U.S. patent application number 15/872964 was filed with the patent office on 2021-10-14 for rehabilitation systems and methods.
This patent application is currently assigned to Bright Cloud International Corp.. The applicant listed for this patent is Bright Cloud International Corp.. Invention is credited to Grigore C. Burdea, Nam Hun Kim, Doru Tadeusz Roll.
Application Number | 20210316984 15/872964 |
Document ID | / |
Family ID | 1000005866136 |
Filed Date | 2021-10-14 |
United States Patent
Application |
20210316984 |
Kind Code |
A9 |
Burdea; Grigore C. ; et
al. |
October 14, 2021 |
REHABILITATION SYSTEMS AND METHODS
Abstract
The present disclosure integrates an actuated tilting
rehabilitation table, video tracking of the patient arm and
opposite shoulder, a low-friction forearm support with grasping
force sensing, remote data transmission and additional weighing
means, one or more large displays, a computer and a plurality of
simulation exercises, such as video games. The patient can be
monitored by a local or remote clinician. The table tilts in order
to increase exercise difficulty due to gravity loading on the
patient's arm and shoulder. In one embodiment, the actuated tilting
table tilts in four degrees of freedom.
Inventors: |
Burdea; Grigore C.;
(Highland Park, NJ) ; Kim; Nam Hun; (Paramus,
NJ) ; Roll; Doru Tadeusz; (Long Beach, NY) |
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Applicant: |
Name |
City |
State |
Country |
Type |
Bright Cloud International Corp. |
Highland Park |
NJ |
US |
|
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Assignee: |
Bright Cloud International
Corp.
Highland Park
NJ
|
Prior
Publication: |
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Document Identifier |
Publication Date |
|
US 20180237284 A1 |
August 23, 2018 |
|
|
Family ID: |
1000005866136 |
Appl. No.: |
15/872964 |
Filed: |
January 16, 2018 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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14575519 |
Dec 18, 2014 |
9868012 |
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15872964 |
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12192818 |
Aug 15, 2008 |
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14575519 |
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60964861 |
Aug 15, 2007 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
B67D 7/0238 20130101;
B67D 7/0227 20130101 |
International
Class: |
B67D 7/02 20060101
B67D007/02 |
Claims
1. A system for rehabilitation comprising: a tilting table
configured to be movable at a tilt angle in at least one degree of
freedom, the tilting table having a low-friction top surface; a
forearm support configured to receive a forearm of a user, the
forearm support being movable on, but not coupled to, the
low-friction top surface of the tilting table; an animated or
virtual reality sequence forming an exercise simulation being
displayed on a display coupled to a vertical support and positioned
above the tilting table; and a tracking device configured to track
movements of the forearm support upon interaction of the user with
the exercise simulation, wherein the tracking device includes at
least one position sensor and tracking software to track an output
from the at least one sensor, the tracking device measuring
movement of the forearm support on the top surface of the tilting
table, and the at least one sensor is coupled to the vertical
support via a support bar such that the at least one sensor
maintains a same relative orientation to the tilting table
regardless of the tilt angle of the tilting table.
2. The system for rehabilitation of claim 1, wherein the tilting
table has a U-shape and includes a parabolic entry to accommodate a
torso of the user when seated at the tilting table.
3. The system for rehabilitation of claim 2, wherein at least one
sensor is positioned on an underside of the tilting table, the at
least one sensor being configured to detect a distance between the
underside of the tilting table and legs of the user when seated at
the tilting table.
4. The system for rehabilitation of claim 2, wherein a first sensor
is positioned on a first interior wall of the parabolic entry and a
second sensor is positioned on a second interior wall of the
parabolic entry, the first interior wall opposing the second
interior wall, such that the first sensor and the second sensor are
configured to determine whether a user is seated at the tilting
table by detecting whether the user has interfered with a light
beam between the first sensor and the second sensor.
5. The system for rehabilitation of claim 1, wherein the at least
one sensor comprises an infrared emitter fixed to the support bar
and positioned to be above or even with the display.
6. The system for rehabilitation of claim 1, further comprising a
base wherein the base includes a forward frame and a rear frame,
the forward frame being adjacent to the rear frame; and a first
side frame and a second side frame, wherein a first leg frame
extends from the first side frame and a second leg frame extends
from the second side frame, the first side frame and the second
side frame respectively extend from the rear frame at obtuse angles
such that a distance between the first leg frame and the second leg
frame is greater than a length of the rear frame, and the vertical
support is positioned on a top surface of the forward frame such
that legs of the user may be accommodated under the tilting table
without interference from a base of the vertical support.
7. The system for rehabilitation of claim 1, further comprising a
first actuator coupled to a first vertical shuttle, the first
actuator configured to control a height of the titling table; a
second actuator coupled to a second vertical shuttle, the second
actuator configured to control a tilt of the titling table; and a
lateral linkage system including a first support having a first end
and a second end, the first end being coupled to the first vertical
shuttle, and a second support coupled to an underside surface of
the titling table and having a first end and a second end, wherein
the first support second end and the second support second end are
coupled together by a rotary joint.
8. The system for rehabilitation of claim 7, further comprising a
roller assembly including a plurality of roller pairs, a first end
and a second end, the first end being coupled to the titling table
via the first support member first end and the second end being
coupled to the first vertical shuttle such that a combination of
the first actuator coupled to the first vertical shuttle and the
roller assembly may modify a height of the tilting table as the
first vertical shuttle moves.
9. The system for rehabilitation of claim 8, wherein the plurality
of plastic roller pairs may be vibration dampeners and motion
guides.
10. The system for rehabilitation of claim 7, further comprising a
slit-pinion mechanism including a first end and a second end, the
first end being coupled to the tilting table and the second end
being coupled to the second vertical shuttle such that a
combination of the second actuator coupled to the second vertical
shuttle and the slit-pinion mechanism may modify the tilt of the
tilting table as the second vertical shuttle moves.
11. The system for rehabilitation of claim 10, wherein the
slit-pinion performs a rotary tilting movement of the tilting
table.
12. The system for rehabilitation of claim 7, further comprising a
a vertical linkage system coupling the first actuator coupled to
the first vertical shuttle and the second actuator coupled to the
second vertical shuttle such that the first actuator may modify a
height of the tilting table without modifying a tilt of the tilting
table.
13. The system for rehabilitation of claim 7, wherein the second
actuator has a thirty inch effective stroke span.
14. The system for rehabilitation of claim 13, wherein the system
may utilize twenty-four inches of the thirty inch effective stroke
span of the second actuator and thereby provide for a +20.degree.
to -15.degree. angle adjustment range of tilting table.
15. A method for rehabilitation comprising: providing a forearm
support adapted for receiving a forearm of a user on a tilting
table, the tilting table adapted to be moveable in at least one
degree of freedom; displaying an animated or virtual reality
sequence on a display coupled to a vertical support and positioned
above the tilting table; and tracking movements of the forearm
interaction with an exercise simulation, wherein at least one
infrared emitter tracks the movements and the infrared emitter is
coupled to the vertical support via a support bar such that the at
least one infrared emitter maintains a same relative orientation to
the tilting table regardless of the tilt angle of the tilting
table.
Description
CROSS REFERENCE TO RELATED APPLICATION
[0001] The present application is a continuation-in-part of U.S.
patent application Ser. No. 14/575,519, filed Dec. 18, 2014, now
U.S. Pat. No. 9,868,012 which is a continuation of U.S. patent
application Ser. No. 12/192,818, filed Aug. 15, 2008, both of which
claim the benefit of and priority to U.S. Provisional Patent
Application No. 60/964,861, filed Aug. 15, 2007, all of which are
hereby incorporated by reference in their entirety.
BACKGROUND
Field
[0002] The present disclosure is a device, system and method of
providing rehabilitation to several types of patients in a
rehabilitation hospital or outpatient clinic. The approach
integrates an actuated tilting and lifting low-friction
rehabilitation table, video or infrared tracking of the patient's
arm, or arms, and opposite shoulder, one or two low-friction
forearm support(s) with grasping force sensing and finger extension
sensing, remote data transmission and additional weighting means,
one or more large displays, a computer, a control box, and a
plurality of video games.
Related Art
[0003] A training system for arm rehabilitation is described in
Yu-Luen Chen et al., "Aid Training System for Upper Extremity
Rehabilitation," 2001 Proceedings of the EMBS International
Conference, Istanbul, Turkey. Patients exercise on a special table
that incorporates reed relays and a hand support ("arm skate") with
small underside wheels. The movement of the arm in the arm skate on
the supporting table is detected by the interaction of the magnet
incorporated in the arm skate with the relays integrated in the
table. A computer presents a variety of patterns on its monitor,
which the patient needs to replicate to improve arm coordination,
with performance data stored by the computer in a clinical
database. The table is horizontal, not tilted, and does not use
virtual reality simulations.
[0004] Another training system that uses a forearm support on a
table for rehabilitation purposes is described by some of the
inventors of the present specification in Kutuva et al., "The
Rutgers Arm: An Upper-Extremity Rehabilitation System in Virtual
Reality," Proceedings of the Fourth International Workshop on
Virtual Rehabilitation (IWVR '05), pp. 94-103, Catalina Island,
Calif., September 2005. The table has a low-friction surface and a
forearm support has a low-friction underside (made of TEFLON.RTM.
studs). The tracking of the forearm movement is done by a magnetic
tracker (Fastrack, Polhemus Inc.), with a sensor mounted on the
forearm support, and an emitter mounted on the table away from the
patient. Patients exercise sitting at the table and looking at a
computer monitor, while playing a plurality of virtual reality
games. The games are designed to improve motor coordination, as
well as dynamic arm response. The table does not tilt.
[0005] Several tilting tables exist commercially and are used in
rehabilitation. They are meant for people who have low blood
pressure and who get dizzy when they stand up. Tilting tables are
also used for the rehabilitation of patients who have to lie down
for a long period of time. The person lies face up on a padded
table with a footboard and is held in place with a safety belt. The
table is tilted so that the angle is very slowly increased until
the person is nearly upright. By slowly increasing the angle, the
patient's blood vessels regain the ability to constrict.
[0006] A study describes development of a sensorized tilt table
which measures and displays the knee bent angle and pressure for
each foot during exercise in real time, as described in Kimet et
al. "An Intelligent Tilt Table for Paralytic Patients," 3.sup.rd
Kuala Lumpur International Conference on Biomedical Engineering,
Kuala Lumpur, Malaysia, 2006. It is expected that the patient's
exercising effect can increase by monitoring these two values
during exercise. Tilt tables are known for providing tilting
manually or using an electrical motor, such as in a Rehab Electric
Tilt Table manufactured by Cardon Rehab.
[0007] An automated stepping training developed with the tilting
table is described in Colombo et al. "Novel Stepping Mechanism:
Design Principles and Clinical Application," Rehabilitation
Robotics, ICORR 2005. Unlike the previous tilting tables it
exercises the feet in stepping. No virtual reality simulation is
incorporated and tilting is done manually, rather than determined
by a simulation.
[0008] All of the above tilting-table based systems are for
rehabilitation of the legs. The tilting tables described above do
not incorporate virtual reality simulations and do not store/upload
clinical data automatically. They have a single degree of freedom
(the tilting angle).
[0009] Some of the inventors have used the BrightArm Duo tilting
and lifting rehabilitation table for rehabilitation of chronic
stroke survivors who are long term nursing home residents. House G,
G. Burdea, K. Polistico, D. Roll, J. Kim, F. Damiani M D, S.
Keeler, J. Hundal, S. Pollack. Integrative rehabilitation of stroke
survivors in Skilled Nursing Facilities: the design and evaluation
of the BrightArm Duo. Disability and Rehabilitation-Assistive
Technology. Nov. 2016. 11 (8):683-94. Patients exercise both arms
supported by forearm supports while playing adaptable games. The
system is designed to train both arms and mind. Two overhead
cameras are used to track the forearms of the patients and are
located on an overhead beam that maintains camera orientation
versus the table surface regardless of tilt. Arm reach and grasp
strength are measured at the start of session so as to adapt games
to dissimilar arm capabilities. A similar setting was used for
patients with chronic upper body pain, which affects the motor
function, strength and range of the arms. House G, G Burdea, N
Grampurohit, K Polistico, D Roll, F Damiani, J Hundal, D Demesmin.
Integrative Virtual Reality Therapy Produces Lasting Benefits for a
Young Woman Suffering from Chronic Pain and Depression Post Cancer
Surgery: A Case Study. 11th Int Conference on Disability and
Virtual Reality Technology, September 2016, Los Angeles. Since
chronic pain is also associated with depression, study results have
shown a reduction of depression severity in a group of 6 breast
cancer survivors after 8 weeks of therapy on the BrightArm Duo.
House G, Burdea G, N Grampurohit, K Polistico, D Roll, F Damiani, J
Hundal, D Demesmin. A feasibility study to determine the benefits
of upper extremity virtual rehabilitation therapy for coping with
chronic pain post-cancer surgery. The British Journal of Pain, Nov.
2016, 10(4):186-197. doi 10.1177/2049463716664370.
[0010] Systems for rehabilitating the arms are known, and are based
on force feedback joysticks (such as those manufactured by Logitech
or Microsoft), or various types of planar or 3D robots. Examples of
planar robots are the MIT Manus or those described in Colombo et
al., "Upper Limb Rehabilitation and Evaluation of Stroke Patients
Using Robot-Aided Techniques", Rehabilitation Robotics, 515-518
(2005). Other examples of 3D robots are the Reo robot manufactured
by Motorika, N.J., or the Haptic Master manufactured by FCS,
Holland.
[0011] Other upper limb rehabilitation systems have been described.
U.S. Pat. No. 7,204,814 describes an orthotic system that performs
predefined or user-controlled limb movements, collects data
regarding the limb movement, performs data analysis and displays
the data results, modifies operational parameters based on the data
to optimize the rehabilitative process performed by the system. A
force sensor data, torque data and angular velocity data can be
collected using an external actuating device.
[0012] U.S. Patent Application Publication No. 2007/0060445
describes a method and apparatus for upper limb rehabilitation
training of coordinated arm/forearm, forearm/forearm, and grasping
movements comprising a non-robotic, passive support, an arm/forearm
sensor, gripping device and sensor. A computer processes
measurements of movements to control a graphical representation of
the arm/forearm and grasping movements in interaction with a
virtual environment.
[0013] It is desirable to provide a device, system and method for
rehabilitation of one or both upper limbs in which an activated
low-friction tilting and lifting table provides a plurality of
degrees of freedom and grasping force and finger extension sensing
are integrated into a video tracking system.
SUMMARY
[0014] The present disclosure integrates an actuated tilting and
lifting rehabilitation table, video tracking of one or both of the
patient arm(s) and shoulder, low-friction forearm supports with
grasping force and finger extension sensing, remote data
transmission and additional weighing means, one or more large
displays, a computer, a control box, and a plurality of simulation
exercises, such as therapeutic video games. The patient can be
monitored by a local or remote clinician. Online storage of data
obtained by the rehabilitation tilting table can be provided.
Automated session report can be generated. Additionally, the table
surface can be constructed as a graphics display making a separate
display unnecessary.
[0015] In one embodiment, a patient's arm rests on a forearm
support that has infrared LEDs. The patient wears similar LEDs on
the opposite shoulder, and an infrared video camera is used to
track the patient's arm movement on the table. The table tilts in
order to increase exercise difficulty due to gravity loading on the
patient's arm. In one embodiment, the present the invention
includes an actuated tilting table which tilts in four degrees of
freedom. A large display, facing the patient presents a sequence of
rehabilitation games with which the patient interacts by moving the
arm resting on the low-friction support, on the table surface.
[0016] In another embodiment the patient sits in a wheel chair,
while resting both arms which are tracked by infrared trackers,
such as those available commercially. The shape of the table
surface is such as to accommodate the trunk of the patient seated
at the table. The underside of the table has a safety mechanism to
detect a proximity of the knees and legs of a patient. The table
actuators are elevated from the table frame, so as to allow a
patient to stretch his or her legs in front of the wheelchair.
BRIEF DESCRIPTION OF THE DRAWINGS
[0017] The foregoing features of the present disclosure will be
apparent from the following Detailed Description of the Invention,
taken in connection with the accompanying drawings, in which:
[0018] FIG. 1 is a schematic diagram of a tilting rehabilitation
table system being used by a patient;
[0019] FIG. 2 is a schematic diagram of the tilting rehabilitation
table system;
[0020] FIG. 3 is a schematic diagram in which a top surface of the
tilting table is provided at an increased angle from the
patient;
[0021] FIG. 4 is a schematic diagram in which the top surface of
the tilting table is provided at an increased right angle from the
patient;
[0022] FIG. 5 is a schematic diagram of actuators of the tilting
rehabilitation table system used with the tilting table;
[0023] FIG. 6 is a detailed view of a top joint assembly connecting
an actuator shaft to the top surface of the tilting table;
[0024] FIG. 7 is a detailed view of a bottom joint assembly
connecting an actuator shaft to the bottom surface of the tilting
table;
[0025] FIG. 8 is a side elevation view of patient wearing the
forearm support assembly used in the tilting rehabilitation table
system;
[0026] FIG. 9 is a schematic diagram of an underside of a forearm
support assembly of the tilting rehabilitation table;
[0027] FIG. 10 is a view of the patient wearing a shoulder harness
assembly used in the tilting rehabilitation table system;
[0028] FIG. 11 is a schematic diagram of an alternate embodiment of
the tilting table;
[0029] FIG. 12 is a schematic diagram of an alternate embodiment of
the tilting table where top surface is a display;
[0030] FIG. 13 is a system block diagram for the tilting
rehabilitation table system;
[0031] FIG. 14 is a schematic diagram of a patient baseline screen
displayed by the tilting rehabilitation table system;
[0032] FIG. 15A is a schematic diagram of a virtual scene displayed
by the tilting rehabilitation table system;
[0033] FIG. 15B is a schematic diagram of a virtual scene displayed
by the tilting rehabilitation table system;
[0034] FIG. 15C is a schematic diagram of a virtual scene displayed
by the tilting rehabilitation table system;
[0035] FIG. 16A is a schematic diagram of a virtual scene displayed
by the tilting rehabilitation table system;
[0036] FIG. 16B is a schematic diagram of a virtual scene displayed
by the tilting rehabilitation table system;
[0037] FIG. 17 is a schematic diagram of a virtual scene displayed
by the tilting rehabilitation table system;
[0038] FIG. 18A is a rear view schematic diagram of another aspect
of the tilting rehabilitation table system;
[0039] FIG. 18B is a front view schematic diagram of another aspect
of the tilting rehabilitation table system;
[0040] FIG. 19 is a schematic diagram of a base of the tilting
rehabilitation table system of FIG. 18;
[0041] FIG. 20 is a schematic diagram of the tilting rehabilitation
table system of FIG. 18 in a stowed position for storage and/or
transport;
[0042] FIG. 21 is a schematic diagram of a lift and tilt mechanism
of the tilting rehabilitation table system of FIG. 18;
[0043] FIG. 22 is a schematic diagram of a rolling assembly of the
lift and tilt mechanism of FIG. 21;
[0044] FIG. 23 is a schematic diagram of a slit-pinion mechanism of
the lift and tilt mechanism of FIG. 21; and
[0045] FIG. 24 is a schematic diagram of an angle adjustment range
of the lift and tilt mechanism of FIG. 21.
DETAILED DESCRIPTION
[0046] Reference will now be made in greater detail to a preferred
embodiment of the invention, an example of which is illustrated in
the accompanying drawings. Whenever possible, the same reference
numerals will be used throughout the drawings and the description
to refer to the same or like parts.
[0047] FIGS. 1 and 2 illustrate tilting rehabilitation table system
1. Tilting rehabilitation table system 1 incorporates tilting table
2 which has top surface 3 and underside surface 4. Top surface 3
can be a U-shaped, symmetrical, low-friction surface. Underside
surface 4 can have a U-shape. For example, low top surface 3 can be
made of carbon fiber, or other durable and light material, covered
by a low-friction coating. Suitable low-friction coatings include
TEFLON.RTM. sheets. Underside walls 14 extend upwardly from
underside surface 4.
[0048] Patient 5 sits in chair 6 and rests arm 7 to be
rehabilitated in low-friction forearm support 25. Patient 5
exercises while watching display 8 placed at the opposite side of
tilting table 2. Preferably, display 8 is a large display having
dimensions of at least about 9 ft by 6 ft. Video camera 9 is
attached to vertical support 10. Vertical support 10 can be
U-shaped and rigid. Vertical support 10 extends from and is
attached to top surface 3. This arrangement allows video camera 9
to view tilting table 2 and patient 5 simultaneously. Video camera
9 can be a conventional digital camera. Infrared filter 11 can be
attached to lens 12 of video camera 9. LEDs 13 are mounted at the
corners of top surface 3 and can be wired to direct current source
(not shown). For example, three LEDs can be used for providing
calibration of video camera 9. Vertical support 10 is mounted to
top surface 3 such that it keeps the same relative orientation
regardless of tilt angle 15 of top surface 3, thereby making
re-calibration of video camera 9 unnecessary once tilt angle 15
changes during a rehabilitation session.
[0049] Computer 16 renders exercise simulation 17 and displays them
on display 8. For example, exercise simulation 17 can be an
animated or virtual reality sequence. Computer 16 is preferably a
multi-core PC workstation. Computer 16 also receives input from
video camera 9. Computer 16 runs tracking software 18 and
communicates with controller 19. Controller 19 activates actuators
20 to provide tilt of top surface 3. Computer 16 is connected to
Internet 66 and transparently uploads clinical data 67 to remote
clinical database server 68. Remote computer 181 connected to
clinical database server 68 over Internet 66 is used to execute
remote graphing software 180.
[0050] FIG. 3 shows the orientation of top surface 3 and camera
support 10 when tilt angle 15 is increased to move the angle away
from patient 5. Increased tilt angle 15 makes in/out movements of
arm 7 more difficult.
[0051] FIG. 4 shows a different tilt of top surface 3, in which
tilt angle 15 is to the right of patient 5. This tilt angle makes
arm movements from left-to-right more difficult than those when top
surface 3 is horizontal. Other tilt angles 15 can be used when the
left side of top surface 3 is tilted up or when the side closer to
patient 5 is tilted up. These make more difficult corresponding arm
7 movements, such as right-left or out-in, respectively. In one
embodiment, top surface 3 can be tilted in four degrees of
freedom.
[0052] Tilt angle 15 is produced by two or more actuators 20 placed
under top surface 3, as shown in FIG. 5. Actuators 20 are
preferably linear electrical actuators. Actuators 20 are positioned
under top surface 3. Each actuator 20 includes base 21 and
translating shaft 22. Translating shaft 22 is connected to top
surface 3 by top joint assembly 23. Base 21 is connected to
underside walls 14 with bottom joint assembly 30. Actuators 20 are
controlled by controller 19. Controller 19 can be a multi-channel
micro-controller such as those which are available commercially.
Controller 19 in turn receives commands from computer 16 running
exercise simulation 17. In one embodiment, five actuators 20 can be
used and the amount of translation of actuator shaft 22 provides
tilt angle 15 which can be varied from about 0 degrees (horizontal)
to about 30 degrees. The more top surface 3 is tilted, the larger
the effect gravity has due to the weight of arm 7 of patient 5 and
of forearm support 25 and the harder exercise simulation 17 is to
perform.
[0053] FIG. 6 shows a detailed view of top joint assembly 23 which
connects actuator shaft 22 to the underside of top surface 3. Top
joint assembly 23 has horizontal rotating joint 26 and vertical
rotating joint 27 which together produce two degrees of freedom for
top joint assembly 23. The axis of rotation of horizontal rotating
joint 26 is perpendicular to the axis of rotation of vertical
rotating joint 27. Horizontal rotating joint 26 is attached to the
underside of top surface 3 using plate 28 and bolts 29.
[0054] FIG. 7 shows a detailed view of bottom joint assembly 30,
which connects base 21 to the inner side of underside walls 14.
Bottom joint assembly 30 has horizontal rotating joint 31 and
vertical rotating joint 32 which together produce two degrees of
freedom for bottom joint assembly 30. The axis of rotation of
horizontal rotating joint 31 is perpendicular to the axis of
rotation of vertical rotating joint 32. Vertical rotating joint 32
is attached to the inner side of underside walls 14 through plate
33 and bolts 34.
[0055] A side view of the patient 5 sitting in chair 6 and using of
forearm support assembly 25 used by patient 5 is shown in FIG. 8.
Forearm 7 and wrist 35 of patient 5 are secured to forearm support
base 36 using a plurality of straps 37. For example, straps 37 can
be formed of a hook and loop material of VELCRO.RTM.. Forearm
support base 36 can be made of a lightweight material such as
plastic, and is hollow. Pressure sensor 41 measures the air
pressure inside hollow compliant element 44. A suitable hollow
compliant element 44 can be a rubber ball. Grasping forces 45
exercised by fingers 46 of patient 5 are measured. Video camera 9
shown in FIG. 1 views LED assembly 42 which is formed of two
infrared LEDs 50 mounted on plastic support 51 for providing data
on arm movements and rotation. LED assembly 42 in turn is mounted
on movable assembly 52. Movable assembly 52 rotates on hinges 53
attached to forearm support base 36. Movable assembly 52 rotates
open to allow forearm 7 to be placed on forearm support top surface
54. Forearm support top surface 54 is preferably made of a
compliant material (such as plastic foam), for increased comfort.
Forearm support base 36 has chambers 39, 76 and 77. Chamber 39 can
be used to incorporate electronics assembly 40 to which is
connected pressure sensor 41. Output of pressure sensor 41 is
processed by electronics assembly 40. Electronics assembly 40
includes an analog-to-digital converter 47 and wireless transmitter
48. Transmitter 48 can be a conventional wireless Bluetooth.RTM.
type transmitter. Transmitter 48 communicates with receiver 49
incorporated in computer 16, as shown in FIG. 2. Computer 16 can
change exercise simulation 17 according to grasping forces 45 of
patient 5. Computer 16 can also change exercise simulation 17 based
on forearm 7 position/orientation given by video camera 9. For
example, exercise simulation 17 can be rehabilitation games. LED
assembly 42 and electronics assembly 40 are connected to battery 43
in chamber 77. Chamber 76 of base 36 can be used to allow the
addition of modular weights 56. The addition of modular weights 56
to forearm support base 36 allows an increased difficulty of
exercise simulation 17. The difficulty of performing exercise
simulation 17 is increased with the increase in modular weights 56,
with the increase in tilting angle 15, and with the number and
level of exercise simulation 17.
[0056] FIG. 9 is a view of the underside of the forearm support
assembly 25. Underside surface 38 of forearm support 25 has a
plurality of low friction studs 55. Low friction studs 55 are
preferably made of TEFLON.RTM..
[0057] FIG. 10 shows shoulder harness assembly 57 worn by patient 5
on shoulder 58 opposite to arm 7 being rehabilitated. Shoulder
harness assembly 57 incorporates shoulder LED 59 wired to battery
60. Shoulder LED 59 is an infrared LED for providing data on
compensatory movements of patient 5. Harness assembly 57 is formed
of adjustable segments 61. Segments 61 are preferably formed of a
hook and loop material, such as VELCRO.RTM.. Video camera 9 takes
images of shoulder LED 59. Tracking software 18 running on computer
16 determines when patient 5 is doing undesirable compensatory
leaning movements. Tracking software 18 can be adjusted by a
therapist to be more sensitive, or less sensitive to leaning of
patient 5.
[0058] FIG. 11 illustrates an alternate embodiment of tilting table
62 for use with two forearm supports 25. Top surface 3 has a
U-shape cutout 63 allowing patient 5 to be seated centrally to
table axis 64. Patient 5 moves two arms 7 while supported by two
low-friction forearm support assemblies 25. This allows training of
both arms simultaneously, with benefits to recovery of patient 5.
In one embodiment, patient 5 also wears one shoulder harness 57, as
it is sufficient to detect the leaning of the shoulder opposite to
the disabled arm 7. Video camera 9 views LEDs 42 on both forearm
support assemblies 25, as well as LEDs 59 on one shoulder harness
assembly 57. Forearm support assembly 25 is modified such that the
number of infrared LEDs 42 differs between the two forearm support
assemblies 25. For example three LEDs 42 will be on the left-arm
forearm support 73, while the right-arm support 71 still has two
LEDs 42 as previously described in FIG. 8. This allows tracking
software 18 to differentiate between left arm and right arm
movements. Tracking software 18 tracks two arms 7 in real time.
Data from tracking software 18 is used by computer 16 to run
two-arm exercise simulation 17. In this embodiment, the same type
of actuators 20 as shown in FIG. 5, can be used in this embodiment.
Preferably, four actuators 20 are used in this embodiment.
[0059] FIG. 12 illustrates an alternate embodiment of tilting table
2. In this embodiment, top surface 3 is also display 69. For
example, display 69 can be similar to commercially available thin
organic LED (OLED) displays. In this embodiment, the tracking of
forearm 7 may be performed by infrared camera 9, or through a
touch-sensitive layer 70 incorporated in display 69. In this case
the display 69 is a touch sensitive screen such as those available
commercially. In case overhead camera 9 is used, forearm support
assembly 25 is modified as shown in FIG. 11. Actuator assembly 20
can be connected to frame 72 bordering display 69 and to supporting
surface 4. A low-friction transparent film 75 can be retrofitted to
display 69, to prevent scratching by the forearm support assemblies
71 and 73 that sit on it.
[0060] A system block diagram for the tilting rehabilitation table
system 1 is illustrated in FIG. 13. Each rehabilitation session
starts with session start block 78. Session start block 78 loads
the patient's ID and other clinical data 67 for arm 7 to be
rehabilitated. Session start block 78 transfers control to the
session scheduler block 79 which sets the structure of a
rehabilitation session, for example, number, type and order of
exercises, as well as the difficulty level settings. Session
scheduler block 79 is structured such that it applies a customized
treatment depending on progress of patient 5 (the order of the
particular session being done out of the prescribed number of
sessions). Session scheduler block 79 begins by starting session
baseline 80 which measures the performance of patient 5 in that
day. Session baseline 80 is stored transparently by clinical
database server 68 and can be used to track progress of patient 5
over the sequence of rehabilitation sessions. Patient 5 progress
can be graphed using remote graphing application 180 running on
remote computer 181. It is envisioned that remote computer 181
communicates with clinical database server over Internet 66.
Session baseline 80 is also used to fine-tune the "gains" of
exercise simulation blocks 81, 82 and 83, such that in virtual
reality movements are amplified and success assured even for very
limited real arm 7 movements. Exercise simulation blocks 81, 82 and
83 can perform exercise simulation 17. Intelligent agent block 84
monitors the patient progress and can automatically vary tilt angle
15 to assist/resist movement. Intelligent agent block 84 can
control actuators 20 through their controller 19 connected to
computer 16 running exercise simulation blocks 81, 82 and 83.
Actuators 20 provide data to exercise simulation blocks 81, 82 and
83 such that virtual table (not shown) in the scene mimics tilt of
tilting table 2. Video camera 9 detects the position of LEDs 50 at
the top of forearm support assembly 25 and sends the information to
tracking software 18 run by computer 16. Tracking software 18
extracts arm position information and body leaning information and
transmits this data to exercise simulation blocks 81, 82 and 83.
This data is then used to animate in real time an avatar of the
patient's hand(s) (not shown). Manual emergency switch 85, when
pressed by attending therapist and/or patient 5 triggers an end to
the rehabilitation session through software block 86.
[0061] FIG. 14 illustrates an example of patient baseline screen 87
displayed in display 8 or on display 69. Patient 5 is asked to move
the arm 7 in large circles to color virtual representation 88 of
the rehabilitation table surface 3. The surface of colored area 89
increases with the movement of virtual sphere 90 which responds to
the movements of forearm support assembly 25. Size and shape of
colored area 89 are a measure of the ability of patient 5 that day.
Extent of movement 91 in the left/right (horizontal) direction and
extent of movement 92 in the in/out direction are used to adjust
the rehabilitation exercise simulation blocks 81, 82 and 83.
Baseline screen 87 also shows tilt angle 15 at which baseline 80
was taken.
[0062] FIG. 15A shows an embodiment of rehabilitation exercise
simulation block 81 with a virtual world representation having
tilted table avatar 88. Virtual sphere 94 is shown on table surface
93 together with a virtual target rectangle 95. An ideal path
between virtual sphere 94 and virtual target rectangle 95 is
visualized by path shown as dotted line 96. The placement of
virtual target rectangle 95 and virtual sphere 94 on table surface
88 is such that it requires patient 5 to move arm 7 close to extent
of movement 91 and extent of movement 92 of baseline 87. Patient 5
is asked to pick up virtual sphere 94 with a semi-transparent hand
avatar 98 and place it in virtual target rectangle area 95. In
order to grasp virtual sphere 94, transparent hand avatar 98 has to
overlap virtual sphere 94 and patient 5 squeezes compliant element
44 on forearm support assembly 25, as shown in FIG. 1. Real
movement of patient 5 is tracked by video camera 9 and computer 16
shows a corresponding trace 97 on table surface 88.
[0063] FIG. 15B shows an alternate embodiment of exercise
simulation block 81 of the pick-and-place exercise in which ideal
path 96 shown as a straight dotted line. This corresponds to in/out
movements of arm 7. This process is repeated a number of times,
with the trial (repetition) number 190 and the total arm movement
(endurance) 191 corresponding to these repetitions being displayed
in simulation 81. Other placements of virtual target rectangle 95
and virtual sphere 94 can be used with corresponding ideal path
specifications 96. The difficulty exercise simulation block 81 such
as a pick-and-place exercise, is varied by making virtual target
rectangle 95 smaller and by requiring patient 5 to make more
pick-and-place movements. For patient 5 capable of exerting finger
forces 45, difficulty is further increased by elevating the
threshold of finger grasping forces 45 detected by the forearm
assembly 25 in FIG. 8 at which level corresponding hand avatar 98
can capture virtual sphere 94.
[0064] FIG. 15C shows bundle of traces 99 displayed by exercise
simulation block 81 at the end of exercises after a number of
pick-and-place movements were completed. In this embodiment, bundle
of traces 99 corresponds to repeated pick-and-place movements of
arm 7 in the left-right-left direction. The tightness of bundle of
traces 99 is indicative of the motor control abilities that day for
patient 5.
[0065] FIG. 16A shows an embodiment of exercise simulation block 82
referred to "Breakout 3D". This exercise depicts ball 100, paddle
101, and array of cubes 102, all located on play board 103. Paddle
101 is used to bounce ball 100 towards cubes 102 with one cube
being destroyed for each bounce of ball 100 off of paddle 101. Ball
100 can bounce off of three sides 104 of play board 103, or off
multiple cubes 102, but is lost if it misses paddle 101. In an
alternate embodiment, paddle 101 can move mostly left-right, within
the lower portion of play board 103, delineated by dashed line 105.
The difficulty of exercise simulation block 82 is set by the number
of available balls 100, the speed of balls 100, and the size of
paddle 101. The higher the speed of ball 100, the smaller the size
of paddle 101, and the fewer the number of available balls 100, the
harder the Breakout 3D of exercise simulation block 82 game is. The
goal of the Breakout 3D exercise simulation block 82 is to destroy
all cubes 102 with the available number of balls 100. The Breakout
3D of exercise simulation block 82 is designed to improve hand-eye
coordination and cognitive anticipatory strategies of patient
5.
[0066] FIG. 16B is another embodiment of the Breakout 3D of
exercise simulation block 82, in which board 103 is rotated to show
array of cubes 102 to one side of the scene. In this example paddle
101 moves mostly vertically in the scene, within the area to the
right of dotted line 105, requiring corresponding in-out-in
movements of arm 7.
[0067] FIG. 17 is an embodiment of exercise simulation block 83
called "Treasure Hunt". The scene depicts deserted island 106 with
line of stones 107 on top of virtual sand 108. The shape of line of
stones 107 replicates the shape of baseline surface colored area
89. There are a number of virtual treasures chests 109 inside sand
108 surrounded by line of stones 107. Patient 5 controls virtual
shovel 110 with which to remove sand 108 covering treasure chests
109. Every time a new treasure chest 109 is found score 111
displayed in the scene is increased. In order to find a new
treasure chest 109 shovel 110 has to be moved in sand 108 that
overlaps treasure chest 109. If tracking software 18 detects
leaning of patient 5 treasure chest 109 is not revealed even if
shovel 110 is in the correct position and score 111 is not
increased. At higher level of difficulty, a sand storm occurs. Part
of the already uncovered treasure chests 109 are covered again by
sand 108 requiring more movement of arm 7 of patient 5 arm 7 to
uncover treasure chest 109 again. The Treasure Hunt exercise
simulation block 83 is timed and remaining time 112 is displayed at
the top of the scene. Patient 5 attempts to uncover all of treasure
chests 109 in the allowed amount of time 112. This exercise is
aimed at increasing arm endurance of patient 5. In other
embodiments, other simulation exercises can be played by patient
5.
[0068] FIGS. 18A and 18B are respectively rear and front view
schematic diagrams of another aspect of the tilting rehabilitation
table system 200. The tilting and lifting rehabilitation table
system 200 includes a infrared emitter system 204, a display 206, a
hollow vertical support 210, a tilting and lifting table 214, a
base 230, a computer 232 and a control box 233.
[0069] The tilting and lifting table 214 has a top surface 216 and
an underside surface 218. The tilting and lifting table 214 may
have a shape matching the perimeter of a person's arm span reaching
forward and sweeping back, with a parabolic entry 215 to
accommodate a patient 202 when seated at the tilting and lifting
table 214 of the tilting rehabilitation table system 200. The
parabolic entry 215 accommodates a torso of the patient 202. In
addition, the parabolic entry 215 may also accommodate a manually
operated (e.g., a wheel chair) or a power-driven device designed
for use by a patient 202 with a mobile disability. The parabolic
entry 215 is placed such that the tilting axis 3000 of the top
surface 216 passes through the torso of patient 202.
[0070] A sensor 222a may be positioned on an interior wall 220a of
the parabolic entry 215 and another sensor 222b may be positioned
on an interior wall 220b of the parabolic entry 215. The sensors
222a and 222b may be infrared or LED sensors or the like. The
sensors 222a and 222b may detect whether a patient 202 is properly
seated at the tilting and lifting table 214 of the tilting
rehabilitation table system 200 by detecting whether a beam between
the sensors 222a and 222b is interrupted when the patient 202 is
seated. In addition, at least one sensor 226 (not illustrated) may
be positioned on the underside surface 218 of the tilting and
lifting table 214. The sensor 226 (not illustrated) may be also be
an infrared or LED sensor or the like. The sensor 226 may detect a
position of the legs of the patient 202 via an infrared beam such
that the tilting and lifting table 214 does not immediately contact
the legs of the patient 202.
[0071] The tilting and lifting table 214 may be symmetrical, light
weight and have a low-friction top surface. For example, the
tilting and lifting table 214 may be carbon fiber or another
durable and light weight material wherein the top surface 216 has a
low-friction coating. Suitable low-friction coatings may include
TEFLON.RTM. sheets or Formica or other such materials.
[0072] To use the tilting rehabilitation table system 200, the
patient 202 rests at least one arm to be rehabilitated on the top
surface 216 of the tilting and lifting table 214 wherein the at
least one arm is positioned in a low-friction forearm controller
(not illustrated) to allow for pronation and supination forearm
rotation. The low-friction underside of the forearm controller
minimizes friction between the at least one arm of the patient 202
and the top surface 216 of the tilting and lifting table 214 as the
patient 202 moves the forearm controller over the top surface 216.
For example, the low-friction forearm controller may be a
controller as disclosed in U.S. patent application Ser. No.
15/669,952. It is appreciated that the tilting and lifting
rehabilitation table system 200 may benefit a patient 202 with at
least one weak arm such as a patient 202 who has survived a stroke.
The tilting and lifting rehabilitation system 200 may also benefit
a patient 202 having chronic upper body pain (e.g., nerve pain), a
traumatic brain injury (e.g., a brain concussion) and/or arthritis
(e.g., rheumatoid arthritis), or any patient in need of physical
and/or mental rehabilitation.
[0073] A size of the tilting and lifting table 214 may meet at
least the ninetieth percentile of an average adult's reach when
seated at the tilting and lifting table 214 of the tilting
rehabilitation table system 200. Accordingly, the tilting
rehabilitation table system 200 requires less clinical space for
operation, transport when stowed (e.g., the system 200 may fit
through a doorway) and storage when stowed. For example, tilting
and lifting table 214 has reduced size than tilting table 224 of
other aspects of the tilting and lifting rehabilitation table
system.
[0074] The patient 202 exercises via the forearm controller while
viewing a graphic display 208 on a display 206. The display 206 may
be a medical grade monitor or television (e.g., a high-definition
television (HDTV)), have any suitable dimensions, large or small,
such as a television of 43'' diagonal, or larger, or smaller, and
include at least one speaker to provide sounds associated with the
graphic display 208. The display 206 is mounted on a vertical
support 210 such that the patient 202 may view the graphic display
208 on the display 206 when seated at the tilting and lifting table
214 even when the tilting and lifting table 214 is positioned at an
angle. The vertical support 210 may be rigid, hollow and houses a
lift and tilt mechanism 212 for modifying a position of the tilting
and lifting table 214 relative to the patient 202. Infrared
emitters 204 are also mounted on the vertical support 210, or on
the TV, via a rigid U-shaped support 228, or other suitable
mounting means, wherein the infrared emitters 204 are fixed on the
support 228 and positioned at or above the display 206. The
infrared emitters 204 may also be positioned to be even with sides
of the display 206. The infrared emitters 204 may be HTC VIVE
infrared emitters, which are commercially available. Alternatively,
the infrared emitters 204 may be conventional digital cameras
having infrared filters attached to the lenses thereof.
[0075] The arrangement of the infrared emitters 204 and display 206
relative to the patient 202 allows the infrared emitters 204 to be
directed to the tilting and lifting table 214 and patient 202
simultaneously. Infrared receivers/detectors may be mounted on the
top surface 216 of the tilting and lifting table 214 to calibrate
the infrared emitters 204 and to locate movement and position on
the patient's arms during use. The support bar 228 is mounted to
the vertical support 210 such that the support bar 228 maintains
the same relative orientation regardless of a tilt angle of the top
surface 216, thereby making re-calibration of the infrared emitters
204 unnecessary if a tilt angle of the tilting and lifting table
214 changes during a rehabilitation session. The vertical support
210 is positioned on a top frame 234 of the base 230 such that the
legs of the patient 202 may be accommodated under the tilting and
lifting table 214 without interference from a base of the vertical
support 210.
[0076] Computer 232 may be enclosed in a box for safety and
protection, while a control box 233 (FIG. 18b) houses at least one
electronic controller to control actuators located in vertical
support 210. Computer 232 renders an exercise simulation displayed
as a graphic display 208 on the display 206. The exercise
simulation may be an animated sequence or a virtual reality
sequence. For example, the exercise simulation 17 could be at least
one game. Games may be a plurality of simulations 17, may differ
and may be sequenced to form an integrative rehabilitation session
wherein the cognitive, motor and emotive aspects of a patient 202
are treated simultaneously. The brain of a patient 202 may be
engaged by playing the games with at least one arm and hand.
[0077] The computer 232 may be a multi-core PC workstation. To
render graphics quickly, it is appreciated that computer 232 may
incorporate a graphics card (not shown). Computer 232 receives an
input from the forearm supports based on signals from the infrared
emitters 204. As mentioned above with reference to FIG. 2, the
computer 232 may execute tracking software and communicate with a
electronic controller positioned inside the control box 233,
wherein the controller activates actuators to tilt the tilting and
lifting table 214 during a rehabilitative session. The computer 232
may also be connected to the Internet and upload clinical data
based on the rehabilitative session to a remote clinical database
server. It is appreciated that such clinical data may be an
automatically-generated session report. For example, when a patient
202 participates in a rehabilitative session, the computer may
store and upload clinical data including but not limited to
specific games played, duration, performance, scores, error rates,
cognitive area trained and a number of movement repetitions by the
arms and fingers of a patient 202. The computer 232 may also
compose a rehabilitative session report that may be presented
locally on the display 206 and/or transmitted to a remote
clinician.
[0078] Accordingly, the tilting and lifting rehabilitation table
system 200 provides advantages over conventional systems and
methods relating to an elevated intensity of a rehabilitation
session and lower costs of a rehabilitation session based on the
automated collection, compilation and transmission of clinical data
regarding the rehabilitation session. Further advantages of the
system 200 is that the system 200 allows for training both arms
simultaneously, which is associated with a higher level of brain
training and physical exercise. Yet another advantage of the system
200 is increased patient 202 safety. The system 200 is passive
wherein actuators are not connected directly to the arms of a
patient 202, unlike rehabilitation robots which are active
elements.
[0079] FIG. 19 is a schematic diagram of the base 230 of the
tilting and lifting rehabilitation table system 200. The base 230
includes a top frame 234, a rear frame 236, a first side frame 238a
and a second side frame 238b (not illustrated) wherein a first leg
frame 240a extends from the first side frame 238a and a second leg
frame 240b extends from the second side frame 238b. The vertical
support 210 is positioned on a top surface of the top frame 234
such that the legs of the patient 202 may be accommodated under the
tilting and lifting table 214 without interference from a base of
the vertical support 210. The first side frame 238a and the second
side frame 238b, respectively extend from the rear frame 236 at
obtuse angles .theta..sub.1 and .theta..sub.2 (not illustrated)
such that a distance between the first leg frame 240a and the
second leg frame 240b is greater than a length of the rear frame
236. Accordingly, the base 230 may accommodate a base portion (or
foot support mechanism) of a manually operated (e.g., a wheel
chair) or a power-driven device designed for use by a patient 202
with a mobile disability.
[0080] FIG. 20 is a schematic diagram of the tilting and lifting
rehabilitation table system of FIG. 18 in a stowed position for
storage and/or transport. As mentioned above in reference to FIG.
18, a size of the tilting and lifting table 214 may meet at least
the ninetieth percentile of an average adult's reach when seated at
the tilting and lifting table 214 of the tilting and lifting
rehabilitation table system 200. Accordingly, the tilting and
lifting rehabilitation table system 200 requires less clinical
space for operation, transport when stowed (e.g., the system 200
may fit through a doorway) and storage when stowed. For example,
tilting and lifting table 214 is smaller than tilting table 224 of
another embodiment of the tilting rehabilitation table system.
[0081] FIG. 21 is a schematic diagram of a lift and tilt mechanism
212 of the tilting and lifting rehabilitation table system 200 of
FIG. 18. The lift and tilt mechanism 212 includes a first actuator
250a coupled to a first vertical shuttle 252a, a second actuator
250b coupled to a second vertical shuttle 252b, a vertical linkage
system 254, a rolling assembly 256, a lateral linkage system 258
including a first support 260a and a second support 260b and a
slit-pinion mechanism 262. The vertical support 210 houses the
first actuator 250a, the first vertical shuttle 252a, the second
actuator 250b and the second vertical shuttle 252b, the vertical
linkage system 254 and the slit-pinion mechanism 262.
[0082] A height of the tilting and lifting table 214 may be
modified by the first actuator 250a in combination with the rolling
assembly 256 An angle of the tilting and lifting table 214 may be
modified by the second actuator 250b in combination with the
slit-pinion mechanism 262. The first actuator 250a and the second
actuator 250b may be linear electrical actuators. For example, the
first actuator 250a may be a Progressive Automations PA-18_10
linear actuator and the second actuator 250b may be a Progressive
Automations PA-18-30 linear actuator. A control box 233 (FIG. 18b)
positioned on the base 230 houses electronics that control each of
the first actuator 250a and the second actuator 250b. For example,
a controller controls the first actuator 250a and the second
actuator 250b based on received commands from the computer 232 when
executing an exercise simulation. The controller may be a
commercially available multi-channel micro-controller or another
commercially available conventional controller. In addition, a
first independent string potentiometer (not shown) measures a
position of the first actuator 250a. A second independent string
potentiometer measures a position of the second actuator 250b. The
combination of inputs from the first and the second string
potentiometers provides feedback to the controller to enable
accurate control of each of the first actuator 250a and the second
actuator 250b. The first string potentiometer is unwound by the
linear movement of the first actuator 250a and the second string
potentiometer is unwound by the linear movement of the second
actuator 250b.
[0083] FIG. 22 is a schematic diagram of the rolling assembly 256
of the lift and tilt mechanism 212 of FIG. 21. The first actuator
250a has an anchor point coupled to the first vertical shuttle 252a
and performs lift actuation to modify a height of the tilting and
lifting table 214. Modifying a height of the tilting and lifting
table 214 provides for accommodating varying body types of patients
seated at the tilting and lifting table 214.
[0084] The rolling assembly 256 includes a plurality of plastic
roller pairs 270, a metal plate 272 having an extension 274 and an
opening 276, and a mating bar 278 positioned within the opening
276. The plurality of plastic roller pairs 270 are configured such
that respective rollers of a pair are positioned on opposite sides
of the metal plate 272. In addition, half of the plurality of
plastic roller pairs 270 may be positioned within the vertical
support 210 and half of the plurality of plastic roller pairs 270
may be positioned outside of the vertical support 210. The
plurality of plastic roller pairs 270 may include plastic rollers
similar to those known in the art (e.g., roller blade rollers). It
is envisioned that such plastic rollers reduce the noise generated
when lifting or lowering the table 214. The extension 274 couples
the rolling assembly 256 to the first vertical shuttle 252a and the
opening 276 couples the rolling assembly 256 to the lateral linkage
system 258. Specifically, the mating bar 278, positioned within the
opening 276, may be positioned within the first support 260a to
couple the rolling assembly 256 to the first support 260a of the
lateral linkage system 258. The first actuator 250a and first
vertical shuttle 252a in combination with the rolling assembly 256
may modify the height of the tilting and lifting table 214 with
minimal noise and/or vibration. It is appreciated that the
plurality of plastic roller pairs 270 may be vibration dampeners
and motion guides.
[0085] FIG. 23 is a schematic diagram of a slit-pinion mechanism
262 of the lift and tilt mechanism of FIG. 21. The second actuator
250b has an anchor point coupled to the second vertical shuttle
252b and performs tilt actuation to modify an angle of the tilting
and lifting table 214. The slit-pinion mechanism 262 couples the
second actuator 250b and second vertical shuttle 252b to the
tilting and lifting table 214. The slit-pinion mechanism 262
provides for a rotary tilting movement of the tilting and lifting
table 214 in comparison to the linear and vertical movement of the
second actuator 250b and the second vertical shuttle 252b.
Modifying an angle of the tilting and lifting table 214 modulates
gravity acting on the arms of a patient 202. For example, tilting
the tilting and lifting table 214 down facilitates movement of the
arms of the patient 202 away from a trunk of the patient 202.
Alternatively, tilting the tilting and lifting table 214 up resists
the movement of the arms of the patient 202 away from the trunk of
the patient 202.
[0086] FIG. 24 is a schematic diagram of an angle adjustment range
of the lift and tilt mechanism 212 of FIG. 21. The lateral linkage
system 258 includes a first support 260a coupled to the roller
assembly 256 and a second support 260b coupled to the underside
surface 218 of the tilting and lifting table 214 wherein the first
support 260a and the second support 260b are coupled together by a
rotary joint 264. In addition, the slit-pinion mechanism 262
couples the second actuator 250b and second vertical shuttle 252b
to the tilting and lifting table 214. As such, the combination of
the second actuator 250b and the second vertical shuttle 252b, the
lateral linkage system 258 and the slit-pinion mechanism 262
provides for modifying an angle of the tilting and lifting table
214. For example, in one embodiment, the tilting and lifting
rehabilitation table system 200 may utilize twenty-four inches of a
thirty inch effective stroke span of the second actuator 250b which
provides for a +20.degree. to -15.degree. angle adjustment range
and adjustable difficulty levels for a patient 202. In addition,
the second actuator 250a and second vertical shuttle 252b are
coupled to the first actuator 250a and first vertical shuttle 252a
via a linkage system 254. The linkage system 254 provides for
modifying a height of the tilting and lifting table 214 without
modifying an angle of the same.
[0087] It is to be understood that the above-described embodiments
are illustrative of only a few of the many possible specific
embodiments, which can represent applications of the principles of
the invention. Numerous and varied other arrangements can be
readily devised in accordance with these principles by those
skilled in the art without departing from the spirit and scope of
the present disclosure.
* * * * *