SK160997A3 - Arrangement for determining the state of curvature of areas of the human body - Google Patents

Abstract

The invention concerns an arrangement (1) for determining the state of curvature of areas of the human body, in particular the curvature of the spine. The arrangement (1) takes the form of a biofeedback system, preferably for the treatment of scoliosis, and comprises a length-measuring element, measuring electronics (10), a sensing element (14) and a power supply source (16). In order to eliminate scoliosis damage in the medium term, the length-measuring element is an elongate extension-measuring rod (5) which is connected to at least one support element (6) and the measuring electronics (10), the elongate extension-measuring rod (5) being attached to the areas (4) of the patient's body whose posture or movement is to be measured. The measuring electronics (10) substantially consist of at least two electrically conductive sensors (11; 12) which can move relative to each other.

Description

BACKGROUND OF THE INVENTION The present invention relates to a device for detecting the curvature of human body areas, in particular spine curvature, by means of a biofeedback system, suitable in particular for the treatment of scoliosis, with at least one length measuring element, measuring electronics, signal transducers and energy.

BACKGROUND OF THE INVENTION

Scoliosis is defined as a partially fixed partial spine curvature that is comparable only at an early stage but stabilizes later. In addition to this lateral deflection, in particular in the case of idiopathic scoliosis in the area of the main curvature, there is a flat back as well as a rotational component of the individual parts of the spine, which are responsible for the rib back deflection and lumbar edema of the human body. Scoliosis is treated by various procedures.

In gymnastics performed with the sick, the programs of various exercises are limited to a 15 ° to 20 ° curvature angle. In many cases, however, it is not possible to prevent further intensification of scoliosis, and it is not possible to influence all scoliosis diseases by gymnastics.

In addition, a corset treatment exists, see for example EP-A-389 379. For this purpose, a number of different corset shapes have been developed, for example the so-called Milwaukee, Cheneau and Boston corsets. In order to exert pressure at certain points, such a corset for stabilizing the spine must be strong enough and relatively bulky and unpleasant when worn. Furthermore, its wearing leads to atrophy of the trunk muscles, which increasingly restricts patient mobility. Finally, wearing the corset can also cause permanent deformation of the ribs or soft tissue under the pressing points. Such corsets should be worn every 23 hours a day, until the skeleton is fully developed. The corset is usually worn for 3 to 4 years. Mostly, corsets are worn by young people and it is therefore understandable that some of these patients do not wear corsets for a sufficiently long time for aesthetic reasons. In addition, the cost of corsets is increasing, which needs to be changed and renewed more often in adolescents.

Reinforcement operations are less frequent, mainly because such an operation is risky.

Finally, electrostimulation treatment is also known. Daily or night stimulation is used, for example by means of an implanted system at an angle of about 15 ° to 30 °. This treatment was only partially enforced. It is not specifically aimed at patients suffering from scoliosis, but is mainly used to treat neurological diseases. However, according to more recent scientific information, electrostimulation treatment is unable to prevent progressive deformation of the spine.

In the so-called biological feedback system, the function of the inactive muscle group is to be maintained by enhanced activation of the still innervated parts, or by special training of agonist replacement functions. An example of such a feedback biosystem is mainly the system called EMG-Biofeedback by Basmajian and De Lucy (1985) Muscles alive. Their fúnctions revealed by Electromyography ', 5th Edition, Williams & Wilkons, Baltimore, USA. Depending on the indication position, the aforementioned treatments are performed either individually, but also at larger curvature angles.

So far, biological feedback systems have been used rarely in spinal deformation. Although they have been described in the literature as successful, they have not yet transposed. In the treatment of scoliosis, the biological feedback system of Dvorkina et al. (described by Wong, Upadhyay, Evans, Luke, Leong (1993) "predition of immediate effectiveness brace prior to its application for Adolescent Idiopathic Scoliosis" Preceedings of the 9 ^th International Symposium Phillip Zobar, Cambridge). This system is based on the recognition that along with the increase in curvature, body length is automatically reduced. Thus, it is a system comprising a longitudinal signaling device which must be mounted on the patient's torso. When the individually adjustable critical length of the individual's body is no longer reached, a signal tone sounds. This is achieved, inter alia, by providing a cable loop over the shoulders and below the crotch on the side and a second cable loop being guided around the torso. This principle has been described as effective but has not been enforced. It is possible that he has not transplanted because it is uncomfortable for the patient to wear a feedback loop throughout the crotch day.

Therapeutic measures, on the one hand, concentrate specifically on the growth stages of a young patient who is afraid of a significant increase in curvature in the short term, and on the other hand on an adult patient suffering from scoliosis. This is mainly about affecting the pain that limits the cardiorespiratory system and especially the worsening of the curvature that occurs after menopause. The abovementioned gymnastic procedures for the patients themselves may affect scoliosis in terms of affecting the curvature. This is evidenced by numerous studies. Thus, many curvature of the spine deviates from gymnastic measures, which must then be reduced by corsets or even stopped by surgery. They are not small

-3 Percentage of patients with progression. which cannot be detained by conservative measures. Even slowly increasing forms of scoliosis can often not be restrained by gymnastic measures. On the other hand, it is precisely for this group of patients that corsets are required. This entails considerable costs, from the first gypsum impression to the preparation of the straightening corset. A high percentage of cases are improperly designed and then the patient refuses to wear a straightening corset. This is due, on the one hand, to cosmetic factors, on the other hand, some patients cannot withstand the pressure exerted by the necessary pellets, even with appropriate skin treatment.

Schroth's three-dimensional scoliosis treatment (described by LehnertSchroth, 1991; "Dreidimensionale Soliose-Behandlung; Atmungs-Orthopädie Schroth System", Gustav Fischer Verlag, Stuttgart) pursues as a specific exercise for scoliosis of the spine the goal of maintaining effective correct posture throughout the day.

The curvature increases due to asymmetric pressure on the vertebral growth area, which in turn results in asymmetric body growth. On the other hand, it is believed that one-sided elongation of the articular sleeves and backbones contributes to the increase in curvature. Finally, scoliosis can also worsen due to escalating degenerative processes. The process of deterioration is always caused by the asymmetry of the spine, the cause of which is partly known, but is still unknown in idiopathic scoliosis. A prerequisite for the deterioration of curvature is obvious mechanical factors, which are supported by upright posture and the associated gravity effect on the curvature. The aim of Schroth's three-dimensional scoliosis treatment is to effectively counteract the deformation forces acting on the spine with its shell and band structures during normal daily activities as described above. Thus, the patient must be able to know when he is in an inappropriate position due to the curvature of his spine during the day, or when his or her torso is in such an inappropriate position. However, meeting this requirement in many patients suffering from scoliosis cannot be achieved in the long term due to their lack of intellectual capacity or little effort. For this reason, the principle of controlling the holding of the back must be supported by an apparatus.

It is also commonly necessary to avoid lateral bending of the spine, which increases the curvature as well as the rotation of the torso, which intensifies the rotation. It would thus be possible to implement the Schroth correction principle, by which existing curves are corrected from below.

Therefore, it is necessary to first influence the main curvature which is lying downwards towards the legs. Firstly, minor minor curves (lumbosacral counter-arc) are not taken into account. As soon as

It is also experienced that muscle adjusting reflexes for higher lying curvature, which also has a beneficial effect on it by increasing the muscle activity of the corrective muscle groups, are straightened.

SUMMARY OF THE INVENTION

SUMMARY OF THE INVENTION It is therefore an object of the present invention to provide a device for detecting the curvature of the human body regions which registers increments of the curvature and twist of the torso in the region between the thoracic and pelvic regions and the ribs. chest and pelvis.

This object is achieved according to the invention in that the length measuring element is at least one longitudinal extension rod connected to the at least one support element and the measuring electronics, the longitudinal extension rod being mounted on the areas of the body to be registered or measured and the electronics essentially consist of at least two electrically conductive sensors movable relative to one another.

Taking into account the fact that the cranial spine sections, i.e. the chest or cervical vertebrae area, can also be reflected by corrective correction of the spine, this device is suitable for favorably influencing the deformation of the spine as a whole above the reflective activation of the higher spine sections. Here, the extensible rod serves to transform mechanical deformations, namely to change the distance between the movable electrically conductive sensors to electrically inertible quantities, the length change being transmitted by the contact of the electrically conductive sensors to the signal transmitter. In this way it is possible to safely detect changes in body posture after fastening the device according to the invention. The signal emitter indicates that the predetermined deformation has been exceeded and thus forces the patient to adopt a more suitable position that will not be accompanied by the signaling device signal.

Although the device according to the invention is mainly intended for detecting the curvature or possibly for checking the misalignment and curvature of the spine, it also allows the control of the boundaries of the

movement of the joints, for example after surgery or movement therapy of muscle activity and intensity, such as shoulder, foot and pectoral muscles.

Advantageously, it is also possible in the device according to the invention to use two protruding rods which are spaced from one another and which are connected to a support element or a measuring electronics. In this case, one of the elongate rods is subjected to tensile stress and the other to compressive force, and both are connected in series with the measuring electronics, so that only one application of the measuring electronics is required for both elongated rods.

In a further embodiment of the invention, the elongate rod is fastened at one end thereof to one support element. At its other end, the elongate rod is slidably connected to the other support element.

To apply an electrical pulse to the signal transmitter, one of the electrically conductive sensors is disposed on the elongate rod and the other electrically conductive sensor on a support member to which the elongate rod is slidably connected. If, in a certain movement of the body, both electrically conductive sensors are connected, the current circuit in the measuring electronics is closed and the signal transmitter is started. For this purpose, the electrically conductive sensors are connected to a signal transmitter. The power source may be a battery or an accumulator, while the signal transmitter may be an acoustic and / or optical transmitter. For a better perception of the transmitter's acoustic or optical signal, the patient may be equipped with an earpiece or goggles incorporating a miniature lamp. The transmission can then be effected by means of a radio signal. In addition, the patient may be provided with a sound signaling means arranged on a portion of his suit. In addition, a number of other measures of how to sell an optical or acoustic signal to the patient are, of course, possible.

In a preferred further embodiment of the invention, the measurement electronics may be equipped with a time delay unit for the signal transmitter, for example with a delay of 10 seconds, so that the patient is not disturbed by the signal transmitter with every small movement.

In order to protect all or part of the device according to the invention from external influences, the whole device or the pull rod together with the supporting elements can be surrounded by a protective hose, thus substantially covering the entire system. The entire measuring electronics can be stored in the cavity of the protective hose. The protective hose preferably consists of a resilient plastic, for example a silicone plastic.

Since it is best if the entire system is arranged in a protective hose, the sensor may also be formed by the hose in the form of interposed tubes, and may additionally include measuring electronics, thereby achieving maximum material utilization. Protective hoses can slide together and the measuring electronics can signal the distraction or compression of the system.

Depending on the purpose of use, the support elements or the protective hose can be directly attached to the patient's skin by means of fasteners. As fastening elements, plasters, bandages or suction elements can be used.

In further use, the support members or the protective hose may be fastened to a resilient, for example, textile garment which surrounds the patient's body.

-6Hook-and-loop fasteners or snap fasteners can be used to fasten the supporting elements or the protective hose to the garment. In addition, the support elements can also be sewn on the garment. It is very advantageous for the device according to the invention that it can be fastened to the patient in a very simple manner. The device may also be mounted on the orthosis or additionally attached thereto. Furthermore, it is also possible to use an elastic T-shirt which is similar to that of the garment on which the device according to the invention is fastened. The T-shirt is conveniently equipped with a clamping device for measuring electronics including a power source and a signal transmitter. The T-shirt and the suit can be made of a lightweight material to accommodate the body contours. In doing so, they must lie tightly in the waist, without however squeezing or affecting the patient's breathing. When compared to a corset or other orthosis, wearing such a T-shirt or garment is considerably more comfortable, which is more acceptable to the patient, and more sustained treatment will ensure greater treatment success.

In another embodiment of the invention, the device may be implanted in a patient.

It is also possible to supplement this device with a transmitter device for remote transmission of the signal to control the change in patient posture, for example, for longer hospital therapy or larger field trials.

BRIEF DESCRIPTION OF THE DRAWINGS

Hereinafter, the invention is described in more detail, and an exemplary embodiment thereof is illustrated in the accompanying drawings. In the drawings, FIG. 1 shows a schematic representation of a device according to the invention applied to a patient; FIG. 2 is a schematic representation of another embodiment of the device of the invention applied to a patient; FIG. 3 schematically shows another embodiment of the device according to the invention, also arranged on the patient, and FIG. 4 is a list of the necessary material, as well as a specific 1: 1 measuring arrangement of the components of the device to be used on a patient.

DETAILED DESCRIPTION OF THE INVENTION

In FIG. 1 shows a device 1 according to the invention used in the case where the spine of a patient 2 has a kyphosis, so that the device 1 acts under tensile conditions. The device 1 according to the invention is fastened on the garment 3, which is threaded on the body of the patient 2, the device 1 being arranged on the central part of the back 4 of the patient.

In contrast, FIG. 2 shows the device I according to the invention, in which the spine of patient 2 exhibits lordosis, thereby acting under pressure conditions, the device I being mounted immediately on the back 4 of patient 2.

-Ίf

The device 1 is equipped with an elongated rod 5, representing the length measuring element. One end of the draw bar 5 is rigidly connected to the support element 6. The rigid connection of the draw bar 5 to the support element 6 is effected by means of an adjusting screw 7 arranged on the support element 6. The support element 6 is shown in FIG. 1 on the garment 3, which has a dressed patient 2, fastened by means of the press buttons 8. The device j. thus, in this embodiment, it is located on the back 4 of patient 2 to capture the curvature of his spine. In a manner not shown, the device may also be mounted on the thoracic side of the patient 2 or even in the lumbar region thereof, in corresponding major curves. In addition, the device 1 can also be mounted on another part of the body.

At each opposite end of the support element 6 of the draw bar 5, the draw bar 5 is longitudinally adjustable with another support element 9, which is also fastened to the garment 3 by means of the pressing buttons 8.

An essential element of the measuring electronics 10 are two electrically conductive sensors 11 and 12 which are intended to be in contact with each other. One sensor U is fixedly arranged in the guiding area of the draw bar 5 on the support element 9. In contrast, the other sensor 12 is arranged on the draw bar 5. According to FIG. 1, the sensor 12 is located at the end of the tie rod 5, under its guidance in the support element 9. This creates contact between the sensor 11 and the second sensor 12 when the patient 2 bends forward, i.e. when the patient develops. tension on the patient's spine 2.

In contrast, according to FIG. 2 a sensor 12 arranged above the support element 9 comprising the sensor U, so that the free end of the draw bar 5 is guided in the support element

9. There is contact between the electrically conductive sensors U and 12 when the patient bends backwards and thereby applies pressure to his spine. JJ sensor. is connected to the signal transmitter j4 via line Γ3. The second sensor 12 is connected by a further line 15 to a current source 16 which in turn is in communication with the signal transmitter 14. It goes without saying that the measuring electronics 10, the signal transmitter 14 and the current source 16 may be arranged in a small housing that can be mounted on the body of the patient 2 at the location of the main curvature of his body.

When the device 1 is placed immediately on the skin of the patient 2, as shown in FIG. 2, the support elements 6 and 9 are fastened by means of suction cups Γ7.

In order to secure the device 1, the patient must first wear the garment 3. Thereafter, the physician will mark the corresponding attachment points for the support elements 6 and 9. At these places the support elements 6 and 9 are then fastened to the garment 3. sensors 11 and 12 are set. In this setting, the contact of sensors ϋ and 12 is closed, thereby closing the line 13, the next line 15 and the current source 16

-8current circuit. The signal transmitter 14 is activated. Patient 2 must learn to correct the curvature of his body so that the signal transmitter 14 does not emit each signal. At the earliest weekly intervals, the distance between the sensors 11 and 12 can be appropriately varied and secured by means of a construction bolt 7 on the support element 6, thereby increasing the curvature correction during the year.

The patient should wear this device all day. In this case, the patient 2 may, for example, have three different outfits in order to be able to change them regularly. The device 1 is protected against undesirable external influences by means of a protective hose system (not shown) by which the device I is coated. Thus, the garment 3 can also be washed with the device 1 without changing it. It is also conceivable to equip the swimsuit with this device 1, so that even in the hot season, the patient 2 has the possibility of self-checking the body posture in the swimming pool.

Depending on the body condition of the patient 2 suffering from scoliosis, it has been found by first experiments that a protruding rod 17 should be placed on the outside of the arch as a distraction measuring element, as shown in FIG. 3, while the compression measuring element formed by the elongated rod 5 is more suitable for the lumbar spine. The elongated rod 17 is subjected to tensile stress as shown by the arrows, while the elongated rod 5 is compressed as well as the arrows. The rib back curvature is the most prominent feature prior to the curvature of the thoracic spine, while the swelling in the lumbar region with the patient's stance 2 does not substantially overlap other body proportions. In the lumbar region, the dorsal bulge is much better visible, so that it would be advisable to place a compression measuring element. In this case, it is best if both measuring elements are connected in series so that they can be equipped with a common measuring electronics 10. As it has been shown in the first experiments, it is advisable to switch off the sensor 11 first so that patient 2 is not unnecessarily worried. A second sensor 12 is then used to monitor the lumbar curvature before the thoracic spine sensor 11 is assigned, so that both sensors ϋ and 12 begin to operate simultaneously and with a delay.

The invention has found an inexpensive embodiment of the measuring system at maximum wear comfort, resulting in good compatibility of the device.

n

Claims (21)

PATENT CLAIMS A device for detecting the state of curvature of areas of the human body, in particular a curvature of the spine, constituting a biological feedback system, suitable, in particular, for the treatment of scoliosis, with at least one length measuring element, measuring electronics, signal transmitter and power supply, in that the length measuring element is at least one longitudinal extension rod (5) connected to at least one longitudinal the supporting element (6) and the measuring electronics (10), wherein the longitudinal protruding rod (5) is mounted on the areas (4) of the body whose holding or movement needs to be registered, and the measuring electronics (10) essentially consists of at least two relative to each other electrically conductive sensors movable relative to one another (11, 12). Device according to claim 1, characterized in that two elongate rods (5) connected to the support element (6) or the measuring electronics (10) are spaced apart from one another. wherein one elongate rod is tensile and the other elongate rod is compressed and connected in series with the measuring electronics (10). Device according to claims 1 and 2, characterized in that the longitudinal rod (5) can be attached at one end to the support element (6). Apparatus according to claims 1 to 3, characterized in that the longitudinal rod (5) is slidably connected to the other support element (9) at its other end. Device according to claims 1 to 4, characterized in that one of the electrically conductive sensors (11) is arranged on the elongate rod (5) and the other electrically conductive sensor (12) is arranged on the support element (9) with which it is connected. a tie rod (5) slidably connected. Device according to claims 1 to 5, characterized in that the electrically conductive sensors (11, 12) are connected to a power source (16) and to a signal transmitter (14). -107. Device according to claim 6, characterized in that the power source (16) is a battery or an accumulator. Device according to claim 6, characterized in that the signal transmitter (14) is an acoustic and / or optical signal transmitter. Apparatus according to claims 1 to 8, characterized in that the measuring electronics (10) comprise a time delay unit for the signal transmitter (14). Apparatus according to claims 1 to 9, characterized in that the protruding rod (5) together with the supporting elements (6,9) is wrapped around a protective hose. Device according to claims 1 to 9, characterized in that the entire device (1) is surrounded by a protective hose. Device according to any one of claims 1 to 11, characterized in that the sensor (11, 12) is formed by a protective hose in the sense of interlocking tubes additionally comprising the measuring electronics (10), the tubes being retractable. Device according to claims 10 to 12, characterized in that the protective hose is made of flexible plastic. Device according to one of Claims 1 to 13, characterized in that the support elements (6, 9) or the protective hose are fastened to the skin of the body by means of fastening elements (8). Device according to claims 1 to 14, characterized in that the fastening elements are patches, bandages or suction cups (17). Device according to one of Claims 1 to 13, characterized in that the support elements (6, 9) and possibly a protective hose can be fastened to a flexible garment (3) surrounding the body of the patient (2). -11 Device according to claim 16, characterized in that Velcro fasteners or compression buttons (8) are arranged on the device for fastening the support elements (6, 9) or the protective hose. Device according to claim 16, characterized in that the support elements (6, 9) or the protective hose are sewn on the garment (3). Device according to claims 1 to 13, characterized in that the device (1) is implantable into the body of the patient (2). The apparatus of claim 6, wherein the signal transmitter is a cooling or temperature element. Device according to claim 1, characterized in that the measurement is based on a purely mechanical principle. Device according to claim 21, characterized in that the signal transmitter (14) also acts mechanically on the patient (2).