GB2347354A - Equipment for treating injuries and benefiting the health of the user/patient - Google Patents

Abstract

Equipment which enables part or all of the body to be supported in one or more intelligently chosen resting positions so as to benefit the person. In order for body tissue to be at rest not only do the muscles within it need to be in a state of non-contraction but also there needs to be no tension on it. This condition can be guaranteed through choosing a resting position which ensures the presence of a compressive force between the items which the body tissue connects. If damaged body tissue is rested at it's longest state of natural extension then any scar tissue which forms is least likely to re-tear during non-resting activities. The scar tissue may need to subsequently be rested at shorter lengths of extension for complete recovery. The embodiments described relate to tilted beds or tables eg for stretching or traction, which include footrests or other limb supports which lie in the same plane or in an inclined plane to the plane of the bed or table. Examples of traction apparatus including a weight and pulley system are also described.

Description

Equipment for Treating Injuries, and Benefiting the Health of the User/Patient Purpose and Definition of the Equipment The prime purpose of the equipment is to enable part or all of a person's body to be supported in positions so as to help provide the optimum conditions for the natural healing, recovery and good health of muscles, tendons, ligaments and body tissue.

In order for a soft body tissue injury to heal it is already known that muscles associated with the damaged body tissue have to be in a rested state of non-contraction.

However, it is believed that until now two further important requirements have been overlooked in trying to create the optimum conditions for the natural healing, recovery and good health of muscles, tendons, ligaments and body tissue.

The first important additional requirement is to also eliminate tension on the damaged body tissue. This can be achieved by supporting a person in a position which guarantees the presence of a compressive force between the items which the damaged body tissue connects. For example, in order to guarantee that the ligaments of a joint are in a relaxed state (which is an obvious requirement for them to heal), it is required that the person's body is supported in a position which guarantees that there is a compressive force between the associated bones of the joint. When this condition is met it can be guaranteed that the ligaments are not having to exert any tensile forces to try to hold the bones in place, and thus that they are in a relaxed state (although not necessarily at their shortest length of natural extension as this depends on the position which the bones of the joint are supported in). It is only when both contraction of muscles within the damaged body tissue and tension on the damaged body tissue is eliminated that the damaged body tissue can truly be guaranteed to be in a relaxed state, which is a necessary requirement for the injury to heal. It is assumed that in the case of some injuries there is healthy tissue which provides this necessary compressive force between the items which the damaged tissue connects. In this case the injury will be a short term injury and will heal without assistance through rest using an unspecific resting position. However, for other injuries there is no healthy tissue to provide the necessary compressive force to eliminate the tensile forces on the damaged body tissue and so in this case the person needs to be supported in an intelligently chosen resting position in order to guarantee the presence of such a compressive force.

The second important requirement is that a person's body is supported in positions such that injured body tissue is being rested as close to it's longest state of natural extension as possible. This is so as any scar tissue which forms is least likely to re-tear during non-resting activities (presumably scar tissue does have some degree of elasticity). Once the scar tissue has formed it may need to be rested at shorter states of extension for the full recovery of the injury.

This patent application is for equipment which is designed to assist in enabling part or all of a person's body to be supported in positions which take advantage of these new requirements, together with already known factors, such as the requirement of muscles to be in a state of noncontraction for them to heal. The positions which the person is supported in need not be static positions, but could move through a range of continuous positions. In using such moving equipment it would be suggested that damaged body tissue be initially rested at or close to it's longest state of extension, and then be rested at lengths which slowly shorten. However, in this patent application such equipment will be described using examples which support a person in static positions. The given examples take advantage of both of the above mentioned important requirements in creating "optimum conditions"at one or more joints in various parts of the body. The examples given are meant to illustrate the type of equipment for which a patent is being applied for, and to also give ideas for alternative implementations and further development of such equipment. Obviously such equipment could also be used in conjunction with existing equipment and technology which is designed to improve the blood circulation to a given body area in order to contribute to creating these"optimum conditions" (for example, ultrasound equipment or heat generating equipment).

As yet (July 1999), very limited testing of the use of such equipment has been done. Such equipment has been used to bring about the near complete recovery of some form of long term ligament/muscle injury in the lower leg and foot of a patient (the injury occurred in January 1993 and was described by one medical professional as"a dropped foot").

Also, since treating the other lower leg and foot of the same patient (myself, Paul Nicholls), the visible appearance of a long term"varicose vein"has improved. The patient is continuing to treat both lower legs and feet, using the equipment and method described, and is still gaining benefit. However, the accuracy of the implementation of the equipment, for treating lower leg and foot injuries, may need some slight adjustment and improvement. In spite of this, the success which the patient has had so far affirms that such equipment, when implemented and used correctly, will provide the right conditions for at least some types of injury to benefit from, and hopefully heal completely.

For some injuries the body part may need to be rested in a repeatable cycle of different positions. It is plausible that as each damaged ligament, muscle and tendon improves so it is able to give greater support to other damaged ligaments, muscles and tendons and thus enables further recovery in these. However, it may be that for other particular injuries only one position needs to be used for supporting a body area in order to bring about a full recovery.

The examples given are not being claimed as the only way, or the best way, to implement such equipment for the given body area and more research, testing and development needs to be done into the use and implementation of such equipment. Equipment which is designed to support a person in various positions which take advantage of the stated requirements may also have benefit for the recovery of injuries associated with internal organs and the ligaments which hold them in place. Such equipment may also benefit other types of soft tissue injuries-more research needs to be done.

The full implications, types of injury which can be treated, and health benefits from using such equipment remains to be discovered. However, the results so far are very encouraging.

A Tested Example of Attempting to Implement and Use Such Equipment to Treat a Long Term Lower Leg and Foot Injury With respect to the lower leg, the foot can tip forwards and backwards, tip sideways in both directions and also rotate in both directions. Obviously, these independent movements can be combined. Also the arch and toes of the person's foot can be supported in more than one position with respect to each other.

Figure 1 shows a patient lying on an inclined bench (item 101) which slopes down from their head. The feet are supported on a ledge (item 102) which is rigidly attached to the inclined bench. The supporting of the person's feet, together with the appropriately angled inclined bench, ensures that there are compressive forces generated between the feet and their respective lower leg bones and thus ensures the elimination of tensile forces on the body tissue which connects the feet to their respective lower leg bones.

Also, as the equipment is doing the work of supporting the person's body, muscles need not be in contraction.

Figure 2 shows the person's feet being supported approximately at one of their extremes of in-line range of movement with respect to their lower legs. In the particular implementation depicted this has been achieved by altering the angle between the ledge (item 102) and bench (item 101).

Figure 3 shows the person's feet being supported approximately at their other extreme of in-line range of movement with respect to their lower legs. In the particular implementation depicted this has again been achieved by altering the angle between the ledge (item 102) and bench (item 101).

In order to support the person's feet in positions of tilting sideways with respect to their lower legs two boards (one beneath each foot) can be placed on the ledge (item 102 of figures 1, 2 and 3). These two boards either tilt down towards the outsteps of the feet (as depicted in figure 4) or tilt down towards the insteps of the feet. The person then supports their feet on these two boards.

In order to support the person's feet in positions of rotation with respect to their lower legs the person can simply rotate the orientation of their feet with respect to the ledge (item 102 of figures 1, 2 and 3). Thus, the feet can point outwards on item 102 or they can point inwards on item 102. Alternatively the person can support their feet on the sloping boards of figure 4 (items 103) and rotate the orientation of their feet on these.

When the feet are being supported in positions of tilting sideways and/or rotating it may be appropriate to use side and/or heel walls to support the feet in position.

It is believed that the foot can be taken through it's greatest range of tilting sideways and rotation when the foot is approximately at 90 degrees to the lower leg (as depicted in figure 1), but as already stated tilting sideways and rotation can be combined with tilting the foot forwards and backwards. The goal is to support the patient in the appropriate resting position (s) for an injury to heal.

It is worth stating that prior to building the equipment depicted in figure 1, a half length inclined bench and ledge were used to support the person in various positions in the hope of providing the right conditions for a full recovery for the lower leg and foot injury. As the inclined bench was approximately half the length of the one depicted in figure 1 the person could not lie back but had to sit upright. A half length bench and ledge was found to provide inferior conditions to a full length bench and ledge for the particular injury, and thus failed to produce the same degree of recovery for the injury. In addition other resting positions based upon sitting positions were also used to treat the injury-these were also found to produce inferior conditions for the recovery of the injury than the apparatus depicted in figure 1.

In treating the particular injury the full length inclined bench and ledge depicted in figures 1,2 and 3 has been used to support the patient in a variety of different resting positions comprising the feet tilting forwards and backwards, rotating and tilting sideways. In addition the resting of damaged tissue at shorter lengths than at it's longest state of natural extension has also been used.

As well as using a completely flat surface to support the sole of the person's feet, other shaped sole supports can also be used to support the arch and toes of the person's feet in various positions. It may be that for some injuries the use of a repeatable cycle of differently shaped sole supports will be needed for a full recovery. It may be that for other injuries a completely flat sole support will be all that is required for full recovery.

Some lower leg and foot injuries may require the choice of a resting position which guarantees the presence of compressive (gravitational) forces acting between the bones of the person's foot. Obviously, when there is no rotation of the foot in figure 1 such compressive forces are present between the bones of the person's foot acting in the direction of the foot.

As yet, the long term ligament/muscle injury in the lower leg and foot has not healed completely, but is very nearly healed (the equipment depicted in figure 1 has only been in use for one week). The patient has had significant, welcome, benefit, from using this equipment and method, and the patient is still gaining benefit from it. The equipment may need some slight improvement with the use of appropriately shaped sole supports for the feet, or it may be that a bit more perseverance and patience with the existing equipment will be sufficient to bring about the full recovery of the injury.

Some Further Examples of Equipment which is Designed to Enable Bones of the Body to be Supported in Static Positions, with Consideration given to the Two Requirements If the slope of the inclined bench (item 101) in figure 1 is sufficiently steep then such a resting position does more than just guarantee the elimination of tensile forces on the body tissue which joins the feet to their respective lower leg bones. Such a resting position also generates compressive forces between a significant number of other adjoining bones of the person's body (eg of the spine and legs) and thus ensures the elimination of tensile forces on the body tissue which connects these bones.

Figure 5 shows a similar situation to figure 1-the only difference being that the person's hips and back have been raised (using a trunk and head support-item 104-see later), and the angle of the supporting ledge (item 102) has been changed slightly with respect to the inclined bench. In order for a back or stomach injury to recover it is expected that the person's back will need to be supported at, or close to, one of it's extremes of range of movement (either tilting forwards or backwards, or tilting sideways, or rotating) and this clearly isn't happening in figure 5.

Figure 6 shows a person lying on an inclined bench with their feet supported on ledges (items 102) and their legs apart. The ledges (items 102) are fixed in place, with respect to the inclined bench (item 101), using rigid items (items 105). Obviously, using this arrangement, body tissue of the insi. de and outside of the legs is being rested at a different state of extension as to when the legs are being supported in a feet together position. In addition the orientation of the feet on the ledges can be rotated.

Figure 7 shows a person supported on an inclined bench (item 101) with one leg bent at approximately 90 degrees to the body (supported on the rigid item, item 106) and the other leg straight with respect to the body with the associated foot supported on a ledge (item 102).

Figure 8 shows a person supported on a rigid platform (item 107) with both legs bent at approximately 90 degrees to the body. This resting position may be good for the recovery of hamstring injuries.

An incline to the side of the person could be introduced in all of these examples by simply placing any of these pieces of equipment on a board which slopes to the side of the person. A trunk and head support (see later) would subsequently be needed to fix the sideways position of the person and to stop the person from sliding sideways off the equipment.

Some of these examples could also be implemented with the additional use of a tilting and rotating foot support beneath each foot (an example of a foot support was shown earlier).

All of these examples, as depicted, could also be implemented with the additional use of a trunk and head support (see later), to support the bones of the trunk and head in a number of positions, taken from their full range of healthy movements with respect to each other.

The examples could also be implemented with the additional use of arm and hand supports (for an example of an arm and hand support, see later).

As further suggestions, the user/patient could be supported in a face down position on an inclined bench with ledge. Alternatively, the user/patient could be supported lying completely on their side on an inclined bench with ledge. In addition the person could also be supported with their head lower than their feet on an inclined bench, with their head and shoulders supported on suitably shaped ledges.

Some Untested Examples of Equipment which is Designed to Enable Bones of the Trunk and Head to be Supported in Static Positions, with Consideration given to the Two Requirements The hips, back, kneck and head can bend from side to side, from front to back, and can also rotate. To treat injuries relating to the trunk and head (eg. back injuries, kneck injuries, stomach injuries and also injured body tissue which is directly attached to the trunk), the bones of the trunk, head and adjoining limbs will need to be supported in a variety of positions taken from their full range of healthy movements with respect to each other. To do this a trunk and head support is needed. Figure 5 depicts a trunk and head support (item 104) being used on an inclined bench with foot ledge. As already stated, the inclined bench and foot ledge enable the gravitational force to act in the direction of the person's body, which generates compressive forces between certain bones (eg of the spine) and thus eliminates tensile forces on the body tissue which connects these bones. Three examples of how to implement a trunk and head support will now be described. The three different examples of a trunk and head support will be described being used in conjunction with an inclined bench, with the person's feet supported on the foot ledge, as in figure 5.

EXAMPLE 1 OF A TRUNK AND HEAD SUPPORT A trunk and head support could be made by taking a number of moulds of the back of the person's trunk and head in a number of different static positions (with the trunk and head bending forwards, backwards, to the sides and rotating) Each of these moulds could then be placed in turn on the inclined bench to support the patient in these various positions. This would enable the bones of the person's trunk and head to be supported in a repeatable cycle of these different static positions to enable the injury to heal. Obviously, some injuries will only need the spine to be supported in one position to enable an injury to fully recover.

EXAMPLE 2 OF A TRUNK AND HEAD SUPPORT As an alternative suggestion for a trunk and head support, the user/patient could wear a special garment over their trunk and head. This garment would have various points of attachment from the front, sides, and back. As a result, this garment could be used to suspend the trunk and head of the user/patient, in various natural positions (bending forwards, backwards, side-ways, and rotating), from an appropriate framework which was supported on the inclined bench. The garment would need to be strapped to the top of the person's legs to maintain the correct orientation of the person's trunk within the garment. Thus, using this arrangement, the bones of the person's trunk and head could be supported in a repeatable cycle of different positions, to enable an injury to heal. The garment may need some ribbing, to give rigidity in certain directions, and may need some moulding, to fit the shape of the person's body.

If the garment also had sleeves, with various points of attachment along them, then these sleevs could be used to support the arms in various natural positions with respect to the person's trunk.

EXAMPLE 3 OF A TRUNK AND HEAD SUPPORT As a further possibility for a trunk and head support, the person's trunk and head could be supported on a series of moulded rigid bars which run at right angles to the direction of the person's spine at the point of support (if the person's trunk is bending to the side of the person then the direction of the person's spine is not the same throughout the spine). The number of rigid bars needed to support the entire spine would have to be determined by experimentation, but it is possible that one rigid bar would be needed for each vertebra in the spine. The shape of each rigid bar would be defined by the shape of the perpendicular cross-section of the back of the person's body at the point where the bar was to be used to give support. Figure 9 shows a person lying face up on an inclined bench (not drawn), which slopes down from their head, with their feet resting on a ledge (not drawn). Item 108 is one such rigid bar (for clarity only one rigid bar has been drawn). The height of the ends of each rigid bar would need to be independently adjustable with respect to the inclined bench to enable rotation of the spine as well as bending forwards and backwards. The ends of each rigid bar will also need to be able to move in the direction of the person's body to enable the person's trunk and head to bend to their sides. Each rigid bar could have two clamps (items 109), which could be slid along the rigid bar and tightened to it to fix the sideways position of the trunk of the person. The ribs and shoulder blades of the person will also need supporting, and the shape of the rigid bars will be defined accordingly. The rigid bar which supports the head will need to be shaped to fulfi. ll this role.

The rigid bars could be linked to each other along the line which the spine of the person is to be supported on.

The movement of each rigid bar, with respect to it's neighbouring rigid bar (s), could be limited according to the maximum natural movement of the spine at that point (bending forwards, backwards, side-ways and rotating). Consequentl. y, when supporting the spine in a position where it is at the maximum range of one of it's natural movements, only a few of the rigid bars would need to be held in position and all of the other rigid bars would automatically adopt their corresponding positions.

Any of these three implementations of a trunk and head support could be used, in conjunction with an inclined bench and foot ledge, and possible arm supports (see later), to support the bones of the person's trunk, head, and adjoining limbs in a repeatable cycle of different static positions, taken from their full range of healthy movements with respect to each other, to enable an injury to heal. In fact, any of the pieces of equipment depicted in figures 5 to 8 could be used in conjunction with a trunk and head support.

When using a trunk and head support in conjunction with one of these pieces of equipment and bending the person's spine to the side of the person it may be helpful to introduce a component of sideways tilt to the piece of equipment by placing it on a board which slopes to the side of the person.

Alternatively, for some injuries it may be more convenient and just as beneficial to use a trunk and head support in a chair which has a sloping back. The sloping back would enable the gravitational force to act along the direction of the person's spine which would provide compressive forces between the vertebrae of the spine.

Again, it may be helpful when tilting the person's spine to their side to place the chair on a board which slopes to the side of the person.

In addition, equipment to support the user/patient's jaw in various positions with respect to the skull could be used in conjunction with a trunk and head support and may be useful in treating some kneck and facial injuries.

Some Untested Examples of Equipment which is Designed to Enable Bones of the Leg and Knee to be Supported in Static Positions, with Consideration given to the Two Requirements Figure 10 shows a person sitting in a chair (item 110) with their legs straight and horizontal. The weight (item 111) is attached via a cable (item 112) which runs over a pulley (item 113) to a sliding foot press (item 114). The weight thus pulls the foot press towards the person and thus provides sufficient compressive force to eliminate tensile forces between the upper and lower leg bones. As the leg is horizontal, gravity provides a compressive force between the person's kneecap and the upper and lower leg bones. The weight (item 111) will only need to be heavy enough to guarantee the presence of a compressive force between the upper and lower leg and thus eliminate tensile forces on the connecting tissue.

Figure 11 shows a person lying in a position with their leg bent. The weight (item 115) is attached via a cable (item 116) which runs over a pulley (item 117) to a sliding kneecap press (item 118). The weight thus pulls the kneecap press towards the person and thus provides sufficient compressive force to eliminate tensile forces between the kneecap and the upper and lower leg bones. It may be useful to provide an extra strap and weight over the person's lower leg in order to hold their leg in it's extreme of being bent at the knee. In addition the person will need some means of stopping themselves from being pushed forwards by the kneecap press.

Some Untested Examples of Equipment which is Designed to Enable Bones of the Arm and Hand to be Supported in Static Positions, with Consideration given to the Two Requirements With respect to the person's body, the arm can swing to the side, to the front, to the back, and can also rotate in the shoulder joi. nt. In addition, the arm can also bend at the elbow, and the lower arm can rotate.

Figure 12 shows equipment for supporting bones of the arm and shoulder in a static position, with consideration given to the two new requirements. A hand grip (item 119) can slide along a fixed rail (item 120). The hand grip is attached, via a cable (item 121), over a pulley (item 122), to a weight (item 123). The weight pulls the hand grip towards the point where the person's shoulder will be, thus providing compressive forces between bones of the arm and shoulder. The person may need to wear an arm brace to keep the elbow rigid when using this equipment. The person's arm will also need to be strapped to the fixed rail to support the weight of the arm, and the person's body should also be strapped to the equipment. No straps have been drawn in figure 12.

Figure 13 shows a person strapped into the equipment just described with the bones of the arm and shoulder being supported in a static position. Items 124 are arm straps which strap the person's arm to the fixed rail to support the weight of the arm. Item 125 is a body strap which straps the person's body to the equipment.

For further natural positions the orientation of the hand grip could be rotated (to allow both the shoulder joint and lower arm to rotate) and the angle of sideways elevation of the arm could be increased or decreased. In addition, the arm could also be held in positions of being swung forwards and backwards with respect to the body.

Similar equipment can be devised to support the arm in a position where it is bent at the elbow.

To treat an injury in the lower arm and hand may not require an arm support for the whole arm. Rigid equipment could be used, in conjunction with the force of gravity, to support the bones of the lower arm and hand in one or more static positions taken from their full range of healthy movements with respect to each other.

Alternatively, an elbow length glove which has a number of points of attachment from which it can be suspended could be worn. Using these points of attachment the glove, with the person's lower arm and hand in it, could be suspended in static positions from an appropriate framework. Thus, the glove, in conjunction with the force of gravity, could be used to support the bones of the lower arm and hand in one or more static positions to enable some injuries in the lower arm and hand to heal. The glove may need ribbing to give rigidity in certain places-possibly across the palm of the hand.

(Presumably a suspended knee length sock could similarly be used to support the bones of the lower leg and foot in static positions to treat some lower leg and foot injuries. Such a sock would most probably require ribbing across the width of the arch of the foot to give rigidity).

Some Additional Thoughts and Suggestions Relating to Such Equipment and this Method of Treatment More research, development and testing, both in the design and use of such equipment, needs to be done.

As with treating any injury appropriate use of ice, compression, warmth, sensible exercise, stretching, and massaging of injured body tissue can be beneficial. More experimentation needs to be done to establish the appropriate use of these in conjunction with the use of this resting equipment.

Testing also needs to be done to discover whether this method of treatment, and such equipment, can also be used to provide conditions for other types of injury to benefit from.

Such equipment may also improve the blood circulation to, and through, uninjured body tissue, thus promoting good health, improving the recovery of fatigued muscles and perhaps combating some aspects of aging.

It is not being suggested that every aspect of natural movement has been considered in the given examples. Nor is it being suggested that the given examples of equipment won't need modifying and improving.

It is expected that the example equipment described will need to be modified, adapted, extended and developed as efforts are made to use such equipment to treat various injuries. It is felt, though, that the stated examples give enough information to enable a person to modify, adapt, extend and develop such equipment, according to the demands of

Claims (1)

1. CLAIMS 1 Equipment which enables part or all of a person's body to be supported in one or more positions such that one or more items/areas of body tissue are in a relaxed state (the definition of relaxation being not only that no muscles within the body tissue are in contraction but also that there is no tension on the body tissue) at one or more appropriate lengths of extension so as to benefit the person.