EP0127653B1 - Apparatus for treating back ailments - Google Patents
Apparatus for treating back ailments Download PDFInfo
- Publication number
- EP0127653B1 EP0127653B1 EP19830903835 EP83903835A EP0127653B1 EP 0127653 B1 EP0127653 B1 EP 0127653B1 EP 19830903835 EP19830903835 EP 19830903835 EP 83903835 A EP83903835 A EP 83903835A EP 0127653 B1 EP0127653 B1 EP 0127653B1
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- EP
- European Patent Office
- Prior art keywords
- patient
- support means
- program
- movements
- tensioning
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
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- 210000004197 pelvis Anatomy 0.000 claims abstract description 20
- 238000003745 diagnosis Methods 0.000 claims abstract description 11
- 230000003213 activating effect Effects 0.000 claims abstract description 3
- 230000008878 coupling Effects 0.000 claims description 10
- 238000010168 coupling process Methods 0.000 claims description 10
- 238000005859 coupling reaction Methods 0.000 claims description 10
- 230000035807 sensation Effects 0.000 claims description 6
- 210000004705 lumbosacral region Anatomy 0.000 claims description 5
- 230000004913 activation Effects 0.000 claims description 3
- 238000006243 chemical reaction Methods 0.000 claims description 2
- 244000182067 Fraxinus ornus Species 0.000 claims 3
- 230000006870 function Effects 0.000 description 3
- 238000013519 translation Methods 0.000 description 3
- 230000009471 action Effects 0.000 description 2
- 238000013461 design Methods 0.000 description 2
- 238000012986 modification Methods 0.000 description 2
- 230000004048 modification Effects 0.000 description 2
- 235000004443 Ricinus communis Nutrition 0.000 description 1
- 240000000528 Ricinus communis Species 0.000 description 1
- 230000001276 controlling effect Effects 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 230000035876 healing Effects 0.000 description 1
- 230000000977 initiatory effect Effects 0.000 description 1
- 238000000034 method Methods 0.000 description 1
- 231100000957 no side effect Toxicity 0.000 description 1
- 230000003534 oscillatory effect Effects 0.000 description 1
- 230000008058 pain sensation Effects 0.000 description 1
- 238000012545 processing Methods 0.000 description 1
- 230000001105 regulatory effect Effects 0.000 description 1
- 238000012360 testing method Methods 0.000 description 1
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- 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
- A61H1/00—Apparatus for passive exercising; Vibrating apparatus; Chiropractic devices, e.g. body impacting devices, external devices for briefly extending or aligning unbroken bones
- A61H1/02—Stretching or bending or torsioning apparatus for exercising
- A61H1/0218—Drawing-out devices
- A61H1/0222—Traction tables
Definitions
- the present invention relates to an apparatus for treating back ailments and more particularly an apparatus of the kind which includes patient support means for supporting a patient in a horizontal, lying position; a first tension take-up means arranged to pass around the pelvis area of a patient; a second tension take-up means arranged to pass around the chest of the patient, tensioning means arranged for connection to a selected one of said first and said second tension take-up means; carriage means intended to support the pelvis region or the chest region of the patient support means; a movably arranged and vertically adjustable lumbar support means mounted on said patient support means; and drive means for activating said tensioning means and the readily movable carriage means according to selected program instructions.
- An apparatus of this general type is disclosed in SE-A-360 560.
- One such apparatus includes a movable support surface intended to support the pelvis region of a patient, said support means being arranged for rotation about a first horizontal axis, about second horizontal axis, and about a vertical axis; a fixed support surface for supporting the chest of the patient; and lumbar support means. It is not possible, however, to apply traction with such an apparatus, which is a serious disadvantage, since traction must be considered an important part of a complete program for successfully treating back ailments. Neither are means provided which are capable of regulating the height of the lumbar support means during the coure of treatment in question, it would appear that the support means can only be set in an initial position corresponding to the shape of the back of a patient undergoing treatment.
- Another known apparatus includes a fixed support for supporting the chest area of a patient; lumbar support means which are rotatable about a vertical axis, so that said lumbar support means can accompany movement of the patient in the longitudinal direction of the apparatus; and movable pelvis support means, which can be imparted a translatory movement in the longitudinal direction of the apparatus (and of the patient). Consequently, it is not possible with this known apparatus to execute any form of rotary movement, other than small movements conforming to a pre-arranged program.
- a further known apparatus of the aforesaid kind includes two movable support means which are arranged one behind the other and which can be rotated about one and the same axis but in mutually different directions, so as to move in an oscillatory fashion, thereby to turn or twist the back of the patient to some extent.
- the apparatus has no means for supporting the small of the back, i.e. the lumbar region of the patient, and cannot subject the patient to traction.
- the turning or twisting (torsion) action is limited to a single axis of rotation.
- Another object is to provide an apparatus of the kind described with which a diagnosis can be made, treatment carried out, and the result of the treatment analysed, in a manner such that the back ailment of a patient can be charted and treated correctly, optionally through the patient's own activities, and in all events so that it is established what should (or can) be done, and so that treatment is effected at the correct locations and at suitable moments in time.
- the apparatus includes a movement program control unit arranged to control said drive means to initiate and to control a selected sequence of movements in accordance with a program entered therein, said control unit including: a movement sequence selector panel having means for selecting translatory, rotational and pivotal movement of the carriage means for setting the limits of such movements, and for restricting the vertical movement of the lumbar support means; a control panel which is coupled to the selector panel and which has arranged thereon a control means for controlling the sequence of movements selected through said selector panel, said control means having three functional states, a first state of which advances the program, a second state of which reverses the program and a third state of which halts the execution of said program; the said control unit further including manually operable and controllable means for registering and recording the reactions of and the sensations experienced by the patient when executing the movements in said program, and manually operable and controllable means for halting all movements of the apparatus irrespective
- the diagnosis is conveniently carried out in accordance with a previously compiled program stored in data processing means incorporated in the control unit and, following instructions given by the doctor or physiotherapist, can be carried out by the patient himself/herself, by manipulation of a control means on the control panel.
- the program includes instructions for testing the ability of the patient to move the small of his back, to bend sideways, and to turn.
- the movement programe is suitably compiled by a doctor, and when required is initiated through the selector panel in the control unit.
- the movement programe can be optionally selected automatically in the data processor, by initiating a previously inserted, fixed program, while observing the result of the initial diagnosis.
- buttons arranged in the control panel for indicating or recording sensations of pain during body movement (e.g. traction)
- the patient is himself able to influence the program, and during the course of treatment cause factors to be recorded which, when taken together, present a true picture of the state of the patient's back. This enables the patient to undergo treatment while in a quiet and relaxed condition.
- the apparatus illustrated in Figure 1 includes a patient support surface 10 for supporting a. patient in a horizontal lying position.
- a carriage means 11 Arranged for ready movement relative to the support surface 10 is a carriage means 11, which is intended to support either the pelvis region of the patient or the chest region thereof.
- the carriage means 11 is arranged for translatory movement and rotational or pivotal movement modes about respective axes, and is driven by means 141, which may have the form of a motor.
- a first tension take-up means in the form of a belt 12 which in this embodiment is intended to support the pelvis region of the patient, and which is tensioned by means of tensioning means 131-131', driven by motor 142.
- a chest support means 13 which has arranged thereon a second tension take-up means in the form of a belt 14, which is arranged to encircle the chest of said patient and which is tensioned by straps 182-182', driven by motor 145.
- the chest support means 13 is stationary relative to the patient support means 10.
- lumbar is meant here, and in the following, as well as in the aforegoing, that area of the body normally referred to as the "small of the back".
- the first tension take-up means i.e. the belt 12 is placed under tension, e.g. for traction purposes, by means of the tensioning means 131 and 131' having the form of cables which extend to a respective post 101 and 101' located at one end of the support means 10, and which are operated by said drive means 142, while the second tension take-up means 14, e.g. for holding the chest firmly on the chest support, has the form of tensioning straps 132, 132', which are operated by drive means 145.
- the reference 17 identifies a coupling means co-acting between the lumbar support means 15 and the carriage means 11 for a purpose which will hereinafter be made apparent.
- each of the drive means 141, 142, 143, 145 is connected to a movement program control unit 18, which includes a movement sequence selector panel 19 and a control panel 20, on which there is arranged a program control means, in the form of a knob or dial 21.
- a movement program control unit 18 which includes a movement sequence selector panel 19 and a control panel 20, on which there is arranged a program control means, in the form of a knob or dial 21.
- Control-signal lines leading to respective drive means 141-145 are shown by chain line 22.
- the drive means 141, 142, 143, 145 are designed and operationally connected to the control unit 18 in a manner such that when a given sequence of movements is initiated, e.g. translation, through the selector panel 19, and the knob or dial 21 is turned clockwise, the translatory movements are carried out successively, while when the knob is turned counter-clockwise, the sequence of movements is effected in the reverse order.
- a given sequence of movements e.g. translation, through the selector panel 19, and the knob or dial 21 is turned clockwise
- the translatory movements are carried out successively, while when the knob is turned counter-clockwise, the sequence of movements is effected in the reverse order.
- the knob 21 illustrated in Figure 1 can be replaced with, for example, a lever having three operational states, namely a right-hand state, an intermediate state, and a left-hand state; or with a keyboard having a right-hand button, a left-hand button, and an intermediate button. All three embodiments form control means which can be easily reached and manipulated by the patient. (For the sake of illustration, the control unit 18 has been drawn slightly to one side of the remainder of the apparatus.)
- the control unit 18 illustrated in Figure 1 includes a data processor (not shown in the Figure) in which is stored a programmed sequence of movements which an be initiated through the selector panel 19.
- the control panel 20 includes, in addition to the control means 21 (the knob), an alarm button 23, and a recording and/or indicating means 24 for recording sensations of pain experienced during the sequence of movements being carried out by the patient (e.g. during traction), said recording means being so arranged that when activated by the patient to record said pain sensations, the programme is either stopped, or a jump is made to a further state or part-program thereof.
- the selector panel 19 includes a keyboard 201 for the selection of such movements as translation, rotation and turning or pivoting of the readily movable carriage means 11, and for setting the limits to which said movements shall be made; and for setting the vertical translatory movement of the lumbar support means 15 and for setting the limits to which such movement shall be made.
- An array of lamps 202-203 is arranged to indicate the positions and values (202) in question, and momentary symbolic images (203) of the sequence of movements being carried out.
- the unit 202 includes digital instruments for reading-off the pressure exerted on the lumbar support means 15 (in Newtons, three figures); the height of said lumbar support means 15 (in centimeters, two figures), the turning or pivot angle (in degrees, two figures), rotation (in degrees, two figures), traction force (in Newtons, three figures), and time (in minutes, three figures).
- the unit 203 includes lamps having symbols which identify the function in question and which illuminate when a corresponding button on the keyboard 200 is pressed.
- the control unit 18 can be swung to any position desired by the patient or the physciotherapist.
- the control unit 18 also includes a register 25 which is arranged to be activated at regular intervals, when the patient activates the recording means 24, and at the end of each movement sequence, e.g. translation, for registration to relevant factors, such as, for example, the tension force in the tensioning means 131-131', the pressure exerted against said lumbar support means 15, etc.
- the data processor incorporated in the control unit 18 is arranged to make a comparison between the factors registered by the register 25 and deriving from an initial mobility diagnosis- made at the beginning of a course of treatment - with factors deriving from a movement program carried out at the end of said course of treatment, thereby enabling a clear and concise picture of the result of said treatment to be obtained.
- the pelvis support means 11 is movable and the chest support means 13 is stationary, and that the tension forces required for traction are generated by the tensioning means 131-131', while the tensioning means 132-132' are intended for holding the patient's chest firmly to the chest support means.
- the pelvis support means 11 can be stationary and the chest support means 13 movable, wherewith the tension force required for traction is obtained through the take-up means 14.
- the tensioning means 132-132' is suitably modified to coincide, for example, with the illustrated tensioning means 131-131'.
- Cables 231-234 required for transferring data to and from the various units are located between the selector panel 19, the control panel 20, and the register 25. Data relating to activation by the patient of knob 21, the recording means 24, and the alarm button 23 is transmitted from the control panel 20 to the selector panel 19 (with data processor) over cable 231.
- Signals containing data relating to instructions for the patient are transmitted from the selector panel 19 to the control unit 20 over cable 232. These instructions are presented on a display 214, and may instruct the patient eitherto turn the knob 21 or to wait (rest), or may inform him that the course of treatment has been concluded.
- Control signals relating to the registration of such data as time-recording, recording of angular values when turning and rotating respective support means, recording of tension and pressure values etc., are transmitted from the selector panel 19 to the register 25 over cable 233.
- Signals containing data relating to activation by the patient of the knob, the recording means 24 and the alarm button 23 are transmitted from the control panel 20 to the register 25 over cable 234.
- the aforedescribed apparatus has three different modes of use, namely manual use; use in accordance with an individual program; or use in accordance with a standard program.
- a given function e.g. traction
- the maximum tension is set by means of keyboard 201, and the value selected is shown on the array- lamps 201.
- the function selected is initiated by turning the knob 21; this being done by either the patient or the physiotherapist. When the knob is turned to the right, the tensioning force is produced through the tensioning means 131-131', while the tension in the tensioning means is relaxed when turning the knob to the left.
- the apparatus When the apparatus is used in conjunction with an individual program, there is first made an initial diagnosis, to establish an original point of departure with respect to the course of treatment adopted, i.e. the patient carries out in said apparatus a programe entailing movement of the small of the back, rotational movements and turning movements, to establish the degree of mobility of the patient.
- the doctor or physiotherapist then compiles a program of treatment, which is entered into the memory of the data processor of the control unit, through the selector panel 19.
- This program is stored, and initiated when the patient reports for treatment.
- the patient can carry out the treatment himelf, by means of the knob 21. When the knob is turned to the right, the program is wound forwards, and is wound backwards when the knob is turned to the left.
- the patient obtains through the display 214 such instructions as "turn the knob” or “wait”.
- the patient signals the feeling of pain by pressing the knob 24.
- the data processor may also be programmed to select the requisite part-program itself, on the basis of the diagnosis carried out.
- a course of treatment can have the following pattern:
- the first mentioned comparison made in the data processor between the initial mobility diagnosis and the concluded program can also include factors of particular interest recorded from the actual treatment carried out such as the maximum extent to which the patient is able to bend, turn etc. without undue discomfort.
- the lumbar support means 15 is so arranged that when the carriage means 11 moves in accordance with a pre-arranged program, movement of the lumbar support means 15 is adapted in a manner which is determined by and which conforms to the natural position of the small of the back of said patient, i.e. the lumbar region thereof.
- the lumbar support means 15 will accompany the translatory and turning movements of the pelvis support to a greater or lesser extent, but will remain stationary during the rotary movement thereof.
- the carriage means 11 forms the means 13 for supporting the chest region of the patient
- the lumbar support means 15 will accompany the carriage means/chest support means throughout the whole of its rotary movement.
- said mechanical coupling 17 (Figure 1) is a combined slide and pivot coupling and comprises a rod 26 which is freely slidable at one end thereof in the longitudinal direction of the apparatus in a bush 27 which is fixed to the carriage means 11. The other end of the rod 26 is mounted for free pivotal movement in a bracket structure 28 attached to the lumbar support means 15.
- the lumbar support means 15 of the Figure 3 embodiment is arranged on rollers or castors 40, so as to be freely movable relative to the patient support means 10. As beforementioned, the height of the lumbar support means 15 above the patient support means 10 is adjustable.
- the arrows A-A indicate the turning or pivoting movements executed by the carriage means 11 about a vertical axis
- the arrows B-B indicate the rotary movements of said carriage means about a horizontal axis.
- Another method of mechanically guiding the lumbar support means for the aforesaid end is to arrange a rectangular recess slightly beneath the upppermost surface of the support, and to insert in said recess a guide means which is fixed relative to the patient support means 10 and which permits freedom of movement in the horizontal plane, within required limits, but which opposes any tendency of the lumbar support means to rotate about a horizontal axis.
- the pelvis support means which forms the carriage means 11.
- the mechanical guide must be such as to enable the lumbar support means 15 to accompany the rotary movement of the carriage means 11, for example by providing the support and said carriage means with a common supporting surface, while being guided by the couplings 27-26-28.
- the lumbar support means 15 when the patient is under traction, the lumbar support means 15, through the rod and bush coupling 26 and 27, will take a position conforming to the natural position of the patient's lumbar region, as the carriage moves relative to the patient support means 10.
- the carriage means when the carriage means is pivoted or swung about a horizontal axis, the lumbar support means will accompany said pivotal movement through the agency of the rod and link bracket coupling 26 and 28 and the rollers 40, to an extent determined by, and conforming to the natural position of the patient's lumbar region.
- the rollers 40 form a positive guide means which when the carriage means 11 executes a rotational movement about a horizontal axis, cause the lumbar support means to take the same position relative to the chest support means 14, during the whole of said rotational movement. All three conditions placed on the lumbar support through the coupling 26-28 and the guide means40 ensurethatthe lumbar support means will always take a position which conforms to the natural position of the small of the patient's back.
- Figures 4, 5 and 6 illustrate alternative embodiments of tension control means, by which the patient can be held firmly to the pelvis support means and to the chest support means, without placing undue strain on the patient's back.
- the belt of the first tension take-up means 12 has mounted thereon a first pair of pullies 112, 112', while the movable carriage means 11 has mounted thereon a second pairofpullies 132, 132'.
- a third pair of pullies 133, 133' is mounted on the patient support means 10.
- the pulley pair 132,132' is mounted on the underside of the movable carriage 11, approximately immediately beneath the pulley pair 112,112', while the pulley pair 133, 133' is mounted at one end of the patient support means 10, adjacent the post pair 101, 101'.
- the belt is connected to the belt tensioning means 30 via a line arrangement, which in the illustrated embodiment comprises line portions 111, 111' extending from said belt to a respective post 101 and 101'.
- Each of the line portions 111, 111' connects one of said first pullies, e.g. 112, with one of the second pullies 132 and one of said third pullies 133.
- One end of each line portion is secured to a tensioning means 30, while the remaining end of one of said line portions is secured to the patient support means, namely to the post 101 for the line 111.
- the line portion 111' connects the wheel or roller 112' with the pulley 132' and the pulley 133', and one end of the line portion is secured to the tensioning means 30 and the remaining end to the post 101'.
- the tensioning means 30 has a grooved wheel 200 around which said remaining ends, the co-linking ends, of the line portions 111, 111' are passed. When the tensioning means 30 is subjected to a tension force, the forces acting in the lines will be equalized through the action of the wheel 200, while possibly turning the carriage means 11 atthe same time.
- Figure 5 illustrates a modification of the embodiment illustrated in Figure 4, in which the force- equalizing wheel 200 has been omitted from the tensioning means 30.
- the lower ends of the line portions 111, 111' are secured directly to the tensioning means 30, which means that each line has a constant length during the course of the treatment. Consequently, the tension forces in the two lines may be mutually different and may vary during the course of said treatment.
- FIG. 6 A further embodiment is illustrated in Figure 6. in addition to the apparatus components described in the aforegoing, the embodiment according to Figure 6 includes a fourth pair of pullies 102, 102', which are mounted on the posts 101, 101'. Attached to the sides of the belt belonging to the tension take-up means 12 are rigid plates 113,113'. These plates extend over the whole width of the belt and somewhat beyond the edge of the belt facing the foot-end of the support means (furthest away from the reader).
- One end of the line portion 111 is attached to the plate 113 and extends around the pullies 102, 112, 132 and 133 in the order just mentioned, while one end of the line portion 111' is attached to the plate 113' and extends around the pullies 102', 112', 132' and 133' in that order.
- the remaining ends of the line portions meet around the grooved wheel 200 in the tensioning means.
- two parts of the line 111 and 111' pass between a respective plate 113 and 113'and a repective pulley 102 and 102', which has been found important with respect to the application of the tensioning force.
- the members 102,102' , 112,112', 132, 132' and 133, 133' have been shown and decribed as pullies, although, as will be understood, these members may have the form of equivalent devices, such as rollers, eyes, etc. which ensure that the lines run freely.
- the members 111, 111' may also comprise straps, bands or the like.
- each of the line portions 111, 111' has the end in question securely connected to the tensioning means 30, i.e. in the manner indicated in Figure 5.
- FIG. 7 illustrates a simplified version of the tension control means according to the invention.
- belt 12 (or the belt 14) is provided with a first pair of pullies 112, 112', while a second pair of pullies is mounted on the movable carriage means 11.
- a line arrangement comprises line portions 111, 111' and connects respective pullies of the first pair to respective pullies of the second pair.
- One end of the line arrangement is connected to the tensioning means 30 or 141, while the other end is fixedly arranged relative the patient support means 10, the first or second straps 12, 14, or to the line itself.
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Abstract
Description
- The present invention relates to an apparatus for treating back ailments and more particularly an apparatus of the kind which includes patient support means for supporting a patient in a horizontal, lying position; a first tension take-up means arranged to pass around the pelvis area of a patient; a second tension take-up means arranged to pass around the chest of the patient, tensioning means arranged for connection to a selected one of said first and said second tension take-up means; carriage means intended to support the pelvis region or the chest region of the patient support means; a movably arranged and vertically adjustable lumbar support means mounted on said patient support means; and drive means for activating said tensioning means and the readily movable carriage means according to selected program instructions. An apparatus of this general type is disclosed in SE-A-360 560.
- Various apparatus for treating back ailments are known to the art, these apparatus being of widely different designs and operational modes.
- One such apparatus includes a movable support surface intended to support the pelvis region of a patient, said support means being arranged for rotation about a first horizontal axis, about second horizontal axis, and about a vertical axis; a fixed support surface for supporting the chest of the patient; and lumbar support means. It is not possible, however, to apply traction with such an apparatus, which is a serious disadvantage, since traction must be considered an important part of a complete program for successfully treating back ailments. Neither are means provided which are capable of regulating the height of the lumbar support means during the coure of treatment in question, it would appear that the support means can only be set in an initial position corresponding to the shape of the back of a patient undergoing treatment.
- Another known apparatus includes a fixed support for supporting the chest area of a patient; lumbar support means which are rotatable about a vertical axis, so that said lumbar support means can accompany movement of the patient in the longitudinal direction of the apparatus; and movable pelvis support means, which can be imparted a translatory movement in the longitudinal direction of the apparatus (and of the patient). Consequently, it is not possible with this known apparatus to execute any form of rotary movement, other than small movements conforming to a pre-arranged program.
- A further known apparatus of the aforesaid kind includes two movable support means which are arranged one behind the other and which can be rotated about one and the same axis but in mutually different directions, so as to move in an oscillatory fashion, thereby to turn or twist the back of the patient to some extent. The apparatus has no means for supporting the small of the back, i.e. the lumbar region of the patient, and cannot subject the patient to traction. Moreover, the turning or twisting (torsion) action is limited to a single axis of rotation.
- These and similar apparatus normally have a very limited healing effect on the back ailments of the patient, and when used wrongly can sometimes be very dangerous.
- Accordingly, it is a first object of this intention to provide an apparatus for treating back ailments which will afford the best possible treatment with the least possible discomfort to the patient.
- Another object is to provide an apparatus of the kind described with which a diagnosis can be made, treatment carried out, and the result of the treatment analysed, in a manner such that the back ailment of a patient can be charted and treated correctly, optionally through the patient's own activities, and in all events so that it is established what should (or can) be done, and so that treatment is effected at the correct locations and at suitable moments in time.
- In accordance with the invention, these objects are achieved by means of an apparatus of the kind defined which is characterized in that the apparatus includes a movement program control unit arranged to control said drive means to initiate and to control a selected sequence of movements in accordance with a program entered therein, said control unit including: a movement sequence selector panel having means for selecting translatory, rotational and pivotal movement of the carriage means for setting the limits of such movements, and for restricting the vertical movement of the lumbar support means; a control panel which is coupled to the selector panel and which has arranged thereon a control means for controlling the sequence of movements selected through said selector panel, said control means having three functional states, a first state of which advances the program, a second state of which reverses the program and a third state of which halts the execution of said program; the said control unit further including manually operable and controllable means for registering and recording the reactions of and the sensations experienced by the patient when executing the movements in said program, and manually operable and controllable means for halting all movements of the apparatus irrespective of the point reached in the program.
- The diagnosis is conveniently carried out in accordance with a previously compiled program stored in data processing means incorporated in the control unit and, following instructions given by the doctor or physiotherapist, can be carried out by the patient himself/herself, by manipulation of a control means on the control panel. The program includes instructions for testing the ability of the patient to move the small of his back, to bend sideways, and to turn.
- The movement programe is suitably compiled by a doctor, and when required is initiated through the selector panel in the control unit. The movement programe can be optionally selected automatically in the data processor, by initiating a previously inserted, fixed program, while observing the result of the initial diagnosis.
- By means of recording means (buttons) arranged in the control panel for indicating or recording sensations of pain during body movement (e.g. traction), the patient is himself able to influence the program, and during the course of treatment cause factors to be recorded which, when taken together, present a true picture of the state of the patient's back. This enables the patient to undergo treatment while in a quiet and relaxed condition.
- So that the invention will be more readily understood and further features thereof made apparent, a number of embodiments will now be described with reference to the accompanying schematic drawings, in which
- Figure 1 illustrates an apparatus for treating back ailments and having a movement program control in accordance with the invention.
- Figure 2 illustrates the movement program control unit in more detail.
- Figure 3 illustrates an embodiment of a coupling means between the lumbar support means and the carriage means; and also illustrates an embodiment of a lumbar support guide means.
- Figure 4 illustrates a first embodiment of a tension control means, and shows the tension take-up means intended for the pelvis region of the patient.
- Figure 5 is a second embodiment of a tension control means;
- Figure 6 is a third embodiment and Figure 7 is a fourth embodiment of a tension control means.
- The apparatus illustrated in Figure 1 includes a
patient support surface 10 for supporting a. patient in a horizontal lying position. Arranged for ready movement relative to thesupport surface 10 is a carriage means 11, which is intended to support either the pelvis region of the patient or the chest region thereof. As will be made more apparent later on, the carriage means 11 is arranged for translatory movement and rotational or pivotal movement modes about respective axes, and is driven bymeans 141, which may have the form of a motor. - Mounted on the carriage means 11 is a first tension take-up means in the form of a
belt 12 which in this embodiment is intended to support the pelvis region of the patient, and which is tensioned by means of tensioning means 131-131', driven bymotor 142. - In order to support the chest of a patient during a course of treatment, there is arranged on the support means 10 at some distance from the carriage means 11, a chest support means 13 which has arranged thereon a second tension take-up means in the form of a
belt 14, which is arranged to encircle the chest of said patient and which is tensioned by straps 182-182', driven bymotor 145. In the illustrated embodiment the chest support means 13 is stationary relative to the patient support means 10. - Arranged between the pelvis and chest support means 11 and 13 is a movable and vertically adjustable lumbar support means 15. By lumbar is meant here, and in the following, as well as in the aforegoing, that area of the body normally referred to as the "small of the back".
- The first tension take-up means, i.e. the
belt 12 is placed under tension, e.g. for traction purposes, by means of the tensioning means 131 and 131' having the form of cables which extend to arespective post 101 and 101' located at one end of the support means 10, and which are operated by saiddrive means 142, while the second tension take-up means 14, e.g. for holding the chest firmly on the chest support, has the form oftensioning straps drive means 145. - The
reference 17 identifies a coupling means co-acting between the lumbar support means 15 and the carriage means 11 for a purpose which will hereinafter be made apparent. - As will be seen from Figure 1, each of the drive means 141, 142, 143, 145 is connected to a movement
program control unit 18, which includes a movementsequence selector panel 19 and acontrol panel 20, on which there is arranged a program control means, in the form of a knob ordial 21. Control-signal lines leading to respective drive means 141-145 are shown bychain line 22. - The drive means 141, 142, 143, 145 are designed and operationally connected to the
control unit 18 in a manner such that when a given sequence of movements is initiated, e.g. translation, through theselector panel 19, and the knob ordial 21 is turned clockwise, the translatory movements are carried out successively, while when the knob is turned counter-clockwise, the sequence of movements is effected in the reverse order. - The
knob 21 illustrated in Figure 1 can be replaced with, for example, a lever having three operational states, namely a right-hand state, an intermediate state, and a left-hand state; or with a keyboard having a right-hand button, a left-hand button, and an intermediate button. All three embodiments form control means which can be easily reached and manipulated by the patient. (For the sake of illustration, thecontrol unit 18 has been drawn slightly to one side of the remainder of the apparatus.) - The
control unit 18 illustrated in Figure 1 includes a data processor (not shown in the Figure) in which is stored a programmed sequence of movements which an be initiated through theselector panel 19. Thecontrol panel 20 includes, in addition to the control means 21 (the knob), analarm button 23, and a recording and/or indicatingmeans 24 for recording sensations of pain experienced during the sequence of movements being carried out by the patient (e.g. during traction), said recording means being so arranged that when activated by the patient to record said pain sensations, the programme is either stopped, or a jump is made to a further state or part-program thereof. - The
selector panel 19 includes akeyboard 201 for the selection of such movements as translation, rotation and turning or pivoting of the readily movable carriage means 11, and for setting the limits to which said movements shall be made; and for setting the vertical translatory movement of the lumbar support means 15 and for setting the limits to which such movement shall be made. An array of lamps 202-203 is arranged to indicate the positions and values (202) in question, and momentary symbolic images (203) of the sequence of movements being carried out. - The
unit 202 includes digital instruments for reading-off the pressure exerted on the lumbar support means 15 (in Newtons, three figures); the height of said lumbar support means 15 (in centimeters, two figures), the turning or pivot angle (in degrees, two figures), rotation (in degrees, two figures), traction force (in Newtons, three figures), and time (in minutes, three figures). Theunit 203 includes lamps having symbols which identify the function in question and which illuminate when a corresponding button on thekeyboard 200 is pressed. - The
control unit 18 can be swung to any position desired by the patient or the physciotherapist. - The
control unit 18 also includes aregister 25 which is arranged to be activated at regular intervals, when the patient activates the recording means 24, and at the end of each movement sequence, e.g. translation, for registration to relevant factors, such as, for example, the tension force in the tensioning means 131-131', the pressure exerted against said lumbar support means 15, etc. - The data processor incorporated in the
control unit 18 is arranged to make a comparison between the factors registered by theregister 25 and deriving from an initial mobility diagnosis- made at the beginning of a course of treatment - with factors deriving from a movement program carried out at the end of said course of treatment, thereby enabling a clear and concise picture of the result of said treatment to be obtained. - In the aforegoing it has been assumed that the pelvis support means 11 is movable and the chest support means 13 is stationary, and that the tension forces required for traction are generated by the tensioning means 131-131', while the tensioning means 132-132' are intended for holding the patient's chest firmly to the chest support means. If considered suitable, the pelvis support means 11 can be stationary and the chest support means 13 movable, wherewith the tension force required for traction is obtained through the take-up means 14. In this respect the tensioning means 132-132' is suitably modified to coincide, for example, with the illustrated tensioning means 131-131'. Cables 231-234 required for transferring data to and from the various units are located between the
selector panel 19, thecontrol panel 20, and theregister 25. Data relating to activation by the patient ofknob 21, the recording means 24, and thealarm button 23 is transmitted from thecontrol panel 20 to the selector panel 19 (with data processor) overcable 231. - Signals containing data relating to instructions for the patient are transmitted from the
selector panel 19 to thecontrol unit 20 overcable 232. These instructions are presented on adisplay 214, and may instruct the patient eitherto turn theknob 21 or to wait (rest), or may inform him that the course of treatment has been concluded. - Control signals relating to the registration of such data as time-recording, recording of angular values when turning and rotating respective support means, recording of tension and pressure values etc., are transmitted from the
selector panel 19 to theregister 25 overcable 233. - Signals containing data relating to activation by the patient of the knob, the recording means 24 and the
alarm button 23 are transmitted from thecontrol panel 20 to theregister 25 overcable 234. - In principle, the aforedescribed apparatus has three different modes of use, namely manual use; use in accordance with an individual program; or use in accordance with a standard program.
- When used manually, a given function, e.g. traction, is selected through the
keyboard 200. The maximum tension is set by means ofkeyboard 201, and the value selected is shown on the array-lamps 201. The function selected is initiated by turning theknob 21; this being done by either the patient or the physiotherapist. When the knob is turned to the right, the tensioning force is produced through the tensioning means 131-131', while the tension in the tensioning means is relaxed when turning the knob to the left. - When the apparatus is used in conjunction with an individual program, there is first made an initial diagnosis, to establish an original point of departure with respect to the course of treatment adopted, i.e. the patient carries out in said apparatus a programe entailing movement of the small of the back, rotational movements and turning movements, to establish the degree of mobility of the patient. The doctor or physiotherapist then compiles a program of treatment, which is entered into the memory of the data processor of the control unit, through the
selector panel 19. This program is stored, and initiated when the patient reports for treatment. The patient can carry out the treatment himelf, by means of theknob 21. When the knob is turned to the right, the program is wound forwards, and is wound backwards when the knob is turned to the left. - As beforementioned, as the programe progresses, the patient obtains through the
display 214 such instructions as "turn the knob" or "wait". The patient signals the feeling of pain by pressing theknob 24. - When using the apparatus in conjunction with a standard program, there is used a part-program which has been previously inserted into the data processor and which can be initiated through the
selector panel 19. The data processor may also be programmed to select the requisite part-program itself, on the basis of the diagnosis carried out. - By way of summary, a course of treatment can have the following pattern:
- 1. The patient himself/herself records factors relating to his/her back ailment on a form intended therefor.
- 2. The doctor or physiotherapist investigates the ability of the patient to bend and turn.
- 3. A statistical diagnosis is made in the apparatus, during which the height of the small of the back is measured, together with the ability of the patient to turn or bend sideways (right and left) and to turn in two dirctions.
- 4. A suitable program of treatment is compiled.
- 5. The patient "runs" through the program himself/herself, whereupon data of interest is registered automatically.
- 6. A fresh statistical diagnosis is carried out on the apparatus and compared with the initial diagnosis.
- 7. A written record of the result of the comparison is obtained from the
register 25, together with suggestions for further treatment. - The first mentioned comparison made in the data processor between the initial mobility diagnosis and the concluded program can also include factors of particular interest recorded from the actual treatment carried out such as the maximum extent to which the patient is able to bend, turn etc. without undue discomfort.
- In order to ensure that the position of the lumbar support means 15 conforms more readily to the positions of other apparatus components, so that the patient suffers no side effects, the lumbar support means 15 according to one embodiment of the invention is so arranged that when the carriage means 11 moves in accordance with a pre-arranged program, movement of the lumbar support means 15 is adapted in a manner which is determined by and which conforms to the natural position of the small of the back of said patient, i.e. the lumbar region thereof. This is effected, inter alia, by means of a
mechanical coupling 17, 26-28 between the lumbar support means 15 and the carriage means 11 and by the design of said lumbar support means 15, such that when the carriage means 11 executes a horizontal translatory or turning movement, the lumbar support means 15 will adopted the position determined by and conforming to the natural attitude of the small of the back of said patient during respective movements, while when the carriage means 11 executes a rotary movement about a horizontal axis, the lumbar support means 15 will take the same position as the chest support means 13 during the whole of said rotary movement. - In accordance with this embodiment, in those cases when the carriage means 11 forms the pelvis support means, the lumbar support means 15 will accompany the translatory and turning movements of the pelvis support to a greater or lesser extent, but will remain stationary during the rotary movement thereof. On the other hand, when the carriage means 11 forms the
means 13 for supporting the chest region of the patient, the lumbar support means 15 will accompany the carriage means/chest support means throughout the whole of its rotary movement. - As will be seen more clearly from Figure 3, said mechanical coupling 17 (Figure 1) is a combined slide and pivot coupling and comprises a
rod 26 which is freely slidable at one end thereof in the longitudinal direction of the apparatus in abush 27 which is fixed to the carriage means 11. The other end of therod 26 is mounted for free pivotal movement in a bracket structure 28 attached to the lumbar support means 15. - The lumbar support means 15 of the Figure 3 embodiment is arranged on rollers or
castors 40, so as to be freely movable relative to the patient support means 10. As beforementioned, the height of the lumbar support means 15 above the patient support means 10 is adjustable. - The arrows A-A indicate the turning or pivoting movements executed by the carriage means 11 about a vertical axis, and the arrows B-B indicate the rotary movements of said carriage means about a horizontal axis. As a result of the extension of the lumbar support means 15 in the transverse direction of the apparatus, i.e. the distance between the
rollers 40 in the transverse direction, said rollers will act as a mechanical guide means to positively prevent the lumbar support means from accompanying the rotary movement of the carriage means 11 about said horizontal axis. The ability of therod 26 to slide freely relative to thebush 27 is also contributory in this respect. Another method of mechanically guiding the lumbar support means for the aforesaid end, is to arrange a rectangular recess slightly beneath the upppermost surface of the support, and to insert in said recess a guide means which is fixed relative to the patient support means 10 and which permits freedom of movement in the horizontal plane, within required limits, but which opposes any tendency of the lumbar support means to rotate about a horizontal axis. - In the aforegoing it has been assumed that it is the pelvis support means which forms the carriage means 11. Although this is considered to be the most practical, there is nothing to prevent the pelvis support means from being permanently fixed, and allowing the chest support means to form said movable carriage means, as beforementioned. In this latter case, however, the mechanical guide must be such as to enable the lumbar support means 15 to accompany the rotary movement of the carriage means 11, for example by providing the support and said carriage means with a common supporting surface, while being guided by the couplings 27-26-28.
- Thus, when the patient is under traction, the lumbar support means 15, through the rod and
bush coupling link bracket coupling 26 and 28 and therollers 40, to an extent determined by, and conforming to the natural position of the patient's lumbar region. As beforementioned, the rollers 40form a positive guide meanswhich when the carriage means 11 executes a rotational movement about a horizontal axis, cause the lumbar support means to take the same position relative to the chest support means 14, during the whole of said rotational movement. All three conditions placed on the lumbar support through the coupling 26-28 and the guide means40 ensurethatthe lumbar support means will always take a position which conforms to the natural position of the small of the patient's back. - Figures 4, 5 and 6 illustrate alternative embodiments of tension control means, by which the patient can be held firmly to the pelvis support means and to the chest support means, without placing undue strain on the patient's back.
- In the embodiment illustrated in Figure 4, the belt of the first tension take-up means 12 has mounted thereon a first pair of
pullies 112, 112', while the movable carriage means 11 has mounted thereon asecond pairofpullies pullies 133, 133' is mounted on the patient support means 10. The pulley pair 132,132' is mounted on the underside of themovable carriage 11, approximately immediately beneath the pulley pair 112,112', while thepulley pair 133, 133' is mounted at one end of the patient support means 10, adjacent thepost pair 101, 101'. - The belt is connected to the belt tensioning means 30 via a line arrangement, which in the illustrated embodiment comprises
line portions 111, 111' extending from said belt to arespective post 101 and 101'. - Each of the
line portions 111, 111' connects one of said first pullies, e.g. 112, with one of thesecond pullies 132 and one of saidthird pullies 133. One end of each line portion is secured to a tensioning means 30, while the remaining end of one of said line portions is secured to the patient support means, namely to thepost 101 for theline 111. Correspondingly, the line portion 111' connects the wheel or roller 112' with thepulley 132' and the pulley 133', and one end of the line portion is secured to the tensioning means 30 and the remaining end to the post 101'. The tensioning means 30 has a groovedwheel 200 around which said remaining ends, the co-linking ends, of theline portions 111, 111' are passed. When the tensioning means 30 is subjected to a tension force, the forces acting in the lines will be equalized through the action of thewheel 200, while possibly turning the carriage means 11 atthe same time. - Figure 5 illustrates a modification of the embodiment illustrated in Figure 4, in which the force- equalizing
wheel 200 has been omitted from the tensioning means 30. Thus, the lower ends of theline portions 111, 111' are secured directly to the tensioning means 30, which means that each line has a constant length during the course of the treatment. Consequently, the tension forces in the two lines may be mutually different and may vary during the course of said treatment. - A further embodiment is illustrated in Figure 6. in addition to the apparatus components described in the aforegoing, the embodiment according to Figure 6 includes a fourth pair of
pullies 102, 102', which are mounted on theposts 101, 101'. Attached to the sides of the belt belonging to the tension take-up means 12 are rigid plates 113,113'. These plates extend over the whole width of the belt and somewhat beyond the edge of the belt facing the foot-end of the support means (furthest away from the reader). One end of theline portion 111 is attached to theplate 113 and extends around thepullies pullies 102', 112', 132' and 133' in that order. The remaining ends of the line portions meet around thegrooved wheel 200 in the tensioning means. Thus, two parts of theline 111 and 111' pass between arespective plate 113 and 113'and arepective pulley 102 and 102', which has been found important with respect to the application of the tensioning force. - In the aforegoing it has been assumed that it is the pelvis region of the patient which is to be pulled, while the chest region is firmly anchored to the support means. In principle the reverse may be the case, so that it is the chest region which is pulled. This reversal, however, necessitates modification of the illustrated arrangements, although while retaining the principles thereof.
- The members 102,102' , 112,112', 132, 132' and 133, 133' have been shown and decribed as pullies, although, as will be understood, these members may have the form of equivalent devices, such as rollers, eyes, etc. which ensure that the lines run freely. The
members 111, 111' may also comprise straps, bands or the like. - The embodiment according to Figure 6 can be modified by omitting the
wheel 200, in which case each of theline portions 111, 111' has the end in question securely connected to the tensioning means 30, i.e. in the manner indicated in Figure 5. - Figure 7 illustrates a simplified version of the tension control means according to the invention. In this embodiment belt 12 (or the belt 14) is provided with a first pair of
pullies 112, 112', while a second pair of pullies is mounted on the movable carriage means 11. A line arrangement comprisesline portions 111, 111' and connects respective pullies of the first pair to respective pullies of the second pair. One end of the line arrangement is connected to the tensioning means 30 or 141, while the other end is fixedly arranged relative the patient support means 10, the first orsecond straps
Claims (15)
Applications Claiming Priority (6)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
SE8206799 | 1982-11-29 | ||
SE8206799A SE8206799L (en) | 1982-11-29 | 1982-11-29 | BACKGROUND TREATMENT DEVICE |
SE8206800 | 1982-11-29 | ||
SE8206800A SE430122B (en) | 1982-11-29 | 1982-11-29 | Device for treating back problems |
SE8206801 | 1982-11-29 | ||
SE8206801A SE442263B (en) | 1982-11-29 | 1982-11-29 | Device for treating back pain |
Publications (2)
Publication Number | Publication Date |
---|---|
EP0127653A1 EP0127653A1 (en) | 1984-12-12 |
EP0127653B1 true EP0127653B1 (en) | 1987-01-21 |
Family
ID=27355278
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP19830903835 Expired EP0127653B1 (en) | 1982-11-29 | 1983-11-18 | Apparatus for treating back ailments |
Country Status (4)
Country | Link |
---|---|
EP (1) | EP0127653B1 (en) |
DE (1) | DE3369247D1 (en) |
ES (1) | ES8407388A1 (en) |
WO (1) | WO1984002075A1 (en) |
Families Citing this family (9)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
GB8513500D0 (en) * | 1985-05-29 | 1985-07-03 | Orme D V | Treatment tables |
GB8607924D0 (en) * | 1986-04-01 | 1986-05-08 | Henshaw J T | Traction apparatus |
CA1252144A (en) * | 1986-05-01 | 1989-04-04 | Ernest Savoia | Therapeutic table |
EP0334274B1 (en) * | 1988-03-21 | 1995-05-31 | Jens Dipl.-Ing. Spethmann | Medical therapy device with a couch, a undercouch diathermic device and a body stretching device |
ES2133215B1 (en) * | 1996-04-15 | 2000-03-01 | Cobo Bernabe Cobo | PHYSIOTHERAPY APPARATUS FOR THE TREATMENT OF ARTICULAR RIGIDITY. |
IL141848A0 (en) * | 1998-08-12 | 2002-03-10 | Dyer Allan E | Operation of a vertebral axial decompression table |
WO2006138045A2 (en) * | 2005-06-16 | 2006-12-28 | Axiom Worldwide, Inc. | System for patient specific spinal therapy |
KR101454392B1 (en) * | 2014-04-30 | 2014-11-04 | 강남구 | Finger pressure bed |
CN109550198B (en) * | 2018-12-25 | 2023-12-05 | 无锡市第九人民医院 | Automatic regulating weight device capable of assisting treatment |
Family Cites Families (9)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US921559A (en) * | 1906-10-22 | 1909-05-11 | John V Mcmanis | Osteopathic table. |
US1138030A (en) * | 1914-12-11 | 1915-05-04 | Calvin H Weston | Physician's treating-table. |
US2950715A (en) * | 1956-12-31 | 1960-08-30 | Herman J Brobeck | Orthopedic bed |
US3134379A (en) * | 1962-09-10 | 1964-05-26 | Frank J Nightingale | Portable bed type traction applicator |
SE360560B (en) * | 1972-02-14 | 1973-10-01 | Static Spa | |
FR2290184A1 (en) * | 1974-11-08 | 1976-06-04 | Cotrel Yves | Spine traction equipment - has ropes reeved round pulleys from handrail to pelvic and Occipital regions |
NL7611461A (en) * | 1976-10-15 | 1978-04-18 | Enraf Nonius | TRACTION DEVICE. |
US4365623A (en) * | 1980-03-06 | 1982-12-28 | Tru-Eze Manufacturing Co. | Apparatus to exert traction in traction therapy |
DE3134999A1 (en) * | 1980-09-05 | 1982-05-27 | Chattanooga Corp., 37405 Chattanooga, Tenn. | Therapeutic device for the intermittent application of a tensile force to the body of a patient |
-
1983
- 1983-11-18 DE DE8383903835T patent/DE3369247D1/en not_active Expired
- 1983-11-18 WO PCT/SE1983/000405 patent/WO1984002075A1/en active IP Right Grant
- 1983-11-18 EP EP19830903835 patent/EP0127653B1/en not_active Expired
- 1983-11-21 ES ES527594A patent/ES8407388A1/en not_active Expired
Also Published As
Publication number | Publication date |
---|---|
WO1984002075A1 (en) | 1984-06-07 |
ES527594A0 (en) | 1984-10-01 |
ES8407388A1 (en) | 1984-10-01 |
EP0127653A1 (en) | 1984-12-12 |
DE3369247D1 (en) | 1987-02-26 |
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