WO2010057873A1

WO2010057873A1 - Rehabilitation bed

Info

Publication number: WO2010057873A1
Application number: PCT/EP2009/065285
Authority: WO
Inventors: Ennio Alessio Monfardini; Caterina Sottini
Original assignee: S.P.A.S. S.R.L.
Priority date: 2008-11-18
Filing date: 2009-11-17
Publication date: 2010-05-27
Also published as: ITMI20082045A1; IT1398506B1

Abstract

A rehabilitation bed (1) comprises a frame (2) on which a supporting surface (3) suitable for receiving a patient is mounted, said supporting surface (3) comprising a first backrest portion (4), a second seat portion (5) and a third portion (6) for supporting the legs and/or the feet of the patient, said first, second and third portions (4, 5, 6) being movably mounted with respect to said frame (2) and respectively associated with driving means (9, 10, 11) suitable for allowing a controlled movement thereof, the bed further comprising a control system provided with at least one control unit (12), said control system being connected to said driving means (9, 10, 11) and suitable for automatically controlling the driving means (9, 10, 11) according to at least one rehabilitation program stored in said control unit (12). The bed (1) further comprises means for adjusting the height of the supporting surface (3) and its inclination in a longitudinal and a transverse direction with respect to the ground, said adjusting means being also connected to the control system.

Description

REHABILITATION BED

The present invention relates to a rehabilitation bed particularly suitable for motor rehabilitation of patients that are in hypokinesis or immobility conditions. In the field of motor rehabilitation of patients that are in serious hypokinesis or immobility conditions, e.g. patients that are in a geriatric department or patients under coma, physiotherapeutic treatments are known that are mainly intended to limit the damages to bones, muscles, tendons, ligaments and joints caused by long periods of immobility. Motor rehabilitation treatments are traditionally carried out by professionals such as physiotherapists or medical personnel by manually forcing the patient to make predefined skeletal-muscular movements.

Motor rehabilitation treatments of patients in hypokinesis or immobility conditions require the use of special platforms or beds comprising a frame on which a supporting surface and one or more accessories depending on the treatments to be carried out are mounted. Generally, the supporting surface comprises different portions that are movable relative to each other such, for example, a tiltable backrest and supports for the legs that are adjustable in various ways.

The professional adjusts the supporting surface in the most suitable position according to the type of exercise the patient has to make, after which he causes the patient to make one or more predefined movements.

Similarly to the beds intended for hospitalization, there are known rehabilitation beds provided with manual or automatic driving means suitable to allow a better and more comfortable adjustment of the different positions of the movable portions of the supporting surface, as well as of the height of the supporting surface with respect to the ground and of its inclination in a longitudinal direction.

Patent US 4805249 discloses, for example, a rehabilitation bed particularly suitable for recovering deambulation, comprising a mattress split into at least three parts that are supported by suitably movable frame support members. The mattress includes a portion for supporting the patient from the pelvis to the head and is provided with separate parts supporting the legs, which are outwardly movable away from one another. Thus a central gap is created wherein the patient can put his legs without shifting his pelvis toward the bed side.

There is also known a rehabilitation platform sold by the Chattanooga Group and known under the trade name MOVEO. The platform comprises a frame and a supporting surface. The frame is provided with driving means suitable to allow to adjust the height of the supporting surface from the ground as well as its inclination in the longitudinal direction. The supporting surface comprises various movable portions for supporting the back, the pelvis and the legs, as well as a pair of boards suitable to allow to support the feet of a patient during the execution of exercises for the rehabilitation of the leg muscles. Patent US 5099828 discloses a repetitive motion apparatus for exercising a patient's entire body and stimulating the cardiovascular system. The apparatus comprises a stationary outer frame having a movable inner frame pivotally mounted thereon. The apparatus includes stimulator mechanisms for the arms, shoulders, hips and legs of the patient. The inner frame of the apparatus may be inclined between a minimum and maximum angle for enhancing the benefit of passive exercise by the patient.

Patent US 5715548 discloses a bed including a frame, an articulating deck on the frame having head, seat, and foot deck sections, and a mattress on the deck. The deck foot section and mattress foot portion have a first length when the foot section is in the up position and a second length shorter than said first length when the foot section is in the down position. A first driver varies the length of the deck foot section, and a second driver moves the foot section relative to said seat section between the generally horizontal up position and the generally vertically downwardly extending down position. Patent application US 2003/040686 discloses an automated therapy table having various support portions capable of being independently and automatically actuated by a physical therapist or other medical practitioner in order to move parts of a person's body medially/laterally, posteriorly/anteriorly and rotatably without causing physical stress to the medical practitioner. Patent application US 2003/135137 discloses a passive motion exercise and/or treatment apparatus which includes a main support assembly for supporting at least part of the body of a user of the apparatus. The assembly includes a first support member and a second support member disposed in a common plane. The second support member is pivotably connected to the first support member and is movable relative thereto so as to provide passive movement of a part of the body of a user supported by the second support member relative to a part of the body supported by the first support member. A separable leg support assembly is adapted to be connected, in use, to the main support assembly at either end so as to support the calves of the legs of the user in a plane parallel to, and elevated with respect to, the common plane while the apparatus provides the passive body movement referred to above. A motorized drive arrangement is used to provide the aforementioned relative movement of the second support member.

Despite the availability of rehabilitation apparatuses that make the work of the professionals easier, there is still the need for improving these apparatuses in order to provide physiotherapists and/or medical personnel with more and more performing rehabilitation equipment. It is therefore an object of the present invention to provide a rehabilitation bed allowing to further ease the work of a professional during a motor rehabilitation treatment on patients that are in hypokinesis or immobility conditions. Said object is achieved with a rehabilitation bed, whose main features are disclosed in the first claim, while other features are disclosed in the remaining claims. The rehabilitation bed according to the present invention comprises a frame on which a supporting surface provided with movable portions is mounted. The movable portions of the supporting surface are respectively associated with driving means suitable to allow a controlled movement thereof and the bed is provided with an automatic control system of the driving means. The bed further comprises means for adjusting the height of the supporting surface and its inclination in the longitudinal and transverse directions with respect to the ground.

The rehabilitation bed according to the present invention provides the professional with a real rehabilitation instrument for patients that are in hypokinesis or immobility conditions, which can autonomously carry out a plurality of maneuvers that are traditionally carried out by the professional himself.

The main advantage of the invention is that the possibility of adjusting the height of the supporting surface from the ground and its inclination in both the longitudinal and transverse directions allows to easily place the patient on the bed and to set a plurality of treatment positions including anti-decubitus and Trendelenburg positions.

Another advantage of the rehabilitation bed according to the present invention is that the driving means may be disconnected from the movable portions of the supporting surface, thus allowing to use the bed also with patients that are recovering their mobility.

Still another advantage of the rehabilitation bed of the invention is that other movable portions, e.g. suitable to support and move the arms and the head of the patient can be removably attached to the frame of the bed, thus allowing to quickly adapt the bed to the desired treatment for the patient while avoiding to deal with a cumbersome structure.

Further advantages and features of the rehabilitation bed according to the present invention will become clear to those skilled in the art from the following detailed and non-limiting description of an embodiment thereof with reference to the attached drawings, wherein: figure 1 shows a lateral view of a bed according to the present invention; figure 2 shows a top view of the bed of figure 1 ; figure 3 shows a lateral view of the bed of figure 1, wherein the backrest portion and the seat portion of the supporting surface are moved back and the backrest portion of the supporting surface is partially inclined; figure 4 shows a top view of the bed of figure 1 , wherein the cushions of the supporting portion of the feet and/or legs are horizontally spaced away from one another and partially rotated backwardly; and - figure 5 shows a lateral view of the bed of figure 1, wherein one of the foot boards is partially inclined. figure 6 shows a lateral view of the bed of figure 1, wherein the supporting surface is inclined with respect to the ground in the longitudinal direction; figure 7 shows a lateral view of the bed of figure 1, wherein the supporting surface is substantially in a vertical position; and figure 8 shows a front view of the bed of figure 1 , wherein the supporting surface is inclined with respect to the ground in the transverse direction.

Referring to figures 1 and 2, the rehabilitation bed 1 according to the present invention comprises a frame 2 on which a supporting surface 3 suitable to receive a patient is mounted. The supporting surface 3 comprises a first backrest portion 4, a second seat portion 5 and a third portion 6 for supporting the legs and/or feet of the patient, that are respectively movably mounted relative to frame 2. Each portion may be advantageously provided with an anti-decubitus mattress.

As shown in figure 3, the backrest portion 4 is pivotally movable between a first position that is substantially aligned with the supporting surface 3 and a second position that is substantially perpendicular thereto. The seat portion 5 is slidable with respect to frame 2 along a longitudinal direction of the bed. Advantageously, the seat portion 5 is mounted on a slide 7 slidable along the frame 2. The slide 7 extends from the seat portion 5 to the underside of the backrest portion 4 and the latter is pivotally connected to slide 7, thus being slidable together with the seat portion 5. Therefore, it is possible to adjust the bed in order to receive patients having different heights as well as to set the position of the patient with the legs more or less flexed and the feet placed on the supporting portion 6.

As shown in figures 2 and 4, the supporting portion 6 for the legs and/or the feet of the patient comprises two cushions 6a, 6b respectively mounted on arms 8a, 8b transversally movable outwardly with respect to frame 2. Advantageously, the cushions

6a, 6b are also pivotable relative to arms 8a, 8b, thus being able to accomplish a rotation-translation movement that allows to support the feet and/or the legs of the patient during exercises that require to spread the legs, while avoiding undesired torsions of feet and/or legs. In order to allow to treat patients that are affected by serious hypokinesis or completely still, the portions of the supporting surface may be provided with means, e.g. straps, for blocking portions of the patient's body.

In order to make easier the adjustment of the various portions of the supporting surface 3, the movable portions 4, 5 and 6 are respectively associated with driving means suitable to allow a controlled movement thereof. The driving means are linear actuators, e.g. comprising a gear motor coupled to a worm screw or a toothed rack. As shown in figures 1 and 3, the backrest portion is associated with a first linear actuator 9, comprising a gear motor 9' and a worm screw 9". The gear motor 9' is connected to slide 7 under the seat portion 5 and the free end of the worm screw 9" is connected to a suitable lever arm 4' arranged proximate to the pivot point of the backrest portion 4.

The sliding movement of slide 7 is controlled by a second linear actuator 10, comprising a gear motor 10' connected to frame 2 and acting on a toothed rack 10" restrained to slide 7.

The transverse movement of arms 8a, 8b supporting cushions 6a, 6b of the supporting portion 6 is controlled by a pair of linear actuators 11 each comprising a gear motor 11 ' fixed to frame 2 and a worm screw 11" having one end restrained to the corresponding arm 8a, 8b (Fig.4).

The linear actuators may also be temporarily disconnected from the movable portions 4, 5 and 6 of the supporting surface 3, thus allowing to use the bed also with patients that are recovering their mobility, i.e. that can autonomously make some movements. In particular, the driving means 10', 10" connected to slide 7 are movable between a first position in which they engage slide 7 and a second position in which they are disengaged therefrom. Thus, by disengaging the driving means 10', 10" from the slide a patient in better health conditions can actively exercise his legs e.g. by pushing with his feet against cushions 6a, 6b and moving with his back slide 7 on which the backrest and seat portions 4, 5 are mounted.

The bed further comprises a control system provided with at least one control unit 12. The control system is connected to the linear actuators 9, 10 and 11 and is suitable to automatically control these actuators through the control unit according to at least one rehabilitation program stored in the control unit 12. Therefore, actuators 9, 10 and 11 are not only used to adjust the various movable portions of the supporting surface before a rehabilitation session, but also as real driving means that substitute the professional in carrying out preset maneuvers on the body of the patient, who rests on and/or is restrained to the supporting surface 3. It is thus possible to make the patient automatically execute bendings of the legs and the lumbar tract, hip movements, combinations thereof and the like. The control unit 12 may be directly mounted on bed 1, e.g. on frame 2, or may be a remote control unit connected to the control system by wire or by means of wireless communication systems. Advantageously, the control system may be provided with a remote control (not shown), thus allowing the professional to set at the bed site the starting positions of the portions of the supporting surface 3 for carrying out a desired motor rehabilitation program, as well as the end-stroke positions for the specific patient, the movement velocity, the number of repetitions of the same movements, the combinations between different movements and the like.

The control system and unit may advantageously be connected to a database through a network, thus allowing monitoring, storing, sharing and processing of the patient's data.

The rehabilitation bed according to the present invention may also comprise a pair of boards 13a, 13b adjacent to the third supporting portion 6. The boards 13a, 13b are pivotally connected to frame 2 and movable between a position that is substantially aligned with the supporting surface 3 and a position that is substantially perpendicular thereto. Similarly to the movable portions of the supporting surface 3, also boards 13a, 13b may be associated with linear actuators 14, e.g. comprising a gear motor 14' and a worm screw 14", controlled by the control system, thus being able to be used according to a motor rehabilitation program in order to cause the patient to make preset ankle movements.

The bed of the invention further comprises means for adjusting the height of the supporting surface 3 with respect to the ground and the inclination of the supporting surface 3 in the longitudinal and the transverse directions. As actuators 9, 10 and 11 connected to the movable portions of the supporting surface 3, also the adjusting means are connected to and controlled by the control system.

The possibility to adjust the height of the supporting surface 3 from the ground allows to ease the access of the patient to the bed. The adjustment of the inclination of the supporting surface in the longitudinal direction serves to exploit the weight of the patient as a variable load on the legs in many types of exercises. The supporting surface may also be so inclined to bring the feet of the patient in a higher position with respect to the head, thus reaching the so-called Trendelenburg position, normally used as a first aid position for shocks or lipothymia, which quite often occur with hypokinetic patients. The adjusting means comprise at least four members 15, e.g. articulated arms, as shown in figures 1, 3 and 5, or linear actuators, as shown in figure 6 to 8, that are respectively mounted proximate to the longitudinal and transverse ends of the bed 1. In order to raise or lower the supporting surface 3, all the four members 15 are raised or lowered in the same way so as to keep the supporting surface 3 in a substantially horizontal position.

In order to incline the supporting surface 3 in the longitudinal direction, the two members 15 of each row in the transverse direction are raised or lowered in a different way with respect to the other row so as to reach a predefined angle with respect to the ground. The inclination of the supporting surface achievable with the adjusting means is comprised between about -20° and 70°. Figure 6 shows the supporting surface 3 in an inclined configuration, forming and angle of 45° with respect to the ground.

In order to allow to place the patient in a vertical position, the adjusting means are not directly mounted on frame 2, but on a sub-frame 2a, which is pivotally connected to frame 2 at one end thereof and can be inclined with respect thereto e.g. by means of an actuator 16. The adjusting means and the actuator 16 are so configured that the angle that the supporting surface 3 forms with respect to the ground in the longitudinal direction is variable between -20° and 90°. In other words, the rotation of the sub-frame 2a can be added to the maximum rotation achievable with the adjusting means in order to bring the supporting surface 3 in a substantially vertical position, which is not possible in the beds of the prior art.

Figure 7 shows the bed of the invention with the supporting surface 3 in a substantially vertical position. As it may be seen, the rotation of the supporting surface 3 results from the sum of the rotation achieved by the adjusting means with respect to the sub-frame 2a and the rotation of the sub-frame 2a with respect to the frame 2.

The adjustment of the inclination in the transverse direction allows to shift the weight of the patient so as to reach a plurality of anti-decubitus positions either during an exercise or when simply lying on the bed for a long time. As shown in figure 8, in order to incline the supporting surface 3 in the transverse direction, the two members of each column in the longitudinal direction are raised or lowered in a different way with respect to the other column so as to reach a predefined angle with respect to the ground. The adjusting means are so configured that the angle between the supporting surface 3 and the ground in the transverse direction is variable between -35° and 35°.

The herewith described embodiment of the bed according to the present invention is only an example susceptible of numerous variants. For example, it is possible to add further movable portions to the supporting surface 3, suitable to independently support and move the arms and the head of the patient by means of respective actuators connected to the control system. This portions may advantageously be detachable from the frame 2, so as to allow to quickly and comfortably configure the bed on the basis of the treatment session the patient has to undergo without having to deal with a cumbersome overall structure.

Claims

1. A rehabilitation bed (1) comprising a frame (2) on which a supporting surface (3) suitable for receiving a patient is mounted, said supporting surface (3) comprising a first backrest portion (4), a second seat portion (5) and a third portion (6) for supporting the legs and/or the feet of the patient, said first, second and third portions (4, 5, 6) being movably mounted with respect to said frame (2) and respectively associated with driving means (9, 10, 11) suitable for allowing a controlled movement thereof, the bed further comprising a control system provided with at least one control unit (12), said control system being connected to said driving means (9, 10, 11) and suitable for automatically controlling the driving means (9, 10, 11) according to at least one rehabilitation program stored in said control unit (12), characterized by further comprising adjusting means for adjusting the height of the supporting surface (3) and its inclination in a longitudinal and a transverse direction with respect to the ground, said adjusting means being also connected to the control system.

2. A rehabilitation bed according to the previous claim, characterized in that said adjusting means are mounted on a sub-frame (2a) which is in turn pivotally mounted to the frame (2) and movable relative thereto by means of an actuator (16) between a first position aligned with the base of the frame (2) and a second position inclined with respect thereto.

3. A rehabilitation bed according to the previous claim, characterized in that the adjusting means and the actuator (16) are so configured that the angle that the supporting surface (3) forms with respect to the ground in the longitudinal direction is variable between -20° and 90°.

4. A rehabilitation bed according to any of the previous claims, characterized in that the adjusting means are so configured that the angle that the supporting surface (3) forms with respect to the ground in the transverse direction is variable between -35° and 35°.

5. A rehabilitation bed according to any of the previous claims, characterized in that said adjusting means comprise at least four actuators (15) respectively mounted proximate to the longitudinal and transverse ends of the bed (1).

6. A rehabilitation bed according to any of the previous claims, characterized in that the first backrest portion (4) is pivotable between a first position substantially aligned with the supporting surface (3) and a second position substantially perpendicular thereto.

7. A rehabilitation bed according to any of the previous claims, characterized in that the first backrest portion (4) and the second seat portion (5) are slidable with respect to the frame (2) in a longitudinal direction of the bed.

8. A rehabilitation bed according to the previous claim, characterized in that the first backrest portion (4) and the second seat portion (5) are mounted on a slide (7) slidable along the frame (2), said slide (7) extending from the second seat portion (5) to the underside of the first backrest portion (4) and the latter being pivoted on the slide

(V).

9. A rehabilitation bed according to the previous claim, characterized in that the driving means (10) connected to the slide (7) are movable between a first position in which they engage the slide (7) and a second position in which they are disengaged therefrom.

10. A rehabilitation bed according to any of the previous claims, characterized in that the driving means (9, 10, 11) are linear actuators, said linear actuators comprising a gear motor (9', 10', 11') coupled to a worm screw (9", 11") or a toothed rack (10").

11. A rehabilitation bed according to any of the previous claims, characterized in that the third portion (6) for supporting the legs and/or the feet of the patient comprises two cushions (6a, 6b) respectively mounted on arms (8 a, 8b) outwardly movable in the transverse direction with respect to the frame (2).

12. A rehabilitation bed according to the previous claim, characterized in that said cushions (6a, 6b) are pivotable with respect to the arms (8a, 8b).

13. A rehabilitation bed according to any of the previous claims, characterized in that said first, second and third portions (4, 5, 6) of the supporting surface (3) are provided with means for blocking portions of the patient's body.

14. A rehabilitation bed according to any of the previous claims, characterized in that said first, second and third portions (4, 5, 6) comprise an anti-decubitus mattress.

15. A rehabilitation bed according to any of the previous claims, characterized by further comprising a pair of foot boards (13a, 13b) adjacent to the third supporting portion (6), said foot boards (13a, 13b) being pivotally connected to the frame (2) and movable between a first position substantially aligned with the supporting surface (3) and a second position substantially perpendicular thereto.

16. A rehabilitation bed according to the previous claim, characterized in that the foot boards (13a, 13b) are associated with linear actuators (14) controlled by the control system.

17. A rehabilitation bed according to any of the previous claims, characterized by further comprising other movable portions suitable for independently supporting and moving the arms and the head of the patient, said movable portions being respectively provided with actuators connected to the control system.