U.S. patent application number 10/017250 was filed with the patent office on 2003-06-19 for supine ergometer brace.
Invention is credited to Falbo, Michael G. SR., Smoler, Martin.
Application Number | 20030114275 10/017250 |
Document ID | / |
Family ID | 21781567 |
Filed Date | 2003-06-19 |
United States Patent
Application |
20030114275 |
Kind Code |
A1 |
Falbo, Michael G. SR. ; et
al. |
June 19, 2003 |
Supine ergometer brace
Abstract
A leg support for a supine bicycle echocardiography table is
provided which maintains proper alignment of the patient's leg with
the bicycle or ergometer portion of the table during lateral
tilting of the table.
Inventors: |
Falbo, Michael G. SR.;
(Gladstone, MO) ; Smoler, Martin; (Shawnee
Mission, KS) |
Correspondence
Address: |
SPENCER, FANE, BRITT & BROWNE
1000 WALNUT STREET
SUITE 1400
KANSAS CITY
MO
64106-2140
US
|
Family ID: |
21781567 |
Appl. No.: |
10/017250 |
Filed: |
December 14, 2001 |
Current U.S.
Class: |
482/57 |
Current CPC
Class: |
A63B 21/4011 20151001;
A63B 22/0605 20130101; A61G 13/04 20130101; A61B 5/4884 20130101;
A63B 2208/0252 20130101; A63B 2230/04 20130101; A63B 2022/0641
20130101 |
Class at
Publication: |
482/57 |
International
Class: |
A63B 022/06; A63B
069/16 |
Claims
Having thus described the invention, what is claimed as new and
desired to be secured by Letters Patent is as follows:
1. A supine bicycle echocardiography table that is tiltable about
its longitudinal axis and having a crank and a pedal arm for
operating the bicycle portion, the table comprising a leg support
having a first end for capturing a patient's leg and a second end
for rotatable connection about the bicycle pedal arm.
2. The table as claimed in claim 1 further comprising a strap for
securing the leg to the support.
3. The table as claimed in claim 1 further comprising a pad
covering the support.
4. A supine bicycle echocardiography table tiltable about its
longitudinal axis and having a crank and a pedal for operating the
bicycle portion, the table comprising a leg support having a first
end for capturing a patient's leg and a second end for rotatable
connection with the bicycle crank.
5. The table as claimed in claim 4 further comprising a strap for
securing the leg to the support.
6. The table as claimed in claim 4 further comprising a pad
covering the support.
7. A leg holder for attachment to the bicycle crank assembly of a
laterally tiltable supine bicycle echocardiography table said leg
holder following the movement of the crank assembly as the bicycle
is operated by a user comprising: a support for attachment to the
leg of a user, a housing, a bearing in said housing said bearing
being connected to the crank assembly for rotation with the crank
assembly, a receiver attached to said housing, and a shaft having a
first end and a second end, said first end connected to said leg
support and said shaft second end connected to said receiver.
8. Leg support for attachment to the bicycle crank of a laterally
tiltable supine bicycle echocardiography table comprising: a leg
pad, a bearing rotatably attached to the crank, and a support rod
connecting said bearing to said pad.
9. The device as claimed in claim 8 further comprising a strap for
securing the leg to the pad.
10. A leg support for attachment to the crank of a laterally
tiltable supine bicycle echocardiography table comprising: a leg
pad, a bearing comprising a housing said housing rotatably
supporting the bicycle pedal arm therein, and a support rod
connecting said bearing to said pad.
11. The device as claimed in claim 10 further comprising a strap
for securing the leg to the pad.
12. A method of reducing the strain on the knee and hip joints of a
patient on a supine bicycle echocardiography table during the
tilting of the table comprising the steps of: securing the leg of a
patient to a support device to maintain a generally perpendicular
alignment between the patient's leg and the bicycle peddle; and
tilting the patient and table.
13. A method of reducing the strain on the knee and hip joints of a
patient while pedaling a bicycle of a supine bicycle
echocardiography table during the tilting of the table comprising
the steps of: placing the foot of the patient on the pedal of the
supine bicycle, attaching a first end of a support device to the
leg of the patient, securing a second end of said support device to
the crank assembly of the supine bicycle.
Description
FIELD OF THE INVENTION
[0001] The present invention relates to devices used in exercise
stress tests, specifically, supine bike echocardiography beds used
in echocardiography stress tests. In particular, the present device
is a leg support for maintaining patient leg alignment during
lateral tilting of a supine bike echocardiography bed.
BACKGROUND OF THE INVENTION
[0002] A stress test, sometimes called a treadmill test or an
exercise test, allows physicians to add exercise to an
electrocardiogram (ECG) in order to determine how well the heart
handles work. During exercise, the body undergoes stress, or work,
and requires more oxygen. The body's pump, the heart, must pump
more blood to the body to meet this oxygen demand. Exercise tests
or stress tests allow the physician to better understand the impact
of this work on the heart.
[0003] Echocardiography is an ultrasound examination of the heart.
An echocardiogram is able to present a clear and more detailed
image of the heart than is possible with ECG studies. Also,
echocardiography is non-invasive, relatively easy to perform and
avoids radiation exposure to the patient. Further, if Doppler
echocardiography is performed, the speed and direction of blood
flow within the heart can be determined.
[0004] When the echocardiogram is performed, the patient is
undressed from the waist up and lies on their left side on an
examination table. The echocardiography technician then places a
transducer against the side of the left chest wall and sound waves
are directed toward the heart. The sound waves are reflected from
the body surfaces they contact and are received by the transducer
and converted into electrical impulses which are used to generate a
picture of the heart. To improve contact with the body, a gel
similar to mineral oil is applied to the transducer to maintain
close contact with the skin.
[0005] The above-described echocardiogram procedure also can be
performed as the heart is placed under exercise or stress.
Typically, to exercise the patient during the echocardiography
procedure, the patient will be asked to walk on a treadmill to
create stress on the heart. An alternative method of exercising the
patient to produce stress on the heart is to use a supine bike
echocardiography table. An example of a prior art supine bike
echocardiography table is shown in FIG. 1. In FIG. 1, supine bike
stress table 10 is comprised of carriage 12 which is made mobile by
wheels 14. Carriage 12 supports elevating pedestal 16 which is
connected frame 18 to which cushions 20, 26 are attached for
patient comfort. Attached to foot end 24 of stress table 10 is
ergometer 26 which operates much like an exercise bicycle.
[0006] Still referring to FIG. 1, in operation, supine bike table
10 is used by having a patent lie on cushions 20, 26 of table 10,
and having the patient place their feet on either side of ergometer
26 and into foot holders 28. Footholders 28 are attached to pedal
52 which is connected to crank 30 of shaft 32 which rotates an
adjustable fly wheel within case 34 of ergometer 26. The fly wheel
resistance and other operational characteristics of ergometer 26
are adjusted by ergometer control 36. When the patient is in
position on table 10, the patient begins to pedal ergometer 26 just
as one would a bicycle. After a time peddling ergometer 26, the
patient will begin to show and feel the signs of this exercise, and
the stress effects of this exercise will begin to be evident in the
heart muscle. To view the effects of exercise on the heart muscle,
the physician or sonographer must perform echocardiography upon the
patient during exercise or within a short time of the cessation of
exercise.
[0007] Performing stress echocardiography with supine bike stress
table 10 is accomplished by using control wand 38 to activate tilt
arm 40 on pedestal 16. Referring now to FIG. 6, tilt arm 40 causes
a lateral tilting of table 10 about the longitudinal axis of frame
18. This tilting can position frame 18, and the patient resting
thereon, at a lateral tilt angle of between zero and up to ninety
degrees although most testing is performed at less than a forty
degree angle. It should be appreciated that with a supine bike
stress table, the patient can continue to exercise during the
tilting of table 10. This allows acquisition of stress
echocardiography data during peak exercise (or the period of peak
ischemia) rather than during the period after exercise known as
recovery which happens when a treadmill is used to induce exercise.
This advantage of supine bike exercise over treadmill exercise will
be further described hereinafter.
[0008] Again, referring to FIG. 1, as stress table 10 is laterally
tilted to an angle of up to ninety degrees, the patient is
supported from sliding off the incline table by shoulder brace 42
and hip strap 43 (FIG. 1). When stress table 10 has achieved the
desired angle, the technician then releases latch 44 of drop panel
22 to place the drop panel in lowered position 46. With drop panel
22 in lowered position 46, the technician has direct access to the
left side chest wall of the patient where the echocardiography
transducer must be placed to be most closely positioned to the
heart and to best observe the actions of the heart. As the
transmitted sound from the transducer is reflected and received by
the transducer, the actions of the beating heart can be on a
monitor attached to the echocardiographic equipment, and the
pictures are recorded digitally and/or on video tape for
examination by a physician. Again, it should be appreciated that
during this entire procedure, that is while table 10 is flat and
while table 10 is being inclined and while the technician is
performing the echocardiography, the patient can continue to
exercise on supine bike table 10.
[0009] By contrast, if a treadmill is used for such stress
echocardiograms, the patient must first exercise on the treadmill
until a sufficient degree of exercise activity has been obtained
and then the patient must be transferred to a horizontal position
on a bed positioned on their left side and only then can the
technician or sonographer perform the echocardiographic
examination. It will be appreciated that during this transfer
process, the patient is no longer exercising and, therefore, for a
period of some time the patient's heart is entering the period
known as recovery during which the heart rate and the changes
induced by exercise are being resolved or eliminated. The longer
the heart is in the recovery period before the echocardiogram is
performed the less relationship the echocardiogram has to true
stress cardiac performance.
[0010] Another problem with the use of treadmills for exercise
occurs when transferring the patient from the treadmill to the bed.
This transfer must be performed while manipulating a substantial
number of electrical leads which are attached to the patient's
chest to allow monitoring of electrocardiographic changes in the
heart. The need to manipulate these wires results in additional
wasted time between cessation of exercise and performance of the
echocardiogram.
[0011] In view of these problems associated with treadmill exercise
it can be appreciated that supine bike echocardiography (SBE) is
considered by many to be a superior means of exercising a patient
for echocardiography. One researcher has determined that ischemic
wall motion abnormalities at the time of echocardiographic imaging
are more frequent and more extensive during supine bicycle
echocardiography, which may increase the detection of coronary
artery disease (CAD) and facilitate interpretation of ischemia.
(See, Shamim-M. Badruddin et al., Supine Bicycle vs. Post-Treadmill
Exercise Cardiography in the Detection of Myocardial Ischemia,
Journal of the American College of Cardiology. Vol. 33, No. 6,
1999.)
[0012] As previously described, during SBE, the patient is
laterally tilted while exercising to place the left side chest wall
in a lowered position for performance of the echocardiogram. This,
of course, places the reclining patient on an angle of up to ninety
degrees, while the patient is continuing to pedal the ergometer.
Most patients upon whom echocardiography is being performed are not
necessarily in the best of physical condition and, in fact, may be
elderly patients who have lost substantial muscle mass in their
legs. This reduction in physical strength can, at times, make it
inconvenient or difficult for the patient to continue to pedal the
ergometer while positioned in a lateral incline of an angle of up
to ninety degrees. Referring now to FIG. 5 it can be appreciated
that an ill or elderly patient, when positioned at such an angle,
will find difficulty in maintaining their legs in anatomical
position while table 10 is tilted. For example, the right leg will
not remain in a parallel position with respect to ergometer case 34
as is indicated by Arrow A. Rather, the patient's right leg will
tend to tilt inwardly along Arrow C and into a position indicated
by Arrow B where the patient's leg and knee will bump against
ergometer case 34. Similarly, the patient's left leg, or downward
leg, will not stay parallel to case 34 as indicated by Arrow A, but
will tend to rotate or fall away from case 34 along a line shown by
Arrow C. This rotation of the patient's left leg into a position
shown by Arrow B can place uncomfortable stress on the patient's
hip, knee and ankle joints and prevent the patient from comfortably
continuing to pedal ergometer 26.
[0013] Therefore, a need exists for a device to support the legs
and knees of a patient exercising on an SBE table while the table
is being inclined to allow performance of the echocardiography
procedure. It will be appreciated that any such support must be
freely movable in the generally circular motion being produced by
the patient's feet on the pedals of ergometer 26 and allow for
comfortable, adjustable support of the legs during reasonably
vigorous exercise.
[0014] Therefore, it is an object of the present invention to
provide support for a patient's legs while on a SBE table when the
table is laterally tilted.
[0015] It is another object of the present invention to provide a
comfortable support for the legs while the patient is exercising
during the tilting of an SBE table.
[0016] Another object of the present invention is to prevent the
patient's right leg from impacting against the ergometer of a
supine bike echocardiography table.
[0017] Yet another object of the present invention is to retain a
patient's left leg in alignment with the pedal and crank of the
ergometer of a supine bike echocardiography table while the table
is being tilted laterally to an angle of up to approximately ninety
degrees.
[0018] Another object of the present invention is that the leg
supports be adjustable and quickly and easily removable so as to be
comfortable for the patient and to avoid becoming an obstruction
should a patient emergency situation arise during the performance
of the stress echocardiogram.
SUMMARY OF THE INVENTION
[0019] These objects and advantages and more are achieved in the
present invention which comprises an adjustable support for
capturing the leg of a patient, the support being attached to an
extension rod which is attached to the ergometer shaft or crank or
pedal and which connection allows complementary movement of the
support and shaft with the movement of the ergometer shaft or crank
or pedal as the patient exercises on the ergometer.
[0020] Alternatively, the objects are achieved by an embodiment of
the present invention in which one end of an elastic or non-elastic
cord is attached to the leg of the patient and the other end of the
cord is attached to a support to prevent the patient's legs from
moving out of anatomical position during tilting of the table.
DESCRIPTION OF THE DRAWINGS
[0021] Preferred embodiments of the invention, illustrative of the
best modes in which the applicant has contemplated applying the
principles, are set forth in the following description and are
shown in the drawings and are particularly and distinctly pointed
out and set forth in the appended claims.
[0022] FIG. 1 is a side elevation view of a prior art supine
bicycle stress echocardiography table;
[0023] FIG. 2 is a right side and foot end perspective view of the
supine bicycle stress echocardiography table of FIG. 1 showing a
patient on the table with the patient's legs inserted into the foot
holders of the ergometer and with the present invention in place on
the ergometer and capturing the leg of the patient;
[0024] FIG. 3 is a fragmentary perspective view of the right side
only of FIG. 2 showing the capture of the patient's leg within the
support of the present invention and the extension rod connecting
the support of the pedal of the ergometer;
[0025] FIG. 4 is a perspective view of the left side of the device
shown in FIG. 2 and showing the bearing connector attached to the
left pedal of the ergometer into which the extension rod for the
support of the present invention is attached;
[0026] FIG. 5 is a perspective view taken from the foot of the
table shown in FIG. 1 and showing the bedframe in a lateral tilted
position;
[0027] FIG. 6 is a rear and head end perspective view of the table
of FIG. 1 showing the table in a tilted position;
[0028] FIG. 7 is an exploded, fragmentary view of the support rod
and bearing of the present invention with a cotter pin shown in
position for coupling the rod to the bearing; and
[0029] FIG. 8 is a foot end perspective view of a supine bicycle
stress echocardiography table showing a patient on the table with
the patient's legs inserted into the foot holders of the ergometer
and with an alternative embodiment of the present invention which
maintains the legs of the patient in anatomical position by use of
support cords.
DESCRIPTION OF THE PREFERRED EMBODIMENT
[0030] Referring to FIG. 4, the components comprising one
embodiment of the present invention will be described. In FIG. 4,
left leg 48 of the patient is shown with the patient's shoe 50
strapped into foot holder 28 which is attached to pedal foot
support 52 of ergometer 26. Left leg 48 is captured within leg
support or leg pad 54 of the present invention and secured thereto
by strap 56. It will be appreciated that the containment of leg 48
within leg pad or support 54 by strap 56 is not an immobilizing
containment, rather, it is a supportive connection to allow
movement of leg 48 to operate pedal 52 and crank 30 of ergometer 26
while preventing leg 48 from uncomfortably falling away from
ergometer 26 and from alignment with pedal foot support 52 when
table 10 is laterally tilted as shown in FIG. 5. Leg support 54 is
a generally oval pad that is positioned in the calf area of left
leg 48 with strap 56 securing leg 48 to support 54 by the use of a
hook and pad fastener such as VELCRO.RTM. or a buckle mechanism.
Leg support is curved to conform to the general shape of the
calf.
[0031] Leg support 54 is adjustably attached to a first end of rod
58 by connector 60. Connector 60 allows leg support 54 to be
adjusted along the longitudinal axis of rod 58 to position leg
support 54 in a comfortable and supportive location on leg 48. A
second end of rod 58 is inserted into receiver 62 and held in
receiver 62 by cotter pin 64 which is inserted through aligned
voids in receiver 62 and rod 58. In a preferred embodiment of the
present invention, receiver 62 is connected to bearing 66 which in
the preferred embodiment shown in FIG. 4 connects pedal arm 68 to
crank 30 by threaded arm 82. Pedal arm 68 has pedal foot support 52
attached thereto.
[0032] It will be appreciated by those skilled in the art that
alternative embodiments can be devised which provide an alternative
connection between rod 58 and the crank assembly of the bicycle.
The crank assembly includes, generally, pedal arm 68 and crank 30
and shaft 32 (FIG. 1) of bicycle or ergometer 26. Pedal arm 68 and
crank 30 and shaft 32 form the cranking mechanism of ergometer 26
and each can serve as a means of connection or a point of
connection for rod 58 in providing a supportive connection of leg
support 54 to the cranking mechanism of ergometer 26. The object of
the alternative connection is to permit leg support 54 and rod 58
to move in conjunction with the cranking apparatus of ergometer 26
which is comprised of pedal arm 68 and/or crank 30 and/or shaft 32.
For example, crank 30 could have an arm attached to crank 30 which
parallels arm 68 and to which a bearing and receiver, similar to
bearing 66 and receiver 62 of the present invention, could be
attached. This would allow attachment of rod 58 to crank 30. In yet
another alternative embodiment, an extension to shaft 32 (FIG. 1)
could be placed on ergometer 26 which would extend beyond crank 30
to allow attachment of rod 58 to shaft 32 via a suitable rotational
bearing with rod 58 being allowed to travel in connector leg which
would rotate with respect to support 54. Alternatively, a cam could
be attached to crank 30 and rod 58 could follow the cam, while
secured therein, to account for the movement of rod 58 with respect
to crank 30. Therefore, it will be appreciated that the preferred
embodiment illustrated herein is not a limitation upon the
construction on the present invention, but rather, is illustrative
of the best mode of which the inventor is presently aware.
[0033] Referring now to FIG. 2, the positioning of a patient 70 on
pad 26 of frame 18 of table 10 is shown. Left leg 48 is shown in
place in pedal support 52 which is on the left side of case 34 of
ergometer 26 and right leg 72 is within pedal foot support 52 which
is on the right side of case 34 of ergometer 26.
[0034] Referring now to FIG. 3, right leg 72 of a patient is shown
secured within leg support 54 by strap 56. By examination of FIGS.
2, 3 and 4 it can be understood that when supine bike stress table
10 is in its horizontal position that a patient is able to operate
ergometer 26 without either of legs 48, 72 contacting case 34.
However, when supine bike table 10 is laterally tilted, as is shown
in FIG. 5, it will be appreciated that, in the absence of the
present invention, right leg 72 would tend to respond to gravity,
and strike or rub against case 34. Likewise, left leg 48 would tend
to fall away from case 34 and require substantial patient effort to
maintain anatomical position of their leg or, that is, the straight
alignment of legs 48, 72 with pedal foot supports 52 of ergometer
26.
[0035] Still referring to FIG. 5 supine bike stress table 10 is
shown in a laterally tilted position, the tilt being a rotation
about the longitudinal axis of table 10. When a patient is in
position on table 10 and the legs of the patient are in position
with the feet captured within foot supports 52 the force of gravity
will tend to move the legs and knees in particular, out of
anatomical position which is a generally perpendicular alignment
with frame 18 of table 10 as represented by Arrows A extending from
foot supports 52. The force of gravity will tend to cause movement
of the legs in the direction of Arrow C and ultimately force the
legs into an angled alignment with respect to frame 18 which is
represented by Arrows B. When the legs of the patient have given
way to the force of gravity and are forced into an alignment
indicated by Arrow B, it can be appreciated that the patient's
right leg, or upper leg, will tend to strike against cover 34 of
ergometer 26 and the left leg, or lower leg, will tend to fall away
from cover 34 of ergometer 26 with only the patient's strength to
serve as a support for the left leg. As previously stated this
rotation of the left leg can cause substantial stress on the
patient's hip, upper leg, and knee and prevent the patient's
ability to engage in useful exercise while on supine bike stress
table 10 when it is in the laterally angled position of FIG. 5.
[0036] The present invention avoids this problem by supportively
maintaining anatomical position and a straight alignment between
legs 48, 72 of patient 70 and the ergometer cranking apparatus
comprised of pedal arm 68, crank 30 and shaft 32 by maintaining
legs 48, 72 directly in line with foot support 52. In this manner,
the patient does not need to expend any effort or energy to prevent
their legs 48, 72 from striking case 34 or falling away from case
34 and can comfortably devote their effort to peddling ergometer 26
to maintain the proper exercise levels for echocardiography.
[0037] Referring now to FIG. 7 a more detailed examination of the
construction and assembly of rod 58, cotter pin 64 and bearing 66.
In general, rod 58 is inserted into receiver portion 62 of bearing
66. Rod 58 is then secured within receiver 62 by the insertion of
cotter pin 64 into aligned voids 63a 63b of rod 58 and receiver 62.
In the present embodiment, it can be seen that receiver 62 is of
unitary construction with housing 80 which encloses bearing 66.
Bearing 66 is, in a preferred embodiment, attached to crank 30 of
ergometer 26 by screwing threaded arm 82 into the threaded void of
crank 30 which normally is used to receive pedal arm 68 (FIG. 4).
After threaded arm 82 has been threaded by hand into crank 30
secured attachment is accomplished by tightening threaded arm 82
into crank 30 through use of hexhead 84. This securely attaches
bearing 66 crank 30. Once bearing 66 is mounted on crank 30, pedal
arm 68 holding pedal 52 can be inserted into threaded void 86 of
bearing 66 and securely tightened. The result of this assembly can
be seen in FIG. 4 wherein bearing 66 is attached to crank 30 and
pedal arm 68 is inserted into void 86 of bearing 66. This preferred
embodiment allows full rotation of pedal 52 about pedal arm 68 and
allows internal bearings contained in housing 80 of bearing 66 to
allow rotation of threaded arm 82 as crank 30 is pedaled by a
patient. This construction also allows rod 58 to rotate about pedal
arm 68 and crank 30 without causing any movement or rubbing of leg
support 54 against the patient's leg.
[0038] Referring now to FIG. 8, an alternative embodiment of the
present invention is presented wherein the legs of the patient are
prevented from being forced out of anatomical position with respect
to pedals 52 during the tilting of table 10 by the use of cords or
elastic cords which are connected between leg cuff or strap 90a,
90b which encircles the patient's leg and which is attached to
either case 34 or an upright support 82 which is attached to frame
18. More specifically, a upright support 82 is attached to the side
of frame 18 which is to be elevated. A connector 84a attaches cord
86a to securing rod 82. A second connector 88a attaches cord 86a to
leg cuff 90a. A similar connection is made for the patient's left
leg, however, cord 86b is secured to case 34 rather than a separate
securing rod 82. It will be appreciated that a second securing rod
82 could be employed approximate to case 34 for holding cord 86b.
As frame 18 is tilted by tilt arm 40 on pedestal 16, cords 86a, 86b
hold the patient's legs in anatomical position with respect to
pedals 52 and to prevent the patient's right leg from hitting
against case 34 and to prevent the patient's left leg from falling
away from case 34 and placing an uncomfortable strain on the
patient's knee and hip joint.
[0039] As required, detailed embodiments of the present inventions
are disclosed herein; however, it is to be understood that the
disclosed embodiments are merely exemplary of the invention, which
may be embodied in various forms. Therefore, specific structural
and functional details disclosed herein are not to be interpreted
as limiting, but merely as a basis for the claims and as a
representative basis for teaching one skilled in the art to
variously employ the present invention in virtually any
appropriately detailed structure.
[0040] In the foregoing description, certain terms have been used
for brevity, clearness and understanding; but no unnecessary
limitations are to be implied therefrom beyond the requirements of
the prior art, because such terms are used for descriptive purposes
and are intended to be broadly construed. Moreover, the description
and illustration of the inventions is by way of example, and the
scope of the inventions is not limited to the exact details shown
or described.
[0041] It is also to be understood that the following claims are
intended to cover all of the generic and specific features of the
invention herein described, and all statements of the scope of the
invention which, as a matter of language, might be said to fall
there between.
* * * * *