Surgery – Diagnostic testing
Reexamination Certificate
1999-09-14
2001-09-04
O'Connor, Cary (Department: 3736)
Surgery
Diagnostic testing
C600S306000, C128S898000, C434S262000
Reexamination Certificate
active
06283916
ABSTRACT:
MICROFICHE APPENDIX
A microfiche appendix is submitted with this application having 252 pages and 3 sheets. The microfiche appendix includes a listing or database of images showing a preferred embodiment of practicing the present invention. These images depict one-hundred and five non-limiting examples of preferred treatment modalities according to the invention, but do not exhaust all possibilities for treatment modalities. These images also include four pages of symptom pattern diagrams permitting a selection of treatment modalities according to the present invention.
BACKGROUND OF THE INVENTION
1. Field of the Invention
The present invention relates to the field of medical treatments for reducing the size and effect of various adhesions or lesions in soft tissues, such as muscles, tendons, blood vessels, fascia, and nerves. More specifically, medical treatments according to the invention utilize an expert system for directing the non-surgical manual manipulation of soft tissues to identify and treat soft tissue adhesions that cause numbness, pain, and restricted range of motion.
2. Statement of the Problem
Unnecessary surgeries are sometimes performed because the medical profession lacks a unified and comprehensive training program for the non-surgical treatment of all types of soft tissue lesions. Prior treatments and training have focused on specific disorders, which results in an ad hoc overall level of expertise in the medical profession and a preference for surgical intervention. Medical practitioners are often unaware of non-surgical treatments offering higher success rates and less trauma to their patients than can be obtained from surgical pr. There is a need for an expert system to guide medical doctors, chiropractors, physical therapists, and occupational therapists in implementing protocols for the non-surgical treatment of all types of soft tissue lesions. This expert system would prevent unnecessary surgeries.
Historically, a preferred treatment modality has been the surgical excision of lesions, if possible, once they become problematic. These surgeries may not be needed even though they may be commonplace. By way of example, surgery for carpal tunnel syndrome can be performed to divide the transverse carpal ligament in a manner that relieves pressure on the median nerve. U.S. Pat. No. 5,501,657 to Feero reports that surgical techniques intended to relieve the syndrome have a failure rate ranging from 50% to 75%. The '657 patent teaches a non-surgical technique for the relief of pain associated with carpal tunnel syndrome. The massage technique includes stretching muscles of the forearm and hand combined with longitudinal manipulation of the forearm muscles to improve circulation. Even though the '657 patent does not identify a success rate for the technique that it teaches, the technique is said to be more successful than prior surgical techniques.
Surgical techniques for soft tissue injuries have low success rates because surgery cannot address all of the potential problem areas. Additionally, surgery itself produces trauma. Leahy in
New Treatment of Carpal Tunnel Syndrome,
Chiropractic Sports Medicine (1992) proposed a non-surgical technique for the treatment of carpal tunnel syndrome. Leahy recognized that carpal tunnel syndrome may involve lesions of the carpal canal, the median nerve, the radial nerve, the posterior interosseus nerve, the axilla, the anterior interosseous nerve, and the ulnar nerve. Thus, the blanket designation of ‘carpal tunnel syndrome’ is inadequate to describe the afflicted anatomy with particularity.
Cumulative Injury Disorders
Cumulative injury disorders involve the soft tissues, and are now perhaps the most significant injury problem in the United States. Federal injury statistics indicate that cumulative injury disorders have worsened by six hundred and seventy percent in the last five years. A variety of injuries including carpal tunnel syndrome may be classified under the broad heading of cumulative trauma disorders or cumulative injury disorders. These disorders include a group of injuries to the muscles, tendons, bones, blood vessels, fascia, and nerves. The term ‘cumulative injury disorder’ is preferred because actual trauma is not necessarily required to bring about the injury.
The three basic injury types include acute injuries, repetitive motion injuries, and constant pressure or tension injuries. Acute injuries result from the tearing of muscle and fascia, and are most often associated with immediate inflammation. Acute injuries trigger biological processes involving white blood cells, the production of fibrinogen, and the growth of adhesions. Adhesions also result from the other types of injuries.
Cumulative injuries result from the law of repetitive motion and the cumulative injury cycle. The law of repetitive motion may be modeled as:
I=NF/AR,
(1)
wherein I is a relative quantity denoting an insult to the tissues; N is a number of repetitions; F is the force or tension of each repetition as a percent of maximum muscle strength; A is the amplitude of each repetition; and R is the relaxation time between each repetition. For example, a jackhammer operator is daily exposed to vibrations wherein N is high, A is low, and R is low. Thus, I is high. Formula (1) above shows that injuries may derive from constant pressure or tension that is without apparent or immediate trauma to soft tissues. Furthermore, cumulative injuries may result from isometric muscle contractions and poor posture with consequences including cellular calcium retention, poor cellular repair, and altered function.
The Cumulative Injury Cycle
The three basic injury types may all contribute to a cumulative injury cycle
100
, as shown in FIG.
1
. Repetitive motion injuries result in weak and tense tissues
102
. Tissues that are adjacent to these weak and tense tissues may also be drawn tight. Weak and tense tissues produce corresponding internal forces
104
including friction and pressure. An acute injury
106
, such as tearing or crushing on a microscopic or macroscopic level, can result from these internal forces. An isolated acute injury
106
can also commence cycle
100
. Inflammation
108
results from the acute injury
106
, and exacerbates the total problem by enhancing the weakness and tenseness of the injured tissues. Internal forces
104
also induce decreased circulation or edema
108
. The effect of these internal forces is usually a decrease in circulation. The acute injury
106
and inflammation
108
contribute to cellular hypoxia from restricted circulation. This cellular hypoxia causes fibrosis and adhesions
110
to occur in and between tissues. Acute injury
106
and inflammation
108
combine to form an inflammation cycle
112
leading to adhesion and fibrosis
110
. A chronic cycle
114
also leads towards adhesion and fibrosis
110
. Chronic cycle
114
includes the effects of decreased circulation and edema
116
. As indicated above, internal forces
104
lead to a decrease in circulation and an increase in internal pressure. The decrease in circulation may be enhanced by the continued application of external pressure, e.g., as from an elastic garment. Pressure applied over a low-pressure lymphatic channel causes swelling or edema, which also leads to adhesion and fibrosis
110
.
Certain persons are predisposed to be more affected than others by injuries on the cumulative injury cycle
100
. For example, smokers and diabetics have relatively poor circulation, which helps perpetuate the cycle. Thyroid deficits and hormonal changes increase musculature tension, and enhance the degree of weakness and tightness in the affected tissues.
The cumulative injury cycle
100
perpetuates itself, and afflicted persons find themselves in a downward spiral until the symptoms and syndromes of cumulative injury disorder are prevalent. Examples of cumulative injury disorders include carpal tunnel syndrome, cubital tunnel syndrome, epicondylitis, tenosynovitis, myofascitis, bursitis, peripheral nerve entrapment, t
Leahy P. Michael
Patterson Tim
Active Release Techniques LLC
Astorino Michael
Duft, Graziano & Forest, P.C.
O'Connor Cary
LandOfFree
Expert system soft tissue active motion technique for... does not yet have a rating. At this time, there are no reviews or comments for this patent.
If you have personal experience with Expert system soft tissue active motion technique for..., we encourage you to share that experience with our LandOfFree.com community. Your opinion is very important and Expert system soft tissue active motion technique for... will most certainly appreciate the feedback.
Profile ID: LFUS-PAI-O-2512850