and said first cuff means relative to said first cuff arm.

11. An apparatus as set forth in claim 10 further including a second lever having a first end portion connected with said fluid motor means and a second end portion connected with said second cuff means, said second lever being connected with said second cuff arm at a location between said first and second end portions of said second lever, said fluid motor means being operable to move said first end portion of said second lever to move said second end portion of said second lever and said second cuff means relative to said second cuff arm.

12. An apparatus for effecting relative movement between first and second body portions interconnected by a joint, the joint and first and second body portions defining on one side of the joint an inner sector which decreases in angle as the joint is flexed and define on the opposite side of the joint an outer sector which decreases in angle as the joint is extended, said apparatus comprising a first cuff arm disposed in the outer sector and having a first end portion adjacent to the joint, first cuff means for connecting said first cuff arm with the first body portion, said first cuff means being movable along said first cuff arm, a second cuff arm disposed in the outer sector and having a first end portion adjacent to the joint, said first end portion of said second cuff arm being spaced from said first end portion of said first cuff arm, second cuff means for connecting said second cuff arm with the second body portion, said second cuff means being movable along said second cuff arm, a connector member disposed in the outer sector and having a first end portion connected to the first end portion of said first cuff arm at a first pivot connection disposed in the outer sector, said connector member having a second end portion connected to the first end portion of said second cuff arm at a second pivot connection disposed in the outer sector, and drive means connected with said first and second cuff arms for effecting pivotal movement between said first and second cuff arms relative to said connector member at said first and second pivot connections and simultaneously therewith effecting movement of said first and second cuff means along said first and second cuff arms to effect relative movement between the first and second body portions.

13. An apparatus as set forth in claim 12 further including means for applying force to said first and second cuff means to distract the joint simultaneously with pivotal movement of said first and second cuff arms relative to said connector member at said first and second pivot connections.

14. An apparatus as set forth in claim 12 wherein said drive means includes a fluid motor which is connected with said first and second cuff arms and is operable under the influence of fluid pressure to pivot said first and second cuff arms relative to said connector member.

15. An apparatus as set forth in claim 14 wherein said fluid motor is disposed in the outer sector and is connected with said connector member.

16. An apparatus as set forth in claim 12 wherein said first and second cuff means are movable away from said first and second pivot connections during operation of said drive means in one direction, said first and second cuff means being movable toward said first and second pivot connections during operation of said drive means in a direction opposite to the one direction.

17. An apparatus as set forth in claim 12 wherein said first cuff means is movable along said first cuff arm in a direction away from said first pivot connection and in a direction toward said first pivot connection, said apparatus further including force transmitting means for transmitting force from said drive means to move said first cuff means along said first cuff arm in the direction away from said first pivot connection upon operation of said drive means in one direction and for transmitting force from said drive means to move said first cuff means in the direction toward said first pivot connection during operation of said drive means in a direction opposite to the one direction.

18. An apparatus as set forth in claim 17 wherein said drive means includes a fluid motor and means for connecting said fluid motor with said first cuff arm and said force transmitting means.

19. An apparatus as set forth in claim 12 wherein said drive means is mounted on said connector member and is at least partially located in the outer sector.

20. An apparatus as set forth in claim 12 wherein said drive means includes an externally threaded member and an internally threaded member which is disposed in engagement with said externally threaded member, said internally and externally threaded members being relatively movable to effect pivotal movement of at least one of said first and second cuff arms relative to said connector member.

21. An apparatus for effecting relative movement between first and second body portions interconnected by a joint, the joint and first and second body portions defining on one side of the joint an inner sector which decreases in angle as the joint is flexed and define on the opposite side of the joint an outer sector which decreases in angle as the joint is extended, said apparatus comprising a first cuff arm disposed in the outer sector and having a first end portion adjacent to the joint, first cuff means for connecting said first cuff arm with the first body portion, a second cuff arm disposed in the outer sector and having a first end portion adjacent to the joint, said first end portion of said second cuff arm being spaced from said first end portion of said first cuff arm, second cuff means for connecting said second cuff arm with the second body portion, a connector member disposed in the outer sector and having a first end portion connected to the first end portion of said first cuff arm at a first pivot connection disposed in the outer sector, said connector member having a second end portion connected to the first end portion of said second cuff arm at a second pivot connection disposed in the outer sector, and force transmitting means for moving said first cuff means away from said first pivot connection as the joint is flexed and for moving said first cuff means toward said first pivot connection as the joint is extended.

22. An apparatus as set forth in claim 21 wherein said force transmitting means includes means for moving said second cuff means away from said second pivot connection as the joint is flexed and for moving said second cuff means toward said second pivot connection as the joint is extended.

23. An apparatus as set forth in claim 21 wherein said force transmitting means includes an externally threaded member and an internally threaded member which is disposed in engagement with said externally threaded member, said internally and externally threaded members being relatively movable in a first direction to effect movement of said first cuff means away from said first pivot connection and being relatively movable in a second direction to effect movement of said first cuff means toward said first pivot connection.

24. An apparatus as set forth in claim 23 wherein said internally and externally threaded members are disposed in the outer sector.

25. An apparatus as set forth in claim 21 further including a fluid motor which is operable under the influence of fluid pressure to effect operation of said force transmitting means and movement of said first cuff means relative to said first pivot connection.

26. An apparatus as set forth in claim 21 wherein said force transmitting means is operable to effect pivotal movement between said first and second cuff arms relative to said connector member at said first and second pivot connections during movement of said first cuff means away from said first pivot connection and during movement of said first cuff means toward said first pivot connection.

27. An apparatus as set forth in claim 26 further including drive means connected with said force transmitting means for effecting operation of said force transmitting means.

28. An apparatus for effecting relative movement between first and second body portions interconnected by a joint, the joint and first and second body portions defining on one side of the joint an inner sector which decreases in angle as the joint is flexed and define on the opposite side of the joint an outer sector which decreases in angle as the joint is extended, said apparatus comprising a first cuff arm disposed in the outer sector and having a first end portion adjacent to the joint, first cuff means for connecting said first cuff arm with the first body portion, a second cuff arm disposed in the outer sector and having a first end portion adjacent to the joint, said first end portion of said second cuff arm being spaced from said first end portion of said first cuff arm, second cuff means for connecting said second cuff arm with the second body portion, connector means disposed in the outer sector for pivotally interconnecting said first and second cuff arms, force transmitting means for effecting pivotal movement between said first and second cuff arms in a first direction to flex the joint and for effecting pivotal movement between said first and second cuff arms in a second direction to extend the joint, said force transmitting means including means for moving said first cuff means away from said connector means during pivotal movement between said first and second cuff arms in the first direction and for moving said first cuff means toward said connector means during pivotal movement between said first and second cuff arms in the second direction.

29. An apparatus as set forth in claim 28 further including fluid motor means connected with said force transmitting means and operable under the influence of fluid pressure to effect operation of said force transmitting means.

30. An apparatus as set forth in claim 28 wherein said force transmitting means includes an externally threaded member and an internally threaded member which is disposed in engagement with said externally threaded member, said internally and externally threaded members being relatively movable in a one direction to effect movement of said first cuff means away from said connector means and being relatively movable in a direction opposite to effect movement of said first cuff means toward said connector means.

31. An apparatus as set forth in claim 30 wherein said internally and externally threaded members are disposed in the outer sector.

32. An apparatus as set forth in claim 28 wherein said force transmitting means includes an externally threaded member and an internally threaded member which is disposed in engagement with said externally threaded member, said internally and externally threaded members being relatively movable in one direction to effect pivotal movement between said first and second cuff arms in the first direction and to effect movement of said first cuff means away from said connector means, said internally and externally threaded members being relatively movable in a direction opposite to the one direction to effect pivotal movement between said first and second cuff arms in the second direction and to effect movement of said first cuff means toward said connector means.

33. An apparatus as set forth in claim 32 further including motor means for effecting relative movement between said internally and externally threaded members, said motor means and said internally and externally threaded members being disposed in the outer sector.

34. An apparatus effecting relative movement between first and second body portions interconnected by a joint, said apparatus comprising a first cuff arm, first cuff means for connecting said first cuff arm with the first body portion, said first cuff means being movable along said first cuff arm, a second cuff arm, second cuff means for connecting said second cuff arm with the second body portion, said second cuff means being movable along said second cuff arm, a connector interconnecting said first and second cuff arms to enable said first cuff arm to move relative to said second cuff arm, and a motor connected with at least said first cuff arm and operable to move said first cuff arm relative to said second cuff arm, said motor being connected with said first cuff means and being operable to move said first cuff means along said first cuff arm, said motor being connected with said second cuff means and being operable to move said second cuff means along said second cuff arm.

35. An apparatus as set forth in claim 34 wherein said motor includes a fluid motor which is operable under the influence of fluid pressure.

36. An apparatus as set forth in claim 34 further including linkage means for transmitting force from said motor to said first cuff arm and to said first cuff means to effect movement of said first cuff arm relative to said second cuff arm and to simultaneously therewith effect movement of said first cuff means relative to said first cuff arm and for transmitting force from said motor to said second cuff means to effect movement of said second cuff means relative to said second cuff arm simultaneously with movement of said first cuff means relative to said first cuff arm.

37. An apparatus as set forth in claim 36 wherein said motor includes a fluid motor which is operable under the influence of fluid pressure.

38. An apparatus effecting relative movement between first and second body portions interconnected by a joint, said apparatus comprising a first cuff arm, first cuff means for connecting said first cuff arm with the first body portion, said first cuff means being movable along said first cuff arm, a second cuff arm connected with said first cuff arm, second cuff means for connecting said second cuff arm with the second body portion, a motor, and a linkage connecting said motor with at least one of said first and second cuff arms and with said first cuff means, said motor being operable to actuate said linkage to move said first cuff means along said first cuff arm under the influence of force transmitted from said motor to said first cuff means by said linkage and to effect movement between said first and second cuff arms under the influence of force transmitted from said motor to said first cuff arm by said linkage.

39. An apparatus as set forth in claim 38 wherein said second cuff means is movable along said second cuff arm, said linkage connecting said motor with said second cuff arm and said second cuff means, said motor being operable to actuate said linkage to move said second cuff means along said second cuff arm under the influence of force transmitted from said motor to said second cuff means simultaneously with movement of said first cuff means along said first cuff arm.

40. An apparatus as set forth in claim 39 wherein said motor is a fluid motor which is operable under the influence of fluid pressure.

41. An apparatus as set forth in claim 39 wherein said motor is an electric motor, said electric motor being connected with said linkage by a screw member which is rotatable by said electric motor.

42. An apparatus as set forth in claim 38 further including a connector which extends between end portions of said first and second cuff arms, a first connection pivotably connecting said connector with said end portion of said first cuff arm, and a second connection pivotally connecting said connector with said end portion of said second cuff arm, said motor being mounted on said connector.

43. An apparatus as set forth in claim 42 wherein said motor is operable in one direction to move a portion of said linkage toward said connector to actuate said linkage to move said first cuff means along said first cuff arm in a first direction, said motor being operable in another direction which is opposite to the one direction to move a portion of said linkage away from said connector to actuate said linkage to move said first cuff means along said first cuff arm in a second direction which is opposite to the first direction.

44. An apparatus as set forth in claim 43 wherein said motor is a fluid motor which is operable under the influence of fluid pressure.

45. An apparatus as set forth in claim 43 wherein said motor is an electric motor.

46. An apparatus as set forth in claim 38 wherein said linkage includes a link having a first end portion connected with said motor, said link having a second end portion connected with said first cuff means, said link having a third portion which is pivotally connected with said first cuff arm, said motor being operable to move said first end portion of said link to move said first cuff arm relative to said second cuff arm under the influence of force transmitted from said motor through the first end portion of said link to the third portion of said link and to move said first cuff means along said first cuff arm under the influence of force transmitted from said motor through the first end portion of said link to the second end portion of said link.

47. An apparatus as set forth in claim 46 wherein said motor is an electric motor, said electric motor being connected with said first end portion of said link through a screw member which is rotatable by said electric motor to move said first end portion of said link.

48. An apparatus as set forth in claim 46 wherein said motor is a fluid motor which is operable under the influence of fluid pressure, said fluid motor being connected with said first end portion of said link and being operable under the influence of fluid pressure to move said first end portion of said link.

49. An apparatus as set forth in claim 46 wherein said second end portion of said link is connected with said first cuff means by a pin-and-slot connection which enables a location where force is transmitted between said second end portion of said link and said first cuff means to be varied relative to a pivot connection between said third portion of said link and said cuff arm during movement of said link by said motor.

50. An apparatus as set forth in claim 49 wherein said motor is reversible to enable said motor to be operated in one direction to actuate said linkage and move said first cuff means along said first cuff arm in a first direction and to enable said motor to be operated in another direction opposite to said one direction to actuate said linkage and move said first cuff means along said first cuff arm in a second direction opposite to said first direction.

51. An apparatus as set forth in claim 50 wherein said motor is an electric motor.

52. An apparatus as set forth in claim 50 wherein said motor is a fluid motor which is operated under the influence of fluid pressure.

53. An apparatus for effecting relative movement between first and second body portions interconnected by a joint, said apparatus comprising a first cuff arm having a first end portion adjacent to the joint, first cuff means for connecting said first cuff arm with the first body portion, said first cuff means being movable along said first cuff arm, a second cuff arm having a first end portion adjacent to the joint, said first end portion of said second cuff arm being spaced from said first end portion of said first cuff arm, second cuff means for connecting said second cuff arm with the second body portion, a connector member having a first end portion connected to the first end portion of said first cuff arm at a first pivot connection, said connector member having a second end portion connected to the first end portion of said second cuff arm at a second pivot connection, and drive means connected with said first and second cuff arms for effecting pivotal movement between said first and second cuff arms and for simultaneously therewith effecting movement of said first cuff means along said first cuff arm, said drive means including a motor mounted on said connector member and a linkage connecting said motor with said first and second cuff arms and with said first cuff means.

54. An apparatus as set forth in claim 53 wherein said motor is a fluid motor which is operable under the influence of fluid pressure to actuate said linkage.

55. An apparatus as set forth in claim 53 wherein said motor is an electric motor, said drive means further including a threaded member which is rotatable by said electric motor.

56. An apparatus as set forth in claim 53 wherein said motor is operable in one direction to actuate said linkage to move said first cuff means along said first cuff arm in a first direction, said motor being operable in another direction opposite to said one direction to actuate said linkage to move said first cuff means along said first cuff arm in a second direction opposite to said first direction.

57. An apparatus as set forth in claim 53 wherein said drive means includes a rotatable screw member connected with said motor and said linkage, said motor being operable to rotate said screw member to actuate said linkage to effect pivotal movement between said first and second cuff arms and to effect movement of said first cuff means along said first cuff arm under the influence of force transmitted from said motor through said screw member to said linkage.

58. An apparatus as set forth in claim 53 wherein said drive means includes a manually actuatable input member connected with said linkage and movable under the influence of manually applied force to actuate said linkage to effect pivotal movement between said first and second cuff arms and to simultaneously therewith effect movement of said first cuff means along said first cuff arm with said motor in an inactive condition in which said motor is ineffective to provide force to actuate said linkage.

59. An apparatus as set forth in claim 53 further including a disconnect mechanism connected with said motor and said linkage, said disconnect mechanism being operable between an engaged condition in which force can be transmitted between said motor and said linkage and a disengaged condition preventing the transmission of force between said motor and said linkage and enabling said linkage to be moved relative to said motor.

60. An apparatus as set forth in claim 53 wherein said drive means includes an internally threaded member and an externally threaded member which are disposed in threaded engagement and are connected with said motor and said linkage, one of said threaded members being rotatable by said motor to move the other one of said threaded members to actuate said linkage.

61. An apparatus as set,forth in claim 53 wherein said linkage includes a rigid link having a first portion connected with said motor, a second portion connected with said first cuff means, and third portion pivotally connected with said first cuff arm, said motor being operable in one direction to pivot said link relative to said first cuff arm and move said first cuff means in a first direction along said first cuff arm, said motor being operable in another direction opposite to the one direction to pivot said link relative said first cuff arm and move said first cuff means along said first cuff arm in a second direction which is opposite to the first direction.

62. An apparatus for effecting relative movement between first and second body portions interconnected by a joint which is capable of being flexed and extended, said apparatus comprising a first cuff arm having a first end portion adjacent to the joint and a second end portion spaced further from the joint than said first end portion of said first cuff arm, first cuff means for connecting said first cuff arm with the first body portion, said first cuff means being movable relative to said first cuff arm, a second cuff arm having a first end portion adjacent to the joint and a second end portion spaced further from the joint than said first end portion of said second cuff arm, said first end portion of said second cuff arm being spaced from said first end portion of said first cuff arm, second cuff means for connecting said second cuff arm with the second body portion, a connector member having a first portion connected to the first end portion of said first cuff arm at a first pivot connection, said connector member having a second portion connected to the first end portion of said second cuff arm at a second pivot connection, and drive means connected with said first and second cuff arms and said first cuff means for pivoting said first and second cuff arms relative to said connector member at said first and second pivot connections to move said second end portions of said first and second cuff arms toward each other to flex the joint and for moving said first cuff means relative to said first cuff arm in a direction away from said first pivot connection during flexion of the joint, said drive means being operable to pivot said first and second cuff arms relative to said connector member at said first and second pivot connections to move said second end portions of said first and second cuff arms away from each other and to move said first cuff means relative to said first cuff arm in a direction toward said first pivot connection during extension of the joint.

63. An apparatus as set forth in claim 62 wherein said drive means includes a fluid motor operable under the influence of fluid pressure to provide force to move said first and second cuff arms relative to each other and to move said first cuff means relative to said first cuff arm.

64. An apparatus as set forth in claim 62 wherein said drive means includes an electric motor which is operable to provide force to move said first and second cuff arms relative to each other and to move said first cuff means relative to said first cuff arm.

65. An apparatus as set forth in claim 62 wherein said drive means includes a motor and a linkage connecting said motor with said first cuff arm and said first cuff means, said linkage being operable to transmit force from said motor to said first cuff arm to pivot said first cuff arm about said first pivot connection and to transmit force from said motor to said first cuff means to move said first cuff means relative to said first cuff arm.

66. An apparatus as set forth in claim 62 wherein said drive means includes a linkage which is connected with said first and second cuff arms and with said first cuff means, said linkage including a base link which is movable toward and away from said connector member along a linear path having a longitudinal axis which extends through said connector member and a plurality of connector links which are pivotally connected with said base link and with said first and second cuff arms and with said first cuff means to transmit force from said base link to said first and second cuff arms and to said first cuff means.

67. An apparatus as set forth in claim 66 wherein said drive means includes a motor connected with said connector member and said base link, said motor being operable in a first direction to move said base link toward said connector member and being operable in a second direction to move said base link away from said connector member.

68. An apparatus as set forth in claim 67 wherein said motor is a fluid motor which is operable under the influence of fluid pressure.

69. An apparatus as set forth in claim 67 wherein said motor is an electric motor.

70. An apparatus as set forth in claim 67 wherein said drive means includes an internally threaded member and an externally threaded member disposed in threaded engagement with said internally threaded member, a first one of said threaded members being connected with said base link and being movable with said base link relative to said connector member, a second one of said threaded members being connected with said motor and being rotatable by said motor to effect movement of said base link relative to said connector member.

71. An apparatus as set forth in claim 67 wherein said drive means includes a connector link having a first end portion which is pivotally connected with said base link, a second end portion which is pivotally connected with said first cuff means, and an intermediate portion which is pivotally connected with said first cuff arm.

72. An apparatus as set forth in claim 62 wherein said second cuff means is movable relative to said second cuff arm, said drive means being connected with said second cuff means and being operable to move said second cuff means relative to said second cuff arm in a direction away from said second pivot connection during flexion of the joint, said drive means being operable to move said second cuff means relative to said second cuff arm in a direction toward said second pivot connection during extension of the joint.

73. An apparatus as set forth in claim 72 wherein said drive means includes a motor and a linkage connecting said motor with said first and second cuff arms and with said first and second cuff means, said linkage being operable to transmit force from said motor to said first and second cuff arms to pivot said first cuff arm about said first pivot connection and to pivot said second cuff arm about said second pivot connection, said linkage being operable to transmit force from said motor to said first cuff means to move said first cuff means relative to said first cuff arm and to transmit force from said motor to said second cuff means to move said second cuff means relative to said second cuff arm.

74. An apparatus as set forth in claim 72 wherein said drive means includes a linkage which is connected with said first and second cuff arms and with said first and second cuff means, said linkage including a base link which is movable toward and away from said connector member and a plurality of connector links which are pivotally connected with said base link and with said first and second cuff arms and with said first and second cuff means to transmit force from said base link to said first and second cuff arms and to said first and second cuff means.

75. An apparatus as set forth in claim 74 wherein said drive means include a motor connected with said connector member and said base link, said motor being operable in a first direction to move said base link toward said connector member and being operable in a second direction to move said base link away from said connector member.

76. An apparatus as set forth in claim 75 wherein said drive means includes an internally threaded member and an externally threaded member disposed in threaded engagement with said internally threaded member, a first one of said threaded members being connected with said base link and being movable with said base link relative to said connector member, a second one of said threaded members being connected with said motor and being rotatable by said motor to effect movement of said base link relative to said connector member.

77. An apparatus as set forth in claim 75 wherein a first one of said connector links of said plurality of connector links has a first portion which is pivotally connected with said base link, a second portion which is pivotally connected with said first cuff means, and a third portion which is pivotally connected with said first cuff arm, a second one of said connector links of said plurality of connector links having a first portion which is pivotally connected with said base link, a second portion which is pivotally connected with said second cuff means, and a third portion which is pivotally connected with said second cuff arm.

78. An apparatus as set forth in claim 77 wherein said motor is a fluid motor which is operable under the influence of fluid pressure.

79. An apparatus as set forth in claim 77 wherein said motor is an electric motor.

80. An apparatus for effecting relative movement between first and second body portions interconnected by a joint, said apparatus comprising a first cuff arm having a first end portion adjacent to the joint, first cuff means for connecting said first cuff arm with the first body portion, said first cuff means being movable along said first cuff arm, a second cuff arm having a first end portion adjacent to the joint, said first end portion of said second cuff arm being spaced from said first end portion of said first cuff arm, second cuff means for connecting said second cuff arm with the second body portion, said second cuff means being movable along said second cuff arm, a connector member having a first portion connected to the first end portion of said first cuff arm at a first pivot connection, said connector member having a second portion connected to the first end portion of said second cuff arm at a second pivot connection, and a drive assembly connected with said connector member, said first and second cuff arms and said first and second cuff means, said drive assembly being operable to effect pivotal movement of said first and second cuff arms relative to said connector member at said first and second pivot connections and to simultaneously therewith effect movement of said first cuff means along said first cuff arm and movement of said second cuff means along said second cuff arm, said drive assembly includes a linkage which is connected with said first and second cuff arms and with said first and second cuff means, said linkage including a base link which is movable toward and away from said connector member, a first connector link having a first portion pivotally connected with said base link, a second portion connected with said first cuff means and a third portion pivotally connected with said first cuff arm, and a second connector link having a first portion pivotally connected with said base link, a second portion connected with said second cuff means and a third portion pivotally connected with said second cuff arm, said base link being movable in one direction relative to said connector member to transmit force through said first connector link to pivot said first cuff arm in a first direction relative to said connector member and to simultaneously therewith move said first cuff means along said first cuff arm in a direction toward said connector member and to transmit force through said second connector link to pivot said second cuff arm relative to said connector member in a second direction which is opposite to the first direction and to simultaneously therewith move said second cuff means along said second cuff arm in a direction toward said connector member, said base link being movable in a direction opposite to the one direction relative to said connector member to transmit force through said first connector link to pivot said first cuff arm in the second direction relative to said connector member and to simultaneously therewith move said first cuff means along said first cuff arm in a direction away from said connector member and to transmit force through said second connector link to pivot said second cuff arm relative to said connector member in the first direction and to simultaneously therewith move said second cuff means along said second cuff arm in a direction away from said connector member, said drive means further including an input apparatus connected with and at least partially disposed between said connector member and said base link to move said base link relative to said connector member.

81. An apparatus as set forth in claim 80 wherein said input apparatus includes a fluid motor which is operable in one direction under the influence of fluid pressure to effect movement of said base link toward said connector member and being operable in a direction opposite to the one direction of operation of said fluid motor to effect movement of said base link away from said connector member.

82. An apparatus as set forth in claim 80 wherein said input apparatus includes a motor which is operable in one direction to effect movement of said base link toward said connector member and is operable in a direction opposite to the one direction of operation of said motor to effect movement of said base link away from said connector member.

83. An apparatus as set forth in claim 80 wherein said input apparatus includes an internally threaded member and an externally threaded member which is disposed in engagement with said internally threaded member, a first one of said threaded members being connected with said base link and a second one of said threaded members being connected with said connector member, one of said threaded members being rotatable in one direction to move said base link toward said connector member and being rotatable in a direction opposite to the one direction of rotation of said one threaded member to move said base link away from said connector member.

84. An apparatus as set forth in claim 83 wherein said input apparatus further includes a manually actuatable input member connected with said one of said threaded members which is rotatable, said manually actuatable input member being movable under the influence of manually applied force to rotate said one of said threaded members which is rotatable.

85. An apparatus as set forth in claim 83 wherein said input apparatus includes a motor connected with said one of said threaded members which is rotatable, said motor being operable in a first direction to rotate said one of said threaded members in one direction and being operable in a second direction to rotate said one of said threaded members in a direction which is opposite to the one direction of rotation.

86. An apparatus as set forth in claim 80 wherein said input apparatus includes a motor which is mounted on said connector member and is connected with said base link, said motor being operable in one direction to move said base link toward said connector member and being operable in a direction opposite to the one of operation of said motor direction to move said base link away from said connector member.

87. An apparatus as set forth in claim 80 wherein said motor is a fluid motor which is at least partially disposed between said connector member and said base link.