EP0129481B1 - Compression-therapy device - Google Patents

Description

The present invention relates to automatic pneumatic massage devices, of the type comprising at least one inflatable sleeve, covering a part of the body of a patient, member in general, placed under rhythmic pressure, a technique commonly called "pressotherapy".

A pressure therapy device has two separate parts:

Firstly, the generator or apparatus proper, provided with the means for producing the compressed air (compressor) and its distribution (valves or distributor); means for adjusting the pressure and its control (regulator and manometer); means for adjusting the duration of the compression and rest and the duration of the application.

Secondly, the compression elements, also called massage elements, connected by pipes to the generator and which, for convenience, we will call "machons". The sleeve is alternately pressurized, time that we will call work or compression, then in the open air, time that we will call rest or depression.

There are two types of sleeves. In the first case, the outer sheath-forming tunic, which represents the maximum volume to be pressurized and the internal tunic which applies pressure to the surface of the treated limb, delimit only one hollow inflatable capacity: we speak in this case mono-alveolar or single enclosure sleeve and non-stage pressotherapy. In the second case, as described in the German patent 2,753,523, the sleeve is divided into several capacities, or cells, or enclosures, independent and pressurized successively, according to different methods. We speak in this case of multi-alveolar sleeve and stepped pressotherapy. Of course, the distribution means are designed as a function of the type of sleeve used and the number of independent enclosures that it may contain.

• soit simultanément: dans ce cas, la distribution de l'air comprimé est a peu près identique à ce qu'elle serait avec un manchon unique, puisqu'il suffit de dédoubler le, ou les orifices de sortie;
• soit alternativement: dans ce cas, pendant qu'un manchon est mis en pression, l'autre manchon est mis à l'air libre, c'est-à-dire au repos. Par suite, la durée du repos est en principe, égale à la durée de la compression.

In general, applications are made with a single tool or with a pair, in the case where two members are treated at the same time. When the sleeves are used in pairs, they can be pressurized:

• or simultaneously: in this case, the distribution of the compressed air is roughly identical to what it would be with a single sleeve, since it suffices to split the, or the outlet orifices;
• or alternatively: in this case, while one sleeve is pressurized, the other sleeve is placed in the open air, that is to say at rest. Consequently, the duration of the rest is in principle equal to the duration of the compression.

The main objective of pressotherapy is to remedy the insufficiencies of the return circulation (venous and, or, lymphatic) and, or, the problems of liquid stasis (edema, for example).

• la pression: une pression trop faible n'agira que sur les vaisseaux superficiels et pas, ou trop peu, sur les vaisseaux profonds sous aponévrotiques, ou sur la stase liquidienne d'un oedème ancien et fibrosé, par exemple;
• la fréquence: (c'est-à-dire le nombre de mises en pression dans l'unité de temps). Une mise en pression qui dure trop longtemps ne peut constituer un facteur d'accélération du flux circulatoire de retour et constitue plutôt une restriction à celui-ci. Ces deux paramètres sont en rapport direct avec la quantité d'air comprimé générée.
• la progressivité des compressions. Avec la technique du manchon, on ne peut bien entendu, qu'envisager des compression par portions, successives. L'objectif étant d'aider la masse liquidienne (libre ou en circulation) dans son voyage de retour en direction du coeur, il semble logique de souhaiter que la compression s'établisse dans le même sens, c'est-à-dire de l'extrémité du membre vers sa racine, sens appelé distal/proximal, mais également, que la pression soit plus forte à l'extrémité.

The quality of the results depends on various parameters:

• pressure: too low a pressure will act only on the superficial vessels and not, or too little, on the deep vessels under aponeurosis, or on the liquid stasis of an old and fibrotic edema, for example;
• frequency: (i.e. the number of pressurings in the time unit). Pressurization that lasts too long cannot be a factor in accelerating the return circulatory flow and rather constitutes a restriction on it. These two parameters are directly related to the amount of compressed air generated.
• the progressiveness of the compressions. With the sleeve technique, one can of course only consider compression by successive portions. The objective being to help the liquid mass (free or in circulation) in its return journey towards the heart, it seems logical to wish that the compression be established in the same direction, that is to say the extremity of the limb towards its root, meaning called distal / proximal, but also, that the pressure is stronger at the extremity.

The pressotherapy devices currently used do not meet all of these criteria.

Thus, no device can apply stronger compression to the extremity of the limb than to the root. Devices with a single-chamber sleeve can therefore only apply the same pressure at all points. The devices studied to press multi-cellular sockets generate a pressure wave which moves, in one direction or the other direction, along the member to be treated. But no device has been studied to apply a different pressure, even if this difference is of little importance, between two alveoli, whether or not adjoining, when these are under pressure. With these devices, any cell is: either in a state of activity, that is to say under pressure, or inactive, that is to say, without pressure.

French Patent No. 1,775,918 uses a rotary valve type valve. The different cells that make up the sleeve are inflated one after the other before being deflated. At the end of the pressurization sequence, all the cells are under pressure and in communication with the compressed air source, see Figures 11 and 12. They can only be at the same pressure.

French patent n ° 1,562,252 uses electromagnetic valves for the successive pressurization of the cells. The cams 39, 40, 41 hold the valves 20, 18, 16 open, that is to say that at the same time, all the cells are in communication with the source of compressed air, therefore at the same pressure.

French Patent No. 2,246,620 uses a pneumatic cylinder as a means of distribution. The piston successively discovers the supply lights of the various cells. Behind the piston, the inflated cells are therefore in communication with the source of compressed air. The pressure in these cells can only be that which exists in the distribution cylinder and the same for each of them.

German patent n ° 27 53 523 does not pretend to innovate in terms of compressed air distribution, since it does not describe a distributor and refers to what exists and in particular to US patent 2,781,041. On this distributor, given as an example, Figures 2, 3, 4, 5, 6 and 8, it can be seen that the various cells which constitute the sleeve remain in communication with the source of compressed air, when they have been inflated. Consequently, they can only be at the same pressure. It should also be noted that 27 53 523 claims nothing else (claim 4) than the means of successively inflating, then deflating the alveoli.

• a) mise en pression sucessive des alvéoles (gonflage);
• b) mise à l'air libre de ces alvéoles (dégonflage).

Thus, the distributors described have only a double function:

• a) successive pressurization of the alveoli (inflation);
• b) venting of these cells (deflation).

The therapeutic action of these devices, in the current state of the art, results only from the displacement along the treated limb, of a pressure wave obtained by the successive inflation of the alveoli. However, no technique uses the therapeutic action which is obtained by a pressure difference between two, or more than two, alveoli under pressure, which makes it possible to orient the movement of body fluids in a state of stasis, of the zones of the strongest pressures, towards the zones of the lowest pressures.

The subject of the present invention is the combination of a compressed air distributor and a pressure therapy sleeve comprising a plurality of cells, the distributor being provided with means making it possible to close the supply line for each cell after 'it was inflated so as to isolate it during the pressurization of the other cells and the sleeve comprising a plurality of flexible partitions, but not elastic, the length of which is greater than the distance separating the two tunics forming the sleeve. Thus, when a first cell has been inflated, its supply line is closed, then the next cell is inflated in turn, at the same supply pressure, which causes a deformation of the walls of the first and a slight increase in the internal pressure of this first cell and thus gradually, with the same supply pressure, the appearance of a pressure gradient, the first swollen cells having an internal pressure slightly higher than that of the second alveolus, itself having an internal pressure slightly higher than that which follows it and so on.

It is therefore possible, thanks to this arrangement, to obtain, with a source of compressed air at constant predetermined pressure, that is to say with a single pressure regulator, a pressure therapy sleeve having bloated cells with a pressure gradient decreasing from the first to the last which until now was only possible by using a pressure regulator for each cell which is a very expensive and bulky solution.

• Figures 1 et 2 deux ensembles de manchons connus;
• Figure 3 une vue schématique d'un manchon selon la présente invention;
• Figures 4 et 5 deux vues schématiques de variantes de réalisation de la figure 3.

By way of nonlimiting example and to facilitate understanding of the invention, the accompanying drawings show:

• Figures 1 and 2 two sets of known sleeves;
• Figure 3 a schematic view of a sleeve according to the present invention;
• Figures 4 and 5 two schematic views of alternative embodiments of Figure 3.

FIG. 1 schematically represents a sleeve A, divided into three independent enclosures A1, A2, A3, by means of two collages A4 and A5, between the two tunics which compose it, the tunic F being the inner tunic forming a sheath in contact with the limb to be treated and the tunic G, not extensible, defining the maximum volume of the sleeve.

In the sleeve A is inserted a segment of member S. It appears clearly that with this mode of division, none of the three enclosures can have an action on another of the enclosures which compose the sleeve. They are strictly independent.

In a second case, the multi-cellular sleeve is produced from a sewn canvas sheath, into which independent inflatable pockets are inserted. The outer wall G corresponds to what has previously been called the outer jacket and the inner wall F to what has been called the inner jacket.

FIG. 2 represents a fabric sleeve B, covering a member segment S, into which three inflatable bags B1, B2, B3 have been slipped, which when inflated, become contiguous at B4 and B5. Pressurized, the pocket B1 will first occupy its volume. Then pocket B2 will do the same. It is only when B3 is pressurized that the canvas sheath will be completely filled and that the three pockets will be joined at B4 and B5, but they will all be at substantially the same pressure.

In the third case, the division into independent enclosures is carried out by means of transverse partitions, connecting the internal tunic F of the sleeve to its external tunic G, the width of these partitions being clearly greater than the distance separating the two tunics G and F when they are in use.

FIG. 3 represents a sleeve C, covering a portion of member S, divided into three separately inflatable enclosures C1, C2, C3, by means of two partitions C4 and C5, of sufficient width, connecting the internal tunic F to the external tunic G This way of proceeding makes it possible to constitute a homogeneous unit, made of a flexible, waterproof and above all non-elastic material, preferably coated fabric. The enclosure C1 is put at a pressure "p" which is that which is determined by the pressure regulator which the apparatus comprises. Then the supply line of the enclosure C1 is closed at the distributor, and the enclosure C2 is then inflated to the pressure "p". While the pressure is rising in the enclosure C2, the compressed air exerts on the partition C4, an increasing force in the direction of C1, from which the air cannot escape since this enclosure is isolated. The pressure of C1 will therefore increase above its initial value "p". In the same way, the isolation of C2, and the pressurization of C3, will increase the pressure in C2, which will be transmitted again in C1. The final pressure in the three chambers will therefore be presented as follows: if "p1" is the pressure in C1, "p2" the pressure in C2, and "p3" the pressure in C3, it being observed that "p3" is equal to "p" pressure determined by the regulator, the different pressures are written as follows:

la dernière enceinte de manchon se trouvant toujours à la pression déterminée par le régulateur. Le phénomène a été vérifié en plaçant un manomètre en dérivation sur chacune des enceintes qui constituent la manchon.With a sleeve comprising a number "n" of speakers, we will have:

the last sleeve enclosure still at the pressure determined by the regulator. The phenomenon has been verified by placing a bypass manometer on each of the chambers which constitute the sleeve.

For this, the compressed air distributor includes a pressure regulator which can be adjusted at will to obtain a constant predetermined pressure and a set of obturation means, one for each supply line, connected to a cell, when the corresponding cell has been inflated to the desired pressure, close the pipe so that the swollen cells cannot communicate with each other.

Thus, the combination of means constituted by the use of a distributor arranged to isolate the enclosures after the pressurization of each and of a sleeve, the division of which into independent enclosures is carried out by means of internal partitions, integral with the tunics which constitute it, the width of these partitions being clearly greater than the distance separating the two tunics G and F when they are in use, makes it possible to create a pressure gradient between the different enclosures of the sleeve, in such a way that, in a way logical, the treated limb is compressed more strongly at its end than at its root. This improvement has never been achieved until now on devices comprising only one pressure regulator.

The apparatus according to the invention combines a compressed air distributor provided with a single pressure regulator and provided with means making it possible to shut off the supply of each cell when it is inflated to the desired pressure so as to isolate the cells from each other and a sleeve whose partition walls are flexible so that the inflation of each cell causes a decrease in the volume of the adjacent cell which has been previously inflated and therefore a slight increase in the pressure in the latter. A pressure gradient is thus obtained while having only one pressure regulator.

However, it is also possible to predetermine the value of the pressure gradient thus obtained. Indeed, the increase in pressure in an isolated enclosure will be proportional to the force exerted by the partition which separates it from the adjoining enclosure. For a higher increase in pressure, greater force is required. The pressure does not change, since it is that which is determined by the regulator, to increase the force, it suffices to increase the surface on which the pressure is exerted in proportion to the whole. Thus, it is possible to form sleeves with a low pressure gradient, by means of partitions of small surface, therefore of reduced width. Conversely, the value of the gradient will be increased by means of partitions of large area, therefore very wide. FIG. 4 schematically represents a sleeve D, with three enclosures D1, D2 and D3, with short partitions D4 and D5, which will generate only a small pressure gradient. FIG. 5 represents a sleeve E, divided into three enclosures E1, E2 and E3, by means of large partitions E4 and E5, capable of determining a greater pressure gradient. It is even possible to form sleeves whose gradient value will be different depending on the level considered, by installing partitions of different width.

An apparatus according to the invention is characterized in that the value of the pressure gradient can be predetermined as a function of the surface of the partitions which divide the sleeve into independent enclosures.

The various improvements envisaged above, can be implemented separately or collectively, depending on the desired goal and the device to be designed, that is to say: use of one or more sleeves - simultaneous pressurization or alternating, in the case of two sleeves - and depending on the number of speakers (at least two or more).

The characteristic function of the means of distributing the compressed air, whatever it may be, is that: in addition to its dual role, successively pressurizing the cells and then venting, the distributor must include a specific means which makes it possible to isolate a cell after it has been pressurized, during the pressurization of the following cells.

Claims (6)

1. Pressure therapy equipment comprising a compressed air distribution device and a sleeve incorporating between its inner envelope (F), which is designed to apply compression to the surface of the limb receiving treatment, and its outer envelope (G), forming a cover of flexible but non-elastic material, a plurality of gas-tight chambers (C, D, E) obtained by inserting flexible transverse partition walls (C4, C5; D4, D5; E4, E5) connecting the two envelopes (F and G), wherein the length of the partition walls is greater than the distance separating the two envelopes, the chambers being destined to be inflated in succession by the distribution device delivering compressed air at a predetermined constant pressure, and then deflated, characterised in that the distribution device incorporates means for isolating each chamber after it has been inflated in such a way that deformation of the partition walls causes the development of a pressure gradient between the chambers, the pressure in one chamber being lower than the pressure of the chamber inflated before it such that "p1">"p2"="p", the difference in pressure between two adjacent chambers being directly proportional to the relationship between the surface area of the separating partition wall and the volume of the chamber first pressurised.

2. Pressure treatment equipment according to claim 1, in which the chambers of the sleeve have equal volumes and the separating partition walls equal surface areas, characterised in that the pressure gradient is uniform.

3. Pressure treatment equipment according to claim 1, in which the sleeve chambers have different volumes separated by partition walls of different surface area, characterised in that the pressure gradient is variable.

4. Pressure treatment equipment according to the foregoing claims, characterised in that the lines of connection between the partition walls and the envelopes (F and G) of the sleeve are placed one on top of the other or are offset with respect to each other in order to increase or reduce the surface area of the partition walls and consequently the magnitude of the pressure difference between the chambers.

5. Pressure treatment equipment according to the foregoing claims, characterised in that the envelopes and the partition walls of the sleeve are of flexible material which is impermeable to air, or of a material which is permeable to air but in this case arranged in such a way as to form chambers into which inflatable pockets of appropriate shape are placed.

6. Pressure treatment equipment according to the foregoing claims, characterised in that the chambers may be associated in groups of at least two chambers, the groups being capable of being pressurised in a sequential manner.

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