GB2152381A - Physiotherapy table for traction and/or massage - Google Patents

Abstract

A treatment table for use by a chiropractor or a physiotherapist has a surface (5) on which a patient can lie face down in a prone position and which is pivoted (at 14) to allow it to be tilted through almost 180 DEG from an upright position and locked in any position (27). Grips, such as overboots (20), are provided at various points of the table so the patient is securely held to it, even when inverted. Mechanical traction devices which are electrically operated may be provided between sections of the table surface to enable the table to be used for mechanical traction therapy as well as manipulative therapy. <IMAGE>

Description

SPECIFICATION Treatment table This invention relates to a treatment table suitable for use by physiotherapists, chiropractors, osteopaths and related practitioners and is more specifically concerned with a table for use in manipulative therapy to enable traction thrust work to be performed on a patient. For convenience, such a table is hereinafter referred to simply as "a physiotherapy table".

State of the Art There are many medical conditions which benefit from traction thrust therapy. For example, muscular displacement along the spine may require prolonged manipulation aided by traction, to coerce a displaced muscle back to its correct position. Also, deep internal adhesions can occurfollowing trauma or surgery and traction can help to separate these adhesions, thus promoting connective tissue resettlement under controlled conditions, in fact assisting most body tissues disturbed by trauma or surgery.

The conventional traction thrust table is provided with floating cushions enabling the patient to lie face down in a horizontal position. The patient may have straps or other fixtures attached to suitable places on his body, such as his ankles and/or his pelvis, depending on personal disabilities of the patient, and between which a vibrating traction may be set up longitudinally of the patient. Such mechanical traction is applied with due regard to the patient's health, physique and injury, all of which must be taken into account when deciding the amplitude, frequency and duration of the vibratory traction to be applied.

Another form of traction used is manipulative traction. The patient is laid prone on a bed or couch and a chiropractor osteopath, physiotherapist or related practitioner performs manipulative traction on the patient with his hands, perhaps moving the patient to aid the manipulative traction being given.

The person administering manipulative traction should always be a skilled practitioner, as the spine contains the central nervous column of the patient and a serious spinal injury of a permanent nature could result if the traction is incorrectly performed.

This is especially so when old style mechanical traction methods are used.

It is customary to follow a period of traction therapy with a period of rest and/or massage. The patient is then moved to a low massage table for this purpose where he can be easily worked on by a physiotherapist or related practitioner.

Object of the Invention An object of the invention is to provide an improved physiotherapy table on which traction therapy can be carried out.

An object of a subsidiary feature of the invention is to provide a physiotherapy table on which massage and traction thrust therapy can be performed and ongoing research into this area of the healing arts can be carried out.

The Invention In accordance with the present invention a physiotherapy table is pivoted intermediate its ends to the upper end of a support which is sufficiently high to enable the table to be tilted about the pivot through about 180" from a substantially vertical position, the table having fixtures for holding a patient prone upon it at all positions to which it is tilted and which are located at longitudinally spaced positions along the patient's length, and means enabling the table to be held in any position to which it is tilted.

The advantage of the table of the invention is that it enables gravitational forces to be utilised during the traction periods as the patient can be held in a head-up or a head-down position during traction or at any intermediate position between the two.

Gravity can thus be used to induce a steady bias on the portion of the patient's body being subjected to traction, that bias being used to aid the effectiveness of the traction. Thus, when the patient is head down, and his weight is supported by his feet, the gravity bias provides a steady force acting to naturally extend the patient's spine. This has advantages both in the case of natural traction and in the case of mechanical or vibratory traction therapy. The ability to use the natural extension of the patient's spine when inverted, i.e. head down, enables traction to be performed under conditions more suited to the therapy to be carried out than has hitherto been possible.

Preferred Features of the Invention The table of the invention may be equipped to administer mechanical thrust or vibratory traction as well as natural or manipulative traction on the patient. When mechanical traction is to be applied, the table is equipped with traction-inducing elements, such as solenoids or vibrators, connected to the fixtures attached to the various parts of the patient on the table. The elements can be energised to apply a suitable longitudinal mechanical traction thrust on the patient of vibratory or constant force type for various angles of slope, attitudes or inversions of the patient.

Preferably the support is vertically adjustable between two vertical positions. At the "high" position the table is sufficiently spaced from the floor for it to be tilted to bring the fixture for engaging the patient's feet to floor level. The patient can then step up to the cushioned face of the traction table and the fixtures applied to him. The table can then be moved to the appropriate angle of tilt at which traction is to be carried out. On completion of traction, the table is moved to the horizontal position and the support is lowered to its second position at which the table is at a convenient height for massage therapy to be performed. The fixtures are then loosened and massage can be carried out. A separate massage table is thus unnecessary.

A suitable form of support comprises a frame formed from pivoted links controlled, conveniently, by a ram system which may be hydraulically operated to move the frame between its traction and massage positions in a controlled manner.

The table may be provided with means for enabling the patient, while held inverted from his feet, to be moved bodily away from the cushions to enable X-ray plates to be located between them so that the behaviour of the spine under traction and in different angles of tilt can be studied.

Introduction to the Drawings The invention will now be described in more detail, by way of example, with reference to the accompanying diagrammatic drawings, in which: In the Drawings FIGURE 1 shows in sketches "A" to "D" a combined traction and massage table in different positions of tilt; FIGURE 2 is a perspective view of a support frame of a modification of the table; FIGURE 3 shows a side view of the support frame of Figure 2 in its "high" or traction position; FIGURE 4 shows the frame of Figure 2 in its "low" or massage position; FIGURES 5 and 6 show another construction of table at two angles of tilt; and FIGURE 7 shows in oblique side view, a simplified version of a natural or manipulative traction table.

Description of First Embodiment Figure 1 shows a physiotherapy table 1 comprising a base 2 for a frame 3 formed by links 4, 5,6 and 7 which are hinged to one another and to the base at points 8.

A hydraulically-operated two directional ram 9 is located between the links 4 and 5 and is pivoted at its lower end to the base 2 at 11, and at its upper end to a pivot point 12 at approximately the middle of the link 4.

The link 7 is of inverted U-shape and has at its upper end a pivot 14 providing a horizontal fulcrum for a traction table 15 on which a patient 16 under treatment is shown. The patient 16 is held in a prone position on the table by fixtures which include a pair of zippered or snap lockable boots 20 and/or a pelvic strap 21 as required. The upper face of the table is lined with floating cushions (not shown) and is divided into four sections which are spaced longitudinally from one another and comprise: a head section ; a dorsal or chest section; a pelvic section; and a foot section. These sections and the cushions associated with them are shown in the embodiment illustrated in Figures 5 and 6. The patient is additionally provided with a handrail 22 which he can grip during movement of the table 15.

The table 15 is provided beneath its centre with a semi-circular brake disc 25 arranged concentrically with respect to the axis of the pivot 14 and which can be gripped between a pair of clamping brake pads 26. A hand lever 27 controlled by the practitioner enables the brake pads 26 to be released to allow manual change in the angle of tilt of the table, and to clamp the table 15 firmly in any new angular position selected.

As is apparent from sketches "A", "B" and "C", the height of the pivot 14 is sufficient to enable the table 15to be moved from nearly the vertical position shown in sketch "A", through almost 180 to the position shown in sketch "C" which shows the patient inverted. The frame 3 is firmly held in the "high" position illustrated in these figures, by the ram 9 which is in its fully-extended position.

Located beneath the table are electrically operated traction-inducing units (not shown) which are connected between the four sections of the table. In practice these are arranged as is described later with reference to Figures 5 and 6. The tractioninducing elements conveniently comprise solenoids which can vibrate the table sections longitudinally with respect to one another and are controlled by a computer (not shown). The computer has controls enabling the elements to be individually selected for operation for a pre-determined period and with a desired frequency and amplitude. Other controls on the computer enable it to respond in a beneficial manner to the heart rate of the patient under traction and galvanic skin currents on the patient.

Operation of Preferred Embodiment The support frame 3 is moved by the ram 9 to its "high" or traction position and arranged as shown in sketch "A".

The patient steps into the boots which are firmly attached to the foot-section of the table 15, and they are zippered or snap closed so that the patient is held to the table irrespective of its angle of tilt. The pelvic strap 21 and/or shoulder or neck harnesses (not shown but which may be required to suit the type of traction decided upon) are also attached to the patient so that they are free of slack and connect the corresponding portions of his body to the corresponding sections of the table.

The practitioner releases the lever 27 and swings the table gently to the chosen angle at which traction is to be carried out. The lever 27 is then moved to clamp the table in that position by means of the brake pads 26. The computer settings are adjusted to suit the therapy to be carried out. While the therapy is in progress the characteristics of the patients may be monitored by the practitioner. The modification of the support in Figure 2 involves the substitution of a bell-crank plate in place of the Ushaped link 7 in Figure 1. The two plates 30 provide, together, surface 31 for stabilising the table when moved to the "low" or massage position.

Figures 5 and 6 shows a different construction of the table also usable for inversion research. It comprises a base 50 having a telescopic support column 51 having a pivot 52 at its upper end. A bracket 53 is tiitable about the pivot 52 in a controlled manner, and is attached to the underside of a table 55 which incorporates a computer-control panel 56 and electrical circuitry associated with the different parts of the table which require to be electrically driven.

The table 55 is provided, spaced from its upper surface, with floating cushions associated with four sections: a head section 57; a dorsal section 58; a pelvic section 59; and a foot section 60. A patient 62 is shown on the table and is held in position on the cushions by either a pelvic strap 63 attached to the pelvic section 59, or shin and ankle clamps 64 attached to the foot section 60. He is provided with an arm rest 61. A platform 66 is provided at the foot section of the table to assist the patient to step into the clamps when standing against the upright table prior to being attached to it by them. A bracket 68 is provided at the other end of the table for the attachment of a cervical traction harness (now shown) when required.

The four sections of the table are each movable relative to one another to suit patients of different height and can each be vibrated longitudinally by independently-operated vibrating means such as solenoids (only one of which is shown). These are controlled by the computer in a way which allows the operating frequency and stroke lengths of the solenoids to be varied. The characteristics of the traction applied to the patient can thus be altered.

One of the solenoids is indicated at 70 beneath the patient's dorsal cushion. As shown, the cushions are supported by side arms 71 spaced from the upper surface of the table. A hand lever 80 is provided at the side of the table to move the ankle clamps 60 between the positions respectively shown in Figures 5 and 6. A second handle (also not shown) enables a practitioner to vary the angle of tilt of the table through 180' from the vertical position shown in Figure 6, by moving it around the pivot 52.

Figure 5 shows the column 51 retracted so that the table 55 can be used as a massage table. Figure 6 shows the column extended to lift the table to a height at which it can be turned about the pivot axis from a horizontal position, to the vertical position shown in Figure 6 where the patient 62 is shown inverted, and suspended by the shin and ankle clamps 64. The lever 80 has been moved to a position at which the clamps 64 are moved away from the table surface so that a space 'x' occurs between the patient and the cushions to enable an X-ray plate to be interposed therebetween.

The table shown in Figures 5 and 6 is used in the same manner as the table shown in Figures 1 to 4 and such use will not therefore be again described.

A simplified version of the table for training purposes and limited clinical usage, is shown in Figure 7, for manipulative and natural traction therapy only. It comprises a base 90 at its upper end.

The pivot is provided by a shaft 93 equipped with a semi-circular braking plate 94 which turns with the shaft and passes between a pair of brake pads 95. A handle 96 on the frame enables the shaft 93 to be clamped in any chosen position by the pads 95.

Atable 97 is attached beneath its central portion to the shaft so that it can tilt about the shaft axis. The table is capable of tilting from a vertical position or near vertical position, through an angle in the region of 180 . In this and the other examples of the invention the angle can be anything between about 150 and 230 .

The upper surface of the table 97 is padded and has a head section 98 and a foot section 99. The head section 98 is formed with two longitudinally extending and spaced parallel rectangular pads between which a slot is formed sufficiently wide to enable a patient, prone upon the table, to place his nose in to facilitate breathing. A padded arm rest 100 is provided beneath the head section of the table and is provided at its underside with a nest of legs 101 which can be individually folded down to provide rest upon the floor and provide the table with a predetermined angle of tilt.

The foot section 99 of the table is provided with a pair of latchable boots 102 attached to the table and which enable a patient to be held firmly with his feet and ankles held securely in the latched boots. The boots 102 are chained to a slider 103 on the table. A leadscrew 104 extends through a hollow tube in the slider 103 and screws into a fixed thread 106 at its end located beneath the central portion of the table.

The other end of the leadscrew has a crank handle 105 which may be turned to vary the position of the slider 103. The table is formed at the foot section with two parallel side bars 108 which respectively pass through tubes 107 at the sides of the slider 103.

Thus the position of the boots may be varied by turning the handle 105 as this turns the leadscrew 104 and causes the slider to assume a new position between the side bars 108 of the table. Patients of different height can thus be accommodated on the table without difficulty.

To use the table the brake pads 95 are released and it is swung to the sloping position shown with the foot section near floor level, and clamped. The patient steps into the boots and faces against the table. The physiotherapist releases the brake handle and swings the table, by hand, to the horizontal position. The boots are then adjusted to a position at which the table is balanced and the patient is comfortable. The brake is again released and the table is tilted to bring the head section of the table down. The tilt of the table may be varied to suit the manipulation required. Various angles of slope at which the table is stable, may be selected by folding down the appropriate leg 101 from a nest of legs under the arm rest so that the lower end of the table rests on that leg. With the patient in this "semiinverted" position for natural traction, he may also receive manipulative therapy, if required.

Alternatively, the table may be tilted vertically so that the patient is suspended by his feet for maximum elongation that is, maximum natural traction, with or without manipulative therapy by a practitioner.

Claims (12)

1. A physiotherapy table pivoted intermediate its ends to the upper end of a support which is sufficiently high to enable the table to be tilted about the pivot through about 180" from a substantially vertical position, the table having fixtures for holding a patient prone upon it at all positions to which it is tilted and which are located at longitudinally spaced positions along the patient's length, and means enabling the table to be clamped in any position to which it is tilted to a patient held down by them on the table.

2. A table as claimed in claim 1, including traction inducing elements connectable to at least some of the fixtures and mechanically operable to apply traction to a patient.

3. Atable as claimed in claim 1 or claim 2 in which the support is vertically adjustable to move the pivot from a "high" or traction position, to a "low" or massage position.

4. A table as claimed in claim 3, in which the support comprises a link frame provided with actuating means operable to move the frame between two stable shapes at which said pivot is respectively at the "high" and "low" positions.

5. Atable as claimed in claim 4, in which the pivot for the table is provided on a bell-crank shaped link having means for stabilising the table when in its massage position.

6. Atable as claimed in claim 3, in which the support comprises a vertically-adjustable, telescopic column.

7. Atable as claimed in any one of claims 3 to 6, in which the support is hydraulically operated.

8. Atable as claimed in any one of the preceding claims, clampable at any chosen angle of tilt by brake pads which cooperate with a brake plate lying in a plane extending perpendicularly to the axis of the table pivot, and a handle is operable to vary the degree of braking applied to the brake plate by the pads.

9. Atable as claimed in any one of the preceding claims, in which the traction-inducing elements comprise solenoids or vibrators of adjustable stroke length and frequency of energisation.

10. Atable as claimed in claim 2 or any one of the claims 3 to 9 when dependent thereon, in which the traction-inducing elements are computer controllable to apply different traction treatments to different patients.

11. A table as claimed in any one of the preceding claims in which the fixtures for gripping the feet of a patient are displaceable to move the patient, when hanging vertically from his feet, bodily away from the vertical table so that X-ray plates can be interposed between the table and the patient

12. A table as claimed in claim 1, arranged and adapted to operate substantially as described with reference to any one of the embodiments shown in the accompanying drawings.