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Device for equilibrium restoration with cerebellar ataxia

Device for equilibrium restoration with cerebellar ataxia
IPC classes for russian patent Device for equilibrium restoration with cerebellar ataxia (RU 2328261):
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FIELD: medicine; neurology.

SUBSTANCE: device for equilibrium restoration with cerebellar ataxia comprises shoes fixed on ellipse-shaped support platform. By ends platform is furnished with fixed angles with mounted rigid metallic rods which are fixed with opposite ends to metallic collar, fastened at a height of upper leg one-third with retainer and holes in upper part of rigid metallic rods.

EFFECT: elimination of talocrural walking and increased walking stability.

2 tbl, 4 dwg, 1 ex

 

The invention relates to medicine, namely, neurology, means to restore the balance in cerebellar ataxia.

Known methods of recovery of the equilibrium function in cerebellar ataxia, aimed at training of balance through exercises based on maintaining balance in different positions of the body, walking on uneven ground, walking with increasing body mass (jarocki A.I. Techniques active workout balance. M.: Medicine, 1943), and passive exercise of the equilibrium function using support devices: canes, crutches (Kogan OG, Naydin V.L. Medical rehabilitation in neurology and neurosurgery. M.: Medicine, 1988). The disadvantages of these methods of rehabilitation are low efficiency and high complexity.

The closest in technical essence to the proposed solution is to walk in the playpen and Walker [A. Belov. Neurorehabilitation. M: The Antidoron, 2002). The disadvantage of these devices are high complexity and low efficiency correction of the equilibrium function.

Object of the invention is a device that provides an effective improvement of the equilibrium function in cerebellar ataxia.

The problem is solved in that the device is used, representing the training is ΓΌ, rigidly mounted on the support platform, having the shape of an ellipse (length 40 cm, width 30 cm). The edge of the platform, firmly by fastening to metal parts, using hard metal rods, which are located at the edges of the platform, fastened with metal screws to a metal cuff on the upper third of the leg of the patient. Metal cuff attached to the tibia with a hard lock. Between the metal sleeve and the surface of the skin of the lower leg are felt pads. Hard rods closer to the metal cuff, there are openings 4 on each side, allowing you to adjust the location of the metal cuffs always at the level of the upper third of the leg.

Device for the recovery of the equilibrium function in cerebellar ataxia is illustrated by drawings: figure 1 is a front view, figure 2 - rear view, figure 3 is a side view, figure 4 is a top view, with 1 shoes, 2 - supporting platform, 3 - metal area, 4 - metal hard thrust, 5 - metal bolt, 6 - metal cuff, 7 - hard latch, 8 - felt strip, 9 - holes on the hard metal rods.

This device is also illustrated by copies of the photos, where figure 1 - front view, figure 2 - rear view, figure 3 is a side view, figure 4 is a top view.

The invention implemented in the form of the device, assuming the shining shoes (1), rigidly mounted on the support platform (2)having the shape of an ellipse (length = 40 cm, W = 30 cm). The edge of the platform, firmly by fastening to metal parts (3), using hard metal rod (4), located on the edges of the platform (2), fixed with metal screws (5) on a metal cuff (6) at the upper third of the leg of the patient. Metal cuff (6) attached to the tibia using a rigid retainer (7). Between the metal sleeve and the surface of the skin of the lower leg are felt pads (8). Hard rods (4), closer to the metal cuff (6), holes (9) on 4 on each side, allowing you to adjust the location of the metal cuff (6) is always at the level of the upper third of the leg.

Device for the recovery of the equilibrium function in cerebellar ataxia works as follows: the patient's shoes (1)rigidly mounted on a support platform (2)on both legs. Metal cuff (6) via a rigid retainer (7) mounted on the upper third of the leg of the patient. This device allows the patient to effectively maintain balance when standing and walking due to the exclusion of the ankle strategy and increase the area of support.

The device was used for the rehabilitation of patients with dysfunction of the balance in cerebellar ATA is these. The patient in the proposed device trains the balance in standing position (duration of exercise is 10 minutes of exercising every day, 2 times a day with open and closed eyes, treatment for 1 month) and when you walk (duration is 20 minutes of exercising daily, 2 times a day at an arbitrary rate, treatment 1 month).

An example of using the inventive device to restore balance in cerebellar ataxia.

Patient M. 40 years. Man. Diagnosis: Anomaly Arnold-Chiari II Art. with the leading syndrome of cerebellar ataxia. The patient complained of feeling dizzy, feeling of unsteadiness and instability when walking.

The first symptoms of the disease appeared in 19 years. The patient was long on the observation of the neurologist on a residence diagnosed with Multiple sclerosis, cerebral form with the leading syndrome cerebellar ataxia, slowly progressive course. Regularly received courses of rehabilitation and maintenance therapy for this disease. 10 years ago was carried out magnetic resonance imaging study of the brain - and has a real diagnosis. At the time of inspection in the neurological status are identified: Srednerussky horizontal nystagmus, more to the right, semanticmediawiki speech. Diffuse hypotonia muscle Diazoketones in the right hand. When performing the finger-nasal samples detected light intention without a clear difference between the parties. When performing knee-heel specimen dysmetria right. A positive test Orzechowski. In the Romberg expressed shakiness in all directions. Ataxic gait and broad-based.

The equilibrium at the test of standing balance (Standing Balance, R.Bohanon, 1989; D.Wade, 1992, as cited in Beebe A.M. Neurorehabilitation. M: the Antidoron, 2002) was estimated at 2 points moderate (patient able to stand on spaced legs more than 30 seconds, but may not be in position "feet together". When the test FUNCTIONAL MOBILITY ASSESSMENT IN PATIENTS on .Tinnetti, 1986, as cited in A. Belov. Neurorehabilitation. M: the Antidoron, 2002) the state of equilibrium subscales stability was estimated at 10 points, which corresponds to a significant degree of imbalance, and the subscales of gait in 12 points, which corresponds to moderate violations of the equilibrium state. Data stabilometric study patient are listed in table 1.

Table 1
The average computer stabilometry patient M. syndrome of cerebellar ataxia to treatment. P=0,95
The obtained results Regulatory indicators
a/b 1,4+/-0,19 2,2+/-0,18
Rx (mm) 4,8+/and-0.6 1,09+/-0,28
Ry (mm) 2,03+/-0,66 2,95+/-0,46
L (mm) 2068,29+/-135,24 527,64+/-30,58
S (mm 2) 1436,69+/-274,82 373,31+7 through 58,52
V (mm/s) 49,7+/-2,76 41,54+/-2,36

Where a/b - eccentricity of the ellipse (the ratio of the long axis of the ellipse to short; Rx is the distance between the real and the ideal center of pressure in the frontal plane; Ry (mm) - distance between the real and the ideal center of pressure in the sagittal plane; S is the average size of stabilogram; L - total length of stabilogram. There is a gross reduction of eccentricity ellipse by 59%due to the increase of the amplitude of oscillations of the center of pressure in the frontal plane, the increase in average 4 times the average square stabilogram and 3.8 times the total length of stabilogram.

The patient underwent a course of treatment offered by the device within 1 month. After a course of rehabilitation was noted improvement in health as reduce the feeling of dizziness and unsteadiness when walking, pohod is becoming more sustainable. The clinical picture is decreased symptoms of cerebellar ataxia. The test of standing balance (Standing Balance, R.Bohanon, 1989; D.Wade, 1992, as cited in A. Belov. Neurorehabilitation. M: the Antidoron, 2002)) the equilibrium was assessed at 3 points, which corresponds to a mild degree (the patient is able to stand in the position of "feet together", but less than 30 seconds). When the test FUNCTIONAL MOBILITY ASSESSMENT IN PATIENTS on M Tinnetti, 1986 (cited by A. Belov. Neurorehabilitation. M: the Antidoron, 2002) the state of equilibrium subscales stability and gait were evaluated in 18 points, which corresponds to a mild degree of imbalance. Data stabilometric study of the patient after treatment are given in table 2.

Table 2
The average computer stabilometry patient M after treatment. P=0,95
Indicators the computer stabilometry The obtained results Regulatory indicators
a/b 2,0+/-0,19 2,2+/-0,18
Rx (mm) 2,34+/-0,52 1,09+/-0,28
Ry (mm) 2,23+/-0,82 2,95+/-0,46
L (mm) 1068,78+/-128,3 527,64+/-30,58
736,4+/-174,62 373,31+/-58,52
v (mm/s) 42,7+/-2,8 41,54+/-2,36

According to these data, all indicators of stabilometry closer to the norm, which is characterized by improved stability of the patient.

Using this device treated 20 patients with the syndrome of cerebellar ataxia, ranging in age from 26 to 54 years.

Rehabilitation activities were carried out during the month.

Good effect of the proposed use of the device was observed in all patients: a significant reduction in the sensation of vertigo, unsteadiness of gait, and increased stability when standing and walking after the course of treatment.

The use of this device to restore equilibrium when cerebellar ataxia has the following advantages:

- reduces the severity of manifestations taxisco syndrome: dizziness, feeling of unsteadiness when walking, increase stability when standing and walking.

- eliminates ankle strategy walk, stability during walking increases.

Device for the recovery of the equilibrium function in cerebellar ataxia, characterized in that it includes shoes, rigidly mounted on a support platform having the shape of an ellipse, the edges of which is rigidly fixed to the corners, to which were attached the hard metal thrust, also fixed other ends of the metal cuff that is fixed at the level of the upper third of the leg with clamp and holes in the upper side of the hard metal rod.

 

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