EP0603135A1 - Rehabilitation device for passive and active shoulder mobilisation according to the principle of pulley-therapy - Google Patents

Abstract

Rehabilitation (therapeutic) device permitting passive and active shoulder mobilisation according to the principle of pulley-therapy. The device is installed in one movement, in a removable manner, on any ordinary door. A support consisting of a flexible rod (1) and forming a clamp (2) in the shape of an "upturned U", a stabilising support (3) and a hook (4) is installed over the top edge of a door. A pulley (5) with an orientable axis is fastened on the hook (4). A rope (cord) (6) passes into this pulley (5). On this rope (6) are fastened two handles (grips), one (8) having a variable position permitting individual adjustment of the height of the pulling points (handles), the other (7) having a stationary position. Passive mobilisation is achieved by pendular movements. Active mobilisation is rendered possible in all useful planes by means of a system for return of the rope under the door handle, without it being necessary to use additional equipment. Its intensity can be adjusted by fitting a modulable counterweight (9). <IMAGE>

Description

Introduction

Many shoulder conditions require substantial mobilization, especially after surgery.

To date, most of this mobilization is carried out at the physiotherapist, which unfortunately implies a considerable restriction of the total duration of the mobilization and high costs.

To remedy this problem, the patient must be able to practice mobilizing his shoulder in a simple, efficient and regular manner.

The pulley therapy, which consists of back and forth movements of a member using a pulley and a rope, represents a solution to this problem, provided that it can be carried out without difficulty by the patient at home and no longer necessarily with the physiotherapist, as is often the case today.

• 1. son mode de fixation très stable et ajustable.
• 2. la possibilité de réglage individuel des points de tire (poignées).
• 3. la mise à profit du support utilisé pour son installation (une porte quelconque), pour permettre une mobilisation active de l'épaule dans tous les plans de l'espace, l'intensité de cette mobilisation active étant ajustable.

The device presented offers an alternative to the systems proposed and used to date for pulley therapy by:

• 1. its very stable and adjustable fixing mode.
• 2. the possibility of individual adjustment of the pulling points (handles).
• 3. taking advantage of the support used for its installation (any door), to allow active mobilization of the shoulder in all planes of space, the intensity of this active mobilization being adjustable.

Description

• a. un support
• b. une corde (6) et 2 poignées (7, 8)
• c. un contre-poids ajustable (9)
  et,
• d. la poignée de la porte, utilisée comme élément additionnel à l'appareil (fig. 6-11).

The device consists of 3 elements:

• at. a support
• b. a rope (6) and 2 handles (7, 8)
• vs. an adjustable counterweight (9)
  and,
• d. the door handle , used as an additional element to the appliance (fig. 6-11).

at. the support

It consists of a flexible rod (1) , coated with a protective sheath with non-slip properties, forming a "U-shaped" clamp (2), a stabilizing support (3) and a hook (4) to allow fixing. a pulley (5). The support is installed on the upper edge of any ordinary, open door. It is removable.

The "U-shaped" clamp (2) secures the system to the upper edge of the door. Thanks to the flexibility of the rod (1) which constitutes it, it can be adapted by simple spacing or bringing together its 2 arms to each ordinary door width.

The stabilizing support (3) forms a wide base, applies to one of the sides of the door and ensures stability of the support in the plane of the door.

The hook (4) is located on the side of the door opposite that on which the stabilizing support rests.

The pulley (5) is fixed on the part of the rod forming the hook (5). It can turn (10) on itself, move (11) along this hook and pivot (12) around the axis of this hook, which optimizes the direction of the pulley with that of the pulling the rope. The hook (4) itself is located at a certain distance from the door panel to move the rope-handle complex away from it.

b. the rope (6) and the 2 handles (7 , 8)

The rope (6) passes through the pulley (5) fixed to the support (3) of the device. The rope (6) crosses 2 handles in the middle of their length. One of the handles is fixed (7), the other is adjustable in height (8).

The fixed position handle (7) is located at one end of the rope (6). An anchoring system (13), placed at the end of the handle, allows the fixing of a counterweight (9) while verticalizing the handle (fig. 4b); this moves it away from the door and thus prevents impacts against it.

The variable position handle (8) can move along the entire length of the rope (6) and can quickly be fixed at any height by means of a clamping screw (14), or any similar system. The clamping screw (14) passes through the longitudinal axis of the handle, tapped to the desired diameter, and clamps or releases the cord where it passes through the handle (fig. 4b).

vs. the counterweight (9)

It attaches to the anchoring system (13) of the fixed position handle (7). It is adjustable by modular weight units.

d. the door handle (fig 6-11)

A door is used to support the appliance (fig. 5-11). The handle of this door is used as a return for the rope (6). In this way, without additional equipment, active mobilization is possible in all shoulder mobilization plans (fig. 6-11). The resistance to this active mobilization is determined by the counterweight (9) fixed on the handle with fixed position (7).

The device is installed approximately on the middle of the upper edge of an ordinary, open door. The hook (4), the pulley (5), the rope (6) and the handles (7, 8) are installed on the side of the door opposite to that which would lean against the wall of the room once the door completely open. Passive and active shoulder mobilization can now begin.

For passive mobilization (fig. 5), the door is completely open and locked against the adjacent wall by a chair or a stool. The patient sits in this chair, back against the door on which the device is installed. After having adjusted the handles (7, 8) to the optimal height (eye height), he grasps each of the 2 handles (7,8) and performs back and forth movements up and down, using his member upper valid (assumed on the right in Figures 5-11) to go up and let down his convalescent upper limb, that is to say to passively mobilize his shoulder.

For active mobilization (fig. 6-11) , a counterweight (9) of adjustable value, determined by the doctor, is anchored to the fixed position handle (7). The rope (6) which leaves from this handle (7) rises towards the pulley (5) fixed to the support, passes through it, descends then is deflected under the door handle towards a direction contained in the plane of the door but moving away from it. By alternately pulling and releasing the rope (6), held in hand via the variable position handle (8), the patient can, by adapting his standing position relative to the door, actively mobilize his sick shoulder in all the useful planes (external rotation (fig. 6) and internal (fig. 7), extension (fig. 8) and flexion (fig. 9), abduction (fig. 10) and adduction (fig. 11)). The intensity of this active mobilization is determined by the counterweight (9) anchored to the fixed position handle (7).

Claims (8)

Therapeutic device for passive and active mobilization of the shoulder, characterized by:
a support to be installed quickly and removably on the upper edge of any ordinary door, consisting of a single flexible rod (1), forming a "U-shaped" clamp (2), a stabilizing support (3) and a hook (4) on which there is a pulley (5),
a rope (6) passing through the pulley (5) of the support, on which 2 handles are installed, one of which is fixed (7), the other adjustable in height (8),
a counterweight (9) adjustable by removable weight units, to be anchored to the end of the handle in a fixed position (7). Therapeutic device according to claim 1, characterized in that the support is surrounded by a protective and non-slip sheath. Therapeutic device according to claim 1, characterized in that the pulley (5) can turn (10) on itself, move (11) along the part of the rod forming the hook and pivot (12) around the axis formed by this rod. Therapeutic device according to claim 1, characterized in that the cord (6) of the device passes through each of the 2 handles, at the place of the middle of their length (fig. 3a, 3b, 4a, 4b). Therapeutic device, according to claims 1 and 4, characterized in that the fixed position handle (7) is equipped with an anchoring system (13) placed at one of its ends to allow on the one hand the fixation a counterweight (9) and on the other hand the verticalization of the handle when the counterweight is fixed (fig. 4b), which moves the handle away from the door panel. Therapeutic device according to claims 1 and 4, characterized in that the variable position handle (8) can be moved and fixed at any height of the rope (fig. 1, fig 3a). Therapeutic device according to claims 1, 4 and 6, characterized in that a clamping screw (14), or any similar system, passing through the longitudinal axis of the handle, firmly clamps the rope at the point where it crosses the handle and thus secures the handle at the desired height on the rope (fig. 3a, 3b). Therapeutic device according to claim 1, characterized in that the door handle (on which the device is installed) is used to return the rope (6) to allow active mobilization of the shoulder in all its planes mobilization (external (fig. 6) and internal rotation (fig. 7), extension (fig. 8), flexion (fig. 9), abduction (fig. 10), adduction (fig. 11)).

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