# US 10,864,100 B2 · Orthopedic device including protruding members

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- Number: US 10,864,100 B2
- Document ID: US10864100B2
- Status: Granted
- Kind: B2
- Application number: 15/302,347
- Filed: 2015-04-10
- Published: 2017-02-02
- Granted: 2020-12-15
- Earliest claimed: 2014-04-10
- Assignees: President and Fellows of Harvard College
- Applicants: President and Fellows of Harvard College
- Inventors: Conor James Walsh; Alan T. Asbeck; Matthew W. Yarri; Jillian Christine Cochran; Stefano Marco Maria De Rossi
- Web page: https://patentgrep.com/patent/US10864100B2

## CPC

- A61F 5/0123: {for the knees (A61F5/0106 takes precedence)}
- A61F 5/0102: {specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations}
- A61F 5/0125: {the device articulating around a single pivot-point}
- A61H 1/024: {Knee (A61H1/0255 takes precedence)}
- A61F 2005/0137: {with two parallel pivots}
- A61F 2005/0155: {with actuating means}
- A61F 2005/0165: {with limits of movement}
- A61F 2005/0179: {with spring means}
- A61F 2005/0188: {having pressure sensors}
- A61F 2005/0197: {with spring means}
- A61H 1/0244: {Hip (A61H1/0255 takes precedence)}
- A61H 1/0266: {Foot}
- A61H 2003/001: {on steps or stairways}
- A61H 2201/0165: Damping, vibration related features
- A61H 2201/1215: Rotary drive
- A61H 2201/1238: with hydraulic or pneumatic drive
- A61H 2201/149: rotation-linear or vice versa
- A61H 2201/164: Feet or leg, e.g. pedal
- A61H 2201/1642: Holding means therefor
- A61H 2201/165: Wearable interfaces
- A61H 2201/1673: Multidimensional rotation
- A61H 2201/501: connected to external computer devices or networks
- A61H 2201/5015: using specific interfaces or standards, e.g. USB, serial, parallel
- A61H 2201/5061: Force sensors
- A61H 2201/5064: Position sensors
- A61H 2201/5069: Angle sensors
- A61H 2201/5082: Temperature sensors
- A61H 2201/5084: Acceleration sensors
- A61H 2230/505: used as a control parameter for the apparatus
- A61H 2230/605: used as a control parameter for the apparatus
- A61F: FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS (dental prosthetics A61C)
- A61H: PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY (electrotherapy, magnetotherapy, radiation therapy or ultrasound therapy A61N)

## Abstract

Orthopedic devices may include rigid members for coupling to portions of a limb that includes a joint, and a cable that couples to the rigid members and extends up to a powered element. The orthopedic devices are configured to produce beneficial forces using the rigid member and the cable, which beneficial forces are translated to the wearer. The orthopedic devices include control systems that generate control signals for controlling the powered element.

## Claims

### Claim 1

A wearable device comprising:
a pair of base mechanisms for positioning along opposite sides of a limb, each base mechanism comprising:
a base portion having a rigid first end, a rigid second end, and a central region;
the central region of the base portion for positioning proximate to an axis of rotation of a joint of the limb, wherein the central region is configured to permit rotation of the rigid first end with respect to the rigid second end; and
a first anterior protrusion extending from the rigid first end of the base portion, proximate to the central region, toward an anterior side of the axis of rotation of the joint to a first pivot point;
a second anterior protrusion extending from the rigid second end of the base portion, proximate to the central region, toward an anterior side of the axis of rotation of the joint to a second pivot point; and
a cable coupled to the first pivot point and the second pivot point;
a control system that receives input from at least one sensor indicating an occurrence of at least one event in a movement of a wearer of the wearable device and generates a responsive control signal; and
at least one powered element that receives the responsive control signal from the control system and, in response, controls a tensile force through the cable between the first pivot point and the second pivot point of each base mechanism to produce beneficial forces in the pair of base mechanisms that are translated to the wearer.

### Claim 2 (depends on 1)

The wearable device of claim 1, wherein:
the limb is a leg;
the control system, in response to first input indicating one or more of a foot strike in the leg, a forefoot contacting a ground, or a knee angle passing through an inflection point from increasing to decreasing, generates a responsive control signal that causes the at least one powered element to limit an extension of the cable or to increase the tensile force through the cable to limit a maximum separation between the first pivot point and the second pivot point of each base mechanism of the pair of base mechanisms to provide resistance to a flexion of a knee; and
the control system, in response to second input indicating a foot strike in another leg of the wearer in a descent movement, generates a responsive control signal that causes the at least one powered element to discontinue limiting the extension of the cable or to reduce the tensile force through the cable to allow an increased separation between the first pivot point and the second pivot point of each base mechanism of the pair of base mechanisms.

### Claim 3 (depends on 1)

The wearable device of claim 1, wherein:
the limb is a leg;
the control system, in response to first input indicating a beginning of an extension moment of a knee, generates a responsive control signal that causes the at least one powered element to increase the tensile force through the cable to decrease a maximum separation between the first pivot point and the second pivot point of each base mechanism of the pair of base mechanisms; and
the control system, in response to second input indicating an approach of an end of the extension moment of the knee, generates a responsive control signal that causes the at least one powered element to reduce the tensile force through the cable to allow an increased separation between the first pivot point and the second pivot point of each base mechanism of the pair of base mechanisms.

### Claim 4 (depends on 1)

The wearable device of claim 1, wherein:
the limb is a leg;
the control system, in response to first input indicating one or more of a foot strike in the leg, a forefoot contacting a ground, or a knee angle passing through an inflection point from increasing to decreasing in an approximately level or ascent movement, generates a responsive control signal that causes the at least one powered element to increase the tensile force through the cable to decrease a maximum separation between the first pivot point and the second pivot point of each base mechanism of the pair of base mechanisms; and
the control system, in response to second input indicating one or more of the knee angle passing through an inflection point from decreasing to increasing, a hip of the leg passing through zero degrees, or a center of mass of the wearer reaching a maximum vertical excursion in an approximately level or ascent movement, generates a responsive control signal that causes the at least one powered element to reduce the tensile force through the cable to allow an increased separation between the first pivot point and the second pivot point of each base mechanism of the pair of base mechanisms.

### Claim 5 (depends on 1)

The wearable device of claim 1, wherein the at least one powered element comprises at least one controllable clutch coupled to the cable of the base mechanism,
wherein a locked state of the at least one controllable clutch limits a maximum allowable extension of the coupled cable, thereby limiting a maximum separation between the first pivot point and the second pivot point of the same base portion, and
wherein an unlocked state of the at least one controllable clutch allows an extension of the coupled cable to vary, thereby permitting variable separation between the first pivot point and the second pivot point of the same base portion.

### Claim 6 (depends on 5)

The wearable device of claim 5, wherein the control system permits the at least one controllable clutch to be manually unlocked.

### Claim 7 (depends on 1)

The wearable device of claim 1, wherein the control system further comprises:
at least one memory; and
at least one processing unit configured to execute instructions stored in the at least one memory, to cause the wearable device to:
compute a joint angle of the joint in response to the input from the at least one sensor; and
generate the responsive control signal based, at least in part, on the computed joint angle.

### Claim 8 (depends on 7)

The wearable device of claim 7, further comprising at least one sensor configured to provide data indicative of at least one of the joint angle, a muscle activation condition, a pressure on a foot during a gait cycle, an instance in time that a foot strikes a surface during a gait cycle, or the tensile force in each cable.

### Claim 9 (depends on 7)

The wearable device of claim 7, further comprising at least one sensor configured to provide input indicative of gait for the wearer of the wearable device, wherein the joint angle is computed based on data indicative of gait.

### Claim 10 (depends on 9)

The wearable device of claim 9, wherein the input indicative of gait comprises data indicative of a gradient of descent of the wearer.

### Claim 11 (depends on 1)

The wearable device of claim 1, further comprising at least one standoff protrusion positioned at the central region of a first base mechanism of the pair of base mechanisms and/or the central region of a second base mechanism of the pair of base mechanisms, for maintaining the cable of each base mechanism separated at a distance from the axis of rotation of the joint.

### Claim 12 (depends on 1)

The wearable device of claim 1, wherein the control system is further configured to generate a control signal that causes the at least one powered element to control the tensile force through the cable between the first pivot point and the second pivot point such that a resistive torque is applied to the limb on detection of a signal indicating a flexion of the limb or a signal indicating a degree of flexion of the limb maintained for a period of time greater than a predetermined threshold.

### Claim 13 (depends on 1)

The wearable device of claim 1, further comprising at least one sensor unit coupled to a portion of the wearable device and/or a portion of the limb, to provide data indicative of a degree of extension or flexion of the limb.

### Claim 14 (depends on 13)

The wearable device of claim 13, wherein the at least one sensor unit is configured to provide data indicative of an angle between a proximal portion of the limb and a distal portion of the limb, thereby providing the data indicative of the degree of extension or flexion of the limb.

### Claim 15 (depends on 1)

The wearable device of claim 1, wherein the central region enables rotation of the rigid first end with respect to the rigid second end in at least one quadrant and prevents rotation of the rigid first end with respect to the rigid second end in two quadrants.

### Claim 16 (depends on 1)

The wearable device of claim 1, wherein at least one of the rigid first end and the rigid second end comprises a leaf spring.

### Claim 17 (depends on 1)

The wearable device of claim 1, wherein the first anterior protrusion is further configured as a longitudinal structure having a length that extends along the central region of the base portion towards the rigid first end.

### Claim 18 (depends on 1)

The wearable device of claim 1, wherein the second anterior protrusion is further configured as a longitudinal structure having a length that extends along the central region of the base portion towards the rigid second end.

### Claim 19 (depends on 17)

The wearable device of claim 17, wherein the longitudinal structure is a padded structure.

### Claim 20 (depends on 1)

The wearable device of claim 1, wherein the at least one powered element comprises at least one actuator coupled to the cable, and wherein, in response to the control signal, the actuator may increase or decrease the tensile force through the cable between the first pivot point and the second pivot point.

### Claim 21 (depends on 1)

The wearable device of claim 1, wherein the control of an extension of the cable comprises allowing a release of the cable of each base mechanism of the pair of base mechanisms on the occurrence of at least one event indicating that the limb is extended.

### Claim 22 (depends on 1)

The wearable device of claim 1, wherein the central region comprises a series of at least three links.

### Claim 23 (depends on 22)

The wearable device of claim 22, wherein the central region enables rotation of the rigid first end with respect to the rigid second end in at least one quadrant and prevents rotation of the rigid first end with respect to the rigid second end in two other quadrants.

### Claim 24 (depends on 22)

The wearable device of claim 22, wherein each of the at least three links comprise incompressible blocks.

### Claim 25 (depends on 24)

The wearable device of claim 24, wherein the central region comprises a flexible backing that couples the incompressible blocks, and wherein the flexible backing allows the central region to bend at a junction between the blocks.

### Claim 26 (depends on 24)

The wearable device of claim 24, wherein each of the at least three links is formed with an angled portion, and wherein the at least three links are disposed relative to each other such that the angled portions of each link prevents the rotation of the rigid first end with respect to the rigid second end within at least two quadrants.

### Claim 27 (depends on 22)

The wearable device of claim 22, wherein the at least three links are coupled via pin joints.

### Claim 28

A wearable device comprising:
a pair of base mechanisms for positioning along opposite sides of a limb including a joint, each base mechanism comprising:
a base portion for positioning along a side of the opposite sides of the limb, the base portion having a rigid first end, a rigid second end, and a central region;
the central region of the base portion for positioning proximate to an axis of rotation of the joint of the limb, wherein the central region is configured to permit rotation of the rigid first end with respect to the rigid second end; and
a first anterior protrusion, configured to extend toward an anterior side of the axis of rotation of the joint, from the rigid first end of the base portion proximate to the central region to a first pivot point;
a second anterior protrusion, configured to extend toward an anterior side of the axis of rotation of the joint, from the rigid second end of the base portion proximate to the central region to a second pivot point;
a cable coupled to the first pivot point and the second pivot point and capable of exerting a tensile force between the first anterior protrusion and the second anterior protrusion; and
at least one resilient component selected from the group consisting of a first resilient component coupled to the first anterior protrusion and configured to apply a first force to the first anterior protrusion and a second resilient component coupled to the second anterior protrusion and configured to apply a second force to the second anterior protrusion, wherein, when the base portion is coupled to the limb, a force from the at least one resilient component is capable of applying a torque to the limb.

### Claim 29 (depends on 28)

The wearable device of claim 28, wherein the at least one resilient component comprises:
a first resilient component that couples the first pivot point to the rigid first end of the base portion; and
a second resilient component that couples the second pivot point to the rigid second end of the base portion.

### Claim 30 (depends on 28)

The wearable device of claim 28, further comprising at least one clutch coupled to the cable, for regulating a separation between the first pivot point and the second pivot point.

### Claim 31 (depends on 30)

The wearable device of claim 30, further comprising:
at least one memory; and
at least one processing unit configured to execute instructions stored in the at least one memory, to cause the wearable device to:
compute a joint angle of the joint; and
to transmit the instructions to cause the at least one clutch to regulate the cable based on the computed joint angle, for regulating the separation between the first pivot point and the second pivot point.

### Claim 32 (depends on 31)

The wearable device of claim 31, further comprising at least one sensor configured to provide data indicative of the joint angle.

### Claim 33 (depends on 31)

The wearable device of claim 31, further comprising at least one sensor configured to provide data indicative of gait for a wearer of the wearable device, wherein the joint angle is computed based on the data indicative of gait.

### Claim 34 (depends on 33)

The wearable device of claim 33, wherein the data indicative of gait comprises data indicative of a gradient of descent of the wearer.

### Claim 35 (depends on 28)

The wearable device of claim 28, further comprising:
at least one actuator coupled to the cable; and
at least one controller configured to actuate the at least one actuator to regulate the cable, for regulating a separation between the first pivot point and the second pivot point.

### Claim 36 (depends on 35)

The wearable device of claim 35, wherein the at least one actuator comprises at least one motor driven actuator, at least one pneumatic actuator, or at least one hydraulic actuator.

### Claim 37 (depends on 35)

The wearable device of claim 35, wherein the at least one actuator comprises a motor driven actuator configured to apply a tensile force to the cable, for regulating the separation between the first pivot point and the second pivot point.

### Claim 38

A wearable device comprising:
two rigid components, comprising:
a medial rigid component for positioning along a medial side of a limb including a joint;
a lateral rigid component for positioning along a lateral side of the limb;
wherein each of the two rigid components comprises:
a base portion for positioning along the limb, the base portion having a rigid first end, a rigid second end, and a central region, wherein the central region is configured to permit rotation of the rigid first end with respect to the rigid second end; and
two protrusions, comprising:
a first protrusion extending from the rigid first end along the plane of flexion of the limb to a first pivot point, and configured to rotate with respect to the rigid first end;
a second protrusion extending from the rigid second end along the plane of flexion of the limb to a second pivot point, and configured to rotate with respect to the rigid second end;
at least two cables, each cable being coupled to the respective first protrusion and second protrusion of each of the two rigid components, for regulating a separation between the respective first protrusion and second protrusion; and
at least two resilient elements comprising:
a first resilient component that couples to the first pivot point of the medial rigid component and is configured to apply a first force to the first pivot point; and
a second resilient component that couples to the first pivot point of the lateral rigid component and is configured to apply a second force to the second pivot point,
wherein the first force and the second force are capable of applying a torque to the limb.

### Claim 39 (depends on 38)

The wearable device of claim 38, further comprising at least one clutch coupled to the at least two cables, for regulating the separation between the respective first protrusion and second protrusion of each of the two rigid components.

### Claim 40 (depends on 39)

The wearable device of claim 39, further comprising:
at least one memory; and
at least one processing unit configured to execute instructions stored in the memory, to cause the wearable device to:
compute a joint angle of the joint; and
to transmit the instructions to cause the at least one clutch to regulate the at least two cables based on the computed joint angle, for exerting the first force and the second force.

### Claim 41 (depends on 40)

The wearable device of claim 40, further comprising at least one sensor configured to provide data indicative of the joint angle.

### Claim 42 (depends on 40)

The wearable device of claim 40, further comprising at least one sensor configured to provide data indicative of gait for a wearer of the wearable device, wherein the joint angle is computed based on the data indicative of gait.

### Claim 43 (depends on 42)

The wearable device of claim 42, wherein the data indicative of gait comprises data indicative of a gradient of descent of the wearer.

### Claim 44 (depends on 38)

A method for regulating an amount of force translated to a limb including a joint, comprising:
positioning the wearable device of claim 38 along the limb, such that the central portion of each of the two rigid components is positioned proximate to an axis of rotation of the joint of the limb;
using at least one processing unit to compute an angle of bending of flexion or extension of the limb; and
using the at least one processing unit to transmit instructions to cause a clutch coupled to the at least two cables to regulate the separation between the respective two protrusions of each of the two rigid components, thereby regulating the amount of force translated to the limb.

### Claim 45 (depends on 44)

The method of claim 44, further comprising using at least one sensor component to provide data indicative of at least one of an angle of bending of flexion or extension of the limb, a muscle activation condition, a pressure on a foot during a gait cycle, an instance in time that a foot strikes a surface during a gait cycle, or a tensile force in each cable.

### Claim 46 (depends on 44)

The method of claim 44, further comprising using at least one actuator coupled to the at least two cables to apply a tensile force to the at least two cables.