RU2700493C1 - Simulator for dosed anti-phase pneumocompression of human feet and hands - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely a device for dosed counterphase pneumocompression of human feet and hands. Device consists of pneumatic compressor, tubes for air supply, pneumatic collars and control unit. Device is configured to act on human feet and hands with pressure in range from 75 to 90 mm Hg with frequency of 0.1 Hz. Pneumatic cuffs are closed with fingers of hands partially with a hand and fingers of feet partially with a foot. Device is configured so that when voltage is applied to pneumatic switch pneumatic compressor supplies air to one pair of cuffs, and after 5 seconds supplies pressure to another pair of cuffs, forming a cycle with duration of 10 seconds. When air is pumped into one pair of cuffs, air is freely released from the second one, since the air-operated switch opens the air release valve.

EFFECT: human tissue exposure to pressure corresponding to human diastolic blood pressure.

1 cl, 6 dwg, 6 photos

Description

Technical field

The invention relates to medical equipment, namely to physiotherapy, and can be used alone or in the complex treatment and rehabilitation of patients with impaired peripheral blood flow to improve systemic microcirculation, including accelerating venous and lymphatic outflows, preventing blood clots.

State of the art

Circulatory system diseases take the first place among all the causes of disability and death in most economically developed countries of the world, including Russia.

Today, for the treatment of chronic edema, the prevention and treatment of chronic and venous insufficiency, trophic skin disorders, a pressotherapy device is widely used. The principle of pneumocompression therapy is widely used in medicine, while tissue trophism and blood supply are improved; the number of functionally active capillaries and the volumetric blood flow velocity in them increase; the process of removing toxins from the body is accelerated. The historically established international name does not have a variable pneumocompression method, in addition, procedures with almost identical goals and objectives differ in their techniques, techniques, modes, and, accordingly, names.

Variable pneumocompression (PPC) [1] is an apparatus physiotherapeutic method of massage effects, the main therapeutic factor of which is controlled deformations (stresses) created in the tissues in the form of compression, tension, shear, displacement due to an external mechanical dosed, periodic, directed force (action) . The working body (manipulator) is a special multi-section pneumatic cuff operating in a cyclic mode of pressure distribution in sections, and the working medium is high pressure air. Moreover, therapeutic goals and objectives, among other things, are also determined by the characteristics of such mechanical periodic stresses. As a rule, most pneumatic cuffs, by virtue of their design, create efforts directed simultaneously at a sufficiently large area of the patient’s body, which is associated more with their compressive effect on human tissue and this principle applies, respectively, to compression therapy.

There are options for variable pneumocompression - standard (similar to uniform over the body area) pneumatic compression using a single-chamber cuff or its equivalent from multi-chamber cuffs; intermittent (intermittent) pneumatic compression using a multi-chamber cuff and various rates (modes) of air injection into the chambers and their drying.

Variants with a multi-chamber pneumatic cuff are considered to be the most physiological, while in the chambers of such a cuff, with the help of various devices, methods, techniques, and techniques, the necessary doses of time-varying pressure are formed for the purpose of a specific therapy, which is transmitted in the form of mechanical stress to the skin, underlying tissues and organs.

In practice, the main goals and objectives of variable pneumocompression are:

directional movement of blood, lymph, intercellular fluid to relieve swelling, stagnation, stasis;

increased local and regional blood flow to improve trophism, normalize metabolic processes in tissues, relieve pain;

correction of the rheological properties of blood, the state of the vascular bed to prevent a different type of thrombosis.

Depending on the areas of medicine, goals and tasks to be solved, and improvements in equipment, techniques and techniques, options / methods for variable pneumatic compression have become widespread: "rhythmic pneumocompression", "pneumopressing", "lymphatic drainage", etc.

1. Rhythmic pneumocompression.

In modern devices of variable pneumatic compression, the healing stress of the underlying tissues is created by the effect of the “traveling air wave” with cyclical sequential injection of air into the sealed chambers of multi-section pneumatic cuffs and its synchronized removal, which makes it possible to more effectively influence human organs. When carrying out procedures for different parts of the body, cuffs are usually performed taking into account the anatomical features - in the form of gloves, sleeves, boots, boots, shorts, vests, cloaks, suits, overalls, etc.

Contraindications for the use of variable pneumocompression (volume pneumopressing) are standard for physiotherapy: acute heart failure; blood pressure over 180 mm. Hg; a person’s body temperature is over 38 ° C and may vary with respect to a specific pneumatic compression device, taking into account the methods developed for it.

The mechanism of action of variable pneumocompression

Usually, the hemostatic and endothelial system [2] are considered in the English literature as organs and functions — targets of the action of variable pneumocompression, and transcapillary exchange [3] in the Russian-language literature, in which the system for regulating capillary permeability processes plays a decisive role in the pathogenesis of most diseases and appears rather complex mechanism, including nerve, humoral and hormonal links.

With cyclical compression of the soft tissues of the limbs, the outflow of venous blood accelerates, and stasis stops. The veins in the compression zone are emptied, venous pressure decreases, the arteriovenous gradient increases, arterial flow is facilitated, and skin circulation is activated. Increased extracellular pressure in the muscles and subcutaneous tissues promotes the return of water to the vascular bed, eliminates edema, reduces skin tension, and activates transdermal oxygen transport and elimination of toxins. The shear stress of endotheliocytes, which occurs when the local blood flow increases, leads to the release of the tissue pathway factor inhibitor hemostasis (antithrombotic effect), tissue plasminogen activator (fibrinolytic effect) and nitric oxide (vasodilating effect) into the blood.

2. Pneumopressing.

The general effect of volumetric pneumopressing is a combination of rhythmic periods of local increase and normalization of pressure in the tissues, which improves the tone of muscle vessels and the selective permeability of capillaries. This leads to an acceleration of transcapillary metabolism and normalization of blood supply to soft tissues.

Volumetric pneumopressing.

Variable pneumocompression can be used in a variant called "volumetric pneumopressing" (OPP). In this method of treatment, medical physiotherapeutic devices of the Bioregulator series are used in specified operating modes, and the procedures are performed according to certain methods / protocols.

The goals and objectives of the OPP method are also, as a rule, in the complex:

stimulation of nerve endings, receptors, receptor zones, metamerno-receptor fields;

stimulation of the functions of internal organs and systems;

activation of central and peripheral circulation;

activation of microcirculation and metabolism;

normalization of disturbed relationships between the cortex, subcortex and the underlying parts of the nervous system;

normalization of vegetative status and its rhythms.

Moreover, the main goal of therapy is the active stimulation of sanogenesis, the restoration of the normal activity of protective and regulatory systems, which leads to the removal of parabiosis, elimination of desynchronosis, regression of pathological symptoms and normalization / harmonization of the functional state of the body.

Programmable Pneumatic Vacuum Compression

In 1992-2008 a number of researchers led by I.V. Tarshinov on the principles of pulsed therapy, taking into account the techniques and techniques of manual, acupressure, apparatus massage, developments in the field of variable pneumatic compression and vacuum compression, a method of hardware pneumatic manipulations was developed, which was called "programmed pneumatic vacuum compression" [1]. In this method, there are a number of features both in understanding the theory of the effect of cyclic and variable pneumatic compression on the whole human body, and in technical and practical implementation. The mechanism is based on the fact that cyclic and rhythmic mechanical manipulations associated with high and low pressure, as irritating factors, affect all morphological structures located both in the projection of the injection chamber and the vacuum applicator - including receptors, receptor fields (zones) and biologically active points, cell membranes, nerve and muscle fibers, and outside it. The therapeutic effect in this case is due to the interconnected reaction of all these structures to verified programmed complex effects. As a rule, the more structures give in to the indicated influences, the more pronounced such reactions are, not only the patient’s local condition, but also regional-segmental, and, first of all, general, is taken into account.

Since intravascular fluids, some reflex arcs and receptor zones (fields) go beyond the scope of the procedures, hemodynamic, biochemical and reflex effects remote in their localization appear, activating the processes of bioregulation.

The circulatory system, peripheral innervation, the autonomic and central nervous system with this approach, being already target systems of mechanical stimulation, provide neurohumoral regulation, forming a systemic response of the body and a stable structural trace. Due to this, programmable pneumatic vacuum compression and volume pneumopressing, in addition to specific clinical effects that contribute to the treatment of a particular disease, in contrast to other methods, also non-specifically affect adaptation-compensatory reactions, while actively stimulating sanogenesis. In practice, it has been observed that in the presence of synergistic diseases, the weakening of even one of them is positive for the effectiveness of the therapy, the closest prognosis and the further quality of life of the patient.

Indications for the use of pneumatic compression

Currently, the most reasonable from the standpoint of evidence-based medicine is the appointment of a variable pneumocompression in the following cases:

Vein thrombosis of the lower extremities (prevention) [4].

Chronic venous insufficiency of I-III and V-VI classes according to CEAP (treatment, rehabilitation) [5].

Lymphedema of the I-III stage (prevention and treatment) [6].

Chronic arterial insufficiency of limbs I-IV degree according to Fontaine-Pokrovsky (treatment) [7].

Chronic cerebral ischemia (treatment).

Diabetic angiopathy of the lower extremities (prevention and treatment).

Variable pneumocompression is included in the rehabilitation programs for athletes and traumatic patients.

Volumetric pneumopressing and programmed pneumatic vacuum compression is also used for certain diseases of the musculoskeletal system, central and peripheral nervous system, eyes, and a number of functional disorders.

In cosmetology, variable pneumocompression is performed for swelling of the extremities of local origin (lymphostasis, varicose veins, the consequences of operations) and cellulite [8].

In general terms, devices for conducting variable pneumocompression consist of the following components:

a source of increased air pressure with its purification system (controlled compressor);

air distributor for sections of the pneumatic cuff (controlled pneumatic unit);

system for delivering a working medium to actuators (pneumatic cables and pneumatic connectors);

executive devices (sections of a pneumatic cuff);

electronic unit for displaying information, monitoring and control of air pressure.

The clinical capabilities of pneumocompression therapy depend both on the methods used and on the technical characteristics of the equipment, which are constantly being improved. Due to the variety of pneumatic compression apparatuses, attempts are made to classify them. Known classification L.A. Tarshinova (2015), based on the functionality and clinical capabilities of medical pneumatic compression devices [1].

Grade I - pneumatic medical equipment with operating principles slightly different from variable pneumocompression (pressure chambers, etc.);

Class II - devices for variable pneumocompression, the use of which is possible without periodic medical supervision in order to improve overall health or cosmetic correction;

Class III - devices for variable pneumocompression, usually used under the supervision of a physician for the prevention, treatment and (or) rehabilitation of one or more diseases similar in pathogenesis;

Grade IV - devices for variable pneumocompression, used under the supervision of a physician to prevent, treat and rehabilitate diseases of various localization and pathogenesis.

3. Lymphatic drainage.

Known apparatus for pressure therapy (lymphatic drainage) Unix Air Smart. The kit includes an air injection unit, hoses and various devices for connecting additional cuffs.

The known apparatus for pressotherapy (lymphatic drainage) Unix Air Control, manufacturer - Maxstar Industrial CO., LTD, which has a pressure range of 30-220 mm Hg and four cameras.

The Unix Air Control device is used in the complex treatment and rehabilitation of patients with impaired peripheral blood flow, including: rehabilitation after mastectomy; postoperative or post-traumatic puffiness; chronic venous insufficiency; as a prophylaxis of thrombosis; diseases of the musculoskeletal system (gout, arthritis, arthrosis, osteochondrosis) cellulite (including postpartum); obesity; local deposits of adipose tissue; muscle weak tone, low elasticity and firmness of the skin; overvoltage; swelling of the legs; stress, chronic fatigue syndrome, insomnia.

The Unix Air Control has cuffs for use on different parts of the body, which are shown in photos 1-6. This device is accepted as the closest analogue.

The disadvantage of the Unix Air Control apparatus is the impossibility of influencing human tissues with pressure corresponding to human diastolic blood pressure, which causes significant compression of tissues with impaired arterial blood flow, the physiological pulsation frequency characteristic of blood vessels is not observed, and a large exposure area entails a large number of contraindications to use. The result of such treatment is not lasting.

The technical problem of the claimed invention is the creation of a device that provides exposure to human tissue with a pressure corresponding to the diastolic blood pressure of a person.

A simulator design has been developed that allows you to affect the tissues of the human body with pressure pumped from 75 to 90 mm. Hg, which corresponds to the diastolic blood pressure of a person. Pneumocompression is carried out with a frequency of 0.1 Hz through the cuffs, while the effect is on a small surface of the body - the feet and hands of a person.

The developed design of the simulator allows you to act on the tissues of the human body with parameters that are most similar to the physiological vibrational rhythms of the person, having the form of a sinusoid, as well as use antiphase effects on the arms and legs of a person. Such an effect causes the most pronounced resonant response from the body, since the zones of the feet and hands of the person are trigger (reflexogenic) for the microvasculature. The impact on these areas, especially antiphase, causes a reflex response of all microvessels. As a result of the improvement of systemic microcirculation in the form of an increase in the intensity of microcirculation of human body tissues, an increase in arteriolar inflow and relief of venous outflow and lymph outflow is achieved and, as a result, the amplitude of vasomotion increases and blood supply to the tissues of the human body improves. The improvement of microcirculation was evaluated by laser Doppler flowmetry using the LAKK-1 Lazma apparatus. In all patients, the amplitude of vasomotion increased to 0.1 Hz.

SUMMARY OF THE INVENTION

The simulator for dosed antiphase pneumocompression of the feet and hands of a person is a pneumocompressor unit controlled by teams of an electronic control unit with cuffs worn on the feet and hands of a person. Cuffs have the ability to adapt to the size and shape of the limb. Pneumocompression is carried out in cycles of 10 seconds (frequency 0.1 Hz) alternately for the arms and legs. During the cycle, for five seconds, air is pumped into the cuffs on the hands with a gradual decrease in pressure in the cuffs on the legs, and then vice versa.

Pressure is generated in the range of 75 to 90 mm. Hg, which corresponds to the diastolic blood pressure of a person. Such compression does not cause a violation of arterial inflow, but causes the most pronounced resonant response from the whole body, since the zones of the feet and hands of the person are trigger (reflexogenic) for the microvasculature.

Laser Doppler flowmetry confirms that as a result of the simulator, the systemic microcirculation of the blood improves, the arteriolar influx increases and the venous outflow and lymph drainage are facilitated. the amplitude of vasomotion increases and the blood supply to the tissues of the whole human body improves.

The simulator for antiphase pneumocompression of the feet and hands of a person is designed to improve systemic microcirculation in the complex treatment and rehabilitation of patients with impaired peripheral blood flow.

The main technical characteristics of the simulator

Technical characteristics of the device are as close as possible to the characteristics of professional lymphatic drainage systems:

15 operating modes (5 basic and 10 in manual mode);

pressure change step: 5 mm. Hg;

pressure level: 75-90 mm. Hg;

Other properties:

compatible with universal accessories of the Unix Air series;

high quality materials of optional accessories;

silent motor with increased resource;

alphanumeric backlit LCD (liquid crystal display from the English. liquid crystal display) TFT (thin-film transistor from the English. thin-film transistor) screen;

remote control included;

miniature housing with shipping handle.

The claimed device belongs to class II. It can be used at home due to its small size, safety and effectiveness.

The main criteria affecting the user's choice of a variable (antiphase) pneumocompression device are:

high safety and good efficacy to improve peripheral blood flow;

comfort, painlessness of use and a good combination with other methods of treatment and prevention;

low cost and multi-use;

ease of management and ease of use;

small overall dimensions and high reliability;

the possibility of quick, inexpensive and high-quality repairs.

Simulator design

In fig. 1 and fig. 2 shows the basic elements of a simulator for antiphase pneumocompression of the feet and hands of a person:

1. Cuffs;

2. Handles of pressure regulators and time setting;

3. The digital indicator displaying pressure in a cuff;

4. A digital indicator that displays the operating time of the simulator;

5. Red indicator;

6. Green indicator;

7. The button to start the simulator;

8. Fittings for quick-connect silicone tubes from the cuffs;

9. Socket 220 V;

10. Pneumatic pressure sensor in the system;

11. Power supply 12 V 100 W;

12. A 12 V pneumatic compressor with a capacity of 13 liters per minute. with air purification system;

13. Tee of pneumotubes;

14. Pneumatic switch;

15. Board control simulator;

16. The top cover of the simulator;

17. Platform base simulator - bottom panel;

18. Ventilation openings;

19. Network cable 220 V;

20. Network switch;

21. Silicone tube.

The device operates as follows

A power cable 19 is connected to the 220 V network, on the panel, a switch 20 is turned on. A green indicator 6 lights up on the front panel, indicating that power is supplied to the control board 15. Insert the tube fitting from the cuff into the inlet fitting on the simulator body. You need to insert until a characteristic click.

Before the procedure, the cuffs must be checked for residual pressure. If pressure remains, the cuffs must be squeezed to a complete “touch” lack of residual pressure. The simulator is automatically calibrated - the control board 15 by means of the pressure sensor 10 determines the state when the pressure in the cuff is removed and takes the residual pressure in the cuffs 1 as zero.

Regulators 2 set the duration 4 of the procedure and pressure 3. The pressure is set in the range of plus or minus 10 mm. Hg from the patient’s diastolic pressure. The duration of the procedure is set in the range from 20 minutes to 40 minutes.

The patient lies on his back, cuffs are put on the hands and feet, and only fingers of the hands with partially wrist and fingers of the feet with partially foot are closed.

The patient can press the start button 7 himself or ask someone to do this. The patient lies all the time during the procedure, with his eyes closed, if desired.

When voltage is applied to the pneumatic switch 14, the pneumatic compressor 12 supplies air to one pair of cuffs (for example, to the arms), and after 5 seconds, pressurizes the other pair of cuffs, forming a cycle of 10 seconds. When air is pumped into one pair of cuffs, air freely leaves the second, as the pneumatic switch opens the air release valve.

After the procedure is complete, it is necessary to remove the cuffs 1, disconnect the fittings on the housing by pressing on the fitting of the housing 8, and put them in the package.

Turn off switch 20 and disconnect the power supply cable from the network.

The possibility of improving the intensity of microcirculation of tissues is confirmed by the following examples.

Example 1

Patient N 66 years old with complaints of a constant feeling of fatigue, not compensated by night sleep, decreased memory, attention, sleep disturbance (difficulty falling asleep).

The study of microcirculation by laser Doppler flowmetry (LDF).

A decrease in the vasomotor activity of the microvasculature was revealed.

Twelve sessions of 30 minutes were prescribed at a pressure of 80 mm. Hg

Subjectively, the patient notes a significant improvement in sleep quality. Improving the tolerance of physical activity, memory, attention.

According to the results of LDF, a steady increase in the vasomotor activity of the microvasculature is observed, which is confirmed by the graph with the achieved vasomotion frequency, up to about 0.1 Hz, shown in FIG. one.

Example 2

A 53-year-old patient with complaints of a feeling of heaviness in the legs, appearing in the evening.

The study of microcirculation by laser Doppler flowmetry (LDF).

When LDF in the lower extremities revealed a decrease in the vasomotor activity of the microvasculature.

Twelve sessions of 20 minutes were prescribed at a pressure of 90 mm. Hg At the end of treatment, lightness in the legs is felt.

According to the results of LDF, a steady increase in the vasomotor activity of the microvasculature is observed, which is confirmed by the graph with the achieved vasomotion frequency to about 0.1 Hz, shown in FIG. 2.

Example 3

Patient L., 23 years old, with complaints of frequent dizziness against a background of lowering blood pressure to 90/60 mm Hg, a feeling of drowsiness.

Twelve sessions of 40 minutes were prescribed at a pressure of 75 mm. Hg

After treatment, there is a decrease in blood pressure lability (daily average pressure 110/70 mm Hg), lack of dizziness.

According to the results of LDF, a steady increase in the vasomotor activity of the microvasculature is observed, which is confirmed by the graph with the achieved vasomotion frequency to about 0.1 Hz, shown in FIG. 3.

Example 4

Patient F., 79 years old, with complaints of a constant feeling of coldness in the feet, pain in the legs with prolonged walking.

A decrease in the vasomotor activity of the microvasculature was revealed.

Twelve sessions of 40 minutes were prescribed at a pressure of 80 mm. Hg

At the end of treatment, he notes a lack of chilliness in the feet, a significant reduction in leg pain when walking.

According to the results of LDF, a steady increase in the vasomotor activity of the microvasculature is observed, which is confirmed by the graph with the achieved vasomotion frequency to about 0.1 Hz, shown in FIG. four.

Bibliography.

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Claims (2)

1. A device for dosed antiphase pneumocompression of the feet and hands of a person, consisting of a pneumatic compressor, air tubes, pneumatic cuffs and a control unit, characterized in that it is configured to affect the feet and hands of a person with a pressure in the range from 75 to 90 mmHg Art. with a frequency of 0.1 Hz, while the pneumatic cuffs are made covering the fingers with a partial brush and the toes with a partial foot, while the device is designed so that when a voltage is applied to the pneumatic switch, the pneumatic compressor delivers air in one pair of cuffs and after 5 seconds applies pressure to another pair of cuffs, forming a cycle lasting 10 seconds, and when air is pumped into one pair of cuffs, air freely leaves the second cuff, since the pneumatic switch opens the air release valve. 2. The device according to claim 1, characterized in that the duration of one session of exposure to the feet and hands of a person is from 20 to 40 minutes.

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