Note: Descriptions are shown in the official language in which they were submitted.
WO91/1 ~ 3 PCT/US91/04319
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Description
Exercise and Rehabilitation Device and Method
5 Technical Field
n The present invention relates generally to
, exercising devices and, more particularly, to a novel
device which provides for strengthening the lower back
without twisting or compressing the vertebral column
,
lO of the user~
-~- Back~round Art.
, The American Back Society has determined that
`` eight out of ten Americans suffer from some form of
l5 lower-back pain. In 1988, the American business
community lost about 20 billion dollars because of
insurance claims for loss of work, due to back injury
` and/or pain. In fact, compensation claims involving
back problems represented a third of all job related
20 compensation claims paid out by insurance companies
that year, and the average back injury compensation
claim amounted to S6.000. Treatment for back pain
~, ' ranges from complicated surgery to a simple drug
prescription. However, growing evidence indicates
~, 25 that proper exercise is the best long-term solution
~d for back ailments.
Some back problems can result from
hyperextensions occurring during improper physical
exercises. Extension of the spine or vertebral column
30 occurs when it is returned to the normal anatomical
po8ition from the flexed (bent forward) position.
Hyperextension of the spine occurs when the extension
movement goes beyond the normal anatomical position
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(in a backward direction), usually recognized by
additional compressing and arching of the spine.
Hyperextensions, and especially excessive
hyperextensions, can be dangerous, since compression
of the spine is involved. This can lead to fractures
of the compressed vertebrae occurring as a result of
the forces acting on the back of the person.
Bending incorrectly and lack of strength and
flexibility in the muscles that support the spine
1~ continues to be a chronic problem. Stress is also a
major contributor to back pain, since it causes a
tensing and tightening of already weak muscles.
The simplest solution is to strengthen the back
by exercise of the muscles of the hip and back. There
are two major types of lower back strengthening
;~ apparati that are used: (1) hyperextension devices and
~; (2) back extension devices.
When a hyperextension device is used, an
individual lies over the device with his face down,
bending the torso in the direction of the ground and
then subsequently raising the torso. The lower part
of the body is kept stationary by a foot attachment.
An important part of this exercise is to raise the
torso upwardly toward and (improperly) beyond the
Z5 position parallel to the ground without compressing
, the spine. However, in view of the design of this
rd` apparatus, it is difficult to properly execute this
exercise without hyperextension and the resulting
substantial compression of the spine. To alleviate
30 this condition, special training of a user such as,
for example, rounding out the back so as to eliminate
compression of the spine, while performing this
exercise, is necessary to ensure correct development
of the lower back muscles and to decrease risk of
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-~ injury to the spine. Lack of such training makes it
; very difficult for an unconditioned person to use the
hyperextension apparatus extensively without
; substantial risk of injury. Substantial
hyperextensions and arching of the back also can bring
on, or increase, pressure on the nerves. This can be
a factor of back pain and, if the sciatic nerve is
- impinged, can lead to pain down the legs.
When the back extension machine is used, an
individual in the seated position presses on part of
the machine with his or her back, so that the upper
part of the body goes from a position substantially
perpendicular to the lower part of the body to a
~, position in which the whole body is substantially
straight. A user of this machine conducts exercises
in the seated position while the spine is already
compressed. When the back presses on part of the
, machine, the spine compresses and arches substantially
further, especially if the resistance is great. This
can lead to excessive compression and shearing forces
acting on the vertebrae and disks, injuring the back
of a person.
Accordingly, it is a principal object of the
present invention to provide an exercise device and
method using the same which can be used to strengthen
the lower back of a user without compression,
hyperextension, or twisting of the spine of the user.
....
Another object of the in~ention is to provide
such device and method which are relatively easy and
30 comfortable to use.
An additional object of the invention is to
~1 . provide such a device that is readily adjusted to
;~ accommodate users of different sizes.
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A further object of the invention is to provide
such a device that is easily and economically
constructed.
Other objects of the present invention, as well
as particular features and advantages thereof, will be
elucidated in, or be apparent from, the following
description and the accompanying drawing figures.
Disclasure of Invention
;i lO The present invention achieves the above
objects, among others, by providing, in one preferred
embodiment, a device for strengthening the lower back
of a user which includes a frame having a horizontal
member for support of the hips of the user and having,
spaced apart from the hip support, a horizontal
platform for support of the head, shoulders, and upper
chest of the user. The user places himself upon the
frame so that his hips, head, shoulders, and upper
chest are supported, with his legs hanging vertically
from the hip support. The chest of the user is
largely unsupported to permit comfortable and easy
breathing. The strengthening motion comprises raising
the legs from the vertical position to the horizontal
position and again to the vertical position. There is
little or no risk of injury to the vertebral column,
due to the fact that the vertebral column is
stàtionary when the exercise is executed. In another
preferret embodiment, a hydraulically operated hin8ed
member effects the above leg movement to provide
therapy for disabled osers.
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Brief Description of Drawin~s
Understanding of the structure of the present
invention and its various features will be facilitated
by reference to the accompanying drawing figures, in
which:
Figure 1 is a side elevation view of one
embodiment of the present invention with a user
thereon.
Figure 2 is a top plan view of the device of
Figure 1 showing the supporting members of the device.
Figure 3 is a fragmentary side elevation view of
the elements of the device shown on Figure 2.
Figure 4 is a front elevation view of the device
of Figure l.
Figure 5 is a side elevation view of another
embodiment of the present invention with a user
thereon.
Figures 6 and 7 are fragmentary side elevation
views and Figure 8 is a top plan view of an
20 alternative hip support according to the present
invention.
Figure 9 is a top/rear/side perspective view,
Figure 10 is a top plan view, and Figure ll is a side
elevational view in cross-section of another
25 alternative hip support according to the present
invention.
Figure 12 is a top/rear/side perspective view
and Figure 13 is a side elevational view in cross-
section of an alternative support platform according
30 to the present invention.
;
Figure 14 is a top/rear/side perspective view
and Figure 15 is a side elevational view of an
alternative embodiment of the present invention.
Figures 16 and 17 are details of Figure 14.
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Best ~ode for Carryin~ Out the Invention
Referring now to the Drawing, in which the same
or similar elements are given consistent identifying
numerals throughout the various figures thereof,
5 Figure 1 depicts a device for use in strengthening the
lower back, constructed according to the present
invention, generally indicated by the reference
numeral 10, with a user thereon.
Device 10 includes an upper horizontal frame
? lo member 12 having a support platform 14 freely movable
,i,
fore and aft thereon. Device 10 further includes a
lower horizontal frame 16 for support of said device
on a floor or like supporting surface. Upper frame 12
; is mounted on a first pair of telescoping le~s having
15 upper sections 22 fixedly attached to the upper frame
and a lower sections 24 fixedly attached to lower
frame 14. A similar, second pair of telescopin~ legs
having upper sections 26 and lower sections 28 movably
1 joins upper horizontal frame member 12 to lower
; 20 horizontal frame 16. The height of upper frame 12 and
support platform 14 from lower horizontal frame 16 is
selectively adjusted by means of a conventional worm
gear mechanism 30.
i Fixedly and horizontally disposed at the rear of
25 upper horizontal frame 12 is a rounded, cushioned hip
support 40 generally disposed somewhat rearwardly of
upper leg sections 22, so that device 10 can
acco-modate users with large thighs.
Referring also to Figures 2 and 3, support
30 platform 14 includes a resilient pad 42 fixed thereon,
the pad having an oval opening 44 formed therethrough,
and the pad sloping from a high point at the forward
ent of the psd to a low point at the rear end of the
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pad. Attached to the forward end of upper horizontal
frame member 12 is an adjustable hand grip structure
50 telescopingly extending forwardly of the member and
selectively fixed in position by means of hand screws
52. Referring particularly again to Figure 1, fixed
hand grips 54 (only one visible on Figure 1) are
attached to upper leg sections 26 as shown.
Completing the description of the major elements
of device 10, there is provided a horizontal foot
stand 56 fixedly attached at the lower ends of lower
leg sections 24.
In use, the user, generally identified by the
reference numeral 60, steps upon foot stand 56 and
bends over hip support 40 to the position shown on
Figure l, with the central portion of the user's face
inserted into oval openin~ 44. Placing the face in
oval opening 44 assists in proper orientation of user
60 on device lO, as well as providing comfortable
support for the head of the user. While moving to the
position shown, the user may find it convenient to
grasp fixed hand grips 54, but while using device 10
for back strengthening, the user may find it more
comfortable to grip adjustable hand grip structure 50
forward of the user's head. Since the length of the
legs and the length of the torso will vary from user
to user, depending on age, sex, etc., mechanisms 30
and 32 will be adjusted for the comfort of each user.
Hip support 40 will be adjusted high enough that the
feet of the u9er can be easily slid off foot stand 56.
Once positioned as shown, the user is supported
at the hips by hip support 40. The shoulders,
cl8vicular area, and face of the user are supported by
resilient pad 42, while additional support of the
upper che~t may be provided by sternum support 46.
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Thus positioned, the lower portion of the user's chest
i9 unsupported, permitting comfortable and easy
breathin8. Furthermore, in the position shown, the
whole vertebral column is stationarily positioned and
is in correct, natural alignment and curvature,
without compression thereof and the back muscles are
relaxed when the feet are in a downward pointing
position. Because of the bent position of the user's
body, the lower back muscles, which are to be
strengthened during the exercise, are somewhat
isolated from the rest of the back muscles. The
gripping of hand grip structure 50 or of fixed hand
grips 54 helps stabilize the position of the upper
torso of user 60 during exercise.
When the back strengthening exercise begins, the
user inhales and raises the lower extremities to a
position substantially parallel to the ground, as
shown in broken lines on Figure 1. On upward
ascension of the lower extremities, the user
preferably points the toes downward into plantar
flexion. On descension, the toes preferably go into
dorsi flexion during the release, while the user
exhales.
When performing the exercise, the user's chest
; 25 freely expands and contracts within the unrestricted
area between hip support 40 and platform 14, thus
-, permitting the user to breathe easily and freely.
Such breathing ensures an adequate supply of oxygen to
the lungs, eliminates discomfort, and helps the user
to exercise efficiently. Having support platform 14
movably disposed on horizontal frame member 12 permits
1 movement thereof during the exercise, thus affording
; user 66 a high degree of comfort and further assuring
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that the vertebral column is neither expanded nor
; compressed.
Figure 5 depicts device io modified for use in
physical rehabilitation programs where injury or
illness has seriously limited the range of movement of
the body, or its strength, with respect to muscles of
the lower back and hip, the modified device being
identified generally by the reference numeral 10'.
Device lO' includes a leg support 70 rotatable about a
shaft 72, the shaft being fixedly attached to device
lO' by means of flange 74 on the right side of device
; lO'. It will be understood that an identical shaft
and a flange (neither shown) are provided on the left
side of device lO'. Leg support 70 is rotated by
means of a conventional hydraulic cylinder 76 having
its distal end rotatably attached between upper leg
sections 22, with its shaft 78 extendable to rotate
the leg support from its vertical position (solid
lines) to its horizontal position (broken lines), thus
raising the legs of the patient. The controls for
hydraulic cylinder 76 are conventional and may be
arranged so that either patient 66 or an attendant can
operate the cylinder. The controls may provide for
selectively adjusting the speed and/or extent of
rotation of leg support 70.
When device lO' is used in a rehabilitation
program, careful attention must be given to the
prevention of over-extension of the lower back muscles
which may have been subject to disease or injury. The
: 30 process of exercising must not be permitted to
aggravste the original condition.
In order to use device lO' for rehabilitation
purposes, patient 66 is placed on the apparatus in the
position similar to that shown, which is identical to
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that of user 60 shown on Figure 1. To raise the legs,
hydraulic cylinder 76 is activated to gradually lift
leg support 70. After leg support 70 reaches a
predetermined eleva~ion, the direction of motion of
; 5 the mechanism is reversed and the legs are gradually
lowered to the initial position. Such exercise can be
repeated with different speeds of motion and different
degrees of elevation of the legs.
;~
In order to have control over the intensity of a
rehabilitation program, the hydraulic controls can be
-~ adjusted to vary the level of support provided by leg
support 70 to the legs. For example, leg support 70
can provide the lifting force to move only 50 percent
of the weight of the patient's legs, the remaining 50
percent of the required force being provided through
` exercise of the patient's own muscles. The level of
support provided by the regulating mechanism is
usually greater at the initial stages of
rehabilitation and can be reduced as the condition of
' 20 the patient improves.
During the rehabilitation exercise, the lower
extremities of a physically impaired person are moved
upwardly into a hip extension to manipulate the muscle
groups of the gluteal and lower back. The regulating
mechanism sssociated with the leg support 70 enables
the patient to raise and lower his or her legs with
different degrees of assistance.
, Figures 6-8 illustrate an alternative hip
s support 90 which may be employed with devices 10 and
30 lO'. Hip support 90 is a generally rectilinear padded
member which is disposed rearwardly of upper sections
22 and which is disposed on a shaft 92 to permit a
`, slight amount of rotational motion as is indicated bycompsring-the relative positions of hip support 90 on
35 Figures 6 and 7. Thus, hip suppart 90 afforts a
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somewhat greater degree of support and comfort than
does hip support 40 shown on Figures 1, 2, and 5. Hip
support 90 includes a cut-out portion 94 for the
increased comfort of male users.
- 5 Figures 9-ll illustrate another alternative hip
support which may be employed with devices 10 and 10',
generally indicated by the reference numeral 100. Hip
support 100 includes a semiresilient body 102 having
embedded therein a reinforcing plate 104. Fixedly
attached to, and rising upwardly from, reinforcing
plate 104 are two mounting tabs 110 and 112. On
Figure 9, hip support 100 is shown rotatably mounted
to the proximal end of upper horizontal frame member
114 at the distal ends of mounting tabs 110 and 112.
It can be Reen from Figure 10 that hip support is V-
shaped in plan view, with the sides of the V forming
an angle of about 130 degrees.
Hip support 100 includes an oblong front portion
~ 120 joined to a rounded rear portion 122 at the narrow
; 20 part of the oblong portion so as to form a first
trough 124 in the upper surface of the hip support
extending transversely from one side of the hip
support to the other. A second trough 126 is defined
in the upper surface of hip support 100 along the
central axis thereof and extending from a notch 128
defined in the front edge of the hip support to the
'` rear edge of the hip support.
First trough 124 is provided to accommodate
~ therein the pelvic crest of a user and rounded rear
;~ 30 portion 122, having a diameter of approximately two
inches, is provided to conform to the space between
the pelvic crest and the pubis of a user. Second
trough 126 accommodates the lower abdominals of the
user for comfort. The distance between the root of
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notch 128 and first trough 124 is approximately three-
and-three-quarters inches which is the average
distance between navel and crest of the pelvis for a
5'-10" male. Other distances can be provided.
Body 102 of hip support 100 may be constructed
of medium density, foamed polyether polyol as
furnished by Cook Composites ~ Polymers, Burlington,
Indiana. When foamed, the material forms a skin of
about 0.030-inch thickness. The surface of body 102
should have a high coefficient of friction, say, on
the order of 0.7, or be slightly textured to maintain
placement during exercise. Reinforcing plate 104 and
mounting tabs 110 and 112 may be constructed of any
suitable relatively rigid material such as steel.
Figures 12 and 13 illustrate an alternative
semiresilient support platform, generally indicated by
the reference numeral 150. Support platform 150
includes a first opening lS2 defined generally
centrally therethrough to accommodate the head of a
user. Defined through support platform 150 above
first opening 150 is a second opening 154 separated
from the first opening by a relatively narrow bridge
portion 156. Second opening 154 and bridge portion
156 are provided to accommodate heads of different
heights by means of the deformation of the bridge into
the second opening. Support platform 150 may be
constructed of the same material as hip support 100.
! Figures 14 and 15 illustrate another embodiment
of sn exerci~e and rehabilitation de~ice according to
30 the present invention, generally indicated by the
reference numeral 200. Referring principally to
Figure 14, de~ice 200 includes an upper frame member
202 on which ia horizontally slidingly disposed a
aupport platform 204 which may be selectively fixed in
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place by means of clamp 212. At the proximal end of
upper frame 202 is rotatably mounted a hip support 206
which is identical to hip support 100 shown on Figures
9-11. A handle structure 208 is telescopingly mounted
to the distal end of upper frame member and is
selectively adjusted by means of threaded knob 210.
Device 200 further includes a lower horizontal frame
member 220 joined to upper fra~e member 202 by means
of two telescoping legs 222 and 224. Telescoping legs
. 10 222 and 224 are actuated, and thus the distance
between upper and lower horizontal frame members 202
and 220 can be adjusted, by means of electro-
mechanical actuators 230 and 232.
Telescoping legs 222 and 224 are fixedly
attached at their lower ends to lower horizontal frame
member 220, but are rotatably attached at their upper
ends to upper frame member 202 such that the upper
frame member can be rotated from the position shown on
: Figure 14 to the position shown on Figure 15 by means
of actuation of an electro-mechanical actuator 226.
Electro-mechanical actuators 230 and 232 are
controlled by "UP" and "DOWN" buttons disposed in the
distal end of upper frame member 202 as shown on
Figure 16 or by "UP" and "DOWN" buttons disposed in
handle structure 208 as shown on Figure 17. Electro-
mechanical actuator 226 is controlled by "RAISE" and
"LOWER" buttons disposed in handle structure 208 as
. ~hown on Figure 18.
Referrin8 now primarily to Figure 15, when a
.. 30 person (not shown) wishes to use de~ice 200, the
device is placed in the position shown on Figure 15
. and the person approaches the device and stands with
his hips touching hip support 206. Using the "UP" and
., "DOWN" buttons in the proximal end of upper frame
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member 202 (Figure 16), the person raises or lowers
the upper frame member and, therefore, hip support 206
until his public crest fits into a first trough 250
defined in the hip support. Alternatively, the person
-; 5 may align his navel with the root of notch 252 defined
in the front edge of hip support 206. Next, the
person uses clamp 212 to adjust support platform 204
and inserts his face into opening 254 and then uses
knob 210 to adjust handle structure 208. Then, the
person presses the "LOWER" button on handle structure
208 (Figure 18) to rotate upper frame member 202 to
the position shown on Figure 14 with the person
thereon in the position shown on Figure 1. Finally,
the person presses the "UP" button on handle structure
208 (Figure 17) to raise the upper platform a few
inches so that the feet of the person will clear the
surface on which device 200 is supported. Exercising
of the lower back, as described above, can now begin.
At the end of exercising, the person presses the
20 "DOWN" button on handle structure 208 (Figure 17) to
lower his feet to the surface on which device 200 is
supported and then presses the "RAISE" button on
handle structure 208 (Figure 18) to rotate upper frame
member 202 to the position shown on Figure 15. The
25 per90n may now wslk away from device 200.
Devices 10, 10', and 200 of the present
invention facilitate extensions of the lower back and
hip areas versus extensions of the upper torso. This
is a substantially safer exercise than those disclosed
30 by the prior art, since possibility of hyperextension
or compression of the vertebral column is
substantially reduced, if not totally eliminated.
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It will thus be seen that the objects set forth
above, among those made apparent from the preceding
description, are efficiently attained and, since
certain changes may be made in the above construction
without departing from the scope of the invention, it
is intended that all matter contained in the above
description or shown on the accompanying drawing
figures shall be interpreted as illustrative only and
not in a limiting sense.
It is also to be understood that the following
; claims are intended to cover all of the generic and
specific features of the invention herein described
and all statements of the scope of the invention
: which, as a matter of language, might be said to fall
~ 15 therebetween.
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