WO2013029771A1

WO2013029771A1 - Therapy apparatus for the spinal column

Info

Publication number: WO2013029771A1
Application number: PCT/EP2012/003598
Authority: WO
Inventors: Thomas Kohler; Norbert BLOOS
Original assignee: KOHLER, Lisa
Priority date: 2011-08-26
Filing date: 2012-08-27
Publication date: 2013-03-07
Also published as: EP2747729A1; DE202011105062U1

Abstract

A stretching apparatus (1) for physiotherapy comprises a bench (3) with a bench surface (5) for supporting a patient, a holder (35) for the patient's feet, a lifting mechanism (7) with which the height of the holder (35) can be changed in such a way that a patient connected to the holder (35) can be transferred from a lying position to an upside down position, and a positioning mechanism (11, 13) which can be operated independently of the lifting mechanism (7) and permits height adjustment, particularly by a linear shift and/or a pivoting movement, of at least one area of the bench surface (5).

Description

Spine therapy device

description

The invention relates to a stretching device for therapeutic gymnastics according to the preamble of the protection claim. 1

Stretching devices of the type discussed here for therapeutic gymnastics are known in principle. For example, FR 2 562 429 shows a stretching device in which a patient can be stored on a mat which can be rolled in a horizontal plane, wherein the rollable mat is arranged only a short distance above the bottom. Furthermore, the feet of a patient are connected by means of a foot holder with a fixed rope, which is guided over a plurality of pulleys. The pulleys are lockable, so that a suspended with the feet on the bracket patient is held upside down in the hanging position. In this hanging position in particular the spine is relieved and the blood supply to the brain is increased. However, the therapeutic effect achievable with this device is limited.

In DE 10 2005 020 667 AI a stretching device for therapeutic exercise is described. The height of a holder 1 for the feet of a patient is by means of a

Lifting device 2 with a drive unit 17 can be changed such that a patient connected to the holder 1 patient can be transferred from a horizontal position in an upside-down position. Furthermore, a rocker 3 is provided with an elastic band 4 and a rocker drive 5, by means of which the patient hanging upside down on the holder 1 can be moved vertically in a rocking manner (paragraphs [0028], [0030]).

Therapeutic beds 10, 30, 40 are described in US 6,243,897 B1. At the foot parts 4, 14, 34, 44 of the therapeutic beds 10, 30, 40 are

Fixing straps 7 provided for the ankles of patients. The

Therapeutic beds 10, 30, 40 can each be brought into a position in which the patient hangs on his feet (FIGS. 1, 5, 6, 10, 11, 13). In GB 2 152 381 A a treatment table 15 for physiotherapy is described. The treatment table 15 is pivotable from a horizontal position (Figure 1D) or a position in which a patient assumes an inclined position (Figures 1A, 1B, 5) in a position in which a patient on shoes 20 at one end of the treatment table 15th hanging upside down (Figures IC, 6).

In DE 2 303 615, flat-type couches 1 are described, at the foot ends of which loops 8 are provided for receiving the feet of a person (page 7, last paragraph, page 8, second paragraph). The couches 1 can be either by means of rotating cables 5 in a vertical position pulled (page 7, last paragraph, Figures 1 to 3) or pivoted by means of bearings 16 near the head end 3 and a Huberzeugers 21 in a vertical position (page 10, first whole Paragraph, Figure 4).

DE 35 22 609 A1 describes a relaxation and stretching hanging bed with several rungs. A person who wears foot cuffs with hooks at their feet can put themselves in a head-hung saga by hanging on each other in the next higher rung (column 2, lines 21 to 34, Figure 2).

In DE 1 181 858 a stretching device for physiotherapy is described. The stretching device comprises a suspension board b and an adjustable padded belt d for attaching the lower legs of a patient B to a wooden or tubular frame a. The frame a can be raised by means of a pulley 9 to bring the patient in an upside-down position (column 3, line 37, to column 4, line 2, figures).

In DE 297 14 490 Ul a pendulum gear for generating ellipsoidal movements is described.

The invention has for its object to provide an improved stretching device of the type mentioned, which in particular achieves an improved therapeutic effect and ensures increased patient safety.

A stretching device comprises a lying surface having a couch for supporting a patient, a holder for the patient's feet, a lifting device, with which the height position of the holder is variable such that the patient connected to the holder from a lying position in a headlamp-hanging position can be transferred, and independently operable by the lifting device positioning means for height adjustment, in particular by a linear displacement and / or a pivoting movement , at least one area of the lying surface.

Due to the height adjustability of at least one area of the lying surface, the change of the distance of the lying surface to a floor level is effected. In other words, the at least one positioning device causes an enlargement or reduction of the vertical distance of at least parts of the lying surface to the ground plane. A displacement of the lying surface can be effected both by a purely linear movement as well as by a pivoting movement. However, particularly preferred is the combination of a linear movement with a pivoting movement.

An essential idea of the invention lies in the fact that the vertical position of the couch can be changed in such a way that it is possible for the patient to comfortably ascend and descend onto the couch and secondly the displacement of the patient into different therapeutic positions to effect optimally. This is made possible by the at least one positioning device, which allows a variable positioning of at least areas of the lying surface in a height direction, because this provides an additional degree of freedom of the stretching device. The therapeutic effect is thereby significantly improved overall, since the stretching device is much better adapted to the physical conditions and needs of the patient.

In a stretching device, as described here, in particular, the lying surface is so movably mounted by means of a pivoting device that it is at least partially displaceable from a horizontal position to an inclined position and vice versa.

If a positioning device is in the form of a pivoting device, the lying surface is at least partially displaceable in a pivoted or inclined position with respect to the ground by means of the pivoting device, so that different therapy positions and different forms of therapy can be realized by the stretching device. In particular, a shoulder stand or even a free hanging position of a patient can thereby be realized without difficulty. Particularly advantageous may be at least partially movably mounted lying surface, because the patient is thereby transferred in a gentle manner exclusively from a lying position in the free hanging position. The lying surface which can be displaced in the direction of inclination thus serves, as it were, as a modulation device which permits a targeted modulation of the displacement path of the patient into different therapeutic positions. This makes it possible to specifically transfer a patient into different therapeutic positions in an optimized and gentle manner.

The maximum inclination or swivel angle of the lying surface or the displaceable lying surface part is in particular about 50 degrees. Alternatively, an even greater inclination of the movably mounted lying surface part is adjustable. In particular, it is provided that the lying surface is formed in two or more parts and in particular has a lifting device facing the foot part and a head part facing away from the lifting device, wherein the foot part is displaceable by means of the pivoting device. Alternatively, the lying surface is integrally formed, but elastically, so that the lying surface is at least in one area by the pivoting device from a horizontal position in an inclined position and vice versa pivoted. The pivoting device is designed, for example, by an electric motor or hydraulically or pneumatically and can be designed in particular by means of a spindle drive or by means of at least one hydraulic or pneumatic lifting cylinder. A pivoting of the lying surface is in particular infinitely possible, so that a particularly comfortable displacement of the patient from a horizontal to an inclined position and vice versa is possible.

In a stretching device, as described here, the couch in particular has a height adjustment device for displacing the lying surface in a vertical direction. A height adjustment device may be provided additionally or alternatively to the pivoting device. The stretching device may be designed such that a single positioning device realizes both the pivoting device and the height adjustment device. The height adjustment device serves for the linear displacement of the lying surface in a vertical direction. In conventional stretching equipment, the lying surface is arranged exclusively directly above the floor. For some patients, however, sitting down and lying down on the lying only about 10 cm above the floor lying area is often a pain. The same applies to the patient getting up from the bed. In addition, there is a risk that a patient may contract injuries when getting up or lying down.

A lying surface, which is located directly above the floor, thus presents a certain safety risk. This is eliminated by the height adjustment device for displacing the lying surface in a vertical direction. In particular, the lying surface can be arranged by the height adjustment device at a greater distance to the ground, in particular at a distance of about 80 cm or higher. In this way, a patient can lie down comfortably on the couch and get up easily from it. To carry out the actual therapy, the lying surface can then be moved again by means of the height adjustment in its ground-level position.

In a stretching device, as described here, the height adjustment device and / or the pivoting device are formed by an electric motor or hydraulically, in particular by means of a spindle drive or by means of at least one lifting cylinder.

The height adjustment device and the pivoting device are arranged in or on the couch and allow a separate displacement of the lying surface in a vertical direction and in a direction of inclination.

In a stretching device, as described here, in particular the couch and the lifting device are arranged as a unit on a common frame. Anrodnung of couch and lifting device as a unit on a common frame allows a particularly stable design of the stretching device.

In a stretching device, as described here, the lying surface may be two or more parts and in particular have a lifting device to ^¬ facing foot and a side facing away from the lifting head, the foot part is displaced by means of the pivoting device.

In a stretching device, as described here, in particular one, two or more support arms are provided, which in each case act together with a holder ^¬ .

In a stretching device, as described here, in particular a plurality of support arms are mechanically decoupled from each other.

In a stretching device, as described here, in particular each support arm is rotatable, in particular by means of a pivot bearing, connected to the lifting device.

In a stretching device, as described here, in particular each support arm is connected to the lifting device via a damping device having at least one damping element.

In a stretching device, as described here, the damping device is arranged in particular between a support arm and a support element of the lifting device.

In this way, overshooting or a crash of the support arms can be avoided by the safe storage on the lifting device. On a safety rope can be dispensed with entirely.

In a stretching device, as described here, in particular the degree of damping of the damping device can be adapted to the weight of the patient.

This makes it possible, regardless of the patient's weight, to ensure a consistent smooth deceleration with progressive energy reduction during the displacement of the patient into different therapeutic positions. In a stretching device, as described here, the damping device has in particular an elastic material and / or is pneumatically formed.

The damping device has in particular a co-polyester elastomer. In pneumatic training, the damping device in particular an air cushioning.

A stretching device, as described here, furthermore comprises, in particular, a drive device for displacing the lying surface in the vertical direction, wherein the drive device is arranged next to the lying surface.

With an arrangement of the drive device next to the lying surface is meant that in a vertical projection drive means and lying surface do not overlap or only partially or only insignificantly. In other words, there are vertical lines that cut the drive unit, but not the bed surface. In particular, the drive device is arranged relative to the lying surface so that no vertical line intersects both the lying surface and the drive device.

In a stretching device, as described here, a threaded spindle or a hydraulic or pneumatic cylinder of the drive means for vertical displacement of the lying surface next to the lying surface is arranged.

An arrangement of the drive device partially or completely next to the lying surface, in particular an arrangement of a threaded spindle or a hydraulic or pneumatic cylinder completely next to the lying surface can allow a displacement of the lying surface in a particularly deep position. In an arrangement of the drive device substantially or completely below the lying surface of the space taken up by the drive means space limits the lowering of the bed down. When the drive device acts on a scissor mechanism, it is generally added that an extremely great force must be generated by the drive device when the scissor mechanism is largely lowered due to the small angle between the bars. A stretching device, as described here, comprises in particular a sliding mat whose upper side forms a lying surface for a patient, and whose underside rests on the upper side of the couch, wherein the underside of the sliding mat and the upper side of the couch are designed as sliding surfaces which form a allow low-friction sliding of the sliding mat on the lounger.

A stretching device comprises a holder for a patient's feet, a lifting device with which the holder is movable in the vertical direction such that a patient connected to the holder can be transferred from a lying position to a head-hanging position, a couch with a top and a Sliding mat whose upper side forms a lying surface for a patient, and whose underside rests on the upper side of the couch, wherein the underside of the sliding mat and the upper side of the couch are designed as sliding surfaces, which allow a low-friction sliding of the sliding mat on the couch.

The upper side of the couch and the underside of the sliding mat in particular have matched materials that allow a particularly low friction. In particular, at least either the upper side of the couch or the underside of the sliding mat is coated with Teflon.

A sliding mat, which slides friction on the couch, can greatly simplify and facilitate a transfer of a patient from a lying position to a head-hanging position and especially a transfer of a patient from the head-hanging position to a lying position. In particular, a (small) inclination of a part of the upper side of the couch can produce a sufficient downward force to bring the patient with the sliding mat automatically in an extended position. This can be comfortable for patients and a significant relief for medical staff.

The invention will be explained in more detail below with reference to the drawings. Show it :

Figure 1 is a schematic side view of a stretching device with a patient in the rest position; Figure 2 is a schematic side view of the stretching device with a patient with raised pelvis;

Figure 3 is a schematic side view of the stretching device with a patient in the shoulder stand;

Figure 4 is a schematic side view of the stretching device with a patient in a free hanging position;

Figure 5 is a schematic side view of the stretching device with a patient when changing from the free hanging position to the rest position;

Figure 6 is a schematic rear view of the upper part of the stretching apparatus;

FIG. 7 shows a detailed representation of the stretching device;

Figure 8 is a schematic side view of another stretching device;

FIG. 9 shows a further schematic side view of the stretching device from FIG. 8.

FIG. 1 shows a schematic view of a stretching device 1 according to the invention. The stretching device 1 comprises a couch 3 with a lying surface 5 and a lifting device 7. The couch 3 and the lifting device 7 are arranged on a common frame 9 and form in this way a compact unit.

The couch 3 comprises a height adjustment device 11 for displacing the entire lying surface 5 in a vertical direction V, wherein the vertical direction V is oriented substantially perpendicular to the horizontal ground plane E. In the operating position shown in FIG. 1, the lying surface 5 is arranged at a vertical distance TH from the ground plane E. On or in the couch 3, a pivoting device 13 is also provided, by means of which at least part of the lying surface 3 of a horizontal, shown in FIG. H. ground parallel position in an inclined position and vice versa relocatable or

is pivotable. A pivoting of the lying surface 5 is in particular infinitely possible from 0 degrees to about 50 degrees or more. FIG. 3 shows the lying surface 5 in a position in which it is arranged by way of example by means of the pivoting device 13 at an angle of approximately 19 degrees with respect to the bottom surface E. The height adjustment device 11 and the pivoting device 13 have in particular separate drive units, which may be designed, for example, by an electric motor, hydraulically or pneumatically. An electric motor-trained drive unit can be designed in particular as a spindle drive or have at least one lifting cylinder. The height adjustment device 11 and the pivoting device 13 form in the embodiment shown in the figures positioning devices according to the invention.

In the embodiment of the invention shown in Figure 1, the lying surface 5 is formed in two parts and comprises a head part 15 and a foot part 17, wherein only the foot part 17 by the pivoting device 13 from a horizontal position in an inclined position and vice versa is pivoted. A pivoting of the foot part 17 takes place in such a way that the angle to the lifting device 7 opens and closes. The pivot axis of the foot part 17 is disposed near the side surface of the foot part 17 adjoining the head part 15 and defined by a pivot bearing or the like, not shown in FIG.

The height adjustment device 11 is designed so that it can displace both the head part 15 and the foot part 17 in a height direction (vertical direction V). Alternatively, embodiments may be used in which the lying surface 5 is integrally formed and consists of an elastic material such that only a portion of the lying surface from a horizontal position in an inclined position and vice versa is displaced. If a hinge defining a pivot axis is provided, it can be integrated into the lying surface 5.

The stretching device comprises a couch guide 19, which allows a safe displacement and guidance of the couch 3 in the vertical adjustment V in the vertical adjustment. The height adjustment device 11 and the pivoting device 13 are controlled in particular by a common control, which is not shown in the figure. The control makes it possible either to make a displacement of the lying surface 5 in the vertical direction V and / or in the inclination direction selectively by an operator or to run a stored program. The lifting device 7 comprises a drive device 21, which is formed in particular by electric motor. With the lifting device, the height of a holder shown below with reference to Figure 2 can be changed so that a patient connected to the holder from a lying position in a head-hanging position can be transferred. The drive device 21 is exemplified in the present embodiment in the form of an electric motor that drives a belt 23. The belt is deflected at a deflection point 25 on the frame 9 by a roller 180 degrees. Alternatively, the lifting mechanism of the lifting device 7 may be designed differently, in particular by means of ball screws or two redundant flat toothed belt. Alternatively, a lifting operation by means of racks or steel cables is provided.

On the belt 23, a lifting carrier 27, which is only indicated here, is attached via a fixed connecting element 29. The lifting carrier 27 is displaceable by means of a guide device 31 almost free of play in the vertical direction V along the frame 9. The guide device 31 may, for example, have one or more linear guides, rail guides or roller guides.

The drive means 21 causes a circumferential movement of the belt 23 around the deflection point 25 around and a displacement of the connecting element 29 and the Hubträgers 27 in the vertical direction V.

Depending on the rotational position of the belt 23, the lifting carrier 27 can assume a lower, ground-level position or an upper, ground-remote position or any position therebetween.

With the lifting device 7, a support arm 33 cooperates, which serves for receiving a holder 35 shown in Figure 2 for the feet of the patient 12. The support arm 33 is rotatably connected via a not visible in Figure 1 and not shown, but visible in Figure 3 and illustrated rotary bearing with the lifting beam 27 and supported by a damping device 39 to a support member 41 which is fixedly connected to the lifting device 7. The support arm 33 is thus connected only indirectly via the damping device 39 with the lifting device 7. As a result, the relocation of the patient ducks are attenuated in various therapeutic positions in an advantageous manner, as will be explained in more detail below.

Only one carrier arm 33 can be seen in FIG. However, in particular two support arms are provided, which are then successively parallel to each other, d. H. are arranged parallel to the plane of the drawing, as can be seen in the figure 6. In the event that two support arms 33 are provided, in particular one foot in each case via a holder 35 is connected to a support arm 33. Several support arms 33 are mechanically decoupled from each other. Thus, these are "cantilevered" support arms 33. Each support arm 33 is assigned in particular a (common) lifting carrier 27 and a common or separate guide device 31 along which the carrier arms 33 can be displaced in the vertical direction V by the lifting device 7 ,

The support arms 33 are rotatably mounted on their associated lifting carrier 27 and thus allow by means of the damping device 39 a comfortable displacement of the patient from a rest position to a freely suspended position. By the damping device 39 between the support arm 33 and the lifting device 7, an equal load distribution is always ensured in a free-hanging patient. In addition, the therapeutic effect can be improved by a resulting even balance, for example, a pelvic obliquity or leg shortening.

The damping device 39 may have one or more damping elements, which may be the same or different. For example, a plurality of separate damping elements may be arranged in a row one behind the other between a support arm 33 and the lifting device 7, wherein the damping elements may be an elastomer having structure damper, in particular co-polyester elastomer structure damper. Alternatively or additionally, pneumatic damping elements, in particular in the manner of air-sprung upholstery or gas springs, may be provided. In this way, it is possible, regardless of the patient's weight to ensure a consistent soft deceleration with progressive energy reduction when moving a patient. Depending on the weight of the patient, different or differently designed damping elements may be provided. For example, in a particularly heavy patient several damping elements or one or more damping elements may be provided with a greater degree of damping. Alternatively, two support arms 33 may be associated with different damping devices 39, which in particular have a different number and / or different types of damping elements.

FIG. 6 shows a schematic rear side view of the upper part of the stretching device 1. FIG. 6 shows the above-described free pivotal mounting of the carrier arms 33 by means of rotary bearings 37 between the carrier arms 33 and the lifting carrier 27. FIG. 6 shows by way of example a somewhat different design and arrangement of supporting elements 41 and damping devices 39. In particular, it can be seen that a support arm 33 is supported in each case on a support element 41 via a damping device 39 which is shown schematically. The support element 41 is in turn connected to the lifting carrier 27, which is displaceable in the vertical direction V by a drive device, in the figure 6 by way of example a spindle-shaped drive 21 '. As explained above, the lifting carrier 27 is connected via guide means 31 to the frame 9 of the stretching device 1. The shape of the support arms 33 is in the figure 6 from the back view of L-shaped and further extends perpendicularly into the image plane. In Figure 1 it can be seen that the support arms 33 are formed in the side view L-shaped. Alternatively, the support arms 33 have other shapes, for example C-shaped.

Figure 2 shows a schematic side view of the stretching device 1 according to the invention. On the lying surface 5, a patient is arranged, whose feet are fastened by means of brackets 35 and associated fasteners 43 in the form of straps, steel cables or other devices made of durable material to the support arms 33. The fastening means are in particular not elastic, but fixed, so that an equal load distribution is always ensured when a patient hangs on the stretching device 1, in particular in the free hanging position shown in FIG. A manipulation of the fastener 43, the too could lead to a fall of the patient is thus virtually impossible.

The bracket 35 for attaching a foot of the patient to a support arm 33 may include lower leg gaiters or compression cups. These are lined inside especially with soft neoprene, natural latex, or other soft material to avoid pressure pain. In addition, the holder 35 has a harder stable surface, in particular an outer shell, in order to ensure a secure hold of the patient's feet. In particular, each foot is connected to its own holder 35, wherein each holder 35 is in turn connected via a fastening element 43 with a support arm 33.

In FIG. 2, the lying surface 5, as in FIG. 1, is arranged in an elevated position approximately 80 cm above the ground plane E. Furthermore, the movable part of the lying surface 5 is arranged in a horizontal plane parallel to the ground plane E. The lifting device 7 and thus the support arms 33 are further arranged in an elevated position such that the patient's feet in the vertical direction V are pulled up by the holder 35, so that the patient's pelvis is lifted off the foot part 17 of the lying surface 5, d. H. is arranged at a distance to this.

It is clear from FIG. 2 that the vertical position of the support arms 33 is to be determined as a function of the vertical position of the lying surface 5, so that the desired therapeutic position can be taken by the patient. Since the vertical position of the couch 3 can be varied by the height adjustment device 11, this is therefore always to be considered in the control of the lifting device 7.

FIG. 3 shows a further schematic view of the stretching device 1, in which a patient 12 is in the shoulder position, ie the head and shoulder blades rest on the lying surface 5. The lying surface 5 is in this therapy position again in an elevated, ie floor-distant position, which is effected by actuation of the height adjustment device 11. Further, the support arm 33, seen in the vertical direction V, is located above the frame 9 and the movably mounted part of the lying surface 5, namely the foot part 17, is inclined relative to the horizontal floor plane E by approximately 19 degrees. The angle opens to the lifting device 7 out. As a result, the patient's legs are raised in the direction of the support arm 33.

To displace the patient, starting from the position shown in Figure 2 with raised pelvis, the patient is moved to the shoulder stand by the distance between the support arms 33 is increased to the ground level E by means of the lifting device 7 and at the same time the lying surface 5 by means of the pivoting device 13 in a tilted position is shifted.

It thus becomes clear that, in contrast to conventional stretching devices, with the present invention a targeted influencing of the displacement path of the patient can be effected. Due to the fact that no conventional fixed guide surface is provided, but rather a dynamically displaceable guide surface in the form of the lying surface, the patient is guided dynamically adaptable during the displacement into different therapy positions. In this way, it is ensured that the patient always assumes an optimal position even at the transitions between therapy positions.

In Figure 3 it can be seen that the support arm 33 is there in its highest position, since a further displacement of the support arm 33 in the vertical direction V by means of the lifting device 7 is no longer possible. Alternatively and deviating from the illustrations in the figures, the frame 9 and / or the guide device 31 and / or the lifting carrier 27 can be made higher. Then, the support arm 33 can be moved to an even higher position.

Figure 4 shows a further schematic side view of the stretching device 1, wherein the patient is arranged in a free hanging position. For this purpose, starting from the shoulder stand of the patient shown in FIG. 3, it is necessary on the one hand to shift the lying surface 5 back into its horizontal position, so that the foot part 17 is thus arranged with the head part 15 in a common horizontal plane. So that the patient can continue to be transferred to the free hanging position without bumping his head on the couch 3, it is also necessary that To move lying surface 5 by means of the height adjustment device 11 in a ground-level position, ie to reduce the vertical distance TH between the ground plane E and the lying surface 5 to a minimum. As can be seen in FIG. 4, the lying surface 5 is arranged there in a position approximately 10 cm above the floor, so that the patient's head can hang freely above the lying surface 5.

FIG. 5 shows a further schematic side view of the stretching device 1 according to the invention. There, the change from the free hanging position shown in Figure 4 is shown back into the rest position of the patient shown in Figure 1. For this purpose, the lying surface 5 are again moved to an elevated, ground-remote position and beyond the movable part of the lying surface 5, namely the foot part 17, so far from a horizontal plane inclined, in Figure 5 by about 50 degrees, that the patient can be comfortably and comfortably moved from the free hanging position to the rest position.

Starting from the position shown in Figure 5, a removal of the holder 35 from the feet of the patient with the help of an operator is first necessary. Subsequently, the foot part 17 can be displaced by means of the pivoting device 13 back into its horizontal position in a common plane with the head part 15. Since the lying surface 5 in the raised position, d. H. is arranged at a distance TH from the bottom surface E, then the patient can easily get up from the couch 3. The risk of injury or discomfort to the patient is significantly reduced.

FIG. 7 shows a schematic detail of a carrier arm 33 of the stretching device, in particular in the variant shown in FIG. According to the invention, the stretching device can bring about an at least slightly circular or elliptical trajectory of the (foot) holder 35 (see reference numeral 45) on the part of the carrier arms 33 assigned to the holder 35. The circular or elliptical path can run in different spatial directions. Alternatively, the stretching device 1 may be designed to generate a movement in all three spatial directions. This degree of freedom of movement is determined by the damping Fung device possible, as will be explained in more detail below. In the following, the trajectory is explained by way of example with reference to the circular movement.

The circular movement of the holder 35 and thus the patient attached thereto is primarily a positive side effect of the free-hanging arrangement of the support arms 33 (see Figure 6). The additionally produced therapeutic effect has a very positive effect on the spine, because in all directions a gentle mobilization of the patient takes place. The same applies to an elliptical modulation motion path.

In the detailed illustration of Figure 7 it can be seen that the support arms 33, which enter through the pivot bearing 37 with the lifting beam 27, a firm but rotatable connection, are supported at its opposite end of the bracket 35 via the damping device 39 to the lifting beam 27. By the damping device 39, the generation of a modulation movement is possible because the damping element or the damping elements of the damping device 39 are first compressed by the patient's weight and again slightly pushed apart when changing direction (at the turning point). In Figure 7, a support arm 33 is shown in two different positions. In a position of the support arm 33 shown by solid lines, the damping device is maximally extended or relaxed, and in the other position of the support arm 33 'shown with dashed lines, it is compressed to a maximum extent, at least in certain areas. H. activated. This results in a maximum damping path 47, which is consequently a function of the damping device used (elasticity, etc.) and the force applied.

It may be provided a modulation device not shown in the figures, which generates a circular or elliptical trajectory of the support arms 33. The modulation device can be designed so that the "modulation time" of the movement path is adjustable. For example, the stretching device 1 is designed so that an operator via a button on the control panel steplessly the modulation time per minute in the range of 0 - max. 100% can set. In this way it can be defined with what speed the circular one Movement (eg, in relation to the number of cycles per minute, between each semicircular movement) takes place during the circular modulation. These adjustments are made especially by the doctor or the therapist and are based on the one hand on the nature and severity of the degenerative disease of the spine of the patient and on the other hand, according to the well-being of the patient to be treated.

Furthermore, the modulation device can be designed so that the circular modulation path and the maximum modulation speed are predetermined before the start of the treatment via an operating selector switch on the operating panel of the stretching device. In this case, the doctor or therapist can set a desired radius of the circular movement. The amplitude is adjustable in particular in the range up to 25 mm or up to 50 mm. The modulation device can be designed to automatically reduce the maximum modulation speed to half in the event of a setting of a large amplitude or of a large modulation stroke MH starting from a predetermined threshold value of, for example, 50 mm in order to preclude incorrect operation. By having a larger radius of the circular modulation movement, an even better therapeutic effect is achieved in this mode of operation because the gentle stretch can act longer on the spine.

The stretching device according to the invention thus comprises a type of vibration damping, which, however, can be configured controllable or controllable by means of a modulation device. It is particularly advantageous that the lower (the brackets 35 opposite) ends of the support arms 33 on the damping devices 39 not over the entire surface, but obliquely, in particular in different spatial directions, are charged. This results in a linearly increasing and consistent soft deceleration with progressive energy reduction during the displacement of the patient and consequently a circular or elliptical modulation movement, which may be pronounced in different directions in space.

The modulation device can be designed electrically. It acts in particular on the bracket 35 opposite ends of the support arms 33rd such that they are displaced against the damping means 39 at an angle, as shown in FIG. A damping direction 39 assigned to a carrier arm 33 is in particular designed such that it favors a circular or elliptical modulation path of the patient. In particular, a damping device for this purpose, a plurality of damping elements, which may be arranged for example in a vertical and / or horizontal row in a suitable manner.

The pivoting device for displacing at least a part of the lying surface 5 from a horizontal position to an inclined position and vice versa enables optimal patient transport in different therapeutic positions. The at least partially pivotable lying surface 5 represents a dynamically adjustable guide unit, which provides support of the patient in the transfer to various therapy positions. This can significantly improve the therapeutic effect.

About the advantageous height adjustment device 11 of the couch 3, it is also possible to realize in conjunction with the lifting device 7 different therapeutic positions and beyond to ensure a particularly simple and safe lying down and getting up of the patient from the couch 3.

Due to the height adjustability of the lying surface 5, in particular by pivoting at least a part of the lying surface and by a linear height adjustment of the entire lying surface 5, a further degree of freedom of the stretching device 1 is created, which can improve the therapeutic effect.

By means of the damping device 39 and the free pivotal mounting of the carrier arm or the carrier arms 33 on the lifting carrier 27, an optimal adaptation of the stretching device 1 to the respective weight and the physical conditions of a patient is ensured. In addition, the damping device 39 provides secure mounting of the support arms 33 on the lifting device 7. A risk to the patient, which could arise in particular in the free hanging position shown in Figure 4, is thus excluded. FIG. 8 shows a schematic representation of a further stretching apparatus 1. The drawing plane of FIG. 8 corresponds to the drawing planes of FIGS. 1 to 5 and 7. The stretching apparatus 1 shown in FIG. 8 is similar in many properties and features to the stretching apparatus described above with reference to FIGS , Below, only the features and features are discussed in which the stretching device 1 of Figure 8 differs from the above with reference to the figures 1 to 7 stretchers.

In contrast to the illustrations in FIGS. 1 to 7, the stretching device 1 shown in FIG. 8 is shown with a lining which hides a frame, guide means and other components similar to those shown above with reference to FIGS. 1 to 7.

The stretching device 1 comprises a couch 3 similar to that shown above with reference to FIGS. 1 to 5. The couch 3 comprises a lower frame 71 and an upper frame 72, which are connected by a scissors mechanism of a plurality of crossed bars 73. The beams 73 are hinged together and connected to the frames 71, 72. One end of each beam is guided in a groove or along a rail on the associated frame 71, 72. The scissors mechanism is particularly somewhat elastic designed to avoid hard shocks when placing a patient.

The couch 3 further comprises a drive motor 75 for a threaded spindle 76 for moving or moving the upper frame 72 in the vertical direction. Alternatively, another drive, for example a hydraulic or pneumatic drive for the vertical movement of the upper frame may be provided.

At the foot of the couch 3, a cover 78 is provided for the threaded spindle 76. The drive motor 75 and the threaded spindle 76 are not arranged below but next to the lying surface. This allows a particularly deep lowering of the upper frame 72, since the required space for the drive motor 75 and especially for the threaded spindle 76 space must not be kept under the bed surface. The first, lower frame 71 of the couch 3 is in particular integrally formed with a part of the concealed by the cladding components or at least rigidly connected. In particular, the lower frame 71 is mechanically rigidly connected to a vertical portion of a frame and guide means.

The lower frame 71 of the couch 3 can be screwed to the ground, for example the floor of a treatment room, or connected rigidly in some other way. Alternatively or additionally, for example, height-adjustable feet may be provided on the lower frame 71, which allow compensation for unevenness of the floor.

The top 93 of the couch 3 is divided. An area of the upper side 93 encompassing the foot end of the couch 3 is inclined, wherein the inclination may be fixed or (manually or motorically) adjustable. The stretching device 10 further comprises a sliding mat 95 for sliding on the top 93 of the couch 3. The top 93 of the couch 3 and the bottom 96 of the sliding mat 95 are designed so that the sliding mat 95 can slide as low friction on the top 93 of the couch 3 , For this purpose, in particular at least either the upper side 93 of the couch 3 or the lower side 96 of the sliding mat 95 has a Teflon layer or another friction-reducing coating.

FIG. 8 shows a patient 12 in an upside-down position. Foot cuffs 14 are connected to carrier arms 34 by means of ropes or straps. In order to transfer the patient 12 back to a lying position, the support arms 34 are downwardly moved (indicated by vertical arrows) and the upper frame 72 of the couch 3 with the sliding mat 95 upwards. As soon as the patient 12 touches the sliding mat 95, he pushes it parallel to the upper side 93 of the bed 3 obliquely downwards. The movement of the patient 12 and the movement of the sliding mat 95 are indicated by a curved or a straight arrow obliquely down to the left.

To the extent that the patient 12 is increasingly placed on the couch 3, the patient slides 12 together with the sliding mat 95 along the top 93 of the couch 3 to the head end (in Figure 8 to the left). Finally will reaches the state shown in Figure 9, in which the patient 12 is completely on the couch 3. The patient 12, the foot cuffs 14 can be removed, the patient 12 can sit up and leave the couch 3.

The low friction on the upper side 93 of the couch 3 sliding sliding mat 95 allows the transition between the upside down position of the patient 12 in Figure 8 and the lying position of the patient 12 in Figure 9 without assistance from the patient 12 or by medical personnel alone the low-friction gliding takes place. In particular, it is not necessary that personnel pulls the upper body of the patient 12 to the head of the couch 3.

LIST OF REFERENCE NUMBERS

I stretching device

3 lounger

5 lying area

7 lifting device

9 frames

II height adjustment

12 patient

13: pivoting device

15: headboard

17: foot part

19: Guided tour

21: drive device

23: belts

25: turning point

27: lifting carrier

29: connecting element

31: Management device

33: Carrier arm

35: holder

37: pivot bearing

39: Damping device

41: support element

43: fasteners

45: non-linear, esp. Elliptical, esp. Circular motion

47: maximum damping path

71 lower frame of the couch 3

72 upper frame of the couch 30

73 bars of a scissors mechanism between the frames 71, 72

75 Drive motor for threaded spindle 76

76 Threaded spindle for height adjustment of the upper frame 72

78 Cover for threaded spindle 76

79 upholstery 93 top of the couch 3

95 sliding mat

96 Bottom of sliding mat 95 E Ground level

V Vertical direction

MH modulation stroke

TH Vertical distance

Claims

Claims:

1. Stretching device (1) for therapeutic gymnastics comprising: a lying surface (5) having a couch (3) for supporting a patient; a bracket (35) for the feet of the patient; a lifting device (7) with which the height position of the holder (35) can be changed such that the patient connected to the holder (35) can be transferred from a lying position into an upside down position; one of the lifting device (7) independently operable positioning means (11, 13) for height adjustment, in particular by a linear displacement and / or a pivoting movement, at least a portion of the lying surface (5).

2. stretching device (1) according to claim 1, wherein the lying surface (5) by means of a pivoting device (13) is movably mounted such that it is at least partially displaceable from a horizontal position to an inclined position and vice versa.

3. stretching device (1) according to claim 1 or 2, wherein the bed (3) has a height adjustment device (11) for displacing the lying surface (5) in a vertical direction.

4. stretching device (1) according to one of the preceding claims, wherein the height adjustment device (11) and / or the pivoting device (13) are formed by an electric motor or hydraulically, in particular by means of a spindle drive or by means of at least one lifting cylinder.

5. stretching device (1) according to one of the preceding claims, wherein the bed (3) and the lifting device (7) are arranged as a unit on a common frame (9).

6. stretching device (1) according to one of the preceding claims, wherein the lying surface (5) is formed in two or more parts and in particular one of the lifting device (7) facing the foot part (17) and one of the lifting device (7) facing away from the head part (15). , wherein the foot part (17) by means of the pivoting device (13) is displaceable.

7. stretching device (1) according to any one of the preceding claims, wherein one, two or more support arms (33) are provided, each cooperating with a holder (35).

8. stretching device (1) according to claim 7, wherein a plurality of support arms (33) are mechanically decoupled from each other.

9. stretching device (1) according to claim 7 or 8, wherein each support arm (33) rotatably, in particular by means of a rotary bearing (37), with the lifting device (7) is connected.

10. stretching device (1) according to any one of the preceding claims 7 to 9, wherein each support arm (33) via a damping element having at least one damping device (39) is connected to the lifting device (7).

11. stretching device (1) according to claim 10, wherein the damping device (39) between a support arm (33) and a support element (41) of the lifting device (7) is arranged.

12. stretching device (1) according to claim 10 or 11, wherein the degree of damping of the damping device (39) is adaptable to the weight of the patient.

13. stretching device (1) according to one of claims 10 to 12, wherein the damping device (39) comprises an elastic material and / or is pneumatically formed.

14. stretching device (1) according to any one of the preceding claims, further comprising: a drive means (12) for vertical displacement of the lying surface (5), wherein the drive means (12) next to the lying surface (5) is arranged.

15. stretching device (1) according to the preceding claim, wherein a threaded spindle or a hydraulic or pneumatic cylinder of the drive means (12) for displacing the lying surface (5) in the vertical direction next to the lying surface (5) is arranged.