Abstract:
A quadruped positioning apparatus having a rear leg unit that is detachably and adjustably connected to a front hand unit. The rear leg unit is provided with buttocks, abductor and leg pads that allow the patient to kneel comfortably thereon, with a plurality of straps designed to secure the patient&#39;s upper and lower legs to the frame of the rear leg unit. The front hand unit is similarly provided with padding and straps, these designed to cushion and secure the patient&#39;s arms and hands when in the quadruped position. The apparatus includes multiple adjustment features to accommodate different patient heights and dimensions, and is further provided with a chest pad located between the rear and front units as a safety measure to absorb the weight of the patient in the event of collapse of the upper extremities due to fatigue.

Description:
BACKGROUND OF THE INVENTION  
         [0001]    1. Field of the Invention  
           [0002]    The present invention is related to the field of physical/occupational therapy and, more particularly, to an apparatus designed to assist physical/occupational therapists in placing patients in the quadruped position for therapeutic treatment.  
           [0003]    2. Description of the Related Art  
           [0004]    Various techniques are used by physical/occupational therapists to treat specific body parts and muscle groups following injury, surgery, birth disorders, developmental or acquired disabilities, or neurological conditions. One such technique that facilitates the development of the patient&#39;s shoulder and hip joints, increases strength in musculature to increase proximal stability, and decreases postural abnormalities can be achieved in a quadruped position. According to the Neurodevelopmental Treatment (NDT), or Bobath approach, weight bearing in the quadruped position provides proprioceptive input to joints, and is perhaps the most effective way to normalize tone and increase function.  
           [0005]    Positioning of the patient in quadruped position, however, can be a difficult and strenuous task. It normally takes one physical therapist to hold and control the hips and legs, two occupational therapists to position the arms, hands, shoulders and trunk, and then another person to work with the patient to perform activities that encourage the patient to look up, reach out, or shift more weight onto one side. Also, a therapist may use skilled techniques to correct orthopaedic deformities or postural alignment. For example, a ball may be held to the side of the patient with the patient being encouraged to reach over with one arm to grasp the ball. This activity to increase weight bearing on the affected extremity is an example of NDT. In order to ensure that the patient remains in proper quadruped position during activities of this nature or deformity correcting exercises, the continuing action of all four people may be required.  
           [0006]    There are known devices for supporting and stabilizing patients in different postures for specific purposes. For example, U.S. Pat. No. 1,498,961 to German discloses a chiropractor bench for supporting a patient in the kneeling position while providing an adjustable cushioned support for the head and shoulders. This bench allows the patient to bear weight on the head and shoulder support and, because dynamic movement is accommodated, does not position the patient in a secure, supported and static position for facilitation of treatment.  
           [0007]    U.S. Pat. No. 4,354,485 to Safadago relates to a therapeutic apparatus for the treatment of muscular and skeletal disorders. The apparatus provides a cushioned prone board that is adjustable for children of different sizes and which allows the therapist to facilitate greater range of motion and participate in a variety of environments. This device, like many in the therapeutic/rehabilitation community, is not able to secure the patient in a quadruped position, but instead positions the patient in a prone position with many points of contact for weight bearing. As a result, the apparatus is not effective for developing or inhibiting tone through weight bearing, but simply provides correctly aligned support in the prone position to allow the child to have the proximal stability required to explore his or her environment. Furthermore, the patient does not have 90 degrees of flexion in the hip or knee, and there is no means of securing the upper extremities in a static weight bearing position to facilitate treatment.  
           [0008]    U.S. Pat. No. 4,838,249 to Jannotta is directed to a lower back therapy device for relieving back stress through cushioned support of the posterior thigh/gluteal region. Such support is necessary to enable the patient to perform routine therapeutic exercises while preventing vertebral/dorsal injury secondary to stress. Like German, Jannotta does not prevent dynamic movement of the patient and does not provide a means of imposing a static quadruped position.  
           [0009]    Therefore, a need exists for an apparatus that allows a single therapist to position the patient in a secure, correct quadruped position and to thereafter have freedom to facilitate during the treatment session for a more effective length of time.  
         SUMMARY OF THE INVENTION  
         [0010]    In view of the foregoing, one object of the present invention is to overcome the difficulties of positioning a patient in the quadruped position with an apparatus that can be used effectively by a therapist working alone with a patient.  
           [0011]    Another object of the present invention is to provide an apparatus for positioning an uncooperative or high maintenance patient, as well as a lower level or low functioning patient in quadruped position for NDT treatment. For the uncooperative or high maintenance patient, the apparatus provides such a level of support that he or she may feel less intimidated as compared with being manually positioned by a therapist.  
           [0012]    A further object of the present invention is to prevent injuries to therapists and patients that can occur in the process of manually positioning the patient into the quadruped position.  
           [0013]    Yet another object of the present invention is to provide a compact and portable device that allows caregivers and family to carry over treatment prescribed by a physician or therapist at home.  
           [0014]    Still another object of the present invention is a quadruped positioning apparatus that provides high level, high functioning patients who have decreased trunk control, the ability to tall kneel, i.e., to maintain an upright “standing” posture while on the knees with the feet extended rearward, for treatment.  
           [0015]    A still further object of the present invention is to provide an apparatus that is not complex in structure, can be constructed from readily available materials, and which can be manufactured at low cost but yet provide an effective rehabilatative device.  
           [0016]    These and other objects and advantages are realized by the present invention which is directed to a quadruped positioning apparatus that is easily transported and used by a therapist working alone or with limited assistance to provide physical/occupational therapy treatment to a patient. The quadruped positioning apparatus includes a rear leg unit that is detachably and adjustably connected to a front hand unit. The rear leg unit is provided with buttocks, abductor and leg pads that allow the patient to kneel comfortably on the rear leg unit, with a plurality of straps designed to secure the patient&#39;s upper and lower legs to the frame of the rear leg unit whether the patient is in the kneeling or quadruped position. The front hand unit is similarly provided with padding and straps which are designed to cushion and secure the patient&#39;s arms and hands when in the quadruped position. A detachable belt provides additional security to the patient during treatment.  
           [0017]    The positioning apparatus of the present invention has multiple adjustment features to accommodate different patient heights and dimensions. The apparatus is further provided with a chest pad located between the rear and front units as a safety measure to absorb the weight of the patient in the event of collapse of the upper extremities due to fatigue. This chest pad can also be used for weight bearing of bilateral upper extremities during use of the apparatus for tall kneel.  
           [0018]    With the device according to the present invention, one or two therapists can strap the patient in but then, once set, no supporting hands are needed to maintain the patient&#39;s positioning. A single therapist can then work with the patient to have him/her shift weight, reach out, raise his/her head, correct alignment and adjust posture, throughout a range of effective neurodevelopmental activities.  
           [0019]    These together with other objects and advantages which will become subsequently apparent reside in the details of construction and operation as more fully hereinafter described and claimed, reference being had to the accompanying drawings forming a part hereof, wherein like numerals refer to like parts throughout. 
       
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       [0020]    [0020]FIG. 1 is a side view of a quadruped positioning apparatus according to the present invention;  
         [0021]    [0021]FIG. 2 is a front view of the quadruped positioning apparatus of FIG. 1;  
         [0022]    [0022]FIG. 3 is a top view of the quadruped positioning apparatus of FIG. 1;  
         [0023]    [0023]FIG. 4A is a rear view of the rear leg unit of the quadruped positioning apparatus of FIG. 1, with the buttocks pad in a vertical position;  
         [0024]    [0024]FIG. 4B is a rear view of the rear leg unit of the quadruped positioning apparatus of FIG. 1, with the buttocks pad in a horizontal position;  
         [0025]    [0025]FIG. 5 is a side view of the quadruped positioning apparatus of FIG. 1 in use, with the buttocks pad in the horizontal position and a patient kneeling with respect thereto; and  
         [0026]    [0026]FIG. 6 is a side view of the quadruped positioning apparatus of FIG. 1 in use, with the buttocks pad in the vertical position and a patient in the quadruped position with respect thereto. 
     
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS  
       [0027]    In describing a preferred embodiment of the invention illustrated in the drawings, specific terminology will be resorted to for the sake of clarity. However, the invention is not intended to be limited to the specific terms so selected, and it is to be understood that each specific term includes all technical equivalents which operate in a similar manner to accomplish a similar purpose.  
         [0028]    As shown in FIGS.  1 - 4 B, the quadruped positioning apparatus of the present invention, generally designated by the reference numeral  10 , includes a rear leg unit, generally designated by the reference numeral  12 , and a front hand unit, generally designated by the reference numeral  14 . The rear leg unit  12  and the front hand unit  14  are joined by an adjustable metal beam, generally designated by the reference numeral  16 . The adjustability of the metal beam  16  allows the distance between the rear leg unit  12  and the front hand unit  14  to be varied in order to provide a proper fit for persons of different heights.  
         [0029]    The rear leg unit  12  is provided with a buttocks pad  18  and an abductor pad  20 . Connected to the underside  22  of the buttocks pad  18  is a length of metal tubing  24  that extends generally perpendicularly to the underside  22  of the pad  18 . The metal tubing  24  fits within an adjustment channel  26  made of metal tubing within which it may be slideably adjusted. The adjustment channel  26  forms the upper portion of a T-shaped holder, generally designated by the reference numeral  27 , with support  34  forming the base of the T-shaped holder.  
         [0030]    The buttocks pad  18  may be adjustably mounted, through the T-shaped holder  27 , to a first metal support tubing  30  that has a hollow center portion and is connected to and extends upwardly from the metal beam  16 . The support  34  is inserted into and projects upwardly from the tubing  30 , and is connected by a fastening element  32  to the adjustment channel  26  so as to be adjustable within and generally perpendicular thereto. By sliding the tubing  24  substantially horizontally within the channel  26 , the buttocks pad  18  may be moved closer to or farther away from the abductor pad  20 , allowing the rear leg unit  12  to be adjusted to fit patients of different heights. The fastening element  32  may be embodied as a screwed fitting, knobbed bolt or a wing bolt that extends through generally circular apertures in the tubing  30 , support  34  and tubing  24 , as appropriate, when such apertures are properly aligned. When mounted in this way, the underside  22  of the buttocks pad  18  is generally perpendicular to the floor in what is termed herein as the vertical position, an orientation suitable for a patient using the positioning apparatus  10  in the quadruped position, as illustrated in FIGS.  1 - 4 A and  6 .  
         [0031]    To provide an alternative mounting position, the metal tubing  24  is also sized to slide into the first metal support tubing  30  such that the buttocks pad  18  may be secured to the tubing  30  without use of the T-shaped holder. With the tubing  24  inserted directly in the first metal support tubing  30 , the underside  22  of the buttocks pad  18  is generally parallel with the floor in what is termed herein the horizontal position. This horizontal orientation is typically suitable for a patient using the quadruped positioning apparatus  10  in a kneeling posture, as illustrated in FIGS. 4B and 5.  
         [0032]    In either position, the height of the buttocks pad  18  may be adjusted by altering the extent to which the support  34  or the tubing  24 , as appropriate, extends into the first metal support tubing  30  using a suitable adjustment element  36 . The adjustment element  36  may be embodied as a pin, a knobbed bolt or other suitable structure that passes through selected ones of a plurality of apertures  35  in the tubing  24  or support  34 , and a pair of apertures  37  in tubing  30 . In the preferred embodiment, the metal tubing  30  is made of one inch square steel tubing, with the metal tubing  24  being three-quarter inch square steel tubing that fits therewithin.  
         [0033]    The abductor pad  20  is mounted to a length of metal tubing  28  that is sized to slide into a second metal support tubing  38  that projects upwardly from and is connected to the beam  16 . The upper and lower surfaces of the abductor pad  20  are generally parallel with the floor.  
         [0034]    The extent to which the tubing  28  is inserted within the second metal support tubing  38  may be modified using an adjustment element such as a pin  36  to alter the height of the abductor pad  20 . In the preferred embodiment, the metal support tubing  38  is made of one inch square steel tubing, with the metal tubing  28  being three-quarter inch square steel tubing that fits therewithin.  
         [0035]    The rear leg unit  12  further includes an outer frame, generally designated by the reference numeral  40 . The outer frame is comprised of a base member or platform  42 , a front wall  44 , and two side walls  46 . The base member or platform  42 , front wall  44  and side walls  46  are each planar, with the front wall  44  and side walls  46  mounted along respective edges to the base member  42  so as to be generally perpendicular thereto, and with each side wall connected to the front wall along an edge thereof. The frame  40  is preferably made of wood, approximately three-quarter inch thick, but could be constructed of any other suitable material.  
         [0036]    Two leg pads  48  extend longitudinally along the upper surface of the base member  42 , preferably abutting the front wall  44  at their forward end. Two additional leg pads  49  may be provided that extend vertically along the inner surface of the front wall  44 . These leg pads  48 ,  49 , which provide cushioning for at least the weight-bearing and frontal portions of the patient&#39;s knees, are best embodied using rubber padding, preferably with an adhesive backing for ease of construction to the base member  42  and front wall  44 , respectively.  
         [0037]    A first pair of flexible straps  50  is connected to the base member  42 , with each strap  50  positioned to extend over a respective leg pad  48  proximate an end portion of the pad remote from the front wall  44 . When a patient kneels upon the leg pads  48  with his/her knees adjacent the front wall  44 , the flexible straps  50  are respectively placed over the calf regions of the patient&#39;s legs to secure the lower legs to the base member  42 . The straps  50  may be of belt-type construction, a hook and loop fabric combination such as Velcro®, elastic, or any other suitable fastening structure. In a preferred embodiment, Velcro® straps are employed for easy and secure fastening and ready unfastening.  
         [0038]    A second pair of flexible straps  52  is coupled to the front wall  44  so as to extend rearwardly from the front wall  44 . When a patient kneels upon the leg pads  48  with his/her knees adjacent the front wall  44 , the flexible straps  52  are respectively wrapped around the thigh regions of the patient&#39;s legs to secure the upper portion of the legs to the front wall  44 . As with the first pair of straps  50 , the straps  52  may be of belt-type construction, elastic, a hook and loop fabric combination such as Velcro®, or any other suitable fastening structure; however, Velcro® straps are preferred.  
         [0039]    The first and second pairs of straps  50 ,  52  may be affixed to the facing surface of the base member  42  and front wall  44 , respectively, or may be looped through spaced openings provided in the base member  42  and wall  44 . Accordingly, each strap may be comprised of two portions individually affixed to the supporting surface or, in a preferred embodiment, may be a single member that is looped through a pair of openings in the supporting surface, one opening on either side of the pads  48 ,  49  supporting each of the patient&#39;s legs.  
         [0040]    Coupled to the rear leg unit  12  is the front hand unit  14  which includes an outer frame, generally designated by the reference numeral  60 , having a base member or platform  62 , a rear wall  64 , and two side walls  66 . The base member or platform  62 , rear wall  64  and side walls  66  are each planar, with the rear wall  64  and side walls  66  mounted along respective edges to the base member  62  so as to be generally perpendicular thereto, and with each side wall connected to the rear wall  64  along an edge thereof. The rear wall  64  has a generally arcuate cutout centrally located along its top edge  65 , shown in FIG. 2, to accommodate the patient&#39;s chest when in the quadruped position.  
         [0041]    Two hand pads  68  extend longitudinally along the upper surface of the base member  62 , preferably abutting the rear wall  64  at their rear ends, to provide cushioning for at least the weight-bearing portion of the patient&#39;s hands when in quadruped position. Two arm pads  69  may be provided that extend along the inner surface of the rear wall  64  to provide cushioning, preferably up to at least the patient&#39;s elbows when in a quadruped position. As with the leg pads  48 ,  49 , the hand pads  68  and arm pads  69  are preferably embodied using rubber padding adhesively adhered to the facing surface.  
         [0042]    A third pair of flexible straps  54  is connected to the rear wall  64  so as to extend generally forwardly from the front surface of the rear wall  64 . When a patient assumes the quadruped position with the palms of the hands against and supported on the hand pads  68 , and with the wrists adjacent the rear wall  64 , the flexible straps  54  are respectively wrapped around the wrist regions of the patient&#39;s arms to secure the lower portion of the arms against the rear wall  64 .  
         [0043]    A fourth pair of flexible straps  56  can be connected to the base member  62 , with each strap  56  positioned to extend over a respective hand pad  68 . When the patient has his or her palms against the hand pads  68 , the flexible straps  56  are respectively placed over the tops of the palm regions of the patient&#39;s hands to secure them to the base member  62 . The straps  54 ,  56  may be of belt-type construction, a hook and loop fabric combination such as Velcro®, or any other suitable fastening structure; however, Velcro® straps are preferred.  
         [0044]    As with the straps of the rear leg unit  12 , the third and fourth pairs of straps  54 ,  56  may be affixed to the supporting surface of the rear wall  64  and base member  62 , respectively, or may be looped through spaced openings provided therein. Accordingly, each strap may be comprised of two portions individually affixed to the supporting surface or, in a preferred embodiment, may be a single elongated member that is looped through a pair of openings in the supporting surface, one opening on either side of the pads  68 ,  69  supporting each of the patient&#39;s hands and lower arms, respectively.  
         [0045]    The front hand unit  14  further preferably includes at least two outer arm cushions  70  that are mounted to the rear wall  64  and adjacent a respective side wall  66 . In the preferred embodiment, the height of the arm cushions  70  is greater than the height of the rear and side walls  64 ,  66  to provide outer support along a greater portion of the patient&#39;s arms. Each cushion is preferably coupled to the rear wall  64  using at least two knobbed bolts  72  received in apertures  73  in the cushion  70 . The bolts  72  slideably extend through appropriately sized horizontal slots  71  in the rear wall so that the positioning of the cushions  70  can be varied relative to the side walls  66  to either abut the side walls or be spaced therefrom. Inward positioning of cushions  70  can accommodate smaller patients to support the outside of their arms when in the quadruped position.  
         [0046]    The rear leg unit  12  and the front hand unit  14  are adjustably and removably connected to one another by the metal beam  16 . The beam  16  includes a front section  74  and a rear section  76 , each section preferably being hollow to receive a connector section  78 . The front section  74  is fixedly connected to the rear wall  64  of the front hand unit  14  by any suitable fastening element, such as plate and bolts  86 . While in the preferred embodiment the beam is made of square metal tubing, other materials of suitable strength and rigidity could be used.  
         [0047]    The connector section  78  has a plurality of aligned apertures  90  in the side walls thereof and is preferably fixed to the front section  74  of the beam  16 , as by a bolt element  75 . The other end of connector section  78  is in sliding engagement with the rear section  76 . The distance between the rear leg unit  12  and the front hand unit  14  is determined by the extent to which the connector section  78  is inserted within the rear section  76 . When a desired distance is obtained, the connector section  78  is secured at the closest insertion position within the rear section  76  using an adjustment element  92 . Adjustment element  92  is preferably a pin or knobbed bolt that extends through a pair of aligned apertures  94  in the rear section  76  to align with a desired pair of the plurality of apertures  90  in the connector section  78 . When a different distance is desired, the adjustment element  92  may be readily removed, the connector section  78  slid further into or out of the rear section  76  as necessary to bring a different pair of connector section apertures  90  into alignment with the pair of apertures  94  in the rear section  76 , and the adjustment element  92  then reinserted therein.  
         [0048]    Affixed to the front section  74 , and extending upwardly therefrom, is a third metal support tubing  84  having a hollow center portion. A chest pad  80  supported on a length of metal tubing  82  is inserted within the third metal support tubing  84  for mounting thereto in the same manner as tubing  28  is inserted within the second metal support tubing  38 . The height of the chest pad  80  may also be adjusted by altering the extent to which the tubing  82  extends into the support tubing  84  and then securing the tubing  82  at that level using an adjustment element  36 . The adjustment element  36  may be embodied as a pin that passes through selected ones of a plurality of apertures  35  in the tubing  82  and a pair of apertures  96  in third metal support tubing  84 .  
         [0049]    In the preferred embodiment of the present invention, the front and rear sections  74 ,  76  of the beam  16  are made of one inch square steel tubing, with the connector section  78  being three-quarter inch square aluminum tubing that fits therewithin. The buttocks, abductor and chest pads are made of foam rubber or other cushioning material covered with cloth or preferably vinyl for easy care and cleaning. Standard fastening elements including welding, screws, bolts, putty, glue, etc., provide the necessary fastening functions as would be known by persons of skill in the art.  
         [0050]    In use of the present invention, as representatively shown in FIGS. 5 and 6, the distance between the front hand unit and the rear leg unit is adjusted as necessary for each patient. The patient kneels upon the base member or platform  42  of the rear leg unit  12  with his/her knees adjacent the front wall  44 . Pads  48 ,  49  cushion the patient&#39;s knees and thighs, respectively. The straps  50  are fastened around the calf area of the lower legs, and the straps  52  are fastened around the lower thigh region. The abductor pad  20  is adjusted to a comfortable height so as to fit between the patient&#39;s legs. Should the patient desire or require therapy in the kneeling position, the buttocks pad  18  is mounted in the horizontal position to allow the patient to lean or sit thereon. A safety belt  19  is preferably wrapped around the patient&#39;s waist and the metal tubing  24 ,  30  supporting the buttocks pad  18 , as shown in FIG. 5. This belt may be tightened as necessary to better secure the patient&#39;s position.  
         [0051]    If the full quadruped position is utilized, the buttocks pad  18  is mounted in the vertical position to provide a limit and support for the buttocks of the patient when rocking backward on the hands and knees. Once strapped into the rear leg unit as just previously described, the patient&#39;s hands are placed, palms down, on the base member  62  of the front hands unit  14  with the wrists adjacent the rear wall  64  and the fingers extending forward, away from the rear wall  64 . Pads  68 ,  69  cushion the patient&#39;s palms and arms, respectively. The straps  54  are fastened around the wrist area, and the straps  56  are fastened over the hands. The cushions  70  may be adjusted inwardly from the side walls  66  in the slots  71  as necessary to provide good side support to the patient&#39;s arms. In this position, the safety belt  19  is best adjusted around the patient&#39;s upper thighs and the metal tubing  24 ,  30  supporting the buttocks pad  18  (not shown).  
         [0052]    The chest pad  80  is positioned at a height that does not allow the patient to distribute weight thereon when his or her arms are extended such that the patient&#39;s back is generally parallel with the floor. Instead, the chest pad  80  is provided as a safety precaution to absorb the weight of the patient should the patient&#39;s upper extremities become fatigued and give out while in the quadruped position. Further, it will be seen in FIG. 3 that the rear edge  98  of the base member  42  and the forward edge  100  of the base member  62  are preferably curved or arcuate, although this is not necessary as other perimeter shapes could also be used.  
         [0053]    In either of the kneeling or quadruped positions, as shown in FIGS. 5 and 6, respectively, the patient may be effectively worked with by a single therapist. The quadruped positioning apparatus ensures that the patient&#39;s position remains as desired throughout a course of therapy. By having the patient reach back or around to grasp an object, whether while kneeling or with one hand free but in the quadruped position, muscles may be effectively toned and coordination developed. Various exercises and stretches that may be advantageously performed while the patient is in the quadruped positioning apparatus will be or become apparent to therapists having skill in the rehabilitation field.  
         [0054]    The foregoing descriptions and drawings should be considered as illustrative only of the principles of the invention. The invention may be configured in a variety of shapes, sizes, and materials, and is not limited by the dimensions of the preferred embodiment. For example, the materials used, the shape and the size of the quadruped positioning apparatus may vary, as may the length and shape of the cushions and padding. Wedges or other forms of cushioning may be added for extra support and/or comfort, and additional straps may be employed to ensure correct positioning of the patient. Numerous applications of the present invention will readily occur to those skilled in the art. Therefore, it is not desired to limit the invention to the specific examples disclosed or the exact construction and operation shown and described. Rather, all suitable modifications and equivalents may be resorted to, falling within the scope of the invention.