Data processing: measuring – calibrating – or testing – Measurement system – Orientation or position
Reexamination Certificate
2001-10-22
2004-09-07
Barlow, John (Department: 2863)
Data processing: measuring, calibrating, or testing
Measurement system
Orientation or position
C702S150000, C702S151000, C702S153000, C600S594000, C600S595000
Reexamination Certificate
active
06789044
ABSTRACT:
BACKGROUND OF THE INVENTION
Field of the Invention
The invention relates to a method for determining the neck movement pattern of a subject. It also relates to a corresponding apparatus for carrying out the method.
It has long been desired to find a suitable examination method in order to be able to measure reliably impairments of neck mobility resulting from a head-neck whiplash injury, termed a cervical column whiplash injury. The principal object of the examination methods or procedures that are to be applied in the physical and functional fields with the focus on symptoms and individual cases is to clarify accident-related injuries in the region of the cervical column.
The cervical column whiplash injury, which counts among the most frequent traumatic injuries of the neck, is a pathological injury that occurs, in particular, as a result of automobile accidents with or without contact with the inside of the vehicle. The cervical column whiplash injury here denotes a physical acceleration or deceleration traumatic injury with a transfer of energy to the head-neck structure, which is connected similarly to a pendulum rod, with a rotary-sliding joint, specifically the head socket joint, mounted on top. The flinging movements can be initiated by linear rear and/or front impact accidents, or by linear impact accidents on the right-hand or left-hand side. Also known, in addition, are comparatively complicated collision mechanisms wherein the vehicles are hit diagonally.
The diagonal collisions generally result in a rotation of the vehicle accompanied by angular rotational accelerations which continue on to the cervical column structure, its joints, ligaments, muscles, tendons and other movement articulations of the or each vehicle occupant. The cervical column whiplash injury is therefore distinguished by a multifarious set of symptoms which frequently can be predicted only with difficulty in the individual case owing to the traumatic injury that is acting. In this regard, various terms are used in the medical literature to describe this injury such as, for example, cervico-encephalic, cervico-brachial, cervico-medullary or cervical syndrome, chronic post-traumatic head
eck injury, cervical column distortion, or whiplash syndrome.
Since the neck region is traversed not only by the spinal cord as the important central nervous control organ, but also by important blood vessels, nerve pathways, muscles, tendons, the esophagus and windpipe, injury in this region can lead to particularly severe medical conditions determined by a multiplicity of symptoms. As a result of the multiplicity of these many symptoms and syndromes, there has so far not been any diagnostic finding which can be established in a simple way and is at the same time reliable and can conclusively prove the cervical column whiplash injury per se.
A first proof has been achieved through a radiological determination of the ligament injuries inside the head socket joint, that is to say the connections between the cranial base and the first and second cervical vertebrae. This involves nuclear magnetic resonance imaging which can, however, in the final analysis ascertain only relatively major morphological injuries such as ligament ruptures, torn ligaments, ligament swelling and eccentricities and/or fractures of the dens axis.
Those affected (the patients) themselves note the substantial changes in the head socket joint after the collision with a vehicle because they acquire a stiff neck or suffer neck pain and are greatly limited in their head-neck mobility.
U.S. Pat. No. 5,203,346 (see international PCT publication WO 91/15148 (PCT/US91/01796)) describes a noninvasive method for determining the movement of the cervical vertebrae. There, a subject in a sitting position is instructed to follow visual stimuli and, systematically, a luminous marking pattern on a wall while his head movements are recorded in three dimensions by means of video cameras. For this purpose, a marking device which can be recorded is fitted on the head of the subject. If deviations from the straight sequence of luminous simulators are determined, these deviations are interpreted as faulty control of the neck movements.
Although the examination is carried out on a seated patient, it is, on the one hand, not ensured in this known method that the patient or subject behaves during the head movement in such a way that no additional head and trunk movements occur which under natural conditions support targeted head movement. On the other hand, the seated position disadvantageously leads to a restriction of the movement of the subject. Since trunk movements supporting the head movement are therefore not taken into account, and it is only from the acquired head movement that conclusions are drawn concerning the movement or mobility of the cervical column without, moreover, distinguishing between the lower cervical column (pendulum rod) and upper cervical column (head socket joint), the known method is not sufficiently exact, particularly with regard to a reliable statement on the type and degree, as well as the localization, of an injury to the cervical column. Consequently, this known method cannot be used, at least not in the way desired, to prove on good foundations the causality of an injury to the cervical column as a consequence of a cervical column whiplash injury caused by a traffic accident.
In the case of a device known from the printed publication entitled “Forschungsbericht Cranio-Corpo-Grafie (CCG)”, ISBN 3-88383-126-3 (June 1986) appearing in the series of papers of the Hauptverband der gewerblichen Berufsgenossenschaften e.V., the head and trunk movement of a subject is visualized by means of markers in the form of incandescent lamps, one each being fitted on either shoulder of the subject and above his forehead and the back of his head. The movement of each marker in the horizontal plane is photographically recorded by a camera, arranged above the subject, under permanent exposure as a luminous trace in what is termed a craniocorpogram. The luminous traces are evaluated on the photograph after the experiment has been carried out. However, the corresponding evaluation of the pictures, which is performed either by measuring the geometry of the luminous traces or by associative connection of the complex movement pattern with comparative patterns denoted as graphic elements is associated with a substantial time outlay. A further disadvantage consists in that some of the information generated in the experiment is lost in the photographic recording of the marker movements, more so since only the horizontal components of the marker movements are to be detected on the photograph. A statement on vertical movements and on the absolute height of a marker in space therefore cannot be made. Moreover, it frequently happens that overlapping of the luminous traces leads to occlusions, since the luminous traces of all the markers are contained on a single photograph. It is therefore difficult or even impossible to characterize individual luminous traces. Information is also lost in the dead angle which is situated directly below the chamber and wherein the chamber projects into the beam path running between the mirror and a marker.
German patent DE 38 29 885 C2 discloses a device wherein use is made, instead of a camera, of an arrangement, fitted above the subject, of photocells for recording the luminous traces. This arrangement eliminates the dead angle. The luminous traces are analyzed there by means of a digital computer, with regard to calculating the movement deviations relevant for craniocorpography. However, no provision is made there for evaluation with regard to an interpretation of acquired movement patterns, in particular of the neck movement pattern.
An apparatus for determining head mobility is described in German utility model DE 295 06 404 U1. Provided for this purpose are a holder, which is fastened on the head of the subject and has three sound transmitters or receivers, and a further three sound transmitters or receivers as reference ma
Barlow John
Claussen Claus-Frenz
Dougherty Anthony T.
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