U.S. patent application number 11/284196 was filed with the patent office on 2006-04-06 for multi-axis cervical and lumbar traction table.
This patent application is currently assigned to The Saunders Group, Inc.. Invention is credited to Stephen James Ryan, H. Duane Saunders, Douglas Gabriel Tomasko.
Application Number | 20060074366 11/284196 |
Document ID | / |
Family ID | 35430371 |
Filed Date | 2006-04-06 |
United States Patent
Application |
20060074366 |
Kind Code |
A1 |
Ryan; Stephen James ; et
al. |
April 6, 2006 |
Multi-axis cervical and lumbar traction table
Abstract
A multi-axis cervical and lumbar traction table and method of
using same. The traction table includes a support frame with a
first body supporting portion and a second body supporting portion.
The first body supporting portion is moveable relative to the
second body supporting portion along a longitudinal axis. A high
friction surface is optionally used to secure a patient to at least
one of the first and second body supporting portions. Linking
mechanism is adapted to move the first body supporting portion
along a path relative to the second body supporting portion,
wherein the path comprises at least one rotational degree of
freedom.
Inventors: |
Ryan; Stephen James;
(Chaska, MN) ; Saunders; H. Duane; (Eden Prairie,
MN) ; Tomasko; Douglas Gabriel; (Woodbury,
MN) |
Correspondence
Address: |
FAEGRE & BENSON LLP;PATENT DOCKETING
2200 WELLS FARGO CENTER
MINNEAPOLIS
MN
55402
US
|
Assignee: |
The Saunders Group, Inc.
Chaska
MN
|
Family ID: |
35430371 |
Appl. No.: |
11/284196 |
Filed: |
November 21, 2005 |
Related U.S. Patent Documents
|
|
|
|
|
|
Application
Number |
Filing Date |
Patent Number |
|
|
10715008 |
Nov 17, 2003 |
6971997 |
|
|
11284196 |
Nov 21, 2005 |
|
|
|
10054631 |
Jan 22, 2002 |
|
|
|
10715008 |
Nov 17, 2003 |
|
|
|
Current U.S.
Class: |
602/32 ; 602/19;
602/36 |
Current CPC
Class: |
A61F 5/04 20130101; A61H
1/0292 20130101; A61H 1/0218 20130101; A61H 1/003 20130101; A61H
1/0222 20130101; A61G 13/009 20130101; A61H 2001/0203 20130101;
A61H 2201/1642 20130101 |
Class at
Publication: |
602/032 ;
602/019; 602/036 |
International
Class: |
A61F 5/00 20060101
A61F005/00 |
Claims
1. A therapeutic apparatus for a patient comprising: a support
frame including a first body supporting portion and a second body
supporting portion, the first body supporting portion moveable
relative to the second body supporting portion along a longitudinal
axis; a first actuator adapted to move the first body supporting
portion relative to the second body supporting portion along the
longitudinal axis; a securing system comprising a high friction
surface on at least one of the body supporting portions sufficient
to secure a patient to such body supporting portion during
therapeutic treatment; and a linkage mechanism adapted to move the
first body supporting portion along a path relative to the second
body portion, the path comprising at least one rotational degree of
freedom, wherein the first actuator is adapted to move the first
body supporting portion along the longitudinal axis without
interfering with movement of the first body supporting portion
along the path comprising at least one rotational degree of
freedom.
2. The therapeutic apparatus of claim 1 wherein the securing system
further comprises a first belt attachable to the first body
supporting portion and adapted to secure the patient to the first
body supporting portion.
3. The therapeutic apparatus of claim 1 wherein the securing system
further comprises a second belt attachable to the second body
supporting portion and adapted to secure the patient to the second
body supporting portion.
4. The therapeutic apparatus of claim 1 comprising at least one
locking mechanism adapted to releasably retain the first body
supporting portion in a plurality of locations along the path
relative to the second body supporting portion.
5. The therapeutic apparatus of claim 4 comprising at least one
locking mechanism for each rotational degree of freedom.
6. The therapeutic apparatus of claim 1 comprising a processor
programmed to determine an adjusted traction force based on patient
parameters.
7. The therapeutic apparatus of claim 1 comprising a processor
programmed to receive the weight of the portion of the patient's
body supported by the first body supporting portion and an angle
between the first body supporting portion and horizontal, the
processor being programmed to determine an adjusted traction
force.
8. A therapeutic apparatus for a patient comprising: a support
frame including a first body supporting portion and a second body
supporting portion, the first body supporting portion moveable
relative to the second body supporting portion along a longitudinal
axis; at least a first actuator adapted to move the first body
supporting portion relative to the second body supporting portion
along the longitudinal axis; a securing system comprising a high
friction surface on at least one of the body supporting portions
adapted to secure a patient to such body supporting portion during
therapeutic treatment; a linkage mechanism adapted to move the
first body supporting portion along a path relative to the second
body portion, the linkage mechanism comprises a roll mechanism, a
pitch mechanism, and a yaw mechanism comprising at least three
rotational degrees of freedom; and wherein the first actuator is
adapted to move the first body supporting portion along the
longitudinal axis without interfering with movement of the first
body supporting portion along the path comprising the rotational
degrees of freedom.
9. The therapeutic apparatus of claim 8 wherein the securing system
further comprises a first belt attachable to the first body
supporting portion and adapted to secure the patient to the first
body supporting portion and a second belt attachable to the second
body supporting portion and adapted to secure the patient to the
second body supporting portion.
10. The therapeutic apparatus of claim 8 comprising: a second
actuator adapted to displace a portion of the therapeutic
apparatus; and a single power source connected to the first and
second actuators.
11. The therapeutic apparatus of claim 8 comprising: a second
actuator adapted to move a head supporting portion of a cervical
traction device relative to the first body supporting portion; and
a single power source connected to the first and second
actuators.
12. The therapeutic apparatus of claim 8 comprising: a head
supporting portion moveable relative to the second body supporting
portion; and a pair of neck wedges adapted to retain a patient's
head to the head supporting portion.
13. The therapeutic apparatus of claim 8 comprising at least one
locking mechanism adapted to releasably retain the first body
supporting portion in a plurality of locations along the path
relative to the second body supporting portion.
14. The therapeutic apparatus of claim 13 wherein the at least one
locking mechanism is continuously adjustable.
15. The therapeutic apparatus of claim 13 comprising at least one
locking mechanism for each rotational degree of freedom.
16. The therapeutic apparatus of claim 8 comprising a processor
programmed to receive the weight of the portion of the patient's
body supported by the first body supporting portion and an angle
between the first body supporting portion and horizontal, the
processor being programmed to determine an adjusted traction
force.
17. A therapeutic apparatus for a patient comprising: a support
frame including a first body supporting portion and a second body
supporting portion, the first body supporting portion moveable
relative to the second body supporting portion along a longitudinal
axis; a linking mechanism pivotally securing the first body
supporting portion relative to the second body portion such that
the first body supporting portion is adapted to move along a path
relative to the second body supporting portion, the path comprising
at least one rotational degree of freedom comprising pitch
movement. a first actuator adapted to move the first body
supporting portion relative to the second body supporting portion
along the longitudinal axis; a second actuator adapted to move the
first body supporting portion relative to the second body
supporting portion along the at least one rotational degree of
freedom comprising pitch movement; and a securing system comprising
a high friction surface on at least one of the body supporting
portions adapted to secure a patient to such body supporting
portion during therapeutic treatment.
18. A method of treating back pain in a patient comprising the
steps of: providing a therapeutic apparatus having a support frame
with a first body supporting portion, a second body supporting
portion, and a first actuator adapted to move the first body
supporting portion relative to the second body supporting portion
along a longitudinal axis; supporting the patient along the first
body supporting portion and the second body supporting portion;
locating the patient on a high friction surface on at least one of
the body supporting portions to secure a patient to such body
supporting portion during therapeutic treatment; moving the first
body supporting portion along a path relative to the second body
supporting portion, the path comprising at least one rotational
degree of freedom; and activating the actuator to move the first
body supporting portion relative to the second body supporting
portion along the longitudinal axis to affect the distance between
the first body supporting portion and the second body supporting
portion without interfering with the step of moving the first body
supporting portion along the path comprising at least one
rotational degree of freedom.
19. The method of claim 18 comprising securing at least a portion
of the patient's body to one of the body supporting portions with a
belt.
Description
REFERENCE TO RELATED APPLICATION
[0001] The present application is a continuation of U.S. patent
application Ser. No. 10/715,008, filed Nov. 17, 2003, entitled
"Multi-Axis Cervical and Lumber Traction Table", which is a
continuation-in-part application of U.S. patent application Ser.
No. 10/054,631, filed Jan. 22, 2002, entitled, "Multi-Axis Cervical
and Lumber Traction Table", the entire disclosures of which are
hereby incorporated by reference for all purposes.
FIELD OF THE INVENTION
[0002] The present invention relates to a therapeutic traction
apparatus, and in particular, to a multi-axis traction device with
a first body supporting portion moveable relative to a second body
supporting portion and a method of using the therapeutic apparatus
to apply traction to a patient.
BACKGROUND OF THE INVENTION
[0003] Back and neck pain are common conditions that can adversely
affect both work and leisure activities. One commonly used
non-surgical approach to alleviating back pain in patients is the
application of traction forces. Traction tables are used to apply
traction forces to the human body through the application of
tension force along the spinal column. Traction tables are
generally used to relieve pain in two areas, the lumbar region,
which is located between a patient's ribs and hipbones, and the
cervical region, which corresponds to the patient's neck
region.
[0004] A traditional system for applying traction to a patient is
through the use of weights and pulleys. The method entails placing
a patient in the supine position and securing the patient to a
resting surface. Cords are then extended from the patient, looped
around suspended pulleys and tied to raised weights which are
released to provide a gravitational force. The weights thereby
apply traction to the patient's back. The system has had only
limited success because it does not sufficiently isolate the region
of the body to which the force is to be applied. In addition, the
system does not adequately treat patients with painful postural
deformities, such as for example a flexed, laterally shifted
posture often seen in patients suffering from a herniated lumbar
disc.
[0005] Furthermore, the traditional system is based upon applying a
linear force in a horizontal or vertical plane to achieve a
particular force exertion on a specific joint or body location. The
forces are typically generated using a static weight or force
generating actuator. The forces applied in a vertical direction
must manually account for weight of a body supporting portion of
the system and weight of a human body to ensure that a correct
force is applied to the intended location. The weight of the body
supporting portion and the human body weight applied in a
horizontal direction have a negligible effect and are typically
applied directly without accommodation. When traction is delivered
in a horizontal plane (perpendicular to gravity), the effect of
these forces is negligible. When traction is delivered in a
vertical plane, these forces must be accommodated for. Traditional
traction methods and devices require that the clinicians manually
take such weight effects on forces administered during traction
into account.
[0006] U.S. Pat. No. 4,890,604 (Nelson) discloses a traction
assembly that applies traction under the inclined weight of the
patient. The traction assembly includes a stationary stand
supportable on a ground or floor surface and a table assembly
connected to the stand. The table assembly includes a frame that is
rotatably assembled to the stand for limited rotation about a
horizontal axis. A flat platform or table is slidably assembled to
the frame for back-and-forth movement under gravitational influence
in a longitudinal direction perpendicular to the axis of rotation
of the frame. Restraints are connected to the patient's ankles and
head. Upon rotation of the frame on the stand to incline the
platform, the body is put in traction according to the weight of
the body and the degree of inclination.
[0007] One shortcoming of the device disclosed in Nelson is that
the degree of applied force depends upon the weight of the body and
the inclination of the frame, rather than by an independently
adjustable force. Furthermore, the assembly does not compensate for
a patient's postural deformities. For example, a patient with a
herniated lumbar disc may not be able to lie perfectly straight on
the table, reducing the effectiveness of the gravitational force.
Further yet, because the patient is anchored to the table at the
neck and ankles, the table does not sufficiently concentrate
traction force on the specific area in need of treatment, for
example, the lumbar region of the body.
[0008] U.S. Pat. No. 4,995,378 (Dyer et al.) discloses a
therapeutic table with a frame and a table top having an upper-body
section rigid with respect to the frame, and a lower-body section
slidable with respect to the frame. The sections provide a
separable surface for a patient to lie prone face down. Hand grips
fixed with respect to the upper-body section extend upwardly of the
plane of the table top. The patient grasps the hand grips with arms
above the head. An anchor is connected to the lower-body section to
which a pelvic belt can be connected. A cylinder and piston drive
slides the lower-body section to increase and decrease the distance
between the hand grips and the pelvic belt anchors.
[0009] Although the Dyer device avoids the use of weights and
pulleys, he still requires a cumbersome harness anchored to the end
of the lower-body section of the table. Dyer also requires the
patient to lie prone and hold on to hand grips during treatment.
The traction force is thus extended along the entirety of the
patient's spine, rather than focusing the force to the lumbar
region. Dyer does not disclose a multi-axis traction device that
can compensate for patient postural deformities that hinder the
application of traction forces along the spine.
BRIEF SUMMARY OF THE INVENTION
[0010] The present invention provides a multi-axis traction device
that is capable of treating back pain for a patient with postural
deformities that hinder the traditional application of longitudinal
traction force along the spine. The present traction device
isolates and concentrates traction force on specific areas of the
body, for example, the lumbar region, without applying the force
along the entirety of the patient's body.
[0011] The present therapeutic apparatus comprises a support frame
with first and second body supporting portions. The first body
supporting portion is moveable relative to the second body
supporting portion along a longitudinal axis. A high friction
surface on at least one of the body supporting portions secures the
patient to such body supporting portion during therapeutic
treatment. A linking mechanism provides the first body supporting
portion movement along a path relative to the second body
supporting portion, the path comprising at least one rotational
degree of freedom.
[0012] The present invention includes a method and apparatus for
determining an adjusted traction force for the patient. The first
body supporting portion is positioned in a non-horizontal
configuration. A compensating force related to a weight of the
first body supporting portion, a weight of an applicable portion of
a patient's body, and an angle between the first body supporting
portion and a horizontal plane is determined. The compensating
force is applied to a desired traction force to determine the
adjusted traction force. The adjusted traction force is applied to
the patient by moving the first body supporting portion relative to
the second body supporting portion along the longitudinal axis to
affect the distance between the first body supporting portion and
the second body supporting portion.
[0013] The compensating force is preferably subtracted from the
desired traction force when the first body supporting portion is
positioned below horizontal. The compensating force is preferably
added from the desired traction force when the first body
supporting portion is positioned above horizontal.
BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWINGS
[0014] FIG. 1 illustrates a therapeutic apparatus in accordance
with the present invention.
[0015] FIG. 2 illustrates an exploded view of the therapeutic
apparatus of FIG. 1.
[0016] FIG. 3 illustrates a patient being treated with a
therapeutic apparatus in accordance with the present invention.
[0017] FIG. 4 is a cut-away perspective view of the therapeutic
apparatus of FIG. 1.
[0018] FIG. 5 illustrates an alternate cut-away view of the
therapeutic traction table of FIG. 1.
[0019] FIG. 6 illustrates another cut-away perspective view of the
therapeutic apparatus of FIG. 1.
[0020] FIG. 7 illustrates a cervical assembly for use with a
therapeutic apparatus in accordance with the present invention.
[0021] FIG. 8 is a schematic view of the therapeutic apparatus
where the first supporting portion is rotated down from its neutral
position in accordance with the present invention.
[0022] FIG. 9 is a schematic view of the therapeutic apparatus
where the first supporting portion is rotated up from its neutral
position in accordance with the present invention.
[0023] FIG. 10 is a schematic view of the therapeutic apparatus
where the head supporting portion is rotated down from its neutral
position in accordance with the present invention.
[0024] FIG. 11 is a schematic view of the therapeutic apparatus
where the head supporting portion is rotated up from its neutral
position in accordance with the present invention.
[0025] FIG. 12 a schematic view of the therapeutic apparatus with
an electrical device adapted to adjust the traction force in
accordance with the present invention.
[0026] FIG. 13 a schematic view of the therapeutic apparatus with a
digital device adapted to adjust the traction force in accordance
with the present invention.
DETAILED DESCRIPTION OF THE INVENTION
[0027] The present invention provides a therapeutic apparatus for
treating a patient suffering from back pain. The apparatus is
adapted to exert a therapeutic traction force on a patient's spine
to relieve pressures on structures that may be causing pain. The
apparatus is further capable of producing the forces and positions
required to cause decompression of the intervertebral discs, that
is, unloading due to distraction and positioning. The apparatus
provided by the present invention can be used to treat many
conditions, including, but not limited to back pain, neck pain,
herniated disc, protruding disc, degenerative disc disease,
posterior facet syndrome and sciatica.
[0028] FIG. 1 illustrates a therapeutic apparatus 10 including a
support frame 12 having a first body supporting portion 14 and a
second body supporting portion 16. First body supporting portion 14
is capable of movement relative to second body supporting portion
16 along a longitudinal axis 18. As used herein, the term
"longitudinal axis" refers to the axis along which a body
supporting portion can be displaced. In FIG. 1, first body
supporting portion 14 is adapted to generally support a patient's
lower body while second body supporting portion 16 is adapted to
support a patient's upper body. The present invention also
contemplates the reverse (i.e. first body supporting portion
supporting the patient's upper body and the second body supporting
portion supporting the patient's lower body).
[0029] The therapeutic apparatus 10 further includes a securing
system 20 adapted to secure a patient to the first and second body
supporting portions 14, 16. Linking mechanism 22 is adapted to
provide movement of the first body supporting portion 14 relative
to second body supporting portion 16 along a path comprising at
least one rotational degree of freedom. As used herein, "rotational
degree of freedom" refers to rotational movement of a first body
supporting portion relative to a second body supporting portion.
Although the embodiment in FIG. 1 shows first body supporting
portion 14 in a neutral position (i.e. along the same horizontal
plane as the second body supporting portion 16), first body
supporting portion is adapted to move along a path comprising up to
three degrees of freedom, including, but not limited to yaw
movement along path 24, pitch movement along path 26, roll movement
along path 28, or a combination thereof.
[0030] Securing system 20 is adapted to secure a patient to the
first and second body supporting portions 14, 16. In the embodiment
of FIG. 1, securing system 20 includes a first belt 30 attached to
the support frame 12, and extending at least to each side edge of
first body supporting portion 14, and a second belt 32 attached to
the support frame 12 and extending at least to each side edge of
second body supporting portion 16 in a similar manner. In FIG. 1,
first and second belts 30, 32 comprise adjustable and releasable
hook and loop fasteners, such as Velcro.RTM.. In another
embodiment, the securing system 20 can be a Velcro.RTM. or other
high friction surface on the body supporting surfaces 14, 16 with
or without belts 30 and 32, pelvic and/or thoracic harnesses, pegs,
binders or any combination of these devices.
[0031] FIG. 2 illustrates an exploded view of the present
therapeutic apparatus 10. Support frame 12 includes a base portion
50, a support member 52, and a platform portion 53. Base portion 50
supports the apparatus and is positioned on a generally horizontal
surface. Support member 52 is secured to base member 50 at a lower
portion 59, and to platform portion 53 at an upper portion 63.
Support member 52 is thereby positioned in a vertical plane and is
adapted to provide support for the first and second body supporting
portions. Support member 52 also includes an actuator (not shown)
for increasing or decreasing the height of the first and second
body supporting portions relative to the base portion 50. Suitable
actuators include pneumatic or hydraulic cylinders, linear motors,
worm gears, rack and pinion systems, and the like. Preferably,
support member 52 is capable of adjustment between about 25 inches
to about 35 inches and is powered by a central source of compressed
air 68.
[0032] In the illustrated embodiment, the second body supporting
portion 16 is rigidly attached to a top side 51 of platform portion
53 and is positioned along a substantially horizontal plane. First
body supporting portion 14 is pivotally secured to platform portion
53 by linking mechanism 22. As shown in FIG. 2, linking mechanism
22 comprises cantilever arm 58, yaw mechanism 60, pitch mechanism
62 and roll mechanism 64. Cantilever arm 58 is pivotally attached
to pitch mechanism 62 by yaw mechanism 60 at pivot point 61 (See
FIG. 6). Pitch mechanism 62 is pivotally attached to platform
portion 53 at pivot points 65 and 67. Roll mechanism 64 is
pivotally attached to cantilever arm 58 at pivot points 71 and 73.
An actuator 66 can be secured to pitch mechanism 62 at lever 69,
the actuator being adapted to facilitate movement along a path
comprising at least one rotational degree of freedom, preferably
facilitating at least pitch movement along path 26 (see FIG. 1).
Almost any type of actuator can be used, however, an actuator of
the present invention is preferably powered by a single central
source of compressed air 68.
[0033] Sliding mechanism 54 is slidably attached to roll mechanism
64. In the illustrated embodiment, sliding mechanism 54 includes
rollers 55 that slide in tracks 57 on roll mechanism 64, although a
variety of structures could be used. First body supporting portion
14 is secured to sliding mechanism 54 and is thereby capable of
movement along longitudinal axis 18, as shown in FIG. 1.
Preferably, first body supporting portion 14 is capable moving up
to 6 inches along longitudinal axis 18. Actuator 56 can be secured
to sliding mechanism 54 to facilitate movement of the first body
supporting portion along longitudinal axis 18. Any type of suitable
actuator can be used, including a pneumatic actuator, hydraulic
actuator, rack and pinion structures, linear motors, worm gear,
solenoids, and the like. In the illustrated embodiment, actuator 56
is a double acting piston powered by a central source of compressed
air 68 and is capable of moving first body supporting portion 14
along longitudinal axis 18 with a force of up to about 200
pounds.
[0034] The present therapeutic apparatus 10 permits the actuator 56
to apply or remove a traction force to the patient without
interfering with the operation of the yaw mechanism 60, pitch
mechanism 62 or roll mechanism 64. In particular, any one or all of
the yaw mechanism 60, pitch mechanism 62 and roll mechanism 64 can
be adjusted before, during or after a traction force is applied to
a patient. The therapeutic apparatus 10 has the added advantage
that there are no rope and pulleys to interfere with the operation
of the yaw mechanism 60, pitch mechanism 62 and/or roll mechanism
64 during traction.
[0035] Processor 70 receives input data, processes that data and
communicates with a central source of compressed air 68 in
response. In the illustrated embodiment, the processor has a
digital display, incorporating touch screen capabilities. Processor
70 is adapted to receive, process and communicate to the traction
apparatus almost any relevant treatment data, including the type of
force (e.g. static or intermittent), force ramp up and ramp down
times, force hold and rest times, magnitude of hold and rest
forces, and treatment times. Optionally, the processor 70 is
adapted to automatically adjusting the table height and/or pitch
movement of the apparatus, as well as a patient control switch
adapted to terminate treatment. As used herein, "processor" refers
to any of a variety of general purpose or special purpose
programmable computing devices, such as for example a PC or a
programmable logic controller. In one embodiment, the processor 70
is a separate stand-alone computer, such as a PC.
[0036] The processor 70 can also store and retrieve pre-programmed
traction protocols. For example, the therapist may develop a
protocol for a particular patient that can be applied multiple time
over the course of treatment. This protocol can be stored in the
processor 70 for future use. A protocol can include any of the
treatment variable available in the processor 70, including without
limitation the type of force (e.g. static or intermittent), force
ramp up and ramp down times, force hold and rest times, magnitude
of hold and rest forces, and treatment times. The processor 70 also
preferably assigns an index number or title to each protocol so
that they can be easily retrieved. In another embodiment, the
therapist generates a treatment protocol off-line on a separate
computer system, such as a PC. The protocol is then uploaded to the
processor 70 using conventional computer communication protocols
and techniques, such as an RS-232 connection. This embodiment
permits the treatment protocol to be sent electronically to other
clinics at which the patient can receive treatment. One method of
electronically transmitting a treatment protocol is using
electronic mail over the Internet.
[0037] FIGS. 4, 5 and 6 show views of a portion of the present
invention and illustrate examples of different rotational degrees
of freedom of which first body supporting portion 14 is adapted to
move relative to second body supporting portion 16. For example, in
FIG. 4, roll mechanism 64 is pivotally secured to cantilever arm 58
at pivot points 71 and 73 to provide roll movement along path 28
about axis 90. It is preferable that roll mechanism 64 be capable
of providing first body supporting portion 14 with up to about 15
degrees of rotation from the neutral position in either a clockwise
or counterclockwise direction.
[0038] In FIG. 5, yaw mechanism 60 (see FIG. 6) is pivotally
attached to pitch mechanism 62 at pivot point 61 (see FIG. 6) and
is adapted to rotate cantilever arm 58 about axis 100 to provide
yaw movement of the first body supporting portion 14 (see FIG. 1)
along path 24. Preferably, yaw mechanism 60 is capable of providing
the first body supporting portion 14 up to about 15 degrees of
rotation in either direction from the neutral position.
[0039] In FIG. 6, pitch mechanism 62 is secured to platform portion
53 at pivot points 65 and 67 and is adapted to rotate cantilever
arm 58 about axis 110 to provide pitch movement along path 26, as
shown in FIG. 1. Although FIG. 6 illustrates rotation flexed above
the neutral position, embodiments of the present invention can also
extend below neutral. Preferred embodiments of the present
invention are capable of flexing up to about 25 degrees and
extending down to about 20 degrees from the neutral position.
[0040] Although FIGS. 4, 5 and 6 each illustrate movement along a
path defined by one rotational degree of freedom (e.g., pitch, roll
or yaw), the present therapeutic apparatus 10 is capable of
movement along paths that comprise two or more rotational degrees
of freedom. That is, each of the rotational degrees of freedom are
preferably independently and simultaneously adjustable. In a
preferred embodiment, the first body supporting structure is
capable of simultaneous movement along a path having three
rotational degrees of freedom, comprising roll, yaw and pitch
movement.
[0041] In the illustrated embodiment, the longitudinal axis 18
comprises the axis of movement of the sliding mechanism 54 relative
to the cantilever arm 58. This movement along the longitudinal axis
18 is independent of the three degrees of freedom. The path upon
which first body supporting portion 14 is positioned affects the
direction and angle of its movement relative to second body
supporting portion 16 along longitudinal axis 18. For example, if
first body supporting portion 14 is positioned along path 26, 10
degrees above the neutral position, then longitudinal axis 18 will
be located 10 degrees above the location of longitudinal axis 18 in
FIG. 1.
[0042] The present invention provides at least one locking
mechanism for releasably retaining first body supporting portion 14
along the path comprising at least one rotational degree of
freedom. The apparatus may further provide a locking mechanism for
releasably retaining the first body supporting portion 14 from
movement along longitudinal axis 18. For example, FIG. 4
illustrates a first locking mechanism 94 adapted to releasably
retain first body supporting portion 14 from longitudinal movement.
Second locking mechanism 96 is adapted to releasably retain first
body supporting portion 14 from yaw movement along path 24 and
third locking member 98 is adapted to releasably retain first body
supporting portion 14 from roll movement along path 28. In another
embodiment, at least one locking mechanism is provided for each
rotational degree of freedom. In one embodiment, the locking
mechanisms 94, 96, 98 are an infinitely positionable mechanical
lock, such as disclosed in U.S. Pat. No. 4,577,730 (Porter), or the
linear positioning devices sold under the trade name Mecklok.RTM.
from P. L. Porter Company of Woodland Hills, Calif.
[0043] The locking mechanisms 94, 96, 98 are preferably biased to a
locked position. The locked position is released using the handles
indicated by the reference numerals. The operator manually releases
one or more of the locking mechanisms 94, 96, 98 and positions the
first body supporting portion 14 in the desired configuration.
Releasing the handle re-engages the locking mechanism 94, 96, 98.
Positioning the first body supporting portion 14 along any
combination of the three rotational degrees of freedom does not
interfere with the movement of the sliding mechanism 54 along the
longitudinal axis 18.
[0044] As illustrated in FIG. 7, an apparatus of the present
invention may also provide a head supporting portion 120 for
generally supporting the head of the patient. Head supporting
portion 120 is slidingly attached to frame 134. The frame 134 is
pivotally attached to platform portion 53 at pivot points 124, 126
(See FIG. 2), and is adapted to move along path 122. Preferably,
the frame 134 is adapted to rotate at pivot points 124, 126 up to
about 30 degrees from a horizontal plane. Locking mechanism 130 is
provided for releasably retaining the frame 134 and head supporting
portion 120 at various locations along path 122.
[0045] The head supporting portion 120 is adapted to move relative
to frame 134 along an axis 132 under the power of actuator 128.
Conventional ropes and pulleys are eliminated. Actuator 128 is
preferably powered by the central source of compressed air 68 (see
FIG. 2) to generate the cervical traction force. In the present
therapeutic apparatus 10, the single power source 68 operates all
of the actuators 56, 66, 128. Neck wedges 136 are preferably used
to retain the patient's head to the head supporting portion 120
(see FIG. 2). The location of the neck wedges 136 is preferably
adjusted to accommodate patients of different sizes. Head strap 121
can optionally be used to retain the patient's head to the head
supporting portion 120. A cervical traction assembly with
adjustable neck wedges suitable for use in the present invention is
disclosed in U.S. patent application Ser. No. 08/817,444, entitled
Portable Traction Device and U.S. Pat. No. 6,171,273. The processor
70 preferably retains cervical traction protocols as well.
[0046] The present invention also provides a method of treating a
patient with the apparatus generally described above. FIG. 3
illustrates a patient being treated on an apparatus of the present
invention. Support member 52 is adjusted to a height that easily
facilitates a patient mounting the apparatus. First body supporting
portion 14 is then moved along a path comprising at least one
rotational degree of freedom to accommodate for any postural
deformities of the patient. The patient is then placed and
supported on the first and second body supporting portions 14, 16
in either a prone or supine position, and is secured to first body
and second body supporting portions 14, 16 by securing system 20.
In FIG. 3, securing system 20 comprises a first belt 30 connected
to the support frame, near each side edge of first body supporting
portion 14 and a second belt 32 is connected to second body
supporting portion 16 in a similar manner. First belt 30 is
tightened around the navel region of the patient, just above the
iliac crests. Second belt 32 is tightened around the ribcage of the
patient, just above the lumbar region. The belts may overlap
slightly.
[0047] Next, first body supporting portion 14 is moved relative to
second body supporting portion 16 along longitudinal axis 18 (see
FIG. 1). As the distance between the first and second body
supporting portion is increased, a traction force is applied to the
patient's lumbar region by the first and second belts. Further,
because the first body supporting portion 14 has been moved along a
path comprising at least one rotational degree of freedom, the
traction force is applied at an angle that compensates for a
patient's postural deformities. As the distance between the first
and second body supporting portions is decreased, the traction
force applied to the patient's lumbar region is decreases.
[0048] Many variations of the above described method can be
accomplished by an apparatus of the present invention. For example,
to further treat a patient's postural deformities, first body
supporting portion 14 can be moved along a path comprising at least
one rotational degree of freedom after the patient is secured to
the table and even during the application of traction force to the
patient. Further, the table can be releasably retained anywhere
along the path during treatment to accommodate the patient's
condition. It may even be desirable to retain first body supporting
portion 14 at multiple locations along a path during a treatment
cycle. Additionally, the traction force created by first body
supporting portion 14 moving away from second body supporting
portion 16 along longitudinal axis 18 can be static (i.e. constant
application of a force during a period of time) or intermittent
(application of greater force for a period of time followed by a
lesser force for a period of time). Further yet, the patient can be
treated in either the supine or prone position and/or both, without
adjusting the apparatus.
[0049] Prior to beginning therapy, a treatment protocol can be
entered into processor 70 to facilitate some or all of the
therapeutic steps. In a preferred embodiment, processor 70 provides
a touch control screen to assist a health care professional in
entering the treatment protocol. Data input such as the mode of
lumbar treatment (e.g. static or intermittent), force ramp up time,
force ramp down time, hold time, rest time, rest force, maximum
force, and treatment time can all be entered to create a desired
treatment protocol. The processor 70 communicates with the power
source (in the illustrated embodiment the source of compressed air
68) to power the actuators 56, 66, 128 and to provide the
designated movement between the first body supporting portion,
second body supporting portions, and/or the head supporting portion
14, 16, 120.
[0050] Performance characteristics of the present invention include
improved ability to treat patients with postural deformities,
greater ease in the treatment of patients, and reduced set-up time.
By providing an apparatus that is adapted to move along a path
comprising at least one rotational degree of freedom, an apparatus
of the present invention can treat patients with postural
deformities who could not be adequately treated with conventional
traction devices. Further, the securing system 20 provides a more
efficient and less cumbersome mechanism of applying traction force
to a patient. Further yet, a single or series of patients can be
treated in either the prone or supine position or both, without
adjusting or altering an apparatus of the present invention. Thus,
the invention has improved performance characteristics, while also
being easier and faster to use.
[0051] In another embodiment of the present method, more accurate
traction forces are provided by compensating for both the weight of
the body supporting portion 14 and the weight of the applicable
portion of the patient supported by the body supporting portion 14.
For example, FIG. 8 is a schematic view of the therapeutic
apparatus 10 generally as illustrated in FIG. 1 with the first body
supporting portion 14 rotated down from a neutral (horizontal)
position relative to the horizontal plane 204. The downward slope
of the first body supporting portion 14 can cause the traction
force to be greater than intended due to the influence of gravity.
That is, gravity acting on the first body supporting portion 14 and
the portion of the patients body supported thereon adds the forces
224 and 226 to the desired traction force 230.
[0052] The present invention uses the force vectors for the weight
222 of the tilted first body supporting portion 14 and the weight
220 of the applicable portion of the patient's body 202 supported
by the body supporting portion 14 to calculate a compensating force
along the longitudinal axis 18 of the tilted first body supporting
portion 14. As used herein, the phrase "compensating forces" refers
to force vectors along a longitudinal axis of a tilted body
supporting portion of a therapeutic apparatus, which accommodate
for the weight of the tilted body supporting portion and the weight
of the applicable portion of the patient's body supported by the
body supporting portion during traction.
[0053] To apply a desired traction force to the patient, the
compensating forces 224 and 226 are either added to or subtracted
from a delivered traction force 230 depending upon whether the
first body supporting portion 14 is rotated up or rotated down from
its neutral position on the horizontal plane 204. As shown in FIG.
8, when the first body supporting portion 14 is rotated down from
its neutral position, the compensating forces 224 and 226 will be
subtracted from the delivered traction force 230.
[0054] In another example, FIG. 9 is a schematic view of the
therapeutic apparatus 10 generally as illustrated in FIG. 1 with
the first body supporting portion 14 rotated up from its neutral
(horizontal) position relative to the horizontal plane 204. Again,
due to the influence of gravity the upward slope of the first body
supporting portion 14 may cause the traction force to be less than
intended. When the first body supporting portion 14 is rotated up
from its neutral position, the compensating forces 224 and 226 is
typically added to the delivered traction force.
[0055] An estimate of the applicable portion of the patient
supported by the body supporting portion can be calculated
according to the following body mass distribution table.
TABLE-US-00001 TABLE 1 Percentage of Body Portion Total Body Mass
Head/Neck about 8% Hips about 12% Thighs about 20% Lower Legs about
9.2% Feet about 3%
The mathematical formula for calculating the compensating forces is
determined according to the equation below: Compensating
forces=Sin(Acute Angle Between Tilted Body Supporting Portion of
Therapeutic Apparatus and Horizontal Plane)*(Weight of Tilted Body
Supporting Portion+Weight of Applicable Portion of Patient)
Adjusting the delivered traction force by the compensating forces
will yield an adjusted traction force. As used herein, the phrase
"adjusted traction force" represents a traction force that is
modified to take the compensating forces into account. The
mathematical formula for calculating the adjusted force is
determined according to whether the force of gravity increases or
decreases the delivered traction force. If the body supporting
portion is rotated down from its neutral position, then Adjusted
Traction Force=Delivered Traction Force-Compensating Forces. If the
body supporting portion is rotated up from its neutral position,
then Adjusted Traction Force=Delivered Traction Force+Compensating
Forces.
[0056] For example, the total body weight of a male patient on the
therapeutic apparatus 10 is about 200 pounds in FIG. 8. His tilted
lower body 202 on the tilted first supporting portion 14 includes
his hip, thighs, lower legs, and feet. In general, an ordinary
human being's lower body weight is equal to approximately 44% of
his or her total body weight. In this example, the patient's lower
body weight 220 is about 88 pounds (200 pounds*44%). The weight 222
of the tilted first body supporting portion 14 of the therapeutic
apparatus 10 is fixed at about 22 pounds. The first supporting
portion 14 is rotated down about 10 degrees from the horizontal
plane 204. The compensating forces 224 and 226 for this example
could be calculated at: Sin(10.degree.)*(22 pounds+88pounds)=17.4
pounds Therefore, when delivering a traction force 230 of 150
pounds, an adjusted traction force of 132.6 pounds (150 pounds-17.4
pounds) should be applied to the patient.
[0057] Referring now to FIG. 9, the same male patient is treated in
this example. The first supporting portion 14 is rotated up about
15 degrees from the horizontal plane 204. The compensating forces
224 and 226 for this example could be calculated at:
Sin(15.degree.*(22 pounds+88 pounds)=28.5 pounds Therefore, when
delivering a traction force 230 of 150 pounds, an adjusted traction
force of 178.5 pounds (150 pounds+28.5 pounds) should be applied to
the patient.
[0058] Referring to FIG. 10, the same male patient is treated in
this example. At this time, the head supporting portion 120 is
rotated down about 10 degrees from the horizontal plane 204. In
general, an ordinary human being's head and neck weight is equal to
approximately 8% of his or her total body weight. Here, the weight
234 of patient's head and neck 203 is about 16 pounds (200
pounds*8%). The weight 236 of the tilted head supporting portion
120 of the therapeutic apparatus 10 is fixed at about 4 pounds. The
compensating forces 238 and 240 for this example could be
calculated at: Sin(10.degree.)*(4 pounds+16 pounds)=3.5 pounds
Therefore, when delivering a traction force 232 of 150 pounds, an
adjusted traction force of 146.5 pounds (150 pounds-3.5 pounds)
should be applied to the patient.
[0059] Referring to FIG. 11, the same male patient is treated in
this example. The head supporting portion 120 is rotated up about 5
degrees from the horizontal plane 204. The compensating forces 238
and 240 for this example could be calculated at: Sin(5.degree.)*(4
pounds+16 pounds)=1.7 pounds Therefore, when delivering a traction
force 232 of 150 pounds, an adjusted traction force of 151.7 pounds
(150 pounds+1.7 pounds) should be applied to the patient.
[0060] FIG. 12 is a schematic view of the therapeutic apparatus
generally as illustrated in FIG. 1 capable of automatically
implementing the theory of the traction force adjustment discussed
above. The therapeutic apparatus 10 includes an electrical angle
measuring device 210, such as a potentiometer, attached to the
pitch mechanism 62. In one embodiment, the angle measuring device
210 provides a signal corresponding to the angle a of first
supporting portion 14 relative to the horizontal plane 204. The
angle measuring device 210 can also measure the angle of the second
supporting portion 16 and/or the head support portion 120 relative
to the horizontal plane 204. Any device that generates a signal
that is proportional to the angle .alpha. can be substituted for
the angle measuring device 210, such as for example an absolute or
incremental optical encoder.
[0061] For most applications, the second body supporting portion 16
remains horizontal, while the first body supporting portion 14
and/or the head supporting portion 120 can move relative to
horizontal. It is also possible for the second body supporting
portion 16 to move relative to horizontal. In some embodiments, the
angle measuring device 210 is three discrete devices that generate
angle signals for each of the first body supporting portion 14, the
second body supporting portion 16 and the head support portion
120.
[0062] A weight measuring device 212 is optionally attached to the
therapeutic apparatus 10 to measure the total body weight of a
patient. A signal from the weight measuring device 212 is
transmitted to the process 70 and is used to calculate the adjusted
traction force. In one embodiment, an operator identifies the
portion of the patient supported by one of the supporting portions
14, 16, 120. The weight of the apparatus 10 is preferably stored in
the processor 70. The processor 70 uses the weight measuring device
212 to calculate the total weight of the patient. The body mass
distribution data in Table 1, stored as a look-up table available
to the processor 70 is used to calculate the weight of the patient
supported by the relevant body supporting portion 14, 16, 120.
[0063] In another embodiment, a weight measuring device 213a, 213b,
213c (referred to collectively as "213") can optionally be provided
on one or more of the first body supporting portion 14, the second
body supporting portion 16 and/or the head support portion 120,
respectively. Signals from the weight measuring devices 213 are
preferably transmitted directly to the processor 70 for use in
calculating the adjusted traction force. Providing multiple weight
measuring devices 213 obviates the need to estimate the portion of
the patient's body supported by a particular support portion 14,
16, 120, such as discussed above.
[0064] In one embodiment, the weight measuring device 212 provides
a voltage signal representing the total weight of the patient. A
percentage of the voltage from a voltage divider of the device 212
can be used to represent the weight of the tilted human body on the
first body supporting portion 14. The weights of the tilted first
and second body supporting portions 14, 16 are fixed and known at
the time of manufacture. Accordingly, a constant voltage signal can
be used to represent the weight of the tilted first body supporting
portion 14. These voltage signals can be combined using electrical
summing and multiplier circuits to provide a signal that represents
the compensating forces. The signal that represents the
compensating forces can be electrically summed with another signal
that controls the actuator 56, so as to control the adjusted
traction force that takes both the weight of the tilted first body
supporting portion 14 and the weight of the applicable portion of
the patient's body into account. Similarly, the weight measuring
device 212 can also be used to control the adjusted traction force
that takes both the weight of the head support portion 120 and the
weight of the head and neck of the patient into account
[0065] The electronic signals from the angle measuring device 210
and weight measuring devices 212 and/or 213 can be directed to an
electronic display indicating. The operator then uses this angle
and weight information to calculate the adjusted traction force. In
another embodiment, the signals from the angle measuring device 210
and the weight measuring devices 212 and/or 213 can be directed to
the processor 70. The processor 70 preferably measures the weight
supported by the supporting portions 14, 16, 120 directly.
Alternatively, the operator inputs the portions of the patient's
body supported by the body supporting portion 14, 16, 120 that is
tilted relative to horizontal. The processor 70 optionally includes
a data entry device, such as a keypad. The processor 70 then
calculates the adjusted traction force. The adjusted traction force
can be entered into the processor 70 by the operator or the
processor 70 can control the operation of one or more of the
actuators 56, 66 (see FIG. 2) to apply the adjusted traction
force.
[0066] FIG. 13 is a schematic view of the therapeutic apparatus in
accordance with the present invention. The therapeutic apparatus 10
includes a digital control system 220 capable of determining the
angle .alpha. that the supporting portions 14, 16, 120 are moved
relative to horizontal. In the embodiment illustrated in FIG. 13,
the first body supporting portion 14 is tilted relative to the
horizontal plane 204.
[0067] The digital control system 220 is also capable of measuring
the total and partial body weight of a patient (see FIG. 12). For
example, the body weight percentage distribution information can be
stored in the system 220, so that the weight of the applicable
portion of the patient's body on the first body supporting portion
14 can be digitally computed. Alternatively, the weight supported
by each support portion 14, 16, 120 can be measured directly and
communicated to the digital control system 220.
[0068] In the embodiment of FIG. 13, the weight of the tilted first
body supporting portion 14 is fixed and known at the time of
manufacture. This weight is preferably stored in the digital
control system 220. Once the adjusted traction force is calculated,
the digital control system 220 controls the actuator 56 to apply
the traction force.
[0069] All of the patents and patent applications disclosed herein,
including those set forth in the Background of the Invention, are
hereby incorporated by reference. Although specific embodiments of
this invention have been shown and described herein, it is to be
understood that these embodiments are merely illustrative of the
many possible specific arrangements that can be devised in
application of the principles of the invention. Numerous and varied
other arrangements can be devised in accordance with these
principles by those of ordinary skill in the art without departing
from the scope and spirit of the invention.
* * * * *