JP5024872B2 - Rehabilitation equipment - Google Patents

Description

  The present invention relates to a rehabilitation device, and more particularly to a rehabilitation device including a so-called splint device used for the purpose of restoring the function of a finger of a hand.

  Conventionally, injured hands and fingers, and when it was forced to fix the injured part for a long time as a treatment, not only decreased muscle strength required for finger movement but also shortened finger ligaments, It is known that not only a decrease in grip strength but also a decrease in function such as a decrease in the bending angle of a finger occurs.

  When such functional deterioration occurs, it often interferes with daily life. Therefore, functional recovery training is performed to restore the reduced function to an extent that does not interfere with daily life. When performing this function recovery training, a so-called rehabilitation apparatus is generally used in which exercise is performed while applying a required load to a muscle for which function recovery is desired.

  In particular, if the hand or finger is injured, the root of the finger is often fixed for treatment. As a result, the contraction of the extended position occurs in the joint of the finger, making it difficult for the finger to bend. It is known that such stretch contractures are resolved by rehabilitation. Note that the joint at the base of the finger is called an MP joint.

  Rehabilitation to resolve stretch contracture is performed immediately after the start of rehabilitation by the therapist bending the hand with stretch contracture directly by hand and using the rehabilitation device by recovering to some extent When possible, the rest is done using a rehabilitation device.

  In this case, the rehabilitation device urges the finger in the bending direction using an elastic body such as a rubber string, and knuckle bender sprint, elastic outrigger sprint, carpeners sprint, dynamic finger reflection sprint, etc. are known. It has been. These sprints generally consist of a wrist brace that is worn on the wrist and forearm, a finger brace that is worn on the finger, and a rubber strap that pulls the finger brace onto the wrist brace. Each of the finger braces is devised according to the stretch contracture, and the fingers are urged to bend by pulling with a rubber string.

If your finger bends sufficiently and you need to improve your muscular strength, attach a brace to the wrist to secure one end of the rubber cord at a predetermined position on the back of your hand. Rehabilitation that improves finger muscle strength by providing a finger brace that allows insertion of a predetermined finger on the end side, inserting the finger into the finger brace, and bending the finger against the bias of the rubber strap An apparatus has also been proposed (for example, see Patent Document 1).
JP 2001-087296 A

  However, in the conventional rehabilitation device that eliminates the contractile contraction at the finger joint, it is not only the bending posture of the finger, but it is effective for the extension of the collateral ligament and the dorsal joint capsule. Had problems.

  That is, in joints where stretch contracture has occurred, the spacing between adjacent bones is narrower than normal due to contraction of tissues including muscles. If the fingers are bent, the cartilage in the joint portion is compressed, and the cartilage may be damaged.

  In rehabilitation performed directly by the therapist, rehabilitation taking this into account is performed, but this is not considered in the rehabilitation device, and the rehabilitation device should be used while cartilage may be damaged. I could not.

  Therefore, since it is necessary to consider the schedule of the therapist in the rehabilitation schedule, the rehabilitation cannot be performed at any time, and the time required for functional recovery has been increased.

  In view of such a current situation, the present inventors have conducted research and development to provide a rehabilitation apparatus suitable for rehabilitation of a finger joint in which an extended position contracture has occurred, and have achieved the present invention.

Rehabilitation device of the present invention includes a palm support portion for restricting the return of wrist held against the wrist portion and the palm portion, the phalanges portion located on the fingertip side of the joint extended position contracture occurs the instrumentation wear to the finger A finger support part that restrains and supports, a pulling means that pulls the finger in a bending direction by pulling the finger support part , and a finger support part when the finger with the finger support part is pulled by the pulling means Moving in the extension direction of the joint in which the extended position contracture occurs, and is restrained by the finger support unit by pulling the finger support unit by the pulling unit and moving the finger support unit by the moving unit. A force that pushes forward upward is applied to the joint-side end where the stretched contracture of the phalange has occurred, and the finger is bent while pulling the joint with the stretched contracture in the extending direction .

Furthermore, the rehabilitation device of the present invention is also characterized by the following points. That is,
(1) The moving means has a cylindrical rotation guide provided on the back side of the finger support portion attached to the belly side of the finger, and a support shaft that is inserted into the rotation guide and supports the rotation guide. The finger support is moved in the direction of extension of the joint where the extension contracture occurs by rotating the rotation guide around.
(2) The support shaft has an insertion portion that extends in a direction intersecting the finger and is inserted into the rotation guide, and a connection portion that is provided on each side of the insertion portion. In addition to connecting to the support part, the insertion part is inclined by placing the index finger side forward of the little finger side.
(3) The finger support portion has a support plate that comes into contact with the finger and a belt that restrains the finger on the support plate, and the belt is provided with an auxiliary plate that holds the finger together with the support plate.
(4) The traction means is pulled toward the scaphoid bone of the hand supported by the palm support portion.

  The rehabilitation device of the present invention is provided with moving means for moving the finger support part in the extension direction of the joint where the extension contracture occurs when the finger with the finger support part is pulled by the pulling means. Thus, it is possible to prevent the cartilage of the joint portion from being pressed when the finger is bent.

  Therefore, the rehabilitation device can be used from a relatively early stage to eliminate finger stretch contracture, and it is not necessary to accompany a therapist, and rehabilitation at home is possible, so rehabilitation can be performed at any time. Therefore, functional recovery can be achieved in a short period of time.

  The rehabilitation device of the present invention, when performing rehabilitation of a finger joint in which the stretch contracture has occurred, a finger support portion attached to the phalange portion located on the fingertip side of the joint in which the stretch contracture has occurred, The finger is pulled in the bending direction while moving in the extension direction of the joint.

  FIG. 1 is a perspective view of the rehabilitation device of the present embodiment, FIG. 2 is a plan view of the rehabilitation device, and FIG. 3 is a side view of the rehabilitation device. The rehabilitation device is applied to the wrist portion and the palm portion to control the burr of the wrist. A finger support unit 20 that is fixedly attached to the finger bone portion located on the fingertip side of the joint in which the stretch contracture has occurred and supports the finger, and the finger is pulled by pulling the finger support unit 20 It comprises pulling means 30 (see FIG. 3) that pulls in the bending direction.

  As shown in FIG. 1, the palm support unit 10 includes a base 14 applied from the palm of the patient suffering from contracted contraction to the wrist, and further to the middle part of the forearm, and a palm portion on the base 14 at the distal end side of the base 14. A first restraining belt 11 for restraining the wrist, a second restraining belt 12 for restraining the wrist portion to the base 14 at the intermediate portion of the base 14, and a forearm portion to restrain the base 14 to the base 14 at the distal end side of the base 14 The third restraining belt 13 is provided.

  In this embodiment, the base 14 is made of thermoplastic plastic, and the plate made of thermoplastic plastic is shaped into a predetermined shape in which the wrist portion is narrower than the palm portion and the forearm portion, and is softened by heating. Thereafter, the substrate 14 is placed on the patient's hand and molded to form a base 14 that matches the patient's hand.

  Further, the base 14 is provided with a guide piece 14a that is bent back between the thumb and forefinger at the palm portion, and this guide piece 14a is positioned at the other portion of the thumb and forefinger to provide a palm support portion. By attaching 10 to the hand, it can be attached to the appropriate position.

  Further, the base body 14 can be made to be less likely to be displaced when the palm support portion 10 is attached to the patient's hand by curving the forearm portion along the forearm, thereby making it easier to regulate the burr of the wrist. be able to.

  The first restraining belt 11, the second restraining belt 12, and the third restraining belt 13 are belt bodies each having one end attached to the base 14 with an adhesive or the like, and the first surface fastener 15 is attached to the back surface. is doing.

  A second surface fastener 16 coupled to the first surface fastener 15 is provided at a predetermined position of the base 14. In particular, the second surface fastener 16 that is coupled to the first surface fastener 15 of the first restraining belt 11 is provided on the guide piece 14a to reliably restrain the hand to the base body 14 and prevent the wrist from being bent.

  As shown in FIG. 4, the finger support portion 20 includes a substantially flat support plate 21 applied to the phalange portion located on the fingertip side of the joint where the stretched contracture occurs. A finger restraining belt 22 is provided for restraining the finger that is in contact with the support plate 21.

  In the present embodiment, as shown in FIG. 1, the finger restraining belt 22 is composed of a left side belt 22L extending to the left side of the support plate 21 and a right side belt 22R extending to the right side of the support plate 21. The left belt 22L and the right belt 22R are fitted with hook-and-loop fasteners that are coupled to each other. Then, after a predetermined finger is brought into contact with the support plate 21, the left belt 22L and the right belt 22R are wound around the finger to join the surface fastener, thereby restraining the finger to the support plate 21.

  Furthermore, as shown in FIG. 5, the finger restraining belt 22 ′ may be provided with an auxiliary plate 25 that holds the fingers together with the support plate 21. The auxiliary plate 25 is preferably curved along the shape of the finger to be restrained.

  Here, the finger restraining belt 22 ′ is attached to the support plate 21 by being inserted through a belt insertion hole 27 formed by a belt guide 26 provided on the back surface side of the support plate 21.

  The auxiliary plate 25 is adhered to one end portion of the finger restraining belt 22 ′ by an adhesive, and a first surface fastener 28 is provided on the surface of the finger restraining belt 22 ′ on the upper side surface of the auxiliary plate 25. The second surface fastener 29 provided at the other end of the finger restraining belt 22 'can be coupled.

  When the finger is restrained by the finger restraining belt 22 ′, the auxiliary plate 25 is brought into contact with the back side of the finger brought into contact with the support plate 21, and the first surface fastener 28 positioned on the upper side of the auxiliary plate 25. Further, the second surface fastener 29 on the other end side of the finger restraining belt 22 'is coupled and restrained.

  In this case, the finger restrained by the finger restraining belt 22 'is sandwiched vertically between the rigid support plate 21 and the auxiliary plate 25, so that the defects present on the flank of the finger are removed by the finger restraining belt 22'. Since it can prevent pressing, it can prevent inhibiting a blood flow. Therefore, even if the finger is restrained with the finger restraining belt 22 'for a relatively long time, the rehabilitation device can be used without causing a blood circulation disorder.

  In this embodiment, the support plate 21 is formed of a flat plate made of thermoplastic plastic, and in particular, is formed as follows using a flat plate made of thermoplastic plastic having a strip shape with a predetermined width.

  First, a U-shaped notch is formed at a predetermined position of a strip-shaped flat plate to form a band-shaped portion that is narrower than the flat plate. Here, the longitudinal direction of the belt-shaped portion is the longitudinal direction of the strip-shaped flat plate. The width of the band is about the width of the finger, and the length of the band in the longitudinal direction is about 10 cm.

  After the strip-shaped flat plate on which the band-shaped portion is formed is heated and softened, as shown in FIGS. 1 and 3, the cylindrical body is formed into a loop shape by winding in the longitudinal direction and bonding the ends with an adhesive or the like. 23 is formed, and the belt-like portion is folded inside the cylindrical body. The cylindrical body 23 has a radius dimension of about 1.5 times the length of the finger restrained by the support plate 21.

  The band-like portion folded inside the cylindrical body 23 is extended in the radial direction of the cylindrical body 23 to form the support plate 21.

  Furthermore, in this embodiment, as shown in FIG.1 and FIG.3, the cylindrical body which wound the front end side among the strip | belt-shaped parts folded inside the cylindrical body 23, and was made into the roll shape is formed. This cylindrical body is used as a rotation guide 41 described later. After the rotation guide 41 is formed, the finger restraining belt 22 is bonded to the support plate 21 with an adhesive.

  As described above, the cylindrical body 23 on which the support plate 21 and the rotation guide 41 are formed is attached to the base 14 via the support shaft 42 inserted into the rotation guide 41 as shown in FIGS.

  That is, the support shaft 42 has insertion portions 42a that extend in a direction intersecting with the fingers and are inserted into the rotation guide 41, and connection portions 42b and 42b provided on both sides of the insertion portion 42a, respectively. The connection portions 42b and 42b are formed in a gate shape, and the end portions of the connection portions 42b and 42b are respectively bonded to the base 14 of the palm support portion 10 with an adhesive.

  When the support shaft 42 is bonded to the base 14, the patient's required finger is attached to the support plate 21 and the base 14 is attached to the patient's hand, and the positional relationship between the support plate 21 and the base 14 After making the proper positional relationship, both ends of the support shaft 42 inserted into the rotation guide 41 of the cylindrical body 23 are bonded to the base 14. At this time, the substantially flat support plate 21 is substantially parallel to the plane of the palm.

  As shown in FIG. 3, the pulling means 30 for pulling the finger support portion 20 is a rubber string 31 in this embodiment, and is provided on the first hook 24 provided on the outer peripheral surface of the cylindrical body 23 and on the back surface of the base body 14. The cylindrical body 23 is pulled toward the base body 14 by hanging a rubber string 31 on the provided second hook 17.

  The first hook 24 is disposed by adhering a plastic material molded into a U shape to the outer peripheral surface of the cylindrical body 23 with an adhesive. The second hook 17 is disposed by adhering a U-shaped plastic material to the back surface of the substrate 14 with an adhesive.

  In particular, the second hook 17 is provided at a position where the pulling direction by the rubber cord 31 faces the scaphoid bone of the hand supported by the palm support portion 10. Thus, by directing the pulling direction toward the scaphoid bone of the hand, the finger can be pulled and bent in the correct direction, and the function recovery effect can be improved.

  Further, the support shaft 42 is made of plastic so as to have elasticity, and the connecting portions 42b and 42b of the support shaft 42 are appropriately bent by pulling by the rubber cord 31.

  When rehabilitation is performed with the rehabilitation apparatus configured as described above, the patient first wears the base body 14 using the first to third restraining belts 11, 12, and 13, and then, as shown in FIG. As shown, a finger bone 51 portion positioned on the fingertip side of the joint 50 where the stretched contracture occurs is fixedly attached to the support plate 21 by the finger restraining belt 22 to support the finger.

  Next, the rubber cord 31 is hung on the first hook 24 and the second hook 17 and the finger restrained by the support plate 21 is pulled, so that the cylindrical body 23 is supported on the support shaft as shown in FIG. It is rotated around 42 insertion portions 42a.

  During the rotation of the cylindrical body 23, the rotation guide 41 through which the insertion portion 42a is inserted moves in the forward direction while sliding the inner peripheral surface in contact with the insertion portion 42a with respect to the insertion portion 42a. It rotates around the part 42a.

  Therefore, the support plate 21 formed integrally with the rotation guide 41 also rotates while moving in the forward direction, and at the end on the joint 50 side where the stretched contracture of the phalange 51 constrained by the support plate 21 occurs, As shown by the arrow S in FIG. 4B, the support plate 21 applies a force that pushes forward upward, thereby causing the joint 50 in which the stretched contracture is generated to be pulled in the stretched direction. be able to.

  By bending the finger by the rotation of the support plate 21 around the insertion portion 42a while pulling the joint 50 in which the stretched contracture occurs in this way, the finger is bent correctly without damaging the joint cartilage. be able to.

  Here, the cylindrical rotation guide 41 provided on the back surface side of the support plate 21 of the finger support portion 20 and the support shaft 42 inserted into the rotation guide 41, the support plate 21 is pulled when the finger support portion 20 is pulled. The moving means moves in the extension direction of the joint in which the extended position contracture occurs, and the moving means can be provided with a very simple configuration. The rotation guide 41 does not necessarily have to be a cylindrical body, and may be configured by a ring attached to the back surface of the support plate 21. As the finger support portion 20 is pulled, the support guide 21 is moved forward. What is necessary is just to be able to produce this movement.

  The rehabilitation device of the present embodiment is for the MP joint that is most prone to stretch contracture, but it is a PIP joint that is a joint between the proximal phalanx and the middle phalanx, or between the middle phalanx and the distal phalanx. For the stretch contracture occurring in the DIP joint, which is a joint of the above, the stretch contracture can be similarly improved by appropriately adjusting the shapes of the base 14 and the cylindrical body 23.

  Further, the cylindrical body 23 can be moved along the insertion portion 42a of the support shaft 42 that extends in the direction intersecting with the finger and is inserted into the rotation guide 41. The index finger and the middle finger are supported on the support plate 21 of the cylindrical body 23. By constraining either the ring finger or the little finger, the contractile contraction in the MP joint of each finger can be improved.

  In particular, as shown in FIG. 2, the insertion portion 42 a has an index finger side forward of the little finger side according to the difference in length of each metacarpal bone, and is inclined so that a dedicated finger is provided for each finger. The cylindrical body 23 can be used without being provided.

  In addition, since the insertion portion 42a has an inclined shape, as shown in FIG. 2, a finger that is not restrained by the cylindrical body 23 can be hung on the insertion portion 42a, and the hand can be supported by supporting the finger with the insertion portion 42a. In addition, an excessive tension state can be prevented. Therefore, the function recovery effect can be further improved by performing rehabilitation in a relaxed state.

  As shown in FIG. 6, in some cases, the cylindrical body 23 can be appropriately replaced with a support plate 21 having a different length according to the length of the phalange of each finger, and the support plate 21 according to each finger. The versatility may be further improved by adjusting the length.

  In the present embodiment, the cylindrical body 23 is provided to pull the finger support portion 20 having the support plate 21, but the finger support portion 20 does not necessarily have to be pulled through the cylindrical body 23. It is good also as another structure which has an equivalent function.

  Further, the rehabilitation device of the present embodiment is a sprint that can be attached to the patient's hand, but it is not necessarily a sprint. For example, as shown in FIG. 7, the wrist is applied to the wrist and palm. A base 61 serving as a palm support portion 10 'that restricts the burr and a support plate 62 that is fixedly attached to the finger bone portion located on the fingertip side of the joint where the stretch contracture occurs and supports the finger It can also be constituted by a finger support portion 20 ′ and a motor 63 that is a pulling means 30 ′ that pulls the finger in the bending direction by pulling the finger support portion 20 ′.

  In this case, the support plate 62 is provided on a cylindrical body 64 having the same configuration as that of the cylindrical body 23 described above, and a rotation guide 65 having the same configuration as that of the rotation guide 41 described above is provided on the back surface of the support plate 62.

  A support shaft 66 is inserted through the rotation guide 65, and the end of the support shaft 66 is attached to the base 61. The support shaft 66 is attached to the base 61 so as to be movable back and forth, and the distance from the base 61 to the cylindrical body 64 can be adjusted according to the size of the hand.

  The cylindrical body 64 is provided with a hook 67 that hangs a tow string 69 that pulls the cylindrical body 64, and the other end of the tow string 69 that is hung on the hook 67 is attached to the rotation shaft of the motor 63. It is connected to a take-up roll 68.

  Then, by driving the motor 63 to rotate, the tow string 69 is taken up by the take-up roll 68 and the cylindrical body 64 is pulled.

  The output shaft of the motor 63 is provided with a detecting means for detecting the tension generated in the tow string 69, or a tension roller (not shown) engaged with the middle part of the tow string 69. The tension applied to the tow cord body 69 is detected, the winding is stopped when the tow cord body 69 reaches a predetermined tension, and the state is maintained for a predetermined time. The traction can be released by rotating the shaft in the reverse direction.

  By adopting such a configuration, it is possible to perform rehabilitation without the need for wearing, and it is easy to give versatility, so it is not necessary to use a rehabilitation device as a sprint, but it is desirable that rehabilitation is mild. Patients suffering from stretch contracture can easily rehabilitate.

  Such a rehabilitation device may be stationary in a hospital or a rehabilitation facility, or may be portable between a hospital and a home as a general type by downsizing.

It is a perspective view of the rehabilitation device concerning the embodiment of the present invention. It is a top view of the rehabilitation device concerning the embodiment of the present invention. It is a side view of the rehabilitation device concerning the embodiment of the present invention. It is principal part explanatory drawing. It is explanatory drawing of the belt for finger | toe restraint. It is explanatory drawing of the rehabilitation apparatus of other embodiment. It is explanatory drawing of the rehabilitation apparatus of other embodiment.

Explanation of symbols

10 Palm support
11 First restraint belt
12 Second restraint belt
13 Third restraint belt
14 Substrate
14a Guide piece
15 First Side Fastener
16 Second side fastener
17 Second hook
20 finger support
21 Support plate
22 Finger restraint belt
22L left belt
22R right belt
23 Cylindrical body
24 First hook
30 Towing means
31 Rubber strap
41 Rotation guide
42 Support shaft
42a Insertion section
42b connection
50 joints
51 phalanges

Claims (5)

A palm support portion for restricting the burr of the wrist by applying to the wrist portion and the palm portion;
A finger support section which instrumentation wear to be supported by constraining the finger phalange portion located on the fingertip side of the joint extended position contracture occurs,
Towing means for towing the finger in the bending direction by towing the finger support portion ;
When prior Symbol finger support portion is towed by said towing means mounted finger, anda moving means for said finger support portion is moved in the direction of extension of the front Stories Takashi Seki,
By pulling the finger support portion by the pulling means and moving the finger support portion by the moving means, a force that pushes forward upward is applied to the joint-side end portion of the phalange restrained by the finger support portion. A rehabilitation device for bending a finger while pulling the joint in the extension direction . The moving means has a cylindrical rotation guide provided on the back side of the finger support portion attached to the belly side of the finger, and a support shaft that is inserted into the rotation guide and supports the rotation guide,
Rehabilitation device as claimed in claim 1, wherein the moving the finger support portion before relaxin exhibition direction by rotating the rotating guide to the support axis. The support shaft includes an insertion portion that extends in a direction intersecting with the finger and is inserted into the rotation guide, and a connection portion that is provided on each side of the insertion portion. While connecting to the palm support,
The rehabilitation apparatus according to claim 2, wherein the insertion portion has an inclined shape in which the index finger side is arranged in front of the little finger side. The finger support unit includes a support plate that comes into contact with the finger, and a belt that restrains the finger on the support plate,
The rehabilitation apparatus according to claim 2 or 3, wherein the belt is provided with an auxiliary plate that sandwiches the finger together with the support plate. The rehabilitation apparatus according to any one of claims 2 to 4, wherein the pulling means pulls toward a scaphoid bone of a hand supported by the palm support portion.

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