EP0801939A2 - Device for a flexible spatial support of an individual - Google Patents

Abstract

The patient positioning apparatus includes one or several bearing elements (16, 36, 40, 48, 48') which are revolvingly arranged around at least one spatial axis (14, 38, 50, 50'). Drive devices for the rotation of one or several of these bearing elements around at least one of these spatial axes, and control devices for the control of the drive devices. The relative position of individual bearing elements with respect to each other, the spatial position of the bearing element, and/or the entirety of the bearing elements is adjustable in reference to at least one rotation axis. The spatial position of the patient is preferably adjusted by a control arrangement in dependence on a predetermined program.

Description

The invention relates to a device for the spatially flexible storage of a subject.

In the field of medicine in particular, there is often a need to regularly re-bed patients (hereinafter referred to as test persons). In this way, for example, bedsores or a coma condition should be prevented; this can also stimulate the circulation.

If the subject is now transferred by hand, for example in a classic hospital bed, this is personnel-intensive and, accordingly, cost-intensive. A technical solution is therefore useful and desirable.

DE 39 15 420 A1 describes a device called a "room bed" which is intended to offer such a technical solution. The subject is bedded inside a rigid shell, which is lined with inflatable air chambers. In this way, "the relaxed body completely painless and pleasantly fixed" should be able to be rotated into every level of the room. The shell is rotatably mounted on two motor-driven axes, so that a desired spatial position of the subject can be adjusted.

However, such a solution prevents a functioning air circulation and a corresponding reduction of the patient's exhalations. For this reason alone, it should hardly be suitable for medical purposes. Noise and vibrations caused by the drive motors also make the bearing uncomfortable.

The present invention aims to provide a device for the spatially flexible storage of a subject, which is more suitable for medical purposes.

It achieves this goal with the subject matter of claim 1, namely with a device for the spatially flexible mounting of a subject, with one or more bearing elements which are arranged rotatably about at least one spatial axis. Drive means serve to rotate one or more of these bearing elements about at least one of these spatial axes. Control means are used to control the drive means or drives. The relative position of individual bearing elements to one another and / or the spatial position of the bearing element or the entirety of the bearing elements can be related. at least one axis of rotation can be set.

In a preferred embodiment, the bearing element or the entirety of the bearing elements is rotatably mounted about a (common) axis. A semicircular arch element is arranged concentrically to this axis and connected to at least two partial areas of the bearing element or the entirety of the bearing elements. A flexible toothed belt is connected to the arch element and runs along its surface. In addition, at least one deflection roller is arranged in the vicinity of the arch element. The flexible tooth frame is away from this arch element guided and meshes with at least one of these pulleys. Drive or braking means for driving or braking at least one of these deflection rollers are present (claim 2).

Such a construction enables the subject to change his spatial position in a particularly comfortable manner. Engine-related noises and vibrations in the lying area can be largely avoided.

Preferably, two deflecting rollers are arranged in the vicinity of the arch element, which are located at substantially the same radial distance from the arch element and in a specific arch distance. Between these two first deflection rollers, a third deflection roller is arranged at a different radial distance from the arch element. The radial distances, the diameters of the deflection rollers and the arc distance are selected such that the toothed belt is first removed from the arch element via one of the first two deflection rollers, then around a partial area of the outer surface of the third deflection roller and finally over the other of the first two deflection rollers is returned to the arch element (claim 3).

This configuration enables a particularly simple technical implementation of the device according to the invention.

All three deflection rollers are preferably arranged outside the arch element and have the same diameter. The first two deflecting rollers are each arranged at an equally large, as small as possible radial distance from the arch element. The arc distance between these first two deflection rollers corresponds approximately to the diameter of the deflection rollers. The third pulley is related. the first two deflection rollers centered at a greater radial distance from the arch element (claim 4).

This embodiment means an optimal configuration of the device according to the invention. This applies in particular if only the third deflection roller is driven or braked by drive or braking means (claim 4).

In a further preferred embodiment, the bearing elements comprise a one-part or multi-part bed cushion and a head and footrest. The headrest and footrest are each rotatably mounted relative to the couch cushion about an axis arranged transversely to the lying direction (claim 6).

In this way, an optimal posture of the subject can be set for every spatial position.

Preferably, the headrest and / or footrest are each driven or braked by drive or braking means (claim 7). This enables the optimal adjustment of the subject's posture as far as possible.

In a preferred embodiment, the subject is fixed via one or more belt anchors in the area of the bed cushion and / or a padded, in particular electromotively adjustable, cradle support and / or adjustable arm supports along the lying direction and / or in particular arm supports that can be attached laterally (claim 8).

In this way, a pain-free and comfortable position for the test subject is possible in any adjustable spatial position.

The drive means or the drive means are preferably controlled by a control device (claim 9). This enables staff to be largely avoided.

The control device preferably varies the spatial position of the test subject according to a predetermined program (claim 10). Such a program can take into account all necessary medical measures regarding the transfer. In the context of rehabilitation treatments, it was shown to be advantageous to expose the test subjects to different spatial positions in the gravity field under program control. This also minimizes supervision of the subject. A circulatory training can also be carried out, for example by the program providing a sequence of the type "change of position-pause-change of position-pause -...". This is particularly important for prevention purposes or for conditioning older subjects.

In a further preferred embodiment, measuring means monitor defined movements, brain waves, parameters of the blood circulation, blood pressure, heart rate and / or muscle potentials of the test subject. The control device adjusts the spatial position of the subject on the basis of these measured values (claim 11).

Such a procedure enables an immediate reaction to, for example, the subject's crisis situation. It is possible, for example, to react immediately to changes in the subject's medical situation if there is a risk of coma. A coma can be avoided by a new adjustment of its spatial position in the gravitational field. It is also possible, for example in the case of severely disabled people, that they can help themselves as far as possible by means of so-called "residual functions" that are still available.

Preferably one or more ultrasonic transmitters and receivers serve as measuring means for movements of the subject (claim 12). This means a technically particularly simple implementation of the device described above.

In a further preferred embodiment, a predetermined spatial orientation of at least one armrest is maintained when the bearing elements are pivoted about the first axis of rotation. (Claim 13). This is particularly advantageous if a dynamic examination of the blood circulation is to be carried out. The subject can be swiveled into different positions using the bearing elements. On the other hand, measurements are made on the arm, which is kept still. In this way, comparable measured values can be obtained at any time. The arm can also be adjusted so that it is always at the heart's height and parallel to the surface of the earth. This optimizes the measurement results.

Fig. 1

ein Aufriß der erfindungsgemäßen Vorrichtung;

Fig. 2

eine Seitenansicht;

Fig. 3

eine Draufsicht; und

Fig. 4

eine Frontansicht;

Fig. 5

eine Seitenansicht einer bevorzugten Armstütze;

Fig. 6

eine Frontalansicht dieser Ausführungsform;

Fig. 7

eine Seitenansicht einer weiteren bevorzugten Armstütze; und

Fig. 8

eine Frontalansicht dieser Ausführungsform.

The present invention is explained in more detail below with reference to exemplary embodiments and the accompanying drawing. In the drawing is:

Fig. 1

an elevation of the device according to the invention;

Fig. 2

a side view;

Fig. 3

a top view; and

Fig. 4

a front view;

Fig. 5

a side view of a preferred armrest;

Fig. 6

a front view of this embodiment;

Fig. 7

a side view of another preferred armrest; and

Fig. 8

a front view of this embodiment.

Fig. 1 shows an outline of the basic principle of the device according to the invention.

A support column 12 is attached to a floor element 10. At the upper end of the support column 12 there is an axis of rotation 14, via which a bearing element 16 is rotatably mounted. An arch element 18 runs concentrically to the axis of rotation 14 from the head end 20 of the bearing element 16 to the foot end 22. A toothed belt 26 runs along the outer surface 24 of the arch element 18. A tubular housing 28 is arranged below the head end 20. Drive means for the toothed belt 26 are located therein.

The drive mechanism for the toothed belt 26 can be seen in FIG. 2. Coming from the head end 20 via the arch element 18, the toothed belt 26 initially runs counterclockwise along approximately a quarter of the outer surface of a first deflection roller 30.

Here, as in the following, it seems appropriate to refer to the image of the analog clock face. In this picture, the toothed belt 26 runs counterclockwise from about 11 a.m. to about 8 a.m. From there, the toothed belt 26 is guided clockwise around a drive roller 32 from 2 to about 8 o'clock. Subsequently, it again runs counterclockwise from about 2 to about 11 a.m. around a second deflection roller 34 before it again joins the curve of the arch element 18.

The drive roller 32 is operated via drive means, not shown in the drawing. For example, an electric motor can be used here. This also serves as a drive and brake means.

In the exemplary embodiment according to FIG. 2, the bearing element 16 only holds the torso of a test subject. The head, on the other hand, is bedded on a headrest 36, which is rotatably mounted at the head end 20 about a second axis of rotation 38 and can be pivoted via an electric motor (not shown).

At the foot end 22 of the bearing element 16 there is a footrest 40, which can be moved along the lying direction long ago via an electric motor drive (not shown). The same applies to a padded crotch 42, which is also driven by an electric motor. In this way, the dimensions of the bearing surface can be adapted to the respective body size of a subject.

In the exemplary embodiment according to FIG. 2, the center of gravity of a subject, who is supported on the bearing elements 16, 36 and 40, is not directly above the first axis of rotation 14. Rather, it is shifted in the direction of the head end 20. Against this background, it is expedient to attach 22 (variable) counterweights 44 to the foot end. These should each be chosen so that the center of gravity of the bearing elements is substantially perpendicular above the first axis of rotation 14. This facilitates smooth operation of the device according to the invention.

Furthermore, an adjustable armrest 46 and an armrest 48 which can be plugged on laterally are shown in FIG. 2. Both support the fixation of a subject on the bearing elements 16, 36, 40 and are carried out on both sides of the bearing elements. This can be seen more clearly in FIG. 3, where the corresponding parts are identified by 46 'and 48'.

The adjustable armpit supports 46, 46 'are rotatably mounted about third axes of rotation 50 and 50'. At the respective front ends 52 and 52 ', support rods 54, 54' are attached so that they can be pulled out. They can be fixed in a desired length using fixation means, not shown.

The footrest 40 and the padded crotch 42 can be moved along guide slots 56 and 58, respectively. Electromotive drive means provided for this purpose are not shown.

Overall, FIGS. 2 and 3 show an open, well-ventilated couch that can be easily adjusted to the body dimensions of the subject.

Fig. 4 finally shows a frontal view seen from the foot end. In particular, the toothed belt 26 on the outer surface 24 of the arch element 18 can be clearly recognized therein. It is also clear that the arm supports 48, 48 'can be attached laterally by means of attachments 60 and 60' (not shown).

Measuring means for determining the position of body parts or for measuring brain waves are not shown in the figures. The position of a body part can be determined, for example, using an ultrasound wave transmitter attached to this body part. In this case, several receivers would have to be installed in the vicinity of the bearing elements. The position is then determined according to the known principles of radio direction finding.

5 to 8, two exemplary embodiments are shown below which are particularly suitable for blood pressure and / or circulatory measurements.

Such measurements can be carried out, for example, on the upper arm or on the subject's finger. Ideally, the hand should be horizontal and approximately at the level of the subject's heart. However, this is difficult to achieve with the arm supports 48, 48 'described so far, since the arm supports 48, 48' would have to be readjusted after each pivoting of the bearing element 16.

On the other hand, however, it is not possible to simply place the arm supports 48, 48 'in a fixed position in space to fix and decouple them from the bearing element 16. For example, when the bearing element 16 is pivoted, the arm supports 48, 48 'have to be shifted upwards and forwards from a horizontal position into a vertical position in order to be able to pick up the subject's arms there too.

An armrest suitable for blood pressure and / or circulatory measurements should therefore on the one hand follow a pivoting rotation of the bearing element 16. On the other hand, a horizontal position of the armrest itself should be maintained.

5 shows a part of the bearing element 16 which is rotatably mounted on the support column 12. The head end 20 or the headrest 36 are on the left in this illustration. An armrest 60 is provided for the right arm of the subject. Attached to this are two cushion elements 62, 64 which are offset in height relative to one another. The first cushion element 62 is located lower and is intended to take up the right elbow of the subject. The second cushion element 64 is arranged higher than the first cushion element 62 and is intended to pick up the right hand of the subject.

In this exemplary embodiment, a test person would therefore be stored as follows: the back on the bearing element 16, the head and at least parts of the shoulders on the headrest 36, the right elbow on the first cushion element 62 and the right hand on the second cushion element 64 the right elbow is always slightly angled so that the right forearm runs diagonally upwards. However, the two cushion elements 62, 64 are each in the horizontal, so that in particular the right hand of the test person always remains in the horizontal.

The armrest 60 is firmly connected to an axis 68 via an angle 66. The axis 68 is in turn rotatably supported in a carrier element 70. The carrier element 70 is fixedly connected to the bearing element 16 via a spacer 72. The spacer 72 extends perpendicular to the side surface of the bearing element 16 in the horizontal. The carrier element 70 is in turn arranged perpendicular to the spacer 72. The two parts are connected to one another via a spindle gear 74, which can be operated via a handwheel 76. In this way it is possible to adjust the distance of the axis 68 from the bearing element 16 in accordance with the dimensions of the subject.

As already mentioned, the axis 68 is rotatably mounted in the carrier element 70. It passes through the carrier element 70 and is connected at its free end to a gear 78. The gear wheel 78 is in turn rotatably mounted on or in a housing 80. The housing 80 has an elongated shape, at one end of which the gear 78 is attached. The other end of the housing 80 is rotatably mounted on a further axis 82. This further axis 82 is in turn firmly connected to the support column 12. It passes through an outer wall of the housing 80. A second gear wheel 84 is attached to its free end. This gear wheel 84 is arranged concentrically with respect to the first axis of rotation 14 and is stationary.

A second toothed belt 86 runs around the two gear wheels 78, 84. The horizontal position, in particular of the second cushion element 64, is thus maintained, for example, when the bearing element 16 is pivoted from the horizontal position shown in FIG. 5 to a vertical position as follows: by the movement of the bearing element 16, the carrier element 70 fixed thereon is moved along a circular path to the top right in the illustration. The separation points of the second toothed belt 86 change from the fixed second gear 84. Since the first gear 78, however, is rotatably mounted and connected to the armrest 60, an opposing rotational movement is generated here, which corresponds in each case to the angle of rotation of the bearing element 16. The armrest 60 and in particular the second cushion element 64 are each held horizontally in this way.

An alternative embodiment of such an armrest is shown in FIGS. 7 and 8. An armrest 90 and the associated adjustment mechanism are arranged on a kind of sidecar 92. In this way, the armrest 90 and the associated adjustment mechanism can be easily removed from the device according to the invention when they are not required. If they are to be used, it is sufficient to fix the sidecar 92 to the floor element 10 via a coupling point 94. This can be seen particularly well in FIG. 8.

The armrest 90 has a similar shape as in the previous embodiment. In particular, the subject's right elbow should also be placed on a lower cushion element 96 and his right hand on an upper cushion element 98.

The armrest 90 is attached to a carriage 100 which can be moved along a horizontal carriage guide 102. The horizontal carriage guide 102 is in turn attached to a second carriage 104. This can be moved along a vertical carriage guide 106.

A pivoting movement of the bearing element 16 is now transmitted to the armrest 90 via a coupling point 108 on a bracket 110 in the following manner (the bracket 110 is fastened to the underside of the bearing element 16 and perpendicularly to it): at the coupling point 108 is one end a transmission unit 112 (details thereof to be explained later) connected to the boom 110 via an axis (not shown). At least one of the two elements must be rotatably mounted. At a
As a result of this coupling, the pivoting movement of the bearing element 16 carries along the transmission unit 112. Thanks to the rotary bearing, only the change in position, but not the torque, is transmitted to the transmission unit 112. The transmission unit 112 initially runs horizontally and transversely to the bearing element 16. Then it goes vertically upwards. Its upper end is coupled to the armrest 90 via an arch element 114. The rotary movement of the bearing element 16 consequently leads to a corresponding displacement of the armrest 90 without, however, changing its spatial orientation.

The armrest 90 is initially set via a second horizontal slide 116, a second vertical slide 118 and electromotive drive means 120. The principle described above is applied accordingly.

As a result, in the initial setting, the relative position of the individual elements of the transmission unit 112 is set according to the dimensions of the subject. Subsequently, the individual elements of the transmission unit 112 always remain in this relative position and are only moved as a unit.

Claims (13)

Device for the spatially flexible storage of a subject, with a) one or more bearing elements (16, 36, 40, 48, 48 ') which are arranged rotatably about at least one spatial axis (14, 38, 50, 50'); b) drive means for rotating one or more of these bearing elements (16, 36, 40, 48, 48 ') about at least one of these spatial axes (14, 38, 50, 50'); and c) control means for controlling the drive means (s), in which the relative position of individual bearing elements (16, 36, 40, 48, 48 ') to one another and / or the spatial position of the bearing element or the entirety of the bearing elements (16, 36, 40, 48, 48') with respect to at least one axis of rotation is adjustable (14, 38, 50, 50 '). The device of claim 1, wherein a) the bearing element or the entirety of the bearing elements (16, 36, 40, 48, 48 ') is rotatably mounted about a (common) axis (14); b) a semicircular arch element (18) arranged concentrically to this axis (14) and with at least two partial areas (20, 22) of the bearing element or the entirety of the bearing elements (16, 36, 40, 48, 48 ') is connected; c) a flexible toothed belt (26) is connected to the arch element (18) and runs along the surface thereof; d) at least one deflecting roller (30, 32, 34) is arranged in the vicinity of the arch element (18); e) the flexible toothed belt (26) meshes with at least one of these deflection rollers (30, 32, 34); and f) drive or braking means for driving or braking at least one of these deflection rollers (30, 32, 34) are present. The device of claim 2, wherein a) two deflection rollers (30, 34) are arranged in the vicinity of the arch element (18), which are located at an essentially equal radial distance (R1) from the arch element (18) and in an arc distance (B); b) between these first two deflection rollers (30, 34), a third deflection roller (32) is arranged at a radial distance R2 from the arc element (18); c) the distances R1 and R2, the diameters of the deflection rollers (30, 32, 34) and the arc distance B are selected such that the toothed belt (26) is first of all via one of the first two deflection rollers (30, 34) from the arch element ( 18) away, then around a partial area of the outer surface of the third deflection roller (32) and finally via the other of the first two deflection rollers (30, 34) back to the arch element (18). The device of claim 3, wherein a) all three deflection rollers (30, 32, 34) are arranged outside the arch element (18) and are of the same diameter; b) the first two deflecting rollers (30, 34) are arranged at a radial distance R1 of the arc element (18) of the same size and as small as possible; c) the arc distance B corresponds approximately to the diameter of the deflection rollers (30, 32, 34); and d) the third deflection roller (32) with respect to the first two deflection rollers (30, 34) is arranged centered at a larger radial distance R2 from the arc element (18). Device according to Claim 4, in which only the third deflection roller (32) is driven or braked by drive or braking means. Device according to one of the preceding claims, in which the bearing elements (16, 36, 40, 48, 48 ') comprise a single-part or multi-part bed cushion (16) and a headrest and a footrest (36, 40), one or both are rotatably mounted relative to the bed cushion (16) about an axis (38) arranged transversely to the lying direction. Apparatus according to claim 6, wherein the headrest and / or the footrest (36, 40) are each driven or braked by drive or braking means. Device according to one of the preceding claims, wherein the fixation of the subject via a) one or more belt anchors in the area of the bed cushion (16); and or b) a padded, in particular electromotive adjustable along the lying, step support (42); and or c) adjustable armpit supports (46, 46 '); and or d) in particular arm supports (48, 48 ') which can be attached laterally he follows. Device according to one of the preceding claims, in which the drive means or the drive means are controlled by a control device. Apparatus according to claim 9, wherein the control device varies the spatial position of the subject according to a predetermined program. Device according to one of claims 9 or 10, wherein a) measuring means monitor defined movements, brain waves, parameters of the blood circulation, blood pressure, heart rate and / or muscle potential of the test person; and b) the control device adjusts the spatial position of the test person on the basis of these measured values. Apparatus according to claim 11, in which one or more ultrasonic transmitters and receivers serve as measuring means for movements of the subject. Device according to one of the preceding claims, in which a predetermined spatial orientation of at least one armrest (60, 90) is maintained when the bearing elements (16, 20, 22) are pivoted about the first axis of rotation (14).

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