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    • 专利摘要:
    PROCESS FOR THE COMMAND OF AN ORTHETIC OR PROSTHETIC JOINT OF A LOWER END. The present invention relates to a process for controlling an orthotic or prosthetic joint of a lower extremity, with a resistance assembly to which at least one actuator is allocated, through which the resistance to bending and/or stretching will be modified. depending on sensory data, and through the sensors during the use of articulation, information about the momentary state will be offered. Sensory data will be determined by at least one set to capture at least two moments or one moment and one force. The sensory data of at least two of the determined quantities will be linked through a mathematical operation and thus at least one auxiliary variable will be calculated which is taken as a basis for the command of the bending and/or stretching strength.
    公开号:BR112012011415B1
    申请号:R112012011415-8
    申请日:2010-11-12
    公开日:2021-05-25
    发明作者:Philipp Kampas；Martin Seyr；Herman Boiten；Sven Kaltenborn
    申请人:Otto Bock Healthcare Products Gmbh；
    IPC主号:
    专利说明:

    Description
    [001] The present invention relates to a process for the command of an orthotic or prosthetic joint of a lower extremity, with a resistance set to which at least one actuator is allocated, through which - in dependence on sensory data - more - the resistance to bending and/or stretching is modified, and during the use of the joint through the sensors, status information is provided.
    [002] Knee joints for orthotics or prostheses feature an upper coupler component and a lower coupler component that are interconnected through a joint. Normally, in the upper coupler component, fittings are provided for an upper thigh stump or an upper thigh rail, while in the lower coupler component a lower thigh rod or a lower thigh rail is provided. In the simplest case, in the simplest case, the upper coupler component and the lower coupler component are pivotally interconnected by a single-axis joint. An arrangement of this type is only sufficient in exceptional cases to guarantee the desired success, or support in the fitting of an orthosis or an image of natural walking in the case of use in a prosthesis.
    [003] To represent in the most natural way possible the different requirements during the different phases of a step or in other actions or to reinforce these aspects, resistance sets are provided that offer a resistance to bending and a resistance to extension. The flexion resistance is used to adjust how easily the lower thigh rod or lower thigh rail oscillates backwards in relation to the upper thigh rod or upper thigh rail, when a force is applied to the unit. . The extension resistance stops the advancing movement of the lower thigh rod or lower thigh rail and forms, among others, a stretch stop.
    [004] From the prior art, for example, DE 10 2008 008 284 A1, a technical orthopedic knee joint with an upper component and a lower component arranged swivel on the upper component has become known, whereas the lower component several sensors are allocated, for example a bending angle sensor, an acceleration sensor, a tilt sensor and/or a force sensor. The extension stop will be determined in dependence on sensory data.
    [005] DE 10 2006 021 802 A1 describes a command of a passive prosthesis knee joint with adjustable damping in the direction of flexion, for fitting a prosthetic assembly with coupling means on the upper side and a connecting element with a artificial foot. Adequacy is verified in the process of climbing a ladder, with slow lifting of the prosthetic foot being detected and the flexion damping, in a lifting phase, will be reduced to below a level that is adequate for walking on a plane. Flexion damping can be neutralized depending on the change in the knee angle and depending on the axial force acting on the lower thigh.
    [006] It is the purpose of the invention to provide a process for commanding an artificial knee joint, with which an adaptation - depending on the situation - of the flexion resistance and the extension resistance is made possible.
    [007] The process according to the invention for the command of an orthotic or prosthetic joint of a lower extremity with a resistance set, to which at least one actuator is allocated, through which it is changed - depending on data sensory - the flexion and/or stretch resistance, and through the sensors, during the use of the knee joint, information about the state is offered, and the process provides that the sensory data are determined by at least one set to the recording of at least - two moments or; - a moment and a force; or - two moments and one force, or - two forces and one moment,
    [008] and the sensory data of at least two of the determined quantities will be mutually linked by a mathematical operation and, in this way, at least one auxiliary variant is calculated which is taken as a basis for the command of the bending and/or stretching strength . Sensors that can be shaped, for example, as knee or ankle moment sensors, or axial load sensors, provide basic data from which an auxiliary variable is calculated through a mathematical operation such as addition, multiplication , subtraction or division. This auxiliary variable has the possibility of providing enough data so that, based on these data, an adequacy of the resistances can be calculated. The auxiliary variable makes it possible to quickly and quickly, without great effort in the calculations, offer a characteristic quantity through which the current resistance to be set as a target quantity can be calculated, and the actuator can be commanded correspondingly so that the desired resistance is achieved. In this case, cutting moments, cutting forces, forces or distances are foreseen as auxiliary variables, and as auxiliary variables can be determined, for example, forces and moments that act in the orthosis or prosthesis sites that do not offer direct access through of sensors. While the sensors only determine the acting forces or moments directly, through the calculation of the auxiliary variable, a quantity can be used to evaluate the adjustment of the resistances that does not need to be captured directly. This expands the possibilities in the evaluation in the sense that when a resistance of this type should be adjusted, at what moment of movement or in what position of the joint or of the prosthesis. Basically, it is possible to determine several auxiliary variables at the same time, integrating them for the purpose of command.
    [009] The sensors are arranged, for example, on the lower thigh shaft or on the lower thigh rail, as well as in the region of the joints. The auxiliary variable can represent a physical quantity in the form of a virtual sensor. As this variable, among others, is calculated based on moments, forces and geometric dimensions of the artificial joint, it can be determined as an auxiliary variable a force, a distance of a force in relation to a reference point or a reference height, a cutting moment or a cutting force at a reference height. As an auxiliary variable, the distance of an energy vector in relation to an axis at a reference height, a cutting moment at a reference height or a cutting force can be determined. Thus, for example, the distance of the ground reaction force vector can be calculated by dividing a moment by the axial force. For this, for example, it is foreseen that at least one set to register the moment, for example, a moment sensor, registers the knee moment, so that the auxiliary variable is determined as the distance of the reaction force vector of ground, for example, at knee height, that is, at the height of the axis of the knee joint. It is also possible to determine the distance in relation to the longitudinal axis, for example, to determine the distance in relation to a reference point in a longitudinal axis where the longitudinal axis connects the sets to register the moment. Thus, for example, the distance of a force vector in relation to the longitudinal axis of the lower coupler component at the knee joint, that is, at the component of the lower thigh, can be used. It is determinable as an auxiliary variable of the distance of the force vector in relation to an axis in the articulation coupler component in a reference position by means of the data link of at least one set for capturing two moments and a force.
    [010] Basically, it is also possible to use other reference heights, with the set to capture the moment being mounted at the reference height or calculating the moment at a reference height by the weighted addition of two moments that are not at the reference height . As an auxiliary variable, a cutting moment or a cutting force can be determined by a component at a reference height. The auxiliary variable that is captured with the virtual sensor - that is, by the mathematical linkage of several sensory values - will be calculated in a calculation unit, for example, a microprocessor.
    [011] Especially the following quantities can be highlighted as auxiliary variables for commanding an artificial knee joint, that is, the distance of the ground reaction force in relation to the axis of the knee joint or the moment of the ground reaction force around the knee axis, the distance of the ground reaction force at foot height or the moment that generates the ground reaction force around the lower thigh axis at foot height, especially at ground level.
    [012] Another possibility to calculate the auxiliary variable is that the distance of the force vector from the axis of the lower thigh in a referential position is determined by the data link of two sets to capture a moment and a force sensor axial. When a moment sensor is discussed here, this formulation also covers sets for capturing a moment that is made up of several components and does not necessarily need to be arranged in the place where the moment operates.
    [013] It is also possible to determine a shear moment at a reference height by a weighted addition or subtraction of the values of an ankle moment sensor and a knee moment sensor. The cut-off moment will then be the auxiliary variable on the basis of which the command will be correspondingly regulated.
    [014] In addition, it is possible and foreseen that, as an auxiliary variable, a transverse force is determined, exerted on a lower coupler component, for example, the foot, which force comes from the coefficient of the difference of two moments, for example, the knee moment and the ankle moment and the distance of the moment sensors. Based on the determined auxiliary variable or several variables, the corresponding resistance value will then be calculated and adjusted. After transposing the maximum to the auxiliary variable, the resistance can be continuously reduced with the auxiliary variable in order to allow easier flexion of the joint on ramps or stairs.
    [015] When a predetermined value for the auxiliary variable is reached, the resistance set can be switched to the state of the oscillating phase, resulting in a basic adjustment of the bending damping and the damping of the modified extension compared to the momentary phase state. For that, a cutting moment or the distance of the ground reaction force vector at the height of the foot is foreseen.
    [016] It is planned to provide sensors for determining the knee angle, knee joint speed, an upper thigh rail position, or an upper thigh position, a lower thigh position or a lower thigh shank position , the alteration of these positions and/or the acceleration of the orthosis or prosthesis, with its data also being used, in addition to the use of the auxiliary variable, for the effect of commanding the resistance, that is, the resistances.
    [017] In order to verify an adequacy with the least possible bending of the resistance to the state conditions, it is foreseen that both for the data recording and also for the calculation of the auxiliary variable and the resistance adequacy are verified in real time. Preferably, the change in resistance takes place continuously with the auxiliary variable and/or with the sensor data in order to perform a smooth adjustment of the change in the command so that the user of the orthosis or prosthesis does not have to face abrupt changes in the behavior of the orthosis or prosthesis.
    [018] In addition, it is foreseen that in the case of a verified relief, that is, a reduction in the ground reaction force on the orthosis or prosthesis, for example, when lifting the leg, the resistance to flexion being reduced and, in the in case of increasing load, the flexural strength will be increased. In a stationary position of this type, which is latently foreseen and which is always fulfilled when the natural pattern of movement is present, resistance can lead to a blockage of the joint. The increase and decrease in resistance is preferably verified continuously, enabling a smooth transition, which approximates the natural movement and results in a sense of security in the wearer of the prosthesis or orthosis. By modifying the auxiliary variable, the blocking or intensification of resistance that was activated in the stationary position can be suspended or reduced, for example, based on the modification of the position of the prosthesis or orthosis in space.
    [019] It is basically foreseen that the transition from the stopped phase to the oscillating phase takes place in the load dependence, and it is also possible to slide from the resistance adjustment to the stopped phase in the resistance adjustment to the oscillating phase through an adjustment progressive resistance and, in case of need, that is, in the presence of corresponding data for the auxiliary variable, it is also feasible to progressively return again to the stopped phase. This is advantageous because especially to enable an oscillating phase on the ramp, when as an auxiliary variable, transverse force on the lower thigh is used.
    [020] Another aspect of the invention provides that the resistance is modified in dependence on a measured temperature. In this way, it becomes possible to protect the resistance assembly or also other components of the artificial, orthotic or prosthetic joint, against excessive heating. Overheating can cause the joint to fail, because parts of the joint lose shape or structural strength, or because the electronics are operated outside of allowable service parameters. In this case, the resistance will preferably be modified in such a way that the dissipated energy is reduced. Based on the smaller amount of energy to be transformed, the resistance assembly or other components of the artificial joint can cool down and work in a temperature range for which they are designed. In addition, it can be envisaged that the resistor assembly is suitable in such a way that changes that appear based on a change in temperature are compensated for. With the decrease, for example, of the viscosity of a hydraulic liquid based on heating, the resistance assembly can be correspondingly readjusted to continue to offer the already usual flexion and extension resistances so that the user of the prosthesis or orthosis may continue to rely on behavior of the artificial joint that is already familiar.
    [021] In a variant it is foreseen that for the stopping phase, for example, during walking, with increasing temperature the resistance will be increased. In this case, both the resistance to extension and the resistance to bending can be increased. Due to the increased resistance, the user is forced to walk more slowly and, in this way, will be able to integrate less energy into the joint. In this way, the articulation can cool down so that it can be operated within the permissible service parameters.
    [022] Another variant provides that, in the floor, the bending resistance for the oscillating phase is reduced in the case of increasing temperature. If in or to the oscillating phase the resistance to bending is reduced, this results in the joint oscillating to a greater extent. With this, the prosthesis foot will later reach the heel placement in the forward direction, with which the user is again forced to walk more slowly, which results in less energy transformation into heat.
    [023] Resistance can be modified when reaching or exceeding the temperature limit value. In this case, the resistance can be modified by salt form when a temperature threshold is reached or exceeded, so that a conversion of the resistance value, that is, the resistance values, will take place. It is advantageously provided that a continuous change in resistance occurs with the temperature after the temperature limit value has been reached. The extent to which the temperature limit value is determined depends on the respective construction parameters, the materials used and the intended uniformity of the resistance behavior of the prosthesis or orthosis. The resistance in the standstill phase, among other aspects, cannot be increased to such an extent that in this way a critical safety situation is generated, for example, when descending a ladder.
    [024] The resistance change induced by temperature is not the only command parameter of a resistance change, but, on the contrary, it is predicted that a resistance change induced by temperature is superimposed on a functional resistance change. An artificial joint, for example, a knee or ankle joint will be controlled, depending on the situation, through a large number of parameters, so that the functional resistance changes, which occur, for example, on the basis of the velocity of the The gait process, gait situation, or similar factors will be complemented by temperature-based resistance change.
    [025] In addition, it can be predicted that when a temperature threshold value is reached or exceeded, an alert signal is released to make the user of the prosthesis or orthosis aware that the joint or the resistance assembly is in a range of critical temperature. The warning signal can be released as an optical or acoustic tactile warning signal. Combinations of the different display possibilities are also foreseen.
    [026] Preferably, the temperature of the resistance set will be measured being taken as a basis for the command and alternatively also other sets can be subjected to temperature measurement when it presents a critical temperature behavior. If, for example, a control electronics is particularly sensitive to temperature, it is recommended to control it in an alternative or complementary way to the resistance assembly and provide a corresponding temperature sensor there. If different components are sensitive to temperature, for example, due to the materials used, it is recommended to provide a measuring set at the corresponding points in order to obtain corresponding temperature signals.
    [027] A readjustment set can be provided, through which the degree of change in resistance is modified. For example, in the determined database, for example, the weight of the user of the orthosis or the prosthesis, or the axial force determined when stepping on, it can be recognized that a high resistance change beyond the proportions will have to be made. There is also the possibility that a manual adjustment set is provided, through which an adjustment of the respective resistance change is verified, so that a greater or lesser tendency change in resistance can be produced depending on adjusted or determined data .
    [028] A device for carrying out the process as described above provides that an adjustable resistance set is present, integrated between two articulated components of an artificial orthotic or prosthetic joint, as well as a set of commands and sensors for recording. of state information on the device. A reset set is provided through which a resistance modification can be activated and/or deactivated. In this way, it becomes possible, for example, to carry out a selectively temperature-controlled resistance change and, especially, to consciously activate or deactivate certain additional modes, functions or functions, for example, from a knee command process .
    [029] An extension of the invention provides that the resistance to bending and/or stretching during swinging and/or stopping, or during the stopped position, will be adequate in the sensory database. While in the state of the art it is known to preserve a readjustment value, once reached, for the oscillating or stopped phase, until a new stage of the floor is presented, according to the invention, it is provided that an adequacy be adjusted in a variable way. flexion and/or extension resistance, during the stopped and/or oscillating phase. During the stop phase, or the oscillating phase, there is, therefore, a continuous adjustment of the resistance, in the case of changing states, for example, greater forces, accelerations or moments. Instead of readjusting the bending resistance and the resistance to extension through switching thresholds, which after the single reach form the basis for the adjustment of the respective resistances, it is foreseen, according to the invention, to verify a variable adjustment and adequate strengths, for example, on the basis of an evaluation of characteristic fields. The formation of a characteristic field for the flexural resistance through the knee lever and the knee angle is foreseen, with the command of the resistance being verified at the base of said characteristic field.
    [030] For the command of artificial joints in the sensory data base, those sensors that are precisely necessary to ensure a safety standard in the detection of overtaking in the walking phase will be mounted. If sensors that exceed the minimum measurement are used, for example, to increase the safety standard, this redundancy of sensors makes it possible to implement commands that take advantage of not all sensors provided near or inside the joint, preserving, even so, a minimum standard of security. It is foreseen that the sensor redundancy is used to implement alternative commands that, in the event of a sensor failure, with the sensors that are still working, they still allow walking with the oscillating phase, offering a minimum safety standard.
    [031] In addition, it may be foreseen that the distance of the ground reaction force vector in relation to an articulated part is determined, with the resistance being reduced when a threshold value of the distance is exceeded, that is, when the distance of the vector of the The ground reaction force is situated above a minimum distance to a pivot component, for example, to a point on the longitudinal axis of the lower thigh component at a given height or to the pivot axis of the knee joint.
    [032] In the stationary phase, the flexion resistance can be reduced to an adequate value for the oscillating phase, when, among other things, an inertial angle of the component of the lower thigh, increasing relative to the vertical plane, is determined. The increasing inertial angle of the lower thigh component shows that the user of the prosthesis or orthosis is walking forward, with the distal end of the lower thigh component being considered as the angular point. It is foreseen that the reduction only takes place when the increase in the inertial angle is above a threshold value. Furthermore, resistance may be reduced when the movement of the lower thigh component relative to the upper thigh component is not flexible, i.e. being stretched or remaining constant, which indicates a forward walking movement. At the same time, resistance can be reduced when the knee stretch moment is present.
    [033] It can be anticipated that the resistance in the standing phase will only be reduced when the knee angle is less than 5°. In this way, it is excluded that during the oscillating phase and with a bent knee, the joint is released from control in an unwanted way.
    [034] The resistance can be reduced to a value suitable for the oscillating phase - also in the case of knee moment in flexion, when it is determined that the knee moment changes from the stretched to flexed position. In this case, the reduction takes place immediately after changing the knee moment, from the stretched to flexed position.
    [035] In addition, it can be foreseen that after a reduction, the resistance is again increased to the value in the stopped phase, when within a determined time after the resistance reduction, a threshold value for an inertial angle of a pivot component, for an inertial angle velocity, for a ground reaction force, for a pivot moment, for a pivot angle or for a distance of the force vector with respect to a pivot component. Expressed in another way, the articulation will again be set to the stopped phase state if within a predetermined time after switching to the oscillating phase state, an oscillating phase is actually determined. This is based on the fact that the release of the oscillating phase already takes place before the toe has left the ground in order to enable an induction of the oscillating phase in a timely manner. If, afterwards, the oscillating phase is not induced, as would occur, for example, in the case of a surrounding movement, the connection to the safe stopped phase resistance must be made again. For that, a timer is foreseen that checks whether a predicted value for one of the quantities determined above is present within a certain period of time. Resistance remains reduced, that is, the oscillating phase remains activated, when an increase in the joint angle is detected, that is, when an oscillating phase is effectively induced. Likewise, it becomes possible that after reaching the threshold value and releasing the oscillating phase, the timer will only be activated when there is a drop in a second threshold value, which is smaller than the first threshold value.
    [036] In addition, the invention may also be provided so that the resistance to flexion is increased or not reduced in the stationary phase, when an inertial angle, decreasing in the vertical direction, relative to a component of the lower thigh or a load on the forefoot. By coupling the sensor magnitude of a decreasing inertial angle, of a component of the lower thigh, in the vertical direction and in the presence of a load on the forefoot, it makes it possible to reliably detect the backward gait and not initiate a phase oscillating, that is, not reducing the resistance to flexion to avoid an unwanted flexion of the knee joint when in backward walking the treated leg is positioned backwards and applied. This makes it possible for the treated leg to be pulled in the direction of flexion, or bent, in a way that makes it possible for a patient who has a prosthesis or orthosis, it will not be necessary to activate a separate block to march backwards.
    [037] A development of the invention provides that the resistance is increased or at least not reduced when the inertial angle velocity and a joint component does not fall below a threshold value or, expressed in another way, an oscillating phase is induced with a drop in bending strength when the speed of the inertial angle exceeds a certain threshold value. It is also possible that by determining the inertial angle of a joint, especially the lower flank component, and the speed of the inertial angle of an articulated component, especially the lower thigh component, it is determined that the user of the prosthesis or orthosis is walking backward, requiring a knee joint blocked against flexion or severely braked. Correspondingly, the resistance will be increased, as long as it is not yet high enough.
    [038] In addition, it may be foreseen to determine the sequencing of the load on the front foot, with the resistance being increased or not being reduced when, in the case of a decreasing inertial angle, of the lower thigh component there is a reduction of the load on the front foot. While in a forward walking movement, after the heel session, the load on the forefoot only increases when the lower thigh component is rotated forward, surpassing the vertical, it will decrease the front foot demand in backward gait with a decreasing inertial angle, so that in the presence of the two states, that is, a decreasing inertial angle and a decreasing demand of the forefoot, it can be concluded that a backward step action is present. Correspondingly, the resistance will then be increased to that value which is foreseen for the stepping-back action.
    [039] Another characteristic quantity can be the moment of the knee that is registered and that serves as a basis for increasing or not reducing the resistance. When a knee moment acting in the direction of flexion is determined, that is, when the prosthetic foot has been placed, and a knee flexion moment is detected, a situation will be present in which an action of walking backwards, of a way that would later justify a bending block, that is, an increase in resistance to a value that does not simply allow bending.
    [040] It can also be predicted that the point of attack of force on the foot is determined, with the resistance being increased or not reduced, when the point of attack of force moves in the direction of the calcaneus.
    [041] The inertial angle of the lower thigh component may be determined directly on a sensor disposed on the lower thigh component or may be determined from the inertial angle of another coupling component, for example, the upper thigh component and a joint angle equally determined. As the articulated angle between the upper thigh component and the lower thigh component can also be used for other command signals, redundancy results from the multiple arrangement of sensors and the multiple use of the signals, so that also in the case of if a sensor fails, the functionality of the prosthesis or orthosis will continue to be preserved. A modification of the inertial angle of an articulated component can be determined directly by means of a gyroscope or a differentiation of an inertial angle signal of the articulated component or of the inertial angle signal of a coupler component or of an articulated angle.
    [042] Below, an example of the implementation of the invention will be described in more detail.
    [043] The figures show: figure 1 - schematic presentation of a prosthesis; figure 2 - schematic presentation to calculate a distance; figure 3 - schematic presentation to calculate a cutting moment; figure 4 - schematic presentation to calculate a distance on the basis of various sensory values; figure 5 - schematic presentation for calculating a transverse force; figure 6 - schematic presentation of sequencing of knee angle values and an auxiliary chronological variable; figure 7 - behavior of characteristic quantities in the case of increasing resistance in the stationary phase; figure 8 - behavior of characteristic quantities of increasing resistance in the oscillating phase; figure 9 - sequencing of knee angle and resistance curve when walking in a flat area; figure 10 - knee angle sequencing and a resistance curve when walking on an inclined plane. figure 11 - a presentation of the sign convention for the inertial angle and schematic presentation of a prosthesis during the step of walking backwards; Figure 12 - a presentation of the sign convention for knee angle and knee moment; figure 13 - a characteristic field for resistance over the knee angle and the knee lever. figure 14 - characteristic quantities when walking on oblique planes, as well as: figure 15 - resistance behavior in case of different maximum transverse force.
    [044] Figure 1 schematically shows a leg prosthesis with an upper thigh rod 1 to fit the upper thigh stump. The upper thigh rod 1 will also be referred to as the upper coupler component. On the upper coupler member 1 a lower coupler member 2 is arranged in the form of a lower thigh rod having a resistance assembly. A prosthetic foot 3 is provided on the lower coupler part 2 . By means of a hinge 4, the lower coupler part 2 is pivotally fastened to the upper coupler part 1 . A moment sensor is integrated in joint 4 which determines an active knee moment. In the lower coupler component 2, a connection component 5 with the prosthetic foot 3 is provided, in which an assembly for determining the actuating axial force as well as the ankle moment is contained. Angle and/or acceleration sensors can also be provided. It is possible that not all sensors, or additional sensors, are present in a leg prosthesis.
    [045] In addition to the resistance assembly that offers the bending and stretching resistance, there is a command assembly in the lower coupler component 2, through which it is possible to modify the respective resistance on the basis of the sensor data received and the evaluation of the sensory data. Therefore, it is foreseen that the sensory data will be used to generate at least one auxiliary variant that is preserved through a mathematical linkage of two or more sensory data. With this, it becomes possible to interlace several force or moment sensors in order to calculate forces, distances and/or moments that are not directly present in the region of the sensors. Thus, for example, it becomes possible to calculate shear forces, shear moments or distances in different reference planes so that based on these data you can evaluate which functions currently must be performed so that a more walking pattern can be achieved. natural as possible. Functions are those command sequences that appear in the context of a natural movement, whereas a mode is a switching state that is induced by a voluntary act, for example, by activating a separate key or a sequence. conscious, eventually conscious, but unnaturally, movement.
    [046] Figure 2 schematically shows how, as an auxiliary variable, the distance a of the distance from the GRF soo reaction force vector to the moment sensor is calculated. In the present case, the auxiliary variable a is presented by the knee lever, also shown in Figure 13, being described there linked with a characteristic field command - there, however, with an inverse sign. The distance a will be calculated from the quotient of the knee moment M and the axial force Fax. The greater the knee moment in relation to the axial force FAX, the greater the distance a of the force vector of the GRF ground reaction at the height of the reference, which, in the present case, forms the axis of the knee. On the basis of the auxiliary variable a, it is possible to vary the resistance to stretching and/or the resistance to bending, since through this auxiliary variable a can be calculated, if and in which stage of the stationary or oscillating phase the prosthesis is, so that from this state onwards, a predetermined flexural and/or stretching strength will be regulated. By changing the auxiliary variable a, it can be determined how the current movement takes place, so that within the movement, also within the stationary or oscillating phase, an adjustment of the resistance to stretching and/or bending can be made. The change in resistance is preferably carried out continuously and depending on the modification of one or more auxiliary variables.
    [047] In Figure 3, the auxiliary variable d is determined as a shear moment Mx at height x from the ground. In the example shown, the calculation is fixed at the height of the foot so that the value x can be assumed to be 0. The shear moment Mx, which is determined at the height x of the lower coupler component 2, is calculated according to formula

    [048] where M1 is the moment in the coupler component 5, that is, normally the ankle moment, the M2 moment representing the knee moment, the length II representing the distance of the ankle moment sensor in relation to the ground, representing the length I2 the distance from the knee moment sensor to the ground and the length Mx representing the reference height above the floor at which the shear moment Mx is to be calculated. Here, the calculation of the auxiliary variable d is verified exclusively on the basis of the measurement of two moment sensors and the mathematical link described above. Based on the moment of the Mx cut, the load inside the lower coupler component 2 can be concluded, from which the load inside the lower coupler component 2 can be calculated, that is, the connection component 5. According to the size and the Orientation of the cut different load scenarios that require proper adjustment of the bending and/or stretch strength can be recognized. On the basis of the respective momentarily active shearing moment Mx, which is memorized as auxiliary variable d in the control, the necessary readjustment of the resistor assembly can then be carried out in real time in order to adjust the corresponding resistance.
    [049] Figure 4 shows how another auxiliary variable b in the form of the distance of the ground reaction force vector GRF can be calculated in relation to an axis, in this case, the connection of the two sets for recording moments, at one height referential to the FAX axial force vector. The auxiliary variable d is calculated from:

    [050] representing M1 the effective moment in the connection component 5, for example, the ankle moment at height II from the ground, moment I2 represents the knee moment at the height of the axis of the knee 4, which is at a distance 12 in relation to the ground. The quantity x is the referential height of the ground, the FAX force is the axial force acting within the connection component 5, that is, in the lower coupler component 2. By modifying the auxiliary variable b, as described, it is possible to continuously regulate both during the oscillating phase as well as during the stopped phase, the respective resistances and adapt it to existing changes. In this way, it becomes possible to activate different functions that are automatically recognized, for example a function of a standing position, by which it is avoided, for example, that the knee joint rubs unintentionally. In the specific case, this auxiliary variable will be used at height x = 0 to release the oscillating phase.
    [051] In the evaluation for release, not only the transposition of the limit value for the auxiliary variable b (x = 0) can be evaluated, but also the trend. Thus, in a backwards march, an inverse sequencing of the auxiliary variable must be assumed, that is, a displacement of the point of attack of force from the finger to the heel. In this case, no resistance reduction should be made.
    [052] Figure 5 schematically shows how the transverse force or the tangential force FT can be calculated as the fourth auxiliary variable c, being used for the process of command of the knee. The tangential force FTe, therefore, also the auxiliary variable c, results from the quotient of the difference between the knee moment and M2 and the ankle moment M1 to the distance l3 between the knee moment sensor and the ankle moment sensor .

    [053] Through the auxiliary variable c can be continuously reduced, for example, the bending resistance in the terminal stop phase in the displacement in oblique planes with the decreasing auxiliary variable, in order to enable an easier oscillation of the joint.
    [054] Figure 6 presents, as an example, how an auxiliary variable can be used to determine the release of the oscillating phase. The upper graph plots the knee angle KA over time t, starting with the HS heel session and an essentially uniform knee angle during the stop phase up to a knee flexion, just before the forefoot lift. at the moment TO. During the oscillating phase, the knee angle KA is then increased, until, after the foot advances, the stretch stop is again around 0, with the calcaneus being positioned again.
    [055] Below the knee angle diagram, by time t, the value of the distance b of the ground reaction force vector in relation to the axis of the lower thigh is shown, according to figure 4, at the reference height x = 0 As soon as the auxiliary variable b has reached a threshold value THRES, this will have to be readjusted in such a way for the release command in order to readjust the resistances that are suitable for the oscillating phase, for example, by a decrease in the resistance of flexion, to facilitate flexion, just before the forefoot session leaves the ground. Resistance reduction can then be done continuously and not saltiformly. It is also possible that the auxiliary variable b changes again, showing an unforeseen path, with the resistances being correspondingly adequate, for example, the resistance being increased or the knee joint even being blocked.
    [056] In addition to the displayed command of the functions through an auxiliary variant, it is possible to use several auxiliary variants for the command of the artificial joint in order to obtain a more precise adaptation to the natural movement. In addition, other elements or parameters can be used to control a prosthesis or an orthosis that cannot be assigned to auxiliary variables.
    [057] Figure 7 is shown as an example in the diagram the dependence of characteristic quantities such as the moment of the knee M, the potential P and the velocity v on the resistance RSTANCE in the stopping phase in the case of a prosthetic joint of knee. In the joint of the knee prosthesis, a resistance assembly and an actuator are integrated, through which the resistance against flexion and/or stretching, which can be changed, is opposed. In addition to a prosthesis, a correspondingly shaped orthosis can also be used, and other sets of joints are also possible as a field of use, such as, for example, hip or foot elements. In the resistance set, mechanical energy will normally be transformed into thermal energy in order to brake the movement of a lower thigh component relative to an upper thigh component, a corresponding action also being applied to other joints.
    [058] In this case, the temperature of the resistor assembly depends on the extent of the potential P that is applied during the standstill phase. Potential P depends on the effective knee moment M and the speed v with which the knee joint is flexed. This speed in turn depends again on the resistance RSTANCE which is opposed by the resistance set presented to the respective movement in the stop phase. If in the still phase, after the calcaneus, the resistance to flexion, and in the continued sequencing in an incipient extension movement is increased, the extension resistance will be reduced to the speed of movement of the articulated components in a reciprocal convergent direction and, with this, also the speed of movement of the resistance set. By decreasing the velocity v, which is stronger than the slight increase in the moment M, the potential P is reduced during the stationary phase, so that the energy to be transformed decreases correspondingly to the potential P in reduction. Correspondingly, with uniform cooling, the temperature of the resistor assembly or that component that is controlled relative to its temperature is also reduced.
    [059] Figure 8 presents the correlation of the characteristic quantities described in relation to the RSWING resistance in the oscillating phase. Due to a decrease in resistance R during the oscillating phase, walking speed, knee moment M and, therefore, also the applied potential P decrease, so that the energy to be transformed will be reduced. Correspondingly, the temperature of the resistor assembly is reduced with a decreasing oscillating phase resistance. A temperature-controlled stop and/or oscillating command can - as a complement to the command - be made through the auxiliary variables described above or also separately from these variables.
    [060] Figure 9 presents in the upper diagram the knee angle KA by time T starting with the so-called "heel strike", ie the heel strike, which is normally performed with a stretched knee joint. During foot placement there is reduced flexion of the knee joint, the so-called standstill flexion to slow down the placement of the foot and the heel session. Once the foot is fully positioned on the ground, the knee joint is fully stretched until the so-called "knee break" in which the knee joint is flexed to move the knee joint forward and shift over the fore leg. Starting from this referred "knee break", it increases the knee angle KA to the maximum knee angle in the oscillating phase and then passes - after the advancement of the bent leg and the prosthetic foot - to a stretched position and be positioned again with the heel . This knee angle sequencing is typical for walking mode in a flat session.
    [061] In the lower graph the resistance R by time is registered, corresponding to the respective knee angle. From this graph it can be seen how a change in resistance in the oscillating phase and in the stationary phase is expressed, which was carried out, for example, due to a resistance change, induced by temperature. If an extension or flexion resistance is present, it depends on the sequencing of the knee angle, with increasing knee angle KA, the flexion resistance will be active, with decreasing knee angle, the extension resistance will be active. After the heel strike (application of the heel), a relatively intense flexion resistance will be present and after movement inversion, a high extension resistance will be present. In the incidence of "knee break" (knee break) resistance will be reduced to facilitate flexion and advancement of the knee. In this way, the action of walking will be facilitated. After the reduction of the resistance in the "knee break" (knee break), the resistance will be maintained by part of the oscillating phase at the low level in order to facilitate an oscillation towards the posterior direction of the prosthetic foot. So that the oscillating movement is not allowed to be expressed too intensely, before reaching the maximum knee angle, the flexion resistance will be increased and, after reaching the maximum knee angle and the inversion of movement, it takes place. an extension resistance for the reduced level of flexion of the oscillating phase. The decrease in the extension resistance is also preserved beyond the extension movement in the oscillating phase, until just before the "heel strike" (knee application). Just before full stretch is reached, the strength will be increased again to avoid a crash, ie hard, encounter at the stretch stop. So that when applying the prosthetic foot, sufficient security for uncontrolled flexion is obtained, the flexural strength is also at a high level.
    [062] If now, the flexion resistance is increased, which is indicated by the dashed line, the speed of the knee angle and therefore also the walking of the prosthesis user becomes slower. After the "heel strike" (application of the calcaneus), only a comparatively reduced inclination in stationary flexion and a slower stretch follows so that less energy is dissipated. Suspension of flexural strength before reaching the maximum knee angle takes place in a less accentuated manner than in the standard event, which is indicated by the arrow pointing downwards. Therefore, the lower thigh and, therefore, the prosthetic foot oscillate to a greater extent so that there will be a longer period of time between the "heel strike" (applications of the heel). oscillating reduces to a decrease in walking speed.
    [063] At the end of the oscillating phase extension, ie, just before stepping and the "heel strike", the extension resistance will be reduced compared to the standard level. It is therefore anticipated that the extension resistance will be reduced so that the lower thigh session more quickly reaches the stretched position. To avoid a hard encounter in the stretch, the prosthesis wearer will walk more slowly so that the potential P, and therefore the energy to be dissipated, is reduced. During the still phase, between heel application and knee interruption, both the flexion resistance and the extension resistance can be increased to slow down the light flexion and stretching movement, thus reducing the speed from the floor.
    [064] In the upper part of figure 10 is shown a sequencing of the angle of the knee when walking on a ramp, in this case, an inclined ramp. After application of the calcaneus, there is a continuous increase in the angle of the knee KA up to the maximum of the knee angle without any interruption of the knee. This is based on the fact that when walking on a ramp, the knee does not achieve a full stretch. After reaching the maximum angle of the knee, there is a rapid advancement of the knee and lower thigh until complete stretching, which coincides with a new application of the calcaneus. The flexion resistance will then remain for an additional stroke at a constant high level until it is lowered to allow for a flexion of the knee and, with this, a lift of the prosthesis foot and an oscillation. This oscillation takes place after reaching the minimum resistance level and after reaching the maximum knee angle. Then the extension resistance will be kept at a reduced level until it is raised again just before stepping.
    [065] If there are unforeseen events in the increased temperatures in the resistance set, the resistance in the stationary phase will be increased to ensure a slow walking speed and also a slow bending. After reaching the maximum tilt angle in the swing phase, forward movement of the prosthetic foot will reduce the extension resistance compared to normal function, which also results in a decrease in the energy to be dissipated.
    [066] In addition to the conventional movement situation in which the patient moves forward, the profile of daily movement is provided for many other situations for which a reaction should be made with an appropriate command.
    [067] Figure 11 shows a prosthesis in a situation in which normally in walking forward, the oscillating phase will start. In this situation, the patient is still supported on the forefoot session and then wants to move the hip so that the knee is also flexed. The patient will also be in the same situation when walking backwards. Starting from a vertical position, in the backward displacement of the treated leg, in this case, the prosthesis will be displaced backwards, that is, in the opposite direction to the normal viewing direction of a prosthesis user. In this way, it results that the inertial angle α1 of the lower thigh component 2 initially increases in the direction of the force of gravity, which is indicated by the vector of the gravity force g, until the prosthetic foot 3 is placed on the ground. As a turning point or angle point for movement or for determining the increasing inertial angle α1, the hip joint should be considered. The longitudinal projection, or longitudinal axis, of the lower thigh component 2, projects by the pivot axis of the prosthetic knee joint 4 and preferably also by an ankle joint pivot axis or centrally by a coupler point between the prosthetic foot 3 and the lower thigh component 2. The inertial angle α1 of the lower thigh component 2 can be determined directly by a sensor arranged in the lower thigh component 2 and, alternatively in this direction, it can also be determined through a sensor in the upper thigh component 1 and a knee angle sensor that records the angle between the upper thigh component 1 and the lower thigh component 2.
    [068] To determine the speed of the inertial angle, a gyroscope can be directly employed or the change of the inertial angle α1 over time will be determined which can be determined with the extension and direction. If there are now unforeseen events at a given inertial angle α1 and a given inertial angular velocity α1, an oscillating phase will be induced if a given threshold value is transposed to the inertial speed α1. If a decreasing inertial angle α1 and, in addition, a load on the forefoot session is foreseen, it can be concluded that a backward gait is present, so that the bending resistance will not be reduced, but will be maintained or increased so as not to induce an oscillating phase reflection. In Figure 12, the prosthesis is shown in a flat placed state on the ground. This presentation is especially useful to define the knee moment and knee angle, as well as the sign convention used. In this case, the knee angle αK corresponds to the angle between the upper thigh component 1 and the lower component 2. A knee moment MK acts around the pivot axis of the prosthetic knee joint 4. The release of the oscillating phase can be complemented by other criteria, for example, by the fact that the knee moment MK needs to be stretched, that is, positive or 0, with the knee angle αK being almost 0. stretched, and/or knee angle velocity equals 0 or stretched.
    [069] An elegant way and way of taking into account different parameters and parameter connections is given by employing a characteristic field. The characteristic field makes it possible - different from what happens with a circuit only controlled by a limit value - to regulate variables, as well as suitable resistances for sequencing, or combinations of the magnitudes of characteristic fields. In this case, the auxiliary variables that have already been described above can also be used.
    [070] Figure 13 presents a characteristic field for the command for the floor in the plane, which was made to determine the resistance R to be adjusted. The characteristic field extends between the resistance R, the knee angle KA, as well as the knee lever KL. KL Knee Lever is the normal distance of the resultant ground reaction force from the knee axis and can be calculated by dividing the acting knee moment and the acting axial force as depicted in figure 2. There, the knee lever was described as an auxiliary variable a - although also with an inverse sign. The maximum value for resistance R will be that quantity in which, without destroying a component, the joint, in this case the knee joint, cannot be flexed or only very slowly. When after an initial raise, the knee lever KL = - a moves against 0, and the lower thigh has been clearly tipped backwards, which is typical for walking on a plane, the flexion resistance R, starting from a resistance from basic flexion up to a maximum stationary phase tilt angle of eg 15° or just below will be increased with increasing knee angle up to RBLOCK block resistance. A curve of this nature is represented as the normal standing phase bending curve RSF in figure 13. The resistance set therefore limits the inward bending in the stopped phase reflection when walking on a flat level. However, when you increase the KL knee lever, the flexion resistance will be increased to a lesser extent. This behavior corresponds, for example, to walking on an inclined plane, descending a ramp or in a braked step, being drawn with the expression RRAMP. Due to the characteristic field, a continuous passage between walking on a flat level and walking on a ramp is possible. If a limit value is not used, but a continuous characteristic field, even in the advanced stage of the standstill phase it is possible to switch between walking on a flat level and walking on a ramp.
    [071] In Figure 14, the characteristic quantities are presented, such as, knee angles KA, tangential force FT, as well as flexion resistance R by time t when walking in oblique planes, in this case, walking on a mountain slope . After the "heel strike" (heel strike), the knee angle KA continuously increases until the moment of lifting the foot TO. Then he will increase the knee angle K once more so that in the swing phase he will bring the lower flank component closer to the upper flank component so that he can position his foot forward. After reaching the maximum knee angle KA, the lower thigh component will be moved forward, the knee angle KA is reduced to 0, so that the leg is again in the stretched state in which the heel is placed, so which starts a new step cycle.
    [072] Tangential force FTor transverse force registers a negative value after knee application, registers a pass at 0 after complete foot placement, and will then increase to a maximum value just before foot suspension. After lifting the foot at the TO moment, the transverse force FT will be 0 until a renewed "knee application".
    [073] The sequencing of the flexion resistance R to the maximum transverse force FT is almost constant and very high so that in the downward displacement it reacts against the force acting in the direction of flexion so that the patient is relieved and does not have to compensate for the side acquired the oscillation of the rotated artificial knee. After reaching the maximum transverse force that is situated before lifting the foot, the flexion resistance R will be continuously reduced with the tangential force to enable an easier flexion of the knee joint. After lifting the front foot session at the TO moment, the flexion resistance R will have its minimum value so that the lower thigh can again rotate slightly backwards. If the lower thigh is moved forward, the extension resistance is active and for reasons of completeness this diagram is not drawn. In the case of decreasing knee angle, resistance R is configured as extension resistance that is increased just before the new placement is reached, that is, just before the renewed "knee application", being increased to a maximum value in order to provide extension cushioning so that the knee joint is not moved within the extension stop in an undamped manner. The flexural strength will be increased to the high value so that immediately after the "application of the heel" the necessary active flexural strength can be provided.
    [074] In figure 15 this shows the relationship between the resistance R to be adjusted and different maximum levels of strength. The decrease in resistance is, in this case, standardized to the maximum transverse force. In this way, the resistance must be reduced from a high value to a low value while the transverse force goes from a maximum to a value of 0. The reduction, therefore, is independent of the intensity of the maximum transverse force. It extends from the stopped phase resistance to the minimum resistance while the transverse force goes from the maximum to 0. If the transverse force is increased again, the resistance will be increased, that is, the prosthesis user can again request more light. the articulation if it interrupts the movement. Here, too, a continuous transition between slight oscillation and load reapplication is possible without using a discrete switching criterion.
    权利要求:
    Claims (16)
    [0001]
    1. Process for commanding a prosthetic or orthotic joint (4) at a lower extremity with a resistance set, to which at least one actuator is allocated, through which the resistance to bending and/or stretching is changed (R) , depending on sensory data, and through sensors, during the use of the joint (4), state information is offered, and the sensory data are determined by at least one set to capture at least one moment and one force ; or - two moments and one force, or - two forces and one moment, and the sensory data will be reciprocally connected by at least two of the determined quantities, through a mathematical operation, and in this way, at least one auxiliary variant is calculated (a , b) which is taken as a basis for the command of the bending and/or stretching resistance (R), characterized by the fact that as an auxiliary variable (a, b) the distance of the force vector of the soil reaction is calculated ( GRF) of the set to capture a moment by dividing the moment (M) by the force (GRF).
    [0002]
    2. Process according to claim 1, characterized in that the distance of the force vector in relation to the articulation axis is calculated by dividing the articulation moment by the axial force (FAX).
    [0003]
    3. Process according to claim 1 or 2, characterized in that as auxiliary variable (a, b), the distance of the force vector to an axis of an articulated coupler component in a reference position is determined by connecting the data of at least one set to capture two moments and a force.
    [0004]
    4. Process according to any one of claims 1 to 3, characterized by the fact that as auxiliary variable (a, b) a cutting moment of a reference height is determined through weighted addition, that is, subtraction of the values of sets for capturing two moments, especially an ankle moment sensor and a knee moment sensor.
    [0005]
    5. Process according to any one of claims 1 to 4, characterized in that as auxiliary variable (c), a transverse force (Ft) exerted on a lower coupler component (2) is determined, arising from the quotient of the difference of two moments (M1, M2) and the distance (I3) of the two sets to determine the moments in the convergent direction.
    [0006]
    6. Process according to any one of claims 1 to 5, characterized in that when a predetermined value for the auxiliary variable is reached or exceeded, the resistance set will be switched into an oscillating phase state.
    [0007]
    7. Process according to any one of claims 1 to 6, characterized in that in the event of a verified decrease in the ground reaction force (GRF) on the orthosis or prosthesis, the resistance (R) will be reduced and with increasing ground reaction force (GRF), the resistance (R) will be increased until the joint locks.
    [0008]
    8. Process according to claim 7, characterized in that the locking of the joint (4) is suspended when the auxiliary variable is changed.
    [0009]
    9. Process according to any one of claims 1 to 8, characterized in that the resistance (R), after the increase, on the basis of a registered change in the position of the orthosis or prosthesis in space or by a registered change in position of the force vector in relation to the orthosis or prosthesis will be reduced.
    [0010]
    10. Process according to any one of claims 1 to 9, characterized in that a temperature sensor is provided and the resistance (R) is modified depending on at least one measured temperature signal, the temperature of the Resistance device is measured and used as the basis for control.
    [0011]
    11. Process according to claim 10, characterized in that during the stopped phase, with increasing temperature, the resistance (R) will be increased and during the oscillating phase, the resistance to bending with increasing temperature will be reduced.
    [0012]
    12. Process according to any one of claims 1 to 11, characterized in that in the event of a failure of sets to capture moments M1, M2), forces (Ft, FAX) and/or articulated angles KA), will be alternative command algorithms used on the basis of the remaining sets to modify the strength (R) to stretching and/or bending.
    [0013]
    13. Process according to any one of claims 1 to 12, characterized in that the distance (a, b) from the ground reaction force vector (GRF) to an articulated component is determined, being the resistance (R) reduced when a distance threshold value (a, b) is exceeded.
    [0014]
    14. Process according to claim 13, characterized in that the resistance (R) after a reduction will be increased again to a value for the stopped phase, when within a determined time, after the reduction of resistance (R), a threshold value is not reached for an inertial angle (αi) of an articulated component, for an inertial angular velocity (WI), for a ground reaction force (GRF), for an articulated moment (M), for an articulated angle (KA) or for a distance (a, b) of a force vector (GRF, FAX) in the direction of an articulated component.
    [0015]
    15. Process according to any one of claims 1 to 14, characterized in that the attack point of force on the foot (3) will be determined and the resistance (R) will be increased or not reduced when the attack point of the force to move in the direction of the heel.
    [0016]
    16. Process according to any one of claims 1 to 15, characterized in that the resistance to bending (R) in the stationary phase is increased or not reduced, when an inertial angle (αI) is determined, decreasing in the direction of vertical, relative to a component of the lower thigh or, simultaneously, a requested forefoot session is determined.
    类似技术:
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    同族专利:
    公开号 | 公开日
    TWI519292B|2016-02-01|
    CN104856787A|2015-08-26|
    JP5678079B2|2015-02-25|
    DE102009052887A1|2011-05-19|
    CN104856787B|2017-04-12|
    JP2013510605A|2013-03-28|
    EP2772232B1|2017-04-26|
    BR112012011415A2|2020-09-08|
    EP2498727B1|2014-10-22|
    RU2572741C2|2016-01-20|
    RU2012124096A|2013-12-20|
    EP2772232A3|2014-10-22|
    WO2011057795A1|2011-05-19|
    CN102740803A|2012-10-17|
    CN102740803B|2015-04-22|
    EP2772232A2|2014-09-03|
    US20120226364A1|2012-09-06|
    DE102009052887B4|2016-09-15|
    TW201125547A|2011-08-01|
    CA2779784A1|2011-05-19|
    EP2498727A1|2012-09-19|
    CA2779784C|2017-07-11|
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    法律状态:
    2020-10-06| B06F| Objections, documents and/or translations needed after an examination request according [chapter 6.6 patent gazette]|
    2020-10-13| B06U| Preliminary requirement: requests with searches performed by other patent offices: procedure suspended [chapter 6.21 patent gazette]|
    2021-03-09| B09A| Decision: intention to grant [chapter 9.1 patent gazette]|
    2021-05-25| B16A| Patent or certificate of addition of invention granted [chapter 16.1 patent gazette]|Free format text: PRAZO DE VALIDADE: 20 (VINTE) ANOS CONTADOS A PARTIR DE 12/11/2010, OBSERVADAS AS CONDICOES LEGAIS. PATENTE CONCEDIDA CONFORME ADI 5.529/DF |
    优先权:
    申请号 | 申请日 | 专利标题
    DE102009052887.3|2009-11-13|
    DE102009052887.3A|DE102009052887B4|2009-11-13|2009-11-13|Method for controlling an orthotic or prosthetic joint of a lower extremity|
    PCT/EP2010/006896|WO2011057795A1|2009-11-13|2010-11-12|Method for controlling an orthotic or prosthetic joint of a lower extremity|
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