U.S. patent application number 09/757480 was filed with the patent office on 2001-07-12 for device for treatment of patients with disturbed posture and motor activity.
Invention is credited to Afanasenko, Nikolai Ivanovich, Barer, Arnold Semenovich, Grigoriev, Anatoly Ivanovich, Kozlovskaya, Inesa Benediktovna, Savinov, Albert Pavlovich, Semenova, Xenia Alexandrovna, Severin, Gai Iliich, Sinigin, Viktor Mikhailovich, Sokolovsky, Igor Antonovich, Tikhomirov, Evgeny Petrovich.
Application Number | 20010007845 09/757480 |
Document ID | / |
Family ID | 34914639 |
Filed Date | 2001-07-12 |
United States Patent
Application |
20010007845 |
Kind Code |
A1 |
Afanasenko, Nikolai Ivanovich ;
et al. |
July 12, 2001 |
Device for treatment of patients with disturbed posture and motor
activity
Abstract
A device for treatment of patients with disturbed posture and
motor activity comprises shoulder, pelvic, knee, pedal, elbow,
hand, and finger supports (1), all of them being interconnected by
fixing elements, which are shaped as elastic tie-members (2) and
placed on the surface of the patient's body in antagonistic pairs
so as to follow anatomical arrangement of skeletal muscles. Each of
the tie-members (2) is connected to two of the supports (1) and
comprises an adjuster (3) of its tension, which is interposed
between the tie-member (2) and one of the supports (1) through a
lock (5).
Inventors: |
Afanasenko, Nikolai Ivanovich;
(Moscow, RU) ; Barer, Arnold Semenovich; (Moscow,
RU) ; Grigoriev, Anatoly Ivanovich; (Moscow, RU)
; Kozlovskaya, Inesa Benediktovna; (Moscow, RU) ;
Savinov, Albert Pavlovich; (Moskovskaya, RU) ;
Severin, Gai Iliich; (Moscow, RU) ; Semenova, Xenia
Alexandrovna; (Moscow, RU) ; Sinigin, Viktor
Mikhailovich; (Moskovskaya, RU) ; Sokolovsky, Igor
Antonovich; (Moskovskaya, RU) ; Tikhomirov, Evgeny
Petrovich; (Moscow, RU) |
Correspondence
Address: |
KENYON & KENYON
ONE BROADWAY
NEW YORK
NY
10004
US
|
Family ID: |
34914639 |
Appl. No.: |
09/757480 |
Filed: |
January 11, 2001 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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09757480 |
Jan 11, 2001 |
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08646214 |
May 7, 1996 |
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08646214 |
May 7, 1996 |
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08196169 |
Feb 15, 1994 |
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08196169 |
Feb 15, 1994 |
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PCT/RU92/00247 |
Dec 18, 1992 |
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Current U.S.
Class: |
482/124 ;
482/121 |
Current CPC
Class: |
A63B 21/0004 20130101;
A63B 21/4025 20151001; A61F 2005/0179 20130101; A63B 2208/0204
20130101; A61F 5/01 20130101; A63B 21/0407 20130101; A63B 21/00069
20130101; A63B 21/4009 20151001; A63B 21/4017 20151001; A63B
21/4013 20151001; A63B 21/4005 20151001; A63B 21/4019 20151001;
A63B 21/055 20130101; A63B 21/023 20130101 |
Class at
Publication: |
482/124 ;
482/121 |
International
Class: |
A63B 021/02 |
Foreign Application Data
Date |
Code |
Application Number |
Jan 31, 1992 |
RU |
5025647 |
Claims
1. A device for treatment of patients with disturbed posture and
motor activity, comprising pelvic and pedal supports (1) placed on
patient's trunk and limbs and interconnected by fixing-elements,
CHARACTERIZED in that the fixing elements are shaped as elastic
tie-members (2) adapted for being placed on the surface of the
patient's body So as to follow anatomical arrangement of the
skeletal muscles, each tie-member (2 ) being connected to two of
the supports (1).
2. A device according to claim 1, CHARACTERIZED in that it
comprises additional shoulder, knee, elbow, finger, and toe
supports (1).
3. A device according to claim 1, and 2, CHARACTERIZED in that it
comprises adjusters (3) of tension of the elastic tie-members (2),
each of the adjusters (3) being interposed between the respective
tie-member (2) and one of the supports (1).
Description
TECHNICAL FIELD
[0001] The present invention relates generally to devices for
nonsurgical (Conservative) treatment of the locomotor apparatus
(locomotorium) in various neuropathies, and more specifically to a
device for treatment of patients with disturbed posture and motor
activity.
[0002] The invention can find most utility when used for treatment
of infantile cerebral paralysis.
[0003] The invention is likewise applicable in cerebrovascular
accidents involving motor disturbances and traumatic lesions of the
spinal cord.
[0004] Furthermore, the invention can be applied for correction of
patient's posture (attitude), as well as for sports exercises.
BACKGROUND ART
[0005] At present the number of neuropathic patients suffering from
affection of the locomotor functions becomes immense, while
infantile cerebral paralysis, in particular, tends to rise, for a
number of reasons, in many countries throughout the world.
[0006] Treatment of motor functions in infantile cerebral paralysis
patients becomes urgent due to both, the number of patients and
imperfection of the treatment method available.
[0007] The present state of the medical art knows a number of
methods and devices for treatment of patients with disturbed
posture and motor activity.
[0008] One state-of-the-art method for treatment of patients with
disturbed posture and motor activity (of. "Surgical Correction of
posture and walking in infantile cerebral paralysis" by A. M.
Zhuravlev et al., 1986, Aiastan Publishers, Yerevan, pp. 90-91 (in
Russian) is known to comprise stage-by-stage plastering, followed
by rigidly fixing the position of the limb and trunk with an
altered posture. A disadvantage inherent in said method resides in
a restricted motor activity (immobility) of a patient, which might
result in amyotrophy, spastic phenomena, and increased hypertensive
syndrome due to enhanced pathological muscular synergies.
[0009] Furthermore, another advantage of said object is a prolonged
treatment period, that is, from 4 to 6 months.
[0010] One state-of-the-art device for treatment of patients with
disturbed posture and motor activity is known (FR, A, 2,120,500) to
appear as overalls into which flexible inflatable tubes are
inserted to impart rigidity thereto.
[0011] A disadvantage inherent in said device is the fact that it
is aimed at maintaining the patient's body in a definite position,
whereby the field of application of said device is extremely
restricted. In addition, said device fails to solve the problem of
muscular exercises of a patient, which might lead to profound
dysfunction of the muscular system.
[0012] Another device for treatment of patients with disturbed
posture and motor activity is known (FR, A, 2,252,836) to comprise
two blades interposed between the patient's thighs, each of said
blades being fixed to a respective thigh, and a mechanical system
connected to the blades.
[0013] The device under discussion suffers from the disadvantage
that it can correct only a wrong position of the thighs, knee
joints, and feet. In addition, said device is bulky and therefore
its application with therapeutic purposes is very questionable.
[0014] One more device for treatment of patients with disturbed
posture and motor activity is known (SU, A, 1,528,485) to comprise
a thoracic, pelvic, and pedal support,-and fixing elements to
interconnect the aforesaid supports to one another.
[0015] The fixing elements are shaped as telescopic stands
interconnecting the pedal supports with the pelvic one and with a
bar one of whose ends is rigidly coupled to the pelvic support. The
bar carries a roller reciprocatingly mounted thereon and rigidly
linked to the thoracic support. Two arms are rigidly connected to
the pelvic support, the free ends of said arms being connected to
springs movably mounted on the telescopic stands.
[0016] With the patient's body in the, erect position the roller
provides a light reclinating effect produced on the entire
vertebral column, while the thoracis support provides rest for the
upper trunk portion. With an inclined position of the trunk the
roller rides over the bar depending on the angle of inclination so
as to assume an optimum position, and the springs impart an effort
to the bar. Thus, the weight of the inclined trunk portion is
compensated for and the muscular system and vertebral column are
released from load.
[0017] A disadvantage of the abovesaid device consists in that it
is intended for treatment of the vertebral column only by releasing
it from load. In addition, use of said device might result in
restricted mobility of a patient followed by amyotrophy and
affected activity of the antigravity muscles. Above all the
treatment process wish the use of said device is too prolonged.
DISCLOSURE OF THE INVENTION
[0018] It is an essential object of the present invention to
provide a physiologically normal stereotype of posture and
movements.
[0019] The present invention has for its principal object to
provide a device for treatment of patients with disturbed posture
and motor activity, wherein the fixing elements interconnecting the
supports have such a construction that enables the patient's trunk
and limbs to be fixed in a position approximating normal
physiological parameters, while maintaining a possibility of
performing energy-loaded movements by the patient, with the
amplitude of said movements characteristic of a given patient.
[0020] The foregoing object is accomplished due to the fact that in
a device for treatment of patients with disturbed posture and motor
activity, comprising pelvic and pedal supports placed on patient's
trunk and limbs and interconnected by fixing elements, according to
the invention, the fixing elements are shaped as elastic
tie-members arranged on the patient's body surface so as to follow
anatomical arrangement of the skeletal muscles, each of the
tie-members being connected to two supports.
[0021] The proposed device is instrumental in fixation of joints in
a required position and to establish a moment of force effecting
flexion, extension, rotation, adduction, and abduction of the
patient's limbs and trunk.
[0022] According to a preferred embodiment of the invention, the
device comprises additional shoulder, knee, elbow, finger, and toe
supports.
[0023] Such an embodiment of the invention makes it possible to fix
practically all the joints of patient's trunk and limbs in a preset
position and enables the patient to perform energy-loaded movements
with amplitudes attainable by a given patient.
[0024] It is quite reasonable that the device comprises tension
adjusters of the elastic tie-members, each of such adjusters being
interposed between the respective tie-member and one of the
supports.
[0025] Provision of the tension adjusters in the device enables one
to vary and individually select the force of action exerted by the
tie-members on the musculoskeletal system, thus adding to the
efficacy of treatment.
[0026] Use of the proposed device makes it possible to utilize
functional (active) correction of the pathologic positions of the
truck and limbs instead of static (passive) corrections thereof,
rearrange the previous pathologic stereotype of the posture and
movements in the central and peripheral nervous systems, potentiate
destruction of the old pathologic complex of reflexes that has been
established in the course of the disease, and create the new
control and conduction system through the intermediary of the
defense structures of the brain. In addition, the effect produced
by the device on patient's organism consists in that the correction
of the locomotorium and energy loading of movements with the limbs
and trunk assuming a new position result in activation of the brain
central structures in elaborating a new arrangement of the control
system of both, the locomotorium and the motor system of the
speech-formation system. Practical application of the proposed
device allows for creation of the stereotype of posture and
movements closely resembling the physiological one.
BRIEF DESCRIPTION OF THE DRAWINGS
[0027] Further objects and advantages of the present invention will
be understood from the following detailed description of a specific
exemplary embodiment thereof and the accompanying drawings,
wherein:
[0028] FIG. 1 is a front view of a device, according to the
invention;
[0029] FIG. 2 is a side view of FIG. 1; and
[0030] FIG. 3 is a rear view of FIG. 1.
BEST MODE FOR CARRYING OUT THE INVENTION
[0031] The device of the invention comprises supports 1 adapted for
being mounted in the region of the patient's shoulders, elbows,
hands, pelvic girdle, knees, feet fingers, and toes. The supports 1
are interconnected through fixing elements which appear as elastic
tie-members 2 adapted to interconnect both the adjacent and
nonadjacent supports 1. The tie-members 2 are so connected to the
supports 1 that they are arranged on the surface of the patient's
body in antagonistic pairs to follow the anatomical arrangement of
the skeletal muscles. Each of the tie-members 2 has an adjuster 3
of its tension, which connects said tie-member 2 to one of the
supports 1.
[0032] Each tension adjuster 3 is in fact a band 4 having one of
its ends connected to the tie-member 2 and the opposite end is held
to a lock 5 which in turn is fastened on one of the supports 1.
[0033] The adjuster 3 may obviously be of any other construction
suitable for performing a similar function.
[0034] The supports 1 can be made of any material featuring a
minimum degree of extensibility, such as fabric, leather, plastics,
and so on.
[0035] Specifically, the tie-members 2 can be made of rubber,
plastics, or appear as metallic springs.
[0036] The device of the invention functions as follows.
[0037] The proposed device is selected individually for emery
patient taking account of his/her state and size of the body. Then
the device is put onto the patient and those tie-members 2 are
tensioned which correct the position of the body parts to be
treated. The tie-members 2 are adjusted for tension with the aid of
the adjuster, whereupon the position thus attained is fixed by the
locks 5. The tie-members 2 are adjusted until a new position of the
trunk and limbs is reestablished, which approximates the normal
physiological one and enables the patient to perform movements with
an amplitude close to a maximum one for a given patient. The
tension of the tie-members 2 is increased at least until a load
appears in the group of muscle corresponding to a given movement.
This done, the device is ready for use.
[0038] Thus, a dynamic supporting structure (functional corset) is
established with the aid of the present device and the patient is
prepared for performing movements.
[0039] The device is utilized by the patient with due account of
his/her status and individual peculiarities daily or a period of up
to 12 hours a day, a treatment cycle lasting for 15-36 days.
[0040] The tie-members 2 arranged on the surface of the patient's
body in antagonistic pairs to follow the anatomical arrangement of
the skeletal muscles with respect to the joints provide for all
kinds of patient's movements in the course of practical application
of the device. In the course of treatment the degree of tension of
the tie-members 2 is gradually increased. As the patient becomes
adapted to the correcting action of the device, the correction
force is increased without affecting the sense of comfort with
respect to the load applied.
[0041] A new stereotype of control of patient's movements is
established in the course of treatment. In addition, the patient's
physiological status becomes predominant, which results in a
reduced amount of pathological muscular synergies and increased
extent of motor activity and allows of correcting the patient's
posture in the cases unamenable to treatment with other correction
methods.
[0042] The present device can be additionally furnished with
overalls put onto patient above the device. The overalls are
provided with openings to provide access to the adjusters 3.
EXAMPLE 1
[0043] Male patient B. K., 17. diagnosis: infantile cerebral
paralysis. The diagnosis has been established since the six-month
age. By the time of treatment with the proposed device the patient
had developed paralysis in the form of spastic diplegia There
occurred triple flexion in the lower limbs complicated by
contractures in the ankle joints, internal rotation of the thighs,
uncompensated body inclination forwards, difficulties in
locomotion, phatologic gait, talipes equinovalgus in both feet
("rocking foot"), internal rotation of bosh arms, and difficult
movements of the hands and fingers. The patient's intellect
remained unaffected, as well as phrasal speech. There was noticed
high level of psychologic motivation for therapeutic
rehabilitation. Previously the patient had been treated medicinally
and with the aid physiotherapy, as well as by correction with
plaster bandages and solid plaster bars. However, the treatment
produced but a transient effect.
[0044] The patient passed a treatment course with the proposed
device for one month, by daily sessions of 2-3 hours.
[0045] The load applied was perceived by the patient within the
initial seven days of treatment after which the sensation of load
disappeared and adaptation ensued. However, within the initial five
days the pathological posture of the patient's trunk and limbs
reappeared in two hours after load releasing. On the 10th day of
treatment a stable result of treatment occurred manifested in
complete disappearance of the pathologic posture, elimination of
flexural disturbances of the lower limbs, improvement in the gait
pattern, facilitating forward displacement of the thighs and higher
walking pace. After the 10th day of treatment the patient could
walk in the erect position. In addition, by the 10th day of
treatment there were observed a considerable decreasing of the
pronation disturbances in the hands and fingers. The patient was
dismissed in 30 days after admission with a considerable
improvement of motor and static functions.
[0046] Given below is table representing the clinical evidence of
practical application of the proposed device in treatment of a
group of patients for the late residual stage of infantile cerebral
paralysis. The age range of the patients was within 15 and 20, a
total number of therapeutic sessions 16-22 for one month.
1TABLE Assess- ment of thera- Num- peutic Form ber effect of of in
five- dis- pat- Progress in process of point Nos ease ients
rehabilitating treatment system 1 Spastic 4 1. Normalization
(though not always 4-3 diplegia complete) of principal pathologi-
cal muscular synergies responsible for triple flexure of the lower
limbs and flexural synergy in the upper limb. Increased pace
length, correct formation of the front and rear thrusts of pace. 2.
Diminished torsion of the trunk and in the shoulder girdle. Lower
intensity of frontal rocking. 3. Disappearance of pathological
synergy in the shoulder girdle. Increased manipulative abilities of
the hand and fingers. 4. Gradual improvement in the articu- latory
aspect of patient's speech. 2 Hyper- 2 1. Walking without support.
Torsion 4-3 kinetic hyperkinetic phenomena of the form neck and
trunk muscles still persisted. 2. Intensity of hyperkinesis reduced
after 10-15 treatment sessions. Walking over long distances became
possible though without conjugate movements of the upper limbs. 3.
Improved speech which became discriminable by the patient's
associates. The patient got able to perform self-care due to
restored movements of the arms. 3 Cere- 2 1. Unassisted walking
over a distance 5 bellar of 200-300 m, the original status being
complete inability to walk. 2. Diminished cerebellar symptoms
(hypermetria, dysmetria, ataxia of the trunk and limbs). 3.
Attenuated speech scanning. Speech became discriminable. 4 Hemi- 2
1. Improvement in motor functions. 3 paretic 2. Decreased fatigue
in walking; form walking over long distances. 3. Improved
manipulative activities of the paretic arm.
[0047] As can be seen from the Table, the best results of treatment
with the present device were obtained with the cerebellar form of
the disease, while the least effect was noted in the hemiparetic
form of infantile cerebral paralysis.
EXAMPLE 2
[0048] Male patient Kh., 40. Diagnosis: affection of the lumbar
cord with partial disturbance of conduction (decompression
sickness).
[0049] The patient passed a treatment course with the proposed
device. The treatment led to improved walking parameters, i.e.,
synchronism in muscular activity, increased walking pace, and
reduced fatigue.
INDUSTRIAL APPLICABILITY
[0050] The proposed device can be used for treatment of patients
affected by infantile cerebral paralysis, as well as in
cerebrovascular accidents involving motor disturbances and
traumatic lesions of the spinal cord.
* * * * *