Orthosis for bending wrists

• US 5,503,619 A
• Filed: 09/15/1994
• Issued: 04/02/1996
• 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.
• Primary Examiner(s): Dvorak, Linda C. M.
• Application Number:
  US08/306,619
• Time in Patent Office: 565 Days
• Field of Search: 602/5, 602/16, 602/20-22, 128/898, 601/23, 601/33, 601/40
• US Class Current: 602/16
• CPC Class Codes: A61F 5/013 for the arms, hands or fingers A61F5/0118 takes precedence
• CPC Class Codes: A61F 5/05866 for wrists, hands, fingers or thumbs
• CPC Class Codes: A61H 1/0285 Hand
• CPC Class Codes: A61H 2201/165 Wearable interfaces

Abstract

The same orthosis can be sequentially used to bend different wrists. The orthosis may be used to bend a first wrist in flexion and a second wrist in extension. When the orthosis is to be used to bend a wrist in flexion, a pair of cuffs and cuff arms are connected with a forearm and hand with the orthosis in a first orientation relative to the wrist. At this time, the cuff arms and an actuator mechanism are disposed in an inner sector disposed adjacent to a palm side of the hand. When the orthosis is to be used to bend the wrist in extension, the orthosis is mounted on the forearm and hand in a second orientation with the cuff arms and actuator mechanism in an outer sector adjacent to the back side of the hand. During operation of the orthosis, force is transmitted from an input member through an actuator mechanism to the cuff arms to pivot the cuff arms about spaced apart parallel axes. At the same time, force is transmitted from the actuator mechanism to the cuffs to move the cuffs along the cuff arms in a direction toward the wrist and axes about which the cuff arms are pivoted.

Claims

1. A method of using the same orthosis to sequentially bend different wrists, said method comprising the steps of mounting the orthosis on a first arm with the orthosis in a first orientation relative to a first wrist, bending the first wrist in flexion by operating a mechanism in the orthosis in a first direction while the orthosis is mounted on the first arm in the first orientation, mounting the orthosis on a second arm with the orthosis in a second orientation relative to a second wrist, said second orientation being different than the first orientation, and bending the second wrist in extension by operating the mechanism in the orthosis in the first direction while the orthosis is mounted on the second arm in the second orientation.

2. A method as set forth in claim 1 wherein said step of mounting the orthosis on the first arm includes connecting a first cuff of the orthosis with a first forearm and connecting a second cuff of the orthosis with a first hand, said step of mounting the orthosis on the second arm includes connecting the first cuff of the orthosis with a second forearm and connecting a second cuff of the orthosis with a second hand.

3. A method as set forth in claim 2 wherein said step of bending the first wrist in flexion includes transmitting force from a first portion of the second cuff to a back side surface of the first hand, said step of bending the second wrist in extension includes transmitting force from the first portion of the second cuff to a palm side of the second hand.

4. A method as set forth in claim 1 wherein said step of operating the mechanism in the orthosis in a first direction while the orthosis is mounted on the first arm in the first orientation is performed by the person having the first arm, said step of operating the mechanism in the orthosis in the first direction while the orthosis is mounted on the second arm in the second orientation is performed by the person having the second arm.

5. A method as set forth in claim 1 wherein said step of operating a mechanism in the orthosis in a first direction while the orthosis is mounted on the first arm in the first orientation includes manually rotating an input member in a first direction relative to the orthosis, said step of operating a mechanism in the orthosis in a first direction while the orthosis is mounted on the second arm in the second orientation includes manually rotating an input member in the first direction relative to the orthosis.

6. A method as set forth in claim 1 wherein said step of bending the first wrist in flexion by operating the mechanism in the orthosis in the first direction includes operating the mechanism in the orthosis in the first direction to bend the first wrist in flexion in a direction away from an initial condition of the first wrist, interrupting operation of the mechanism in the orthosis for a period of time, and, thereafter, resuming operation of the mechanism in the orthosis in the first direction to resume bending of the wrist in flexion in the direction away from the initial condition, said step of bending the second wrist in extension by operating the mechanism in the orthosis in the first direction includes operating the mechanism in the orthosis in the first direction to bend the second wrist in extension in a direction away from an initial condition of the second wrist, interrupting operation of the mechanism in the orthosis for a period of time, and, thereafter, resuming operation of the mechanism in the orthosis in the first direction to resume bending of the second wrist in extension in the direction away from the initial condition of the second wrist.

7. A method as set forth in claim 1 wherein said step of bending the first wrist in flexion by operating a mechanism in the orthosis in the first direction includes moving an actuator member in the mechanism in a direction away from the first wrist, said step of bending the second wrist in extension by operating a mechanism in the orthosis in the first direction includes moving the actuator member in the mechanism in a direction away from the second wrist.

8. A method as set forth in claim 1 wherein the first wrist, a hand connected with the first wrist, and a forearm connected with the first wrist define an inner sector which decreases in angle as the first wrist is bent in flexion, the mechanism in the orthosis being disposed in the inner sector when the orthosis is mounted on the first arm in the first orientation, and wherein the second wrist, a hand connected with the second wrist, and a forearm connected with the second wrist define an outer sector which decreases in angle as the second wrist is bent in extension, the mechanism in the orthosis being disposed in the outer sector when the orthosis is mounted on the second arm in the second orientation.

9. A method as set forth in claim 1 wherein the first wrist, a hand connected with the first wrist and a forearm connected with the first wrist define an inner sector which decreases in angle as the first wrist is bent in flexion and an outer sector which increases in angle as the first wrist is bent in flexion, the mechanism in the orthosis being disposed in a first one of the inner and outer sectors when the orthosis is mounted on the first arm in the first orientation, and wherein the second wrist, a hand connected with the second wrist and a forearm connected with the second wrist define an inner sector which increases in angle as the second wrist is bent in extension and an outer sector which decreases in angle as the second wrist is bent in extension, the mechanism in the orthosis being disposed in a second one of the inner and outer sectors when the orthosis is mounted on the second arm in the second orientation.

10. A method as set forth in claim 1 wherein said step of mounting the orthosis on the first arm with the orthosis in a first orientation relative to a first wrist includes connecting a first cuff and a first cuff arm with a first forearm and connecting a second cuff and a second cuff arm with a first hand, said step of bending the first wrist in flexion includes moving one of the first and second cuffs along one of the first and second cuff arms, said step of mounting the orthosis on the second arm with the orthosis in a second orientation relative to the second wrist includes connecting the first cuff and the first cuff arm with a second forearm and connecting the second cuff and the second cuff arm with a second hand, said step of bending the second wrist in extension includes moving said one of the first and second cuffs along said one of the first and second cuff arms.

11. A method as set forth in claim 10 wherein said step of moving said one of the first and second cuffs along said one of the first and second cuff arms toward the first wrist includes transmitting force from the mechanism in the orthosis to said one of the first and second cuffs to move said one of the first and second cuffs along said one of the first and second cuff arms under the influence of force transmitted from the mechanism to said one of the first and second cuffs during bending of the first wrist in flexion, said step of moving said one of the first and second cuffs along said one of the first and second cuff arms toward the second wrist includes transmitting force from the mechanism in the orthosis to said one of the first and second cuffs to move said one of the first and second cuffs along said one of the first and second cuff arms under the influence of force transmitted from the mechanism to said one of the first and second cuffs during bending of the second wrist in extension.

12. A method as set forth in claim 11 wherein said step of moving said one of the first and second cuffs along one of the first and second cuff arms during bending of the first wrist in flexion includes moving said one of the first and second cuffs toward the first wrist, said step of moving said one of the first and second cuffs along one of the first and second cuff arms during bending of the second wrist in extension includes moving said one of the first and second cuffs toward the second wrist.

13. A method as set forth in claim 1 wherein said step of mounting the orthosis on a first arm with the orthosis in a first orientation relative to the first wrist includes connecting a first cuff and a first cuff arm with a first forearm and a second cuff and a second cuff arm with a first hand, said step of bending the first wrist in flexion includes moving the first cuff along the first cuff arm and simultaneously therewith moving the second cuff along the second cuff arm, said step of mounting the orthosis on a second arm with the orthosis in a second orientation relative to the second wrist includes connecting the first cuff and the first cuff arm with a second forearm and the second cuff and the second cuff arm with a second hand, said step of bending the second wrist in extension includes moving the first cuff along the first cuff arm and simultaneously therewith moving the second cuff along the second cuff arm.

14. A method as set forth in claim 13 wherein said steps of moving the first cuff along the first cuff arm and simultaneously therewith moving the second cuff along the second cuff arm during bending of the first wrist in flexion includes moving the first and second cuffs toward the first wrist under the influence of force transmitted to the first and second cuffs from the mechanism in the orthosis, said steps of moving the first cuff along the first cuff arm and simultaneously therewith moving the second cuff along the second cuff arm during bending of the second wrist in extension includes moving the first and second cuffs toward the second wrist under the influence of force transmitted to the first and second cuffs from the mechanism in the orthosis.

15. A method as set forth in claim 1 wherein said step of mounting the orthosis on a first arm with the orthosis in a first orientation relative to the first wrist includes connecting a first cuff and a first cuff arm with a first forearm and connecting a second cuff and a second cuff arm with a first hand, said step of bending the first wrist in flexion includes transmitting force from the mechanism in the orthosis to the second cuff arm to pivot the second cuff arm about an axis which is offset from the first wrist on a side of the first wrist toward which a palm of the first hand faces, said step of mounting the orthosis on a second arm with the orthosis in a second orientation relative to the second wrist includes connecting the first cuff and the first cuff arm with a second forearm and connecting the second cuff and the second cuff arm with a second hand, said step of bending the second wrist in extension includes transmitting force from the mechanism in the orthosis to the second cuff arm to pivot the second cuff arm about an axis which is offset from the second wrist on a side of the second wrist toward which a back of the second hand faces.

16. A method as set forth in claim 15 wherein said step of bending the first wrist in flexion includes transmitting force from the mechanism in the orthosis to the first cuff arm to pivot the first cuff arm about an axis which is offset from the first wrist on a side of the first wrist toward which the palm of the first hand faces, said step of bending the second wrist in extension includes transmitting force from the mechanism in the orthosis to the first cuff arm to pivot the first cuff arm about an axis which is offset from the second wrist on a side of the second wrist toward which the back of the second hand faces.

17. A method as set forth in claim 16 wherein said step of bending the first wrist in flexion includes transmitting force from the mechanism in the orthosis to the first and second cuffs to simultaneously move the first and second cuff arms toward the first wrist, said step of bending the second wrist in extension includes transmitting force from the mechanism in the orthosis to the first and second cuffs to simultaneously move the first and second cuffs along the first and second cuff arms toward the second wrist.

18. A method as set forth in claim 15 wherein said step of bending the first wrist in flexion includes transmitting force from the mechanism in the orthosis to the second cuff to move the second cuff along the second cuff arm, said step of bending the second wrist in extension including transmitting force from the mechanism in the orthosis to move the second cuff along the second cuff arm.

19. A method as set forth in claim 1 wherein said step of operating the mechanism in the orthosis to bend the first wrist in flexion includes moving an actuator member disposed in the mechanism away from the first wrist along a path which extends through the first wrist, said step of operating the mechanism in the orthosis to bend the second wrist in extension includes moving the actuator member disposed in the mechanism away from the second wrist along a path which extends through the second wrist.

20. A method as set forth in claim 19 wherein said steps of operating the mechanism in the orthosis include effecting relative rotation between internally and externally threaded members to move one of the threaded members connected with the actuator member relative to the other threaded member.

21. A method as set forth in claim 1 further including forming an adapter having a first side surface with a configuration corresponding to the configuration of a palm of a first hand connected with the first wrist, and mounting the adapter on a portion of the orthosis, said step of mounting the orthosis on the first arm includes connecting a first cuff of the orthosis with a first forearm connected with the first wrist and connecting a second cuff on the orthosis with the first hand with the first side surface of the adapter in engagement with the palm of the first hand.

22. A method as set forth in claim 1 further including forming an adapter having a first side surface with a configuration corresponding to the configuration of a second hand connected with the second wrist, and mounting the adapter on a portion of the orthosis, said step of mounting the orthosis on the second arm including connecting a first cuff of the orthosis with a second forearm connected with the second wrist and connecting a second cuff on the orthosis with the second hand with the first side surface of the adapter in engagement with the back of the second hand.

23. A method as set forth in claim 1 wherein said step of operating the mechanism in the orthosis in a first direction includes operating a motor to effect the transmittal of force from the motor to the mechanism.

24. A method as set forth in claim 1 wherein the first wrist, a hand connected with the first wrist, and a forearm connected with the first wrist define an inner sector which decreases in angle as the first wrist is bent in flexion, said step of bending the first wrist in flexion includes transmitting force from the mechanism in the orthosis to the second cuff to pivot the second cuff about an axis which is disposed in the inner sector, and wherein the second wrist, a hand connected with the second wrist, and a forearm connected with the second wrist define an outer sector which decreases in angle as the second wrist is bent in extension, said step of bending the second wrist in extension includes transmitting force from the mechanism in the orthosis to the second cuff to pivot the second cuff about an axis which is disposed in the outer sector.

25. A method as set forth in claim 24 wherein the mechanism in the orthosis is disposed in the inner sector when the orthosis is mounted on the first arm in the first orientation and the mechanism in the orthosis is disposed in the outer sector when the orthosis is mounted on the second arm in the second orientation.

26. A method as set forth in claim 1 wherein the first wrist, a hand connected with the first wrist, and a forearm connected with the first wrist define an inner sector which decreases in angle as the first wrist is bent in flexion, said step of bending the first wrist in flexion includes transmitting force from the mechanism in the orthosis to the first cuff to pivot the first cuff about a first axis which is disposed in the inner sector and transmitting force from the mechanism in the orthosis to the second cuff to pivot the second cuff about a second axis which is disposed in the inner sector and is spaced from the first axis, and wherein the second wrist, a hand connected with the second wrist, and a forearm connected with the second wrist define an outer sector which decreases in angle as the second wrist is bent in extension, said step of bending the second wrist in extension includes transmitting force from the mechanism in the orthosis to the first cuff to pivot the first cuff about a third axis which is disposed in the outer sector and transmitting force from the mechanism in the orthosis to the second cuff to pivot the second cuff about a fourth axis which is disposed in the outer sector and is spaced from the third axis.

27. A method as set forth in claim 26 wherein the mechanism in the orthosis is disposed in the inner sector when the orthosis is mounted on the first arm in the first orientation and the mechanism in the orthosis is disposed in the outer sector when the orthosis is mounted on the second arm in the second orientation.

28. A method as set forth in claim 26 wherein said step of bending the first wrist in flexion includes effecting relative rotation between internally and externally threaded members about an axis which extends between the first and second axes, said step of bending the second wrist in extension includes effecting relative rotation between internally and externally threaded members about an axis which extends between the third and fourth axes.

29. A method as set forth in claim 26 wherein said step of operating a mechanism in the orthosis in a first direction while the orthosis is mounted on the first arm in the first orientation includes manually rotating an input member about an axis which extends between the first and second axes, said step of operating a mechanism in the orthosis in a second direction while the orthosis is mounted on the second arm in the second orientation includes manually rotating the input member about an axis which extends between the third and fourth axes.

30. A method as set forth in claim 29 wherein said step of manually rotating an input member about an axis which extends between the first and second axes is performed by the person having the first arm, said step of manually rotating the input member about an axis which extends between the third and fourth axes is performed by the person having the second arm.

31. A method of using an orthosis to bend a wrist, said method comprising the steps of connecting a first cuff and a first cuff arm with a forearm which is connected with the wrist, said step of connecting a first cuff and a first cuff arm with the forearm includes connecting the first cuff arm with the forearm with an end portion of the first cuff arm adjacent to and offset to one side of the wrist, connecting a second cuff and a second cuff arm with a hand which is connected with the wrist, said step of connecting a second cuff and a second cuff arm with the hand includes connecting the second cuff arm with the hand with an end portion of the second cuff arm adjacent to and offset to the one side of the wrist and spaced from the end portion of the first cuff arm, and bending the wrist, said step of bending the wrist includes pivoting the first cuff arm about a first axis which is offset to the one side of the wrist and extends through the end portion of the first cuff arm, and pivoting the second cuff arm about a second axis which is spaced from the first axis and is offset to the one side of the wrist.

32. A method as set forth in claim 31 wherein said step of bending the wrist includes manually moving a member relative to the wrist, and transmitting force from the member to the first and second cuff arms.

33. A method as set forth in claim 32 wherein said step of manually moving a member is performed by the person having the wrist.

34. A method as set forth in claim 31 wherein said step of bending the wrist includes operating a mechanism in the orthosis in a first direction to bend the wrist in a direction away from an initial condition of the wrist, interrupting operation of the mechanism in the orthosis for a period of time, and, thereafter, resuming operation of the mechanism in the orthosis in the first direction to resume bending of the wrist in the direction away from the initial condition.

35. A method as set forth in claim 31 wherein said step of bending the wrist includes moving an actuator member along a path which extends between and is perpendicular to the first and second axes.

36. A method as set forth in claim 31 wherein said step of bending the wrist includes moving one of the first and second cuffs along one of the first and second cuff arms in a direction toward the wrist.

37. A method as set forth in claim 31 wherein said step of bending the wrist includes operating a mechanism in the orthosis, transmitting force from the mechanism to the first cuff arm to pivot the first cuff arm about the first axis, and transmitting force from the mechanism to the second cuff arm to pivot the second cuff arm about the second axis.

38. A method as set forth in claim 37 wherein said step of bending the wrist includes transmitting force from the mechanism to the first cuff to move the first cuff along the first cuff arm toward the wrist and transmitting force from the mechanism to the second cuff to move the second cuff along the second cuff arm toward the wrist.

39. A method as set forth in claim 37 wherein said step of operating a mechanism includes rotating a threaded member about an axis which extends perpendicular to said first and second axes and extends through the wrist.

40. A method of using an orthosis to bend a wrist, said method comprising the steps of connecting a first cuff and a first cuff arm with a forearm which is connected with the wrist, connecting a second cuff and a second cuff arm with a hand which is connected with the wrist, and bending the wrist, said step of bending the wrist includes moving an actuator member away from the wrist along a path which extends through the wrist, transmitting force from the actuator member to the first cuff arm to pivot the first cuff arm as the actuator member moves away from the wrist, and transmitting force from the actuator member to pivot the second cuff arm as the actuator member moves away from the wrist.

41. A method as set forth in claim 40 wherein said step of moving an actuator member away from the wrist includes rotating a threaded member about an axis which extends through the wrist.

42. A method as set forth in claim 40 wherein said step of transmitting force from the actuator member to the first cuff arm includes transmitting force through a first link which is pivotally connected with the actuator member and is pivotally connected with the first cuff arm, pivoting the first link about a pivot connection between the first link and the actuator member, and pivoting the first link about a pivot connection between the first link and the first cuff arm, said step of transmitting force from the actuator member to the second cuff arm includes transmitting force through a second link which is pivotally connected with the actuator member and the second cuff arm, pivoting the second link about a pivot connection between the second link and the actuator member, and pivoting the second link about a pivot connection between the second link and the second cuff arm.

43. A method as set forth in claim 40 wherein said step of moving an actuator member along a path which extends through the wrist includes manually moving an input member relative to the wrist.

44. A method as set forth in claim 43 wherein said step of manually moving an input member is performed by the person having the wrist.

45. A method as set forth in claim 40 wherein said step of bending the wrist includes moving one of the first and second cuffs along one of the first and second cuff arms in a direction toward the wrist ;

under the influence of force transmitted from the actuator member to the one cuff.

46. A method as set forth in claim 40 wherein said step of bending the wrist includes transmitting force from the actuator member to the first cuff, moving the first cuff along the first cuff arm under the influence of the force transmitted to the first cuff from the actuator member, transmitting force from the actuator member to the second cuff, and moving the second cuff along the second cuff arm under the influence of the force transmitted to the second cuff from the actuator member.

47. A method of using an orthosis to bend a wrist, said method comprising the steps of connecting a first cuff and a first cuff arm with a forearm which is connected with the wrist, connecting a second cuff and a second cuff arm with a hand which is connected with the wrist, and bending the wrist, said step of bending the wrist includes moving the first cuff along the first cuff arm in a direction toward the wrist and moving the second cuff along the second cuff arm toward the wrist.

48. A method as set forth in claim 47 wherein said step of bending the wrist includes pivoting the first cuff arm about a first axis which is offset to one side of the wrist and extends through an end portion of the first cuff arm simultaneously with performance of said step of moving the first cuff along the first cuff arm and pivoting the second cuff arm about a second axis which is offset to the one side of the wrist and extends through an end portion of the second cuff arm simultaneously with performance of said step of moving the second cuff along the second cuff arm.

49. A method as set forth in claim 48 wherein said step of bending the wrist includes moving an actuator member away from the wrist along a path which extends through the wrist, said step of moving the first cuff along the first cuff arm includes transmitting force from the actuator member to the first cuff, said step of moving the second cuff along the second cuff arm includes transmitting force from the actuator member to the second cuff, said step of pivoting the first cuff arm about a first axis includes transmitting force from the actuator member to the first cuff arm, said step of pivoting the second cuff arm about a second axis includes transmitting force from the actuator member to the second cuff arm.

50. A method as set forth in claim 47 wherein said step of bending the wrist includes operating a mechanism in the orthosis in a first direction to bend the wrist in a direction away from an initial condition of the wrist, interrupting operation of the mechanism in the orthosis for a period of time, and, thereafter, resuming operation of the mechanism in the orthosis in the first direction to resume bending of the wrist in the direction away from the initial condition.