Surgery: kinesitherapy – Kinesitherapy – Exercising appliance
Reexamination Certificate
1999-09-27
2004-01-06
Yu, Justine R. (Department: 3764)
Surgery: kinesitherapy
Kinesitherapy
Exercising appliance
C601S023000, C482S049000
Reexamination Certificate
active
06673028
ABSTRACT:
FIELD OF THE INVENTION
The present invention relates to a device and a method for moving a joint and, more specifically, to a device and method for passively exercising a patient's joint in effort to return the joint to a more natural range of motion.
BACKGROUND OF THE INVENTION
Patients who have suffered damage to tendons, soft tissue, or bone near a joint, either from trauma or disease, are frequently advised to adhere to an exercise regime to prevent the loss of mobility in the joint. Often, the exercise regime requires a physical therapist or a complex and expensive machine, such as a continuous passive motion (CPM) machine to repeatedly move the joint. With many patients, however, the inconvenience of attending to such treatments severely affects the time that such therapy is administered.
Another problem to effective treatment is that many exercise regimes require motivation, diligence, and perseverance on the part of the patient. For example, inactivity during the night causes many patients with arthritis or other types of joint stiffness to experience a decrease in the range of motion of an affected joint. As a result, such patients are often advised to spend a certain amount of time each morning manually moving and bending the affected joint. Although the prescribed exercise program is intended to restore the joint to its natural range of motion, patients often fail to perform the necessary exercises due to pain, frustration, or inconvenience. This is a significant drawback with a manual exercise treatment that requires a high level of patient compliance in order to be effective.
Accordingly, different types of passive movement devices have been employed. Such devices typically exercise a joint by flexing and/or extending the joint using inflatable members, such as pouches, bladders, or sacs, which are attached to the joint. Movement is effected by cyclically inflating and deflating the inflatable members with gas, fluid, or heated fluid. However, such positive pressure devices are not always practical and are not always effective in applying a suitable force during deflation of the bladder to properly exercise the joint. Additionally, there is an attendant risk that the inflatable member will burst during use.
In other conventional devices, the joint is alternately flexed and extended by attaching inflatable members to both the flexion and extension sides of the joint. The joint is then systematically flexed and extended by cyclically inflating one of the inflatable members and deflating the other inflatable member in a synchronous manner. however, such systems require precise timing of inflation and deflation of the inflatable members to apply suitable pressure for effective treatment.
In other conventional devices, the joint is alternately flexed and extended by attaching inflatable members to both the flexion and extension sides of the joint. The joint is then systematically flexed and extended by cyclicly inflating one of the inflatable members and deflating the other inflatable member in a synchronous manner. However, such systems require precise timing of inflation and deflation of the inflatable members to apply suitable pressure for effective treatment.
One method of avoiding the difficulties associated with the use of multiple inflatable members has been to use a spring steel element to bias the joint into the non-extended position, in conjunction with the use of an inflatable pouch positioned on the extension or outer side of the joint to bias the joint into the extended position. In operation, the joint is extended by inflating the pouch. The joint is then flexed by deflating the pouch and allowing the spring steel element to return the joint to the flexed position. However, with certain patients, the spring steel biasing element may apply excessive forces at points of connection or attachment to the patient's joint. In addition, it is difficult to control or regulate the application of the force to achieve more uniform pressure to tissues surrounding the joint.
In light of the foregoing, it would be desirable to provide a device for passively exercising a joint wherein the device is biased to the neutral or extended position in such a manner that the biasing force is exerted uniformly to the underlying tissue without the use of positive pressure devices such as inflatable bladders.
SUMMARY OF THE INVENTION
The present invention relates to a passive movement device for moving or exercising a selected joint or joints of a patient. The device is secured into proper position at or about a selected joint and is then operated to move or exercise the patient's joint in a controlled manner. The passive movement device comprises a resilient, open-cell foam section and a flexible cover or casing that functions to enclose the foam section to form a sealed chamber. Joint positioning means is used to maintain the joint to be treated at a desired position in relation to the device. For example, hand and finger slots may be provided in the foam section to effect proper retention and positioning of a patient's hand. Alternatively, a glove may be fixedly or removably attachable to the sealed chamber to properly hold the patient's hand in position. In applications in which another joint such as a patient's elbow is being treated, a sleeve may be used to secure the sealed chamber at the elbow joint.
A pump in the form of a vacuum pump is operatively connected with the sealed chamber to supply a reduced pressure, i.e. below atmospheric pressure, to the sealed chamber. The application of reduced pressure to the sealed chamber, for example, during the “on” cycle of the pump, collapses the pores in the foam section thereby collapsing or contracting the sealed chamber against the resiliency of the foam section in a controlled manner dependant on the amount and timing of the suction. Collapsing the sealed chamber exerts a force on the joint causing the joint to bend from a first or neutral position, i.e. a relaxed position between full extension and full bending. Since the pores are distributed throughout the foam section, the force is exerted generally uniformly to the underlying tissue. The suction may then be removed, for example during the “off” cycle of the pump, causing the foam section to expand back toward its original position, due to the resiliency of the foam section, thereby causing the joint to bend back toward the first or neutral position.
The foam section may comprise any of a number of commercially available materials, such as a sponge, having an open-cell structure. The foam section provides a resilient member for returning the sealed chamber to its uncollapsed position when the suction supplied by the vacuum is sufficiently reduced or removed. The porosity and resiliency of the foam section can be chosen for particular uses. For example, a foam section having smaller pores or cells provides a greater biasing force and, therefore, may be preferred when treating a particularly stiff joint. Conversely, when a weaker force will suffice, a more compressible foam section may be preferred. In addition, the foam section may comprise two or more adjoining sections having different degrees of stiffness.
The foam section can be provided in a variety of sizes and shapes to fit the individualized needs of a particular patient. The foam section may be shaped to comfortably fit along the flexion or inner side of the joint when the joint is in either the neutral or the extended position. Alternatively, the foam section can be shaped to conform to the extension or outer side of the joint when the joint is in either the neutral or the flexed position.
The cover or casing for enclosing and sealing the foam section can be formed of a plastic laminate or sheet which is wrapped or folded around the foam section to provide the sealed chamber. Additionally, the cover can be molded around the foam section to form the sealed chamber. The cover can be manufactured of any of a variety of materials, such as polyruethane films, provided that the material is su
Argenta Louis C.
Morykwas Michael J.
Dann Dorfman Herrell & Skillman, PC
Piper, Jr. Donald R.
Wake Forest University Health Sciences
Yu Justine R.
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