MXPA96003571A - Apparatus and method for the continuous passive motion of the lum region - Google Patents

Abstract

An apparatus for cyclically moving the lower back of a person, through a substantial margin of lordosis, characterized the apparatus because it comprises: a substantially static structure adjacent to the back of a person, a force application apparatus placed between the structure static and the person's back, the force application apparatus includes a back-engaging surface, movable in a cyclical manner to increase and decrease the distance between the static structure and the back-engaging surface, thereby Cyclically moving the lower back through the margin of lordosis, and a transducer that has a forceful exit response between the mating surface to the back and the lower back, the force application apparatus responds to the output of the transducer for control the force applied to the back and also includes the programmable circuitry to control the force, to be a pre-selected function of time

Description

APPARATUS AND METHOD FOR THE CONTINUOUS PASSIVE MOVEMENT OF THE LUMBAR REGION BACKGROUND OF THE INVENTION This invention relates to a method and an apparatus for the provision of continuous passive movement to the body, and more particularly to the lumbar region of the spine. U.S. Patent No. 4,981,131 issued to one of the inventions herein, describes the apparatus for oscillating the lumbar region of the spine through a substantial margin of lordosis, in order to relieve pain of the lower back. The teachings of this patent are incorporated by reference herein. In this patent, an air chamber or inflatable bag in contact with the back is pressurized and depressurized to effect the substantial change in the lordosis. There was no provision, however, to measure and control the force applied to a person's back throughout the inflation and deflation cycles. Therefore, the teachings in this patent could not easily accommodate variations in a person's flexibility, posture, and spinal position during spinal mobilization. This patent also did not show the adjustment of the location of REF: 22946 the air chamber or bag to accommodate different individuals.

; - • BRIEF DESCRIPTION OF THE INVENTION The apparatus for subjecting the lower back of a person to cyclic movement through a substantial margin of lordosis, includes a substantially static structure adjacent to a person's back, and an apparatus for the application of force placed between the static structure and the body. back. The force application apparatus includes a cyclically movable back-engaging surface to increase and decrease the distance between the static structure and the back engaging surface, thereby moving the lower back cyclically through of the margin of lordosis. A transducer is provided that has an output response to the force between the mating surface to the back and the lower back. The force application apparatus responds to the output of the transducer, to control the force applied to the back. In a preferred embodiment, the apparatus further includes the programmable circuitry for controlling the force to be a preselected function of time. In this embodiment, the apparatus includes the set of synchronization circuits to provide a period of increase in force, to increase the force applied to the back to a preselected maximum, and a period of decrease in force to * decrease the force on the back . A third period of substantially constant force can be provided between the force increase period and the force decrease period. In one embodiment, the force application apparatus includes an inflatable and deflatable bag or air chamber, and the transducer responds to pressure within the air chamber. A pump supplies a fluid to inflate the air chamber, and a valve communicating with the air chamber is provided to deflate the air chamber. It is preferred that the site of the back engaging surface be adjustable in height, so that the force engaging surface can be adapted to the lumbar region of a particular person. In other embodiments, the force application apparatus includes a rack and pinion arrangement or a mechanical cam to cyclically increase and decrease the force on the person's back. In these mechanical modalities, the force transducer is a load cell.

The force feedback of the present invention allows a maximum force to be preselected by the user to accommodate the elasticity of the spine of that particular user, and other factors.

BRIEF DESCRIPTION OF THE DRAWINGS Figure 1 is a cross sectional view of one embodiment of the apparatus described herein.

Figure 2 is a schematic illustration of the arrangement of the components for the apparatus of the invention.

Figure 3 is a schematic illustration of the functional relationship between the components of the apparatus of the invention.

Figure 4 is a graph of the support pressure as a function of time.

Figure 5 is a logical diagram for the force feedback.

Figures 6 and 7 are diagrams of the return r, of the main program and the return of the interruption process.

Figure 8 is a cross sectional view of a cam operated mode of the invention.

Figure 9 is a cross sectional view of a rack and pinion embodiment of the present invention.

Figures 10, 11 and 12 are perspective views of one embodiment of the invention, which allow adjustment of the site of the inflatable air chamber.

Figure 13 is a perspective view of one embodiment of the invention, including multiple air chambers.

Figure 14 is a cross-sectional view of the embodiment of Figure 13.

Figure 15 is a perspective view of an embodiment of the invention, which allows mechanical adjustment of the site of the inflatable air chamber.

Figure 16 is a cross-sectional view of the embodiment of Figure 15.

Figure 17 is a cross-sectional view of a modality for supine use.

DESCRIPTION OF THE PREFERRED MODALITY Referring first to Figure 1, a person 10 sits in a seat 12 having a lower support 14 and a backrest portion 16. The seat 12 can typically be a car or other vehicle seat (airplane, boat) or, for example, an office chair. Placed between the person 10 and the backrest 16 in this mode, there is a device 18 of continuous passive movement. As will be clearer below, the device 18 includes the cyclic movement apparatus of the lumoar region 20 of the person 10, to cyclically move the lower back or lumbar region 20, through a substantial margin of lordosis. As discussed in detail in the applicant's prior US Patent No. 4,981,131, the research indicates that the continuous passive movement of the lower back through a substantial margin of lordotic movement decreases the pain of the lower back. Such movement is not massage, which refers merely to the superficial tissues, but it constitutes the movement of the vertebrae one with respect to the other. Because spinal elasticity varies among individuals in a population, an appropriate force for one individual may be insufficient or excessive for another person. The present invention recognizes these differences and provides preselected power versus time patterns to accommodate such variations in the general population. Figure 2 is a schematic representation of the arrangement used in a commercial version exemplifying the present invention, and available from Ergomedics, Inc. of Winooski, Vermont, assignee of the present application. In this embodiment, a pump 22, available from Appollo Enterprises, Inc., Ontario, Califor- nia, model 5000, is preferably an alternating current (AC) pump of 12 volts, similar to those used for the aeration of tanks. fish. It is preferred that pump 22 be an alternating current pump, because alternating current pumps are less expensive than their direct current counterparts. A control circuit board 24 or processor, synthesizes the appropriate alternating current power, which is supplied to the pump 22 through the conductors 26. The processor board 24 operates with a direct current of 12 volts supplied, for example. , through the cigarette lighter in a car. Processor 24 converts the direct current from 12 volts to a four-phase square wave of alternating current, for the operation of the pump 22. The four-phase square wave changes from plus 12 volts for 6.92 milliseconds to 0 volts for 1.54 milliseconds, at minus 12 volts for 6.66 milliseconds, at 0 volts for 1.54 milliseconds, again at plus 12 volts, etc. Through this process a waveform substantially 60 Hz is created. Suitable pumps may be in the range of 10 to 150 Hz. It is preferred that the flow rate be in the flow rate range of 4 to 6 liters per minute, with a minimum pressure of 150 millimeters of mercury. The pump 22 supplies air to an air chamber or bag 28 through a flexible tube 30. A valve 32 communicates with the tube 30, and when opened allows air to flow out of the air chamber 28. It is an appropriate valve 32 is available, under the designation of part number B6673 of Bicron Electronics Company of Canaan, Connecticut. This valve is normally open and closed when a voltage or voltage is applied. This includes a return spring for positive opening. The apparatus 18 includes a pressure transducer 34 which is in fluid communication with the air chamber 28, through the pipe 36. A preferred pressure transducer 34 is a silicon wafer that provides a proportional control voltage. to the pressure in the air chamber 28. An appropriate pressure transducer is available from Fujikura Ltd., Japan, type FPN-07PG. With reference now to Figure 3, the apparatus 18 includes the operator controls such as the timer 40, the on and off buttons 42 and 44 respectively, and a pressure control 46. A light emitting diode (LED) 48 can be provided to indicate when the unit is operating. An important aspect of this invention is the ability to control the force applied to the lumbar region, to take into account variations in the elasticity or spinal flexibility of a user, and other factors such as variations in the sitting position. According to this embodiment of the invention, when the unit is turned on, the pump 22 starts to supply air to the air chamber 28, causing the pressure of the air chamber 28 to rise. This pressure is verified continuously by the pressure transducer 34. Because the pressure transducer 34 communicates with the air chamber 28 through a line separate from that used by the pump 22, the pressure transducer 34 is isolated from the low level pressure fluctuations, generated by the operation of the pump 22. The operator sets the desired pressure setting using the pressure control 46. The pre-selected pressure, adjusted by the user, will be maintained within plus or minus 4 millimeters of mercury with respect to the nominal setpoint. This pressure hysteresis is illustrated in Figure 4. Lines 50 and 52 are coupled to the nominal pre-selected pressure, which is adjustable to be in the range of 10 millimeters of mercury to 140 millimeters of mercury. In order to ensure proper operation, the pressure transducer 34 must have a sensitivity to pressure changes within the air chamber 28, of two millimeters of mercury. As shown in Figure 4, the system moves cyclically between two states, namely, a period of inflation and a period of deflation. A typical inflation profile is presented in curve 54. During this segment, the pressure and therefore the force on the back increases, to fall generally within the band defined by lines 50 and 52. There may be some small amount of overshoot or undershoot, depending on, for example, the user's movement. The time for inflation, which is to the left of a line 56, and that for the deflation, which is * to the right of line 56, can be adjusted by the user using the synchronizer control 40. A typical profile is 60 seconds of inflation followed by 60 seconds of deflation. During the time controlled inflating phase, to the left of line 56 in Figure 4, pump 22 fills the air chamber at a pressure within the band around the pre-selected set point. The system will adjust the volume of air in the air chamber in order to maintain a constant pressure in the air chamber, even if the user moves forward or backward in the seat. At the beginning of the cycle the pump 22 is turned on to start the filling of the air chamber 28, to increase the force to the back, to provide the substantial change in the degree of lordoses. If, for example, the user were to move backwards against the air chamber during this filling phase, thereby increasing the pressure above the preset pressure level, the valve 32 is opened to reduce the pressure until the pressure is within the preselected band. Similarly, if the user moves forward, away from the air chamber 28, thereby reducing the pressure in the air chamber below the preset pressure level, the pump 22 is activated to increase the pressure, that the pressure is again within the preselected band. At the end of the inflation period, the pump 22 is turned off and the valve 32 is opened to the atmosphere, allowing air to flow out of the air chamber 28, allowing the spine to relax to its "neutral" condition. " Figure 5 is a block diagram illustrating the logic described above with respect to Figure 4. The logic illustrated in Figure 5 is implemented by a turn of the main program, shown in Figure 6, and an interruption process lap shown in Figure 7. The components of a preferred embodiment of the BackCycler MR, will now be described. When the ON button 42 is activated by the user, the inflation cycle will begin. An optional sound transducer (not shown) will generate audiofrequency pulses at a frequency of approximately 600 Hz, with a duration of 0.13 seconds, and with an interval between the audio frequency pulses of 0.083 seconds. If the ON button 42 is depressed while the unit is already on, the timer 40 will reset a cycle counter at the beginning of the inflation cycle. Pressing the shutdown button 44 will turn off the unit, and this can be signaled by a simple audio impulse that lasts 0.13 seconds, to alert the user that the unit has been turned off. The preselected desired pressure in the air chamber 28 is adjusted by the pressure control 46, which is an adjustable linear potentiometer, in this mode. The potentiometer in the pressure control 46 can be adjusted between 1 and 5, for a total resolution of 130 discrete points on the full scale. One on the scale represents 10 millimeters of mercury, and 5 represents 140 millimeters of mercury on this linear scale. The pressure control potentiometer 46 can be adjusted while the unit is operating. In this case, if the potentiometer is adjusted in the negative direction by any amount, the valve 32 will automatically open to decrease the pressure, thereby decreasing the force on the back. Conversely, if the potentiometer is adjusted in the positive direction by any amount, the pump 22 will automatically increase the pressure in the air chamber 28, notwithstanding the phase of the cycle in which the unit is then currently operating. The light emitting diode (LED) 48 is turned on when the unit itself is turned on. Once lit, the LED indicator 48 remains on until the unit is turned off or is automatically turned off. The time cycle can be adjusted by timer 40 between 10 seconds and an infinite period. When the timer 40 is set to the infinity inflation time period, the force application apparatus acts as a static support which actively controls the amount of force to the back. In this state, the force will be controlled continuously, as long as the device is turned on. The cycle of time is defined as a complete inflation and deflation cycle, and with infinite adjustment the unit can be used as a static lumbar support. The processor board 24 is powered by a 12 volt direct current source, and while the unit is off, the processor is continuously running in a sleep mode. The maximum current draw or extraction in the standby mode is less than or equal to approximately 15 milliamps. At this level of intake, a typical car battery could last 1500 hours. The processor board 24 performs the on-board diagnostic test to ensure proper operation. In a test mode, the following components are verified: processor, gate verification, valve verification, pump verification, loudspeaker verification, zero calibration of the look-up table system, 100-millimeter calibration test of mercury, and a check to confirm that the full range of 0 to 140 millimeters of mercury can be read. The unit also includes protection against voltage or voltage. In particular, a voltage above 18 volts will be set and will cause a fuse to trip (not shown). If the voltage should fall below 9.8 volts, the processor board 24 turns off the pump 22 to provide protection to the field effect transistor (FET) (not shown). The valve 32 and the pressure transducer 34 will remain operative under these conditions. If the voltage drops below 4.6 volts on a 5 volt line to the processor board 24, then the processor is readjusted and maintained until the voltage goes above 4.6 volts. Once the voltage is greater than 4.6 volts, a delay of 0.2 seconds is observed before the processor is re-started. The suppression of radio frequency (RF) noise is provided in the FET during the 60 Hz modulation of the pump 22. A capacitor (not shown) is provided to act as a 60 Hz noise suppression filter. An automatic shutoff can be provided if a person is not seated against the air chamber 28, for a selectable period of time, such as for 12 seconds. Referring now to Figure 8, a continuous, mechanical, passive motion device 60 includes a motor 62 which drives a cam 64. Cam 64 moves a flexible panel 66 in and out to apply movement to the lumbar region. of the spine. A load cell 68 measures the force between the flexible panel 66 and the back of a person (not shown). The cam 64 is driven by a band 70 in contact with the motor 62. Another mechanical embodiment of the invention is shown in Figure 9. The apparatus 90 includes a motor 92 that drives a band 94. The band 94 rotates a pinion 96 which is coupled to a rack 98. By this means, a moving surface 100 can be moved inwardly and outwardly to engage the lumbar region of a user's spine (not shown). A cajrga cell 102 responds to force on the surface 100. The mechanical devices illustrated in Figures 8 and 9 operate in substantially the same manner as the pneumatic mode described above. As mentioned, the force is increased for a period, followed by a period of decreased strength, to move the lumbar spine through substantial margins of lordodis. With respect to Figures 10, 11 and 12, a modality is described that allows the placement of the force application member, to be adjusted to accommodate different individuals, or to the particular preference of a given individual. In these figures, a bracket or bracket 110 is adapted to receive a sleeve 112 which carries, in this embodiment, an inflatable bladder unit 1 4. The bracket or clamp 110 includes an extension portion 116 which is keyed between a seat cushion 118 and a seat backrest 120, of a seat that can be found in, for example, a car. The vertical portion of the bracket or bracket 110 is curved in a backward direction so that it engages the backrest 120 of a seat, when the extension portion 116 is properly keyed or inserted between a seat cushion 118 and the backrest 120 of the seat. The support 110 and the sleeve 112 include cooperating adherent structures (not shown) such as the crochet and curl structures commonly known as the Sailboat \ to fix the placement of the sleeve 112 with respect to the support 110 in the vertical direction, as shown in these figures. With reference to Figure 12, the placement of the sleeve 112 can be adjusted by inserting the fingers between the support 110 and the sleeve 112, at its lower portion, to release the crochet and curl material, after which the sleeve 112 is moved to a vertical deferential location, after which the crochet and loop structure is engaged again. In this way, the placement of the force application section 114 can be adjusted as desired by a user. The support is completely removable from the sleeve 112, so that the sleeve 112 can be placed on a substantially horizontal surface, such as a bed or floor for use in a supine position, as described below in conjunction with Figure 17 Yet another embodiment of the invention, which provides a selectable placement for the force application member, is shown in Figures 13 and 14. This embodiment is particularly designed to be construed within a seat such as portion 120. back rest, of a car. This embodiment includes a plurality of spaced apart air chambers 122, 124, 126 and 128. The user can select which of the air chambers to activate to adjust the height of the force application surface, as desired. The operation of each of the spaced air chambers is the same as the simple air chamber mode described in conjunction with the first figures in this specification. Yet another embodiment of the invention is shown in Figures 15 and 16. This design is also particularly suitable for an integral application within the backrest 120 of a vehicle seat, or other chair shape. An air chamber 130 is fixed to a flexible material 132, which is coupled to a rotary shaft 134. The shaft 134 can be manually rotated using a knob 136. As the knob 136 is rotated, the location of the air chamber 130 it moves up and down, as shown by the arrows in Figure 15, whereby the location or location of the air chamber with respect to a user is adjusted. Figure 17 illustrates the use of the present invention when the user is in a supine position. As shown in the Figure, a person 10 lies on his back on a substantially horizontal structure, such as a bed 150. The force application apparatus 118 applies force to the lumbar region 20 of the individual 10. The apparatus of force application 118 operates as described in conjunction with the other figures in this specification. As with the other embodiments, the force application apparatus 118 moves the spine in the lumbar region 20 through a substantial margin of lordotic movement, while the person 10 is lying down. It is recognized that modifications and variations of the present invention will be apparent to those skilled in the art, and it is intended that all such modifications and variations be included within the scope of the claims.

It is noted that in relation to this date, the best method known by the applicant to carry out the aforementioned invention, is the conventional one for the manufacture of the objects to which it relates. Having described the invention as above, property is claimed as contained in the following:

Claims (16)

1. / An apparatus for cyclically moving the lower back of a person, through a substantial margin of lordosis, characterized the apparatus because it comprises: a substantially static structure adjacent to the back of a person; a force application apparatus placed between the static structure and the back of the person, the force application apparatus includes a back-engaging surface, movable in a cyclical fashion to increase and decrease the distance between the static structure and the surface coupling to the back, with which the lower back cyclically moves through the margin of lordosis; and a transducer that has an output response to the force between the coupling surface to the back and the lower back, the force application apparatus responds to the output of the transducer to control the force applied to the back and also includes the programmable circuitry to control the - •• "•• '••• - - - • -;

2. The apparatus for cyclically moving the lower back of a person through a substantial margin of lordosis, characterized in that it comprises: a substantially static structure adjacent to the back of a person; a force application device placed between the static structure and the person's back, the force application apparatus includes a back-engaging surface, movable cyclically to increase and decrease the distance between the static structure and the surface of coupling to the back, with which the lower back moves cyclically through the margin of lordosis; and a transducer that has a forced exit response between the mating surface to the back and the lower back, the force application apparatus responds to the output of the transducer to control the force applied to the back, and also includes the set of synchronization circuits to provide a period of increase of force, to increase the force applied to the back to a preselected maximum value, and a period of force reduction to decrease the force on the back.

3. The apparatus for cyclically moving the lower back of a person through a substantial margin of lordosis, characterized in that it comprises: a substantially static structure adjacent to the back of a person; a force application apparatus placed between the static structure and the person's back, the force application apparatus includes a back-engaging surface, movable cyclically to increase and decrease the distance between the static structure and the coupling surface to the back, with which the lower back moves cyclically through the margin of lordodis; and a transducer having an output that responds to the force between the coupling surface to the back and the lower back, the force application apparatus responds to the output of the transducer to control the force applied to the back, and is also adapted to provide a period of strength increase, to increase the force applied to the back at a preselected maximum value, and to maintain the force value during the operation of the apparatus.

4. The apparatus according to claim 2, further characterized in that it includes a period of substantially constant force between the period of increase of force and the period of decrease of force.

5. The apparatus of cyclically moving the lower back of a person through a substantial margin of lordosis, characterized in that it comprises: a substantially static structure adjacent to the face of a person; a force application apparatus placed between the static structure and the person's back, the force application apparatus includes a back-engaging surface, movable cyclically to increase and decrease the distance between the static structure and the coupling surface at the back, with which the lower back moves cyclically through the margin of lordodis; and a transducer having an output that responds to the force between the coupling surface to the back and the lower back, the force application apparatus to the transducer outlet to control the force applied to the back, the apparatus of force application comprises an inflatable or deflatable bag or air chamber.

6. The apparatus according to claim 5, further characterized in that it includes a pump for supplying a fluid to isolate the air chamber, and a valve communicating with the air chamber, which deflates the air chamber.

7. The apparatus for the cyclic movement of the lower back of a person, through a substantial margin of lordosis, characterized in that it comprises: a substantially static structure adjacent to the back of a person; a force application apparatus placed between the static structure and the person's back, the force application apparatus includes a back-engaging surface, cyclically movable to increase and decrease the distance between the static structure and the coupling surface to the back, with which the lower back moves cyclically through the margin of lordosis; and a transducer that has an outlet that responds to the force between the mating surface to the back and the lower back, the force application apparatus responds to the transducer outlet to control the force applied to the back, where the location of the coupling surface to the back is adjustable in height.

8. The apparatus according to claim 5, characterized in that the transducer comprises a silicon insert adapted to provide a voltage signal proportional to the pressure.

9. The apparatus according to claim 4, characterized in that it includes a fluid pump for supplying fluid to the air chamber.

10. The apparatus according to claim 5, further characterized in that it includes an electrically operated valve for deflating the air chamber.

11. The apparatus for cyclically moving the lower back of a person through a substantial margin of lordosis, characterized in that it comprises: a force application apparatus that includes a back-engaging surface, cyclically movable to increase and decrease the force on the lower back, with which the lower back moves cyclically through the margin of lordosis; and the apparatus for adjusting the location of the mating surface to the back, with respect to the person's back.

12. The apparatus according to claim 11, characterized in that the adjustment apparatus comprises: a bracket or bracket including means for securing the bracket or bracket to a seating structure; and a sleeve including the force application apparatus adapted to slide on the support, the sleeve and the support include at least two cooperating, separate adhesion structures, whereby the position of the sleeve with respect to the support is adjustable.

13. The apparatus according to claim 12, characterized in that the support or clamp is removable from the sleeve, allowing the force application apparatus to be used on the substantially horizontal surface.

14. The apparatus according to claim 12, characterized in that the adhesion structures comprise elements of hooks and curls.

15. The apparatus according to claim 11, characterized in that the adjustment apparatus comprises: a flexible material that surrounds and engages a rotating shaft, the flexible material carries the force application apparatus; and a clamping structure fixed to the shaft to rotate the shaft, whereby the location of the force application apparatus is adjusted.

16. The apparatus for cyclically moving the lower back of a person, through a substantial margin of lordosis, characterized in that it comprises: a force application apparatus including at least two separate back coupling surfaces, each cyclically movable for increase and decrease the force on the lower back, which moves the lower back cyclically through the margin of lordosis; and the selection logic for selecting one of at least two separate surfaces for cyclic movement, which is adjustable by the location of the mating surface to the back.