JP4073959B2 - Passive articulation apparatus and method using the same - Google Patents

Description

指の中手指関節（ＭＣＰ）、近位指関節（ＰＩＰ）及び遠位指関節（ＤＩＰ）の関節可動域（相対）を測定した。その結果を表１に示している。
表１の結果から、関節可動域の平均変化率（変化％）は約２０％と決定される。変化％とは、治療後の可動域から治療前の可動域を減じ、それを治療前の可動域で割り、１００％を乗じたものである。従って、受動運動装置による治療は作用された関節の可動域を実質的に改良した。
この発明の広範の発明概念に外れることなく上述の具現例に変更及び修正を加えることができることは当業者には明確であると思われる。それゆえ、本発明はここで示された特定の具現例に限られず、請求の範囲に記載された発明の範囲と精神に反することのない全ての変更及び修正を含むものと考える。 TECHNICAL FIELD OF THE INVENTION
The present invention relates to an apparatus and method for moving a joint, and more particularly to an apparatus and method for passively moving a joint to return the range of motion of a patient's joint to a more natural state.
Background of the Invention
Patients whose trauma or disease hurts tendons, soft tissues or bones near the joint are frequently advised to follow an exercise plan to prevent loss of joint mobility. This motion plan often requires complex and expensive machines such as physical therapists or continuous passive motion machines (CPM) to continuously move the joints. However, the time for such treatment is troublesome for many patients.
Another problem that affects treatment is that many exercise plans require patient motivation, hard work and patience. For example, night inactivity causes many patients to experience arthritis or other joint stiffness, reducing the range of motion of the affected joint. As a result, such patients are advised to move and bend the affected joints every morning without using a machine. Although prescribed exercise programs are intended to return the range of motion of the joint to a natural state, patients often do not have the necessary exercise due to pain, frustration or discomfort. This is a serious drawback of exercise therapy that does not use a machine that requires high patient compliance to be effective.
Accordingly, various types of passive exercise devices have been utilized. Such devices typically attach an inflatable member, such as a pouch, bladder, or sac, to the joint to bend and / or extend the joint to move the joint. The inflatable member is periodically expanded and contracted with a gas, liquid or warmed liquid to cause movement. However, such a pressurizing device may not be practical and effective for applying the appropriate force during contraction of the sac to move the joint appropriately. In addition, the inflatable member may burst during use.
In other conventional devices, the joint is bent or stretched alternately by attaching inflatable members to the bending side and the extending side. By periodically inflating one inflatable member and simultaneously shrinking the other inflatable member, the joint is systematically bent and stretched. However, in such a system, in order to apply an appropriate pressure for effective treatment, the inflatable member needs to be expanded and contracted at an accurate timing.
One way to avoid the difficulties when using multiple inflatable members is to place an inflatable sac on the extension side or outside of the joint to deflect the joint to the extended position and spring steel elements Is used to deflect the joint to a position where it is not extended. In effect, the joint is extended by inflating the capsule. The joint is retracted to the position bent by the spring steel element by contracting the capsule. However, for some patients, excessive force is applied to the patient's joint at the position where the spring steel deflection element is connected or attached. Furthermore, it is difficult to control or manage the application of force to apply more uniform pressure to the tissue surrounding the joint.
In view of the above points, it is desirable to provide a device that passively moves a joint without using a pressurizing device such as an inflatable sac. Here, the device can be deflected to a neutral position or an extended position, and the deflection force is uniformly generated in the underlying tissue.
BRIEF DESCRIPTION OF THE INVENTION
The present invention relates to a passive motion apparatus that moves or moves a selected joint or joints of a patient. The device is fixed at a selected joint position or at an appropriate position relative to that joint, and then manipulated to move and move the patient's joint in a controlled manner. The passive motion device has a resilient open cell foam portion and a flexible cover or casing surrounding the foam portion to form a sealed chamber. A joint position fixing means is used so that the joint is placed at an appropriate position with respect to the apparatus. For example, the foamed portion may be provided with a hand and finger hole so that the patient's hand can be appropriately held or fixed. Alternatively, the glove may be secured to the sealed chamber or removably attached to keep the patient's hand in place. In applications where other joints such as the patient's elbow are treated, a sleeve may be used to secure the sealed chamber to the elbow joint.
A pump, which is a vacuum pump, is operatively connected to the sealed chamber and depressurizes, that is, lower than atmospheric pressure. For example, when the pump depressurizes the sealed chamber by controlling the amount and timing of suction during an “on” cycle, the pores of the foamed portion contract against the elasticity of the foamed portion, and the sealed chamber collapses and contracts. By contracting the sealed chamber, a force is exerted on the joint to cause the joint to bend from a first or neutral position, ie, a relaxed position between a fully extended position and a fully bent position. Since the pores span the entire foamed portion, the force is generally uniformly generated throughout the underlying tissue. Thereafter, for example, when the pump releases suction during the “off” cycle, the foamed portion expands due to the elasticity of the foamed portion and returns to the initial position, and the joint returns to the first position or the neutral position.
The foamed portion may include any number of commercially available materials having an open cell structure, such as a sponge. The foamed portion provides an elastic member so that the sealed chamber returns to a non-contracted position when the vacuum applied by suction is fully released or removed. The porosity and elasticity of the foamed part are selected according to the intended use. For example, foamed portions with smaller pores or cells have a greater deflection force and are therefore suitable when applied to particularly stiff joints. Conversely, when a weaker force is sufficient, a more compressible foamed part is preferred. In addition, the foamed portion may include adjacent portions having two or more different stiffnesses.
The foamed portion can be provided in a variety of sizes and shapes to suit individual patient needs. The foamed portion is formed so as to be comfortably along the bending side, that is, the inside, of the joint when the joint is in a neutral position, that is, a bent position.
The cover or casing that surrounds and seals the foamed portion is formed from a plastic sheet or sheet, and encloses or surrounds the foamed portion to provide a sealed chamber. In addition, the cover may be formed around the foamed portion to form a sealed chamber. The cover is made of various materials such as polyurethane film, provided that it is substantially gas-impermeable and flexible enough to allow the casing to be depressurized and to contract and expand while releasing the depressurization. It may be manufactured from any material. Alternatively, the cover is formed by coating the outer surface of the foamed part with a sufficiently flexible or substantially gas-impermeable material, or by sealing the pores on the outer surface of the foamed part with heat sealing or the like. Is done.
The joint position fixing means has a suitably shaped groove or hole in the foamed portion to house the selected joint and hold the device in position on that joint. For example, the fixing means may have a finger or hand hole in the foamed portion. Alternatively, the securing means may comprise gloves or mittens, or may have selected portions thereof. These are attached to the sealed chamber and place the sealed chamber in an appropriate position relative to the joint to be treated. The gloves or mittens are formed from a porous material such as cotton for patient comfort. Fixing means such as laces or belts are provided so that the device is placed in an appropriate position relative to the patient's joint.
The suction means is provided in the form of a vacuum pump and is connected to the cover of the sealed chamber by a fluid transmission tube. The tube is connected to the sealed chamber, and the sealed chamber can be depressurized. One end of the tube is placed in a sealed chamber and embedded in the foamed portion. The other end of the tube is outside the sealed chamber and is connected to a vacuum pump.
Optionally, one or more struts may be used at selected locations relative to the patient's joint to reinforce the foamed portion. The struts are rigid or semi-rigid bars made of a suitable material such as wood or plastic and are embedded in the foamed part. The support column is disposed in the foamed portion, and is positioned inside the joint and extends in the horizontal axis direction with respect to the joint. The struts function to limit the shrinkage of the foamed portion in the direction parallel to the struts, thus reducing the force applied to the joint in the transverse direction relative to the direction in which the joint bends. In this way, the struts allow the joints around the struts to bend properly.
In particular, in the case of a rigid joint, a force larger than the force applied when the foamed portion returns to the original shape due to elasticity may be required to return the joint to the original neutral position. In such a case, sealed chambers incorporating separate foamed portions are placed on both sides of the joint. Accordingly, the first foamed portion enclosed in the first sealed chamber is disposed outside the joint, that is, on the extension side, and the second foamed portion sealed in the second sealed chamber is disposed on the inside, ie, the bent side of the joint. When the joint is in a bent or neutral position, the first sealed chamber is aspirated and the vacuum state of the second sealed chamber is released, so that the first foamed portion contracts and the second foamed portion expands and the joint expands. Stretch out. Instead, when the second sealed chamber is aspirated and the vacuum state of the first sealed chamber is released, the second foamed portion contracts and the first foamed portion expands to bend the joint. By using such two sealed chambers, the joint can be bent and extended more easily from the neutral position.
The present invention also relates to a method for passively exercising a patient's joint. A device having a foamed part and a casing enclosing the foamed part to form a sealed chamber is placed in a preferred position relative to the joint to be moved. The device may be arranged, for example, on the bending side or inside of the joint.
The sealed chamber is then depressurized with a controlled vacuum at a controlled rate. By depressurizing the sealed chamber, the bubbles in the foamed portion contract at a predetermined speed, and therefore, a predetermined force is applied to the joint to generate a predetermined movement in the joint. When the foamed portion is placed inside the joint, the joint is bent from its neutral or extended position by sucking the sealed chamber.
After the foamed portion contracts and the joint is moved, the decompressed state of the sealed chamber is released. When the pressure returns to atmospheric pressure, the foamed portion returns to its original shape and size. As the foamed portion expands, force is applied to the joint and the joint returns to the neutral or extended position.
By controlling the rate of contraction and controlling the amount of pressure applied, the joint can be moved in a manner most suitable for each patient. For example, a joint that has just started treatment is stiffer and requires more force to move, so a higher vacuum is initially used to aspirate the chamber. Also, in the early stages of treatment, the patient may feel more painful as the joint is moved, and it may be better to move at a slower rate to minimize the amount of pain involved. Therefore, at the beginning of treatment, it is better to depressurize with a high degree of vacuum at slow intervals.
[Brief description of the drawings]
The foregoing brief description of the invention and the detailed description of the preferred embodiment of the invention set forth below will be better understood when read in conjunction with the following drawings.
FIG. 1 is a perspective view of a first embodiment of a passive exercise device for exercising a hand according to the present invention.
2 is a cross-sectional view of the apparatus shown in FIG. 1 taken along line 2-2 of FIG. 1, but shows a hand inserted into the apparatus.
FIG. 3 is a perspective view of a second embodiment of the passive exercise device for exercising the hand according to the present invention, and the hand inserted into the device is indicated by a broken line.
4 is a cross-sectional view of the apparatus shown in FIG. 3 taken along line 4-4 of FIG.
FIG. 5 is a cross-sectional view of the apparatus shown in FIG. 4, but with the fingers of the hand bent.
FIG. 6 is a perspective view of a third embodiment of the passive exercise device for exercising the hand according to the present invention.
FIG. 7 is a cross-sectional view of the device shown in FIG. 6 taken along line 7-7 in FIG. 6, but shows a hand inserted into the device.
FIG. 8 is a perspective view of a fourth embodiment of a passive exercise device for moving an arm according to the present invention.
FIG. 9 is a side view of the apparatus shown in FIG. 8, but with the arm bent.
FIG. 10 is a perspective view of a fifth embodiment of the passive exercise device for exercising the hand according to the present invention.
11 is a cross-sectional view of the apparatus shown in FIG. 10 taken along line 11-11 in FIG. 10, but the hand inserted into the apparatus is indicated by a broken line.
FIG. 12 is a cross-sectional view of a sixth embodiment according to the present invention, in which divided sealing chambers are provided on both sides of the finger joint to keep the joint in a neutral position.
FIG. 13 is a cross-sectional view of the device shown in FIG. 12, but with the finger joints extended.
FIG. 14 is a cross-sectional view of the device shown in FIG. 12, but in a position where the finger joints are bent.
FIG. 15 is a flowchart showing a first embodiment of a method for moving a joint according to the present invention.
FIG. 16 is a flowchart showing a second embodiment of the method for moving a joint according to the present invention.
Detailed Description of the Invention
1 and 2 show a passive exercise device 20 that exercises a hand. The device 20 is particularly suitable for moving the five fingers of the right hand.
The device 20 has a generally cylindrical open cell foam portion 26. The foamed portion can be easily compressed from its normal shape, has sufficient elasticity, and is expanded to the original normal position even after being compressed. Formed directly on the inner surface of the foamed portion 26, a patient's right hand 19 is supported at a position in the foamed portion of the device 20 by a hand support, generally designated 30. The hand support 30 includes a recess 38 and finger holes 31 a to 31 e extending from the recess 38 on the outer surface of the foamed portion 26 to the inner surface of the foamed portion 26. The holes 31a to 31e of each finger are arranged in such a size that each finger can be stored in the neutral position. The external openings 32 a to 32 d at the mouths of the four finger holes 31 a to 31 d other than the thumb are substantially aligned along the length direction of the foamed portion 26. Furthermore, the finger holes 31a-31d generally extend parallel to each other along a narrow, precise trajectory into the foamed portion 26 so that when the patient's fingers are held in a neutral position, Are comfortably supported in the holes 31a to 31d. As a result, the finger holes 31a to 31d comfortably accept the index finger, middle finger, ring finger, and little finger of the right hand 19 of the user so as to be snug. The thumb hole 31e is located away from the other finger holes 31a to 31d in order to receive the thumb of the right hand 19 of the user closely. An indentation 38 on the outer periphery of the foamed portion is formed to fit the palm of the user's hand when the user's finger is inserted into the appropriate finger hole 31a-31e and in a relaxed and well-supported position Has been.
A flexible, fluid impermeable cover or casing 21 is provided over the entire surface of the foamed portion 26 to effectively surround and seal the foamed portion 26 to form a sealed chamber 22. Accordingly, the casing 21 extends along the finger holes 31a to 31e, and the user's fingers are stored in the finger holes 31a to 31e while maintaining the sealing formed by the casing 21. . The cover or casing 21 must be sufficiently flexible so that it can contract and expand as the foamed portion 26 contracts and expands while suction by the vacuum source 42 is performed and not. The cover 26 must be sufficiently gas impermeable so as to keep the sealed chamber sealed.
A vacuum source generally indicated by reference numeral 42 includes a vacuum pump 46 and a fluid transmission tube 43 having a tip 44 and a tip 45, so that the pressure in the sealed chamber 22 can be made lower than atmospheric pressure. A distal end 44 of the tube 43 extends through the casing 21 through the casing 21. The distal end 44 of the tube 43 may be embedded along the center line of the cylindrical foam portion 26. The tube 43 passes through the casing 21 so as to maintain the sealing property of the sealing chamber 22. Therefore, the tube 43 must be sealed with respect to the casing 21 at the opening through which the tube 43 passes the casing 21. The end 45 of the tube 43 is connected to a vacuum pump 46, and the suction port of the vacuum pump 46 is operatively connected to the sealed chamber. The portion embedded in the foamed portion 26 of the distal end 44 of the tube is provided with a plurality of openings along the length direction to promote contraction of the foamed portion.
A second embodiment of the device 120 according to the invention for precisely moving the hand is shown in FIGS. A foamed portion 126 is provided that is generally rectangular in shape. The upper surface 127 of the foamed portion 126 is essentially planar while the lower surface 129 is contoured in a recessed or retracted state. As a result, the cross-sectional area that is sectioned perpendicular to the longitudinal axis of the foamed portion 126 varies along the length of the foamed portion 126. The greater the cross-sectional area of the cross-sectional slice along the length of the foamed portion 126, the stiffer the foamed portion 126 at that location. In other words, if the thickness of the foamed portion 126 becomes thinner at the recessed portion, the foamed portion 126 becomes less rigid. As shown in FIGS. 3-5, the recessed portion of the foamed portion 126 is typically located below the finger joint. Additionally, the thickness of the foamed portion under the fingertip of the hand is thinner than the thickness of the foamed portion under the palm of the hand. By contouring the foamed portion 126, the tip of the finger can be easily bent when the foamed portion is contracted. By adjusting the location and amount of foam thickness, the device 120 can be designed to provide different strengths of deflection and restoring forces at different sites around the joint to be moved. For example, as shown in FIG. 4, the portion of the foamed portion 126 below the finger joint may be thinnest so that the joint can bend easily when the sealed chamber 122 is evacuated.
The foamed portion 126 is entirely enclosed in a flexible cover or casing 121 and sealed to provide a sealed chamber in which the foamed portion 126 is contained. The cover 121 must be sufficiently flexible and generally gas impermeable to maintain the sealed chamber 122 even when the internal foamed portion 126 contracts and expands.
In order to properly position the user's hand 119 relative to the device 120, a hand support, generally indicated by the number 130, is provided. For this purpose, a glove 133 is attached to the outer surface of the casing 121 along the upper surface of the foamed portion 126. The rear portion of the glove 133 can be removed or elongated, and the user's hand 119 can be easily placed in the glove 133. Furthermore, a string 134 is attached to the glove 133 so that the user's hand is securely held in the glove 133. As shown in FIGS. 3-5, the lace 134 has a hook portion and a loop portion that allow the lace to be tightened and secure the patient's hand during treatment.
A vacuum source 142 is also provided. The vacuum source 142 is essentially the same as the vacuum source 42 described in the first embodiment shown in FIGS. Therefore, the vacuum pump 146 is connected to the sealed chamber 122 via the fluid transmission tube 143.
The device 120 shown in FIGS. 3-5 also has two elongated rods or disc-shaped struts 148 made from a rigid or semi-rigid material, such as wood or plastic, which is typically It is fitted in the horizontal axis direction with respect to the bending direction of the finger joint. The support column 148 generally extends in the width direction of the foamed portion 126. The struts 148 serve to minimize contraction of the foamed portion 126 in the transverse direction relative to the bending direction of the joint when the sealed chamber 122 is depressurized and the foamed portion 126 contracts. The strut 148 can be placed at a preferred location in the foamed portion 126. For example, the strut 148 may be disposed in the foamed portion 126 so as to be directly under the joint to be treated or opposite the joint to be treated. As shown in FIGS. 3-5, the strut 148 is disposed on the opposite side of the joint and on the opposite side of the recessed recess of the lower surface 129 of the foamed portion 126, the foamed portion 126 being the recessed portion below the joint. It is easy to bend. By controlling the position at which the foam portion bends during decompression, the device 120 functions more effectively to properly bend the joint.
A third embodiment of the device 220 according to the invention for moving the hand 219 is shown in FIGS. Device 220 is similar to device 120. However, the hand support 230 of the device 220 is provided by a hand-shaped depression or recess 231 formed in the upper surface of the foamed portion 226 of the device 220. The depression 231 is generally formed so as to conform to the shape of the hand, and the user's hand 219 is comfortably supported in the depression 231. A cover flap 235 is provided to be placed over the hand 219 when the user's hand 219 is placed in the recess 231. A fingertip holding port 228 extends from the top surface 227 of the foamed portion 226 over the user's fingertip so as to hold the user's hand 219 in position in the device 220. The holding port 228 forms a fingertip hole 229 for wrapping the user's fingertip. A hook-loop closure patch 236 is attached to the end of the cover flap 235. A hook-loop closure string 238 is attached to the cooperating lower flap 239 and engages the closure patch 236 to secure the device to the patient's hand 219 during treatment. Device 220 is connected to vacuum pump 246 by tube 243 and provides a vacuum source 242.
A fourth embodiment of the device 320 according to the invention is shown in FIGS. Device 320 is designed to be used for elbow or knee movement. Thus, the device 320 includes a foamed portion 326 that is shaped and fitted to fit along the flexed or inner side of the joint to be treated. The joint support of the device 320, generally designated 330, is provided by a flexible sleeve 336 and serves to secure the generally sealed foamed portion 326 in place at the patient's joint. The sleeve 336 is a tubular sleeve or a planar portion of material that can be wrapped around a joint and secured in a joint position with a closure strap 334. For this purpose, a hook-loop closure string 334 is attached to the sleeve, releasably securing the foamed portion 326 in place with respect to the joint. The sleeve 336 can be stretched to fit tightly around the joint when the foamed portion is inflated, that is, in an uncontracted shape, and when the foamed portion 326 wrapped through the tube 343 is sucked from the vacuum pump 346 and contracted. However, it is preferable to be manufactured from a material such as a stretchable fabric that is sufficiently elastic to maintain its position. When sucked, the foamed portion 326 contracts and the elbow is bent as shown in FIG. When suction is removed, the foamed portion 326 expands and the elbows extend to the neutral position as shown in FIG.
A fifth embodiment of the device 420 according to the invention for exercising the hand is shown in FIGS. Similar to the embodiment shown in FIGS. 1 and 2, the device 420 has a cylindrical foam portion 426. However, the diameter of the foam portion 426 is selected so that the user can grasp the foam portion 426 with his or her hand 419. A foamed portion 426 is encased by a sealed casing or cover to provide a sealed chamber 422.
A hand support, generally designated 430, is provided to secure the user's hand 419. Hand support 430 includes a plurality of adhesive strips attached to the outer surface of cover 412. In the embodiment shown in FIGS. 10 and 11, the adhesive strip is in the form of a hook-loop closure strip 437a and is an elongated strip that extends in parallel along the outside of the outer periphery of the cylindrical foam portion 426. The closing strip 437a is located parallel to the central axis of the foamed portion 426, and is spaced along the outer periphery of the foamed portion 426. Glove 433 is fitted with a hook-loop closure 437b that coincides with closure strip 437a along the inside of the finger and palm portions. Thus, when the user inserts his or her hand 419 into the glove 433 and grips the foamed portion 426, the hook-loop closure 437b of the gripping surface contacts the closure strip 437a of the foamed portion 426 and the gloved user Are removably secured to the sealed foam portion 426.
In operation, the devices 20, 120, 220, 320 and 420 are used in essentially the same way. A method for passively moving a joint using the devices 20, 120, 220, 320 and 420 is shown in FIG. First, in step 50, a particular device 20, 120, 220, 320 or 420 is placed at the appropriate location for the joint to be moved.
Once the device 20, 120, 220, 320 or 420 is properly positioned relative to the joint, in step 55 the sealed chamber 22, 122, 222, 322 or 422 is evacuated and the sealed chamber 22, 122, 222, 322 or 422 is depressurized to a pressure lower than atmospheric pressure. This reduced pressure causes the bubbles in the foamed portion 26, 126, 226, 326 or 426 to contract, and each foamed portion contracts to exert a force on the joint and bend the joint.
If the joint bends, in step 57, the vacuum of the sealed chamber 22, 122, 222, 322 or 422 is released. When the pressure in the sealed chamber 22, 122, 222, 322, or 422 returns to atmospheric pressure, the bubbles in the foamed portion 26, 126, 226, 326, or 426 expand, and each foamed portion expands and exerts a force on the joint. Returns to its initial position, the neutral position.
In step 59, it is determined whether to continue the joint motion. If further joint movement is desired, the method returns to step 55. However, if the joint motion is not continued, the method ends at step 56.
A sixth embodiment of the device 520 according to the present invention for exercising the hand is shown in FIGS. The device 520 has two foamed portions 526a and 526b. Foamed portions 526a and 526b are sealed by covers 521a and 521b, respectively, thus forming two sealed chambers 522a and 522b.
Each sealed chamber 522a and 522b is connected to one vacuum pump or a plurality of pumps via tubes 543a and 543b. Therefore, each sealed chamber 522a and 522b is decompressed separately, and the decompressed state is maintained or the decompressed state is released.
Posts 548a-548d are provided on the foamed portions 526a and 526b. More specifically, the columns 548a and 548b are embedded in the first foamed portion 526a, and the columns 548c and 548d are embedded in the second foamed portion 526b. The struts 548a to 548d generally extend in the width direction of each foamed portion, and are generally positioned in the horizontal axis direction with respect to the bending direction to limit the foam shrinkage, and thus are transverse to the bending direction of the joint. The movement in the axial direction is limited.
In operation, a method for passively moving a joint using the device 520 is illustrated in FIG. In step 150, the joint to be moved is arranged with the first foamed portion 526a of the first sealed chamber 522a on the extension side or outside of the joint, and the second foamed portion 526b of the second seal chamber 522b on the bent side or inside of the joint. Are installed in the apparatus 520 so that the Here, the joint is preferably in the neutral position as shown in FIG.
When the device 520 is installed with respect to the joint, the first sealed chamber 522a is sucked in step 155a, and the pressure of the first sealed chamber 522a is made lower than the atmospheric pressure. Due to this reduced pressure, the pores of the first foamed portion 526a are contracted, so that the first foamed portion 526a contracts to exert a force on the joint and extend the joint as shown in FIG.
After the joint is extended, in step 157a, the pressure in the first sealed chamber 522a is returned to atmospheric pressure. When the pressure in the first sealed chamber 522a returns to atmospheric pressure, the pores of the first foamed portion 526a expand, and therefore the first foamed portion 526a expands and exerts a force on the joint, as shown in FIG. Return to neutral position.
Next, in step 155b, the second sealed chamber 522b is sucked, so that the pressure in the second sealed chamber 522b is made lower than the atmospheric pressure. Due to the reduced pressure, the bubbles in the second foamed portion 526b are contracted, so that the second foamed portion 526b contracts and exerts a force on the joint, and the joint is bent as shown in FIG.
After the joint is bent, in step 157b, the pressure in the second sealed chamber 522b is returned to atmospheric pressure. When the pressure in the second sealed chamber 522b returns to the atmospheric pressure, the pores of the second foamed portion 526b expand, so that the second foamed portion 526b expands and exerts a force on the joint, and the joint is as shown in FIG. Return to the neutral position.
This process is continued for an appropriate amount of time to move the joints. In step 159, it is determined whether to continue the joint motion. If the joint is to be moved further, the method returns to step 155a. On the other hand, if the joint motion is not continued further, the method ends at step 161. The decompression of the first and second sealed chambers is of course controlled by time and intensity to provide a controlled exercise environment for the patient's joint. For example, the strength of decompressing the first sealed chamber may be different from the strength of decompressing the second sealed chamber. In fact, even in the same sealed chamber, different applied vacuum strengths will give different results. Further, the pressure may be reduced at a selected interval to release it. For example, the other chamber may be depressurized while one chamber is depressurized at selected intervals. Additionally, the elasticity and stiffness of the foamed portion can be selected to allow each patient to perform a desired passive motion program for a selected time.
Example
A passive exercise device according to the present invention was used to exercise the right and left hands of a patient. The patient suffered full width burns on both hands, and the wound was treated with an intermediate skin graft. For the treatment of the patient, the same passive exercise device as the embodiment shown in FIGS. This device is used for 48 hours of treatment, and each index finger, middle finger, ring finger, and small finger

The range of motion (relative) of the metacarpal joint (MCP), proximal finger joint (PIP), and distal finger joint (DIP) of the finger was measured. The results are shown in Table 1.
From the results in Table 1, the average rate of change (% change) of the range of motion is determined to be about 20%. % Change is obtained by subtracting the range of motion before treatment from the range of motion after treatment, dividing it by the range of motion before treatment, and multiplying by 100%. Thus, treatment with a passive exercise device substantially improved the range of motion of the affected joint.
It will be apparent to those skilled in the art that changes and modifications may be made to the embodiments described without departing from the broad inventive concepts of the invention. Thus, the present invention is not limited to the specific embodiments shown herein, but is intended to include all changes and modifications that do not depart from the scope and spirit of the claimed invention.

Claims (27)

A passive exercise device for moving a patient's joint having a flexion side and an extension side ,
a. A foamed part;
b. A casing that encloses the foamed portion to form a sealed chamber around the foamed portion, wherein the joint is pre-determined at a predetermined position for selectively depressurizing and releasing the depressurized chamber. The sealed chamber is depressurized to cause the foamed portion to contract to move toward a selected position, and the joint is returned to the predetermined position to allow the foamed portion to expand. A casing to which a pump for releasing the decompression is operatively connected;
c. And a joint positioning means for positioning the joint with respect to the passive motion apparatus. The passive motion device of claim 1, wherein the foamed portion comprises an open cell foamed portion. The passive motion device according to claim 1, wherein the foamed portion includes a sponge. The passive exercise device according to claim 1, wherein the foamed portion has a shape that fits along the bent side of the joint. The passive exercise device according to claim 1, wherein the foamed portion has a shape that fits along the extension side of the joint. The foam portion includes a plurality of portions having different stiffnesses fixed at different positions with respect to the joint, and controls movement of the joint during decompression of the sealed chamber and release of the decompression. The passive exercise device described in 1. The passive motion device according to claim 1, wherein the casing includes a thin plate around the foamed portion to form the sealed chamber. The passive motion device according to claim 1, wherein the casing has a coating covering the foamed portion to form the sealed chamber. 2. The joint position fixing means has a groove for one finger in the foamed portion, and inserts one finger into the groove to fix the other finger to the sealed chamber. The passive exercise device described. The passive exercise device according to claim 1, wherein the joint position fixing means includes a glove and fixes a hand to the sealed chamber. The passive exercise device according to claim 1, wherein the joint position fixing means has a sleeve, and a joint is inserted into the sleeve to fix the joint to the sealed chamber. The apparatus further comprises at least one post embedded in the foamed portion at a selected location relative to a joint to prevent contraction of the foamed portion in a transverse direction relative to the joint. Item 2. The passive exercise device according to Item 1. A passive exercise device for moving a patient's joint having a flexion side and an extension side ,
a. A first foamed portion formed to fit the extended side of the joint;
b. A second foamed portion formed to fit the bent side of the joint;
c. A first casing enclosing the first foamed portion to form a first sealed chamber;
d. A second casing enclosing the second foamed portion to form a second sealed chamber;
e. A joint position fixing means for determining a position of the joint relative to the first and second sealed chambers, wherein the first and second sealed chambers controllably move the joint. 2. A passive motion device operatively connected individually to a pressure reducing and releasing pressure of the first and second sealed chambers to selectively contract and expand the foamed portion . The passive motion device of claim 13, wherein the first and second foamed portions include open cell foamed portions. The passive exercise device of claim 13, wherein the first and second foamed portions comprise sponges. The first foamed portion includes a plurality of portions having different rigidity so as to be fixed at different positions with respect to the joint, and during the decompression and release of the first and second sealed chambers The passive motion device according to claim 13, wherein the motion of the joint is controlled. The second foamed portion includes a plurality of portions having different rigidity so as to be fixed at different positions with respect to the joint, and during the decompression and release of the first and second sealed chambers The passive motion device according to claim 13, wherein the motion of the joint is controlled. The passive motion device according to claim 13, wherein the first casing includes a thin plate around the first foamed portion to form the first sealed chamber. The passive motion device according to claim 13, wherein the second casing includes a thin plate around the second foamed portion to form the second sealed chamber. The passive motion device according to claim 13, wherein the first casing has a coating covering the first foamed portion to form the first sealed chamber. The passive motion device according to claim 13, wherein the second casing has a coating covering the second foamed portion to form the second sealed chamber. The passive exercise device according to claim 13, wherein the joint position fixing means includes a glove and fixes a hand to the first and second sealed chambers. The passive exercise device according to claim 13, wherein the joint position fixing means has a sleeve, and a joint is inserted into the sleeve to fix the joint to the first and second sealed chambers. The device further comprises at least one post embedded in the first foamed portion at a selected position relative to the joint, wherein the first foamed portion is transverse to the joint. The passive exercise device according to claim 13, which prevents contraction. The apparatus further comprises at least one strut embedded in a selected position in the second foamed portion relative to the joint, wherein the second foamed portion is transverse to the joint. The passive exercise device according to claim 13, which prevents contraction. A pump operatively connected to the sealed chamber to selectively depressurize and release the sealed chamber;
Depressurizing the sealed chamber to contract the foam portion to move the joint from a predetermined position toward a selected position, returning the joint to the predetermined position, and expanding the foam portion The passive exercise device according to any one of claims 1 to 12, further comprising a pump for releasing the pressure reduction of the sealed chamber in order to make it possible. In order to selectively contract and expand the first and second foamed portions for controllable movement of the joint, the first and second sealed chambers are individually depressurized and released to release the depressurization. The passive exercise device according to any one of claims 13 to 25, further comprising a pump operatively connected to the first and second sealed chambers.

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