U.S. patent number 3,777,744 [Application Number 05/125,579] was granted by the patent office on 1973-12-11 for hand assist breather.
Invention is credited to James D. Fryfogle, Carl C. Garland.
United States Patent |
3,777,744 |
Fryfogle , et al. |
December 11, 1973 |
HAND ASSIST BREATHER
Abstract
A medical appliance of a belt-like structure which is hand
operable to improve and sustain respiration, and more specifically
can be used by a patient for assisting exhalation of breath from
the patient afflicted with obstructive lung disease which is
operative by compressing the upper abdomen forcing the diaphragm
against the distended lungs.
Inventors: |
Fryfogle; James D. (Southfield,
MI), Garland; Carl C. (Detroit, MI) |
Family
ID: |
22420395 |
Appl.
No.: |
05/125,579 |
Filed: |
March 18, 1971 |
Current U.S.
Class: |
601/41 |
Current CPC
Class: |
A61H
31/00 (20130101); A61H 31/007 (20130101); A61H
2201/165 (20130101) |
Current International
Class: |
A61H
31/00 (20060101); A61h 031/00 () |
Field of
Search: |
;128/24,25,28,60,96 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Trapp; Lawrence W.
Claims
What is claimed is:
1. A portable, hand operated, medical appliance for assisting
exhalation of breath from a patient by compressing the lower rib
cage and upper abdomen to force the diaphragm against the lungs,
the appliance comprising: a pressure plate having an inner surface
adapted to contact the upper abdomen and dimensioned to be located
in between the frontal lower edges of the rib cage; a belt member
having an end portion detachably connected to said plate and
adapted to encircle the lower rib cage; and means supported by said
plate and operative on an opposite end of said belt for selectively
constricting said belt from a first condition in which said belt
member is relatively untensioned to a second condition in which
said belt member is tensioned to compress the lower rib cage while
simultaneously forcing said pressure plate compressively against
the upper abdomen, said means including an actuating lever lying
closely adjacent a confronting outer surface of said pressure plate
when in said first condition, to define a low profile whereby said
medical appliance can be continuously worn by the patient with no
impediment to his mobility.
2. The medical appliance, as recited in claim 1, with said pressure
plate having an arcuately contoured inner surface to facilitate
conformation to the contour of the upper abdomen.
3. The medical appliance, as recited in claim 1, with said pressure
plate having an area, for an average adult, of 25 to 30 square
inches.
4. The medical appliance, as recited in claim 1, with said pressure
plate having a pair of elongated slots located adjacent to one
outer edge, and wherein said one end of said belt member is
adjustably connected to said pressure plate by engagement through
each of said pair of elongated slots.
5. The medical appliance, as recited in claim 1, wherein said
pressure plate includes a pair of edges inclined outwardly from the
inner surface whereby the contacting inner surface is substantially
smooth.
6. The medical appliance, as recited in claim 1, with said belt
member having a width for an average adult of approximately 4
inches.
7. The medical appliance, as recited in claim 1, wherein the width
of said belt substantially conforms to the width of said pressure
plate.
8. The medical appliance, as recited in claim 1, wherein said
pressure plate includes an elongated belt loop connected to an
outer surface of said pressure plate, and wherein said opposite end
of said belt member is slidably received through said loop.
9. The medical appliance, as recited in claim 8, wherein said
opposite end of said belt member is folded-over to define a passage
therealong; and wherein said appliance includes an elongated pin
member located in said passage for restraining said opposite end of
said belt member from disengagement with said belt loop.
10. The medical appliance, as recited in claim 9, with said means
being connected with said pin member whereby movement of said
actuating lever results in constriction of said belt member.
11. The medical appliance, as recited in claim 1, further
comprising: a first pulley rotatably connected to said one end of
said actuating lever; and wherein said means includes a flexible
connector operatively engaging said first pulley and having one end
connected to said opposite end of said belt member.
12. The medical appliance, as recited in claim 11, further
including a second pulley rotatably connected to said operating
lever, said second pulley being spaced inwardly from said first
pulley and operatively engaging said cord.
13. The medical appliance, as recited in claim 1, wherein the
pivotal movement of said lever transmits a force normal to said
pressure plate which is adapted to compress the upper abdomen.
14. A portable, hand operated medical appliance, for assisting
exhalation of breath from a patient afflicted wilh an obstructive
lung disease, by compressing the upper abdomen to upwardly urge the
diaphragm against the lung, which comprises:
a pressure plate having an inner surface adapted to contact with
the upper abdomen and dimensioned to be located in between the
frontal lower edges of the rib cage;
a bracket connected to an outer surface of said pressure plate;
an elongated actuating lever having one end pivotably connected to
said bracket;
a pulley rotatably supported by said actuating lever and located
inwardly along the elongated axis of said actuating lever from the
pivotal axis;
a belt having one end adjustably connected to said pressure plate
and adapted to encircle the lower rib cage; and
a cord, engaging said pulley, and connecting an opposite end of
said belt and said bracket whereby pivotal movement of said
actuating lever will simultaneously constrict said belt and urge
said pressure plate inwardly against the upper surface of the
abdomen.
15. A portable, hand operated medical appliance, for assisting
exhalation of breath from a patient afflicted with an obstructive
lung disease, by compressing the upper abdomen to upwardly urge the
diaphragm against the lung, which comprises:
a pressure plate having an inner surface adapted to contact with
the upper abdomen and dimensioned to be located in between the
frontal lower edges of the rib cage;
a bracket connected to an outer surface of said pressure plate;
an elongated actuating lever having one end pivotably connected to
said bracket, said actuating lever lying closely adjacent the
confronting outer surface of said pressure plate in a first
condition to define a low profile whereby said medical appliance
can be continuously worn by the patient with no impediment to his
mobility;
a pulley rotatably supported by said actuating lever and located
inwardly along the elongated axis of said actuating lever from the
pivotal axis;
a belt having one end adjustably connected to said pressure plate
and adapted to encircle the lower rib cage; and a cord, engaging
said pulley, and connecting an opposite end of said belt and said
bracket whereby pivotal movement of said actuating lever from said
first condition will simultaneously constrict said belt and urge
said pressure plate inwardly against the upper surface of the
abdomen.
16. A medical appliance for assisting exhalation of breath
comprising: a pressure plate adapted to be located against the
upper abdomen between the lower rib cage; a belt having a first end
detachably secured to said plate and adapted to encircle the rib
cage; an actuating lever pivotably connected to said plate; means
including at least one pulley rotatably supported by said lever and
operative with an opposite end of said belt for constricting said
belt in response to pivotal movement of said lever, whereby said
plate may be selectively urged against the upper abdomen and said
belt is compressed around the rib cage to assist exhalation of
breath.
17. The medical appliance, as recited in claim 16, wherein said
means includes first and second pulleys rotatably supported by said
lever, and wherein one of said pulleys is coaxially located with
the pivotal connection of said lever with said plate.
18. The medical appliance, as recited in claim 17, wherein the
other of said pulleys is spaced from said one pulley along a
longitudinal axis of said lever.
19. The medical appliance, as recited in claim 16, wherein one end
of said lever is bifurcated, and wherein said at least one pulley
is located in a recess formed by said bifurcation.
20. The medical appliance, as recited in claim 16, wherein said
lever lies closely adjacent a confronting outer surface of said
plate when said belt is unconstricted relative to said rib cage to
define a low profile whereby said medical appliance can be
continuously worn by a patient with no impediment to his mobility.
Description
SUMMARY AND BACKGROUND OF THE INVENTION
This invention relates generally to medical appliances and more
particularly to a belt-like device for use as a respiratory
aid.
In the normal respiration process of the human body, inspiration of
air is accomplished by increase and decrease in the size of the
thorax. Breathing normally takes place at an intrathoracic pressure
slightly below that of the atmosphere and provides a partial vacuum
between parietal and visceral pleural surfaces. As the thoracic
muscles of inspiration contract to enlarge the chest cage, the
lungs passively follow the diaphragm and chest wall due to the
increased pressure which exists.
The greatest amount of air that can be expired after a maximum
inspiration is termed the vital capacity, the vital capacity
normally being a function of the size and vitality of the
individual person. In this regard, however, it has been found that
a person with a normal respiratory function retains a residual air
volume after expiration of approximately 20 percent.
Any condition which interferes with the normally negative
intrapleural pressure or which increases the residual air volume
generally has a serious effect on the respiratory function. Medical
patients afflicted with obstructive lung diseases, such as
emphysema, experience difficulty in breathing because they are
unable to adequately empty their lungs, i.e., 40 percent or more
residual air remains therein after expiration. Thus, essentially
two mechanical problems are present:
1. The lung substance is stretched, loses its elastic recoil and
physiologically obstructs air flow at the terminal bronchial
levels; and
2. The distended lung pushes the diaphragm down and fixes the chest
wall in the inspiratory position, i.e., the "barrel" chest.
Consequently, the patient's inspiratory and expiratory efforts are
thwarted, he relies on the accessory muscles of respiration, namely
those of the shoulder girdle, in an attempt to move air in and out
of his inefficient thorax.
The most effective muscle of respiration, however, is the
diaphragm, which as indicated above, is held on stretch by the
expanded rib cage and therefore its active use is minimal.
Various methods or techniques are presently employed to treat a
patient afflicted with an obstructive lung disease. Initially, the
patient can be taught to blow against a mild obstruction, such as
pursed lips or a retard valve, etc., to increase intrabronchial
pressure during expiration. This has been found to maintain
bronchial patency, which allows better emptying of the alveolar
spaces. Concurrently, the patient can be taught to breath using
abdominal muscles, increasing diaphragmatic usefulness.
The hand assist breather device of the subject invention has great
use in augmenting both of these courses of instruction. With
respect to the latter technique, the subject invention directs the
patient's attention to breathing with the lower chest and abdominal
muscles. Additionally, it has been found that functional activity
is increased for those patients not confined to beds.
Thus the hand assist breather device, for assisting a patient to
expel excessive residual air, includes an adjustable belt for
encircling the lower thoracic cage and a contoured pressure plate
confronting the upper abdomen therebetween the lower edge of the
frontal rib cage. One end of the belt is adjustably connected to
the pressure plate, whereas the opposite end is connected to an
actuating means disposed on the outer surface of the pressure
plate. The actuating means includes an operating lever having a
pair of pulley members rotatably supported at one end thereof, and
a cable connected therebetween the pulleys and the opposite end of
the belt. Pivotal manipulation of the operating lever is adapted to
force the pressure plate against the upper abdomen and compress the
lower rib cage; this compression forces the diaphragm upwardly
against the distended lung to assist exhalation. The device is of a
lightweight, simple construction and of a compact design. In its
non-operative position, the operating lever assumes a position
generally parallel with the pressure plate which allows the device
to be worn under conventional street clothing or otherwise
continuously worn by the patient with no discomfort and without
hindering his mobility.
Accordingly, it is an object of the present invention to provide a
simple compact device to assist a patient to expel excessive
residual air.
It is another object of the present invention to provide a device
useful in instructing a patient to breathing with the lower chest
and abdominal muscles.
It is another object of the present invention to provide a device
to improve and sustain respiration.
It is still another object of the present invention to provide a
simple compact device which assists exhalation by applying an
inward force on the upper abdomen to compress the lower rib cage
and force the diaphragm upwardly against the distended lungs.
It is still a further object of the present invention to provide a
respiratory aid which is portable, compact, inexpensive and
manually operated.
It is another object of the present invention to provide a medical
appliance which is compact and may be comfortably worn under
conventional clothing or otherwise continuously worn without
discomfort and without hindering mobility of the wearer.
It is yet another object of the present invention to provide a
respiratory aid that is easy to manipulate, rugged in construction,
and decoratively attractive.
Other advantages of the present invention will become apparent from
a consideration of the following detailed description taken in
conjunction with the accompanying drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a perspective view of the present invention as applied to
a schematic depicting the neck-waist human anatomy;
FIG. 2 is a frontal elevation of the pressure plate buckle of the
present invention in association with a fragmentary belt portion;
and
FIG. 3 is a cross-sectional elevation of the pressure plate and
fragmentary belt portion taken along the line 3--3 of FIG. 2.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT
With reference to FIG. 1 of the drawing, a hand assist breather
device is indicated generally at 10 in operative relationship to a
neck-waist representation 12 of the anatomy of a patient P. The
anatomy is not intended to be inclusive of all organs but various
pertinent portions are illustrated for providing a cursory
understanding of the operation of the device 10.
With reference then to the anatomy, a pair of lungs are indicated
at 14 disposed inwardly of a rib cage 16. The lower edge of the
frontal rib cage is illustrated at 18 with the rearward portion at
19, and superimposed thereabove is a diaphragm portion 20.
Interposed between the lower adjacent frontal edges 18 of the rib
cage 16 is the upper abdomen 22.
The breather device 10 comprises a flexible belt portion 24,
preferably constructed of a durable, strong two-ply fabric, and a
pressure plate 26. The belted portion 24 is adapted to encircle the
lower thorax or rib cage 16 with its ends operatively secured to
the pressure plate 26, as shall hereinafter become apparent. The
pressure plate 26 is suitably arcuately contoured to comfortably
fit the upper abdomen 22 and is dimensioned to have its vertical
edges disposed between the lower edge of the ribs 18.
Turning now to FIGS. 2 and 3, the pressure plate 26 is generally
rectangular in shape and suitably arcuately contoured to generally
conformingly contact an area of the upper abdomen to afford maximum
comfort. If required, additional backing could be added to the
rearward surface thereof, to further facilitate contact with
various forms of anatomy. Preferably, the plate 26 is constructed
of stainless steel, which affords good rigidity and is not subject
to oxidation. Dimensionally, the plate 26, to most effectively
accommodate an average adult, encompasses a surface area of
approximately 25 to 30 square inches in order to provide for an
area of maximum operational effectiveness; of course, this area
could be varied to accommodate different anatomical requirements.
As illustrated in FIG. 1, the horizontal dimension of the plate 26
is slightly smaller than the distance between the lower rib edge 18
to have the capability of depressing the upper abdomen 22 without
touching the frontal rib structure. For additional comfort, the
upper and lower edges 28 and 30 are inclined outwardly so that the
edge surfaces themselves do not contact the abdominal portion 22 to
be depressed.
With reference now to FIGS. 2 and 3, the right hand portion of the
pressure plate 26 can be seen to include a pair of elongated
openings or slots 32 and 34, disposed adjacent one to the other.
The dual openings 32 and 34 are adapted to receive the belt 24
whereby one end of the belt 24 is fed from the lower surface of the
plate 26 through the opening 32 and under the immediate surface
portion 36 of the plate 26 and thence out through the opening 34.
The extreme right end of the plate 26 will compress the double
layer of belt 24 and will assist in holding the belt from slipping.
Further, the above described engagement affords a convenient and
comfortable adjusting means for properly encircling and positioning
the belt 24 around the rib cage 16.
At the extreme left end of the pressure plate 26 an elongated belt
loop 38 extends upwardly from the face surface thereof, and is
connected thereto preferably by means of suitably spaced spot
welds. The elongated aperture defined by the belt loop 38 functions
as a guide for the belt 24 during tensioning thereof, and is
further adapted to prevent disengagement of the left end of the
belt 24 from the pressure plate 26 as shall now be explained.
The left end of the belt is looped and stitched as at 40 to define
a loop portion 42, and an opening 44 is centrally located in the
edge of the folded end. To assemble the belt 24 to the pressure
plate 26, the loop portion 42 of the belt 24 is guided through the
belt loop 38, and a pin member 46, which has an eyelet 48 secured
centrally thereto, is inserted into the loop portion 42 with the
eyelet 48 extending through the opening 44. With the pin member 46
located in the loop portion 42 of belt 24 that end of the belt 24
cannot now slip through the aperture of the belt loop 38.
Completing the description of the pressure plate 26, a U-shaped
bracket 49 is located on plate 26 near the elongated slot 32 and
adapted for use in pivotably connecting an actuating assembly
60.
The actuating assembly 60 includes a handle 62 which has a pair of
leg portions 64 and 66 connected to a solid plastic bar portion 68.
The handle 62 is pivotally supported to bracket 49 via a fastener
assembly 78. A pair of pulleys 72 and 74 are located between the
leg portions 64 and 66 and rotatably secured thereto with pulley 74
supported on fastener assembly 76 and with pulley 72 rotatably
supported on fastener assembly 78.
One end of a cord 80 is connected to the eyelet 48 and the other
end is guided over the pulley 72, and thence under the pulley 74.
The end of the cord 80 is retained under the pulley 74 by means of
a knot indicated at 82. In this manner, the one end of the belt 24
is connected to the actuating assembly 60.
To utilize the breather device 10, the pressure plate is positioned
over the upper abdomen 22, between the lower edges 18 of the rib
cage 16 of a patient P, and the belt 24 is encircled around the
lower rib cage 16 and comfortably and firmly buckled to the right
end of the plate 26 in the manner previously described. The width
of the belt 24, which is preferably just slightly less than the
width of the pressure plate 26, by providing a large surface
contact area, provides for a structure which is not uncomfortable
to the patient while at the same time working over a large
effective area.
With reference to FIG. 3, it will be observed that when the
actuating assembly 60 is in its non-operative position, the
breather device 10 provides an extremely compact, low profile with
respect to the upper abdominal surface; this enables the breather
device 10 to be worn under conventional street clothing with no
discomfort or impediment to the wearer. This feature allows the
device 10 to be continuously worn, so as to increase the functional
activity of the patient P suffering from an obstrusive lung
disease.
To actuate the breather 10, the handle 62 is gripped by the patient
P and pivoted counterclockwise as viewed in FIG. 3 around the
pivotal axis defined by the fastener assembly 78. In pivoting the
handle 62, it will be noted that significant mechanical advantage
is afforded the patient P due to the effective moment arm of the
handle 62 and also due to the effect of the pulleys 72 and 74; the
pulleys 72 and 74 also provide an advantage for effecting travel of
the belt 24 whereby the belt 24 will actually travel a distance
substantially greater than the distance traveled by the pivot axis
defined by fastener 76. These features facilitate the compactness
of the device 10. Note that in pivoting the handle 62 about the
axis of fastener 78 to its upright position, a component of the
tensile force applied to the rope 80 is transmitted in a direction
normal to the pressure plate 26 whereby the plate 26 is moved
inwardly against the upper abdomen whereby the compression of the
abdomen is enhanced; of course, the plate 26 is also moved against
the abdomen by the tensioning of the belt 24. By virtue of the
compression of the upper abdomen, the diaphragm 20 is urged
upwardly into contact with the distended lungs and increased
exhalation is accomplished. Thus it can be seen that the device 10
is of a compact and inexpensive construction which is readily
portable and can be literally worn at all times by the patient with
no discomfort and without impeding the patient's mobility.
While it will be apparent that the preferred embodiment illustrated
herein is well calculated to fulfill the objects above stated, it
will be appreciated that the present invention is susceptible to
modification, variation and change without departing from the scope
of the invention.
* * * * *