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(11) | EP 1 043 008 A1 |
| (12) | EUROPEAN PATENT APPLICATION |
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| (54) | Clapping method and system |
| (57) A system for providing clapping therapy, which includes a clapper device (20) having
at least one clapper element (24) mounted onto a first elongate support (28); and
drive apparatus (41) for selectably imparting to each the clapper element, via the
first elongate support (28), a predetermined reciprocating motion, thereby to bring
each clapper element into force transfer contact with a portion of a patient, so as
to periodically apply a clapping stroke thereto in clapping therapy of the patient. |
FIELD OF THE INVENTION
[0001] The present invention relates to clapper devices and patient treatment support surfaces in general, and to the use of same in removal of mucus from the lungs of human patents, in particular.
BACKGROUND OF THE INVENTION
[0002] Clapping therapy has long been known in the art, and has found to be of great value in the treatment of congestive disorders of the lungs. Problems have arisen with manual treatment, per se, and with the physical limitations of a therapist administering the treatment.
[0003] A disadvantage of manual clapping treatment is that it is known on occasion to introduce nosocomial infections. A further disadvantage is that human hands vary from therapist to therapist thereby introducing inconsistencies in the configuration of the clapper and the clapped area. An attempt to circumvent these problems is seen in US Patent 4,429,688 to Duffy, entitled "Medical Appliance for Percussive Respiratory Therapy," in which use of a conical device is described. The device is intended to be held in the hand of a therapist so as to avoid actual physical contact between the therapist's hand and the body of the patient.
[0004] Also known are motorized devices designed to avoid the problems of the tiring of the therapist during the course of the treatment. These devices provide contact, of constant pressure and intensity, between a percussive device and a respiratory patient. US Patent 5,167,226 to Larouche et al. entitled "Combined Clapping and Vibrating Device for Expelling Retained Obstructive Secretions in the Lungs," teaches use of a device for clapping-type treatment, but also introduces the use of vibrational energy. Such vibrational techniques have been found to be beneficial, but are effective in only a limited number of cases. This is mostly due to the fact that thicker secretions, such as those usually associated with diseases such as Cystic Fibrosis, are generally neither dislodged nor moved by vibration alone.
SUMMARY OF THE INVENTION
[0005] The present invention seeks to provide a system for providing mechanized clapper technique treatment of respiratory disorders involving congestion of the lungs. The invention utilizes a mechanized system for providing efficient clapper therapy while avoiding drawbacks sometimes introduced by the addition of vibrational energy.
[0006] The invention includes a system for providing clapping therapy, which includes a clapper device having one or more clapper elements mounted onto a first elongate support; and drive apparatus for selectably imparting to each clapper element, via the first elongate support, a predetermined reciprocating motion, thereby to bring each clapper element into force transfer contact with a portion of a patient, so as to periodically apply a clapping stroke thereto in clapping therapy of the patient.
[0007] The system included with the invention further includes at least two clapping elements, wherein each support of the system is mounted in association with the drive apparatus so as to be driven thereby in a predetermined out-of-phase manner such that only one of the clapping elements is in physical contact with a patient being treated at any given instant during treatment.
[0008] The system included with the invention further includes a support for a patient; and apparatus for providing adjustment of the relative portions of the clapper device and the support, thereby to bring a patient mounted onto the support and the device into a desired relative orientation for clapping therapy.
[0009] Still further included with the invention is a system wherein the apparatus for adjusting is operative to move the clapper device.
[0010] Still further included with the invention is a system wherein the apparatus for adjusting is operative to move the support.
[0011] The system included with the invention further includes apparatus wherein the support includes a head support portion which is independently movable relative to the remainder of the support, and wherein the head support portion is an end portion of the support and wherein the head support portion is configured for supporting the upper body portion of a patient receiving clapper therapy.
[0012] Yet further included with the system of the invention is apparatus wherein the motor drives a rotor, and wherein the rotor is connected to a drive shaft by a transmission mechanism. The apparatus further includes a plurality of cam-support wheels affixed to the drive shaft at predetermined intervals, along the length of the drive shaft, and a plurality of cam-followers, each of which abuts one of the plurality of cams, and wherein each individual cam-follower of the plurality of cam-follower elements is constructed as a two-pronged elongate element and is operative to pivot reciprocally about a fixed, predetermined point, such that, as the respective cam rotates, the elongate cam-follower pivots in a first direction and subsequently in a second opposite direction. The apparatus further includes a plurality of first elongate support members each of which is attached to one of the elongate cam-followers, wherein each individual handle of the plurality of first elongate support handles is rigidly affixed to its respective elongate cam-follower and pivots in conjunction therewith.
[0013] The system included with the invention further includes apparatus wherein each of the plurality of first elongate support handles is attached to at least one clapping-piece.
[0014] The system included with the invention further includes a method of providing clapping therapy to a patient, which includes the supporting of a plurality of clapper elements in a selected location adjacent to a portion of a patient to be treated; and the driving of the clapper elements so as to impart to each clapper element a predetermined reciprocating motion, thereby to bring each clapper element into force transfer contact with a portion of a patient, so as to periodically apply a clapping stroke thereto.
[0015] Still further included with the system of the invention is a method of providing clapping therapy to a patient, wherein, upon the impact stroke, a force is applied to the body of a patient receiving treatment, and whereinafter the force is transferred to an area of the patient's lungs.
[0016] Still further included with the system of the invention is a method of providing clapping therapy to a patient, wherein, upon the retraction stroke, a vacuum suction force is applied to the area undergoing respiratory treatment, and wherein the vacuum force is also transferred to the area of the patient's lungs being treated.
BRIEF DESCRIPTION OF THE DRAWINGS
[0017] The present invention will be more easily understood and appreciated from the following detailed description, taken in conjunction with the drawings, in which:
Figure 1A is a pictorial representation of a clapper device, constructed and operative in accordance with a preferred embodiment of the present invention;
Figure 1B is a further view of the device depicted in Figure 1, shown with its cover removed;
Figure 2 is an enlarged view of a portion of Figure 1B enclosed by dotted circle 2 of Figure 1;
Figure 3A is a cross-sectional view of the device seen in Figure 1A, taken along line C-C' in the direction of arrows 3 and 3' depicting a first elongate support and clapping-piece of the device in a retracted position;
Figure 3B is a cross-sectional view of the device similar to that seen in Figure 3A, except depicting a first elongate support and clapping-piece of the device in a mid-stroke position;
Figure 3C shows a side view of the device seen in Figure 1A, depicting a first elongate support and clapping-piece of the device in an end-stroke position similar to the position of clapping-piece 24b in Figure 1 B;
Figure 4A shows a child patient in place on an adjustable support constructed and operative in accordance with a further embodiment of the invention, in which the child is shown as being supported in an upper position;
Figure 4B shows the support surface of Figure 4A seen in an intermediate position; and
Figure 4C shows the support surface of Figure 4A seen in a lower position.
DETAILED DESCRIPTION OF A PREFERRED EMBODIMENT
[0018] Referring to Figures 1A and 1B, there is seen a clapper device, referenced generally 20, constructed and operative in accordance with a preferred embodiment of the invention, for administering mechanized respiratory therapy, powered by at least one drive apparatus, to patients with obstructive secretions of the lungs. The device 20 is operative to dislodge and suction obstructive pulmonary secretions by imparting clapping-type blows along with vacuum suction, in a predetermined phase-shifted cycle, to the back of a patient receiving treatment. The drive apparatus of the embodiment of the invention described herein is motor element 37 (Fig. 1B). The device can be adjusted to impart between 40 and approximately 160 strokes per minute.
[0019] Referring now specifically to Figure 1B, the device includes a plurality of clapping-pieces 24, which are mounted onto first elongate supports 28. These first supports are, in turn, mounted onto elongate cam-follower elements 42, via second elongate supports 43. Cam-follower elements 42 are operative to undergo reciprocal imparting and retracting motion.
[0020] Referring now to Figure 3A it is seen that a single elongate cam-follower element 42a includes prongs 34 and 36 and is constructed with an aperture, at location 44 through which pivot rod 46 (Fig. 1B), extends.
[0021] As seen in Figure 1B, pivot rod 46 extends the length of the device 20 between end support members 48. Pivot rod 46 is operative both as a support and as a pivot location for elongate cam-follower elements 42.
[0022] Further seen in Figure 1B, in accordance with a preferred embodiment of the invention, there is provided a motor 37 (Fig. 1B), connected to a rotor (not shown) which is, in turn, connected to a drive shaft 50 (Figures 3A and 3B), by a transmission shown schematically at 54 (Fig. 1B).
[0023] A driving motion is transferred from a drive mechanism, shown schematically at 41, to cam-follower elements 42. The embodiment of the invention described herein includes apparatus for transferring motion by at least one cam support wheel 58, which extends radially outward from drive shaft 50. The embodiment of the invention described herein, is one of several preferred embodiments of the invention. Preferably, there are provided four cam wheels 58 located preferably at evenly spaced intervals along drive shaft 50.
[0024] A single cam 62 is eccentrically mounted onto each cam-support wheel 58. Cam 62 extends generally parallel to pivot rod 46 and so as to be disposed between and in abutting relation with prongs 34 and 36 of elongate cam-follower element 42.
[0025] From a comparison of Figures 3A, 3B, and 3C, drive shaft 50 causes a rotation of cam-support wheel 58 and thus of cams 62, in the direction indicated by arrow 68 so as to apply a displacement force to prong 34 of elongate cam-follower element 42, as cam 62 slides along prongs 34 and 36. This motion causes elongate cam-follower element 42 to pivot about pivot rod 46 thereby moving elongate cam-follower handle 30, and thus supports 28 and clapping pieces 24, in a generally rearward direction as indicated by arrows 70.
[0026] Referring now again to Figure 1B, elongate cam-follower elements 42 are seen to be at various angles with respect to base support element 60. This results in clapping-pieces 24 being at differing stages in the stroke cycle or out-of-phase. The out-of-phase configuration permits the device 20 to impart clapper therapy strokes via clapping-pieces 24 in a predetermined phase-shifted cycle in order to achieve various frequencies and forces of impact to impart to the patient the therapy that is most beneficial for that particular individual.
[0027] As mentioned above, the frequency cycle of impact strokes of the device is adjustable from approximately 40 strokes per minute to a maximum of approximately 160 strokes per minute. As a therapy session is usually of approximately 40 minutes in duration, a further advantage of a mechanized system is that the invention, powered by a mechanized drive apparatus, is not subject to the physical limitations that cause a human therapist to tire during this time interval. The device is further able to provide clapping strokes of consistent force and frequency for this length of time.
[0028] Yet a further advantage of the invention, is that the current embodiment utilizes a 24V motor to power the mechanized system. Use of this relatively low voltage motor precludes any chance of any person in contact with the device, from receiving an electrical shock of sufficient strength to cause any significant damage even in the highly unlikely event that a surface voltage discharge is produced.
[0029] Referring now to Figure 1A, there is seen that further in accordance with a preferred embodiment of the system there is provided a pressure activated switch 29 for the activation of the device. This type of switch must be held down constantly to activate the device. Releasing the switch stops the treatment. This ensures that a patient cannot be left unattended or unsupervised while in therapy, for an unspecified or indefinite amount of time.
[0030] Referring now to Figure 2, clapping-piece 24a is enlarged to show that it is typically constructed of two main portions, namely, a base-member 76 and a cupping member 72. Base-member 76 is attached to first elongate support 28 and is operative to support clapping-piece 24. Cupping member 72 is constructed of a cushion-like material, of a preselected firmness such as rubber. An advantage of the current invention over the prior art is the use of such rubber or poly-vinyl plastic elements with an automated device. One of the further advantages of the present invention over the current art, is that, in fact several different cupping members may be included, each of which has a differing degree of softness or stiffness. This facilitates further customizing of the treatment to a given patient receiving therapy.
[0031] When cupping member 72 is brought into contact with any surface with sufficient force to compress the cushion-like material from which it is constructed, some of the air which is normally contained in the internal cup-like volume of cupping member 72 is forced out. This creates a partial vacuum which remains until cupping member 72 is drawn away from the surface it has contacted.
[0032] It is this combination of contact force and vacuum suction which is operative to perform the respiratory therapy of the clapper device.
[0033] Referring now briefly to Figure 1A, there is typically also provided a cover member 22 which prevents dust and other contaminants from entering the internal mechanical and mechanized components of the invention.
[0034] Referring now to Figure 4A, there is seen a support, referenced generally 120 with a child 124 in place to receive clapping treatment. The support in this embodiment of this portion of the invention is animal-shaped member 126. Clapper device 128 is an alternate embodiment of the clapper device described in detail above, being generally similar thereto, but typically having only a pair of clapping elements. Clapper device 128 in this embodiment of the current invention is mounted on one end of support 126 at location 130.
[0035] Referring now also to Figure 4C, clapper device 128 may be selectably positioned relative to animal-shaped support 126 in order to facilitate a proper conjunction of the clapper device 128 and that portion of the patient's body to be treated.
[0036] The movement of clapper device 128 is accomplished in the present embodiment of the invention by activating a piston-type apparatus (not shown) referenced in Figure 4C as being located at location 130 of the animal-shaped support 126.
[0037] Referring again to Figure 4C, it is seen that animal-shaped support 126 is operative to be raised and lowered so as to better present the area of the patient's body to be treated to the clapper device. For example, raising the support struts 132 at the end of the device 120 upon which the lower portion of the patient's body is supported, is done so as to move the patient's body into a posture for drainage of the lower lobes of the patient's lungs. The end of the device upon which the upper portion of the patient's body lies is supported by extensible support struts 136.
[0038] Still referring to Figure 4C, struts 132 have been extended through an arc a relative to the rest position shown in Figure 4A. This raising of the portion of the animal-shaped support 126 which supports the lower portion of the patient's body, is accomplished by extending piston 140 from its rest position (shown in Figure 4A), to a raised position (Figure 4C). Piston 140 is supported on base 138 by piston anchor 142. Piston 140 is attached to animal-shaped support 126 at location 144. Raising and lowering piston 140 causes the support surface 122 to move from a position in which a patient 124 is supported in a basically level position, to a position in which the patient's head is substantially lower than the patient's feet, as seen in Figure 4C.
1. A system for providing clapping therapy, which includes a clapper device having:
at least one clapper element mounted onto a first elongate support; and
drive apparatus for selectably imparting to each said clapper element, via said first elongate support, a predetermined reciprocating motion, thereby to bring each said clapper element into force transfer contact with a portion of a patient, so as to periodically apply a clapping stroke thereto in clapping therapy of the patient.
2. A system according to claim 1, wherein said at least one clapping element includes
at least two clapping elements, and wherein each said support is mounted in association
with said drive apparatus so as to be driven thereby in a predetermined out-of-phase
manner such that only one of said clapping elements is in physical contact with a
patient being treated at any given instant during treatment.
3. A system according to claim 1, and also including:
a support for a patient; and
apparatus for providing adjustment of the relative portions of said clapper device and said support, thereby to bring a patient mounted onto said support and said device into a desired relative orientation for clapping therapy.
4. A system according to claim 3, and wherein said apparatus for adjusting is operative
to move said clapper device.
5. A system according to claim 3, and wherein said apparatus for adjusting is operative
to move said support.
6. An apparatus according to claim 3, wherein said support includes a head support portion
which is independently movable relative to the remainder of the support, and wherein
said head support portion is an end portion of said support,
and wherein said head support portion is configured for supporting the upper body portion of a patient receiving clapper therapy.
and wherein said head support portion is configured for supporting the upper body portion of a patient receiving clapper therapy.
7. An apparatus according to claim 1, wherein said motor drives a rotor,
and wherein said rotor is connected to a drive shaft by a transmission mechanism, and wherein said apparatus includes:
a plurality of cam-support wheels affixed to said drive shaft at predetermined intervals, along the length of said drive shaft,
and wherein each of said plurality of cam wheels corresponds to one of said plurality of cam-support wheels, and
a plurality of cam-followers each of which abuts one of said plurality of cam wheels, and wherein each individual cam-follower of said plurality of cam-follower elements is constructed as a two-pronged elongate element and is operative to pivot reciprocally about a fixed, predetermined point, such that, as said respective cam wheel rotates, said elongate cam-follower pivots in a first direction and subsequently in a second opposite direction, and
a plurality of first elongate support members each of which is attached to one of said elongate cam-followers, wherein each individual handle of said plurality of first elongate support handles is rigidly affixed to its respective said elongate cam-follower and pivots in conjunction therewith.
8. An apparatus according to claim 7, wherein each of said plurality of first elongate
support handles is attached to at least one clapping-piece.
9. A method of providing clapping therapy to a patient, which includes:
supporting of a plurality of clapper elements in a selected location adjacent to a portion of a patient to be treated; and
driving the clapper elements so as to impart to each clapper element a predetermined reciprocating motion, thereby to bring each said clapper element into force transfer contact with a portion of a patient, and so as to periodically apply a clapping stroke thereto.
10. A method according to claim 9 and wherein, upon said impact stroke, a force is applied
to the body of a patient receiving treatment, and whereinafter said force is transferred
to an area of the patient's lungs.
11. A method according to claim 9 and wherein, upon said retraction stroke, simultaneously
a vacuum suction force is applied to said area undergoing respiratory treatment, and
wherein
said vacuum force is also transferred to said area of the patient's lungs.
said vacuum force is also transferred to said area of the patient's lungs.