FIELD OF THE INVENTION
[0001] Present invention related to medical equipment used in therapy and management of
pain caused by the hip condition related to coxarthrosis, nerve compression syndrome,
hip labral tear and the like.
BACKGROUND AND THE PRIOR ART
[0002] Painful hip condition is usually related to the coxarthrosis, nerve compression syndrome,
hip labral tear and the like. Depending on the severity of the underlying disease,
various treatment options are available: cold and warm presses, pain medication, physical
therapy and surgery. Quality of life of such a patient is hugely affected by this
condition and it is important that it is treated efficiently and appropriately according
to the degree of the progression of the underlying disease. In cases with mild to
moderate pain, physical therapy is proved to be useful in alleviating pain, postponing
or even avoiding surgery. Successful physical therapy usually includes traction, most
commonly manual, very often accompanied with the manually produced vibrations on the
surrounding structures and soft tissues. However, quality and efficiency of such a
therapy depends on the possibility of the application of the specific force and uniformity
of the vibrations applied, which is, on the other hand, largely dependent on the skill
of the physiotherapist, strength, tiredness etc. For example, it is known that physical
therapist can not apply constant force for longer that 20 minutes. Also, it is not
possible to measure the force that has been applied manually, so it is very likely
that manually applied force is not optimal, usually is either too weak or too strong.
Due to the pain and various other conditions, it is often very difficult to fix the
pelvis of the patient as well as the torso. Proper fixing mentioned above is also
one of the main factors influencing successful traction and vibration treatment.
[0003] There are several attempts to automatise the manual traction and vibration technique,
however all these efforts have number of drawbacks. For example, the HipTrac (MedRock
Inc. 101 SW Madison, Suite 9262, Oregon) which has shown to be beneficial in clinical
studies (
Madeiros JM and Rocklin T: Manual Therapy, Therapeutic Exercise, and HipTrac™ for
Patients with Hip Osteoarthritis: A case Series. Ortopaedic Practice Vol 29:1:17) has only the long-axis traction (progressive and prolonged) functionality thus limiting
its therapeutic use, does not provide vibration function. Similar solution is provided
with Tombo-brace which is also limited to the axial traction of the hip joint which
helps in compression reduction and alleviates pain (
Gustin S and Hespeel C (2018): The clinical use of a hip traction device in conservative
treatment of femoroacetabular impingement: a comparative and randomised controlled
clinical trial. Dissertation, Ghent University). Again, since only one traction axis could be used for stimulation and the lack
of vibration component, Tombo-brace has severe limitations for use in clinical setting.
Another example is given in
US 2009/0259253 A1 (Bensoussan C: Apparatus for stretching the vertebral column of the person, July
9, 2007) which discloses an apparatus for stretching the vertebral column of a person,
comprising a table equipped with a traction system which effect traction of the legs
and the column, and oscillating means that act so as to obtain movements of lateral
oscillation of both legs. The lateral oscillation movements and traction movements
are combined and the effects of the lateral oscillation movements are used for muscle
relaxation in the region of pelvis and the lumbar regions, which makes the subsequent
stretching of the lower back more effective. Unlike present invention, the apparatus
of
US 2009/0259253 A1 has only possibility for one traction direction (long-axis or caudal), the oscillation
is provided separately from traction, the muscle relaxation of the lumbar region provides
limited fixation of the pelvis and torso region and could therefore used only for
traction of vertebral column.
Therefore, there is a need for an automated and controllable medical device for treatment
of the panful hip condition that would enable traction in all directions (ventral,
lateral and caudal) respecting biomechanics of the hip structure, provide vibration
component and provide mechanism for the efficient fixation of the pelvis and torso
of the patient in order to separate joint parts in the hip joint (acetabulum and femur),
relax surrounding structures and soft tissues and initiating flow of the synovial
fluid into damaged cartilage. Another technical problem to be solved is to provide
additional measurement and control means which can quantitatively measure traction
force applied and to adjust it to the force used by manual technique as well as to
measure and adjust the vibration mode in order to provide optimal individual treatment.
[0004] Also, due to specific variation of the anatomy of the hip damage (left or right sided),
it would be important to provide the possibility to enable the optimal intervention
of the both left and right sided hip damage.
BRIEF DESCRIPTION OF THE INVENTION
[0005] The invention discloses the apparatus for traction and vibration of the hip joint,
and its use in the treatment of therapy and management of pain caused by the hip condition
related to coxarthrosis, nerve compression syndrome, hip labral tear and the like.
[0006] The apparatus for traction and vibration of the hip joint, comprises base (1), main
housing (7) with electronical components, wherein assembly for moving along Z axis
(2) by making use of central linear electric motor (13), assembly for moving along
X axis (3) containing bearings (17), horizontal linear electric motor (14) and ventral-caudal
traction mechanism having fixator of the proximal part of the lower leg (4) and fixator
of the distal part of the lower leg (5), lateral traction mechanism (12), fixing mechanism
and vibration unit and operating software and
wherein
- fixator of the proximal lower leg (4) contains the ball bearing assembly (11) enabling
traction in all direction under 60°, the ball bearing (11) consisting of ball (20),
delimiter (21), housing of the ball bearing assembly (23), slider (22), spring (24)
and linear electric motor for the ball bearing assembly (25), the slider (22) having
the slope where delimiter slides and moves along Z axis, blocking ball (20) into fixed
position, the upper part of the fixator of the proximal lower leg (4) contains ball
bearing assembly (15) and handle of the proximal part of the lower leg (10a);
- handle of the proximal part of the lower leg (10a) contains proximal sensor (18) which
reads intensity of the applied traction force;
- linear electric motor (19) drives fixator of the proximal part of the lower leg (4)
which moves along Z axis in the range of 150 mm;
- fixator of the distal part of the lower leg (5) contains in the upper part the ball
bearing assembly (15) and handle of the proximal part of the lower leg (10b), the
said fixator moving along Z axis in the range of 200 mm using left linear electric
motor (16);
- lateral traction mechanism consists of pulley (33), cable (34), thigh belt (35), lateral
sensor (36) and lateral DC worm electric motor (37), lateral sensor (36) being placed
between lateral DC worm electric motor (37) and the thigh belt;
- housing of the lateral traction mechanism (38) is equipped with emergency button (39);
- assembly for moving along X axis contains the screen (8) and screen reception (9):
- fixation mechanism contains belt (26), sponge part (27), adjusting means (28) and
fastening means (29), part of the being boarded up with thin sponge and covered with
leather material or leather imitation material coating the sponge part (24);
- vibration unit consisting of belt (30), housing of the vibration unit (31) containing
electric motor with excentre (32) producing vibrations in the range of 0-33 Hz, while
housing of the vibration unit contains belt reception part;
- software is web based application.
BRIEF DESCRIPTION OF THE DRAWINGS
[0007]
FIGURE 1 shows the exterior components of the apparatus for traction and vibration.
FIGURE 2 shows the cross-section of the assembly for moving along Z axis.
FIGURE 3 shows the cross-section of the assembly for moving along X axis.
FIGURE 4 shows the cross-section of the fixator of the distal part of the lower leg.
FIGURE 5 shows the cross-section of the fixator of the proximal part of the lower
leg.
FIGURE 6 shows the detail of the cross-section of the ball bearing assembly enabling
traction in all directions.
FIGURE 7 shows the method for positioning the vibration unit on the thigh which sends
low-frequency vibrations into the hip joint and surrounding structures.
FIGURE 8 shows the method for positioning and fixing the pelvis to the bed in order
to enable separation of the ball bodies (traction).
FIGURE 9 shows the cross-section of the ball bearing assembly.
List of the marking used:
[0008]
- 1 -
- Base
- 2 -
- Assembly for moving along Z axis
- 3 -
- Assembly for moving along X axis
- 4 -
- Fixator of the proximal part of the lower leg
- 5 -
- Fixator of the distal part of the lower leg
- 6 -
- Four wheels
- 7 -
- Main housing
- 8 -
- Screen
- 9 -
- Screen receptor
- 10a -
- Handle of the proximal part of the of the lower leg
- 10b -
- Handle of the distal part of the of the lower leg
- 11 -
- Ball bearing assembly
- 12 -
- Lateral traction mechanism
- 13 -
- Central linear electric motor
- 14 -
- Horizontal linear electric motor
- 15 -
- Ball bearing assembly
- 16 -
- Left linear electric motor
- 17 -
- Bearing
- 18 -
- Proximal sensor
- 19 -
- Right linear electric motor
- 20 -
- Ball
- 21 -
- Delimiter
- 22 -
- Slider
- 23 -
- Housing of the ball bearing assembly
- 24 -
- Spring
- 25 -
- Linear motor for the ball bearing assembly
- 26 -
- Belt
- 27 -
- Sponge part
- 28 -
- Adjusting means
- 29 -
- Fastening means
- 30 -
- Belt
- 31 -
- Housing of vibration unit
- 32 -
- Electric motor with excentre
- 33 -
- Pulley
- 34 -
- Cable
- 35 -
- Thigh belt
- 36 -
- Axial force sensor
- 37 -
- DC worm electric motor
- 38 -
- Housing of the lateral traction mechanism
- 39 -
- Emergency button
DETAILED DESCRIPTION OF THE INVENTION
[0009] The apparatus for traction and vibration of the hip joint, comprises base (1), main
housing (7) with electronical components, wherein assembly for moving along Z axis
(2) by making use of central linear electric motor (13), assembly for moving along
X axis (3) containing bearings (17), horizontal linear electric motor (14) and ventral-caudal
traction mechanism having fixator of the proximal part of the lower leg (4) and fixator
of the distal part of the lower leg (5), lateral traction mechanism (12), fixing mechanism
and vibration unit and operating software.
[0010] Traction mechanism comprises base (1) positioned on four wheels (6) which provide
the mobility of the whole apparatus according to the invention. The base (1) comprises
main housing (7) which contains electronic components (Figure 1). The assembly for
moving along Z axis (2) is placed on the base (1) which moves by making use of central
linear electric motor (12) in order to enable hight adjustments of the physiotherapeutic
table (Figure 2). The assembly for moving along X axis (3) is used to make possible
adjustment on the individual length of the lower leg so the patient's leg could be
easily accommodated (Figure 3).
[0011] The assembly for moving along X axis (3) also comprises bearings (17) which enable
bilateral use of the apparatus so it can be put on either left or right side of the
physiotherapeutic table depending on the side of the patient's hip damage (Figure
4) Moving is accomplished by making use of horizontal linear electric motor (14) (Figure
3). The assembly for moving along X axis (3) is further connected to the fixator of
the proximal part of the lower leg (4) and the fixator of the distal part of the lower
leg (5) (Figure 1). The fixator of the proximal part of the lower leg (4) is used
for placing and accommodation of the proximal part of the patient's leg and enables
the traction force in the range of 0-1000 N (Figure 5). The fixator of the proximal
part of the lower leg (4), in its lower part comprises ball bearing assembly (11)
which enables traction (ventral/lateral/caudal) by rotation in all directions of 60
degrees (Figure 1). Ball bearing assembly (11) consists of ball (20), delimiter (21),
housing of the ball bearing assembly (23), slider (22), spring (24) and linear electric
motor (25) for the ball bearing assembly (Figure 9). Activation of the linear electric
motor (25), causes oppression of the spring (24) which then causes moving of the slider
(22) (Figure 9). Slider (22) is construed in a way that it has a slope on which the
delimiter (21) slides and by this delimiter is moved along Z axis. In this way, ball
(20) is blocked to a certain position which is optimal for the position of the patient's
leg and particular traction direction (Figure 6). Upper part of the fixator of the
proximal part of lower leg (4) comprises ball bearing assembly (11) which enables
more comfortable accommodation of the leg and the handle of the proximal part of the
lower leg (10a) (Figure 1). Handle of the proximal part of the lower leg (10a) comprises
sensor (18) which reads the intensity of the applied traction force (Figure 5). Right
linear electric motor (19) drives fixator of the proximal part of the lower leg (4)
which moves along Z axis in the range of 150 mm. Fixator of the distal part of the
lower leg (5) contains in the upper part the ball bearing assembly (15) and handle
of the proximal part of the lower leg (10b), the said fixator moving along Z axis
in the range of 200 mm using left linear electric motor (16) (Figure 4). Ball bearing
assembly (11) which are part of the fixator of the proximal part of the lower leg
(4) and the fixator of the distal part of the lower leg (5) enable the mobility of
the handle of the proximal part of the lower leg (10a) and the handle of the distal
part of the lower leg (10b) in order to place the thigh and lower part of the leg
in optimal position according to patient's hi damage characteristics and respecting
the type of traction force to be applied (ventral/caudal/lateral) (Figure 1). Screen
(8) and screen receptor (9) are installed on the assembly for moving along X axis
(3) (Figure 1). Screen 8 serves in the process of controlling all electric motors
comprised by the apparatus according to the invention. These could be operated by
mobile devices, tablets or computers enabling the physical therapist to set and modulate
the intensity, direction and the duration of the application of the traction force,
in any point of time, to be applied on the patient.
[0012] Lateral traction mechanism consists of pulley (33), cable (34), thigh belt (35),
lateral sensor (36) and lateral DC worm electric motor (37), lateral sensor (36) being
placed between lateral DC worm electric motor (37) and the thigh belt. Housing of
the lateral traction mechanism (38) is equipped with emergency button (39).
[0013] Fixation mechanism contains belt (26), sponge part (27), adjusting means (28) and
fastening means (29), part of the being boarded up with thin sponge and covered with
leather material or leather imitation material coating the sponge part (24) (Figure
8). Sponge part (27) is placed on the pelvis of the patient on the level of the hip
and it is adjusted by the adjusting means (28) and fastening means (29) which is under
the table. By making use of the belt and fixing it, the pelvis is put in the fixed
position enabling successful traction of the femur in relation to the acetabulum (Figure
8).
[0014] Vibration unit consists of belt (30), housing of the vibration unit (31) containing
electric motor with excentre (32) producing vibrations in the range of 0-33 Hz, while
housing of the vibration unit contains belt reception part. Intensity and the duration
of the vibration is determined and controlled through web based software using screen/mobile
phone/computer. Vibration unit is placed on the thigh and the vibrations produced
thereby cause muscle and surrounding structures relaxation (Figure 7).
[0015] Additionally, synergistic action of the traction and vibration enables synovial liquid,
present in the joint, to be evenly distributed and to get through the damaged parts
of the cartilage. The software enables the user to operate all the electric motors
(13, 14, 16, 19, 32, 37) and set up and modulate duration, direction and intensity
of the traction force and duration and intensity of the vibration in any point of
time.
[0016] The apparatus is intended for use in a clinical setting. The treatment duration is
approximately 20 minutes and it repeated according to the severity of the underlying
disease, typically 3 times a week during 1-2 months.
[0017] The traction force used is mostly around 400 N and the vibration frequency is around
7 Hz (relaxation of the muscles and surrounding structures).
[0018] This method of treatment is superior to manual traction and vibration technique since
it is not dependent on the human factor and more efficiently alleviates pain and postpones
or even completely eliminates the need for surgery of the hip in patients with coxarthrosis,
nerve compression syndrome, hip labral tear and the like.
1. The apparatus for traction and vibration of the hip joint, comprising base (1), main
housing (7) with electronical components, wherein assembly for moving along Z axis
(2) by making use of central linear electric motor (13), assembly for moving along
X axis (3) containing bearings (17), horizontal linear electric motor (14) and ventral-caudal
traction mechanism having fixator of the proximal part of the lower leg (4) and fixator
of the distal part of the lower leg (5), lateral traction mechanism (12), fixing mechanism
and vibration unit and operating software and
wherein
- fixator of the proximal lower leg (4) contains the ball bearing assembly (11) enabling
traction in all direction under 60°, the ball bearing (11) consisting of ball (20),
delimiter (21), housing of the ball bearing assembly (23), slider (22), spring (24)
and linear electric motor for the ball bearing assembly (25), the slider (22) having
the slope where delimiter slides and moves along Z axis, blocking ball (20) into fixed
position, the upper part of the fixator of the proximal lower leg (4) contains ball
bearing assembly (15) and handle of the proximal part of the lower leg (10a);
- handle of the proximal part of the lower leg (10a) contains proximal sensor (18)
which reads intensity of the applied traction force;
- linear electric motor (19) drives fixator of the proximal part of the lower leg
(4) which moves along Z axis in the range of 150 mm;
- fixator of the distal part of the lower leg (5) contains in the upper part the ball
bearing assembly (15) and handle of the proximal part of the lower leg (10b), the
said fixator moving along Z axis in the range of 200 mm using left linear electric
motor (16);
- lateral traction mechanism consists of pulley (33), cable (34), thigh belt (35),
lateral sensor (36) and lateral DC worm electric motor (37), lateral sensor (36) being
placed between lateral DC worm electric motor (37) and the thigh belt;
- housing of the lateral traction mechanism (38) is equipped with emergency button
(39);
- assembly for moving along X axis contains the screen (8) and screen reception (9):
- fixation mechanism contains belt (26), sponge part (27), adjusting means (28) and
fastening means (29), part of the being boarded up with thin sponge and covered with
leather material or leather imitation material coating the sponge part (24);
- vibration unit consisting of belt (30), housing of the vibration unit (31) containing
electric motor with excentre (32) producing vibrations in the range of 0-33 Hz, while
housing of the vibration unit contains belt reception part;
- software is web based application.
2. Use of the apparatus for traction and vibration of the hip joint, according to claim
1, in the treatment, therapy and management of pain caused by the hip condition related
to coxarthrosis, nerve compression syndrome and hip labral tear.