RU2657375C1 - Simulator for improving microcirculation of human blood - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medical equipment and can be used independently or in the complex treatment and rehabilitation of patients with impaired peripheral circulation. Simulator for improving the microcirculation of human blood comprises a lounger and a support element provided with frames, to which actuators providing movement of the lounger are attached. Lower part of the support element is a base in the form of a rectangular flat frame structure to the ends of which, with the help of bolts, legs, increasing a simulator resting base, are attached, and equipped with two vertical supports with struts mounted opposite each other on long sides of the base closer to the corners. On the axis connecting the vertical supports with the help of bearings, a rocker arm is fixed, the upper part of the rocker arm has a rectangular shape. Longitudinal sides of the rocker arm are equipped with linear guides for longitudinal movement of the top frame, there is a rotatable frame above, with the possibility of rolling around the longitudinal axis and equipped with transverse guides, providing transverse movement of the top frame. Actuator, providing rolling of the rocker arm which, is fixed between the base and rocker arm, actuator, providing linear longitudinal movement, is fixed between the longitudinal movement frame and rocker arm, actuator, providing rolling around the longitudinal axis, is fixed between the rotatable frame and rocker arm, actuator providing linear transverse movement is fixed between the rotatable frame and transverse movement frame.

EFFECT: invention provides an effective recovery of peripheral circulation.

8 cl, 6 dwg

Description

Field of Invention

The invention relates to medicine and can be used independently or in the complex treatment and rehabilitation of patients with peripheral circulation disorder.

State of the art

One of the most pressing problems of scientific medicine and practical health care of the 2nd half of the 20th century and the beginning of the 21st century are diseases of the circulatory system. These diseases take the 1st place among all causes of death in most economically developed countries of the world, including Russia. In our country, diseases of the circulatory system take the first place among the causes of disability and death.

A known method of treatment and prevention of vascular insufficiency of the brain and body tissues by the orthostatic method (Roslomy L.K. The art of healing, published http://www.xliby.ru/zdorove/iskusstvo_vrachevanija/p12.php), which consists in the fact that the patient is placed on a special table with a triangle at the base, on the top of which a flat surface with soft and volumetric casing is installed and fixed, which can change the angle of inclination of the working surface relative to the fixed triangular base - alternately raise and lower g Karlovna end of the table. The table is equipped with a belt, which, together with the soft upholstery of the table, did not allow the patient to slide on the surface when he inclined. The patient lies with his back on the table, fixed in a neutral position, when the head and foot ends of the table are at the same level and the plane of the table is horizontal. After fixing the patient’s body with a belt, lower its head end at a certain speed down to an angle of 5 to 30 degrees. Holding the table in the extreme position for about 10 seconds, raise the head end to a horizontal level and then up to an angle of the same magnitude. The retention time of the head end of the table in the upper position may be equal to the retention time in the lower position or longer. Alternating these movements for a certain time, complete the procedure by holding the head end of the table in the upper position.

The disadvantage of this method is that the static gravitational effect on the upper half of the body causes reflex reactions in the form of increased blood pressure and impaired venous outflow from vital organs. With this treatment, there is no improvement in the microcirculation of the brain, heart and lungs, and there is a serious flow of blood to the skin.

The inversion table is described in the patent for utility model RU 145871. The inversion table for the therapeutic effect on the patient consists of a support element to which a tabletop with a frame is attached through hinges; two drives providing complex rotations of the countertop in two planes; a mattress placed on the countertop with buttons for attaching to the countertop. The device is also equipped with fasteners, which are soft straps for fixing the patient in the pelvis and hips, and a device for breeding the patient's hips made of soft materials.

The disadvantage of this design of the table is the inability to ensure continuous movements and in this regard, the insufficiently high efficiency of the restoration of peripheral circulation.

The developed simulator design allows you to create a spiral mode, that is 3D. With this effect, continuity of movement is created. Thereby, a greater microcirculation restoration effect is achieved. The restoration of microcirculation now occurs continuously throughout the entire cycle of the procedure, whereas in the previous model this cycle was intermittent at the moment the actuator reached a fixed position.

The continuous movements of the simulator are most similar to physiological oscillatory rhythms, which have the form of a sinusoid. Such an effect causes the most pronounced resonant response from the body. The use of three-dimensional oscillations in the new model allows to accelerate the manifestation of a positive clinical effect, that is, reduce the number of treatment procedures in one cycle to 5-8, moreover, patients tolerate the procedure, there are no unpleasant sensations during the first two treatment sessions, which is observed in some cases on the old inversion table model.

Brief Description of Drawings

In fig. 1-5 shows the basic elements of the simulator.

Picture 1

In fig. 1 shows the appearance of the simulator, the control panel - 24, the orthopedic mattress - 26.

The control panel increases the convenience of controlling the simulator by both the clinic staff and private owners.

Figure 2

In fig. 2 shows the base 1, which is intended for:

- transmission to the vertical supports 2 with braces of the arising loads from the plank bed with the patient in the positions allowed by the procedure;

- articulating the rocker 4 on it and ensuring the stability of its position in space during the procedures;

- hinged on it the actuator (engine) of the actuator 7 of the rocker arm 4, for longitudinal rolling (around the transverse axis);

In fig. 2 also shows a beam 4, to which a linear actuator 8 is pivotally mounted to move the frame of longitudinal movement 5.

The base is made of a rectangular flat frame structure with two vertical supports 2 rigidly fixed on it.

Legs 3 are attached to the ends of the base, which allow to increase the support base of the structure.

The legs are removable to reduce the transport width of the base.

Rocker 4 is designed for:

- articulating on it a frame of longitudinal movement 5,

- mounting linear guides on it 6.

The rotation of the beam is provided by two pairs of bearings mounted on the axis 9 and fixed in the beam 4.

A protractor 20 is fixed on the beam (Fig. 3), which serves to accurately determine the passage of the angle of inclination of the beam 4 of longitudinal rolling (the measurement error of the displacement is 0.02 degrees).

Figure 3

The rotary frame 10 is designed for lateral rolling (around the longitudinal axis) and for fastening the transverse movement frame 11 on it (Fig. 4).

The rotary frame is equipped with two linear guides 12 for the movement of the frame of the transverse movement 11 (Fig. 4) by means of the actuator 13 (Fig. 4).

A protractor 20 is mounted on the rotary frame, which serves to accurately determine the passage of the angle of inclination of the transverse rolling (around the longitudinal axis) (the measurement error of the displacement is 0.02 degrees).

The actuator 16 is attached to the rotary frame, ensuring the tension of the patient's seat belt 18 (Fig. 5).

Figure 4

In fig. 4 are shown:

- frame transverse movement 11 for movement in the third plane (along the transverse axis);

- linear actuator 13 for lateral movement;

- the base of the sunbed 25 is mounted with a displacement in the longitudinal direction to the frame of the transverse movement 11 and is used for rigidly fastening the sunbed 14 (Fig. 5).

Figure 5

In fig. 5 displayed

- lumbar bandage 17 for lumbar patient attachment during the procedure;

- the patient’s seat belt 18, which serves to attach the lumbar brace to it 17. The belt 18 is tensioned by a linear actuator 16 (Fig. 3);

- the fence of the sunbed 21, which serves as additional protection for the patient from falling during the procedure (the main one is the patient's seat belt 18 and the lumbar bandage 17).

- panel 22, which is a decorative fence to create a favorable appearance and protect against unauthorized penetration of the patient to the mechanical and electrical parts of the simulator;

- the box for electronics 23 serves to protect the electronic control unit of the simulator from unauthorized entry of the patient.

Fig. 6

Figure 6 shows a general view of the angiotrainer in two projections with the specified overall dimensions.

SUMMARY OF THE INVENTION

The simulator for the restoration of peripheral blood circulation consists of a lounger and a supporting element, equipped with frames, to which actuators are attached, providing movement of the lounger. The lower part of the support element is a base in the form of a rectangular flat frame structure, to the ends of which with legs and nuts are attached legs that increase the support base of the simulator, and equipped with two vertical supports with struts mounted opposite each other on the long sides of the base closer to the corners. On the axis connecting the vertical bearings, using bearings, a beam is installed, the upper part of which is in the form of a rectangular frame, the longitudinal sides of the beam are equipped with linear guides for longitudinal movement of the frame located on top. A rotary frame is located above the frame of longitudinal movement, with the possibility of rolling around the longitudinal axis and equipped with transverse guides providing lateral movement of the frame located on top. The sunbed is equipped with a base, which is rigidly attached to the base of the sunbed (25), and it, in turn, is rigidly attached to the frame of the transverse movement (11).

The sunbed is offset in the longitudinal direction relative to the support element and is provided with a fence for convenience.

The simulator can be equipped with a fastener in the pelvic area.

The fastener in the pelvic region is preferably a seat belt with a lumbar brace. The actuator for tightening-releasing the seat belt is attached to the swing frame.

The simulator is equipped with a control unit located at the bottom of the support element and connected to the control panel.

The beam and swing frame can be equipped with goniometers.

The actuator that provides the rocker arm is fixed between the base and the rocker arm. An actuator providing linear longitudinal movement is fixed between the frame and the beam. The actuator, providing rolling around the longitudinal axis, is fixed between the rotary frame and the beam. The linear transverse actuator is secured between the pivot frame and the transverse frame.

On the beam 4, linear guides 6 are installed, to the sliders of which the longitudinal movement frame 5 is attached.

The longitudinal movement frame 5 has eyelets, with the help of which the rotary frame 10 with bearings installed in the bushes is mounted by installing axles and nuts (Fig. 3, view A).

On the rotary frame 10, linear guides 12 are installed, to the sliders of which the transverse displacement frame 11 is attached. The base of the sunbed 25 is attached to the transverse displacement frame.

This type of simulator differs from the utility model in the following parameters:

1. Removable lounger - allows you to reduce the portable weight of the table, and also allows you to bring the table into the doorways with a width of 750 mm, which is very important, since most doorways have a size of 2000 × 900 mm.

2. The sunbed, is equipped with a base, which allows you to rigidly fasten the sunbed to the frame with no backlash. This provides a clear passage of cycles. In the well-known utility model, a sunbed and a swivel frame were rigidly attached. During transportation, it was necessary to disconnect the fasteners of the actuators and the rotary frame in order to bring the table into the doorway of less than 1100 mm. In this case, the settings of the angle sensors were lost and, as a result, there was a need to reconfigure the software. This design allows you to set the settings during assembly, which do not go astray during transportation.

3. Goniometers allow you to accurately set the angle without being tied to the engines when writing software. Goniometers allow you to write a linear mathematical model of engine control (actuator). The mathematical model of engine control does not always have a linear model.

4. Removable legs allow you to reduce the transport dimension of the base.

5. Protections allow the patient to stay more safely during the procedure.

6. The tension mechanism allows maintenance personnel not to waste strength on pulling up - releasing the patient.

7. The distance from the floor to the level of the sunbed is reduced by reducing the height of the support element. This fundamental solution allows you to get rid of any devices for lifting the patient on the table. The utility model was relatively high at about 900 mm. I had to use a step for the patient, which is not very convenient. Now, even a not very tall patient can calmly climb onto the table.

8. The lounger and the base of the lounger are offset relative to the support element in the longitudinal direction to ensure a safe distance between the floor and the lounger in the working position at an inclination angle of 30 °.

9. Added an additional frame for lateral movement to move in the third plane.

10. The linear actuator of the transverse frame drive has been added.

11. Added an additional frame for longitudinal movement to move in the fourth plane

12. A linear actuator for the drive of the longitudinal movement frame has been added.

Key Specifications

The simulator complies with the requirements of GOST 20790, technical specifications TU BY 192389051.001-2015, working drawings and a set of design documentation.

The simulator provides the required operating mode with a uniformly distributed maximum working load of up to 150 kg.

The time for establishing the operating mode of the simulator is no more than 20 s.

The simulator provides the following mode of operation: 20 minutes - work, 10 minutes - pause, for at least 8 hours a day.

The average life of the simulator is at least 5 years. The criterion for the ultimate state of the simulator is the impossibility or economic inappropriateness of its recovery.

Type of climatic modification of the simulator - UHL 4.2 according to GOST 15150.

For safety, the simulator meets the requirements of GOST 20790-93, STB IEC 60601-1-1-2005, GOST 30324.0-95, protection class I, degree of protection of the working part B.

According to electromagnetic compatibility, the simulator complies with STB IEC 60601-1-2-2006.

Simulator design and operating modes

The simulator consists of a supporting element 1 (Fig. 2) and a lounger 14 (Fig. 5), which is the surface for placing the patient in a prone position. On four adjacent sides, the lying surface is bounded by the backs of the fence 21 (Fig. 5) for the convenience and safety of the patient. Orthopedic mattress 26 (Fig. 1), made of a material with the effect of shape memory, allows you to feel as comfortable as possible during the procedure. A lumbar bandage 17 is also attached (Fig. 5), fixing the patient to the seat belt, traction under the influence of their own body weight. The appearance and device of the simulator are shown in Fig. 1-5.

The simulator has five actuators. The actuator for lateral rolling 15 and the actuator for longitudinal rolling 7 have a load capacity of at least 600 kg each.

Actuator 7 (Fig. 2), fixed between the base 1 (Fig. 2) and the beam 4 (Fig. 2), provides rolling in the longitudinal direction.

Actuator 8 (Fig. 2), fixed between the beam 4 (Fig. 2) and frame 5 (Fig. 2), provides a linear movement of the lounger along the longitudinal axis of the simulator.

Actuator 15 (Fig. 3), fixed between the beam 4 (Fig. 2) and the pivoting frame 10 (Fig. 3), ensures the rolling of the lounger in the transverse direction.

Actuator 13 (Fig. 4), mounted between the rotary frame 10 (Fig. 3) and frame 11 (Fig. 4), provides a linear movement of the lounger along the transverse axis of the simulator.

Using the actuator 16 (Fig. 3), mounted on the rotary frame of the sunbed 10 (Fig. 3), the tension (weakening) of the patient fixation belt is provided.

The supporting structure of the simulator is made of steel pipes coated with powder paint of the highest grade, which ensures safety during use. At the bottom of the base of the simulator is an electronic power and control unit.

In the manufacture of the electronic circuit of the control unit of the inversion simulator, modern highly stable electronic elements were used. Thanks to this, the simulator’s high reliability, its safety, small dimensions, weight and, as a result, ease of use are achieved.

The simulator is controlled using the remote control 24 (Fig. 1).

The simulator kit is included in the kit. Additionally, for the comfort of the patient, soft ottomans (fences) are placed on the mattress along the long and short sides of the lounger.

Devices for diluting the patient's hips are in the form of a tetrahedron, which allows the patient's hips to be diluted at an angle of 30 or 45 degrees, and are made of materials that do not injure the patient and do not allow compression of the main neurovascular bundles.

Operating mode (movement parameters of the bed base)

The simulator works continuously, with a given cycle, performing reciprocating movements and movements along the transverse axis and the longitudinal axis, and also the lounger moves in the third plane to the right - to the left, and back - forward. When there is a downward movement, 1 second before the end of lowering the frame begins to move longitudinally forward. When moving the frame of the longitudinal movement forward 1 second after moving back up the lounger, the frame of the longitudinal movement begins to move backward. Thus, there is a continuity of movement up and down and back and forth. The same movement occurs with the frame transverse movement. When moving the lounger to the right 1 second before the end of the movement to the right, the frame of the transverse movement begins to move. Further, the frame of the transverse movement returns back when the lounger begins to move back up. The same movement to the left for the sunbed and the frame transverse movement. The mini-cycle of moving the base of the lounger to the right and left relative to the longitudinal axis is repeated until it tilts about 30 ° relative to the transverse axis. Upon reaching an angle of 30 °, the cycle of movements continues in the reverse order until the base of the lounger returns to its original horizontal position.

The full working cycle of moving the base of the sunbed (at an angle of 30 ° and then back to horizontal position) is 20 minutes.

The simulator is used as follows:

- after connecting to the power supply and pressing the on / off button (ON / OFF), the simulator is automatically calibrated on the control panel;

- automatic calibration is carried out after each connection to the network and pressing the ON / OFF button. After the end of automatic calibration, the sunbed of the simulator becomes automatically in a horizontal position;

- the patient is laid on the lying surface of the simulator with a pillow under his head in a position on the right side with bent lower extremities in the hip and knee joints and fixed with a seat belt to prevent its displacement;

- between the thighs in the proximal part is placed a device for diluting the patient's hips (tetrahedron), due to which the angle of dilution of the hips is 30 or 45 degrees;

- after placing the patient and starting the simulator with the help of drives (actuators), the lounger begins to make a cycle of movements in three planes. Stage-by-stage inclinations and rises of a plank bed in the longitudinal and transverse direction, and also linear movements in the specified directions are carried out;

- as a result of a ten-minute cycle of such movements, the sunbed gradually tilts the patient with his head downward at an angle of 30 degrees, after which he performs similar cycles of movements to return him to his original (horizontal) position for 10 minutes.

The ability to restore peripheral circulation is confirmed by the following examples.

Example 1

Patient N., 46 years old, complained of swelling, a feeling of heaviness in the lower extremities. Objectively: in the region of both lower extremities, dilated veins in the basins of the large saphenous veins, multiple telangiectasias, feet and the lower third of the legs are determined to be pasty. Ultrasound revealed an expansion of the mouths and trunks of large saphenous veins. The patient underwent a treatment consisting of six sessions of gravitational therapy using an angiotrainer. A clinical examination revealed the absence of edema in the feet and lower legs, a decrease in the contouring of the dilated veins. According to the results of ultrasound: a significant reduction in the diameter of the trunks and mouths of the large saphenous veins.

Example 2

A 72-year-old patient complained of sleep disturbance, poor physical exercise tolerance, and an increase in fasting blood glucose up to 7.5 mmol / L, despite the constant use of drugs. The patient underwent 5 sessions of gravitational therapy on an angiostrainer. At the end of the cycle, she noted a significant improvement in sleep quality, good exercise tolerance. Over the next week, a regular control measurement of fasting blood glucose was performed. The average value of this indicator during the week was 5.7 mmol / L. Correction of drug therapy during treatment was not performed.

Example 3

A 44-year-old patient has 3 history of stroke in the basin of the left middle cerebral artery. Last ONMK - 2 years ago. At the time of examination: right-sided paraparesis, sensory-motor aphasia. The patient was treated on an angiostrainer. Already after the fifth session, an increase in the range of movements in the right upper limb was noted, the number of pronounced sounds increased.

Thus, the use of the simulator in the treatment of diseases, conditions caused or accompanied by impaired peripheral circulation, can significantly increase the therapeutic effect.

Claims (8)

1. A simulator for improving microcirculation of human blood, consisting of a sunbed and a support element, equipped with frames to which actuators are attached, providing movement of the sunbed, characterized in that the lower part of the support element is a base in the form of a rectangular flat frame structure, to the ends of which with the help of bolts, legs are attached that increase the support base of the simulator, and equipped with two vertical supports with struts mounted opposite each other on the long sides of the base closer to the corners, n of the axis connecting the vertical bearings with bearings, a beam is fixed, the upper part of which is rectangular, the longitudinal sides of the beam are equipped with linear guides for the longitudinal movement of the frame located above, the rotary frame is located above, with the possibility of rolling around the longitudinal axis and equipped with transverse guides providing transverse the movement of the frame located on top, while the actuator, providing the rocker arm, is fixed between the base and the arm, act op that provides a linear longitudinal movement between the fixed frame and the longitudinal movement of the rocker, the actuator providing rolling about the longitudinal axis is secured between the pivoting frame and the yoke, the actuator providing a linear transverse movement, is secured between the pivoting frame and the frame lateral movement. 2. The simulator according to claim 1, characterized in that the lounger is offset in the longitudinal direction relative to the support element. 3. The simulator under item 1, characterized in that the lounger is equipped with a fence. 4. The simulator according to claim 1, characterized in that it is equipped with a fastener in the pelvic region. 5. The simulator according to claim 4, characterized in that the fastener in the pelvic region is a seat belt with a lumbar bandage. 6. The simulator according to claim 5, characterized in that an actuator is attached to the rotary frame for tightening and releasing the seat belt. 7. The simulator according to claim 1, characterized in that it is equipped with a control unit located in the lower part of the support element and connected to the control panel. 8. The simulator according to claim 1, characterized in that the beam and the swinging frame are equipped with goniometers.

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