EP3915535A1 - Appareil pour la traction et la vibration de l'articulation de la hanche - Google Patents

Appareil pour la traction et la vibration de l'articulation de la hanche Download PDF

Info

Publication number
EP3915535A1
EP3915535A1 EP21175657.2A EP21175657A EP3915535A1 EP 3915535 A1 EP3915535 A1 EP 3915535A1 EP 21175657 A EP21175657 A EP 21175657A EP 3915535 A1 EP3915535 A1 EP 3915535A1
Authority
EP
European Patent Office
Prior art keywords
traction
lower leg
electric motor
fixator
axis
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.)
Withdrawn
Application number
EP21175657.2A
Other languages
German (de)
English (en)
Inventor
Petra Josipovic
Filip Sironic
Filip Nikolic
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Fizio Tech d o o
Original Assignee
Fizio Tech d o o
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Fizio Tech d o o filed Critical Fizio Tech d o o
Publication of EP3915535A1 publication Critical patent/EP3915535A1/fr
Withdrawn legal-status Critical Current

Links

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
    • A61H1/0237—Stretching or bending or torsioning apparatus for exercising for the lower limbs
    • A61H1/0244—Hip
    • 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
    • A61H11/00—Belts, strips or combs for massage purposes
    • A61H11/02—Massage devices with strips oscillating lengthwise
    • 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
    • A61H23/00—Percussion or vibration massage, e.g. using supersonic vibration; Suction-vibration massage; Massage with moving diaphragms
    • A61H23/02—Percussion or vibration massage, e.g. using supersonic vibration; Suction-vibration massage; Massage with moving diaphragms with electric or magnetic drive
    • A61H23/0254—Percussion or vibration massage, e.g. using supersonic vibration; Suction-vibration massage; Massage with moving diaphragms with electric or magnetic drive with rotary motor
    • A61H23/0263—Percussion or vibration massage, e.g. using supersonic vibration; Suction-vibration massage; Massage with moving diaphragms with electric or magnetic drive with rotary motor using rotating unbalanced masses
    • 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
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/01—Constructive details
    • A61H2201/0173—Means for preventing injuries
    • A61H2201/0176—By stopping operation
    • 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
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/12—Driving means
    • A61H2201/1207—Driving means with electric or magnetic drive
    • A61H2201/123—Linear drive
    • 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
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/16—Physical interface with patient
    • A61H2201/1602—Physical interface with patient kind of interface, e.g. head rest, knee support or lumbar support
    • A61H2201/1628—Pelvis
    • A61H2201/163—Pelvis holding means therefor
    • 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
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/16—Physical interface with patient
    • A61H2201/1602—Physical interface with patient kind of interface, e.g. head rest, knee support or lumbar support
    • A61H2201/164—Feet or leg, e.g. pedal
    • A61H2201/1642—Holding means therefor
    • 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
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A61H2201/5007—Control means thereof computer controlled
    • A61H2201/501—Control means thereof computer controlled connected to external computer devices or networks
    • A61H2201/5012—Control means thereof computer controlled connected to external computer devices or networks using the internet
    • 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
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A61H2201/5023—Interfaces to the user
    • A61H2201/5043—Displays
    • 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
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A61H2201/5058—Sensors or detectors
    • A61H2201/5061—Force sensors
    • 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
    • A61H2203/00—Additional characteristics concerning the patient
    • A61H2203/04—Position of the patient
    • A61H2203/0443—Position of the patient substantially horizontal
    • A61H2203/045—Position of the patient substantially horizontal with legs in a kneeled 90°/90°-position
    • 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
    • A61H2203/00—Additional characteristics concerning the patient
    • A61H2203/04—Position of the patient
    • A61H2203/0443—Position of the patient substantially horizontal
    • A61H2203/0456—Supine

Definitions

  • Present invention related to medical equipment used in therapy and management of pain caused by the hip condition related to coxarthrosis, nerve compression syndrome, hip labral tear and the like.
  • Painful hip condition is usually related to the coxarthrosis, nerve compression syndrome, hip labral tear and the like.
  • various treatment options are available: cold and warm presses, pain medication, physical therapy and surgery. Quality of life of such a patient is hugely affected by this condition and it is important that it is treated efficiently and appropriately according to the degree of the progression of the underlying disease.
  • physical therapy is proved to be useful in alleviating pain, postponing or even avoiding surgery.
  • Successful physical therapy usually includes traction, most commonly manual, very often accompanied with the manually produced vibrations on the surrounding structures and soft tissues.
  • Tombo-brace which is also limited to the axial traction of the hip joint which helps in compression reduction and alleviates pain
  • Tombo-brace has severe limitations for use in clinical setting.
  • the apparatus of US 2009/0259253 A1 has only possibility for one traction direction (long-axis or caudal), the oscillation is provided separately from traction, the muscle relaxation of the lumbar region provides limited fixation of the pelvis and torso region and could therefore used only for traction of vertebral column.
  • the invention discloses the apparatus for traction and vibration of the hip joint, and its use in the treatment of therapy and management of pain caused by the hip condition related to coxarthrosis, nerve compression syndrome, hip labral tear and the like.
  • the apparatus for traction and vibration of the hip joint comprises base (1), main housing (7) with electronical components, wherein assembly for moving along Z axis (2) by making use of central linear electric motor (13), assembly for moving along X axis (3) containing bearings (17), horizontal linear electric motor (14) and ventral-caudal traction mechanism having fixator of the proximal part of the lower leg (4) and fixator of the distal part of the lower leg (5), lateral traction mechanism (12), fixing mechanism and vibration unit and operating software and wherein
  • the apparatus for traction and vibration of the hip joint comprises base (1), main housing (7) with electronical components, wherein assembly for moving along Z axis (2) by making use of central linear electric motor (13), assembly for moving along X axis (3) containing bearings (17), horizontal linear electric motor (14) and ventral-caudal traction mechanism having fixator of the proximal part of the lower leg (4) and fixator of the distal part of the lower leg (5), lateral traction mechanism (12), fixing mechanism and vibration unit and operating software.
  • Traction mechanism comprises base (1) positioned on four wheels (6) which provide the mobility of the whole apparatus according to the invention.
  • the base (1) comprises main housing (7) which contains electronic components ( Figure 1 ).
  • the assembly for moving along Z axis (2) is placed on the base (1) which moves by making use of central linear electric motor (12) in order to enable hight adjustments of the physiotherapeutic table ( Figure 2 ).
  • the assembly for moving along X axis (3) is used to make possible adjustment on the individual length of the lower leg so the patient's leg could be easily accommodated ( Figure 3 ).
  • the assembly for moving along X axis (3) also comprises bearings (17) which enable bilateral use of the apparatus so it can be put on either left or right side of the physiotherapeutic table depending on the side of the patient's hip damage ( Figure 4 )
  • Moving is accomplished by making use of horizontal linear electric motor (14) ( Figure 3 ).
  • the assembly for moving along X axis (3) is further connected to the fixator of the proximal part of the lower leg (4) and the fixator of the distal part of the lower leg (5) ( Figure 1 ).
  • the fixator of the proximal part of the lower leg (4) is used for placing and accommodation of the proximal part of the patient's leg and enables the traction force in the range of 0-1000 N ( Figure 5 ).
  • the fixator of the proximal part of the lower leg (4), in its lower part comprises ball bearing assembly (11) which enables traction (ventral/lateral/caudal) by rotation in all directions of 60 degrees ( Figure 1 ).
  • Ball bearing assembly (11) consists of ball (20), delimiter (21), housing of the ball bearing assembly (23), slider (22), spring (24) and linear electric motor (25) for the ball bearing assembly ( Figure 9 ).
  • Activation of the linear electric motor (25) causes oppression of the spring (24) which then causes moving of the slider (22) ( Figure 9 ).
  • Slider (22) is construed in a way that it has a slope on which the delimiter (21) slides and by this delimiter is moved along Z axis.
  • Upper part of the fixator of the proximal part of lower leg (4) comprises ball bearing assembly (11) which enables more comfortable accommodation of the leg and the handle of the proximal part of the lower leg (10a) ( Figure 1 ).
  • Handle of the proximal part of the lower leg (10a) comprises sensor (18) which reads the intensity of the applied traction force ( Figure 5 ).
  • Right linear electric motor (19) drives fixator of the proximal part of the lower leg (4) which moves along Z axis in the range of 150 mm.
  • Fixator of the distal part of the lower leg (5) contains in the upper part the ball bearing assembly (15) and handle of the proximal part of the lower leg (10b), the said fixator moving along Z axis in the range of 200 mm using left linear electric motor (16) ( Figure 4 ).
  • Ball bearing assembly (11) which are part of the fixator of the proximal part of the lower leg (4) and the fixator of the distal part of the lower leg (5) enable the mobility of the handle of the proximal part of the lower leg (10a) and the handle of the distal part of the lower leg (10b) in order to place the thigh and lower part of the leg in optimal position according to patient's hi damage characteristics and respecting the type of traction force to be applied (ventral/caudal/lateral) ( Figure 1 ).
  • Screen (8) and screen receptor (9) are installed on the assembly for moving along X axis (3) ( Figure 1 ).
  • Screen 8 serves in the process of controlling all electric motors comprised by the apparatus according to the invention. These could be operated by mobile devices, tablets or computers enabling the physical therapist to set and modulate the intensity, direction and the duration of the application of the traction force, in any point of time, to be applied on the patient.
  • Lateral traction mechanism consists of pulley (33), cable (34), thigh belt (35), lateral sensor (36) and lateral DC worm electric motor (37), lateral sensor (36) being placed between lateral DC worm electric motor (37) and the thigh belt. Housing of the lateral traction mechanism (38) is equipped with emergency button (39).
  • Fixation mechanism contains belt (26), sponge part (27), adjusting means (28) and fastening means (29), part of the being boarded up with thin sponge and covered with leather material or leather imitation material coating the sponge part (24) ( Figure 8 ).
  • Sponge part (27) is placed on the pelvis of the patient on the level of the hip and it is adjusted by the adjusting means (28) and fastening means (29) which is under the table.
  • the pelvis is put in the fixed position enabling successful traction of the femur in relation to the acetabulum ( Figure 8 ).
  • Vibration unit consists of belt (30), housing of the vibration unit (31) containing electric motor with excentre (32) producing vibrations in the range of 0-33 Hz, while housing of the vibration unit contains belt reception part. Intensity and the duration of the vibration is determined and controlled through web based software using screen/mobile phone/computer. Vibration unit is placed on the thigh and the vibrations produced thereby cause muscle and surrounding structures relaxation ( Figure 7 ).
  • synergistic action of the traction and vibration enables synovial liquid, present in the joint, to be evenly distributed and to get through the damaged parts of the cartilage.
  • the software enables the user to operate all the electric motors (13, 14, 16, 19, 32, 37) and set up and modulate duration, direction and intensity of the traction force and duration and intensity of the vibration in any point of time.
  • the apparatus is intended for use in a clinical setting.
  • the treatment duration is approximately 20 minutes and it repeated according to the severity of the underlying disease, typically 3 times a week during 1-2 months.
  • the traction force used is mostly around 400 N and the vibration frequency is around 7 Hz (relaxation of the muscles and surrounding structures).
  • This method of treatment is superior to manual traction and vibration technique since it is not dependent on the human factor and more efficiently alleviates pain and postpones or even completely eliminates the need for surgery of the hip in patients with coxarthrosis, nerve compression syndrome, hip labral tear and the like.

Landscapes

  • Health & Medical Sciences (AREA)
  • Epidemiology (AREA)
  • Pain & Pain Management (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Rehabilitation Therapy (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Rehabilitation Tools (AREA)
  • Orthopedics, Nursing, And Contraception (AREA)
EP21175657.2A 2020-05-27 2021-05-25 Appareil pour la traction et la vibration de l'articulation de la hanche Withdrawn EP3915535A1 (fr)

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
HRP20200856AA HRP20200856A1 (hr) 2020-05-27 2020-05-27 Uređaj za trakciju i vibraciju zgloba kuka

Publications (1)

Publication Number Publication Date
EP3915535A1 true EP3915535A1 (fr) 2021-12-01

Family

ID=76098847

Family Applications (1)

Application Number Title Priority Date Filing Date
EP21175657.2A Withdrawn EP3915535A1 (fr) 2020-05-27 2021-05-25 Appareil pour la traction et la vibration de l'articulation de la hanche

Country Status (2)

Country Link
EP (1) EP3915535A1 (fr)
HR (1) HRP20200856A1 (fr)

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20090259253A1 (en) 2006-07-19 2009-10-15 Satisform Apparatus for stretching the vertebral column of a person
FR2995781A1 (fr) * 2012-09-27 2014-03-28 Franck Germain Appareil d'etirement, etirant simultanement les chaines musculaires anterieures et posterieures des membres inferieurs sans contraindre le rachis lombal
WO2017039550A1 (fr) * 2015-09-04 2017-03-09 Kalkan Özcan Mécanisme de traitement de troubles du mouvement survenant aux extrémités en conséquence de lésions du système nerveux

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20090259253A1 (en) 2006-07-19 2009-10-15 Satisform Apparatus for stretching the vertebral column of a person
FR2995781A1 (fr) * 2012-09-27 2014-03-28 Franck Germain Appareil d'etirement, etirant simultanement les chaines musculaires anterieures et posterieures des membres inferieurs sans contraindre le rachis lombal
WO2017039550A1 (fr) * 2015-09-04 2017-03-09 Kalkan Özcan Mécanisme de traitement de troubles du mouvement survenant aux extrémités en conséquence de lésions du système nerveux

Non-Patent Citations (2)

* Cited by examiner, † Cited by third party
Title
GUSTIN SHESPEEL C: "Dissertation", 2018, GHENT UNIVERSITY, article "The clinical use of a hip traction device in conservative treatment of femoroacetabular impingement: a comparative and randomised controlled clinical trial"
MADEIROS JMROCKLIN T: "Manual Therapy, Therapeutic Exercise, and HipTracTM for Patients with Hip Osteoarthritis: A case Series", ORTOPAEDIC PRACTICE, vol. 29, no. 1, pages 17

Also Published As

Publication number Publication date
HRP20200856A1 (hr) 2021-12-10

Similar Documents

Publication Publication Date Title
EP1169003A1 (fr) Dispositif et procede pour une therapie de locomotion
RU2391084C1 (ru) Механургический стол для массажа и мануальной терапии
US7662115B2 (en) Musculoskeletal loading device
US20090204039A1 (en) Device and Method for Treating Neck Tension or Neck Injury
CN111407601A (zh) 一种下肢康复训练机器人
EP3982901B1 (fr) Équipement à rayons infrarouges pour rééducation robotique sur un tapis roulant, ayant une fixation pelvienne flexible
RU2308257C1 (ru) Способ лечения заболеваний позвоночника
RU2423963C2 (ru) Массажер-тренажер
EP3915535A1 (fr) Appareil pour la traction et la vibration de l'articulation de la hanche
RU199025U1 (ru) Аппарат для комплексной терапии позвоночника
RU2320165C1 (ru) Устройство для вибрационно-механического массажа позвоночника
RU168180U1 (ru) Аппарат для воздействия на биоактивные точки организма и разгрузки паравертебральных мышц позвоночника
Siddiqi et al. A computer-aided walking rehabilitation robot
RU2336069C1 (ru) Аппарат для вибрационно-механического массажа позвоночника
RU2728099C1 (ru) Способ восстановительного лечения поражений в краниовертебральном сочленении позвоночника на уровне сустава С0/С1
RU2386428C1 (ru) Аппарат для вибрационно-механического массажа позвоночника
RU179661U1 (ru) Тренажер для восстановления функциональной активности верхних и нижних конечностей
RU2026051C1 (ru) Устройство для механизированного массажа
WO2019177561A1 (fr) Dispositif de prophylaxie et de traitement des maladies de l'appareil locomoteur chez l'humain
RU2794817C1 (ru) Способ коррекции атланта и устройство для его осуществления
CN212817071U (zh) 一种下肢康复训练机器人
RU2782782C2 (ru) Аппарат для комплексной терапии позвоночника с помощью массажных выступов и нагрева
US20130012845A1 (en) Knee joint mobilizer
RU103071U1 (ru) Тренажер для вытяжения позвоночника
Kutyina et al. Automated complex of motion control based on vibrotactile feedback for rehabilitation

Legal Events

Date Code Title Description
PUAI Public reference made under article 153(3) epc to a published international application that has entered the european phase

Free format text: ORIGINAL CODE: 0009012

STAA Information on the status of an ep patent application or granted ep patent

Free format text: STATUS: REQUEST FOR EXAMINATION WAS MADE

17P Request for examination filed

Effective date: 20210527

AK Designated contracting states

Kind code of ref document: A1

Designated state(s): AL AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HR HU IE IS IT LI LT LU LV MC MK MT NL NO PL PT RO RS SE SI SK SM TR

B565 Issuance of search results under rule 164(2) epc

Effective date: 20211018

STAA Information on the status of an ep patent application or granted ep patent

Free format text: STATUS: THE APPLICATION IS DEEMED TO BE WITHDRAWN

18D Application deemed to be withdrawn

Effective date: 20231201