EP0101081A1 - Orthopedic apparatus - Google Patents

Abstract

1. Orthopedic apparatus for treating vertebra defects of persons, comprising a base frame being displaceable vertically or almost vertically, accommodating one person and stretching his/her spine (14, 16; 72), as well as a first element (48, 88) acting intermittently on a part of the spine, at least almost vertically to the stretching arrangement of the person, wherein the first element (48, 88) is adjustable in height and for the purpose of producing any individual shock whatever, said element is configured as a back shock device of knob shape acting shock-like vertically on the part of the spine, controllably prestretchable under elasticity or as a flywheel mass controllably swivable against gravity, with release.

Description

The invention relates to an orthopedic device, in particular for the treatment of spinal damage of persons with an element which acts in an abrupt manner on the spine.

In order to treat vertebral damage such as vertebral bodies shifted or dislocated against one another, an individual treatment is predominantly carried out today, for example by a chiropractor. Essential treatment exercises are that the patient is raised, that is, the spine is stretched, in order then to allow a jerky movement to act on the spine. For this purpose, the patient crosses his arms at the back of the head and is grasped and raised on the back by a treating person on his forearms. Then there is a short push in the back area. However, this manual treatment of a patient has certain disadvantages. For example, the treating person, for example the chiropractor, is put under a lot of stress, with the spine in particular being overstrained, if necessary. The patient himself runs the risk that the forces exerted during the therapy or the impact are too strong. However, since the patient has no way to avoid this treatment, unwanted pain and possibly unintentional damage occur again and again.

There are orthopedic devices in which elements have a sudden impact on a patient's spine. However, the Treatment always lying down, so that the vertebrae to be treated can only be shifted with considerable force on the adjacent healthy vertebrae. However, this creates a risk of injury. Furthermore, there is hardly any possibility of controlling the action of force, ie not applying it by hand. (see for example US-A-21 80 775, US-A-14 55 320, DE-C-234 809, CH-C-46 81 83, DE-B-22 26 073)

The object of the present invention is to provide an orthopedic device for the treatment of vertebral damage to persons, with the aid of which individual treatment of the patient is possible, controlled and reproducible application of force can take place, one or more vertebrae independently of the adjacent vertebrae can be treated.

The object is achieved in that the device comprises a vertically or almost vertically displaceable, a person receiving and stretching their spine base frame and a desired impact-like effect on one or more vertebrae (first) element which, depending on the extension of the Spine can be activated. The first element is horizontally and vertically adjustable and preferably as a knob-like designed back-pushing device which acts in a spring-loaded manner on the spine in a controlled manner perpendicular to or perpendicular to the direction of extension of the person, which preferably penetrates or is surrounded by a backrest, which in turn at least sections of the Supports the patient's back.

The device according to the invention provides for the first time the opportunity to understand the treatment of a chiropractor, but the decisive advantage is that a reproducible treatment is possible. This means that individual impact-like forces on the people to be treated Treating vertebrae can act, so that there is no danger that damage will occur instead of a healing effect. The device according to the invention ensures that really only the vertebral section to be treated is acted upon by the abruptly advancing element without the adjacent vertebrae being affected. This is due to the fact that the jerky movement begins before the stretching is complete. During the stretching process itself, the individual vertebrae, which can sometimes be tilted against each other, are quasi separated from one another and aligned in a row without muscle tension occurring at the same time. This occurs only when the stretching is complete, that is to say the patient is virtually "hung up". Before this muscle tension occurs, however, the individual vertebrae are still largely free to move against each other, the impact occurs, so that, for example, tilted or twisted vertebrae can be aligned with the others in the required manner.

The treatment works as follows. The base frame, which starts from a base plate, is height-adjustable and has forearm and armpit supports in its upper section. After the base frame has been extended or lowered onto the person to be treated, the frame can be thought of as a column having telescopic sections, the forearm supports and the armpit supports are placed on the patient. The back pushing device, which is also height-adjustable and horizontally adjustable, is then aligned with the area of the back area that is to be treated. Finally, the back pushing device is tensioned to an extent that ensures the desired push application to the vertebrae to be treated. Finally, the leveling device is tensioned. This means that if necessary by spring preload after alignment the column on the person per se and adjusting the forearm supports and armpits, the stretching causing the lifting of the column takes place in order to trigger the back-pushing device after an adjustable and predefinable extension length, so that the impulse-like action of force on the part of the spine to be treated takes place before muscle tension.

The column can then be lowered so that another patient can be treated, or the stretching process and the impulsive impact on the back area are repeated.

In an alternative embodiment, the first element interacts with a further second element, which is designed to rest against the spine and can be pivoted and raised at least about an axis of rotation. The second element, which is adapted to the spine, is received by a frame which in its upper region merges into at least one swivel arm which is articulated via the horizontally arranged axis of rotation to the at least height-adjustable base frame in the form of, for example, a column. In this case, the swivel arm itself is preferably connected to a lever, but can also pass into this in order to then be swiveled by cooperation with a power cylinder.

The alternative solution also simulates the manual treatment of a chiropractor. Determined by the construction of the device, the patient must also rest with his back on the second element adapted to the spine. It is also necessary for his arms to lie in arm holders. The frame is then lifted together, which simultaneously causes the spine to stretch. In this treatment position, the patient then only touches the floor with his toes, which can be a base plate of the height-adjustable base frame. The treatment is then carried out to the extent that the element which causes a shock-like impact is included interacts with the element adapted to the spine. This element can preferably be a swing element such as a pendulum, by the deflection of which the force acting on the spine is predetermined. An individual placement on the patient is also given in that the deflection of the swing element has a desired adjustable size or angle. The precise metering of the impact intensity can be metered by means of a measuring device and can therefore be set reproducibly.

The impact on the spine can also occur during the stretching process, even after the alternative solution, but also only after the stretching process. This depends on the type of treatment required.

One advantage that the patient is "suspended" from axle supports or forearm supports is that the patient can slide out of the supports if the impact forces are too great and thus lead to pain.

In a further embodiment of the invention, the impulse-like impact is not transmitted directly from the first element, for example as a swing element or as a knob-like recoil device, to the spine or the back element adapted to the spine, but an absorption element can be interposed, thereby delaying or The impact is damped. This has the advantage that the therapy is strengthened.

The orthopedic devices according to the invention in accordance with the proposed solutions described above consist recognizably of a static part and a dynamic part. The static part includes that Base frame, ie the column or frame with which the arm brackets or armpit supports and forearm supports as well as the height-adjustable back pushing device, all of which are adjusted to the physical conditions of a patient before the treatment. In addition, there is of course the standing area for the patient, which inevitably defines the starting position.

The dynamic part has force elements, such as hydraulic cylinders or spring elements, which have the effect that after the patient has assumed the basic position, the latter is raised and thereby stretched, preferably with a reproducible, adjustable impulse-like impact being applied to the spine before the stretching has ended can.

Another important exercise for healing spinal damage is that the spine rolls along an arched plane. In practice, this is achieved in that two patients stand together with their backs and roll against each other on their backs. However, this exercise poses dangers because individual adjustment is hardly possible, especially not if the people are of different weights or sizes.

However, the same exercise can be simulated with the orthopedic device according to the invention, which has the pivotable backrest. For this purpose, the curved second element, which is articulated in the upper edge region and preferably via the swivel arm, is used. The articulation point serves as the stationary axis of rotation of the curved element. According to one embodiment, the bent element is pivoted in that, for example, a hydraulic cylinder acts on a lever which can be connected to the upper end region of the bent element or the pivot arm. If a patient is now lying with his back part against the curved element, the hydraulic cylinder, lever, curved element and, if necessary, swivel arm, the rolling movement. For this purpose, holding devices for elbows are preferably provided in the middle region between the upper and lower ends of the curved element.

Finally, there is the possibility of simulating the rolling movement in that the upper and lower free ends of the first element are fixed, i.e. the upper and lower axes cannot be rotated relative to one another, but the entire device can be pivoted about an axis running parallel to the upper pivot axis.

Furthermore, there is the possibility of receiving the base frame, preferably in the form of a column, from a stationary frame, such as, for example, a trestle, in order to thereby pivot through 90 °. The column or the frame can then form the basis for a bed cover so that a further medical purpose is fulfilled, for example it can serve as a resting position for medical massages or the like.

Regarding the second element or the backrest, which support at least sections of the spine and is adapted to the shape, it should be noted that these can preferably be a curved board. Of course, there is also the possibility to design them as frames with interchangeable inserts. There are also other possible solutions. It is only essential that an adaptation of the spine is possible.

Further details, advantages and features of the invention result from the following description of preferred exemplary embodiments.

• Fig. 1 eine erste Ausführungsform eines erfindungsgemäßen orthopädischen Geräts in Seitenansicht,
• Fig. 2 das orthopädische Gerät nach Fig. 1, jedoch von einem Gestell aufgenommen,
• Fig. 3 das von dem Gestell nach Fig. 2 aufgenommene orthopädische Gerät, jedoch um 90° verschwenkt,
• Fig. 4 eine zweite besonders hervorzuhebende Ausführungsform eines orthopädischen Geräts in Seitenansicht,
• Fig. 5 das orthopädische Gerät in Draufsicht und
• Fig. 6 Weg-Schritt-Diagramm für das Gerät nach Fig. 4.

Show it:

• 1 shows a first embodiment of an orthopedic device according to the invention in side view,
• 2 shows the orthopedic device according to FIG. 1, but taken up by a frame,
• 3 shows the orthopedic device received by the frame according to FIG. 2, but pivoted through 90 °,
• 4 shows a second embodiment of an orthopedic device to be particularly emphasized in a side view,
• Fig. 5 shows the orthopedic device in plan view
• 6 path-step diagram for the device of FIG. 4th

Fig. 1 is a first. Embodiment of orthopedic device 10 according to the invention can be seen, which consists of a column 12 which can also be replaced by a frame or a frame. The column 12 consists of two sections 14 and 16 which can be shifted into one another. This means that the section 16 can be lengthened or shortened relative to the section 14 by means of cylinders 18 arranged in section 14 in the form of preferably hydraulic cylinders. An element 20 is arranged on the section 16, which is adapted to the shape of a spine. The element 20 is preferably received by a frame 22 which is constructed from sections 24 which run vertically and form rigid axes, and rigid horizontal arms. Furthermore, the frame 22 rests in its lower, rigid on the arms 26 extending from the section 16, and merges into swivel arms 28 in the upper region. If desired, an articulated connection between the frame 22 and the arms 26 could also take place via an axis 30. The vertical sections 22 preferably merge rigidly into the swivel arms 28, thus forming part of the frame 22, but can also be articulated with the swivel arms 28 via axes 32 be attached. The swivel arms 28, which are connected to the upper section 16 of the column 12 via an axis 34, pass into lever 36, which in turn can be connected to a piston rod 38 of a preferably hydraulic cylinder 40. The movement of the piston 38 takes place parallel or almost parallel to the longitudinal axis of the column 12. Above the first element 20, armrests 42 are also arranged. In addition, 20 arm supports 44 are provided in the side region of the first element.

The element 20 adapted to the spine also interacts with a pivotable element 46, the axis of rotation of which preferably coincides with the axis 34. The pivoting element can be a pendulum, the preferably cylindrical body 48 of which optionally interacts with the central region of the first element 20 via an elastic, controlled force-absorbing element 50. The deflection of the swivel element 46, that is to say in the exemplary embodiment of the cylinder 48, takes place in that a handle 54 provided on the pendulum rod 52 is gripped. The pendulum is then pivoted out in such a way that it is held by a locking element, such as pawl 58, arranged on an adjustable measuring device such as, for example, scale 56. After removal of the pawl 58, the pendulum 46 then swings out in the direction of the element 20 adapted to the shape of a spine and can thus transmit a metered impulse-like impact to it.

The column 12 is preferably arranged on a base plate 60 which, in the front region, comprises a foot plate 62 on which the feet of a patient are to be placed.

The hydraulic cylinders 18 and 40 can be controlled via a control unit 64, which is arranged on the base plate 60, in order to achieve simple handling in the area of the orthopedic device 10 according to the invention.

If the desired extension of the back column with the desired metered impact into the back area is to take place in succession or overlapping, the patient's feet are placed on the plate 62. The arms are then inserted into the arm handles 42. An individual setting is made according to the size of the patient. Then, by actuating the hydraulic cylinders 18, the section 16 is displaced with respect to the section 14, that is to say the upper section is moved out of the lower section. The displacement takes place to such an extent that the patient still touches the footplate 62 with his toes. In this state, the spine is stretched to the desired extent. Then or shortly before the final stretching, the pendulum 46 with the pendulum body 48 is moved away from its rest position from the element 20 in order to interact with the pawl 58, which is pinned on the scale 56 depending on the impact applied. As soon as the pawl 58 no longer interacts with the cylinder 48, the pendulum moves in the direction of the first element 20 and, if necessary, transmits an impulse-like impact to the back area via the shock-absorbing element 50, whereby the desired orthopedic treatment is achieved. (When the element 20 interacts with the pendulum, the one with the frame 22 is lifted off the horizontally extending arms 26.)

If the orthopedic device according to the invention is to be used to simulate a movement of the spinal column, the patient must insert his arms into the arm supports 44. Then the hydraulic cylinder 40 can be actuated so that the piston rod 38 exerts approximately a movement which takes place parallel to the longitudinal axis of the column 12. This movement causes the lever 36 to pivot about the axis 34. Since the lever 36 can be rigidly connected to the pivot arm 28 or merges into it, the element 20 is simultaneously rotated about the axis 34. Accordingly, the desired rolling movement of the Spine along this attached fit element 20 take place. (Of course, when the piston 38 is displaced, the hydraulic cylinder 40 must be pivotable about an axis at its lower fixed point)

A further possibility of achieving the desired rolling movement can be achieved in that the second section 16 can be pivoted relative to the first section 14 about an axis (not shown) running parallel to the axis 34.

Now only the second section 16 has to be tilted relative to the first section 14 about the axis mentioned. It is then no longer necessary for the hydraulic cylinder 40 to be actuated. Rather, this can be eliminated.

As can be seen from FIGS. 2 and 3, the orthopedic device 10 according to the invention can be received by a bearing block 68 via an axis 66. This means that the orthopedic device 10 can be pivoted about the axis 66. A pivoting through 90 ° can take place, as illustrated in FIG. 3. This has the advantage that the orthopedic device according to the invention with its column 12 and the element 20 adapted to the spine can form the basis for, for example, a treatment bed. However, other orthopedic exercises may also be possible in this position.

4 and 5 show a particularly noteworthy embodiment of an orthopedic device 70 designed according to the invention, in particular for the treatment of vertebral damage. The device 70 consists of a base frame 72, which can consist of telescopically displaceable columns 74, 76 and 78. Furthermore, the device 70 comprises a base plate 80, which serves as a base for a patient to be treated. Armpits go from column 72 82 and forearm supports 84, a backrest 86 which is adapted to the spine and an element 88 in the form of a back-pushing device which causes an impact force on the parts of the spine to be treated. Furthermore, a so-called leveling device 90 is indicated, the function of which is to be described below with that of the back-pushing device 88. Finally, on the column section 78 there is an adjusting element 92, designed as a lever in the exemplary embodiment, for the back pushing device, and a clamping element 93 for adjusting the height of the back pushing device.

The operation of the orthopedic device 70 according to the invention is now as follows. After a patient has stood on the base plate 80, the column 72 or its sections 74, 76 and 78 are displaced relative to one another in such a way that the forearm supports 84 and armpit supports 82 are adjusted to the body size. The armpits and forearms of the patient are then placed in the arm supports and in the forearm supports. In order to be able to make an individual adjustment here, the corresponding supports can be pivoted about the longitudinal axis of the column and are also designed to be height-adjustable along the longitudinal axis of the column. After the column length and the supports are accordingly adapted to the patient, the leveling device 90 is activated such that the patient is lifted with the feet still touching the base plate 80. During this lifting, the spine is stretched to a degree which relaxes the vertebrae, for example, which are shifted or tilted against each other and are thus aligned in a line. After the vertebrae are largely aligned, but without the stretching process necessarily having to be ended, the recoil device 88 is activated by a trigger element (not shown) in such a way that a pulse-like impact on the vertebrae or parts of the vertebrae to be treated can take place perpendicular to the stretching direction. The strength of the force can be adjusted by means of the clamping element 92. That is to say that the element 88 to be preloaded, for example by means of a spring, is preloaded to the extent that the required impact force is exerted on the vertebrae lot can act. The back pushing device 88 is itself adjustable in height and horizontally in order to be able to treat different parts of the back in a targeted manner.

Even if the triggering of the back pushing device 88 is not shown in more detail depending on the stretching process of the patient, triggering can take place via locking elements, for example, but also by means of a proximity switch or the like.

In order to clarify the teaching according to the invention, FIG. 6 shows a path-step diagram by means of which the functional sequence that is to be carried out when treating patients with the aid of the device 70 according to the invention is to be illustrated. The process steps to be considered for themselves are provided with the Roman numerals I to VII and their respective sequence with letters from A to V.

In process section I, the column 78 is lowered (A) in order to then be raised (B) to adapt it to the patient to be treated. The armpits are open (E) so the patient can put their armpits in. Then the armpits are closed (F). The same applies to the forearm supports, which, however, can still be lowered (K) or raised (L) in process section III or IV in order to ensure precise adaptation to the patient. In method section V, the back abutment device 88 is adjusted in height to the back area to be treated by means of the clamping element 93 (N, 0), in order to be able to have a targeted impulse impact from the back abutment device 88 on the vertebral area.

The process sections VI and VII represent the essential treatment steps which are carried out with the orthopedic device 10 according to the invention. The non-prestressed vertical surge device 9G (Q) is tensioned (R) in order to trigger at point 96, which in the diagram lies on line 94 intersecting the other method steps. This causes the spine to stretch to point 98 or shortly before. In or before point 98, the recoil device 88 is then activated in order to use up the prestress by applying force to the spine. The treatment is completed at point 102, so that the back pushing device, the forearm supports, armpit supports and the column height can be moved back to their basic positions (D, G, J, M, P). In this case, of course, the height pushing device 90 and the back pushing device 88 are also relaxed (S, V).

As an alternative to this, only process step V, VI or VII can of course be carried out, namely when a further impulsive impulse is intended to act on the same or a different spine part of the same patient.

It should be pointed out once again that it is possible for the first time after the proposed solutions of the device according to the invention to be able to perform a spinal column treatment in a targeted and reproducible manner, with which the known treatment of a chiropractor is simulated.

The jerky impulse is preferably triggered before the final stretching of the spine in order not to get into the tension phase of the muscles. Of course, if necessary, the same process step can only be triggered after stretching.

Claims (9)

1. Orthopedic device, in particular for the treatment of spinal damage to persons, with an element which acts in an abrupt manner on the spine,
characterized,
that the device (10, 70) comprises a vertically or almost vertically displaceable, a person receiving and stretching its spine base frame (14, 16; 72) and a desired impact-like action on a spinal column first element (48, 88), the can be activated depending on the extension of the spine. 2. Orthopedic device according to claim 1,
characterized,
that the first element (88) is adjustable in height and is preferably in the form of a knob-like recoil device, preferably a backrest (86), preferably in the form of a split back cushion, which can be preloaded in a controlled manner by spring force and acts vertically or almost perpendicularly to the direction of extension of the person is penetrated or surrounded by it, which in turn supports at least sections of the back of the patient (FIG. 4). 3. Orthopedic device according to claim 1 or 2,
characterized,
that the first element (46) interacts with a further (second) element (20), which is designed to rest against the spine and can be pivoted and raised at least about an axis of rotation (34). 4. Orthopedic device according to claim 2 or claim 3,
characterized,
that the first element (48, 88) for generating a pulse-like impact is a swing element which is adjustable in its deflection direction, for example a pendulum. 5. Orthopedic device according to claim 3,
characterized,
that the second element (20) adapted to a spine is received by a frame (22) which in its upper region merges into at least one swivel arm (28) which is articulated via the horizontally arranged axis of rotation (34) with the at least height-adjustable base frame (12 ) in the form of, for example, a pillar. 6. Orthopedic device according to claim 5,
characterized,
that the swivel arm (28) can be connected to or merges with a lever (36) which can preferably be pivoted by means of a power cylinder (40). 7. Orthopedic device according to claim 2 or claim 3,
characterized,
that between the first element (48, 88) causing the impact on the part of the spine and possibly the second element adapted to a spine (20) or the spine itself an absorption element (50) is arranged for further regulation of the impulse-like impact acting on the spine area. 8. Orthopedic device according to claim 3,
characterized,
that the base frame (12) is pivotable about a horizontal axis (66) (Fig. 3).

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