WO2018067098A2

WO2018067098A2 - A physiotherapist controlled pronation and supination device

Info

Publication number: WO2018067098A2
Application number: PCT/TR2017/050396
Authority: WO
Inventors: Mehmet KORKMAZ
Original assignee: Korkmaz Mehmet
Priority date: 2016-08-18
Filing date: 2017-08-18
Publication date: 2018-04-12
Also published as: WO2018067098A3; TR201611675A2

Abstract

This invention relates to a device that accelerates the rehabilitation process after the bone union of the fractured bone and it can perform the rehabilitation exercises without the need of an expert. Moreover, it is able to perform hot and cold treatment during the exercises. On the other hand, the device is able to follow and record the recovery of the patient and improve the comfort of the patient.

Description

A PHYSIOTHERAPIST CONTROLLED PRONATION AND SUPINATION DEVICE

TECHNICAL FIELD

This invention relates to a device that accelerates the rehabilitation process after the union of the fractured bone and it can perform the rehabilitation exercises without the need of an expert. Moreover, it is able to perform hot and cold treatment during the exercises. On the other hand, the device is able to follow and record the recovery of the patient and improve the comfort of him.

PRIOR ART

The human skeleton system consists of bones and structures such as muscle, cartilage, organs that support them. The wholeness of the human bone structure is of great importance in terms of both the protection of tissues and organs and the realization of desired movements. This skeletal structure may be deteriorated by the situations called fracture, sprain, dislocation etc. A fracture is a medical term that there is a damage in the continuity of the bone. Fractures usually occur in milliseconds and cause soft tissue damage. It is necessary to heal this kind of situations and rehabilitate the loss of the motion occurred in the broken part.

Human body joints generally consist of three different types of joints: synovial, fibrous, and semi-play (cartilaginous). The (hand) wrist is placed as a synovial joint and people frequently need the flexibility of this joint in daily routines. From this angle, the hand wrist fractures have significant drawbacks that directly affect the daily life of a person. The hand wrist consists of eight small bones with two forearm bones, radius and ulna. The movements in the direction of forward, backward; up, down; and right, left are done with the help of this joint. The most common types of fractures in general and wrist are the fractures at the distal ends of radius bone and they constitute 1/6 of the fractures treated at emergency polyclinics.

As with all fracture types, it is firstly aimed to provide a stable anatomic reduction in the treatment process after Radius / Ulna fractures and the patient is requested to back to the healthy situation immediately. With this thought, a different type of treatment methods is applied to the patient such as encasing in a plaster cast, pinning and external fixation. Physical therapy and rehabilitation for a broken wrist subsequent to healing is an indispensable treatment process. The 90% of the patient having fractures are in need of physical therapy and rehabilitation after the union of the broken bones. In the fracture treatments, "the immobilization of the broken" part is an indispensable step for the healing of the fractures but this phenomenon leads to the problems such as joint limitation, dysmotility, scleromata. For this reason, the main purpose of the rehabilitation process is to overcome the side effect of the casting period. In this rehabilitation period, strengthening of muscles and eliminating of joint-limitations are expected by applying a heat (paraffin, whirlpool, hot water bottle etc.), doing weight training etc. Without the help of these exercises, it might be very difficult to catch up the healthy function for the wrist movements.

The wrist generally has a three-axis rotation similar to the roll, pitch and yaw movements of a plane. After the fracture getting better and removing the cast, it is necessary to rehabilitation process to regain these movements. In this rehabilitation period, conventionally the fractured part is warmed, muscles related to the broken parts are stimulated by electricity and finally, a physiotherapist applies an axial stretching to the patient. The invention which is claimed to the patent provides a solution at this point. BRIEF DESCRIPTION OF THE INVENTION

A patient whose wrist is broken and applied a treatment may continue individually the rehabilitation of wrist except for the pronation and supination movements. However, the patient is in need of an expert to practice the pronation and supination rotations. In addition to this, the implementations such as whirlpool, hot water bottle are done by an expert to the fracture site for effective stretching. However, there is no design that simultaneously warms the related site while stretching by the expert. Therefore, depending on the ambient temperature, the temperature in the relevant broken site may decrease and the limit of axial forces are likely to reduce. Furthermore, it is needed for data on how well the patient has made a progress on rehabilitation period. Obtaining these data both indicate a concrete improvement to the expert and may be a measure of how well the patient has healed. Finally, if global data on the recovery of patients is collected, it is possible to make an estimate on how well a new patient will recover as a result of the rehabilitation based on the situation of his first condition.

Our research has shown that there is no suitable design with the mentioned functions. In this respect, the presented invention offers new solutions to recuperate the patient as soon as possible and provide a better rehabilitation process. The problems mentioned above are solved by the invention with its own design.

These solutions;

• With the help of presented invention, the pronation and supination rotations of the patient's wrist are done automatically by the special software controlled by the expert,

• The use of resistive heating technique to protect the temperature of the patient's rehabilitation site,

• The use of peltier modules for cooling,

• Keeping the daily performance by recording the patient's wrist rotations in each pronation and supination cycle and supplying a tangible data about the recovery process of the patient,

• Two different operation modes called active and passive. It is only operated between the angles which the expert is set for passive mode while the device smoothly increases the rotation angle in each cycle for active mode.

LIST OF FIGURES

Figure 1 . Invention mounted isometric view

Figure 2. Invention mounted side view

Figure 3. Invention mounted top view

Figure 4. Invention mounted front view

Figure 5. Invention mounted the detailed isometric view of A and B points

Figure 6. Detailed view of A

Figure 7. Detailed view of B

Figure 8. Invention transparent view

Figure 9. Invention transparent isometric view

Figure 10. Detailed view of C The correspondence of the part numbers illustrated in figures is listed below.

1 . Power button

2. Software

3. Inner needle

4. Outer needle

5. Motor

6. Motor step counter (encoder)

7. Limit switch

8. Motor holder kit

9. Device forearm holder

10. Pressing tools

1 1. Device skid length

1 1.1 . Device skid length slot

12. Data recording unit

13. Device skid length fixing element

14. Upper extremity tool

15. Upper extremity angle tool

15.1 . Inclined angle slot

15.2. Angle fixing screw

16. Handle

17. Angle chart

18. Driver

19. Heater/cooler wristband

20. Screen

21. Speed controller

22. Emergency button

DETAILED DESCRIPTION OF THE INVENTION

The invention is a medical device that mechanically applies the rehabilitation exercises to a patient, keeps warm the relevant site during the stretching exercises, saves the amelioration data and presents the saved data in daily, monthly or yearly. It is characterized with the equipment that consist of a power button (1 ), a software (2), an inner needle (3), an outer needle (4), a motor (5), a motor step counter (encoder) (6), a limit switch (7), a motor holder kit (8), a device forearm holder (9), at least one pressing tool (10), at least one device skid length (1 1 ), a device skid length slot (1 1 .1 ), a data recording unit (12), at least one device skid length fixing element (13), an upper extremity tool (14), an upper extremity angle tool (15), an inclined angle slot (15.1 ), an angle fixing screw (15.2), a handle (16), an angle chart (17), a driver (18), a heater/cooler wristband (19), a screen (20), a speed controller (21 ), and an emergency button (22).

The device operation procedures are as follows;

1 . Some calibration and adjustments related to patient-device compatibility are to set before it is powered.

a. The first adjustment is the set of the device regarding the patient's forearm length. In order to do that the patient has seated across the device and his forearm is placed to the device forearm holder (9). The device skid length (1 1 ) is set as regards the patient's forearm length moving forward or backward inside the device skid length slot (1 1.1 ). This length is immobilized via the device skid length fixing element (13) using the screwing technique

b. The upper extremity has to be immobilized later than fastening up the patient's forearm. The angle between the upper extremity angle tool (15) and the upper extremity tool (14) is adjusted and fixed by means of the angle fixing screw (15.2) according to the patient's position. The slope is provided with the motion of the upper extremity tool (14) inside the inclined angle slot (15.1 ). The patient forearm placed among these apparatus is clamped via the pressing tools (10). The pressing tools (10) have a flexible style and can stretch out as far as the size of the patient's arm. Accordingly, the apparatuses which are the pressing tools (10) extending as to the size of patient's arm, the device forearm holder (9), and the upper extremity tool (14) are attached to the other end of the device.

c. Finishing the adjustment of the length and the angle, it is necessary to determine the patient's current pronation and supination (P/S) angle ranges. The wrist has been treated by putting in a plaster cast or other methods and after the removing of the cast, the pronation and supination angles fall below the normal value of +/- 90 degrees. The low limit of P/S degrees depends on many factors such as the patient's age, a duration of the cast, a type of plaster etc. The handle (16) is grabbed by a patient later on making necessary adjustments under the control of the expert. The patient's pronation and supination angles are obtained from the angle chart (17) by rotating the device in the direction of left and right (pronation/supination) without energy. These data will then be used for the data entry. The angle chart (17) shows the parts corresponding to the X axis with 90 degrees and the angles decrease in the direction of the Y-axis to 0 degrees, in which the angle differences are less than 1 degree.

After completing the length setting process and determining the P / S values, the device is turned on with the power button (1 ) and energized. The motor (5) is rotated in the direction of left or right so that the reference position information can be given to the software (2) by means of the inner needle (3). During this preliminary movement, it is desirable to touch the limit switches (7) placed at the boundaries of the pronation and supination (+/- 90 degrees) by way of the inner needle (3). At least one limit switch (7) is placed at the part where the inner needle (3) is located. If the limit switch (7) is used more than one they are placed on the inner needle (3) plane in equally, so that the reference information can be handled both in the direction of pronation and supination. Through this contact, the actual position information of the motor (5) is provided to the software (2) and after then the movements of the motor (5) is directly calculated considering the motor step degree and the driver (18) setup. The motor (5) steps can also be controlled using the encoder (6) module coupled to the backside of the motor (5). After the reference information obtained, the motor (5) and the outer needle (4) come to the 0 degree position and the patient is made ready for rehabilitation exercises. The limit switch (7) also allows the device to operate at +/- 90 degrees. In a case of exceeding of the limit values, the information supplied by the inner needle (3) synchronized with the outer needle (4) is conducted to the software (2), and the operation is halted. Slipping of the motor (5) in any way may distort the reference information, hence, the motor holder kit (8) and the motor (5) are fixed.

In the previous steps, the device is harmonized with the patient and the patient's P / S values are determined. Then, the software settings relevant to the operation of the device are required.

a. For this, the patient-related information should be entered via the touch panel on the screen (20). Entering this information, first of all, the data special to the patient has to be described. This special data are might be the patient's social security number or the ID number defined by rehabilitation center.

b. Next, the obtained (as mentioned in section 1 -c) P/S values of the patient is entered via the touch panel on the screen (20), respectively.

c. The device speed set is determined. This speed which is empirically determined by the expert can be previously defined in the software (2) or it can be increased or decreased on the operation or before the operation via the speed controller (21 ).

d. The time information is entered into the software (2) in order to follow and finish the rehabilitation process. There are three different ways to stop the operation which are the use of the emergency button (22), the button placed on the screen (20) or the time defined by the expert. The device is stopped automatically by means of these methods.

e. On the rehabilitation period, it is important to keep the patient's wrist circumference warm or cold in order to maintain better stretching. Because of this reason, the temperature of the wrist circumference is kept in a defined level while P/S rotation is ongoing. When the cases that the patient's wrist circumference is requested cold or warm, the information about this is activated by the touch panel on the screen (20) to the software (2) and the heater-cooler wristband (19) are worn to the patient's wrist after the process described in step 2. If the heater-cooler wristband (19) is activated, the energy from the device is provided. On the heating case, the patient's wrist is warmed using the resistance modules. Contrary to this, the peltier modules are energized to keep cool the patient's wrist. During this process, the sensor mounted in the heater-cooler wristband (19) conveys the temperature information to the software (2). Thus, the patient's wrist is protected from the excessive hot or cold,

f. When the device is operated in the active mode, a working condition which contributes to the healing of the patient is provided. If the device is to be operated in the passive mode, the passive mode information is handed in the software (2) and the operation is done in the range of current P/S values. However, when the information that the device work on active mode is given to the software (2), the device tries to enhance the current P/S values. This information is given via the touch panel on the screen (20). This kind of approach may provide better rehabilitation because of the reason patient's wrist muscles are stretched incrementally. The angle values are increased by at most 5 degrees in at least 20 minutes via the software (2) when the operation is set to active mode.

The procedures 1 and 2 are for the harmonization between the device and patient and procedure 3 is for the adjustment of the software (2). After completing these steps, the exercises are practiced according to the active or passive operation mode to the patient. The exercise continues until the defined time is finished or the operation is halted by any interruption. The data recording unit (12) is used to save the movements of the patient during the operation. The end values in the direction of both P/S are kept by means of the data recording unit (12) for each cycle. These records are obtained during exercise and as unique to each patient. Therefore, the rehabilitation process of the patient can be saved in a daily, monthly etc. routines. With the help of these data, the concrete data about the patient can be presented to the expert. On the other hand, these data may be assessed by a software (2) in an online system so that the estimations about the progress of a new patient may be provided. For instance, entering a new patient current P/S values, the software (2) may predict the progress of the patient or the time that the patient may heal.

Claims

1. It is a physiotherapist controlled physiotherapy device which is characterized by the equipment; a power button (1 ), a software (2), an inner needle (3), an outer needle (4), a motor (5), a motor step counter (encoder) (6), a limit switch (7), a motor holder kit (8), a device forearm holder (9), at least one pressing tool (10), at least one device skid length (1 1 ), a device skid length slot (1 1 .1 ), a data recording unit (12), at least one device skid length fixing element (13), an upper extremity tool (14), an upper extremity angle tool (15), an inclined angle slot (15.1 ), an angle fixing screw (15.2), a handle (16), an angle chart (17), a driver (18), a heater/cooler wristband (19), a screen (20), a speed controller (21 ), and an emergency button (22).

2. The device of claim 1 , wherein the device skid length (1 1 ) is characterized by a movement of forward and backward for adjustment as to the patient's arm length inside the device skid length slot (1 1 .1 ).

3. The device of claim 1 , wherein the device skid length fixing element (13) is characterized by a fixed tool with the screwing feature for the device skid length (1 1 ).

4. The device of claim 1 , wherein the upper extremity angle tool (15) is characterized by having the inclined angle slot (15.1 ) which allows to adjust regarding the patient's position.

5. The apparatus of claim 4, wherein the upper extremity angle tool (15) is characterized by having the angle fixing screw (15.2) which immobilized the angle via the inclined angle slot (15.1 ).

6. The device of claim 1 , wherein the pressing tool (10) is characterized by having a flexible style.

7. The device of claim 1 , wherein the angle chart (17) is characterized by showing the parts corresponding to the X axes at 90 degrees and in the direction of Y axis the angles are decreased at least 1 degree interval.

8. The device of claim 1 , wherein the inner needle (3) is characterized by a tool which provides an information about the reference by touching the limit switches (7) when the power on.

9. The apparatus of claim 8, wherein the limit switch (7) is characterized by placing equally on both sides on the plane of the inner needle (3).

10. The apparatus of claim 9, wherein the limit switch (7) is characterized as a tool which conveys a signal to the software (2) when the inner (3) and outer (4) needles exceed the limit values.

1 1 . The device of claim 1 , wherein the software (2) is characterized by having active and passive operation mode.

12. The method of claim 1 1 , wherein the active mode is characterized by a rotation of the handle (16) at most 5 degrees in the duration of at least 20 minutes.

13. The method of claim 1 1 , wherein the passive mode is characterized by a rotation of the handle (16) in the range determined by the expert (doctor).

14. The device of claim 1 , wherein the heater/cooler wristband (19) is characterized by having resistance and peltier coolers.