lllillflllfllllllllllllllliilllliillilfllllllfl
`
`USOOS759 165A
`
`United States Patent
`
`[191
`
`[11] Patent Number:
`
`5,759,165
`
`[45] Date of Patent: Jun. 2, 1998
`Malewicz
`
`
`
`-1.503.I11
`4.520.801
`4,538.6(X}
`4565.l9t}
`4.633.867
`4.651.000
`4.726361
`4.733.252
`4.317.588
`4.84-1.05?
`4.862.378
`5203.766
`5.407.420
`
`.
`
`-1-‘I935 Hepburn.
`6/1985 DiGeorge.
`931985 Hepburn .
`H1936 Pimiantgen et al.
`H1987 Kausek et a].
`.
`4/198? Hepburn .
`2-F1933 Farley .
`-M988 Friddle el al.
`431989 Bledstae.
`711989 Ho)".
`931989 Davison eta]. _
`411993 Carter cl :1].
`.............................. 60Qf2l
`-331995 Bastyr et al.
`....................... .. 502320 X
`
`_
`
`FOREIGN PATENT DOCLMENFS
`
`1426-530-A 211937 U.S.S.R. .
`
`Primai-_r EXa'mt'fl¢’.-"—-RiCi1a.l‘d J. Apley
`Assistant Examiri.-3r—Kim M. Lee
`Artome}; Agent, or Firm-—Kinncy 8.: Lange. BA.
`
`[57]
`
`ABSTRACT
`
`A range-of~motion orthosis for applying torque across a
`forearm of a patient is disclosed. The orthosis includes a
`support hook for supporting a hand of the patient. First pivot
`means pivotally connects the support hook to a forearm
`bracket. The forearm bracket
`includes first and second
`portions interconnected at an angle of between 80° and 100°.
`Second pivot means pivotally connects the forearm bracket
`to an upper arm bracket such that the first portion of the
`forearm bracket is capable of rotation about an axis inter-
`secting the second pivot means. A first upper arm hook is
`connected to the upper arm bracket for supporting an upper
`arm of the patient. Torque applying means interconnects the
`forearm bracket and the upper arm bracket and applies
`torque between the forearm bracket and the upper arm
`bracket. thereby rotating the first portion of the forearm
`bracket about the axis intersecting the second pivot means.
`
`
`
`_
`
`22 Claims. '1' Drawing Sheets
`
`[S4] FOREARM SUPINATION RANGE-O53
`MOTION ORTHOSIS
`
`[75]
`
`Inventor: Andrzej M.Ma1ewicz. Minneapolis.
`Minn.
`
`[73] Assignee: Empi, Inc.. St. Paul. Minn.
`
`[21] Appl. No.: 597.667
`
`[22]
`
`Filed:
`
`Feb. 7., 1996
`
`Related U.S. Application Data
`
`[63] Continuation-in-pan of Ser. No. 338,482. Feb. 14. 1995. Pat.
`No. 5.520.625. which is a cotitinuation-in-part of Ser. No.
`205.837. Mar. 4. 1994. Pat. No. 5.437.619. which is a
`continuation-in-part of Ser. No. 85.753. Jun. 30. 1993. Pat.
`No. 5.399.i54.
`
`A6lF 5100
`Int. Cl.‘
`{SI}
`.. 60231: 602!16
`[52] U.S. Cl.
`
`623/18. 20. 39:
`[58] Field of Search
`432x127. ‘l'."1‘i5'.:'.60E.-I-5-. 16. 20. 21. 23. 26.
`27; 4732464. 615. 513. 474. 453. 412. 207.
`22. S9. 63
`
`[56]
`
`References Cited
`ILS. PATENT DOCUMENTS
`
`3.-‘I932 Dresser.
`1.847.823
`271946 Svoboda.
`2,395,763
`.
`3.086.521 M1963 Desai et a1.
`4.130.870
`H1980 Radulovic cl I11.
`4.252.I ll
`2111981 Chao el al.
`.
`4.280.490
`711981 Samy
`4,397,308
`8.11933 Hepburn.
`4.433.679
`231984 Mauldin et al.
`4.456.002
`E91984 Barber :21 al. .
`4.485.803 131984 Hepburn .
`4.439.718
`12.11984 Martin _
`4.493.316
`H1935 Rood et. 2].
`
`.
`
`.
`
`632316
`
`

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`U.S. Patent
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`Jun. 2, 1998
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`Sheet 1 of 7
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`5,759,165
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`LANTZ 1008.2
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`U.S. Patent
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`Jun. 2, 1998
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`Sheet 2 of 7
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`5,759,165
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`-uh
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`mhl.“H.3041;..-l;!-z
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`<om$4«mom
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`mm
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`LANTZ 1008.3
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`

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`U.S. Patent
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`Jun. 2, 1998
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`Sheet 3 of 7
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`5,759,165
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`LANTZ 1008.4
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`U.S. Patent
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`Jun. 2, 1998
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`Sheet 4 of 7
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`5,759,165
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`713%.
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`A
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`E./‘iL.l.«|
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`po.a1—____"_"_.u
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`LANTZ 1008.5
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`U.S. Patent
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`Jun. 2, 1998
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`Sheet 5 of 7
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`5,759,165
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`LANTZ 1008.6
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`U.S. Patent
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`Jun. 2, 1993
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`Sheet 6 of 7
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`5,759,165
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`LANTZ 1008.7
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`

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`U.S. Patent
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`Jun. 2, 1998
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`Sheet 7 of 7
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`5,759,165
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`LANTZ 1008.8
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`

`
`1
`FOREARM SUPINATION RANGE-OF-
`MOTION ORTHOSIS
`
`REFERENCE TO RELATED APPLICATIONS
`
`This application is a continuation-in-part of commonly
`assigned U.S. patent application Ser. No. 08/388.482. filed
`Feb. 14. 1995. now U.S. Pat. No. 5.520.625 entitled
`“RANGE-OF-MOTION WRIST SPLINT”. which is a
`continuation—in-part of Ser. No. 205.837. filed Mar. 4. 1994.
`now commonly assigned U.S. Pat. No. 5.437.619. granted
`1. 1995. entitled “RANGE—OF-MOTION SPLINT
`WITH ECCENTRIC SPRING". which is a continuation-im
`part of Ser. No. 085.758. filed Jun. 30. 1993. now commonly
`assigned U.S. Pat. No. 5.399.154. granted Mar. 21. 1995.
`entitled “CONSTANT TORQUE RANGE-OF—MOTION
`SPLINT”.
`
`BACKGROUND OF THE INVENTION
`
`The present invention relates to orthosis assemblies. and
`more particular to dynamic orthoses or braces for applying
`torque across a limb undergoing rehabilitative therapy.
`Injury or surgery to human joints. such as wrists and
`elbows. often result in flexion or extension contractures.
`These debilitating conditions prevent the patient from fully
`flexing (in the case of an extension contracture) or extending
`(in the case of a flexion contracture) the injured joint.
`Range—of-motion (ROM) orthoses are dynamic devices
`commonly used during physical rehabilitative therapy to
`increase the range-of-motion over which the patient can flex
`or extend the joint. Orthoses of this type are known. and
`disclosed. for example. in U.S. Pat. No. 5.399.154 entitled
`“CONSTANT TORQUE RANGE-OF-MOTION SPLINT"
`and in U.S. Pat. No. 5.437.619 entitled “RANGE-OF-
`MOTION SPLINT WITH ECCENTRIC SPRING".
`
`Commercially available ROM orthoses typically include
`spring loaded brace or bracket sections or applying torque to
`the insured joint in opposition to the contracture. This force
`tends to gradually increase the working range or angle of
`joint motion. Springs. however. are passive devices and
`exert decreasing amounts of force as they retract. Most
`ROM orthoses. therefore. require continual adjustment to
`maintain a constant amount of applied torque as the patient’s
`range of joint motion increases during therapy. These torque
`adjustment procedures are time consuming and inconve-
`merit.
`
`In addition. with respect to an injury to a patient’s wrist
`or elbow. the forearm of the patient is often immobilized for
`a significant length of time. Thus. in addition to the wrist and
`elbow sufiering from flexion or extension contractures. the
`connecting tissue surrounding the forearm have become
`debilitated.
`
`The forearm is made up of two separate bones: the ulna
`bone and the radius bone. The ulna bone is a long bone
`positioned at the inner side of the forearm. while the radius
`bone is a shorter bone positioned at the outer side of the
`forearm. The two bones interconnect at their upper extremi-
`ties near the elbow joint and at their lower extremities near
`the wrist joint.
`When a patient’s forearm has been immobilized for a
`significant length of time. the connecting tissue surrounding
`
`5.759.165
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`2
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`painful. It is necessary to provide low level stretching of the
`connecting tissue surrounding the ulna and radius bones of
`the forearm so that pronation and supination is again pos—
`sible.
`Therefore. it is evident that there is a continuing need for
`an improved ROM orthosis. In particular. there is a need for
`a ROM orthosis capable of applying relatively constant
`torque over the entire working range-of-motion of the fore-
`arm to rehabilitate the connecting tissue surrounding the
`ulna and radius bones of the forearm with respect to prona-
`tion and supination. The amount of torque applied by the
`orthosis should be adjustable to suit the needs of different
`patients. The orthosis should also provide for the natural
`motion of the forearm.
`
`SUMMARY OF THE INVENTION
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`20
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`The present invention is a range-of-motion orthosis for
`providing torque across a forearm of a patient undergoing
`rehabilitative therapy. The range—of—motion orthosis is
`designed so that it provides for the natural motion of the
`forearm.
`
`The range of motion orthosis comprises a support hook
`for supporting a hand of a patient and a forearm bracket
`consisting of a first portion and a second portion. The second
`portion of the forearm bracket is connected to the first
`portion of the forearm bracket at an angle of between 80°
`and 100°. First pivot means pivotally connects the support
`hook to the forearm bracket. Second pivot means pivotally
`connects the forearm bracket to an upper arm bracket such
`that the first portion of the forearm bracket is capable of
`rotation about an axis intersecting the second pivot means.
`A first upper armhook is connected to the upper arm bracket
`for supporting an upper arm of the patient. Torque applying
`means positioned near the second pivot means applies
`torque between the forearm bracket and the upper arm
`bracket. thereby rotating the first porlion of the forearm
`bracket about the axis intersecting the second pivot means.
`In a preferred embodiment. the forearm bracket further
`comprises a first forearm telescoping bracket for connection
`to the first pivot means and a second forearm telescoping
`bracket for connection to the upper arm bracket. A forearm
`securing pin secures the first forearm telescoping bracket to
`the second forearm. telescoping bracket. Similarly. the upper
`arm bracket further comprises a first upper arm telescoping
`bracket for connection to the forearm bracket and a second
`upper arm telescoping bracket for connection to the first
`upper arm telescoping bracket. An upper arm securing pin
`secures the first upper arm telescoping bracket to the second
`upper arm telescoping bracket.
`BRIEF DESCRIPTION OF THE DRAWINGS
`
`FIG. 1 is a first perspective view of the present invention
`shown attached to an arm of a patient.
`FIG. 2 is a second perspective view of the present
`invention shown attached to the arm of the patient.
`FIG. 3 is an exploded view of the present invention.
`FIG. 4 is a sectional view of the pivotal connector of the
`present invention as shown from line 4-4 of FIG. 1.
`FIG. Sis a detailed view of the drive assembly as shown
`from line 5-5 of FIG. 4. illustrating the pivot assembly in
`a first position.
`FIG. 6 is a detailed view of the drive assembly as shown
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`5.759.165
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`3
`FIG. 8 is a pictoral view of an adjustable range—of-motion
`stop mechanism.
`FIG. 8A is a top view of the adjustable range-of-motion
`stop mechanism.
`DETAILED DESCRIPTION OF THE
`PREFERRED EMBODIMENTS
`
`The present invention relates to range-of-motion (ROM)
`orthosis 10 shown in FIGS. 1-3 for applying torque across
`a limb undergoing rehabilitive therapy. FIG. 1 is a perspec-
`tive view of ROM orthosis 10 attached to a forearm of a
`
`patient. In FIG. 1. ROM orthosis 10 is shown in a first
`position. FIG. 2 is also a perspective view of ROM orthosis
`10 attached to a forearm of a patient. FIG. 2 shows ROM
`orthosis 10 in a second position. FIG. 3 is a exploded View
`of ROM orthosis 10.
`As shown in FIGS. 1-3. ROM orthosis 10 includes
`support hook 12. support hook pad 14. first support hook
`securing straps 16. second support hook securing strap 18.
`forearm bracket 20 comprising first forearm telescoping
`bracket 22 and second forearm telescoping bracket 24. pin
`26. holes 28. pivotal connector 30. first upper arm hook 32
`second upper arm hook 34. first upper arm hook pad 36.
`second upper arm hook pad 38. first upper arm hook
`securing strap 40. second upper arm hook securing strap 42.
`upper arm bracket 44 comprising first upper arm telescoping
`bracket 46 and second upper arm telescoping bracket 48. pin
`50. holes 52. pivotal connector 54. housing 56 having handle
`58 and lock 60.
`
`As shown in FIGS. 1-3 support hook 12 is connected to
`first forearm telescoping bracket 22 Of forearm bracket 20
`via screw 62 and nut 64 (shown in FIG. 3). Support hook 12
`supports the hand of the patient. Cap 66 covers screw 62 and
`nut 64 in order to prevent any rough edges from being
`exposed. In one preferred embodiment. screw 62 and nut 64
`are replaced by a rivet. Support hook pad 14 can be either
`one pad or a series of pads. Pad 14 can be formed to the
`inside of support hook 12 and secured to support hook 12 by
`any number of methods. including the use of VELCRO
`material.
`
`First and second support hook securing straps 16 and 18
`can be secured to the outer surface of support hook 12 via
`various materials. such as Velcro material. First and second
`support hook securing straps 16 and 18 are used to secure the
`wrist and hand area of the patient to ROM orthosis 10. As
`shown in FIG. 1 first and second support hook securing
`straps 16 and 18 can be positioned about the thumb of the
`patient. This type of design provides for both proper support
`and comfort.
`
`As shown in FIGS. 2 and 3. support hook 12. with its
`accompanying support hook pad 1 is connected to first
`forearm telescoping bracket 29 via pivotal connector 30.
`Support book 12 is capable of rotation with respect to first
`forearm telescoping bracket 22 by way of pivotal connector
`30 comprising screw 69 and nut 64 positioned beneath cap
`66. The rotation of support hook 12 with respect to forearm
`bracket 20 is shown in FIG. 2 by arrows A. The amount of
`tension supplied at this pivot point can be adjusted by
`adjusting screw 62 and nut 64. Rotation of support hook 12
`about pivotal connector 30 corresponding to screw 62 and
`nut 64 allows the patient to position his hand in comfortable
`
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`holes 28. As shown in FIG. 3 pin 26 can be fastened to first
`forearm telescoping bracket 22. Thus. it is possible to adjust
`the length of forearm bracket 20 by placing pin 26 in any of
`various holes 28. The adjustable nature of forearm bracket
`20 provides that ROM orthosis 10 can be secured to any
`number of patients having various forearm lengths. This
`feature provides additional comfort for the patient.
`First upper arm book 32 is secured to first upper arm
`telescoping bracket 46 via screws 68 and nuts 70. In one
`preferred embodiment. screws 68 and nuts 70 can be
`replaced by rivets. Likewise. second upper arm hook 34 is
`connected to second upper arm telescoping bracket 48 via
`screws 72 and nuts 74. Once again in one preferred
`embodiment. screws 72 and nuts 74 can be replaced by
`rivets. First and second upper arm hook pads 36 and 38 can
`be attached to first and second upper arm hooks 32 and 34
`via a variety of means. such as the use of VELCRO material.
`First and second upper arm hook pads 36 and 38 provide
`comfort for the patient. First and second upper arm hook
`securing straps 40 and 42 are secured to first and second
`upper arm books 32 and 34 via any number of means. such
`as through the use of VELCRO material. First and second
`upper arm book securing straps 40 and 42 secure ROM
`orthosis 10 to the upper arm of the patient and provide the
`proper stability points such that ROM orthosis operates
`properly. First and second upper arm telescoping brackets 46
`and 48 are interconnected via pin 50 and holes 52 in a
`manner similar to the connection of first and second forearm
`
`telescoping brackets 22 and 24. The adjustable nature of
`upper arm bracket 44 provides that ROM orthosis 10 can be _
`secured to any number of patients having various upper arm
`lengths. This feature provides additional comfort for the
`patient.
`As shown in FIGS. 1—3. second forearm telescoping
`bracket 24 includes first and second portions connected at an
`angle of between 80 and 100 degrees. preferably 90 degrees.
`This configuration allows first forearm telescoping bracket
`22 and the first portion of second forearm telescoping
`bracket 24 to rotate about an axis which intersects pivotal
`connector 54. This rotation is shown in FIGS. I and 2 by
`arrow B. Pivotal connector 54 connects forearm bracket 20
`to upper arm bracket 44. The approximate center of the
`forearm of a patient can lie in the same axis as the axis which
`intersects pivotal connector 54. Once ROM orthosis 10 is
`properly positioned on a patient. ROM orthosis 10 can
`provide low level stretching of connecting tissue surround-
`ing the ulna and radius bones of the forearm of the patient.
`These tissues often become debilitated when a patient has
`had his arm immobilized for a significant length of time. i.e.
`a broken wrist or forearm.
`
`FIG. 4 is a sectional view of pivotal connector 54
`enclosed within housing 56 as shown from line 4—4 of FIG.
`1. As shown in FIG. 4. housing 56 encloses drive assembly
`80 which further includes pin 82. spiral spring 84. gear 86.
`gear shaft 88. recess 90 of housing 56 and adjustment worm
`92.
`
`As shown in FIG. 4. spring 84 and gear 86 are positioned
`about pivot pin 82. which also serves to permit forearm
`bracket 24 to rotate with respect to upper arm bracket 44.
`More specifically. spiral spring 84 is positioned about shaft
`88 which encompasses pivot pin 82. An inner end of spiral
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`5759.165
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`shown in FIG. 5. forearm bracket 24 is free to rotate with
`respect
`to upper arm bracket 44 to increase angle C.
`However. as shown in FIG. 6. adjustment range-of-motion
`stop mechanism 100 prevents forearm bracket 24 from
`rotating with respect to upper arm bracket 44 to increase
`angle C. Adjustable range-of-motion stop mechanism is
`used to prevent a range-of—motion which may injure the limb
`of the patient. In certain instances. a physician or clinician
`may wish to limit the range-of-motion which a patient can
`utilize.
`
`FIGS. 8 and 8A are a pictoral view and a top view of the
`range-of-motion stop mechanism used in the present
`invention. respectively. Adjustable ROM stop mechanism
`100 can be made of molded plastic. metal or any other
`suitable material. Adjustable ROM stop mechanism 100
`includes series of grooves 102. slot 104. back 106 and
`handle 108. Series of grooves 102 interacts with rack 124
`positioned on the inner surface of housing 56 (shown in
`FIGS. 5-7) to hold adjustable ROM stop mechanism 100 in
`place. Back 106 and slot 104 have a slight arc to them such
`that they precisely conform to the outer surface of housing
`
`In use. adjustable ROM stop mechanism 100 can be
`placed at any one of a plurality of positions on housing 56.
`Forearm bracket 24 can rotate with respect to upper arm
`bracket 44 until forearm bracket 24 comes in contact with
`adjustable ROM stop mechanism 100. At this point. forearm
`bracket 24 can no longer rotate with respect to upper arm
`bracket 44.
`
`Adjustable ROM stop mechanism 140 enables a clinician
`to control the extent of rotational motion between upper arm
`bracket 44 and forearm bracket 24. This is necessary to
`prevent damage to the connecting tissue surrounding the
`ulna and radius bones of the forearm of the patient due to
`overextension.
`
`As shown in FIGS. 4 and 7. a torque adjustment mecha-
`nism is shown which includes adjustment worm 92 having
`end 110. crank 112 having handle 58. and pivot 114.
`As shown in FIGS. 4 and 7. adjustment worm 92 is
`mounted within recess 90 of housing 56 for engagement
`with gear 86. End 110 of adjustment worm 92 extends
`through housing 56 and is connected to crank 112 by pivot
`pin 114. Crank 112 is configured for pivotal movement about
`a retracted posifion adjacent housing 56 (shown in solid
`lines). and an extended position (shown in broken lines).
`When in the extended position. handle 58 of crank 112 can
`be actuated to rotate adjustment worm 92 which is rotatably
`connected to upper arm bracket 44. thereby rotating gear 86
`rotatably connected to upper arm bracket 44 to wind and
`unwind spiral spring 84 in order to increase and decrease the
`amount of torque applied across upper arm bracket 44 and
`forearm bracket 24 by spring 84. Gear 86. adjustment worm
`92 and crank 112 thereby function as a torque adjustment
`mechanism.
`
`FIGS. 4 and 7 show locldng mechanism 120 which can
`releasably lock upper arm bracket 44 and forearm bracket 24
`with respect to one another. Locking mechanism 120. con-
`nected to forearm bracket 24. includes pawl 122. rack 124.
`lock lever 60 and base member 128 having handle 130. Pawl
`122 is actuated by lock lever 60 which includes base
`member 128 and handle 130. Base member 128 is mounted
`
`6
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`pawl 122 is in the disengaged position. upper arm bracket 44
`and forearm bracket 24 can freely rotate with respect to one
`another. Conversely. when pawl 122 is in the engaged
`position. pawl 122 is biased into engagement with rack 124
`such that upper arm bracket 44 and forearm bracket 24 are
`incapable of rotation.
`Locking mechanism 120. connected to forearm bracket
`24. enables upper arm bracket 44 and forearm bracket 24 to
`be conveniently and rigidly locked with respect to one
`another at any desired position within the range-of-motion
`of orthosis 10. In one embodiment. the teeth forming rack
`124 are symmetrical or bi-directional. Housing 56 can
`therefore be used on range—of—motion orthosis 10 configured
`for both supination and pronation contractures of an elbow
`15 joint.
`Although the present invention has been described with
`reference to preferred embodiments. workers skilled in the
`art will recognize that changes may be made in form and
`detail without departing from the spirit and scope of the
`invention.
`What is claimed is:
`1. A range-of—motion orthosis adapted to apply torque to
`a forearm of a patient. the orthosis comprising:
`a support hook adapted to support a hand of the patient;
`a forearm bracket;
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`connection means for connecting the forearm bracket to
`the support hook;
`an upper arm bracket;
`21 first upper arm hook connected to the upper arm bracket;
`a second upper arm hook connected to the upper arm
`bracket;
`
`pivot means pivotally connected to the upper arm bracket
`and the forearm bracket such that the forearm bracket
`rotates about a longitudinal axis of the forearm; and
`torque applying means connected to the forearm bracket
`and the upper arm bracket for applying torque to the
`forearm bracket such that the forearm bracket rotates
`about a longitudinal axis of the forearm.
`2. The range-of-motion orthosis of claim 1 wherein the
`connection means further comprises:
`
`support hook pivot means for pivotally connecting the
`forearm bracket to the support hook such that the
`support hook can rotate with respect to the forearm
`bracket about the support hook pivot means.
`3. The range-of-motion orthosis of claim 1 wherein the
`forearm bracket further comprises:
`a first forearm telescoping bracket for connection to the
`first pivot means;
`a second forearm telescoping bracket having a first por-
`tion and a second portion. wherein the first portion is
`connected to the second portion at an angle of between
`80° and 100°;
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`a forearm securing pin for securing the first forearm
`telescoping bracket to the second forearm telescoping
`bracket;
`wherein the first portion of the second forearm telescop-
`ing bracket interconnects with the upper arm bracket
`via the second pivot means. and wherein the second
`portion of the second forearm telescoping bracket inter-
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`4. The range-of-motion orthosis of claim 1 wherein the
`upper arm bracket further comprises:
`a first upper arm telescoping bracket for connection to the
`forearm bracket; and
`
`a second upper arm telescoping bracket for connection to
`the first telescoping bracket; and
`an upper arm securing pin for securing the first upper arm
`telescoping bracket to the second upper arm telescop-
`ing bracket.
`5. The range-of—motion orthosis of claim 1 and further
`comprising:
`a support hook securing means connected to the support
`hook adapted to secure the support hook to a hand of
`the patient;
`a first upper arm hook securing means connected to the
`first upper arm hook adapted to secure the first upper
`arm hook to an upper arm of the patient; and
`a second upper arm hook securing means connected to the
`second upper arm hook adapted to secure the second
`upper arm hook to the upper arm of the patient.
`6. The range—of~motion orthosis of claim 5 and further
`comprising:
`a support hook pad connected to the support hook;
`a first upper arm hook pad connected to the first upper arm
`hook: and
`a second upper arm hook pad connected to the second
`upper arm hook.
`7. The range-of-motion orthosis of claim 1 wherein the
`torque applying means further comprises:
`a spiral spring having an inner end and an outer end for
`applying torque between the forearm bracket and the
`upper arm bracket. the inner end mounted to the upper
`arm bracket and the outer end mounted to the forearm
`bracket.
`8. The range-of—motion orthosis of claim 7 and further
`comprising:
`a torque adjustment mechanism for adjusting the torque
`applied by the spiral spring between the forearm
`bracket and the upper arm bracket.
`9. The range-of-motion orthosis of claim 8 wherein the
`torque adjustment mechanism further comprises:
`a gear rotatably connected to the upper arm bracket such
`that the inner end of the spring is connected to the gear;
`and
`
`an adjustment worm rotatably connected to the upper arm
`bracket and engaged with the gear for rotating the gear
`to adjust the tension of the spiral spring.
`10. The range-of-motion orthosis of claim 8 and further
`comprising:
`a cover connected to the upper arm bracket for enclosing
`the spiral spring and the torque adjustment mechanism;
`and
`
`a handle connected to the adjustment worm and capable
`of movement between a retracted position adjacent the
`cover and an expanded position. such that the handle
`can rotate the adjustment worm when in the extended
`position.
`11. The range-of-motion orthosis of claim 10 and further
`comprising:
`a locking mechanism connected to the forearm bracket for
`
`10
`
`15
`
`20
`
`25
`
`30
`
`35
`
`40
`
`45
`
`50
`
`55
`
`a rack positioned on an inner surface of the cover;
`a pawl pivotally connected to the forearm bracket for
`releasable engagement with the rack‘. and
`a lever connected to the pawl and extending from the
`cover for actuating the pawl.
`13. A range-of—motion orthosis for applying torque to a
`forearm of a patient. the orthosis comprising:
`a support hook adapted to support a hand of the patient:
`a forearm bracket comprising:
`a first portion: and
`a second portion connected to the first portion at an
`angle of between 80° and 100°;
`first pivot means for pivotally connecting the support
`hook to the first portion of the forearm bracket:
`an upper arm bracket;
`second pivot means pivotally connected to the second
`portion of the forearm bracket and the upper arm
`bracket such that the first portion of the forearm bracket
`rotates about a longitudinal axis of the forearm;
`a first upper arm hook connected to the upper arm bracket
`for supporting an upper arm of the patient; and
`torque applying means connected to the forearm bracket
`and the upper arm bracket for applying torque to the
`forearm bracket such that the forearm bracket rotates
`about a longitudinal axis of the forearm.
`14. The range—of-motion orthosis of claim 13 wherein the
`first portion of the forearm bracket further comprises:
`a first forearm telescoping bracket for connection to the
`first pivot means;
`a second forearm telescoping bracket for connection to
`the second portion of the forearm bracket; and
`a forearm securing pin for securing the first forearm
`telescoping bracket to the second forearm telescoping
`bracket.
`
`15. The range-of-motion orthosis of claim 13 wherein the
`upper arm bracket further comprises:
`a first upper arm telescoping bracket for connection to the
`forearm bracket;
`a second upper arm telescoping bracket for connection to
`the first upper arm telescoping bracket; and
`an upper arm securing pin for securing the first upper arm
`telescoping bracket to the second upper arm telescop-
`ing bracket.
`16. The range-of-motion orthosis of claim 13 and further
`comprising:
`a support hook securing means connected to the support
`hook for securing the support hook to a hand of the
`patient;
`a first upper arm hook securing means connected to the
`first upper arm hook for securing the first upper arm
`hook to an upper arm of the patient;
`a second upper arm hook connected to the upper arm
`bracket for supporting the upper arm of the patient;
`a second upper arm hook securing means connected to the
`second upper arm hook for securing the second upper
`arm hook to the upper arm of the patient;
`a support hook pad connected to the support hook;
`a first upper arm hook pad connected to the first upper arm
`
`LANTZ 1008.12
`
`

`
`5.759.165
`
`9
`a spiral spring having an inner end and an outer end for
`aPP1YiI18 tofque b¢tW€¢n
`the f0l‘¢31'm bracket and th6
`“PP€1' arm bfackefi [ha inn” end m°”“‘°d to the UPPCT
`arm bracket and the outer end mounted to the forearm
`bracket.
`18. The range—of—motion orthosis of claim 17 and further
`comprising:
`a torque adjustment mechanism for adjusting the torque
`applied by the spiral spring between the forearm
`brackct and 315 "PPCI 3”“ bfackct
`19. The range-of~motion orthosis of claim 18 wherein the
`torque adjustment mechanism further comprises:
`a gear romiably Connected to he .uppCr arm bracket Such
`that the inner end of the spring 1S connected to the gear;
`and
`an adjustment worm rotatably connected to the upper arm
`mack?‘ and °“3a3Fd with the 3?” forfotaung the gear
`to adjust the tango.“ of the SP1“! Spring‘
`20. The range—of-motion orthosis of claim 19 and further 20
`comprising:
`a cover connected to the upper arm bracket for enclosing
`the spiral spring and the torque adjustment mechanism;
`and
`
`10
`
`5
`
`10
`a handle connected to the adjustment worm and capable
`of movement between a retracted position adjacent the
`cover and an expanded position. such that the handle
`can rotate the adjusment worm when in the extended
`position
`,
`_
`_
`'
`21. The range-of-motion orthosis of claim 20 and further
`Compnsmg:
`a locking mechanism connected to the forearm bracket for
`releasably engaging the cover and locking the angular
`Position of me forearm bracket with respect to thc
`upper arm bracket
`22. The range—of—motion orthosis of claim 21 wherein the
`,
`,
`,
`15 locking mechanism further comprises:
`8 rack P0Siti0I1Cd 011 all iflllfif Sl1I’f3C€ Of the COVCY;
`a pawl pivotally connected to the ‘forearm bracket for
`releasable engagement with the rack’ and
`‘
`a lever connected to the pawl and extending from the
`COVCI f0I actuating 316 PaW1~
`
`:1:
`
`as
`
`>1:
`
`:4:
`
`we
`
`LANTZ 1008.13