METHOD FOR MANUFACTURING ORTHOPEDIC APPARATUS OF LOWER EXTREMITY FOR PATIENTS WITH CONSEQUENCES OF PARALYSIS OF LOWER EXTREMITIES Russian patent published in 2023 - IPC A61H3/00 A61F5/00 A61B5/103 A61N1/00 

FIELD: medicine.

SUBSTANCE: method for manufacturing an orthopedic apparatus of the lower extremity for patients with the consequences of paralysis of the lower extremities, which consists in manufacturing, in accordance with medical indications, a lower extremity orthopedic apparatus (LEOA) prescribed to the patient, containing a link for its attachment to the body, a hip link, connected by a hip joint to the axis, a shin link, connected to the thigh link by knee joints with an axis, ankle joints with an axis, connected at the top to the shin sleeves, and the bottom - to the foot link, which has a rigid plantar plate, including the metatarsophalangeal and interphalangeal sections, an electrical stimulator with a power source and cutaneous electrodes, installed in the area of one of the joints, as well as electric drives of hinge joints with axes with a control system and an external energy source. Preliminarily (in the beginning), plaster negatives are made, and from them plaster positives of the thigh and lower leg segments with the foot of the patient’s lower extremity are made. Their centers of mass are determined in projection onto the sagittal plane. A LEOA is manufactured with an electrical stimulator and cutaneous electrodes, and electric drives for articulated joints. The centers of mass of the links of the thigh and lower leg with the foot of the LEOA are determined, and they are combined with the centers of mass of the plaster casts of the thigh and lower leg with the foot, respectively. A simulating device of the lower extremity is manufactured, which has adjustable weight and length parameters of the lower extremity, hip, knee, and ankle axes. The centers of mass of the hip and shin links with the foot of the device are set in accordance with the centers of mass of the plaster positive segments of the hip and shin with the patient’s foot. The frequency of natural vibrations of the links of the lower extremity simulator device is determined. Adjust the position of the leg link with the foot. The frequency of natural vibrations of the lower leg and foot link is determined. The manufactured LEOA is installed on a lower extremity simulator, the frequency of natural vibrations of the lower extremity link with the foot of the lower extremity simulator with the lower extremity link with the LEOA foot is determined, the position of the center of mass of the shin link with the LEOA foot is adjusted by changing the location of the masses of parts and assemblies in the lower leg link and the foot link, knee joint unit, moving the installation site of the drives, bringing the frequency of natural vibrations of the lower leg and hip joint of the knee joint closer to the frequency characteristic of the arbitrary walking pace of an average person with similar medical indications and anthropometric data. The degree of pathological damage to the muscles of the lower extremity is determined and the stiffness of the anterior and posterior hip, knee and ankle elastic elements is selected depending on the degree of damage, in proportion to the degree of damage. Then the rear and front adjustable ankle supports with rear and front counter-supports are installed on the lower leg and foot links. A rear automatic adjustable knee support is installed on the shin link and connected to the control system. A hip link counter support is installed on the hip link at the back. Consoles are installed on the shin and thigh links in front. A rear adjustable hip support is placed at the top of the hip link at the back. A rear body support is installed on the rear surface of the body fastening link. An adjustable stop is installed on the front surface of the thigh link. The fastening link on the body has a front body support. Then the elastic elements are made and installed on the rear and front adjustable ankle pads, on the rear automatic adjustable knee pad, on the console, on the rear adjustable hip pad and the adjustable pad in accordance with the previously determined stiffnesses. The plantar plate is made of a composite material that is rigid in the heel region, arch-shaped in the central part and elastically flexible in the form of plates in the area of the metatarsophalangeal and interphalangeal areas. A knee joint is made with a polycentric axis of rotation in the form of a cycloid, the initial instantaneous point of rotation of which is at least 10 mm away from the instantaneous point of rotation at a flexion angle in the knee joint of 60 degrees. The center of the axis of the hip hinged joint is aligned with the center of the axis of the hip joint. The instantaneous center of rotation of the axis of the polycentric knee hinged joints in the straightened position is combined with the conditional center of the axis of the knee joint in the straightened state, and the centers of the axes of the ankle hinged joints are combined with the centers of the ankle joint axis.

EFFECT: increase in motor functions when a patient walks in a lower extremity orthopedic apparatus (LEOA) with the consequences of spastic, flaccid paralysis, paresis of the lower extremities, accompanied by pathological conditions, contractures in the joints, decreased motor functions, optimization of biomechanical characteristics in the emerging biotechnical system (BTS) LEOA-lower limb, such as the mass-inertial characteristics of the links, the components of the moments of external forces due to the recovery of energy by elastic elements in the hip, knee and ankle joints and the metatarsophalangeal and interphalangeal sections of the foot link, the elimination of immobilization in the metatarsophalangeal and interphalangeal joints of the foot, compliance alignment of the knee hinged joint and the knee joint, elimination of piston movements of the limb in the LEOA, optimization of the construction scheme, which helps to improve motor functions and thereby increase the level of rehabilitation, mobility, activity in everyday life, reduce disability, and severe limitations in life.

1 cl, 13 dwg, 1 ex