FIELD OF INVENTION The present invention relates to a physiotherapist wearable device which is primarily intended to provide stretch to the Achilles tendon of the gastrocnemius muscle. More particularly, the physiotherapist device consists of a wearable forearm gear which consists of a glove with control buttons for increasing stretch intensity (placed over the thumb) and decreasing stretch intensity (placed over the index finger as a forearm gear.

BACKGROUND ART

Connective tissue injuries and disorders have a significant impact on society In the present time there is a need for treatment of tissue injuries which are different and reliable to standard treatments such as anti-inflammatory medication, bracing, rest etc. Injuries or other damage to flexible, relatively avascular connective tissues are known to take a very long time to heal (months or even years). In many cases, injuries to connective tissues may never heal properly, necessitating surgical intervention. Incompletely treated tissue is weaker than normal tendon tissue and lacks the strength to function normally. This tissue also limits the patient by causing pain and negatively impacting the patient's quality of life.

One example of a connective tissue disorder is tendinosis. Unlike tendonitis, tendinosis is not primarily an inflammatory condition. Tendinosis is an accumulation over time of small-scale injuries that don't heal properly; it is a chronic injury of failed healing. Tendinosis can occur in any tendon, with some of the most common areas being the hand, wrist, forearm, elbow, shoulder, knee, and heel.

The Achilles Tendon is more prone to injury than any other tendon of the body due to the heavy load exerted on it. 1,2 It is the tendon of the gastrocnemius muscle. Following the acute Achilles tendon injury, the most common approach chosen is either surgical or conservative. Gastrocnemius tightness can prove to be major contributory factor for gait abnormalities during the rehabilitative phase.

TECHNICAL PROBLEM ADDRESSED 1. Early mobilization of the tendoachilles is recommended in order to accelerate the recovery by prevent shortening of the gastrocnemius muscle.

2. Especially while planning the rehabilitation of bed ridden patients, the only method available to give passive stretching to the Tendo Achilles is manual stretching by the physiotherapist. 3. The female physiotherapists might lack the adequate force and endurance which might affect the treatment output.

4. This necessitates the availability of a portable device which would provide or aid in providing sustained passive stretch to the gastrocnemius muscle by generating and sustaining a constant mechanical force thus ultimately reducing the load on the physiotherapist.

In the prior art Zellers et al (2019) conducted a systematic review of the available literature on types of early rehabilitative interventions used following acute Achilles tendon rupture. According to him, the following interventions are adopted as a part of early rehabilitative measures either immediately or 2 weeks after surgery.

Early weight bearing Range of motion exercises Strength training Isometric exercises

....Cardiovascular exercises Core strengthening Balance training

Others In other prior art an European Patent application EP3695815 discloses Achilles tendon orthosis. The Achilles tendon comprises a compression structure holding two compression elements. A biasing mechanism allows a change of the configuration of the Achilles tendon orthosis between a non- biasing state and a biasing state. The inventive Achilles tendon orthosis preferably applies a compression force to a contact area of a foot at a location anterior to the mid-portion Achilles tendon and posterior to the lower leg and/or ankle joint.

In another prior at a Chinese specification CN210384722 discloses standing position shank triceps muscle and Achilles tendon retractor. Another document CN110167505 discloses massage device which is suitable for massaging the Achilles tendon. Yet another Chinese document CN21 1067348 discloses a wearable heel pain treatment pad. DRAWBACKS

1. As far as patients admitted in surgical wards are concerned, it is highly impossible to ask them to perform active static or dynamic stretching of the Tendoachilles. 2. In case of female physiotherapists, the administration of passive TA stretch using manual force becomes inefficient because of less maximal force generation as compared to male physiotherapists. This might reduce the treatment output and delay rehabilitation.

3. The issue of inadequate maximal force generation might be an issue not only for female physiotherapists but also for some male physiotherapists.

OBJECT OF INVENTION

The principle object of the present invention is to design a wearable forearm gear which would provide the additional force to sustain the Tendo Achilles stretch for a prolonged duration. Another object of the present invention is to provide effective passive stretch to the Tendo Achilles by overcoming the shortfalls of manual stretching like subjective variations in power, endurance etc.

SUMMARY OF THE INVENTION

The herein disclosed wearable forearm gear for tendon achilles stretcher is an innovative device conceptualized to reduce the manual load on the physiotherapist as well as to cope-up with the inability to sustain maximal force exertion for a prolonged period of time while administering passive Tendo Achilles stretch.

The present device is a portable and automatic device which could provide passive sustained stretch to the Tendo Achilles. Especially in prolong bed ridden patients in ICU who are not mobile due to various restricting factors, the utilization of dynamic stretching exercises or self-stretching maneuvers is practically difficult. Such patients need passive stretching of the gastrocnemius muscle (Tendo Achilles) which is done by the physiotherapist. It is performed by holding the heel of the affected leg in order to ensure a firm grip. The foot is supported over the forearm of the physiotherapist. The foot is taken into dorsi-flexion until the available range of motion (ROM). Once the physiotherapist starts experiencing resistance to movement, the physiotherapist clears the further ROM by exerting additional mechanical force until the anatomical limit of motion is reached. At this point; where further progression in ROM is not possible, the Physiotherapist sustains the position for 30-45 seconds. The major practical limitation of this manual TA stretching is the inadequacy of female therapists to generate maximal force for a prolonged period of time. Secondly, the administration of this passive stretching maneuver becomes difficult in endomorphic, obese or even heavily built patients. So in order to remove the element of disparity by addressing the two major limitations of manual TA stretching (inadequacy of force generation and uniformity in the sustained stretch), is designed. It is portable and is battery operated.

Therefore such as herein described there is provided a wearable forearm gear for Achilles Tendon Stretcher comprising of a wearable glove including a dorsal forearm component with a forehand palm portion and a wrist portion; a Foot rest Pad disposed over the wrist portion of the said glove; a plurality of adjustable belts fixed on the said glove ; a heel rest notch fitted with pivot hinge operably connected with the wearable glove; an Electrically operated Mini-scissor lift; and a plurality of electrical button disposed over the fingers connected with a battery operated circuit configured for operating a mini scissor lift which provides variable mechanical force necessary while stretching the gastrocnemius muscle and reducing the load on the physiotherapist.

BRIEF DESCRIPTION OF THE ACCOMPANYING DRAWINGS. Fig 1 illustrates the wearable forearm gear for achilles tendon stretcher in accordance with the present invention;

Fig 2 illustrates a graph showing the comparable statistical analysis of the wearable forearm gear for achilles tendon stretcher in accordance with the present invention;

DETAILED DESCRIPTION

The proposed invention is a portable, wearable device which is primarily intended to be used for providing sustained stretch to the Achilles tendon of the gastrocnemius muscle. The device consists of a wearable forearm gear which consists of a glove with control buttons for increasing adjustable (high and low) stretch intensity (placed over the thumb) and decreasing stretch intensity (placed over the index finger). The Physiotherapist has to wear the above mentioned device as a forearm gear. The physiotherapist has to place the heel of the patient’s foot over the heel rest notch (4) provided over the palm area of the device. Once the heel is placed in firm position, the physiotherapist can grasp the hind foot area for additional grip and stability. Then he/ she has to ask the patient to rest his foot completely on the foot rest pad (1). If any movement restriction is present, then the physiotherapist can adjust the starting position of the foot rest pad using the pivot hinge. Once the patient’s foot has been placed in firm proximity with the foot rest pad, then the physiotherapist can switch ON the machine and using the increase stretch intensity button (2) he/ she can initiate a progressive stretch of the TA tendon. The electrically operated mini -scissor lift is adjustable for upper and lower limit in accordance with the ROM. Once the desired ROM (adjustable) is achieved, the physiotherapist has to release the button and has to maintain the position for 30-45 seconds. After completing the duration of 30-45 seconds, the physiotherapist has to press the decrease intensity button located on the tip of the index finger of the glove till the starting position is achieved. The physiotherapist has to keep the forearm positioned parallel with the foot of the patient so that additional stability can be obtained and output of the intervention can be further amplified. The device is battery operated, portable and ergonomically advantageous for the physiotherapist as well as the patient.

The device is designed to reduce the manual load on the physiotherapist as well as to cope-up with the inability to sustain maximal force exertion for a prolonged period of time while administering passive Tendo Achilles stretch. The objective is to provide a portable and automatic device which could provide passive sustained stretch to the Tendo Achilles. Especially in prolong bed-ridden patients in ICU who are not mobile due to various restricting factors, the utilization of dynamic stretching exercises or self stretching maneuvers is practically difficult. Such patients need passive stretching of the gastrocnemius muscle (Achilles Tendon) which is done by the physiotherapist. It is performed by holding the heel of the affected leg in order to ensure a firm grip. The foot is supported over the forearm of the physiotherapist. The foot is taken into dorsi-flexion until the available range of motion (ROM). Once the physiotherapist starts experiencing resistance to movement, the physiotherapist clears the further ROM by exerting additional mechanical force until the anatomical limit of motion is reached. At this point; where further progression in ROM is not possible, the Physiotherapist sustains the position for 30-45 seconds. The major practical limitation of this manual TA stretching is the inadequacy of female therapists to generate maximal force for a prolonged period of time. Secondly, the administration of this passive stretching maneuver becomes difficult in endomorphic, obese or even heavily built patients. So in order to remove the element of disparity by addressing the two major limitations of manual TA stretching (inadequacy of force generation and uniformity in the sustained stretch), was designed. It is portable and is battery operated.

The herein disclosed device is made up of light weight surgical steel. The foot rest component and gloves are made up of silicone for ergonomic and antiskid comfort to the foot. The mechanical ramp below the foot rest will also be made up of light weight steel sheet with suitable thickness to withstand the weight of foot of the subject.

During use, the said device has to be worn as a forearm gear. The patient has to place his feet over the rest-piece which is parallel to the forearm of the therapist. Then with the help of straps it is fixed firmly. With the help of control keys, the stretch is initiated until it reaches the available limit. Once the patient starts wincing or gives any expressions which indicate that he / she would not be able to tolerate any further increase in Range of Motion (ROM), the therapist has to stop at that ROM and wait for 30-45 sec. After that the range has to be lowered. Since the device is battery operated, therefore addition of portable battery might make the device heavier. A person skilled in the art may use portable rectifiers and / or invertor extensions for the power requirement. As per an embodiment the said glove includes control buttons for increasing stretch intensity (placed over the thumb) and decreasing stretch intensity (placed over the index finger) and under condition that upper limit of ROM is reached, further switching of control button for the increase of intensity will result in maintain the stretched position..

COMPONENTS

1. Foot rest Pad

2. Increase intensity button

3. Decrease intensity button 4. Heel rest notch

5. Wearable glove

6. Adjustable Palm belt

7. Pivot hinge

8. Adjustable Wrist belt 9. Dorsal forearm component

10. Electrically operated Mini-scissor lift Example:

A pilot study was conducted with 12 subjects to see the effectiveness of the above mentioned novel device on Tendo-Achilles tightness. A total number of 32 subjects were screened for TA tightness and out of those 12 were recruited for this study. The pre-test data for all the outcome measures was recorded prior to the commencement of the treatment. All participants were given passive TA stretches for duration of 30-45 sec. The procedure was repeated 10 times. Frequency of the treatment was twice a day, six days a week. The entire duration of the treatment protocol was 3 weeks. The post test data was recorded after the completion of 3 weeks.

Statistical Analysis

The software used for statistical analysis was Instat version 3. The pre and post-test ankle dorsi-ilexion ROM were compared using paired t-test . The mean ± sd for the pre-intervention values was 13.25±2.63 whereas for the post intervention values were 16.45±2.32. It was found out that there was a statistically significant (p < 0.0001) reduction in tightness of Tendo Achilles in all the patients. Average improvement in ROM was found to be approximately 96%. Thus, the results reveal that the above mentioned Tendo-achilles stretcher device is effective in treating chronic TA tightness and ultimately improving the ankle dorsi-flexion ROM.

INVENTIVE STEP The only device which can provide completely passive as well as passive- assisted stretch to the Achilles Tendon. The device is portable and can be used effectively especially in ICU or even during field sports. The device would provide standard stretch irrespective of the subjective variations in terms of maximal force generation (power) and endurance.

Without further elaboration, it is believed that one skilled in the art can, using the description herein, utilize the present disclosure to its fullest extent. The embodiments described herein are to be construed as illustrative and not as constraining the remainder of the disclosure in any way whatsoever. While the embodiments have been shown and described, many variations and modifications thereof can be made by one skilled in the art without departing from the spirit and teachings of the invention. Accordingly, the scope of protection is not limited by the description set out above, but is only limited by the claims, including all equivalents of the subject matter of the claims. The disclosures of all patents, patent applications and publications cited herein are hereby incorporated herein by reference, to the extent that they provide procedural or other details consistent with and supplementary to those set forth herein.

REFERENCES

1.Korni, PV; Fukashiro, S; Jarvinen, M: Biomechanical loadingof Achilles tendon during normal locomotion Clin Sports Med. 11:521 - 531, 1992.

2. Wren, TA; Yerby, SA; Beaupre, GS; Carter DR: Mechanical properties of the human Achilles tendon. Clin. Biomech. 16:245 - 251, 2001. 3. Zellers JA, Christensen M, Kjasr IL, Rathleff MS, Silbernagel KG. Defining components of early functional rehabilitation for acute Achilles tendon rupture: a systematic review. Orthopedic journal of sports medicine. 2019 Nov 22;7(11):2325967119884071.