Note : Les descriptions sont présentées dans la langue officielle dans laquelle elles ont été soumises.
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Vibration Unit for Musculoskeletal Vibration System for Jointed Limbs
STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR
DEVELOPMENT
CROSS REFERENCE TO RELATED APPLICATION
[0001] This international application claims the benefit of U.S.
Provisional Patent
Application Ser. No. 61/443,037 filed on February 15, 2011.
BACKGROUND OF THE INVENTION
[0002] The present invention relates to a musculoskeletal loading system
for stimulating
bone and muscle tissue.
[0003] Musculoskeletal tissues atrophy rapidly during periods of disuse,
for example,
during hospital stays or periods of prolonged bed rest. U.S. patents
7,662,115, and U.S. patent
application 2010/0222722 describe devices for mechanically stimulating bone or
muscle and
suitable for use with bedridden patients, specifically those who cannot stand
on a vibrating
platform of the type conventionally used for such stimulation. These patents
describe a harness
system that pulls a vibrating platform against the sole of the foot as braced
by restraining
couplings attached at the knees and, optionally, also at the hips. This latter
embodiment
permits beneficial therapy to be applied to different segments of the jointed
limb.
SUMMARY OF THE INVENTION
[0004] The present invention includes a vibration unit that may be used for
stimulating
bone and muscle tissue and that may provide independent adjustability of
vibration
characteristics such as frequency and amplitude. The vibration unit may
provide a first motor
that rotates an eccentric and can adjust vibration frequency and a second
motor that that may
move the eccentric within the vibration unit in a manner that adjusts
amplitude of the vibration.
[0005] It is thus an object of the invention to allow for delivery of
highly adjustable
vibration stimulus for treating patients.
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[0006] Specifically then, the present invention provides a system having a
vibration unit
that may include a shaft positioned for rotation about an axis and having an
eccentric portion
arranged for rotation along an eccentric path about the axis. A motor may
rotate the shaft so that
varying the rotational speed of the motor may varying a frequency of a
vibration produced by the
vibration unit. A follower may be provided that is movable with respect to the
axis to move the
eccentric portion to different locations within the apparatus. A coupler may
be reciprocally
driven by the eccentric portion to produce a vibration having an amplitude
that corresponds to
the position(s) of the follower within the apparatus to allow variability of
the amplitude.
[0007] Thus, it is an object of the invention to provide a vibration unit
that may produce a
vibration having independently adjustable frequency and amplitude.
[0008] In a further embodiment, an eccentric may include an angled shaft
and a bearing
that is mounted upon the shaft and that can move axially along the angled
shaft to adjust how
near the bearing is to an axis of rotation of the eccentric. This may allow
the bearing to be
moved axially along the angled shaft so as to adjust an amplitude of a
vibration being produced
by the vibration unit.
[0009] It is thus an object of the invention to provide a system that may
allow for
mechanical adjustment of vibration amplitude.
[0010] In a further embodiment, an eccentric wheel may be mounted off
center upon an
output shaft of a motor. The eccentric wheel may engage and directly drive a
patient support
into vibrating reciprocation or may engage an intervening pivot arm that
drives a patient
support into vibrating reciprocation. Moving the engagement location of the
eccentric wheel
and patient support or pivot arm may provide variation in the amplitude of
vibration.
[0011] It is thus an object of the invention to provide as system having a
vibration unit that
allows for controlling amplitude of vibration independently of frequency of
vibration with
relatively few components can be made with simple machining and assembly
procedures.
[0012] These particular objects and advantages may apply to only some
embodiments
falling within the claims and thus do not define the scope of the invention.
BRIEF DESCRIPTION OF THE DRAWINGS
[0013] Fig. 1 is a fragmentary, side elevation of view in phantom of a
patient positioned on
one embodiment of a system of the invention for musculoskeletal stimulation of
the lower leg;
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[0014] Fig. 2 is a simplified linkage diagram representing the leg of Fig.
1 and showing
forces applied by a tension strap and a knee restraint;
[0015] Fig. 3 is a perspective view of the first embodiment of a hip
support suitable for use
with the apparatus of Fig. 1 for applying loading between the patient's feet
and hip;
[0016] Fig. 4 is a figure similar to that of Fig. 3 showing an alternative
to the hip support of
Fig. 3 for applying loading between patient's feet and hip and shoulders;
[0017] Fig. 5 is a simplified top plan view of a mechanism providing force-
equalizing
support for foot platforms used in the embodiment of Fig. 1;
[0018] Fig. 6a is a fragmentary, side elevation of view in phantom of a
patient positioned
on another embodiment of a system the invention for musculoskeletal
stimulation of the lower
leg;
[0019] Fig. 6b is a variant of the system of Fig. 6a;
[0020] Fig. 7 is a figure similar to that of Fig. 2 showing operation of
the present invention
for applying vibration under tension during passive or exertive motion;
[0021] Fig. 8 is a simplified diagram of one embodiment of a vibration
mechanism suitable
for providing vibration to the foot support of Fig. 1 providing an adjustable
eccentric
mechanism;
[0022] Fig. 9a and 9b are diagrams showing two positions of the eccentric
mechanism of
Fig 7 for providing different amplitude and frequency of vibration;
[0023] Fig. 10 is a simplified diagram of another embodiment of a vibration
mechanism
suitable for providing vibration to the foot support of Fig. 1;
[0024] Fig. 11 is a simplified diagram of yet another embodiment of a
vibration mechanism
suitable for providing vibration to the foot support of Fig. 1;
[0025] Fig. 12 is a variant of the vibration mechanism of Fig. 10; and
[0026] Fig. 13 is a flowchart showing one use of the system.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT
Patient Support
[0027] Referring now to Fig. 1, in one embodiment, a system 10 provides
vibration through
the legs of a supine patient 11 lying on a horizontal planar surface of a
table 14 such as an
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examination table or the like. The vibration passes along superior-inferior
axis 12 from the
patient's foot to the patient's hip.
[0028] The vibration is supplied by a vibrator apparatus shown as a
vibration unit 16
positioned at one end of the table 14 supported on a linear track 18, the
linear track 18 allowing
the vibration unit 16 to be moved along axis 12 to different locations to
accommodate different
patients. A front surface of the vibration unit 16 facing the patient 11
supports foot support 20
for receiving the patient's feet at a height slightly elevated above the table
14 so that a lower leg
22 of the patient is essentially horizontal. The foot support 20 may be a
coupler that provides a
first support or attachment point between the patient 11, such as a proximal
end of a limb to
receive vibration, and the system 10. The foot support 20 may be adapted to
conduct vibrations
from the vibration unit 16 to the patient 11. The foot support 20 may have
vertical portions
abutting the soles of the patient's feet and attached to a vibrating arm 21 of
the vibration unit
16. In this way, the vibration unit 16 may provide vibrations that are
transmitted in a vibration
transmission direction that may face a direction extending away from the
vertical portions of
the foot support 20 and generally parallel to a longitudinal axis of the
vibrating arm 21 and/or
the superior-inferior axis 12. The foot support 20 may further include a
horizontal shelf
extending from a lower edge of the vertical portions providing a support for
the patient's heel
from below.
[0029] A joint restraint may limit out-of-axis movement of a joint that is
provided between
the proximal and distal ends of the patient's limb being treated. In one
embodiment, the
patient's knee may be restrained against movement along the direction
perpendicular to the axis
12 by a padded support cushion 24 beneath the knee (as held on the linear
track 18) and an
upper padded restraint 26 communicating by straps 28 to the linear track 18.
Accordingly, the
knee may be restrained in a manner that prevents hip flexion or hip extension
so that an end of
the upper leg 30 that connects to the knee is maintained at a constant height
or position. This
restraint allows some axial motion but largely prevents upward or downward
motion of the
knee. In this regard, the padded restraint 26 may locate the knee in an axial
alignment position
in which an axis of rotation of the knee, about which the knee flexes and
extends, faces a first
direction and the restraint 26 may limit movements of the knee outside of this
axial alignment
position and thus upwardly or downwardly away from the vibration transmission
direction.
The padded restraint 26 may be provided to the knee so as to allow natural
compressive
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interaction between the bones of the lower leg 22 and of the upper leg 30. It
will be appreciated
that in an alternative embodiment, the padded support cushion 24 may be
attached directly to
the table 14.
[0030] Still referring to Fig. 1, the patient's hips may be supported on a
back support 32 that
may provide a second support or attachment point between the patient 11, such
as a distal end
of a limb to receive vibration, and the system 10. The back support 32 may be
attached directly
to the table 14 and adjustment of the linear track 18 may be used move the
vibration unit 16 and
accommodate patients with different leg length. The patient's hips may be
restrained by the
back support 32 with respect to the table 14 simply by friction and the weight
of the patient or
by an auxiliary padded belt 34 pulling the patient 11 against the back support
32. The back
support 32 may include wings 33 extending upward about the hips further
restraining motion of
the patient's hips.
[0031] Referring also to Fig. 2, generally, the location of the hips will
be slightly below that
of the knee so that the bones of the upper leg 30 and lower leg 22 are
slightly angled.
[0032] Referring again to Fig. 1, a tension member 36, for example, a cable
or strap, may
attach at one end to the vibration unit 16 (or any point on the movable
surface of the linear
track 18) and at the other end to a point fixed with respect to the patient's
hips, for example, the
wings 33 of the back support 32 (if they are sufficiently stiff) or the table
14. The tension
member 36 may be used to provide a predetermined compression preload to the
patient's legs
by biasing and thus moving the vibration unit 16 toward the back support 32,
the supports that
engage opposing ends of the leg and generally face toward each other, so as to
reduce the
distance therebetween and define a direction of compression along which the
vibration unit 16
may move. Notably, this preload or compression passes through the joint of the
knee and is not
simply across the bones of the upper leg 30 and lower leg 22. The amount(s) of
compression or
preload which may be stored in the memory of a controller 80 (Figs. 8 and 10)
or which may be
set using a console 82 (Figs. 8 and 10) is described in greater detail
elsewhere herein.
[0033] By slight angulation of the patient's leg, as shown in Fig. 2,
tension on the tension
member 36 is translated to a compression on the leg, with flexure of the leg
(such as would
lessen the vibration to the upper leg) prevented by out-of-axis restraint of
the knee indicated by
force arrow 38. The preload compression may be achieved by the tension member
36 biasing
and thus moving the complete vibration unit 16 toward the back support 32.
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[0034] This force can be provided without the need for a tight restraint on
the knee, for
example, without using collars on the knee of the type that would support
individual tension
members between the knee and foot and between the knee and hip. It will be
understood that
this support of the joint permits vibration imparted to the foot of the
patient to be transferred
through lower leg 22 and the intervening knee joint to the upper leg 30.
[0035] The tension member 36 may include a spring scale, load cell, or
other measuring
device to provide an indication of the tension and thus to permit a
predetermined preloading of
compression on the patient's leg with the vibration unit 16 freely movable
with low friction on
the linear track 18. An adjustment mechanism, such as a lead screw, for
shortening or
lengthening the tension member 36 may be used for this purpose. Alternatively,
the linear track
18 may be locked against movement, and the compression on the leg may be
adjusted by
changing the relative position between the foot support 20 and the vibration
unit 16 using, for
example, a knob 40 attached to a lead screw or the like joining the vibration
unit 16 and the foot
support 20.
[0036] The vibration unit 16 may provide for predetermined amplitude of
vibration in a
range of frequencies, for example, as taught by US patent 7,662,115.
Alternatively, a vibration
unit 16 providing controlled amplitude may also be used as will be described
below.
[0037] Referring now to Fig. 3, the back support 32 may provide a semi-
rigid molded
contoured back 44 having an upper padded surface and fitting beneath the
patient's hips and
padded wing 33 curving up and around the patient's abdomen. The tension
members 36 may be
attached to the rigid portion of the back 44 or to the wings.
[0038] Alternatively, as shown in Fig. 4, in yet another embodiment, a belt
51 fitting
around the patient's hips and/or suspenders 53 fitting over the patient's
shoulders may be used
to provide a termination point for the tension members 36 transmitting this
force to the patient's
hips and shoulders and permitting, in the latter case, vibration to pass into
the compressively
preloaded patient's lumbar spine. A variety of different restraints are
contemplated according
to the attached materials.
[0039] Referring now to Fig. 5, the foot support may include a pair of foot
platforms 20a,
20b and the vibration unit 16 may attach to the foot platforms 20a and 20b for
the patient's left
and right foot respectively as positioned at either end of a horizontally
extending lever 50. The
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lever 50 is attached at fulcrum point 52 to the vibrating arm 21 of the
vibration unit 16
providing the desired vibration. The fulcrum point 52 allows equalization of
forces 60 from the
vibration unit 16 to the feet by pivoting in the manner of the balance. Each
of the foot
platforms 20a and 20b may likewise be attached to ends of the lever 50 by
pivot points 62 to
provide equalization of forces across the foot despite angulation of the
ankle.
[0040] Referring now to Fig. 6a, in this embodiment, system 10 is largely
the same as that
of Fig. 1, whereby such description need not be repeated here. One difference
between the
systems of Fig. 6 and Fig. 1 is that the system 10 of Fig. 6 provides
vibration through the legs
of a patient 11 who is in a seated position instead of a patient 11 who is
lying down as in Fig. 1.
System 10 of Fig. 6 includes a frame 15 that has a vibration unit support 17
and a seat support
19. The vibration unit support 17 has interconnected pieces of tubing,
including spaced-apart
upright pieces of tubing that are connected at their upper ends by
horizontally extending pieces
of tubing. The horizontally extending pieces of tubing of the vibration unit
support 17 provide
the linear track 18 allowing the vibration unit 16 to be moved longitudinally
with respect to the
frame 15 to accommodate different patients and to facilitate compression
preload to the
patient's legs.
[0041] Still referring to Fig. 6a, the vibration unit 16 may be placed into
longitudinal
movement along the frame 15 by a tension element that provides a linear
actuator-type position
drive 37 that can include an electric motor that rotates a gear which engages
a fixed toothed
rack (not shown) or rotates a nut upon a lead screw (not shown) or the like to
create the
movement of the vibration unit 16. Like the previously discussed tension
member 36, the
position drive 37 may include or cooperate with a spring scale, load cell, or
other measuring
device to provide an indication of the tension and thus to permit a
predetermined preloading of
compression on the patient's leg(s) with the vibration unit 16 freely movable
with low friction
on the linear track 18. The position drive 37 may be operably connected to the
control unit 80
and console 82 (Figs. 8 and 10) for establishing the amount of compression
preload for legs of a
particular patient.
[0042] Still referring to Fig. 6a, the seat support 19 includes a forward
provided upright
piece(s) of tubing to which a front portion of a seat assembly 23 is pivotally
coupled in a
manner that allows a rear portion of the seat assembly 23 to move up and down.
The seat
assembly 23 includes a lower seat surface 25 that may be substantially aligned
with and thus
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provided at about the same height as the foot support 20, which may allow the
feet and hips of
the seated patent 11 to be substantially aligned at the same height. The lower
seat surface 25
supports the seated patient 11 from below and a back rest 27 that supports a
back of the patient
11 from behind. The back rest 27 may be movable in a longitudinal direction
with respect to
the lower seat surface 25 to accommodate different sized patients 11. In this
embodiment, the
padded restraint 26 is aligned with a front portion of the lower seat surface
25 and is height
adjustable to accommodate patients 11 having upper legs 30 of different
thicknesses while
providing an upper boundary to restrict out-of-axis movement of the knee(s) of
the patient 11.
Such height adjustability of the padded restraint 26 may be provided by a pin
that may insert
through one of multiple vertically spaced holes in a post to which the padded
restrain 26 is
mounted and a hole in a collar that is mounted to the upright tubing piece at
the front of the seat
support 19 and in which the padded restraint post is slidingly held.
Optionally, a pair of collars
that can receive the padded restraint post may be provided at opposing sides
of the seat support
19 so that the padded restraint 26 may be reversibly mounted to either side of
the seat support
19 and the patient may enter the seat assembly through a gap that is defined
between the
padded restraint 26 and lower seat surface 25 at the other side of the seat
support 19.
[0043]
Still referring to Fig. 6a, a manual or automated actuator, shown as an
actuator 31,
supports a back portion of the seat support 19 that is opposite the front
pivot attachment. The
actuator 31 may include a linear actuator such as a hydraulic or pneumatic
cylinder, electrically
actuated lead screw, or the like. The actuator 31 may be actuated to a fully
extended position
that presents the lower seat surface 25 generally parallel to the ground which
may facilitate the
patient 11 entering the seat assembly 23 for treatment in the system 10. The
actuator 31 may be
actuated to a fully retracted position that presents the lower seat surface 25
in an angled
position in which the back portion is relatively closer to the ground than the
front hinged
portion. Moving the actuator 31 between the extended and retracted positions
during use of the
vibration unit 16 allows passive motion to be imparted to the knee joint and
thus relative
movements between the lower and upper legs 22, 30 without requiring effort of
the patient 11.
This may provide an arcuate movement path of a rearward portion of the seat
assembly 23 so as
to flex and extend the knee of the patient 11 while the distance between a
forward portion of the
seat assembly 23 and the restraint 26 remains substantially constant, so that
the knee remains
restricted against upward or downward motion along a vertical axis. The
actuator 31 may
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communicate with and be controlled by the controller 80 so as to establish a
pattern of cyclical
passive motion to the patient 11 during use of the system 10.
[0044] Fig. 6b shows a variant of the system 10 of Fig. 6a. In this
embodiment, the
vibration support 17 and/or the seat support 19 are moveable toward each
other. This may be
provided by arranging the track 18 longitudinally between the vibration
support 17 and the seat
support and mounting one or both of the vibration support 17 and/or the seat
support 19 to the
movable portions of the track 18. Like that described with respect to Fig. 6a,
the system 10 of
Fig. 6b may include a tension element that provides a linear actuator-type
position drive that
may be controlled by the control unit 80 and which may create the linear
motion of the
vibration support 17 and/or seat support 19. Such tension element may include
or cooperate
with a spring scale, load cell, or other measuring device to provide an
indication of the tension
and thus to permit a predetermined preloading of compression on the patient's
leg(s) with the
vibration unit 16 so as to establish the amount of compression preload for
legs of a particular
patient. The padded restraint 26 of this embodiment has two segments that are
spaced from
each other and may be arranged to engage above and below a user's knee(s). The
vibration
support 17 may provide a hinge or other pivot joint to support the vibration
unit 16 while
allowing the vibration unit 16 to pivot about a horizontally extending axis.
This may allow for
manual flexing and extending of a user's ankle joints by an attendant of the
system 10 or an
actuator (not shown) may be provided within the vibration unit 16 and
controlled by the control
unit 80 so as to provide oscillating pivotal movements of the vibration unit.
Such actuator may
be provided external of the vibration unit 16 for providing its pivotal
movements, similar to the
actuator 31 shown in Fig. 6a, only engaging and pushing into oscillation the
vibration unit 16 in
lieu of or in addition to the seat assembly 23 for embodiments having multiple
actuators 31.
[0045] Referring now to Fig. 7, the ability to impart vibration along the
entire length of the
jointed limb of a patient with only out-of-axis restraint of the joint permits
the present invention
to be used to apply vibration to a limb during exercise or movement of the
limb, for example, in
a passive motion machine of a type known in the art, optionally, by
controlling the actuator 31
to impart movement of the seat support 19 as shown in Fig. 6. In such a
system, the length of
the tension member 36 (Fig. 1) or position drive 37 (Fig. 6) may be optionally
adjusted by the
controller 80 with motion of the limb to ensure a predetermined preload on the
limb as the limb
is moved.
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Vibration Unit
[0046] Referring now to Figs. 8, 10, and 11, in one embodiment, a vibration
unit 16 suitable
for use with the present invention may provide both of independently
controllable frequency of
vibration and controllable amplitude of vibration and thus variable and
controlled displacement
of the foot support 20. It will be appreciated that control may be
alternatively expressed as
independently controllable frequency and force, independently controllable
force and
amplitude, independently controlled frequency and displacement, independently
controlled
frequency and acceleration, or the like, each being simple mathematical
transformations of the
others.
[0047] Referring now to Fig. 8, in one embodiment, the vibration unit 16
may provide for
an eccentric 70 rotating about an axis 72, generally perpendicular to axis 12,
along which
vibration will be transmitted. The eccentric shaft 70 may have two cylindrical
bearing surfaces
74 and 76 aligned along axis 72 and supported by axially aligned bearings 77
for rotation by a
first motor 78. The motor 78 may have speed control provided by a control unit
80 (Figs. 8 and
10), of the type known in the art. The bearing surface 76 may include a stub
shaft that extends
toward the motor 78 and which may include splines that engage a
correspondingly splined
coupler at an end of the output shaft of the motor 78.
[0048] Still referring to Fig. 8, the control unit 80 (Figs. 8 and 10) may
include one or more
processors and one or more memory mediums that have program instructions that
are
executable by the one or more processors for monitoring operational
characteristics of and
correspondingly controlling the various components of the system 10 to provide
the operations
described herein. For example, the control unit 80 may monitor and control the
tension
member 36 and/or the position drive 37 to provide the preloading force to the
tissues of the
patient 11 being treated, monitor and control the motor 78 to establish or
vary a frequency of
vibration and, as described in greater detail elsewhere herein, monitor and
control the motor 96
to establish or vary an amplitude of vibration. The control unit 80 may be
operably connected
to a user console 82 that includes a user interface such as a display and
buttons inputting and
setting the operational parameters of the system 10 so as to allow
manipulation of the
preloading, frequency and amplitude of vibration, joint angle within a series
of body tissues of
the patient being treated, and passive movement characteristics of the
joint(s) within a series of
body tissues of the patient being treated, as will be described.
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[0049] Still referring to Fig. 8, the bearing surfaces 74 and 76 as so
arranged are joined by a
diagonal shaft 84 passing from an inner face of one of the bearing surfaces 74
near its periphery
to the opposed inner face of the second of the bearing surfaces 76, at a point
near but offset
from its axial center. This diagonal shaft 84 may have a generally circular
cross-section to be
received within an angled bore of a bearing 86 which may be a ball bearing, a
plane bearing, or
other structure having a bearing surface, that may define an eccentric portion
of the eccentric 70
and which is shown in the first position 89a and the second position 89b. The
diagonal shaft 84
and bearing 86 may be provided with corresponding engagement structures such a
splines, keys
and keyways, optionally non-circular cross sections, which lock the bearing 86
into rotational
unison with the diagonal shaft 84 while permitting the bearing to move in a
longitudinal
direction along the shaft between the potion 89a and 89b. At either position
89a or 89b
representing the extremes of motion of the bearing 86 along the shaft 84, an
outer periphery of
the bearing 86 may contact a pusher plate 90 communicating with the vibrating
arm 21
movable along axis 12 to impart motion to the vibrating arm 21. In this way,
as the diagonal
shaft 84 rotates, since the bearing 86 is radially spaced from the axis 72,
the bearing 86
cyclically advances toward and regresses from the pusher plate 90 to impart a
reciprocating
motion to the pusher plate 90 as the pusher plate 90 follows the position of
the bearing 86
relative to the axis 72.
[0050] Still referring to Fig. 8, the bearing 86 is shown in its top-center
position in which
the pusher plate 90 and vibrating arm 21 are pushed furthest away from the
axis 72. When the
diagonal shaft 84 is rotated 180 degrees from the position shown in Fig. 8,
bearing 86 would be
in its bottom-center position in which the pusher plate 90 and vibrating arm
21 would be closest
to the axis 72. A position of the bearing 86 axially upon the shaft 84
determines the amplitude
of the vibration established by the vibration unit 16.
[0051] Referring now to Figs. 8 and 9a, it will be appreciated that when
the bearing 86 is
closest to the bearing surface 74 at position 89a, it will be supported on a
portion of the shaft 84
that is most eccentric with respect to the rotation axis 72 to produce a high
amplitude of
vibration 87 (shown in Fig. 9a) on the pusher plate 90 and hence the vibrating
arm 21.
[0052] Referring now to Figs. 8 and 9b, when the bearing 86 is at position
89b closest to
the bearing surface 76, the bearing 86 will be supported on a portion of the
shaft 84 that is least
eccentric with respect to the rotation axis 72 to produce a low amplitude of
vibration 87 (shown
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in Fig. 9b). Accordingly, by movement of the bearing 86 along axis 72
different amplitudes of
vibration of the same frequency (independently determined by the rotational
speed of the motor
78) may be obtained. This repositioning of bearing 86 may be provided by a
positioner that is
movable within the vibration unit 16 such as a fork 92 that has tines flanking
opposite sides or
end surfaces of a periphery of the bearing 86. The fork 92 may move the
bearing 86 to align
with different portions of a lower surface of the pusher plate 90 by using a
linear actuator which
may include a lead screw 94 to translate the fork 92 by a second motor 96,
also controllable by
the control unit 80.
[0053] Control of the motor 96 may thus be used to adjust the position of
the bearing 86
upon the shaft 84 and thus the amplitude of the vibration independent of its
frequency and
control of the motor 78 may be used to adjust the frequency of vibration
independent of its
amplitude. Control of motor 96 may thus also be used to adjust the position of
the bearing 86
independent of the amount of preload force being applied by the tension member
36 (Fig.1) or
position drive 37 (Fig. 6).
[0054] Still referring to Fig. 8, the vibrating arm 21 may have an attached
sensor 100 that is
operably coupled to the control unit 80 and which may be, for example, a
strain gauge detecting
force on the vibrating arm 21 or an accelerometer or the like so as to provide
for feedback
control of amplitude or velocity according to a control variable of force
acceleration or the like
by way of the control unit 80. The sensor 100 may be used by the control unit
80 to determine
the value of the preload being applied to the patient 11 instead of a separate
spring scale, load
cell, or other measuring device at the tension member 36 (Fig. 1) and/or the
position drive 37
(Fig. 6).
[0055] Referring now to Fig. 10, in a second embodiment the vibration unit
16 of this
embodiment may also use the control unit 80 to control the motor 78 to vary
the frequency of
vibration and control the motor 96 to vary the amplitude of the vibration
independently of each
other. In this case, the positioner may be incorporated into or defined by the
eccentric 70 itself,
for moving the entire eccentric 70 within the vibration unit 16. In this
embodiment, the motors
78 and 96 that may be joined to move together. Movement of both motors 78 and
96 and thus
the entire eccentric 70 within the vibration unit 16 may allow for varying the
amplitude of
vibration, explained in greater detail below.
[0056] Still referring to Fig. 10, the eccentric 70 may include an
eccentric wheel 71 that
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defines the eccentric portion of the eccentric 70 and that may have a round
perimeter shape and
mounted off-center upon an output shaft of the motor 78. An outer
circumferential surface of
the eccentric wheel 71 engages a surface of a pivot arm 91 that faces the
eccentric wheel 71.
The pivot arm 91 includes an outer end 93 that is pivot mounted to a bracket
95 which is fixed
to a housing of the vibration unit 16 to define a hinge joint 97. An opposing
inner end 99 of the
pivot arm 91 may be provided relatively nearer a centerline of the vibration
unit 16 and may
pivot about the hinge joint 97 so as to move along an arcuate travel path. As
the eccentric
wheel 71 rotates as driven by the motor 78, the pivot arm inner end 99 is
cyclically displaced
outwardly by the eccentric wheel 71 as the portion of the outer
circumferential surface of the
eccentric wheel 71 that is radially spaced furthest from the axis of rotation
of the motor 78
slides across the surface of the pivot arm 91. The pivot arm 91 cyclically
returns to its resting
state when the portion of the outer circumferential surface of the eccentric
wheel 71 that is
radially spaced closest to the axis of rotation of the motor 78 slides across
the surface of the
pivot arm 91. In this way, rotation of the eccentric wheel 71 forces the pivot
arm inner end 99
to oscillate in an arcuate back and forth movement. The pivot arm inner end 99
is pivot
connected to the end of the vibrating arm 21 so that the arcuate back and
forth movement of the
pivot arm inner end 99 is translated into a substantially linear reciprocating
movement of the
foot support 20. In this way, the pivot arm 91 may act as a third class lever
having its fulcrum
defined at the hinge joint 97, the load being defined by the vibrating arm 21
and foot support
20, and the effort force being applied by the eccentric wheel 71.
[0057] Still referring to Fig. 10, moving the entire eccentric 70 and thus
the assemblage of
the motors 78, 96 longitudinally with respect to the pivot arm 91 allows the
placement of the
effort force delivered by the eccentric wheel 71 to be varied along the length
of the pivot arm
91. This allows for varying the amplitude of vibration and thus displacement
of the vibrating
arm 21 and foot support 20, independent of frequency of vibration or
preloading of the tissues
being treated. The eccentric wheel 71 may displace the portion of the pivot
arm 91 that it
engages by a predetermined distance maximum difference that corresponds to the
radial
spacing between the axis of rotation of the output shaft of motor 78 and the
portion of the outer
circumferential surface of the eccentric wheel 71 that is spaced furthest from
such axis of
rotation.
[0058] Still referring to Fig. 10, when the eccentric wheel 71 drives a
portion of the pivot
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arm 91 that is relatively further from the hinge joint 97, such as shown in
Fig. 10 by the
eccentric 70 drawn in solid lines, the pivot arm inner end 99 and foot support
20 are displaced a
relatively smaller distance(s) and, thus, smaller amplitude(s) of vibration
are provided as
represented by the solid-line arrow immediately to the right of the pivot arm
inner end 99. The
eccentric 70 drawn in solid lines in Fig. 10 may provide the low amplitude of
vibration 87
shown in Fig. 9b. When the eccentric wheel 71 drives a portion of the pivot
arm 91 that is
relatively nearer to the hinge joint 97, such as shown in Fig. 10 by the
eccentric 70 drawn in
dashed lines, the pivot arm inner end 99 and foot support 20 are displaced a
relatively greater
distance(s) and thus larger amplitude(s) of vibration are provided as
represented by the dashed-
line arrow to the right of the solid-line arrow adjacent the pivot arm inner
end 99. The
eccentric 70 drawn in dashed lines in Fig. 10 may provide the high amplitude
of vibration 87
shown in Fig. 9a.
[0059] Still referring to Fig. 10, varying of the engagement location of
the eccentric wheel
71 upon the pivot arm 91 may be achieved by providing a nut that translates in
unison with and
is driven into rotation by the motor 96. The nut may be held in a common
housing with the
output shaft of the motor 96 and may be directly driven by the output shaft or
by way of an
intervening gear-train. Rotating the nut engages the threads upon the lead
screw 94 which is
fixed against rotation so as to advance or regress the eccentric 70 along the
length of the lead
screw 94, depending on the direction of rotation of the nut. Optionally, the
lead screw 94
translates in unison with and is rotated by the motor 96 and the nut is fixed
against rotation so
that rotating the lead screw 94 by the motor 96 provides the movement of the
eccentric 70
along the length of the pivot arm 91.
[0060] Referring now to Fig. 11, the vibration unit 16 is largely the same
as that of Fig. 10,
whereby such description need not be repeated here. One difference between the
vibration
units 16 of Figs. 10 and 11 is that the vibration unit 16 of Fig. 11 does not
utilize a pivot arm
91. Instead, the eccentric wheel 71 engages a surface of the foot support 20
itself. The hinge
joint 97 is defined by a lobe that extends from a corner of the orthogonally
intersecting
segments of the foot support 20 which is pivotally attached to the bracket 95
that is fixed to a
housing of the vibration unit 16. In this embodiment, the eccentric 70 is
shown as driving an
upright segment of the foot support 20, although the eccentric 70 may drive
the lower generally
horizontal segment of the support in a variant of this embodiment. The
eccentric 70 drawn in
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solid lines in Fig. 11 may provide the low amplitude of vibration 87 shown in
Fig. 9b since it
actuates the foot support 20 at a location that is furthest from the pivot
axis of foot support 20
defined at the hinge joint 97. The eccentric 70 drawn in dashed lines in Fig.
11 may provide
the high amplitude of vibration 87 shown in Fig. 9a since it actuates the foot
support 20 at a
location that is nearest to the pivot axis of foot support 20 defined at the
hinge joint 97.
[0061] Fig. 12 shows a variant of the vibration unit 16 of Fig. 10. In this
embodiment,
instead of engaging an outer surface of the pivot arm 91, the eccentric wheel
71 is houses
within a slot 98 that extends in a longitudinal direction along the pivot arm
91. In this
arrangement, the positioner may be defined by the lead screw 94 that can be
rotated to move the
eccentric wheel 71 along the length of the slot 98. As with other embodiments
of the eccentric
wheel 71, the eccentric wheel 71 may include a plane bearing that is
concentrically mounted to
the main body of the eccentric wheel 71 and which provides the interface
between the eccentric
wheel 71 and the slot 98. In this embodiment, instead of the eccentric wheel
71 being mounted
off-set directly upon the motor output shaft (as is shown in Figs. 10 and 11),
an intermediate
crank arm interconnects the motor output shaft and the eccentric wheel 71. The
rotation of the
lead screw 94 may be automated, for example rotated by motor 96 (Figs. 10 and
11) in
communication with the control unit 80 or the lead screw 94 may be manually
rotated. For
example, a handle or knob may be connected to an end of the lead screw 94 that
is further from
the motor 78 and which may be provided outside of an enclosure of the
vibration unit 16 to
permit manipulation by a user.
[0062] Although embodiments of the vibration unit 16 have been described as
providing a
single eccentric 70 that delivers vibration through a single support 20, which
may include a pair
of platforms 20a, 20b, which may provide synchronous bilateral limb loading
and vibration
stimulation. However, it is understood that in some embodiments, the vibration
unit 16
includes a separate eccentric 70 for each of the platforms 20a, 20b of the
support 20 and which
are independently controlled by the control unit 80 so as to provide
asynchronous loading and
vibration stimulation. Optionally, alternate loading of a pair of limbs may be
achieved by
arranging the pivot 97 centrally with respect to the support 20 and arranging
the eccentric 70 so
as to drive one end of the support to impart a back and forth teetering of the
support 20 about
the pivot 97.
[0063] Referring now to Fig. 13, one suitable technique for using system 10
may include
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having the patient 11 enter the system and be positioned on the table 14 (Fig.
1) or seat
assembly 23 (Fig. 6) and be restrained corresponding to the top two boxes in
Fig. 13. During
restraint, a joint within a limb that is supported at opposing ends may be
restrained against out
of axis movement. When upper and lower leg segments are being are supported at
the patient's
hip and foot, the knee may be restrained in a manner that restricts hip
flexion and hip extension
of the upper leg so that upward and downward movement of the knee is
correspondingly
restricted. Compressive loading or a preload is applied in a generally axial
or longitudinal
direction with respect to the limb and stimulation may be applied to at least
one of the end of
the limb, corresponding to the third and fourth boxes from the top in Fig. 13.
The stimulation
may be vibration from the vibration unit 16 that may be transmitted through
the lower leg 22,
the compressed knee joint, and the upper leg 30 and into the hip.
[0064]
Corresponding to the bottom two rows of boxes in Fig. 13, the stimulation may
be
adjusted by varying individual characteristics of the stimulation,
independently of the others.
By controlling the tension member 36 and/or position drive 37, the compressive
preload to the
entire limb may be adjusted independently of vibration characteristics. The
compressive
preload to the limb may be statically held, cyclically reduced and increased,
or otherwise varied
independently of other system 10 characteristics. By controlling the
rotational speed of the
output shaft of motor 78, the frequency of vibration may be controlled
independently of other
system 10 characteristics. By controlling rotation of the motor 96, the
amplitude of vibration
may be controlled independently of other system 10 characteristics. By
controlling the actuator
31, the limb may be moved through a range of motion while maintaining
compression of the
limb and while the limb receives the stimulation. In this way, each of
displacement of the foot
support 20, acceleration of the foot support 20, compressive loading of the
limb(s), amplitude
of vibration, frequency of vibration, and position of the limb segments with
respect to each
other, may be controlled independently of the others, which may allow the
others to be
maintained in a constant state or varied at a different rate(s).
[0065] It
will be appreciated that analogous structure may be used on any jointed limb
of
the patient 11, for example, the arms. This may be done by anchoring a
shoulder of the patient,
restraining the patient's elbow against movement along a direction
perpendicular to an axis
defined between a corresponding hand and the anchored shoulder, preloading the
upper arm
and lower arm on opposing sides of the elbow, and applying vibration
stimulation to the hand
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so that the vibrations are transmitted through the lower arm, elbow, and upper
arm so that the
vibration passes into the compressively preloaded shoulder.
[0066] Certain terminology is used herein for purposes of reference only,
and thus is not
intended to be limiting. For example, terms such as "upper", "lower", "above",
and "below"
refer to directions in the drawings to which reference is made. Terms such as
"front", "back",
"rear", "bottom", and "side," describe the orientation of portions of the
component within a
consistent but arbitrary frame of reference which is made clear by reference
to the text and the
associated drawings describing the component under discussion. Such
terminology may
include the words specifically mentioned above, derivatives thereof, and words
of similar
import. Similarly, the terms "first", "second", and other such numerical terms
referring to
structures do not imply a sequence or order unless clearly indicated by the
context.
[0067] When introducing elements or features of the present disclosure and
the exemplary
embodiments, the articles "a", "an", "the", and "said" are intended to mean
that there are one or
more of such elements or features. The terms "comprising", "including", and
"having" are
intended to be inclusive and mean that there may be additional elements or
features other than
those specifically noted. It is further to be understood that the method
steps, processes, and
operations described herein are not to be construed as necessarily requiring
their performance
in the particular order discussed or illustrated, unless specifically
identified as an order of
performance. It is also to be understood that additional or alternative steps
may be employed.
[0068] References to "controller" or control unit may include or be coupled
to at least one
memory medium that may store program instructions for achieving the present
functions of the
system 10 and can be understood to include one or more controllers or
microprocessors that can
communicate in a stand-alone and/or a distributed environment(s), and can thus
be configured
to communicate via wired or wireless communications with other processors,
where such one
or more processor can be configured to operate on one or more processor-
controlled devices
that can be similar or different devices. For example, the control unit 80 may
include a wireless
transmitter(s) and receiver(s) to communicate with remote processors. One such
remote
processor may be located at a doctor's office where treatments can be
monitored and new
treatment regimens can be wirelessly transmitted to the receiver of the
control unit 80. The
control unit 80 may be configured to transmit communications through online
web-based or
other applications to provide information that may be accessible in real time
or later by the user
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or another designated authorized viewer of such information. Such applications
may be usable
as part of a diet and exercise tracking software, usable for providing real-
time biofeedback to
the patient, or usable for a variety of other purposes that may enhance the
user experience and
may improve patient outcomes. Furthermore, references to memory, unless
otherwise
specified, can include one or more processor-readable and accessible memory
elements and/or
components that can be internal to the processor-controlled device, external
to the processor-
controlled device, and can be accessed via a wired or wireless network.
100691 It is specifically intended that the present invention not be
limited to the
embodiments and illustrations contained herein and the claims should be
understood to include
modified forms of those embodiments, including portions of the embodiments and
combinations of elements of different embodiments as come within the scope of
the following
claims. All of the publications described herein, including patents and non-
patent publications,
are hereby incorporated herein by reference in their entireties.
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