Surgery – Diagnostic testing – Measuring anatomical characteristic or force applied to or...
Reexamination Certificate
2000-08-30
2002-04-09
Hindenburg, Max (Department: 3736)
Surgery
Diagnostic testing
Measuring anatomical characteristic or force applied to or...
Reexamination Certificate
active
06368291
ABSTRACT:
FIELD OF THE INVENTION
This invention relates generally to assessment of lower extremity function for a human body, and more particularly to a method and an apparatus for assessing muscle strength, balance, endurance, coordination for a human body.
BACKGROUND OF THE INVENTION
Physical rehabilitation is an important and oftentimes necessary step for improving an individual's state of health, particularly after the individual's body has undergone a traumatic event, such as an injury or surgical procedure. Rehabilitation of the lower extremity of the body is commonplace, particularly in light of injuries suffered from work related injuries or participation in any of numerous sports requiring lower extremity contribution, such as running (i.e., baseball, basketball, football, soccer and tennis), skiing (water skiing or snow skiing), cycling, weight lifting, roller blading and hockey. Furthermore, rehabilitation after a lower extremity injury or surgical procedure is critical for returning a patient to full functional capacity. Proper and effective rehabilitation of the lower extremity of the body requires continual assessment of the lower extremity function. For example, standardized data relating to the capabilities of muscle groups in the lower extremities are needed in order to properly guide a patient's rehabilitative treatment after suffering from a lower extremity injury (i.e., hip, leg, knee, ankle or foot injury) or following a lower extremity surgical procedure (i.e., reconstructive knee surgery) and also to properly evaluate the patient's overall physical ability to return to functional activities such as sports, work and general activities of daily living. Lower extremity function is generally evidenced by the integration of strength, balance, endurance and coordination.
Lower extremity function has been studied for many years. Several clinical tests have been used to assess lower extremity function after suffering from lower extremity injuries. For example, much discussion has focused on the most effective approach to rehabilitation of a lower extremity (i.e., hip, leg, knee, ankle or foot injury), specifically the use of open kinetic chain (OKC) exercises and closed kinetic chain exercises (CKC). Similarly, much discussion has focused on whether OKC exercises or CKC exercises are the more valid and reliable test for evaluating a patient's overall ability to return to functional activities such as sports, work and activities of daily living, without further risk of injury. Much controversy exists in the literature as to the correlation between these two testing philosophies. Several studies have demonstrated a positive correlation between OKC and CKC testing, while others have demonstrated little if any correlation. As is the case with rehabilitation philosophies, OKC and CKC testing methods have both been utilized. Recently however, the use of CKC exercises has been advocated due to many documented advantages over OKC exercises.
Of the CKC tests performed, hop tests are most commonly used to assess lower extremity function. The hop test provides an assessment of functional strength, balance, endurance and coordination of the entire lower extremity. The hop test involves single-leg hopping across a floor. Unfortunately, the hop test can not be safely implemented until the later stages of the rehabilitation process. This is in part due to the requirement, associated with the hop test, that the muscles, which are still undergoing rehabilitation, must exhibit not yet attainable explosive exertion upon vertical takeoff. This is also in part due to the tremendous and potentially damaging forces that the muscles, ligaments, joints, cartilage and surrounding supportive tissues, which are still undergoing rehabilitation, must endure upon gravitational impact. Another CKC test is based on an inclined squat or leg press test. Even though this test assesses strength and endurance in the CKC environment, the inclined squat or leg press test does not take into account the balance issue and the coordination issue because the patient is resting on the inclined squat or leg press machine.
Of the OKC tests, isokinetic testing remains the standard mainly because of the ability to perform isolated lower extremity muscle strength testing. The isokinetic test provides an isolated strength assessment of the quadriceps and hamstring muscles on an individual basis and typically uses a sophisticated testing machine having a mechanical strength-electronic measuring instrument in which force is exerted by the patient's foot against a lever-arm attached to a dynamometer and subsequently electronically measured while the patient remains sitting on the machine. Unfortunately, the isokinetic test does not assess balance or coordination and does not assess the entire lower extremity as one functional unit. Additionally, the isokinetic test is capital intensive for the rehabilitative administrating facility because the test typically requires the use of mechanical strength-electronic measuring instrumentation that is not only expensive but also sophisticated, thus requiring costly and time consuming training. Furthermore, the isokinetic test may also be cost intensive to the patient as charges related to the use of the mechanical strength-electronic measuring instrument are unfortunately not always reimbursed by insurance companies. With the advent of the managed care environment, isokinetic testing is not always clinically practical.
At the present time, there is no satisfactory test to assess muscle strength, balance, endurance, coordination and lower extremity function during rehabilitation of the lower extremity of the body that is also inexpensive and easy to administer on patients. As such, a need exists for other means of testing lower extremity function (e.g., the successful integration of strength, balance, endurance and coordination), and this test must be economical and easy for the clinician or healthcare professional to implement on patients. In particular, what is needed is a method and an apparatus for testing the lower extremity as one functional unit. Further needed is a method and an apparatus for testing the lower extremity that may be safely implemented during all stages of the rehabilitative process. More particularly, what is needed is a method and an apparatus for testing the lower extremity for an assessment of functional strength, balance, endurance and coordination of the entire lower extremity that is cost-effective and is simple to administer on patients.
SUMMARY OF THE INVENTION
The invention is a method and an apparatus for testing the entire lower extremity as one functional unit. More particularly, the invention is a method and an apparatus for testing the entire lower extremity for an assessment of functional strength, balance, endurance and coordination of the entire lower extremity. The invention may be safely implemented during all stages of the rehabilitative process. The invention is cost-effective and is simple to administer on patients.
The invented apparatus marks the maximum angle of movement at the hip, knee and ankle as the patient squats down using only a single test leg.
The invented lower extremity testing apparatus comprises a horizontally planar base having a knee tripodal portion and a hip tripodal portion adjustably coupled to the knee tripodal portion by a variable length connector, a knee post fixedly attached to the knee tripodal portion and vertically extending orthogonally away from the horizontal plane of the horizontally planar base, a hip post fixedly attached to the hip tripodal portion and vertically extending orthogonally away from the horizontal plane of the horizontally planar base, a knee bar that is adjustably connected to the knee post and a hip bar that is adjustably connected to the hip post. The knee tripodal portion may be releasably secured to the variable length connector by a locking fastener. The hip tripodal portion may be releasably secured to the variable length connector by a locking fastener.
Dougherty & Clements LLP
Hindenburg Max
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