Note: Descriptions are shown in the official language in which they were submitted.
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PROPRIOCEPTIVE/K1NESTHETIC APPARATUS AND METHOD
FIELD OF THE INVENTION
The present invention relates generally to apparatus for training, developing
and
enhancing proprioceptive and kinesthetic skills, neuromuscular control and
core stability.
BACKGROUND OF THE INVENTION
Proprioception refers to the ability to know where a body part is located in
space
and to recognize movements of body parts (such as forgers and toes, feet and
hands, legs
and arms). Kinesthesia is a related term, and refers to the sensation by which
position,
weight, muscle tension and movement are perceived. In some of the medical
literature,
proprioception refers to the conscious and unconscious appreciation of joint
position,
while kinesthesia refers to the sensation of joint velocity and acceleration.
Proprioception
is often used interchangeably with kinesthesia, and herein as well, the terms
will be used
interchangeably. (Throughout the specification and claims, the term
"proprioception" will
be used to encompass proprioception, kinesthesia, core stability and the
like.)
The neuromuscular control system of the body integrates peripheral sensations
relative to joint loads and processes these signals into coordinated motor
responses. This
muscle activity serves to protect joint structures from excessive strain.
Certain mechanoreceptors are present throughout the soft tissues of the
musculoslceletal system which interact with the central nervous system and
coordinate
body movements, postural alignment, and balance. Mechanoreceptors are located
in the
muscles, tendons, ligaments, joint capsules and the skin. These nerve fibers
provide
information to the brain regarding the status and function of the
musculoslceletal system.
The mechanoreceptors send electrical signals along peripheral nerves to the
spinal cord.
The electrical signals travel via the spinal cord to the brain where the
signals are
interpreted to recognize movements of body parts, muscle tension, movement and
the
like.
Some examples of mechanoreceptors for controlling the muscular system include
muscle spindles. Muscle spindles are found interspersed within the contractile
fibers of
skeletal muscles, with the highest concentration in the central portion of
each muscle.
Muscle spindle fibers respond to changes in the length of muscles. These nerve
endings
provide the central nervous system information used to maintain muscle tone
and the
correct muscle tension on opposite sides of each joint.
Fibrous tissues that surround and protect most joints generally contain a
variety of
sensory nerve endings for proprioception and kinesthesia. The input from these
sensory
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nerve endings provides the central nervous system information regarding the
location,
stretch, compression, tension, acceleration, and rotation of the joint.
The foot is the anatomical region that contains the second largest number of
proprioceptive or kinesthetic sensory receptors in the body (the spine has the
most).
Proprioceptive and kinesthetic exercises and exercise devices are well known
for
improving agility, balance and coordination, and for rehabilitation of persons
whose
proprioceptive ability has been impaired, such as after accidents or illness.
One such class
of exercise devices includes tilt boards, wherein a patient stands on a board
or similar
platform that has a ball mounted underneath. The board does not lie horizontal
due to the
presence of the ball, and this challenges the ability of the patient to
balance and perform
maneuvers on the platforni. Repeated exercises on the tilt board may be used
to develop
or rehabilitate the proprioception and neuromuscular control of the patient,
as well as
strengthen muscles, tendons and connective tissues in the foot area.
Other known proprioceptive and kinesthetic exercise devices include a shoe
with a
single ball mounted underneath the sole of the shoe. The shoe with the ball is
used similar
to the tilt board. Another kind of shoe has a rod mounted underneath the sole
of the shoe,
used for strengthening dorsiflexor muscles.
Yet another proprioceptive and kinesthetic exercise device is described in US
Patent 6,283,897 to Patton. This device consists of one or more pegs
protruding upwards
from a baseboard. The pegs have a rounded top and sit in concave depressions
(divots) in
the bottom of an overshoe shaped like a sandal. Specifically, the bottom of
the shoe's sole
has three concave, hemisphere-shaped divots, with one located within the heel
portion,
one directly underneath the ball of the foot, and one located in the center.
Elastomeric
bands may support the user's foot as the user turns his foot and/or hips to
develop the
strength, range of motion, and proprioception of the anlcle and hips.
SUMMARY OF THE INVENTION
The present invention seeks to provide novel proprioceptive and kinesthetic
exercise apparatus, which provides significant advantages over prior art
apparatus, such
as tilt boards or shoes with a single protrusion. As is described more in
detail
hereinbelow, in one embodiment of the present invention, footwear is provided
that
includes two bulbous protrusions protruding from the underside thereof,
instead of the
single ball of the prior art boards and shoes. The extra protrusion may
significantly
increase the possibilities and enable walking, and accelerate and improve the
results of
proprioceptive and kinesthetic treatment plans. Other proprioceptive and
kinesthetic
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exercise devices are provided, such as novel treadmills, exercise surfaces,
exercise
bicycles, exercise steppers, slci machines or elliptic exercise machines, as
is described
more in detail hereinbelow.
The apparatus of the present invention may be used in proprioceptive,
neuromuscular control and coordinative exercises and training for children and
athletes
alike, for developing and improving proprioceptive and kinesthetic ability.
The invention
may be used to perform exercises and training to prevent injuries in athletes
and non-
athletes alike. The invention may be used to work on core stability for
stabilizing the back
and hips area, to prevent, stop or reduce back pain. The invention may be used
in
exercising and training persons who have had ankle, knee, hip and back
injuries in the
past (or other injuries) in order to prevent future recurrences of such
injuries. The
invention may be used in exercising and training persons with physical
handicaps (e.g.,
cerebral or neurological diseases or other disabilities). A user of the
exercise devices of
the invention may move in six degrees of freedom (translation in three
mutually
orthogonal directions (x, y, z) and rotation about these axes (azimuth,
elevation and roll)).
All of the exercises and training sessions involve causing instability to the
person while in
motion, particulaxly translational motion - walking, running or other
movement.
There is thus provided in accordance with an embodiment of the present
invention
an exercise apparatus comprising a foot-contact surface adapted to support a
user's foot
thereon, an actuator adapted to move the foot-contact surface during an
exercise plan, and
a bumping mechanism operative to disrupt a balance of a user on the foot-
contact surface.
In accordance with an embodiment of the present invention the bumping
mechanism is operative to move the user in six degrees of freedom, comprising
translation in three mutually orthogonal directions and rotation about these
axes.
There is also provided in accordance with an embodiment of the present
invention
a method comprising performing a proprioceptive exercise comprising overcoming
a
balance-disruptive force while moving in translational motion.
There is also provided in accordance with an embodiment of the present
invention
a method comprising performing an exercise on an exercise machine that is
initially
devoid of balance-disruptive forces, and deliberately applying a balance-
disruptive force
while exercise on the exercise machine.
BRIEF DESCRIPTION OF THE DRAWINGS
The present invention will be understood and appreciated more fully from the
following detailed description taken in conjunction with the appended drawings
in which:
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Fig. 1 is a simplified pictorial illustration of footwear constructed and
operative in
accordance with an embodiment of the present invention;
Figs. 2 and 3 are simplified side-view and rear-view illustrations,
respectively, of
the footwear of Fig. 1;
Fig. 4 is a simplified top-view illustration of the footwear of Fig. l,
showing
further features of other embodiments of the present invention;
Fig. 5 is a simplified pictorial illustration of a treadmill constructed and
operative
in accordance with an embodiment of the present invention;
Fig. 6 is a simplified pictorial illustration of an exercise surface
constructed and
operative in accordance with an embodiment of the present invention;
Fig. 7 is a simplified pictorial illustration of an exercise bicycle
constructed and
operative in accordance with an embodiment of the present invention;
Fig. 8 is a simplified pictorial illustration of an exercise stepper
constructed and
operative in accordance with an embodiment of the present invention;
Fig. 9 is a simplified pictorial illustration of a slci machine constructed
and
operative in accordance with an embodiment of the present invention;
Fig. 10 is a simplified pictorial illustration of an elliptic exercise machine
constructed and operative in accordance with an embodiment of the present
invention;
and
Fig. 11 is a simplified pictorial illustration of a rowing machine constructed
and
operative in accordance with an embodiment of the present invention.
DETAILED DESCRIPTION OF THE PRESENT INVENTION
Reference is now made to Figs. 1-4, which illustrate footwear 10 constructed
and
operative in accordance with an embodiment of the present invention. Footwear
10 may
be supplied as one or more pairs of shoe-like devices, or alternatively, as
just one of the
shoe-like devices.
Footwear 10 preferably comprises a support member 12 having a periphery in a
shape of a shoe sole with an upper surface 14. In the illustrated embodiment,
the upper
surface 14 is indented with a peripheral ridge 16, but it is appreciated that
other
configurations of upper surface 14 are within the scope of the invention.
Footwear 10 may
be attached to a foot of a user (not shown) by means of a boot 18 and/or
fasteners 20,
such as but not limited to, VELCRO straps, buckles, shoe laces, and the like.
Boot 18 may
be fashioned for attachment to the user's foot with or without fasteners 20.
Similarly,
fasteners 20 may be used to attach footwear 10 to the user's foot without boot
18.
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Two bulbous protuberances 22 may protrude from a lower surface 24 of support
member 12. Alternatively, bulbous protuberances 22 may protrude from the upper
surface
14 of support member 12. Each protuberance 22 may have a curved outer contour
26. The
cross-section of the contour 26, that is, either the cross-section taken with
respect to a
longitudinal axis 28 (Fig. 4) of support member 12 (corresponding to the shape
seen in
Fig. 2) or the cross-section taken with respect to a latitudinal axis 30 (Fig.
4) of support
member 12 (corresponding to the shape seen in Fig. 3), or any other cross-
section, may
have any curvilinear shape. For example, the contours 26 may have the shape of
a conic
section, that is, the shape of a circle, ellipse, parabola or hyperbola. The
various cross-
sections of the contours 26 of protuberance 22 may be shaped identically or
differently.
As seen clearly in Fig. 2, one protuberance 22 may be positioned more
posteriorly
than the other protuberance 22. As seen in Fig. 4, the protuberances may be
positioned on
a common longitudinal axis of support member 12, such as the centerline 28 of
support
member 12, and on opposite sides of the latitudinal midline 30. As seen in
Fig. 2, the
rearward protuberance 22 may be positioned generally underneath a calcaneus
(heel,
ankle) support portion 23 of support member 12, while the forward protuberance
22 may
be positioned generally underneath a metatarsals suppout portion 25 and/or
phalanges
support portion 27 of support member 12.
Alternatively, as indicated by broken lines 33 in Fig. 4, one of the
protuberances
22 (e.g., the forward one) may be aligned on a longitudinal axis 34 offset
from centerline
28, and the rearward protuberance 22 may be positioned offset from axis 34,
such as on
the centerline 28. It is appreciated that the above are just some examples of
positioning
the protuberances 22, and many other possibilities exist within the scope of
the invention.
The protuberances 22 may be constructed of any suitable material, such as but
not
limited to, elastomers or metal or a combination of materials, and may have
different
properties. For example, the protuberances may have different resilience or
hardness,
such as having different elasticity properties or Shore hardness. The
protuberances 22
may protrude by different amounts from the lower surface 24 of support member
12.
In accordance with an embodiment of the present invention, one or more
protuberances 22 may be slidingly mounted on support member 12. For example,
protuberance 22 may be moiulted on a track 36 (Fig. 2) formed in the lower
surface 24 of
support member 12, and may be selectively positioned anywhere along the track
and
fastened thereto. Track 36 may extend along a portion of the shoe sole or all
along the
length of the shoe sole. Alternatively or additionally, the amount of
protrusion of
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protuberance 22 may be adjusted, such as by mounting protuberance 22 with a
threaded
fastener 38 (Fig. 3) to support member 12 and tightening or releasing threaded
fastener
38.
In accordance with an embodiment of the present invention, in addition to the
bulbous protuberances 22, there further may be provided one or more non-
bulbous
protuberances 39, shown in Fig. 3. Protuberances 39 may be formed in the shape
of a peg,
stud, bolt, pin, dowel and the like, although the invention is not limited to
these shapes.
Protuberances 39 may be rigid or flexible. As with protuberances 22, the
protuberances
39 may have different resilience or hardness, such as having different
elasticity propeuties
or Shore hardness, .and they may protrude by different amounts from the lower
surface 24
of suppout member 12. As above, the amount of protrusion of protuberances 39
may be
adjusted. Protuberances 39 may be mounted at any place on the lower surface 24
of
support member 12.
The features described above, such as the protuberances 22 being slidingly
mounted on support member 12, may be implemented in the alternative embodiment
wherein the bulbous protuberances 22 protrude from the upper surface 14 of
support
member 12. For example, footwear 10 may have a normal outer sole and have a
sliding/shifting mechanism for the protuberances 22 inside the sole of
footwear 10. The
sliding/shifting mechanism may comprise, without limitation, a mechanism that
floats in a
viscous matrix (e.g., fluid in a chamber formed in the sole) or that is
suspended by inner
cables.
Reference is now made to Fig. 4. In accordance with an embodiment of the
present invention, footwear 10 may comprise a flange 40 that extends outwards
from the
periphery of support member 12. In the illustrated embodiment, flange 40
extends
sideways outwards from the periphery of support member 12, but it is
appreciated that
flange 40 may extend forwards or rearwards or in any other direction as well.
Flange 40
may be provided on one side of footwear 10, as illustrated, or may be provided
on both
sides. Flange 40 may supplement the range of proprioceptive exercises possible
with
footwear 10, by providing an additional support surface during tilting and
maneuvering
with footwear 10.
Flange 40 may be constructed of any suitable material, such as but not limited
to,
elastomers or metal or a combination of materials, and may have portions 42
with
different properties. For example, portions 42 may have different resilience
or hardness,
such as having different elasticity properties or Shore hardness. The portions
42 of flange
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40 may have differently curved contours. Flange 40 may be adjustably attached
to support
member 12 such that the amount that flange 40 extends from support member 12
is
adj ustable.
A user may attach footwear 10 to his/her foot and perform a variety of
maneuvers
in a proprioceptive and/or kinesthetic exercise plan for the lower foot, upper
leg and even
upper torso and other body parts and organs. For example, footwear 10 may be
used to
reestablish neuromuscular control during rehabilitation of joints, to restore
the mechanical
and functional stability of the neuromuscular system, to improve or
rehabilitate
anticipatory (feed-forward) and reflexive (feed-baclc) neuromuscular control
mechanism,
and to regain and improve balance, postural equilibrium and core stability.
Reference is now made to Fig. 5, which illustrates a treadmill 50 constructed
and
operative in accordance with an embodiment of the present invention.
Treadmill 50 may comprise a foot-contact rumzing surface 52 that rotates about
a
pair of spaced pulleys 54. Running surface 52 may comprise one or more
protuberances
56 protruding upwards from running surface 52. Protuberances 56 may be of
different or
similar configuration (e.g., height, size, shape and/or slope). Protuberances
56 may have a
fixed size/shape, or alternatively, may have a variable size/shape. The
variable size/shape
may be achieved by constructing protuberance 56 from an inflatable element,
which may
be inflated pneumatically with air or hydraulically with a liquid (e.g., water
or oil). A
controller 58 may be provided that controls inflation and deflation of
protuberances 56.
Protuberances 56 and/or rumling surface 52 may have different or similar
material
properties. For example, they may have different or similar resilience or
viscosity (in the
inflatable version) and may be made of different or similar materials.
Protuberances 56 may be movable. For example, one or more of the protuberances
56 may be translatable such as in a track 57 (e.g., forwards, backwards,
sideways or
diagonally) and/or rotatable about its own or other axis, or a combination of
such
motions. A protective strap (not shown) may be provided to maintain the user
in an
upright position and help prevent accidental falls.
Reference is now made to Fig. 6, which illustrates an exercise surface 60
constructed and operative in accordance with an embodiment of the present
invention.
Exercise surface 60 may comprise one or more protuberances 62 protruding
upwards
from the upper (foot-contacting) face and/or lower (floor-contacting) face of
exercise
surface 60. Protuberances 62 may be of different or similar configuration
(e.g., height,
size, shape and/or slope). Protuberances 62 may have a fixed size/shape, or
alternatively,
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may have a variable size/shape. The variable size/shape may be achieved by
constructing
protuberance 62 from an inflatable element, which may be inflated
pneumatically with air
or hydraulically with a liquid (e.g., water or oil). A controller 64 may be
provided that
controls inflation and deflation of protuberances 62. Protuberances 62 may
have different
or similar resilience or viscosity (in the inflatable version), and may be
made of different
or similar materials.
Protuberances 62 may be movable. For example, one or more of the protuberances
62 may be translatable such as in a track 66 (e.g., forwards, backwards,
sideways, radially
or diagonally) and/or rotatable about its own or other axis, or a combination
of such
motions. A user of the exercise surface 60 may thus move in six degrees of
freedom
(translating in three mutually orthogonal directions (x, y, z) and rotating
about these axes
(azimuth, elevation and roll)).
Reference is now made to Fig. 7, which illustrates a stationary exercise
bicycle 70
constructed and operative in accordance with an embodiment of the present
invention.
Exercise bicycle 70 may comprise apparatus with its own pedals, wheel and
sensors (e.g.,
speedometer, odometer, etc.) or may comprise an indoor bicycle trainer,
wherein a user
mounts a bicycle to a stand, which permits pedaling the bicycle while the
bicycle remains
stationary. Exercise bicycle 70 may comprise a bumping mechanism 72 corrected
to a
front axle 74 or rear support 75 of bicycle 70 and/or a bumping mechanism 76
connected
to a seat 78 of bicycle 70. The bumping mechanisms may oscillate, rock, bump
and
otherwise disrupt the balance of the user of the exercise bicycle 70 (as
indicated by
arrows in Fig. 7). The bumping mechanisms may move the rider in six degrees of
freedom (translation in three mutually orthogonal directions (x, y, z) and
rotation about
these axes (azimuth, elevation and roll)). The bumping mechanisms in this
embodiment,
as in other embodiments of the invention, may comprise a plate on which
exercise bicycle
70 is mounted, wherein the plate provides the bumping action in six degrees of
freedom.
Exercise bicycle 70 may be used to exercise the neuromuscular control in the
back, hip, pelvis, ankle, lcnee and other parts of the body by means of bumps
during
riding, which may simulate riding on bumpy roads. A controller 77 may be
provided to
control operation of bumping mechanism 72.
Reference is now made to Fig. 8, which illustrates an exercise stepper 80,
constructed and operative in accordance with an embodiment of the present
invention.
Exercise stepper 80 may comprise a controller 82 that varies the resistive
force offered by
pedals 84 of the stepper 80. Controller 82 may also vary the angle of the
pedals 84, such
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as to create eversion and inversion, as indicated by arrows in Fig. 8. Here
too, controller
82 may move the pedals 84 in six degrees of freedom (translation in three
mutually
orthogonal directions (x, y, z) and rotation about these axes (azimuth,
elevation and roll)).
Reference is now made to Fig. 9, which illustrates a slci machine 90,
constructed
and operative in accordance with an embodiment of the present invention. Slci
machine 90
may comprise a controller 92 that varies the resistive force offered by slci
platforms 94 of
the ski 90. Controller 92 may also vary the angle of ski platforms 94, such as
to create
eversion and inversion, as indicated by arrows in Fig. 9. Controller 92 may
move the slci
platforms 94 in six degrees of freedom (translation in three mutually
orthogonal
directions (x, y, z) and rotation about these axes (azimuth, elevation and
roll)).
Some exercise experts have noted several drawbacks to prior ai-t exercise
equipment. For example, stationary exercise bicycles may utilize only a
relatively small
number of muscles, throughout a fairly limited range of motion. Cross-country
skiing
devices may exercise more muscles than a stationary bicycle, however, the
substantially
flat shuffling foot motion of the device may limit the range of motion of some
of the
muscles being exercised. Stair climbing devices may exercise more muscles than
stationary bicycles, however, the limited range of up-and-down motion may not
exercise
the leg muscles through a large range of motion.
In response to these concerns, elliptic exercise machines have been developed
that
simulate natural walking and rumiing motions and exercise a large number of
muscles
through a large range of motion. The machines provide variable, flexibly
coordinated
elliptical motion of the leg muscles. An example of one of the many elliptic
exercise
machines in the prior art is described in US Patent 5,848,954.
Reference is now made to Fig. 10, which illustrates an elliptic exercise
machine
100, constructed and operative in accordance with an embodiment of the present
invention. Elliptic exercise machine 100 is shown for convenience with some
elements
similar to that of US Patent 5,848,954, but it is emphasized that the
invention is not
limited to this construction. In any case, the proprioceptive features of the
invention are
not found in US Patent 5,848,954 or any of the prior ai-t.
Elliptic exercise machine 100 may comprise a frame 102 and a linkage assembly
104 movably mounted on frame 102. Linkage assembly 104 may generally move
relative
to frame 102 in a manner that links rotation of a flywheel 106 to generally
elliptical
motion of a force receiving member or "skate" 108. Frame 102 may include a
base 110, a
forward stanchion or upright 112, and a rearward stanchion or upright 114.
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It is noted that the term "elliptical motion" is intended in a broad sense to
describe
a closed path of motion having a relatively longer first axis and a relatively
shorter second
axis (which extends perpendicular to the first axis). It is fiu ther noted
that in the
illustrated embodiment, there is left-right symmetry about a longitudinal
axis, and the
"right-hand" components are 180° out of phase relative to the "left-
hand" components.
However, like reference numerals are used to designate both the "right-hand"
and "left-
hand" parts on elliptic exercise machine 100, and when reference is made to
one or more
parts on only one side of the machine, it is to be understood that
corresponding parts) are
disposed on the opposite side of the machine.
The forward stanchion 112 may extend perpendicularly upward from base 110 and
support a telescoping tube or post 116. A pair of handles 118 may be pivotally
mounted to
post 116 at a pivot 119. Handles 118 may have gripping portions 120. A display
122 may
be disposed on post 116. Skates 108 may slide on rails 124. A user may place
his/her foot
on a foot-contacting surface 126 of slcate 108.
In accordance with an embodiment of the present invention, elliptic exercise
machine 100 may comprise one or more bumping mechanisms 130 connected to a
front
support 132 and/or a rear support 134 of rails 124. The bumping mechanisms 130
may
oscillate, rock, bump and otherwise disrupt the balance of the user of
elliptic exercise
machine 100. The bumping mechanisms 130 may move the user in six degrees of
freedom (translation in three mutually orthogonal directions (x, y, z) and
rotation about
these axes (azimuth, elevation and roll)). A controller 136 may be provided to
control
operation of bumping mechanism 130.
Reference is now made to Fig. 11, which illustrates a rowing machine 150,
constructed and operative in accordance with an embodiment of the present
invention.
Rowing machine 150 may comprise a rail 152 on which a seat 154 is slidingly
mounted.
Rail 152 may have a rear support 155. Rail 152 may extend from a forward-
mounted
tension drum 156, which may be mounted on a front support 157. A cord 158 may
be
wound around tension drum 156. Cord 158 may be provided with a handle 159.
Footrests
160 may be mounted on rail 152.
A user (not shown) may sit on seat 154, place feet against the footrests 160,
grasp
handle 159 and pull cord 158 towards the rear of rowing machine 150, outwards
from
tension drum 156. This motion simulates the action of pulling oars in a
rowboat. The seat
154 may slide back and forth on rail 152 during the rowing motion. Tension
drum 156
resists the pulling action on cord 158, thereby exercising muscles used in
rowing. The
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tension in tension drum 156 may be adjusted to suit the desired level of
exercise. A
controller 162 may be provided that varies the resistive force offered by
tension drum
156.
In accordance with an embodiment of the present invention, rowing machine 150
may comprise one or more bumping mechanisms 164 connected to front support 157
and/or rear support 155 of rail 152, or to seat 154. The bumping mechanisms
164 may
oscillate, rock, bump and otherwise disrupt the balance of the user of rowing
machine
150. The bumping mechanisms 164 may move the user in six degrees of freedom
(translation in three mutually orthogonal directions (x, y, z) and rotation
about these axes
(azimuth, elevation and roll)). Controller 162 may control operation of
bumping
mechanisms 164.
It will be appreciated by persons skilled in the art that the present
invention is not
limited by what has been particularly shown and described hereinabove. Rather
the scope
of the present invention includes both combinations and subcombinations of the
features
described hereinabove as well as modifications and variations thereof which
would occur
to a person of skill in the art upon reading the foregoing description and
which are not in
the prior art.
