FR3081702A1 - THERAPEUTIC POSITIONING DEVICE FOR THE TREATMENT OF SPINAL DEFORMATIONS IN HYPOTONIC PATIENTS - Google Patents

Abstract

The present invention relates to a therapeutic positioning device for the treatment of deviations of the spine in hypotonic patients, in particular hypotonic scoliosis of neurological or neuromuscular origin, of the type comprising a seat (1) on which is mounted a backrest (3 ) which comprises a frame, said seat (3) comprising means for wedging the pelvis (11, 13, 15) of a patient, said frame comprising first means (72) for attaching the torso of a patient. According to the invention, typically, said frame comprises on its front face which is oriented towards said seat: - a straightening corset (31) integral with said frame and also extending above said seat (1), along the depth of said seat (1), said corset (31) comprising lateral windows, and - a lateral support (311) and a lateral support (313), which extend according to the depth of said seat (1) and the height of said backrest (3) and which are mounted on said frame at different heights through said side windows provided in said corset (31), said support (311) and said counter-support (313) being mounted adjustable and lockable in position by translation along the width of said backrest (3) and optionally according to the depth of said seat (1) and the height of said backrest (3) and said first attachment means (72) of the patient's torso connect said support (311 ) and said counter-support (313) .

Description

Description

Title of the invention: Therapeutic positioning device for the treatment of deformities of the spine in hypotonic patients The present invention relates to a therapeutic positioning device for the treatment of deformities of the spine in hypotonic patients, in particular hypotonic scoliosis of neurological or neuromuscular origin.

Document LR 3009189 describes a support device for hypotonic patients. This device makes it possible to keep the patients seated or put them in a semi-upright position which is beneficial for their treatment. The device described in this document comprises, in particular, a seat and a back which can be covered with cushions made to measure for the patient, by milling a block of foam. The device described in this document is only used to keep the patient seated; it is to a certain extent a therapeutic device because it makes it possible to modify the patient's position, which modification proves beneficial to the treatment of his pathology or at least to the non-aggravation of his pathology.

It turns out that hypotonic patients often also have a deformation of the spine, usually scoliosis.

These patients are therefore forced to wear a straightening corset which makes it possible to control the development of scoliosis or even to treat it while being installed in an orthopedic seat which makes it possible to keep them seated.

In addition, these patients are often afflicted with other pathologies which cause swings from front to back of their torso.

An object of the present invention is to provide a therapeutic device for treating deformities of the spine, in particular scoliosis, which is suitable for hypotonic patients.

Another object of the invention is to provide a device as mentioned above which allows a certain mobility of the treated patient and in particular allows the torso to swing.

Another object of the present invention is to provide a device as mentioned above which allows an X-ray of the patient to be carried out without having to remove the patient from the device.

The present invention relates to a therapeutic positioning device for the treatment of deviations of the spine in hypotonic patients, in particular hypotonic scoliosis of neurological or neuromuscular origin, of the type comprising a seat on which is mounted a backrest which includes a frame, said seat comprising means for wedging the pelvis of a patient, said frame comprising first means for attaching the torso of a patient. Typically, according to the invention, said frame comprises on its front face which is oriented towards said seat:

- A straightening corset, integral with said frame and also extending above said seat, according to the depth of said seat, said corset having side windows, and [...] - lateral support and lateral support against , which extend along the depth of said seat and the height of said backrest, said support and said counter support are mounted on said frame at different heights through said side windows formed in said straightening corset, said support and said counter support being mounted adjustable and biocable in position by translation along the width of said backrest and optionally according to the depth of said seat and the height of said backrest and said first means of attachment of the patient's torso connect said support and said counter-support.

The corset, which can be made to measure for the patient, keeps the bust of the latter against the backrest. The cooperation of the corset, the support, the counter support and the first attachment means makes it possible to straighten the spine of the patient, in the manner of a standard therapeutic treatment corset (treatment of scoliosis, in particular) which acts with force and counter force applied to the spine.

It will be understood that the position of the support and the counter-support relative to the backrest can be adjusted in translation and then be locked in a given position which corresponds to the morphology of the patient.

According to a particular embodiment, said backrest is mounted mobile in rotation on said seat so as to be able to pass from a vertical position relative to said seat to a position inclined in the direction opposite to said seat according to a determined stroke , when a force of intensity greater than a given level is exerted on said backrest in said direction opposite to said seat and said backrest is able to return to said vertical position when the force ceases to be exerted.

Such a file allows the patient to swing back and forth while maintaining good support and effective recovery of the spine. The backrest always returns to its vertical position.

According to an alternative embodiment, the backrest can move from the vertical position (forming an angle of 90 ° with the seat) to a maximum tilt position of 45 °.

Advantageously, the device comprises means for blocking the position of the backrest which thus make it possible to position the backrest in any intermediate position between the vertical position and the position of maximum inclination.

According to a particular embodiment which can be combined with any one of the aforementioned embodiments and their variants, said backrest includes a particularly metallic frame which comprises two vertical uprights spaced apart along the width of said backrest, said corset comprises a internal shell obtained by molding the patient's bust and fixed on said vertical uprights above said seat, said support and said counter-support are each mounted on one of the uprights, said backrest also comprises an external shell which is mounted on said uprights vertical and which covers the rear face of the backrest and the internal shell, the internal shell and the external shell being integral with each other, said shells possibly being made of material transparent to X-rays.

The two shells can be fixed to the frame by means of adhesive strips, strips of the type comprising hooks which cooperate with loops. The two shells can be glued to the frame or screwed onto it. The two shells can be joined to each other and in particular glued together.

The metal frame provides good rigidity and solidity to the device of the invention. The aforementioned amounts allow, because of their position, to use the device of the invention to perform an X-ray of the patient's back while the latter is installed on the device of the invention.

The two integral shells ensure good maintenance of the patient's bust; the corset formed by the inner shell and the outer shell is thus securely attached to the backrest since the latter's frame is sandwiched between the two shells.

According to a particular embodiment of the articulation of the backrest, combinable with any one of the abovementioned embodiments, said device comprises a stop disposed behind said backrest and under said seat, said seat comprises a guide element which comprises a groove in which said stop slides, said device comprises a jack arranged under said seat and which connects said back to said seat and said device optionally includes means for locking in position of said stop in said groove.

The cylinder serves as a means of recalling the file. It also provides good support for the patient's back since it allows the backrest to be tilted only if the patient pushes on it. Its arrangement under the seat, as well as that of the other metal parts (guide element, stop) does not interfere with the radiography.

Advantageously, the backrest may further include two lateral holding elements arranged facing one another, at the shoulders of said patient, said holding elements being optionally adjustable and biocable in position by translation along the height of said backrest and / or the width of said backrest and / or the depth of said seat and of the second attachment means of the torso of said patient connect said lateral retaining elements.

These holding elements ensure good support of the patient against the file. The wedging means of the patient's pelvis on said seat may, according to a particular embodiment, comprise two lateral wedges which extend along the depth of said seat and a central wedge capable of being disposed between the legs of the patient .

Advantageously, the backrest further comprises a headrest connected to said backrest by a rod offset relative to a vertical axis passing substantially through the middle of the width of said backrest, said headrest possibly being slidably mounted on said rod. .

The remote file does not interfere with the radiography of the patient's back. The rod can be an upright of the frame and the headrest can be slidably mounted in this upright.

Advantageously, said support and said support against are pivotally mounted between a therapeutic position in which they extend along the depth of said seat and a spread position called placement in which they extend parallel to the width of said seat and they are able to be locked in either of these positions and / or said lateral wedges and / or the lateral holding elements are also pivotally mounted between a therapeutic position in which they extend according to the depth of said seat and a placement position in which they extend parallel to the width of said seat and they are capable of being locked in either of these positions.

It is thus easy to install the patient in the device of the invention without having to modify the position of the support, the counter-support, the lateral wedges, the central wedge and the lateral retaining elements. Their position is adjusted when the device is made available; to install the patient or remove him from the device, it suffices to switch from the therapeutic position to the discarded position and vice versa without modifying the settings. Thus, the therapeutic function of the device which comes from these settings cannot be disturbed when the device is used by the patient's family.

Pins can be used for locking in position in each of the above positions.

The straightening corset is not limited according to the invention. It may include a front portion coming into contact with the patient's chest; this front portion can be articulated or retractable to allow the patient to be inserted into the corset. Advantageously, the corset has no front portion extending between its side walls, parallel to the backrest; it therefore has only a rear portion which forms the backrest and two lateral portions provided with windows. In this case, it is the first attachment means which are rigid and ensure the function of the front portion of the straightening corset. The corset may also have an ventilation window in the backrest.

Advantageously, whatever the embodiment, the corset has a window provided in said folder.

The present invention, its characteristics and the various advantages which it provides will appear better in the light of the following description of a particular embodiment, presented by way of illustrative and nonlimiting example and which refers to annexed drawings in which:

[Fig. 1] shows a perspective front view of a particular embodiment of the device of the invention, the inner shell of the corset and the outer shell being flat for the sake of clarity, the device being in the therapeutic position and not inclined;

[Fig. 2] shows a perspective view from the back of the internal shell forming the corset and of the backrest frame of [Fig. 1];

[Fig. 3] shows the device of [Fig. 1], the holding elements, the support, the counter-support and the hip wedging elements being in the separated position, thus allowing the patient to be placed on the device;

[Fig. 4] shows a side view of a detail of the means of articulation of the seat backrest of FIG. 1; and [Fig. 5] shows the device of [Fig. 1] in the therapeutic position, the backrest tilted backwards.

In all the figures, except for [Fig. 2], the straightening corset is not shown for the sake of simplification.

Referring to [Fig. 1], a particular embodiment of the device of the invention will now be described.

The device of the invention comprises a seat 1 and a folder 3. The seat 1 has two lateral wedges 11 and 13 which extend along the depth of the seat 1 and a central wedge 15 which slides between the patient's legs. The central wedge 15 is mounted on the front thickness of the seat, the backrest 3 being mounted opposite, that is to say at the bottom or rear of the seat.

The position of the central wedge 15 relative to the depth of the seat 1 is adjustable in translation. Once the position has been adjusted according to the morphology of the patient, the displacement in translation of the wedge is blocked by means of a pin 151.

The central wedge 15 can be unlocked to be tilted in rotation towards the front of the seat around the horizontal axis 153, in order to allow the patient to be replaced in the seat previously adjusted.

The position of each of the wedges 11 and 13 according to the width of the seat, the depth of the latter and the height of the backrest can be adjusted in translation by means of knobs not visible. The position of the wedges 11 and 13 once adjusted for the morphology of the treated patient is blocked. It is no longer possible to modify the position of the shims 11 and 13 by translation, once the adjustment adapted to the patient has been made. Locking in position is obtained by screwing, for example. The position of the shims 11 and 13 can nevertheless be modified by rotation around the axes 111 and 131 as explained later with reference to [Fig. 3].

The backrest 3 has on its face oriented towards the seat 1, an internal shell 31 covered with an external shell 32 which form the righting corset. This internal shell 31 is flat in [Fig. 1] but in reality it is obtained by thermoforming a rigid plastic plate on a molding of the bust of the patient to be treated. This aspect will be more fully explained with reference to [Fig. 2]. The rear face of the backrest 3 comprises the outer shell 32, also made of rigid plastic which will be more fully described with reference to [Fig. 4].

Referring to [Fig. 1], the backrest 3 includes a ventilation window 33 and two side windows 35 and 37. The lateral support 311 and the lateral support 313 are mounted on the backrest 3 at the level of these side windows 35 and 37. The support 311 and the counter-support 313 extend laterally, according to the depth of the seat 1 and above the latter. The first support 311 and the first counter-support 313 make it possible to correct the curvature of the spine of the patient in cooperation with the straightening corset. They are connected to the back frame by metal rods. The corset 31, the support 311 and the counter support 313 assure by their cooperation the therapeutic function of the device of the invention.

The position of the support 311 and the counter-support 313 is adjustable in translation according to the height of the backrest 3, its width and according to the depth of the seat 1; the rods carrying the support and the counter-support are slidably mounted on the uprights of the back frame and the support and the counter-support are themselves slidably mounted on these rods. Once the translation adjustments have been made to adapt the seat of the invention to the patient's morphology, the position of the aforementioned elements is blocked by screwing, for example. They can nevertheless be pivoted as explained later with reference to [Fig. 3]. The support 311 and the counter-support 313 are thus slidably mounted on the frame of the backrest 3.

The support 311 is mounted substantially at the waist of the patient while the counter-support 313 is higher and is arranged substantially at the bust of the patient.

The metal frame of the backrest is partially visible in [Fig. 1]. It has a lateral vertical upright 370 which protrudes from the backrest 3 and the end of which supports a headrest 4.

The backrest 3 also includes two lateral holding elements 51 and 53 arranged opposite one another above the support 311 and against the support 313. As previously explained with reference to the support 311 and against the support 313, the position of the holding elements 51 and 53 is adjustable in translation by means of knobs (not visible) according to the height of the backrest 3, the width of the latter and according to the depth of the seat 1. Once the adjustment has been made, the holding elements 51 and 53 can only pivot about a vertical axis 510 or 530 as explained with reference to FIG. 3.

Second means 71 for attaching the patient's torso to the file 3 connect the ends of the lateral wedging elements 51 and 53. First means 72 for attaching or fixing the patient's torso to the file 3 connect the 'support 311 to the counter-support 313. These attachment means 71/72 are adjustable and allow, on the one hand, to properly hold the patient's back against the internal shell 31 and, on the other hand, also to avoid that the patient does not collapse and fall forward of the seat. They are preferably rigid and integral with the frame of the backrest in order to properly ensure the therapeutic function of straightening the patient's spine.

Referring to [Fig. 2], the internal shell 31, the support 311 and the counter-support 313 will now be described in more detail.

The internal shell 31 is fixed to the frame of the backrest 3, which comprises two lateral uprights 370 and 371 on which the support 311 and the counter-support 313 are also mounted. A horizontal bar 373 connects the ends of the uprights 370 and 371 near the seat 1. This bar 373 is used to articulate the backrest 3 with respect to the seat 1, as explained with reference to [Fig. 4]. The support 311 is disposed at the waist of the patient while the counter-support 313 is disposed higher, substantially at the level of the patient's chest. The support 311 and the counter-support 313 allow the patient's spine to be straightened. They are connected by the first attachment means 72 which not only keep the patient against the backrest 3 but also exert a force between the support 311 and the counter-support 313 so as to act on the spine of the patient.

In [Fig. 2], the patient is installed in the device of the invention, the back pressed against the internal shell 31 which partially forms the corset. The inner shell 31 extends from below the patient's waist to an area under his arms. The dimensions of the inner shell 31 are the same as that of an existing spinal torsion treatment corset. The internal shell 31 therefore also extends laterally, depending on the depth of the seat, towards the front of the latter, so as to partially enclose the patient's bust. The correction of the curvature of the column is obtained by adjusting the first support 311 and the first counter-support 313 according to the width of the seat, so as to maintain and straighten the patient's torso.

When the patient is moved from the device of the invention, for example, for his toilet, and must be installed there again, the wedges 11, 13 and 15 are positioned, the support 311, the counter-support 313 and the lateral holding elements as shown in [Fig. 3]. To do this, we remove the pins and rotate the shims and each of the other aforementioned elements around their respective axis of rotation. The pin is then released so as to lock them in this separated position which allows the patient to be installed on the device of the invention.

Referring to [Fig. 3], in the separated position, the wedges 11 and 13 extend on each side of the seat 1, substantially in the same plane as the latter. The wedge 15 is substantially vertical and remote from the front of the seat 1. The support 311 and the counter-support 313 are substantially in the same plane as the backrest 3 and extend along the width of the latter. It is the same for the lateral holding elements 51 and 53.

Referring to [Fig. 4], the articulation of the backrest 3 relative to the seat 1 will now be described. The backrest frame 3 includes the bar 373 shown in [Fig. 2] and which is located at the lower end of the backrest 3. The two uprights 370 and 371 are integral with this bar 373 and extend perpendicular to the latter. The bar 373 and the two uprights 370 and 371 are in the same plane. The external shell 32 covers the metal frame of the backrest 3 and is integral with the internal shell 31. The bar 373 has a rod 6 which is perpendicular to it and which extends towards the rear of the backrest, in the direction opposite to the 'seat 1. The free end of the rod 6 is equipped with a stop 61, perpendicular to the rod 6. The metal frame of the seat has a guide element 120 which extends towards the rear of the seat 1. This guide element has one end forming a plane which extends perpendicular to the plane of the seat 1. The planar end of the guide element 120 has a guide groove 123 which forms an arc of a circle. The stop 61 slides in this guide groove 123. The guide groove 23 is such that when the stop 61 is disposed at the top end of the guide groove 123, the backrest 3 forms an angle of 90 ° with l 'seat 1. When the stop 61 is in abutment at the lower end of the groove 123, the backrest 3 and the seat 1 form an angle of 45 °.

Referring to [Fig. 4], the bar 373 also comprises a vertical rod 4 disposed substantially in the same place as the rod 6. This rod 4 extends towards the bottom of the backrest 3. Its end is disposed substantially below the frame of the seat 1. The seat 1 comprises a support rod 42 which is integral with its lower face. A jack 8 connects the free end of the rod 4 with the free end of the horizontal rod 42. This jack exerts a given intensity force between the backrest 3 and the seat 1. Thus, thanks to the jack, the backrest 3 can only tilt backwards when the patient exerts on the backrest a force greater than a given value. In addition, the jack 8 exerts a restoring force on the backrest 3, bringing it back to its initial position (the stop 61 wedged in the upper end of the guide groove 123); as soon as the patient stops leaning against the backrest 3, the latter returns to a vertical position.

Locking means (not shown), of the type comprising a threaded rod insertable through the guide groove 123, a stop fitted to one end of the threaded rod and a handle cooperating with the threaded rod make it possible to fix in position the folder. When the handle is tightened on the threaded rod, against the flat part of the guide element 120, the stop 61 is locked against the threaded rod and the backrest 3 is locked in position or at least its stroke is limited.

On [Lig. 5] which will now be described, the inner shell 31 and the outer shell 32 have been removed. Only the metal frame of the device of the invention is visible. When the backrest 3 is tilted as far back as possible, the stop 61 is in abutment in the lower end of the guide groove 123. The headrest 4 is articulated at two points of rotation so that it can be tilted towards the forward or backward. The headrest 4 is slidably mounted in the upright 370.

The use of the device of the invention will now be described with reference to the above figures. A rigid plastic plate (thermazote®, for example) is thermoformed to form the internal shell 31, the first support 311 and the first abutment 313 on a molding of the bust of the patient to be treated. The part of the support 311 and the counter-support 313 which comes into contact with the patient's body is cut from the thermoformed plastic so as to conform to the patient's body. The ventilation window 33 is formed in the internal shell 31 and the side windows (which are formed by recess to recover the support 311 and the counter-support 313) are adjusted through which the support support rods 311 will pass. and of the counter-support 313. The internal shell 31 is fixed on the uprights 370 and 371, the support 311 and the counter-support 313 on their respective supports which are mounted on the metal frame of the device. The rear face of the backrest 3 and the external face of the shell 31 are covered with the external shell 32 which is also thermoformed and the internal shell 31 is secured to the external shell 32; the back frame is therefore sandwiched between the two shells 31 and 32.

We put the device in the separated position shown in [Lig. 3]. The patient is placed in the device and adjustments are made to the shims, the support and counter-support and the holding elements. We block all these elements in position.

The patient installed in his seat can lean back if he wishes and if he presses hard enough on the backrest. Thanks to the jack 8, as soon as the force ceases, the backrest returns to its vertical position. The patient can be easily removed from the device of the invention because of the possibility of putting the device in the separated position, as shown in [Lig. 3].

If an X-ray of the patient's spine is to be performed, there is no need to remove it from the device of the invention. Indeed, all the metal parts of the back frame being offset relative to the vertical center axis of the back, no element hinders the passage of X-rays. The jack 8 is also placed under the seat 1 and does not interfere so not the x-ray.

Claims (1)

[Claim 1] [Claim 2] [Claim 3] claims Therapeutic positioning device for the treatment of deviations of the spine in hypotonic patients, in particular hypotonic scoliosis of neurological or neuromuscular origin, of the type comprising a seat (1) on which is mounted a backrest (3) which includes a frame said seat (1) comprising means for wedging the pelvis of a patient (11, 13, 15), said frame comprising first means (72) for attaching the torso of a patient, characterized in that said frame comprises on its front face which is oriented towards said seat (1): - a straightening corset (31) integral with said frame and also extending above said seat, according to the depth of said seat (1), said corset comprising side windows, and - At least one lateral support (311) and one lateral support (313), which extend along the depth of said seat (1) and the height of said backrest (3) and said support and said counter-support (31; 33) are mounted on said frame at different heights through said side windows formed in said corset (31), said support (311) and said counter-support (313) being mounted adjustable and biocable in position by translation along the width of said backrest (3) and possibly depending on the depth of said seat (1) and the height of said backrest (3); and in that said first attachment means (72) of the patient's torso connect said support (311) and said counter-support (313). Device according to claim 1, characterized in that said backrest (3) is mounted so as to be able to rotate on said seat (1) so as to be able to pass from a vertical position relative to said seat (1) to an inclined position in the direction opposite to said seat (1) according to a determined stroke, when a force of intensity greater than a given level is exerted on said backrest (3) in said direction opposite to said seat (1) and in that said backrest (3 ) is able to return to said vertical position when the force ceases to be exerted. Device according to claim 1 or 2, characterized in that said backrest includes a metal frame (370, 371, 373) which comprises two vertical uprights (370; 371) spaced apart along the width of said backrest (3), in that said corset comprises an internal shell (31) obtained by molding the patient's bust and fixed on said vertical uprights (370; 371) above said seat (1), in that said support (311) and said abutment (313) are each mounted on one of said vertical uprights (370; 371), in that said backrest (3) also comprises an external shell (32) which is mounted on said vertical uprights (370 ; 371) and which covers the rear face of the backrest (3) and said internal shell (31) and in that the internal shell (31) and the external shell (32) are integral with each other, said shells (31; 32) possibly being of material transparent to X-rays. [Claim 4] Device according to either of Claims 2 and 3, characterized in that the said device comprises a stop (61) disposed behind the said back (3) and under the said seat (1), in that the said seat comprises a guide element ( 120) which has a groove (123) in which said stop (61) slides, in that said device comprises a jack (8) arranged under said seat (1) and which connects said backrest (3) to said seat (1) and in that said device possibly includes means for locking in position of said stop (61) in said groove (123). [Claim 5] Device according to any one of the preceding claims, characterized in that said backrest (3) further comprises two lateral holding elements (51; 53) arranged opposite one another, at the shoulders of said patient , said retaining elements (51; 53) being optionally adjustable and biocable in position by translation according to the height of said backrest and / or the width of said backrest and / or the depth of said seat and in that second attachment means ( 71) of the torso of said patient connect said lateral holding elements (51; 53). [Claim 6] Device according to any one of the preceding claims, characterized in that said means for wedging the patient's pelvis on said seat include two lateral shims (11; 13) which extend along the depth of said seat (1) and a shim central (15) able to be disposed between the legs of the patient. [Claim 7] Device according to any one of the preceding claims, characterized in that it further comprises a headrest (4) connected to said backrest (3) by a rod offset relative to a vertical axis passing substantially through the middle of the width of said backrest, said headrest (4) being optionally mounted to slide on said rod. [Claim 8] Device according to any one of the preceding claims, characterized in that said support (311) and said counter support (313) are pivotally mounted between a therapeutic position in which they extend according to the depth of said seat (l) and a spread position [Claim 9] [Claim 10] called placement in which they extend parallel to the width of said seat (1), in that they are able to be locked in either of these positions and / or in that said lateral wedges (11; 13) and / or the lateral retaining elements (51; 53) are also pivotally mounted between a therapeutic position in which they extend according to the depth of said seat (1) and a placement position in which they extend parallel to the width of said seat (1) and in that they are capable of being locked in one and the other of these positions. Device according to any one of the preceding claims, characterized in that said corset (31) is free from a front portion extending between its side walls and parallel to the backrest. Device according to any one of the preceding claims, characterized in that the said corset comprises a window (33) formed in the said folder (3).