Classifications

• • A—HUMAN NECESSITIES
  • A63—SPORTS; GAMES; AMUSEMENTS
  • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
  • A63B21/00—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices
  • A63B21/008—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices using hydraulic or pneumatic force-resisters
  • A63B21/0085—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices using hydraulic or pneumatic force-resisters using pneumatic force-resisters
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B5/00—Measuring for diagnostic purposes; Identification of persons
  • A61B5/22—Ergometry; Measuring muscular strength or the force of a muscular blow
  • A61B5/224—Measuring muscular strength
  • A61B5/225—Measuring muscular strength of the fingers, e.g. by monitoring hand-grip force
• • A—HUMAN NECESSITIES
  • A63—SPORTS; GAMES; AMUSEMENTS
  • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
  • A63B21/00—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices
  • A63B21/00058—Mechanical means for varying the resistance
  • A63B21/00069—Setting or adjusting the resistance level; Compensating for a preload prior to use, e.g. changing length of resistance or adjusting a valve
• • A—HUMAN NECESSITIES
  • A63—SPORTS; GAMES; AMUSEMENTS
  • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
  • A63B23/00—Exercising apparatus specially adapted for particular parts of the body
  • A63B23/035—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously
  • A63B23/12—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously for upper limbs or related muscles, e.g. chest, upper back or shoulder muscles
  • A63B23/16—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously for upper limbs or related muscles, e.g. chest, upper back or shoulder muscles for hands or fingers
• • A—HUMAN NECESSITIES
  • A63—SPORTS; GAMES; AMUSEMENTS
  • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
  • A63B2220/00—Measuring of physical parameters relating to sporting activity
  • A63B2220/50—Force related parameters
  • A63B2220/51—Force

Definitions

• This invention relates to a measurement apparatus and method.
• Grip strength dynamometers for measuring the strength of the hand to perform grasping work, including persons with RSI.
• Known devices have a pair of substantially parallel spaced apart bars which are drawn together by hand against a fixed force with the strength of the grip being measured.
• Such apparatus is essentially a modified strain meter which quantitatively assesses the strength of the isometric grasp of the hand.
• the pneumatic reservoir means is deformable.
• this invention resides broadly in a method of comparatively assessing the strength of a user, the method including :- causing the user to repeatedly vent a pneumatic reservoir; measuring parameters indicative of strength, work, work rate and speed of muscle contraction of the user in repeatedly evacuating the pneumatic reservoir, and displaying indications of strength, work, work rate and speed of muscle contraction thus measured in comparison with a norm.
• the pneumatic reservoir means is a resilient bladder adapted to resile from a deflated configuration after evacuation to an inflated configuration for re-evacuation.
• the pneumatic reservoir means may be a limp collapsible bladder, the apparatus including a source of positive pressure to re-inflate the limp bladder from a deflated configuration after evacuation to an inflated configuration for re-evacuation.
• the apparatus includes a constant volume chamber pneumatically connected to the pneumatic reservoir means and the measuring means includes pressure measuring means to measure the pressure in the constant volume chamber .
• the volume of the pneumatic pipe linking the exit valve of the pneumatic reservoir, the pressure measuring means and the constant pressure valve, ie the high pressure line is trivial in relation of the volume of gas usually expelled from the pneumatic reservoir.
• each hand pump action results in sufficient pressure in the pneumatic reservoir and the high pressure line to open the constant pressure valve and eject a significant volume of gas, approximating the volume of gas ejected from the pneumatic reservoir.
• a constant volume chamber can be connected to the high pressure line.
• the pressure of the gas in the constant volume chamber will increase until it reaches the pressure setting of the constant pressure valve. From this event, further repetitive evacuation of the pneumatic reservoir will result in gas being released by the constant pressure valve at its pressure setting with no further increments of pressure occurring in any part of the high pressure line, including the constant volume chamber .
• the volume of the constant volume chamber may be selectively variable.
• the operating pressure of the constant pressure valve may also be selectively variable with the measuring means including pressure measuring means to measure the pressure at which the constant pressure valve operates.
• the measuring means includes time measuring means for measuring the time at the beginning and end of each evacuation and calculating means for calculating the time taken to actively deflate the pneumatic reservoir means (pump duration) and the time before initiation of the next pump cycle (recovery duration) .
• the measuring means may also include calculating means for calculating parameters indicative of strength, work, work rate and speed of muscle contraction of the user.
• the pressure in the constant volume chamber remains substantially constant after each successive evacuation.
• the apparatus may also include control means for controlling the volume of the constant volume chamber, and/or control means for controlling the initial pressure of the constant volume chamber, and/or control means for controlling the pressure of a positive pressure source for supply to a limp collapsible bladder.
• the apparatus preferably includes pressure generating means operable by an analyst to selectively control the initial pressure in the constant volume chamber .
• the apparatus includes nonreturn valve means located at the inlet and outlet of the pneumatic reservoir means, the non-return valve means respectively preventing reflux of a gas from the pneumatic reservoir when operated by a user and preventing reflux of gas from the constant volume chamber to the reservoir after operation of the reservoir by the user.
• the parameters indicative of strength, work, work rate and speed of muscle contraction of the user preferably include one or more of the following specific parameters : - a. contraction or pump duration b. rest or recovery duration c. total cycle time (which conveniently can be presented as the inverse, ie "cycle frequency"), this being equivalent to the metronome rate of this cycle d. volume of gas vented (stated in volumetric or "volume equivalent pressure” terms) e. cycle load or pressure overcome (the average pressure in the fixed volume chamber for the cycle, or the pressure set in the pressure release valve, if that component is functioning) f . work performed g. power achieved h. volumetric muscle shortening velocity (this is a general measure of the average shortening velocity of the contracting muscles acting on the pneumatic reservoir, stated as the volumetric rate of air venting (per unit time) from the pneumatic reservoir) .
• the assessment method has been found to produce beneficial physiological and psychological effects and accordingly in a further aspect this invention resides broadly in a method of treatment of patients having muscle weakness, the method including: - causing the patient to repeatedly vent a pneumatic reservoir; measuring parameters indicative of strength, work, work rate and speed of muscle contraction of the patient in repeatedly evacuating the pneumatic reservoir, and displaying to the patient indications of strength, work, work rate and speed of muscle contraction thus measured in comparison with previous patient ' s indications; whereby the action of repeated evacuation has a beneficial physiological effect for the patient and the display of improved indications in comparison with previous indications has a beneficial psychological effect for the patient.
• this invention resides broadly in a method of monitoring the state of weakness and clinical improvement of a patient having muscle weakness, the method including :- causing the patient to repeatedly vent a pneumatic reservoir; measuring parameters indicative of strength, work, work rate and speed of muscle contraction of the patient in repeatedly evacuating the pneumatic reservoir, and displaying indications of strength, work, work rate and speed of muscle contraction thus measured in comparison with a norm.
• FIG 1 is a schematic diagram illustrating the invention
• FIG 2 schematically illustrates a first embodiment of the invention seen in FIG 1;
• FIG 3 schematically illustrates a second embodiment of the invention seen in FIG 1;
• FIG 4 schematically illustrates a third embodiment of the invention seen in FIG 1;
• FIG 5 illustrates an alternative embodiment of the pneumatic reservoir
• FIG 6 schematically illustrates another embodiment of the invention
• FIGS 7 is a tabulation produced in accordance with the invention.
• FIGS 8A, 8B and 8C and FIGS 9 to 26 are graphs of the results produced in accordance with the invention.
• measuring apparatus 30 has a bulb reservoir 31
• the constant volume chamber is replaced by a constant pressure valve 32 to which is coupled a measuring device 33 for measuring the volume of air which passes from the system through constant pressure valve 32.
• Manometer 34 measures the pressure at which valve 32 operates. The pressure at which valve 32 operates is selectively variable.
• FIG 4 illustrates another form of the invention in which measuring apparatus 40 includes a pneumatic bulb reservoir 41 having non-return valves 45 and 46 connected on either side of the bulb reservoir to respectively prevent reflux of air from the bulb to atmosphere during operation and from the system to the bulb after operation.
• Constant volume chamber 42 is vented by a variable bleed valve 43. The rate of release is variable whereby when the user squeezes the bulb 41, the person conducting the test can vary the bleed rate of valve 43 to maintain a substantially constant pressure in constant volume chamber 42.
• the constant pressure within constant volume chamber 42 is read by means of manometer 39 and the volume of air pumped by the user at this pressure is measured by volumetric measuring device 44.
• the analyst ie the person conducted the tests, can vary the initial pressure within the constant volume chamber at which the tests commence. This is achieved by providing a second pneumatic bulb reservoir 47, or other pumping means, which is operated by the analyst. This arrangement can also be used with the embodiments illustrated in FIGS 2 and 3.
• a sphygmomanometer-type bulb reservoir has an elastic recoil pressure against which a user must work.
• This configuration requires unmeasured work to be performed each cycle against the elastic recoil of the bulb, thus introducing an error into the assessment by understating strength achieved and in the calculation of actual work performed.
• grip strength is greatly reduced, the inherent elastic recoil of the bulb requires significant strength to overcome and significant muscle work is performed in doing this. This unmeasured strength and work is a significant component of the actual strength required and work performed.
• FIG 5 illustrates a system 60 in which a pneumatic bulb reservoir 61 is repeatedly vented thereby varying the pressure and/or volume within an assembly 62.
• Timing means 63 are associated with bulb 61 and monitor the commencement and conclusion times of each operating cycle.
• Pressure measuring means 64 and volume measuring means 65 are associated with assembly 62 and measure pressure and volumetric changes associated therewith.
• Timing means 63 The outputs of timing means 63, pressure measuring means 64 and volume measuring means 65 are connected with computation means 66 wherein calculations subsequently to be described are made.
• Calculating means 66 typically comprises a computer which produces an output 67 which is indicative of the strength, work, work rate and speed of muscle contraction performed by a user of the equipment with each pump cycle.
• control means that controls settings and actuates components of the apparatus, such as valves and pumps, between tests vary the volume of the constant volume chamber, and control the speed of metronome means that indicates to the subject the desired times of bulb reservoir evacuation.
• control means within the computation means can be managed by the analyst to set tests suitable for his or her intentions, or can administer a test process set up and programmed within the computation means, independent of and unknown to the analyst, to obtain a "double blind" assessment.
• the control means can also control the venting valve (as for example via control from computer 66) .
• pressure measuring and controlling means 64 and volume measuring means 65 are associated with assembly 62 and measure and can control pressure and volumetric changes associated therewith.
• the outputs of timing means 63, pressure measuring and controlling means 64 and volume measuring means 65 are connected with computation means 66 wherein the calculations subsequently to be described are made.
• the pressure setting of the constant pressure valve can conveniently be measured with a gauge or transducer sited between the exit valve of the bulb and the constant pressure valve.
• the pressure within the constant volume chamber can conveniently be measured within that chamber or elsewhere in the high pressure line.
• the constant pressure valve embodiment allows the threshold pressure that permits flow of air to be varied, to allow study of the ability of the grip of the hand to do work against different pressures in the bulb.
• the configuration of this embodiment is the most analytical, as it permits continuing bulb evacuation cycles against a constant pressure at the will of the analyst, increases in the pressure also being able to be induced at the will of the analyst, at the times of his or her choice. Thus the strength and the endurance of the hand in grip work can be studied independently.
• the constant pressure valve can be simulated by using a variable flow release valve to obtain a constant rate of pumping using a metronome.
• a variable flow release valve to obtain a constant rate of pumping using a metronome.
• the system then calculates the average pressure of each cycle, the pressure increase achieved in each cycle and the equivalent volume of that pressure increase.
• the duration of each cycle is determined from the time measurements and the rate of doing work in each cycle is calculated by dividing the work done in each cycle by the duration of the cycle (in seconds) .
• the rate of doing work can be expressed arbitrarily in RPUs (Rosendahl power units) .
• the pressure is conveniently measured in kilopascals, the volume in millilitres. This provides a more ready comparison between assessments made using the pressure increase in the constant volume chamber and the flow through a pressure release valve.
• the analyst can control the valve so that the user establishes during successive cycles a substantially constant pressure in the high pressure line, which with the variable bleed valve will - and with the constant pressure vent valve may - include a constant pressure chamber. (To achieve the goal of constant pressure with the variable bleed valve there is a requirement that the subject maintain a constant pumping rate and eject the same volume of gas from the pneumatic reservoir in each pump cycle.
• the system measures the pressure in the high pressure system, and the volume of air bled or vented from the variable bleed or constant pressure vent valve - or entered into the collapsible hand reservoir - over time, or per cycle time, or per pump duration and rest duration, or per aliquots of each, and the calculations are then made as described above.
• the volume measurements are real rather than of "volume equivalent pressure" .
• FIGS 8A-C shows a graphic display of the results in which equivalent volume (including pump phase duration and recovery phase duration) , work done and rate of doing work are plotted against an axis of increasing pressure .
• Adjacent to the sphygmomanometer dial is a large LED display with timing circuits that displays three numeric LEDs, one cycling from zero to nine in one second intervals, the second cycling from zero to nine in one tenth second intervals, and the third cycling from zero to nine in one hundredth second intervals.
• the first row of the spreadsheet already has appropriate formulae prepared (the formulae are stated in spreadsheet form on the sample tabulation) . These formulae are simply copied down for the number of pump cycles for which data has been abstracted from the video.
• the normal graph can be derived from some simple empirical observations.
• the normal adult male and female medical practitioner is able to pump to 300mm Hg rapidly and without trouble when measure blood pressures. A rate of three pump cycles per second can be maintained to this pressure .
• a 600 mil chamber was utilised, the maximum pressure being obtained over ten pump cycles, nine of which are graphed.
• the duration of the pump phase was 8-10 one hundredths of a second, the duration of the recovery phase about 26-30 one hundredths of a second, the REV falling from about 20mil to about 15mil (as the pressure increases the "ejection fraction" diminishes) .
• the graph clearly demonstrates work performance in excess of 5000RWU at 300mm Hg, and a power approaching 12000RPU at that pressure .
• a 2 litre constant volume chamber was utilised. This provides for many more pump cycles (a total of 67 in all) .
• the duration of the pump phase was unaltered from 8-10 seconds, and remained constant for the 67 pumps.
• the duration of the recovery phase was also maintained, the patient maintaining rhythm with a metronome set at 180 beats per minute however the REV was always less than 20mil, and at a pressure of 125mm Hg began to fade away, being less than lOmil from 170mm Hg onwards.
• the rate set by the metronome the patient only partially emptied the hand- bulb. With the reduction in the volume achieved the work performed never exceeded 2000RWU, even though the full pressure of 300mm Hg was obtained. Because the speed of pumping was maintained, the rate of doing work exceeded the numerical value of the work performed by a factor in excess of two, however a plateau is clearly seen developing at about 125mm Hg pressure, and there is only one power reading in excess of 5000RPU.
• the appearance of a dip and then a gradual increase from about 200mm Hg reflects the encouragement given to the patient from that pressure.
• the patient was unable to obtain a pressure greater than 150mm Hg.
• the patient reported being fatigued and chose to stop despite encouragement.
• the duration of the pump phase remained relatively constant, but at a longer duration of close to 20 one hundredths of a second and the duration of the recovery phase increased from 40 one hundredths of a second to almost 80 one hundredths of a second over the duration of the test.
• the equivalent volume achieved was the maximum available at low pressures, but began to reduce gradually towards the end of the trial.
• the maximum power achieved by the repetitive exhaustion of the hand pump bulb is in principle independent of the mechanism and configuration of the mechanism used to measure it. Consequently, confirmatory evidence can be obtained that a subject has worked with maximal exertion in several tests by demonstrating equivalent values of maximum power by testing with differing volumes of the hand pump bulb or the constant volume chamber, or with differing speed of pumping.
• the present invention can be utilised in the clinical testing of persons claiming significant loss of grip strength and the ability to perform work with the hand(s), in medical, occupational health, and pre- employment assessments. As with blood pressure measurements, variability of results in one patient from test to test and from day to day is expected.
• FIGS 9 to 26 illustrate graphical presentations available with the present invention to assist in diagnostic evaluation.
• the present invention relates not only to a measurement assembly for and a method of measuring the strength of a user, but also relates to a method of treatment of patients having muscle weakness .
• the invention has an important psychological benefit. Persons suffering from occupational overuse syndrome, cumulative trauma disorder or RSI frequently become depressed not only because of slow recovery which may take a number of years, but also because severe bouts of pain can frequently re-occur which can mask the fact that there may have been a significant improvement in the disability threshold. This depression has a direct adverse impact on the physical condition which is made worse by tension.
• the present invention serves a most useful purpose in displaying to the patient empirical evidence that progress is being maintained in spite of re-occurrence of pain even at a level as severe as previously.
• the repeated evacuation of the bulb at an appropriate set pressure provides an exercise regime at a level conditional upon the patient's condition in that the patient works to his or her level of comfort, pain and disability.
• the threshold level of the condition improves the exercise regime strengthens and importantly, the patient receives positive feedback by way of seeing the graphically displayed results which compare favourably with the results at an earlier period of the condition when the threshold level was worse. This encourages the patient at times when pain regressions mask the fact of overall and continuing improvement and lessen the potential for the patient to become depressed.
• the apparatus and method of the present invention pneumatically measures grip strength, grip work and rate of grip work per pneumatic pump cycle.
• Grip work is measured by computing the product of pressure and volume and uses that computation of grip work, divided by the time taken for each work cycle, to compute the rate of doing grip work per cycle.
• the "equivalent volume” from the pressure excursion obtained in each single pump cycle there is no requirement for volume measurement in the calculation of grip work when using the constant volume chamber.
• Simulation of constant pressure testing at constant pumping rates is possible when using a fixed volume chamber by the provision of a variable aperture flow release valve, ie variable bleed valve.
• the present invention provides a measure of muscle shortening and relengthening velocity, both as an average for each pump cycle, and plotted at short time intervals during any specific pump duration and recovery duration.
• the muscle shortening information (including both an average shortening velocity for each pump cycle and an "instantaneous" shortening velocity plotted at short time intervals for a given pump cycle) can be derived from the total increase in pressure occurring in a pump duration, and by measuring the increments in pressure occurring over short time periods (as for example 10 millisecond intervals) during a pump duration.
• the testing device of the present invention can measure pressures substantially greater than that available with a sphygmomanometer, and the testing process can be continued until the maximum pressure is reached (ie the person can no longer force air from the hand pump bulb into the constant volume chamber) , or the subject stops on account of the severity of the pain induced by the attempt .
• the maximum pressure ie the person can no longer force air from the hand pump bulb into the constant volume chamber
• pressures up to 100 kilopascals can commonly be attained.
• males maximum pressures from 80 to 150 kilopascals can be attained.
• the upper levels of pressure attained by each gender is achieved by persons who are well-muscled and in training. The extension of the test into the higher pressure range provides for a completion of the relevant parameters .
• recovery duration initially is constant. However, once the pressure load at maximum power output is attained, the recovery duration tends to increase, slowly at first, then more rapidly.
• the present invention furthermore allows a series of tests to be performed for each hand, by changing the variables of volume of the hand pump bulb, volume of the constant volume chamber, speed of pumping, or varying from a constant volume to a set pressure technique.
• the invention has a number of advantages over known methods and apparatus for assessing strength. These include the following: -
• the present invention can assess muscular strength, endurance, work performed, power generated, the speed of contraction of the muscle system, disability of muscle action, and it is believed susceptibility to the onset of upper limb disability (and pain) precipitated by repetitive hand grasp or finger action.
• the present invention provides the means for the hand to perform formal incremental work by repeatedly squeezing a bulb to partially empty it of air, the air being forced into a constant volume chamber or through a constant pressure valve .
• the work done in each cycle is the product of the volume pumped and pressure against which the air is forced, either through the constant pressure valve or present in the constant volume chamber.
• the present invention provides a number of independent ways to assess the possibility of a subject attempting to feign disability by perversely simulating maximal effort. These include (1) control and variation of threshold valve pressure which is unknown to the subject, (2) control and variation of the volume of the "fixed" volume version which is unknown to the subject,

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• Health & Medical Sciences (AREA)
• Life Sciences & Earth Sciences (AREA)
• Orthopedic Medicine & Surgery (AREA)
• General Health & Medical Sciences (AREA)
• Physical Education & Sports Medicine (AREA)
• Biophysics (AREA)
• Engineering & Computer Science (AREA)
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• Animal Behavior & Ethology (AREA)
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• Measuring And Recording Apparatus For Diagnosis (AREA)
• Measuring Pulse, Heart Rate, Blood Pressure Or Blood Flow (AREA)

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• 1997
  • 1997-09-12 AU AUPO9177A patent/AUPO917797A0/en not_active Abandoned
  • 1997-09-12 AU AU37559/97A patent/AU690882B3/en not_active Ceased
• 1998
  • 1998-09-11 JP JP2000511405A patent/JP2001516606A/ja active Pending
  • 1998-09-11 EP EP98942376A patent/EP1018939A4/en not_active Withdrawn
  • 1998-09-11 WO PCT/AU1998/000747 patent/WO1999013771A1/en not_active Ceased
• 2000
  • 2000-03-16 US US09/527,954 patent/US6606907B1/en not_active Expired - Fee Related

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