GB2516084A

GB2516084A - Manipulation treatment apparatus

Info

Publication number: GB2516084A
Application number: GB201312419A
Authority: GB
Inventors: Vincent James Barnes; Geoffrey William Tilbury; Keith William Coles; Terry Chow
Original assignee: BARNES CLINIC Ltd
Current assignee: BARNES CLINIC Ltd
Priority date: 2013-07-11
Filing date: 2013-07-11
Publication date: 2015-01-14
Also published as: GB201312419D0; WO2015004484A3; WO2015004484A2

Abstract

Manipulation treatment apparatus comprising a force application means 20 with oscillating drive means is fixed relative to a manual treatment table 3 to cyclically apply and release a force to a contact means adapted to contact a portion of a patient, such as a belt 51 or plate 26 for manipulating the patient, or oscillating plate 38 for massaging across soft tissues or reciprocating piston / applicator (31, Figure 5) for pushing into soft tissue. A load cell, such as a strain gauge connected between the belt 51 and flexible cord 50, measures the force being applied, the output of which is used to control the timing and amount of force applied during each cycle. The force, cycle frequency and treatment time can be longer than the practitioner could reasonably carry out. The apparatus may be switched to a learning mode in which the load cell detects and records the force and frequency applied by the practitioner and then carries it out in treatment mode.

Description

MANIPULATION TREATMENT APPARATUS

This invention relates to manipulation treatment apparatus for use in the treatment of individuals for a variety of muscular and joint conditions.

It is well-known that a variety of physical conditions may be improved by manipulation of the human body by a skilled practitioner. The manipulation very often involves repeated flexing or massaging movements which, when satisfactorily applied, produce an improvement. This is commonly achieved by the practitioner using physical manipulation of the patient's joints, soft tissue or the like, with treatment times for repetitive manipulation movements generally not exceeding several minutes on a specific area. However, if the condition is chronic, so that fibrosis of the tissues has occurred, it is possible that, for such a treatment to be successful, a repeated manipulative movement needs to be carried on for considerably longer, for example 40 minutes or more.

A problem arises in achieving such treatment times when the manipulation is applied by an individual practitioner. They tire and it can be difficult to maintain a rhythmic even treatment, particularly if the forces needing to be applied are substantial.

Apparatus is known for applying repeated manipulation to a patient. Thus, WO 2011/073989 discloses apparatus for use in physiotherapy which can be taught to carry out a sequence of manipulation movements on a patient. A cradle is illustrated into which the patient's head may be fitted, and which is then moved to move the patient's head relative to his body.

Such apparatus is expensive to build and maintain, and inflexible in operation. The present invention seeks to provide a flexible treatment apparatus which can be used by individual practitioners, constructed by retrofitting suitable components to existing treatment tables, and which is easily adjusted to enable a wide variety of different manipulations to be carried out on the limbs and spine of a patient.

According generally to the present invention, there is provided manipulation treatment apparatus comprising a manual treatment table on which a patient may be supported, force application means fixed relative to the table, contact means adapted to contact a portion of the patient, and the force application means including oscillating drive means adapted to apply a force to the contact means and to release such force, a load cell positioned to measure the force being applied by the force application means or to or by the contact means, and control apparatus for controlling the timing and amount of force applied by the force application means or to the contact means during a treatment session, taking into account signals derived from the load cell.

The oscillating drive means may be configured in several ways. A preferred approach is a mechanical drive adapted to apply a force via a clutch which can be disengaged to release the force. An alternative is a suitably controlled pneumatic or hydraulic piston-cylinder arrangement.

In a preferred embodiment of the invention, the drive means is connected to the contact means via a flexible cord, and the load cell is arranged to measure the instantaneous tension in the cord, either during a learning mode of use of the apparatus, or in a treatment mode. The load cell may be a strain gauge incorporated into the cord itself or, for example, a torque gauge forming part of a drive system for applying tension to the cord.

EP-A-0692234 discloses apparatus for use in physiotherapy including means attaching cords to the limbs of a patient lying on a treatment table. One of the cords may be attached to a vibrator mounted on the apparatus so as to apply a vibrational movement to a patient.

The contact means may take a variety of forms. For example, it may be in the form of a belt adapted to be secured around a limb or the body of a patient, connected to the oscillating drive means via a flexible cord incorporating a load cell. After adjustment to place the cord under slight tension, the cord is then pulled cyclically by the drive means to pull the part of the patient to which the belt is affixed in a given direction and to a certain extent, then to reduce the tension to a very low value, and then re-apply the tension. An alternative form of contact means is that of a plate which may be cyclically reciprocated against the patient, again the cycle commencing with gentle contact pressure, the pressure then increasing to a predetermined value and then being released. By mounting the plate on a suitable arm which can be moved about an axis by means of the cyclical application of increasing and decreasing force by the force application means, a repetitive massaging or manipulating may be effected on the patient. In one possible arrangement, the arm is pivotally mounted at one end and the plate is mounted on it between its ends, with the other end of the arm then being periodically pulled in a direction such that the plate then periodically applies pressure to the part of the patient with which it is in contact. An alternative structure is a pivoted arm having a pressure plate on its end and a cable between the pivot and the end enabling the arm to be rotated about the pivot and press the pressure plate against the patient.

The control apparatus may have means enabling the adjustment of the frequency of a given repeated manipulation, i.e. the cycle time for each particular movement.

The apparatus is preferably configured so that it may be switched between a learning mode and a treatment mode. In the learning mode, the practitioner reciprocally manipulates the contact means as desired with the load cell arranged to detect the amount of force applied by the practitioner and, at the same time, the apparatus records the parameters of force and frequency.

Preferably, in learning mode, the force and frequency parameters are captured and analysed until the variation between, say, ten successive pressure or pulling cycles carried out by the practitioner is less than a given threshold, e.g. less than 10% variation at which point the average values of force and cycle time are calculated and stored so they can be used for the treatment bout carried out by the apparatus. The control apparatus may include an indicator to show when the condition has been achieved. The parameters can then be applied in treatment mode for a length of time chosen by the practitioner. The control apparatus may also include manually settable means enabling the practitioner to set the force applied and frequency manually, as well as the overall treatment time. It may also include means to interrupt or pause the manipulation movement for a time to enable a practitioner to examine the patient during a treatment session, or to allow the patient to enjoy a brief rest period. Furthermore, it may include means to record the date, time, patient name and treatment parameters so these can be easily retrieved when the same patient is being treated on a subsequent occasion.

The apparatus of the present invention may also conveniently include some form of manually-operated trip switch which may be provided to the patient and which communicates with the control apparatus, so that if the patient at any point decides to terminate a bout of treatment, he can do so immediately and effectively. Likewise, if the load detected by the load cell exceeds a preset maximum load, the treatment may be immediately halted, to avoid the risk of injury to the patient, with the load on the contact means automatically reduced to zero.

Although a wide variety of apparatus may be constructed in accordance with the general principles of the present invention as described above, it is of particular value in the context of individual treatments requiring repeated soft tissue manipulation applied over an extended period of time, for example 40 to 50 minutes. In such treatments, the soft tissue being manipulated goes through a series of changes, its consistency being initially dominated by elastic recoil, then moving to one of plastic deformation, yield and finally relaxation. It has been observed that soft tissue relaxation, and associated increased flexibility of adjacent joints, does not occur until a substantial treatment time, e.g. 40 minutes, has elapsed. Because the apparatus of the invention does not tire, it enables such treatments to be used by manipulation practitioners to provide extended treatment times while maintaining the rhythm and intensity of manipulation throughout the extended time period.

Examples of treatment apparatus according to the invention are illustrated in the accompanying drawings and described in detail in what follows.

In the drawings: Figure 1 is a perspective view of a framework and associated equipment forming part of a first embodiment of treatment apparatus in accordance with the present invention; Figures 2 and 3 are views of the frame and associated equipment shown in Figure 1 from a different angle and with certain items having moved relative to one another compared with Figure 1; Figures 4 to 6 are diagrammatic views of apparatus according to the invention, taken from various angles, and incorporating the frame and associated equipment shown in Figures 1 to 3; Figure 7 is a set of diagrams showing the mounting of one end of a lever arm shown in Figures 1 to 6; Figure 8 is a diagrammatic illustration showing the control panel of the control and force applicator apparatus forming part of the apparatus of Figures ito 6; Figure 9 is a block diagram illustrating a possible arrangement of components within the force applicator device; Figure 10 is a diagrammatic illustration showing how part of the apparatus in accordance with the invention may be calibrated; Figure 11 is a diagrammatic perspective view of a second embodiment of treatment apparatus in accordance with the present invention, seen from the "head" end; Figure 12 is a view of the same embodiment as in Figure 11 but seen from the "foot" end and showing the drive mechanism in more detail; Figure 13 is a perspective view of the embodiment shown in Figures 11 and 12 with certain additions; Figure 14 is a diagram showing the control panel of the treatment apparatus shown in Figures 11 to 13; Figure 15 is a diagram showing the driver arrangements used in the apparatus of Figures 11 to 13 for repeatedly applying a pulling force; Figure 16 is a diagram showing the operation of part of the drive mechanism shown in Figure 15; Figure 17 is a diagram showing the drive arrangement for repeatedly applying a compression force; and Figure 18 shows a component of the drive system shown in Figure 17.

Referring first to Figures 1 to 3, these show a framework suitable for converting a treatment table on which a patient lies for treatment into apparatus according to the invention.

Various types of table are used by manipulation practitioners, and the one shown in Figures 4 to 6 in the drawings is merely exemplary. In the specific case illustrated in those Figures, the table comprises a base frame consisting of a central frame 1 with retractable wheels 2 which rest on the floor.

The framework illustrated in Figures 1 to 3 consists of a pair of cross-members 6, 7 which acts as a support for two rails 8, 9 which run down each side of the central frame 1 forming part of the table base frame and around one end of it.

Rails 8 and 9 are supported on the ends of cross-members 6 and 7 and by a stand-off bracket 10 mounted midway along cross-member 7. Rails 8 and 9 in turn support a plurality of carriages 14, 15, 16, each of which includes wheels 13 for engaging with the rails 8 and 9 in such a fashion that the carriages may be moved along on the rails 8, 9. Means are provided to enable the position of the carriages on rails 8 and 9 to be clamped, actuated by a clamping knob 17.

As shown in Figures ito 6, two of the carriages 14, 15 carry upstanding posts 18, 19 while the other supports a repetitive force application unit 20 described in more detail below as well as a short post 21.

At the top of each of posts 18, 19 and 21, there is a yoke 22, the yoke 22 mounted on post 19 being shown in more detail in Figure 7. A socket 23 is fitted into each of the yokes 22 on posts 18 and 19. A rod 24 may be inserted into those two sockets 23, the leading end projecting from one of them by an amount depending on the relative positions of carriages 14 and 15. Rod 24 has a handle 25 on its other end which can be grasped to move the rod 24 about the point where it is supported in the socket 23 on post 18. Post 18 can be rotated about a vertical axis as shown in the drawing and socket 23 is mounted in yoke 22 so that it can rotate about a horizontal axis. Rod 24 cannot rotate about its own axis, but can be moved to and fro using handle 25 because socket 23 on post 19 has a slot 30 in it.

Slot 30 is located in a circular block 34 and is wide enough to enable rod 24 to pass through it. The angle of the slot 30 may be varied by rotating block 34 in a block 35 and then fixing its position with two grub screws 39. Block 35 is mounted for rotation in yoke 22 about a horizontal axis 36. Blocks 34 and Attached to rod 24 is an adjustable position mounting 27 on which is set a metal plate applicator 26. Means may be provided to vary the position of mounting 27 along rod 24 and to clamp it firmly to rod 24 when in the desired position, and to vary the angle of applicator 26 from a plane perpendicular to the axis of rod 24 (as shown in the drawings) to a plane parallel to that axis, and to fix the plate 26 relative to mounting 27.

The position of rod 24 and plate applicator 26 may be varied by moving the locations of the carriages 14, 15 and 16 in a horizontal plane on rails 8, 9 and vertically by moving the posts 18 and 19 up or down until the yokes 22 are at the desired levels. As shown in the drawings, the vertical position of each post 18, 19 is controlled by a linear actuator 28. Other adjustment systems may be satisfactory, e.g. locating each post in a vertically aligned socket providing a series of evenly spaced holes in each post and a pin which passes through the side of the socket and into one of the series of holes to hold each of posts 18 in the desired vertical position. In a further alternative, a rack and pinion system may be used to move the posts up or down, with a suitable locking means to hold the post at the desired height.

The repetitive force application unit 20 may likewise have its vertical position varied relative to carriage 16 by a linear actuator 28.

The repetitive force application unit 20 consists of a housing 41 containing a drive mechanism and control apparatus for the drive mechanism. A control panel 42 is mounted on one face of the housing. Connected to the control apparatus via a flexible lead 45 is a patient-operable push switch 44.

Extending from the top of housing 41 is a cord 50 to the end of which is attached a belt 51. Cord 50 runs over a pulley 53 set in a swivellable block 52 mounted on housing 41. Block 52 can swivel freely about a vertical axis.

Mounted on one side of housing 41 is a support for post 21, seen clearest in Figure 3.

Also extending from housing 41 is a flexible force-transmitting connection 29 to an oscillating plate device 38 (as shown in Figures 1 to 3) or to an oscillating piston device 31, as shown in Figures 4 to 6.

As noted above, to form apparatus according to the invention, shown in Figures 4 to 6, the cross-members 6, 7 shown in Figures 1 to 3 are fixed directly to a base frame, including a central frame 1 with retractable wheels 2 which rest on the floor, and the rails 8 and 9 are also attached to some stand-off brackets 12 fixed to frame 1. Cross-members 6, 7 and brackets 12 are held to part of frame 1 via pairs of U-bolts 32. At the ends of frame 1 are two upstanding end boards 4, 5 located on top of frame 1. Between boards 4 and 5 is a firm mattress 3 on which the patient is to be supported. The surface is a vinyl-covered foam on a particle board top. The mattress is conventionally of a fairly firm but resilient foam core with a vinyl sheet covering.

Figure 8 shows the detailed arrangement of the control panel 42. At the bottom left is a master on/off power switch 60 and at the top left an emergency stop button 61. At top centre, there is a small LED screen 62 to indicate the operation mode of the unit and below that are three displays 63, 64, 65 which show respectively the force being applied by cord 50, the time remaining of a treatment period and the frequency of application of the intermittent pulls on cord 50.

Panel 42 has three control knobs 66, 67, 68 respectively, to vary the maximum force applied to cord 50, the time extent of the treatment period and the repetition frequency of application of force to cord 50. In the centre of the control panel and towards the bottom are three control buttons 70, 71, 72 used to initiate, pause or end the treatment.

At the bottom right of the control panel is a set of calibration controls including a switch 80 which can be moved between a calibration and a treatment setting, a force adjustment switch 81 and a drive switch 82. Finally, the panel includes a switch 83 which may be toggled between a treatment mode and a learning mode, and a button 84 to actuate the start of a learning session.

Figure 9 shows diagrammatically the electrical and mechanical components within housing 41. A main board 100 is connected to the control panel 42, and is connected to the mains power supply (not shown). It is also connected to a motor controller 101 which controls the operation of a motor 102 which, via a gear box 103, torque limiter 104, clutch 105 and final drive shaft 106, can rotate a drum 107 about which is wound cord 50. Torque limiter 104 and clutch 105 are connected to the main board 100. Drive shaft 106 is fitted with a torque gauge 108, which may likewise be connected to main board 100.

The tension in the cord 50 may be determined from the torque in shaft 106 provided that the cord always leaves the drum at the same distance from its axis. For this reason, the drum 107 is preferably machined with a spiral groove on its surface into which cord 50 fits. Drum 107 may include a rewind mechanism to pull in cord 50 under no load conditions until its outer end abuts the block 52 mounted on the top of housing 41. Alternatively, cord 50 may be rewound on to drum 107 using an external key 110. Drum 107 is preferably mounted in needle or roller bearings so as to take up the considerable lateral strain on it in use.

Clutch 105 is disengaged when the system is not powered, and normally engages when the drive mechanism is switched on. Depressing emergency stop button 61 breaks the power supplied to clutch 105. It may also be disengaged using the drive switch 82 on the calibration section at the bottom right-hand corner of the control panel 42 as shown in Figure 8.

The torque limiter 104, which may be of slipping clutch type, acts as an additional safety feature. If it slips, the control electronics can disengage clutch 105.

The calibration set-up is illustrated in Figure 10. Cord 50 is connected to one part of a strain gauge 118 which may be connected to the control apparatus via an input connection 112 in Figure 9. This enables the external strain gauge 118 to be connected to main board 100 via a switch 114 shown in Figure 9. The external strain gauge 118 is attached via a solid metal ring denoted 120 to a strong spring 122 which is in turn attached at 123 to the frame 1 or something fixed relative thereto.

The calibration process may be carried out as follows: First of all, with the power to the unit switched off, switch 80 is moved to calibration mode, the speed control 68 is set to zero and the handle 110 is used to wind any slack in cord 50 on to the drum 107.

The power is now turned on and switch 114 operated to connect the electronic main board 100 to the external strain gauge input 112. On the calibration control panel at the bottom right of the control panel 42, the switch 81 is switched to increase the force and switch 82 then moves to "drive-on" while increasing the speed slowly using the speed control 68 while observing window 63 to see what the strain gauge reading is.

When the strain gauge reading has reached an appropriately high level, the drive switch 82 is switched to "off' and, at this point, the system is left untouched for a little while in order for the force reading which is still displayed in window 63 to stabilise. Switch 114 is then switched over so that the input is from torque gauge 108 rather than the external strain gauge. If the reading in window 63 remains the same, then calibration is correct for that strain. If not, then, by the use of an appropriate trim control on the main board, the reading in window 63 can be adjusted to match the strain in the external strain gauge.

This procedure can be repeated in order to ensure that the calibration of the torque gauge and the external strain gauge match. If they diverge too greatly, the torque gauge may need replacement. Once calibrated, the external strain gauge 118 is disconnected or removed and switch 80 is switched over to treatment mode and switch 114 over to internal strain gauge.

One way of using the apparatus in practice is to position a patient on mattress 3 on the treatment table and place belt 51 around the patient. Cord 50 is then connected to belt 51 via a load cell, which can replace or supplement an adjustable buckle on belt 51 enabling the belt to be tightened round the patient. The output of the load cell is connected to the main board 100. The switch 83 is moved to the learning mode and button 84 depressed to start a learning procedure.

The practitioner then pulls on belt 51 or cord 50 to manipulate the patient in a regular manner. The instantaneous force will be displayed on window 63, and software in the main board 100 looks for a repeated pattern of increasing tension and release. Once a set of such "wave forms" has been detected of adequate substantially equal maximum force and spaced out in time at reasonably regular intervals, the software on main board 100 changes the display on mode display 62 so that the practitioner knows that the rhythm and maximum force have now been captured by the internal memory on the electronics. Switch 83 is now switched over to treatment mode, and then, with cord 50 connected directly to the belt 51, or e.g. to rod 26, start button is operated to enable the respective force applicator device, controlled by the electronics 100, which receives signals from the torque gauge 108, to apply a repetitive tension to the cord 50. The calibration mode sets up a correlation between the tension in cord 50 and the reading of the torque gauge 108.

Prior to pressing the start button, control 67 may be set to a maximum treatment time, shown in window 64 and, when the treatment start button is pressed, this figure, conveniently set out in minutes, gradually decreases as the time passes and, when it runs to zero, the treatment stops automatically.

All this time, the patient has press button switch 44 in his or her hand so that, if there is discomfort or pain, or the patient wants the treatment to stop, all that is necessary is to press button switch 44 and the machine is stopped.

The force in cord 50 drops to zero.

By suitable control and design of the components shown in Figure 9, motor 102 can drive the oscillating plate device 38, which incorporates a reciprocating carriage (for manipulating/massaging across soft tissues as opposed to directly into them), or the reciprocating piston/applicator device 31 (shown in Figure 5) being able to push into a given soft tissue.

The gearbox 103 may have a suitable output to drive these via the force-transmitting connection 29 shown in Figures 1 to 6 and to ensure that the amplitude and the amount of force applied are appropriately controlled.

When using plate 26 to apply repetitive pressure to a part of the patient's body, the cord 50 and its strain gauge are attached to handle 25 following the appropriate adjustments of the positions of carriages 14 and 15 on rails 8 and 9, the heights of yokes 22, the position and angle of mounting 27, the angle of plate 26, and the angle of the slot in guide member 34. This is all done with the patient held in fixed position on mattress 3.

Referring now to Figures 11 to 18, these show a second embodiment of treatment apparatus in accordance with the present invention. The underlying structure of a treatment table having a surrounding U-shaped framework with carriages moveably positioned on it is maintained, but, as can be clearly seen in Figures 11 to 13, there are just two carriages denoted and 131. Carriage 130 incorporates a mechanism (described in more detail below) for applying a repetitive pulling force to a cord 133, while carriage 131 includes a drive unit for driving a compression member repeatedly to apply compression to part of the patient. This takes the form of a jointed overhead arm 136 on the free end of which may be mounted, at an appropriate angle, a suitable pressure pad for application of pressure to a part of the patient.

Figure 13 shows additionally that each of carriages 130 and 131 may have a yoke 140 mounted on it which supports a rod 141 in respective bearing shells 142. Mounted on rod 141 by means of a variable position, variable angle mounting 145 is a pressure-applying pad 146. Motion can be imparted to the pad 146 using the repetitive pulling mechanism in carriage 130, or the repetitive compression or pushing mechanism located in carriage 131.

Each of carriages 130 and 131 has a casing 150 with a control panel on its surface. A typical control panel layout is shown in Figure 14. This has a main on/off switch 160 adjacent to which is an emergency stop button 161. The operation of the apparatus is controlled by a bank of push buttons in the centre of the control panel, for starting, pausing, holding the position and ending the treatment session. Pressing a start button 162 commences a treatment bout, either with previous settings or settings input by the practitioner. Pressing a pause button denoted 163 in Figure 14 stops the treatment and is arranged to remove any pushing or pulling force, but the settings (see below) remain unaffected. Treatment can be restarted by pressing the start button 162. A hold button 164 pauses the pulling or pushing action, but does not relieve the force being applied to the patient.

Again, pressing start button 162 enables the treatment cycle to continue. A stop button 165 may be used to stop a treatment bout prematurely and is arranged to return the control electronics to their initial state.

The amount of force to be applied may be adjusted using a rotary knob 166 and this is associated with a numerical display 167 showing the amount of force applied or, when the control panel is in set-up mode, the maximum amount of force to be applied. A rotary knob 168 may be used to set the time of the bout of treatment, shown in a display 169 and, during treatment, this display may be regularly decremented as time passes to show the amount of time left in the treatment bout.

Finally, a rotary knob 170 is provided to adjust the frequency of the pulling or pushing cyclic movement, with the number of cycles per minute being shown on an adjacent display 171.

As in the case of the control panel described above with reference to Figures 1 to 10, there is a switch which can be moved between a learning mode and a manual setting. The switch is denoted 175 and, if this is switched to learn mode, then a push button 176 is actuated when the practitioner wishes to teach the apparatus the desired treatment activity. As before, the practitioner applies the load to the patient physically and rhythmically and, when the maximum load applied and cycle time are within an appropriate narrow tolerance band for ten cycles, the electronics in the apparatus detect this and an indicator shows that the learning process for the apparatus is complete.

An LED indicator next to the start button, denoted 178 on Figure 14, may, for example, be red illuminated when switch 175 is made to select the learn mode, then flashes green to show that valid data is being received once the practitioner starts to work on the patient, with a continuous green light being displayed by LED 178 once the steady state has been reached, so enabling the practitioner to know when to stop because the machine is now ready to continue the treatment without further practitioner intervention.

The control panel shown in Figure 14 also has three warning lights to show if there is excessive force, i.e. force in excess of that set by the practitioner, excessive motor current, see below, or excessive movements. This may occur if limits which is described below are actuated.

Turning now to Figures 15 and 16, these show diagrammatically certain features of the drive mechanism located on carriage 130. As shown in Figure 12, the carriage carries a motor and gearbox assembly 180 which drives a wheel 181 via a clutch mechanism 182. Cord 133 is attached to wheel 181 and has set in it a strain gauge 183. The wheel is of sufficient diameter to provide an appropriate stroke length for the pulling movement which may be relatively short, for example 5 to 10 centimetres. A pair of limit switches 184 are located adjacent the wheel and these may be triggered by radial ribs 185 which rotate with the wheel. If, for any reason, the limit switches are actuated, then the limits warning light may be illuminated on the control panel.

As in the apparatus described with reference to Figures ito 10, the basic drive system is controlled via a motor controller which is in turn controlled via a main electronics board, which is connected to the various controls and displays on the control panel. If the motor current exceeds the maximum allowable, the electronics may de-energise the motor and actuate the excessive motor current warning light.

Figures 17 and 18 illustrate the corresponding arrangements for the compression cycles effected by arm 136 shown in Figures 12 and 13. In this case, the basic drive system 180 and clutch 182 can be the same, but instead of a wheel 181 which acts as a pulley for cord 133, the drive unit includes a wheel 190 which carries an eccentric mounting 191 which has a rod 192 rotatably mounted on it. Wheel 190 carries a pair of ribs 194 which are designed to cooperate with limit switches 195 so that inappropriate excess movement of wheel 190 can be detected and indicated on the control panel and, if necessary, the system de-energised.

The amount of compression applied to the patient may be reflected in the amount of compression exerted on rod 192, measured via a strain gauge 197 located on the end of the rod and the movement may be transmitted to the end of articulated arm 136 by means of a Bowden cable.

In the case of both embodiments, care needs to be taken to ensure that the treatment apparatus meets necessary conditions set down by health and safety standards, for example as regards moving pads and electrical safety.

As can be seen from the foregoing descriptions of two embodiments, the apparatus according to the invention is capable of treating any area of the body requiring manual therapy for a prolonged period of time, with the manipulation treatment faithfully reflecting that effected by a skilled practitioner but over a period of time generally greater than that comfortably achievable by his or her unaided efforts.

Claims

CLAIMS1. Manipulation treatment apparatus comprising a manual treatment table on which a patient may be supported, contact means adapted to contact a portion of the patient, force application means fixed relative to the table, including oscillating drive means adapted to apply a force to the contact means and to release such force, a load cell positioned to measure the force applied by the force application means and contact means, and control apparatus for controlling the timing and amount of force applied by the force application means to the contact means during a treatment session, using measurement signals derived from the load cell.
2. Apparatus according to Claim 1 wherein the oscillating drive means includes a mechanical drive adapted to apply a force via a clutch which can be disengaged to release the force.
3. Apparatus according to Claim 1 wherein the oscillating drive means includes a pneumatic or hydraulic piston-cylinder arrangement and the apparatus includes control means for the pneumatic or hydraulic piston-cylinder arrangements.
4. Apparatus according to any one of Claims 1 to 3 wherein the drive means is connected to the contact means via a flexible cord, and the load cell is arranged to measure the instantaneous tension in the cord.
5. Apparatus according to any one of the preceding Claims wherein the contact means is in the form of a belt adapted to be secured around a limb or the body of a patient, connected to the oscillating drive means via a flexible cord.
6. Apparatus according to any one of Claims 1 to 4 wherein the contact means is a plate which may be cyclically reciprocated against the patient.
7. Apparatus according to Claim 6 wherein the plate is mounted on a suitable arm which can be moved about an axis by means of the cyclical application of increasing and decreasing force by the force application means to effect a repetitive massaging or manipulating action on the patient.
8. Apparatus according to Claim 7 wherein the arm is pivotally mounted at one end and the plate is mounted on it between its ends, and means are provided to pull the other end periodically in a direction such that the plate then periodically applies pressure to the part of the patient with which it is in contact.
9. Apparatus according to Claim 7 wherein the arm is in a pivoted arm having a pressure plate on its end and a cable is provided between the pivot and the end enabling the arm to be rotated about the pivot to press the pressure plate against the patient.
10. Apparatus according to any one of the preceding Claims wherein the control apparatus includes means enabling the adjustment of the frequency of a given repeated manipulation.
11. Apparatus according to any one of the preceding Claims and configured so that it may be switched between: a learning mode, in which a practitioner reciprocally manipulates the contact means as desired, with the load cell so arranged as to detect the amount of force applied by the practitioner, and during the reciprocal manipulation of the contact means the apparatus records the parameters of force and frequency, and a treatment mode during which the apparatus operates taking the stored parameters into account.
12. Apparatus according to Claim 11 wherein, when the apparatus is operated in the learning mode, the force and frequency parameters are captured and analysed until the variation between a plurality of successive pressure or pulling cycles carried out by the practitioner is less than a given threshold, whereafter the average values of force and cycle time are calculated and stored for use in the treatment session carried out by the apparatus.
13. Apparatus according to any one of the preceding Claims wherein the control apparatus includes manually settable means enabling the force applied, the frequency of application and the overall treatment time to be set.
14. Apparatus according to any one of the preceding Claims wherein the control apparatus includes means to interrupt or pause the manipulation movement for a time to enable the patient to be examined during a treatment session.
15. Apparatus according to any one of the preceding Claims and including means to record the date, time, patient name and treatment parameters for retrieval when the same patient is being treated on a subsequent occasion.
16. Apparatus according to any one of the preceding Claims and including a manually-operated trip switch which is connected to the control apparatus to enable a patient to terminate operation of the treatment apparatus during a treatment session.