Exercise devices – User manipulated force resisting apparatus – component... – Utilizing fluid resistance
Reexamination Certificate
1999-06-07
2001-05-01
Yu, Mickey (Department: 3764)
Exercise devices
User manipulated force resisting apparatus, component...
Utilizing fluid resistance
C601S034000, C602S023000, C602S016000
Reexamination Certificate
active
06224521
ABSTRACT:
FIELD OF THE INVENTION
The present invention relates to orthopedic exerciser for therapy, post-surgery rehabilitation or healing of a knee or the muscles of a leg.
BACKGROUND OF THE INVENTION
Various surgical techniques have been known since the early 80's for the treatment of articular disorders. The complete replacement of an articulation of the knee is commonly practised nowadays. Rehabilitation of operated knees has become needy and different new options have been developed.
Several exercises have been proposed in different rehabilitation programs. They all aim to recover the knee to the normal articular mobility to disappearance of pain, to functional proprioception and to normal muscular function.
Currently there are four main type of exercises to aid in the rehabilitation of the knee, namely, passive, active assisted, active and “against resistance”. The condition of the patient may determine the type of exercise to be practised. Traditionally, passive movement is used to allow a gain of amplitude in the articular movement by diminishing inflammatory reactions, pain or muscular cramps. The exercises requiring active muscular movement usually follow after disappearance of the pain.
A CPM (Continuous Passive Motion) apparatus is a commonly used apparatus in knee rehabilitation. This apparatus allows execution of passive flexion and extension movement during a long period of time and without effort from the patient. CPM may be very efficient in terms of reducing pain in the knee or leg in post-surgery rehabilitation treatment, reducing hospitalization time and reducing a number of complications that may occur during the rehabilitation period. However, CPM does not replace functional activity and active movement.
Once the patient is able to execute contraction of muscles without excessive pain, which may be very soon, active assisted movement of the leg is practised. It is then possible to gain range of movement (ROM) without any motorised assistance. In our experience, simple mechanical assistance in either flexion or extension movement allows greater benefits than a motorised device. Assistive active devices are necessary when muscles are not functional enough to move the joint in the devised range.
The next step to undertake for allowing full recovery of the knee or leg, that is for allowing their proper functioning, is to execute “against resistance” exercises. Actually, this type of exercise allows restoration of proprioceptive neuromuscular facilitation. It is known that rehabilitation of a muscle and maintenance of development of the muscle tone is possible from the different reflex mechanisms generated by stretching of the muscle which results from the physical action of the muscle itself.
Different publications and patents disclose an apparatus allowing application of resistance during extension of the knee through a movement of an arc of a circle. The thigh is maintained still or partially still, whether the patient is sitting or lying down. Other apparatuses comprise a simple support for receiving a thigh and a resistance device which may be a bag of sand attached to the foot. In other instances, the resistance device may be an elastic band. In all cases, the foot usually lacks proper support and the resistance is exercised on the wrong portion of the leg, for instance, in the lower portion, i.e. the shank. All these apparatus challenge the muscles in a wrong bio-mechanical way, and may damage the knee. These old-fashioned exercises are so called “open circuit” type.
Obviously, it is important to provide an apparatus that will allow execution of the exercise without causing tension on the knee. Recent data have shown the best benefits of a new approach.
SUMMARY OF THE INVENTION
It is an object of the present invention to provide an apparatus allowing execution of a wide range of exercises of a leg without causing excessive tension on the knee.
It is a further object of the present invention to provide an apparatus allowing execution of a complete combination of exercise that will result in the complete recovery of the joint of exercises, performed in a normal functional way, by applying resistance or assistance on the plantar part of the foot. These exercises are called “closed circuit exercises”, or “closed kinetic chain” exercises. They challenge muscles and articulation in the proper bio-mechanical way. One important feature of the apparatus according to the invention lies in the use of the same mechanical device i.e. a pair of pistons, to either assist active still movement, to gain range or resist active movement to gain strength, in opposite directions of course, but in both flexion and extension.
The apparatus according to the present invention comprises a main frame, and a leg support member slidably mounted on the main frame. The support member comprises a first portion designed to receive a thigh, a second portion designed to receive a shank and a third portion designed to receive a foot. The first and second portions each comprise two opposite side edges defining the width of the support member. The first and second portions are pivotably connected to each other and form a first rotation axis for allowing flexion of a knee about a second rotational axis. The apparatus is characterized in that it comprises:
a dynamic adjustment mechanism for minimizing tension on the knee during extension or flexion of the leg, said mechanism allowing no eccentricity between the first and second rotational axes.
The first and second portions are pivotally connected so that when the leg is flexed and extended, the first and second axes are substantially coincident throughout the range of motion.
As mentioned above, one advantage of having such a dynamic adjustment mechanism is to allow proper resistive or assistive exercise of the leg without running the risk of further injuring the knee.
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Mission Santé Bois-Francs Inc.
Pothier Denise
Robic
Yu Mickey
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