Note: Descriptions are shown in the official language in which they were submitted.
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ROTARY REHABILITATION APPARATUS AND METHOD
RELATED APPLICATIONS
This application is a continuation-in-part application of U.S. Patent
Application Serial Number 10/687,207, filed October 16, 2003. The
aforementioned
application is incorporated herein by reference.
BACKGROUND OF THE INVENTION
1. Field of the Invention
This invention relates generally to the field of exercise and rehabilitation,
and
more specifically, to an apparatus providing selective adjustment of the range
of
motion of a user's extremities, including either arms and legs, actively
engaging in or
passively participating in a cycling action.
2. Description of the Related Art
One of the most significant and the most common athletic injuries is to the
knee, and published data continues to report at an incidence of between one-
quarter
and one-third of all men and women experience some type of knee injury
annually.
Approximately 10.8 million individuals visit a physician for knee injuries
alone each
year. Total estimated annual U.S. costs of all musculoskeletal conditions is
$254
billion. Many injuries to the lower extremities of persons necessitate the use
of
rehabilitation exercises. Such injuries may include those to the joints of a
person's
leg (e.g., knee, hip ), replacement of one's joint (e.g., total hip or knee
arthroplasty
[THA, TKA]), ligaments or tendons associated with these joints (e.g., anterior
cruciate or medial collateral ligament [ACL, MCL], or patella or quadriceps
tendons),
or muscles of the leg (e.g., Rectos or biceps femoris, etc). Rehabilitation
exercises are
also frequently prescribed after surgery and are performed to further repair
an injured
site on a user's extremity.
Major trunk injuries are also exceedingly common in the United States. Major
trunk injuries include those injuries that affect the shoulders and back. The
shoulder
joint, being the most flexible joint in the human body, can be easily injured
because of
accidentally over-extending the range of motion. The U.S. Department of Labor
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estimates that thirty-five percent of all muscoskeletal injuries are major
trunk injuries.
Over four million visits are made to health care professionals each year
because of
shoulder injuries. Moreover, the U.S. Department of Labor estimates that the
average
time off-work for shoulder injuries is twelve days. This corresponds to an
estimated
$13-20 billion due to time lost from work.
One common rehabilitation exercise recommended to improve muscle,
ligament and tendon strength, and endurance for extremities post-injury or
post-
surgically, is movement in a cycling motion. The movement of a person's upper
or
lower extremity in a circular path induces motion in the articulations that
form the
shoulder and elbow or hip and knee, respectively. However, for rehabilitation
to be
effective, it must be tailored to the specific needs of a given person based
on their
physical size, type of injury, and plan for recovery, among other factors. For
example, if a surgical repair has been made to a torn ACL of a person's leg,
it is often
desirable at the beginning of a rehabilitation regimen to limit the flexion or
extension
of the knee, due not only to pain, but also to avoid damage to the repair.
Likewise, for
the shoulder, a physician may recommend limiting the motion of the shoulder to
something far less than its full capability of 360 degrees until natural
recovery and
sufficient rehabilitation has occurred. Although cycle-type exercise machines
are
recommended for use in certain rehabilitation regimens, they generally do not
facilitate the adjustment of the range of motion of one individual extremity.
Further,
these machines are limited to the standard pedal or handle arrangement where
one
lever (handle or pedal) is offset from the other by 180 degrees around a hub.
There
are, however, rehabilitation regimens where benefits to flexibility, strength,
and/or
endurance are achieved by offsetting levers or handles at another angles for
passive,
assisted active, and active range of motion.
SUMMARY OF THE INVENTION
A rotary rehabilitation apparatus is presented that allows for the selection
of a
range of motion for upper and/or lower extremities of a person engaging in a
cycling
action. The adjustable lever assembly allows for safer, more immediate
rehabilitation
following hip, knee, shoulder, and/or elbow injuries and further provides for
pain
reduction, increasing the range of motion, strengthening soft tissue and
general
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conditioning. The assembly comprises one movable lever and a flywheel
rotatably
mounted on a support and having a series of bores along a diameter thereof
with
which the movable lever or handle is releasably mounted. In an exemplary
arrangement where the rotary rehabilitation apparatus is incorporated with a
cycle-
type exercise machine, for example a cycle ergometer, a user will sit on the
seat and
place their feet or hands on the levers to impart a force thereon. As the
user's feet or
hands move in a circular path, the extremities engage in extension and flexion
to
cause movement in the articulations formed at the user's hip and knee or
shoulder and
elbow joints. The amount of movement in the articulations of the extremity and
consequently, the range of motion at these joints can be controlled by
mounting the
lever with the appropriate bore on the flywheel. If increased extension and
flexion is
desired, the lever can be mounted with a bore further away from the axis of
rotation of
the flywheel. Conversely, if a smaller degree of extension and flexion is
preferred,
the lever can be mounted with a bore closer to the flywheel axis of rotation.
In one configuration, the moveable lever is releasably mounted within a
mounting bore of the flywheel and the other lever is left at full diameter.
This
configuration allows an adjustable range of motion for one extremity and a
fixed
range of motion for the other extremity, which allows for more limited,
rehabilitative
exercises for one extremity (e.g., an injured knee or shoulder) and more
robust
exercises for the other.
In another aspect, more than one series of bores extend across different
diameters of the flywheel, so that the movable lever can be mounted at various
angles
with respect to the fixed lever around the axis of rotation. For example,
while levers
are typically aligned 180 degrees from one another around a hub on an cycle-
type
exercise machine, it may be desired in rehabilitation regimens to position the
levers at
a different angle to work on the passive range of motion ("PROM"), the
assisted
active range of motion ("AAROM"), and the active range of motion ("AROM").
The rotary rehabilitation apparatus of the present invention provides improved
options for rehabilitation regimes where a cycling or rotary action would be
beneficial
to recovery from injury of a person's extremities. As a user progresses in
their injury
recovery, such as by increasing strength and flexibility in their extremities,
the
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movable lever or handle can be disengaged and remounted within another bore
that
provides a different range of motion for their extremity when rotating the
assembly.
By rapidly affecting PROM, AAROM and AROM this invention will reduce
the time required to recover from extremity injuries, increasing improvements
in
measurable outcomes such as range of motion, edema, proprioception, return to
unassisted gait activities, initial functional independent measures, strength
and
conditioning; reduce overall inpatient and outpatient costs, accelerate return
to
vocational or avocational activities; and significantly improve quality of
life by
expediting a return to autonomy.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a right side elevation view of the rotary rehabilitation apparatus
of
the present invention incorporated with a cycle-type exercise machine;
FIG. 2 is perspective view of the rotary rehabilitation apparatus of the
present
invention incorporated with a cycle-type exercise machine;
FIG. 3 is a top plan view of the rotary rehabilitation apparatus of the
present
invention incorporated with a cycle-type exercise machine;
FIG. 4 is a front elevation view of the rotary rehabilitation apparatus of the
present invention incorporated with a cycle-type exercise machine;
FIG. 5 is a side elevation view of an embodiment of the flywheel with a non-
linear configuration of bore holes;
FIG. 6 is a side elevation view of an embodiment of the flywheel with a non-
linear configuration of bore holes with a continuous ring of additional mass
applied to
the outer perimeter of the flywheel to increase the flywheel inertia;
FIG. 7 is a side elevation view of an embodiment of the flywheel with a non-
linear configuration of bore holes with a non-continuous ring of additional
mass
applied to the outer perimeter of the flywheel to increase the flywheel
inertia;
FIG. 8 is a left perspective view of the flywheel with a linear configuration
of
bore holes mounted with the hub;
FIG. 9 is a right perspective view of the flywheel of FIG. 8;
FIG. 10 is an exploded view of the flywheel as mounted with the hub;
FIG. 11 is a front elevation view of the flywheel of FIG. 8;
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[0001] FIG. 12 is a right side elevation view of the flywheel of FIG. 8;
FIG. 13 is a perspective view of an embodiment of a pedal lever assembly;
FIG. 14 is an exploded view of an embodiment of a pedal lever assembly;
FIG. 15 is a top plan view of an embodiment of a pedal lever assembly;
FIG. 16 is a left side elevation view of an embodiment of a pedal lever
assembly;
FIG. 17 is an front elevation view of an embodiment of a pedal lever
assembly;
[0002] FIG. 18 is an exploded view of the slotted bushing including the
locking lever and a standard bicycle pedal;
FIG. 19 is a perspective view of the slotted bushing with the locking lever in
position;
FIG. 20 is a sectional view of the beveled front of the slotted bushing
including the locking pad and locking face;
FIG. 21 is a side view of the slotted bushing with phantom threads for
connecting to the pedal;
[0003] FIG. 22 is a side view of the quick release adaptor inserted through
the flywheel with the locking face positioned against the planar surface of
the
flywheel;
FIG. 23 is a left perspective view of the rotary rehabilitation apparatus
showing one lever approaching engagement with one of the bores of the flywheel
and
the flywheel rotatably mounted with a hub;
FIG. 24 is a right perspective view of the rotary rehabilitation apparatus
showing the lever mounted with the flywheel and the hub with which the
flywheel is
mounted;
FIG. 25 is a top view of the rotary rehabilitation apparatus showing the lever
mounted with the flywheel, and the flywheel mounted with the hub;
FIG. 26 is a front elevation view of the rotary'rehabilitation apparatus of
FIG.
25;
FIG. 27 is a right elevation view of the rotary rehabilitation apparatus of
FIG.
25;
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FIG. 28 is a side elevation view of one embodiment of the disk of the flywheel
showing a linear configuration of bores along two diameters thereof;
FIG. 29 is a side elevation view of another embodiment of the disk of the
flywheel showing a linear configuration of bores along four diameters thereof;
FIG. 30 is a side elevation view of one brace member of the flywheel;
FIG. 31 is a front elevation view of the brace member of FIG. 30;
FIG. 32 is a rear elevation view of the coupling for mounting the hub with the
flywheel;
FIG. 33 is a side elevation view of the coupling of FIG. 32;
FIG. 34 is a front elevation view of the coupling of FIG. 32;
FIGS. 35 and 36 schematically show leg members having feet positioned on
the levers of the rotary rehabilitation apparatus at a first position of
rotation and at a
second position of rotation;
FIGS. 37 and 38 schematically show leg members having feet positioned on
the levers of the rotary rehabilitation apparatus with one of the levers
mounted at a
different position on the flywheel than the levers of FIGS. 35 and 36 and the
levers
being at a first position of rotation and at a second position of rotation;
FIG. 39 is a right side elevation view of a rotary rehabilitation apparatus
configured for upper extremity movement of the shoulder and/or elbow; and
FIGS. 40-44 show various views (perspective view, exploded perspective
view, right side elevation view, top plan view and front elevation view) of
the lever
assembly of a rotary rehabilitation apparatus of the present invention.
DETAILED DESCRIPTION OF THE INVENTION
One rotary rehabilitation apparatus 10 providing for the selection of a range
of
motion for one or both legs 200 of a person is shown in FIGS. 1-4. An
embodiment
of the rotary rehabilitation apparatus for rehabilitating a person's upper
extremities
will be discussed in detail below. The rotary rehabilitation apparatus 10 is
shown
incorporated in a cycle-type exercise machine 100 having a support 102 upon
which
the apparatus 10 is rotatably mounted and a seat 104 positioned at a distance
from the
support 102. In this arrangement, the person can sit in the seat 104, place
their feet
204 on the levers 12a and 12b and impart a pushing force thereto with their
legs 200
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to rotate a flywheel 14 at a center point 15 thereof around an axis extending
in the
horizontal plane.
The adjustable range of motion for each leg 200 is achieved by having the
movable lever 12a be repositionable along one or more diameters of the
flywheel 14.
The flywheel 14 has a series of bores 16 extending laterally there through
parallel to
the flywheel rotational axis and formed in a row along the flywheel diameter
so that
the lever 12a can be removably mounted with one of the bores 16. In the
embodiment
of the rotary rehabilitation apparatus 10 shown in FIGS. 1-4, the flywheel 14
has two
separate series of bores 16 each aligned along one flywheel diameter and
orthogonal
to one another. FIGS. 5-7 show an embodiment of the flywheel 14 that utilizes
a non-
linear configuration of two series of bores. This non-linear configuration
provides
separate options for ranges of motion and can be highly beneficial with
certain
patients who have experienced difficulty in achieving improvements with their
range
of motion utilizing the linearly arranged bore holes. FIG. 6 reveals an
embodiment of
the flywheel 14 that utilizes a continuous ring 19 at the outer perimeter wall
of the
flywheel. FIG. 7 conversely utilizes a non-continuous outer ring 17. Both
embodiments include additional mass at the outer ring of the flywheel 14 to
increase
the inertia of the flywheel and enhance the benefits associated with passive
rotation.
By increasing the mass of the flywheel at the perimeter wall of the flywheel,
the
desired rotation speed can be maintained with reduced energy input from the
extremity of the user.
As can also be seen in FIGS. 1-4, the movable lever 12a is mounted with the
flywheel 14 and the fixed lever 12b is mounted with a crank 18 extending
radially
from a hub 20 with which the flywheel 14 is rotatably mounted at the center
point 15.
This configuration allows for lever adjustment both along the flywheel 14
diameter
towards or away from the center point 15, and concentrically on the flywheel
14
around the center point 15 such that the leverl2a may be at an offset angle
relative to
the fixed lever 12b about the flywheel axis of rotation of 90, 180 or 270
degrees.
Figs. 8-12 show more detail of the flywheel 14 and mounting with the hub 20.
The flywheel 14 comprises a circular disk 22 having opposing first and second
planar
surfaces 24, 26 and a perimeter wal128, and a circumferential ring 30 fixed
around
the perimeter wall 28. The ring 30 may be press fit onto the disk perimeter
wall 28 or
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may be mounted thereto with fasteners or adhesives. A first set of notches 32
are
formed along an inner edge 34 of the ring 30 adjacent to the disk first planar
surface
24 and in alignment with each row of the series of bores 16. These notches 32
facilitate the extension of brace members 36 across the disk planar surface 26
on a
diameter of the ring 30 to matingly fit with the notches 32. A second set of
notches
38 having a curved profile are formed along the ring inner edge 34 adjacent to
the
disk second planar surface 26. When the movable leverl2a is mounted with the
bore
16 furthest from the center point 15, the notches 38 provide extra clearance
such that
the lever 12 fits properly adjacent to the second planar surface 26.
Depending on the functionality desired in the cycle-type exercise machine
100, the flywheel 14 can be designed to have a relatively large or small
moment of
inertia. A large moment of inertia flywheel 14 requires more peddling force to
accelerate the same to a given speed, but also causes the flywheel 14 to
better resist
changes in speed, resulting in smoother "steady-state" cycling, which may be
preferred in certain rehabilitation exercises. The higher moment of inertia is
created
by making the flywheel 14 heavier and/or moving more of the flywheel weight
out to
the circumferential ring 30.
The flywheel 14 is mounted with the hub 20 by insertion of a fastener 39
through the bore 16 of the disk 22 forming the center point 15 of the flywheel
14 and
through a coupling 40 for securing with the hub 20. Specifically, the fastener
39
extends into a receiving bore 42 formed in a stem 44 rotatably mounted within
a body
46 of the hub 20. In this arrangement, the hub body 46 is stationary on the
support
102 while the hub stem and the mounted flywheel 14 rotate relative to the hub
body
46. The hub 20 is preferably mounted adjacent to the first planar surface 24
on a side
of the flywheel 14 opposite of the movable lever 12a.
In addition to controlling the moment of inertia in the flywheel 14, the
overall
resistance to turning of the flywheel 14 may be controlled to increase the
amount of
work a user must perform in peddling, as those of skill in the art appreciate
with
respect to known cycle-type exercise machines. For example, frictional
resistance
may be incorporated in to the design of the hub 20, such that the rotation of
the stem
44 relative to the hub body 46 requires a certain amount of force to overcome
the
static and dynamic friction within the hub 20. Alternatively, a frictional
surface (not
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shown), for example, a brake, may selectively engage the circumferential ring
30 to
create static and dynamic friction.
FIGS. 13-17 show the components of the movable lever 12a. The lever body
48 has opposing surfaces 49 onto which the user's foot is placed and a bore 50
extending through the body 48 from a lateral side face 52 to a medial side
face 54. A
chamfer 56 is also formed at the bore entrance of the lateral side face 52. A
sleeve 58
has a first end 60 and a second end 62, and is configured for insertion into
the bore 50
such that the second end 62 extends out of the lever medial side face 54 as
shown in
FIG. 15. A pin 64 is inserted into the sleeve 58 and has a shank 66 extending
out of
second end 62 thereof, and a collar 68 having a concentric base 70 configured
to abut
the first end 60 and a beveled region 72 mateably fitting within the chamfer
56. A
protrusion 74 is formed on the shank 66 near an end distal to the collar 68
such that
the pin 64 frictionally fits within one bore 16 of the flywheel 14 to secure
the lever
body 48 thereto. If enough of a pulling force is applied to the lever body 48
away
from the flywheel 14, the protrusion 74 is removed from the frictional fit in
the bore
16 and may be repositioned as desired in another bore 16. The lever body 48
and
sleeve 58 are also rotatable about the pin 64 such that as the flywheel 14
rotates, one
of the peddling surfaces 49 is maintained in alignment such that the user can
continue
to apply a force thereto with their feet 204 through the cycling motion.
In an alternative embodiment as shown in FIG. 18, a standard bicycle pedal
330 can be employed with a quick release adaptor 332. The utilization of a
standard
bicycle pedal 330, a bicycle pedal with clips or a hand grip, with the quick
release
adaptor 332 is highly desirable in this application because if the pedal is
damaged or
simply wears out it can be quickly and inexpensively replaced by purchasing it
at a
wide array of commercial retail establishments. Moreover, it is critical in
rehabilitation settings that the levers be easily removed and repositioned
because
many patients have reduced strength because of injuries or debilitating
illnesses that
lirnit the amount of force they can apply in these situations. While the
application of
a bicycle pedal in this invention is addressed in more detail below it should
be
understood that other apparatus for application of force from the extremities
of a user
are also contemplated. For example, hand grips for utilization by the hands of
a user
in-lieu of pedals for the feet are also contemplated by this invention.
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In FIG. 18 a standard bicycle pedal 330 is shown approaching engagement
with the quick release adaptor 332. The quick release adaptor 332 is comprised
of a
machined bushing 336 with a beveled edge 338, a first shaft 340 of diameter Dl
and a
second shaft 342 of diameter D2. A slot 344 is machined into the bushing 336
wherein a spring loaded locking lever 346 resides. The portion of the locking
lever
346 proximate the beveled edge 338 is biased upward away from the center of
the
shafts 340, 342 through the force of a spring 348. The locking lever 346 is
held in
position in the slot 344 with the assistance of a roll pin 350 that is
inserted through
holes 352, 354 in the second shaft 342 and through a hole 353 in the locking
lever 346
itself. The roll pin 350 serves as a pivot point about which the locking lever
346 can
rotate a sufficient amount to facilitate detachment of the quick release
adaptor 332
from the flywheel 14.
As shown in FIG. 19, the locking lever 346, in its preferred embodiment,
utilizes a push pad 356 wherein finger or hand pressure P is applied forward
of the
roll pin 350 to overcome the force of the spring 348 (not shown), which is
also
located forward of the roll pin and beneath the locking lever 346 in the slot
344.
Pressure P rotates the locking lever 346 downward about the roll pin 350. As
seen in
Fig. 18 and extending from the push pad 356 is a locking lever shaft 358 such
that
when the locking lever 346 is positioned within the slot 344 the surface 360
of the
locking lever shaft 358 is flush with, or slightly below, the outer diameter
Dl of the
first shaft 340. Maintaining the locking lever shaft 358 flush with the outer
shaft
diameter D1 allows the quick release adaptor 332 to be inserted into the bore
14
without interference. As shown in FIG. 18 adjacent to the shaft 358, and
opposite the
push pad 356, is the locking pad 362. The locking pad 362 utilizes a locking
face 364
that upon insertion into and once passing through the bore 14 secures the
quick
release adapter 332 in position and prevents inadvertent extraction of the
quick release
adapter 332. The upper surface 366 of the locking pad 364 is beveled at the
same
slope as the beveled edge 338 to further facilitate insertion of the quick
release
adapter 332 into position through the bore 16. Once the locking pad 362 is
inserted
entirely through the bore the spring 348 forces the entire locking pad 362
upward
including the locking face 364.
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As shown in Fig. 21, second shaft 342 with diameter D2 includes internal
threads 370 for installation of a standard bicycle pedal 330. The preferred
threads are
standard 9/16 inch with 20 threads per inch; however, it should be understood
that
other thread configurations are also contemplated.
In operation, the bicycle peda1330 is threaded into the internal threads 370
of
the quick release adaptor 332. The user then inserts the end of the quick
release
adaptor 332 with the beveled edge 338 into the desired flywheel bore 16 to the
point
where the locking face 364 of the locking pad 362 reaches the opposite side of
the
flywheel 14. As shown in FIGS. 20 and 22 once the locking face 364 reaches the
opposite side of the flywheel 14 the force of the spring 348 pushes the
locking face
364 upward to a point where the tip 372 of the locking face 364, measured from
the
centerline CL of the shaft 340 exceeds the dimension D 1. Once the tip 372 of
the
locking face 364 extends beyond D 1 the quick release adaptor 332 cannot be
withdrawn through the bore 16 without the tip 372 of the locking face being
lowered
to at least D 1 because the tip 372 interferes with the opposite face of the
flywheel 14
when attempting to withdraw the quick release adapted 332. In order to
withdraw the
quick release adaptor 332, the user must apply pressure P to the push pad 356
forward
of the roll pin 350 thereby causing the locking lever 346 to rotate downward
forward
of the roll pin 350. Once the tip 372 of the locking face 364 is lowered to a
point
where it less than D 1 from the centerline CL the entire assembly comprised of
the
quick release adaptor and the bicycle peda1330 can be withdrawn from the bore
16 of
the flywheel 14 and repositioned as desired by the user by repeating the steps
outlined
above.
FIGS. 23-27 show an exemplary orientation for the rotary rehabilitation
apparatus 10 where the movable lever' 12a is shown mounting with one of the
radially
outermost bores 16 of the flywheel 14. In FIG. 28, an embodiment of the
flywheel 14
having two series of linear bores 16 is shown. Each concentric dotted line on
the
flywheel disk 22 connecting bores 16 on different rows represents a certain
distance
from the center point 15 (i.e., point of rotation) of then flywheel 14, for
example, one
inch. Thus, one can quickly determine the degree of adjustment achieved by
mounting a movable lever 12a with one particular bore 16. Fig. 29 shows
another
flywheel 14 embodiment having four series of bores 16 with each row rotated 45
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degrees with respect to one another. Other bore arrangements of 30 and 60
degrees,
for example, are also contemplated as required by the needs of the user's
extremities.
This arrangement allows for more fine-tuning of the angle offset between the
movable
lever 12a and the fixed lever 12b, which may be desired in certain
rehabilitation
regimens.
FIGS. 30 and 31 show one brace member 36 having a curved edge 76 for
abutting the coupling 40 on an end opposite of the notches 32 of the
circumferential
ring 30, and beveled edges 78 on either side of the curved edges 76. Each
beveled
edge 78 of one brace member 36 abuts a beveled edge 78 of another brace member
36
extending along an adjacent row of the series of bores 16. FIGS. 32-34 also
show the
coupler 40 in detail. A cavity 80 is formed in the cylindrical coupler 40 and
is shaped
to receive the stem 44 of the hub 20. Also as seen in FIG. 10 along with FIGS.
32-34,
a bore extends from the cavity 80 through the coupler 40 with a length
sufficient to
allow the fastener 39 to extend there through to reach the stem 44. In this
way, the
coupler 40 provides the interface to more securely mount the flywheel 14 for
rotation
about the hub body 46.
The motion of a person's legs 200 utilizing the rotary rehabilitation
apparatus
of the present invention is simulated in FIGS. 35-36 showing the hip joint
206, the
upper leg 208 (e.g., the femur), the knee joint 210 and the lower leg 212
(e.g., the
tibia). In Figs. 35 and 36, the fixed lever 12b is at a radial distance (e.g.,
6 inches)
from the flywheel 14 axis of rotation that is much greater that the radial
distance of
the movable lever 12a (e.g., 1 inch) from such axis of rotation. This provides
a
relatively large range of motion for the user's leg peddling the fixed lever
12b while
providing a relatively small range of motion for the leg rotating the movable
lever
12a. In this configuration, the movable lever 12a limits the change in angle
formed
between the lower leg 212 and a tangent extension of the upper leg 208 to 11
degrees,
with the angles remaining between 67 degrees and 56 degrees.
This rehabilitation regimen may be recommended when the user is not to bend
their leg to a certain degree, for example, to limit stresses on the hip 206
or knee 210.
Conversely, in FIGS. 37 and 38, the movable lever 12a and fixed lever 12b are
at the
same radial distance (e.g., 6 inches) from the flywheel 14 axis of rotation.
Thus, both
of the user's legs will participate in a large range of motion when peddling
with the
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apparatus 10. The movable lever 12a, in the embodiment of FIGS. 37 and 38,
allows
for the angle formed between the lower leg 212 and a tangent extension of the
upper
leg 208 to cycle between 6 degrees and 88 degrees. This large range of motion
rehabilitation regimen brings about much more flexion and extension than the
configuration of FIGS. 35 and 36, and consequently more movement of the hip
and
knee articulations. Thus, the embodiment of Figs. 37 and 38 may be preferred
during
a later stage of injury or post-surgery rehabilitation when the flexibility
and strength
of the affected joint, for example, a user's ACL or total knee arthroplasty
(TKA) has
increased.
In the embodiment of the rotary rehabilitation apparatus 218 shown in FIG.
39, for upper extremities including the shoulder, wrist and elbow, the
adjustable range
of motion for each arm 220 is achieved by having the movable hand lever 222 be
repositionable along one or more diameters of the flywheel 224. The flywheel
224
has a series of bores 226, either linear or non-linear as discussed above and
depending
upon the needs of the user's extremities, extending laterally there through
parallel to
the flywheel rotational axis and formed in a row along the flywheel diameter
so that
the hand lever 222 can be removably mounted with one of the bores 226. In the
embodiment of the rotary rehabilitation apparatus 218 shown in FIG. 39, the
flywheel
224 has two separate series of bores 226 each aligned along one flywheel
diameter.
As previously discussed and as shown in Figs. 5-7 is an embodiment revealing a
series of non-linearly arranged bores in the flywheel which is also
contemplated by
this invention.
Shown in FIGS. 40-44, is a fixed hand lever for use on the flywheel 224 seen
in FIG. 39. The fixed hand lever is mounted to the flywhee1224 which is
rotatably
mounted at the center point 228. This configuration allows for lever
adjustment both
along the flywhee1224 diameter towards or away from the center point 228, and
concentrically on the flywheel 224 around the center point 228 such that the
hand
lever 222 may be at an offset angle relative to the fixed hand lever about the
flywheel
axis of rotation of 30, 45 and 90 degrees or multiples thereof.
FIGS. 40-44 show the components of the movable hand lever 222. The hand
lever body 248 may be tubular in shape or have other configurations that
readily
accommodate gripping by the human hand. The hand lever has a bore 250
extending
CA 02587773 2007-05-16
WO 2006/057634 PCT/US2004/039231
14
through the body 248 from a lateral side face 252 to a medial side face 254. A
chamfer 256 is also formed at the bore entrance of the lateral side face 252.
A sleeve
258 has a first end 260 and a second end 262, and is configured for insertion
into the
bore 250 such that the second end 262 extends out of the lever medial side
face 254.
A pin 264 is inserted into the sleeve 258 and has a shank 266 extending out of
second
end 262 thereof, and a collar 268 having a concentric base 270 configured to
abut the
first end 260 and a beveled region 272 mateably fitting within the chamfer
256. A
protrusion 274 is formed on the shank 266 near an end distal to the collar 268
such
that the pin 264 frictionally fits within one bore 226 of the flywheel 224 to
secure the
hand lever body 248 thereto. If enough of a pulling force is applied to the
hand lever
body 248 away from the flywheel 224, the protrusion 274 is removed from the
frictional fit in the bore 226 and may be repositioned as desired in another
bore 226.
The lever body 248 and sleeve 258 are also rotatable about the pin 264 such
that as
the flywheel 224 rotates, the lever body and sleeve also rotate such that the
user can
continue to apply a force thereto with their hands and arms through the rotary
motion.
Similarly contemplated for the embodiment directed to the upper extremities is
the use of the quick release adaptor 332 that is referenced above. In place of
the
bicycle pedal that is depicted in FIG. 18 would be a hand grip or other
comparable
device for gripping by the upper extremities.
Many alterations and modifications may be made by those having ordinary
skill in the art without departing from the spirit and scope of the invention.
Therefore,
it must be expressly understood that the illustrated embodiment has been shown
only
for the purposes of example and should not be taken as limiting the invention
which is
defined by the following claims. The following claims are thus be read as not
only
literally including what is set forth by the claims but also to include all
equivalent
elements for performing substantially the same function in substantially the
same way
to obtain substantially the same result even though not identical in other
respects to
what is shown and described in the above illustration.
