Abstract:
A therapeutic device for improving the respiration of a patient, with a curved or bent pipe section and a mouthpiece inserted in a first end of the mouthpiece and adapted to provide an easy-to-handle medicinal device by means of which diseases of the airway can be treated, or the pulmonary volume, as well as the pulmonary inhalation performance, of a patient can be improved. This is achieved in that a holding peg connected to the pipe section can be pushed into a second end of the pipe section, and a passage channel disposed in the holding peg which penetrates into the inside of the pipe section, completely or in part, and the holding peg has a flexible hose is attached to it which runs inside the pipe section, the free end of which can move freely in the area of the mouthpiece between inner walls of the pipe section.

Description:
BACKGROUND OF THE INVENTION 
     1. Field of the Invention 
     The present invention relates to a therapeutic device for improving the respiration of a patient, with a curved or bent pipe section and a mouthpiece inserted in its first end. 
     2. Description of the Prior Art 
     A therapeutic device for supporting the respiration of a patient is disclosed in EP 0681853. In this case, the curved pipe section has a height-adjustable mouthpiece inserted in its end. As a result, the mouthpiece penetrates inside the pipe section in areas. The penetrating area of the mouthpiece has a hose attached to it, which is bent by the inner contour of the pipe section. The second end of the pipe section is open, therefore the therapeutic device can be used for inhalation and exhalation. The ending of the hose section causes the device to undergo oscillatory vibration during inhalation and exhalation, thereby causing vibrations to be generated in the pharyngeal and pulmonary areas of the patient, thus allowing diseases of the airways to be treated. 
     Although the therapeutic device disclosed in EP 0681853 A1 has proven effective in practice, it has become apparent that no optimum treatment successes can be achieved when the air is inhaled through the hose section because the vibrations generated by the hose section during inhalation are significantly smaller in amplitude and frequency than those during exhalation. 
     A further disadvantage with this therapeutic device during inhalation is that the cross-sectional area of the hose section is often narrowed to such an extent that the air resistance is considerable or the hose section is completely closed, with the effect that no air can get into the patient&#39;s airways. 
     SUMMARY OF THE INVENTION 
     The object of the present invention is, therefore, to develop a therapeutic device of the aforementioned type in such a way that an oscillating air resistance can be generated during inhalation, thereby making it possible to clear the patient&#39;s airways of mucus and other impurities, or to allow the patient&#39;s airways to be trained in order to achieve a larger pulmonary volume for elite sports. At the same time, the therapeutic device should be easy to handle and be adjustable in response to the patient&#39;s individual medicinal requirements. 
     This is achieved in that a holding peg firmly connected to the pipe section can be pushed into the second end of the pipe section, in which case the holding peg penetrates the inside of the pipe section completely, or in part, and has a passage channel therein, and the holding peg is provided with a flexible hose attached to it that runs inside the pipe section, the free end of which can move freely in the area of the mouthpiece between the inner wall of the pipe section. 
     It is particularly advantageous for a screw to be inserted in the second end of the pipe section and which can be turned in relation to the pipe section and is supported on it, and for the screw to have a passage hole therein, with the holding peg inserted in it, such that the hose attached to the holding peg can be changed in its position within the pipe section. The pipe section is curved, with the effect that the hose is in contact with the inner wall of the pipe section at two positions, at least in the home position, so that turning the screw allows the contact surface between the inner wall of the pipe section and the hose to be changed, or results in torsion being applied to the hose. Such setting options have the advantageous effect that the air resistance is adapted to a patient, because the air drawn in through the mouthpiece initially flows through the hose and is output from it in a pulsed fashion. The adjustable positioning of the hose makes it possible to alter the bending of the hose and the resulting air resistance depends on the bending conditions of the hose, with the effect that each patient can adapt the air resistance of the hose to his or her individual medicinal requirements. 
     The air resistance can also be adjusted by making the length of the holding peg that penetrates into the pipe section variably adjustable, meaning that the hose runs inside the pipe section with different height positions. 
     Further advantageous configurations of the invention are disclosed hereinbelow. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The drawings show sectional views of therapeutic devices configured in accordance with the present invention, the details of which are explained below. In the drawings, 
         FIG. 1  shows a first illustrative embodiment of a therapeutic device with a curved pipe section, inside of which a hose attached to a holding peg makes contact, with a free end of the hose freely movable in an area of a mouthpiece between the inner walls of the pipe section, in a first operating condition, 
         FIG. 2  shows the therapeutic device in accordance with  FIG. 1  in a second operating condition, 
         FIG. 3  shows the therapeutic device in accordance with  FIG. 1  in a third operating condition, 
         FIG. 4  shows the therapeutic device in accordance with  FIG. 1  in a fourth operating condition, 
         FIG. 5  shows a second sample embodiment of a therapeutic device with a curved pipe section, inside which a ventilation hose is disposed in the area of the mouthpiece and through which ambient air can be sucked in, and 
         FIG. 6  shows a third sample embodiment of a therapeutic device with a curved pipe section and a holding peg inserted in it, and that has a cover providing an almost air-tight seal against the outside, by means of which the air supply can be adjusted. 
     
    
    
     DESCRIPTION OF THE PREFERRED EMBODIMENTS 
       FIGS. 1 to 4  show a therapeutic device  1  by means of which a patient&#39;s airways can be treated using an oscillating air resistance. The therapeutic device  1  in this case is used for supporting respiration during inhalation by the patient, or as a sporting implement in order to increase the pulmonary inhalation performance or a pulmonary volume of the sportsperson. 
     The therapeutic device  1  comprises a curved pipe section  2 , the lengthways section of which is approximately that of a quarter circle. The pipe section  2  is provided with two ends  3  and  4 , which are open. The first end  3  is provided with a mouthpiece  6  disposed therein, which is configured as a beak. A least one filter insert  7 ′ or  7 ″ is provided inside the mouthpiece  6 . The filter insert  7 ′ is arranged adjacent a free end  24  of a hose  13  and has microporous passage openings that are intended to capture impurities or other particles present in the air to be inhaled or which become detached from the hose  13 . The filter insert  7 ″ is impregnated with medicinal substrates or other substances with a therapeutic effect on the patient&#39;s airways, with the effect that air flows through the filter insert  7 ″ during inhalation, thereby picking up particles of the medicinal substrate and transporting them into the patient&#39;s airways with every breath.  FIGS. 1 to 4  show the various selection possibilities; this is because the various kinds of filter insert  7 ′ or  7 ″ are inserted in the mouthpiece  6 . 
     A screw  14  is supported in a thread  15  in a rotational arrangement on the second end  4  of the pipe section  2 . The centre of the screw  14  has a passage opening  16  therein, in which a holding peg  11  is disposed and is held in a height-adjustable location. The holding peg  11  therefore partially projects into the inside of the pipe section  2 . The holding peg  11  fixes the position of the hose  13  fixed onto it inside the pipe section  2 , with the design and configuration of the hose  13  explained in more detail below. The holding peg  11  is provided with a passage channel  12  therein which emerges in the inside of the hose  13 . The ambient air is consequently sucked through the passage channel  12  into the hose  13  during inhalation, and from there into the mouthpiece  6 . 
     A plurality of notches  26  are formed on the outside of the holding peg  11 , with the notches  26  configured as undercuts. The outside of the screw  14  is provided with a detent hook  25  disposed thereon and connected to it, with the detent hook  25  engaging in a particular notch  26  so that the holding peg  11  is held on the screw  14  in a height-adjustable arrangement by the detent hook  25 . 
     The hose  13  is provided with at least two bending areas  21  and  22  that are arranged as transitional areas between an entry area of the hose section  13  and two bulbous sub-areas  23  of the hose  13 . The internal diameters of the bending areas  21  and  22  are smaller than the internal diameter of the two bulbous sub-areas  23  of the hose  13 . This means turning the screw  14  enables the position of the hose  13  to be changed in relation to a wall  5  of the pipe section  2 , and the hose  13  twists about its own lengthways axis.  FIG. 1  shows how the bending areas  21  and  22  run in the area of the wall  5  of the pipe section  2 . They can be lifted away from the wall  5  by the twisting of the screw  14 . The height adjustment of the holding peg  11  enables the hose  13  running inside the pipe section  2  to be changed in its position, thereby adjusting how the hose  13  runs in relation to the wall  5  of the pipe section  2 . 
     During inhalation, the free end  24  of the hose  13  starts to oscillate, because it can flutter back and forth freely between the walls  5 . Furthermore, individual sub-areas of the hose  13  are filled by air to different extents during the inhalation process. This is because the bending areas  21  and  22  decelerate the flow of air out of the particular sub-area  23 , thereby causing the sub-area  23  on the inlet side to be inflated with a bulbous shape.  FIG. 4  shows how the free end  24  of the hose  13  moves back and forth between the walls  5 . 
     The hose  13  in  FIG. 3  has four sub-areas  23  with differently sized lengthways dimensions. The transitional areas between the bulbous sub-areas  23  are already narrowed by design measures, or the bends in the hose  13  are created by the turning of the screw  14  or by the height adjustment of the holding peg  11 . A constriction of this kind in the transitional area  22  between two adjacent sub-areas  23  can also be achieved by the hose  13  making contact with the wall  5  of the pipe section  2 . 
       FIG. 2  shows the holding peg  11  pushed deeper into the pipe section  2  compared to its position in  FIG. 1 , meaning that the hose  13  adopts a different position and therefore a different deflection compared to those in  FIG. 1 . 
     An inlet opening  17  is disposed in the wall  5  of the therapeutic device  1 , with the inlet opening  17  having an inlet valve  18  pushed into it which runs in the area of the holding peg  11  and is connected to the inside of a container  28  by means of a hose  27 . An adjusting element  19  changes a cross-sectional area  20  of the inlet valve  18  through which air flows, with the effect that the patient can inhale air from the atmosphere or a gas or a medicine not only through passage channel  12  and the hose  13 , but also through the inlet valve  18  and its cross-sectional area through which air flows. The gas or medicine, preferably oxygen, is held in the container  28 , the inside of which is connected to the inlet valve  18 , and therefore enters the inside of the pipe section  2  in an adjustable quantity. The gas in the container  28  can be subjected to positive pressure or is sucked out of it by means of the patient&#39;s inhalation. 
       FIG. 5  shows a second sample embodiment which takes the form of a further configuration of the therapeutic device  1  according to  FIGS. 1 to 4 . A ventilation pipe  31  is inserted between the mouthpiece  6  and the free end  24  of the hose  13 , by means of which a bypass line communicating with the atmospheric air is provided. The ventilation pipe  31  is provided with an inlet hole  34  having a specified internal diameter worked into it. The lengthways axis of the inlet hole  34  runs at right angles to the flow direction of the breathing air inside the pipe section  2 . The inlet hole  34  is sealed with an adjusting ring  32  to allow the supply of ambient air through the inlet hole  34  to be adjusted. The adjusting ring  32  is mounted in a rotating arrangement on the outer circumference of the ventilation pipe  31 , and four passage openings  33  are disposed in the adjusting ring  32  in the embodiment shown in  FIG. 5 . The four passage openings  33  have differently sized internal diameters; the largest internal diameter of the passage opening  33  in this case corresponds to the internal diameter of the inlet hole  34 . If the inlet hole  34  is sealed by the adjusting ring  32 , then no ambient air flows through the inlet hole  34  and the mode of function of the therapeutic device  1  corresponds to the basic version of the therapeutic device  1  in accordance with  FIGS. 1 to 4 . 
     Turning the adjusting ring  32  allows the four passage openings  33  in the adjusting ring  32  to be brought into line with the inlet hole  34 , with the effect that passage opening  33  is arranged above the inlet hole  34 , a specified quantity of air can be sucked into the inside of the pipe section  2  during the inhalation process. This measure achieves the effect that the patient has to exert greater pulmonary force in order to start the free end  24  of the hose  13  oscillating, because in addition to the air quantity to be sucked in through the hose  13 , ambient air enters the inside of the pipe section  2  through the passage holes  33  and the inlet hole  34 . In particular, it is this additional possibility for inhaling ambient air that enables a medical contribution to be made towards increasing the pulmonary volume and the pulmonary force, with the effect that the therapeutic device  1  in accordance with  FIG. 5  can also be used as a sports device, for example for divers or cyclists. 
       FIG. 6  shows a further embodiment of the therapeutic device  1  in accordance with  FIGS. 1 to 4 . The free end of the holding peg  11  is sealed by a cover  35  with an inlet hole  36  therein. The inlet hole  36  is covered by an adjusting ring  37  supported on the cover  35  in a rotational arrangement. The lateral outer contour of the adjusting ring  37  has several passage channels  38  therein, the internal diameters of which differ in size in relation to one another. The largest internal diameter of the passage channels  38  in this case corresponds to the internal diameter of the inlet hole  36 . This means twisting the adjusting ring  37  allows the amount of ambient air flowing through the inlet hole  36  and the corresponding passage channel  38  to be adjusted. Depending on the selected setting, it takes more pulmonary force to suck air from the atmosphere through the inlet hole  34  into the hose  13 . As a result, this measure also increases the effectiveness of the therapeutic device  1  to such an extent that it can be used as a sports device for the training of elite sportspersons. 
     The further embodiments of the therapeutic device  1  in accordance with  FIGS. 1 to 4  which are shown and explained in  FIGS. 5 and 6  can be combined with one another or connected to the therapeutic device  1  in accordance with  FIGS. 1 to 4  in a modular arrangement. The measures described in  FIGS. 5 and 6  change the suction speed at which oscillation of the hose  13  is triggered. As a result, each patient can adjust the therapeutic device  1  in accordance with his or her personal requirements, and use it for what is referred to as incentive spirometry or as an inspirational muscle trainer. The system comprising the cover  35  and adjusting ring  37  connected to the holding peg  11 , which together form a perforated ring device, adjusts and varies the inhalation pressure required when the adjusting ring  37  is turned to different positions.