APPARATUS FOR THE ANTIGRAVITY MODIFICATION OF THE MYOTENSIONS ADAPTING THE HUMAN POSTURE IN ALL OF THE THREE PLANES OF THE SPACE

Abstract: A diagnostic and therapeutic apparatus for re-educating the posture of the backbone includes in combination means for controlling the orthostatic posture of the patient, means for carrying out a differential traction on the same patient at different levels in order to cancel out all or a part of his weight, means for correcting the postural defects in the three planes of the space and for blocking the patient within postural limits in order to prevent him from assuming postures other than that therapeutic even during the deambulation. In particular, the orthostatic posture is controlled by measuring the weight resting on each foot of the patient through footboards (19A, 19B) sensitive to changes in pressure placed under a travelling band (18), and the traction means are lacings or traction slings (24) slidable around pulleys (22) carried by a rigid framework and put under tension manually by the operator or automatically by a microprocessor receiving data measured from the footboard (19A, 19B) sensitive to changes in pressure.

Description: APPARATUS FOR THE ANTIGRAVITY MODIFICATION " OF THE MYOTENSIONS ADAPTING THE HUMAN POSTURE IN ALL OF THE THREE PLANES OF THE SPACE The present invention relates to an apparatus for re-educating the posture of the backbone of an individual in all of the three plane of the space, i.e. frontal, sagittal, and transversal, thus avoiding the posture defects and all of the pathologic consequences arising threfrom, under antigravity. dynamic conditions and through deambulation on a travelling band. As known, the weight of the human body is supported by the skeleton, muscles, ligaments, and fasciae. The line representing that weight goes down from above along the backbone, bifurcates at the third lumbar vertebra, turns to the two opposite coxae (hip-joints) , goes down along the lower limbs and goes up again by the same way until it rejoins at the centre of the pubic bone to form a closed loop of forces. However, skeleton is very seldom postured in a physiologically correct way so as to absorb the most of the weight of the human body. Actually men assume comfort postures or postural bad habits requiring the aid of supports constituted by muscular tensions, fasciae, and ligaments to restore the balance. Such "dynamic compensations" of a "static defect" become permanent in time such as to constitute a pseudo scheme of movement (the automatic total scheme of movements) that, even if it is not physiologically correct, becomes definitively functional, thus causing pathologic modifica ions in capsules, ligaments and joint surfaces and occurrence of aches and pains of different nature and intensity. The phvsiatrics is aware of such problem for some time so that several equipment have been manufactured to try to solve it. The latter, however, have never considered the "global problem", i.e. the functional and dynamic whole of the human body. Thus apparatus have been manufactured for the specific treatment of the single postural defect such as cervical traction apparatus in which the patient sits and his cranium is hanging, lumbar vertebral traction apparatus in which the patient is laid out on a bed, cervical traction apparatus in which the patient is walking on a travelling band, and so on. Such apparatus are less and less used since they are directed to the solution of the symptomatic "pain" more than to the "cause" thereof. It has not been taken into account that at the end of the therapy the patients begin to act and to move again according to the old scheme of movement which caused so much damages. This is why the intervention has never been total but only sectorial. The present invention seeks to overcome the limits of the existing apparatus and to provide an apparatus of quite different design by which the correction of postural bad habits upstream of the several peripheral symptoms which can occur in different ways becomes total, permanent, spontaneous and directed in all of the three pLanes of the space. The inventive concept nf the present invention is of providing an apparatus by which the patient can b subjected to differential tractions at different levels by cancelling out all or a part of his weight and effecting a number of successive corrections such as to force the patient to assume a correct posture in the frontal, sagittal, and transversal planes in static attitude, and by forcing the patient to keep such posture even in dynamic attitude, i.e. during the deambulation, until he reaches stably and definitevely a new correct total scheme of movements. Therefore, the present invention provides according to a first aspect thereof a diagnostic and therapeutic apparatus for re-educating the posture of the backbone which includes in combination means for controlling the weight resting on each patient's foot, means for carrying out a differential traction on the same patient at different levels in order to cancell out all or a part of his weight, means for correcting the postural defects by leading the patient again to the respect of the symmetries in the three planes of the space and for blocking the patient within postural limits inside which he is free but from which he cannot come out, means for allowing the patient to walk in his tridimensionally corrected hanging posture in order to force him to the new automatic scheme of movements adapted to the incidental situation. Another object of the invention is of providing an apparatus as described above, wherein the means for controlling the weight resting on each foot supplies data to a microprocessor adapted to automatically control the operation of the traction means for leading the patient again to a predetermined postural attitude. A further object of the invention is of providing an apparatus as described above, wherein the data of the displays is transmitted to a computer adapted to store the data of the beginning and the end of the treatment and to issue a graphic representation of the same. Still another object of the invention is of providing an apparatus including, instead of the means for measuring the patient's weight, optical and/or electronic means for detecting the spatial variation of the position of a reference point attached to the patient's body. According to a first preferred embodiment the apparatus of the present invention includes in combination a travelling band for the deambulation provided with two footboards sensitive to changes in pressure and adapted to indicate on a display the weight resting on each foot of the patient standing thereon, and a rigid framework which can be firmly anchored to the floor and/or to the ceiling of the operational room above said travelling band, and to which the patient is secured by a number of traction slings fastened to five suspension points, e.g. pulleys. Such slings allow both the displayed data to be set, i.e. the weight resting on both feet to be compensated, and such weight to be partially released in a symmetric way at different levels so as to display the wrong postural attitudes of the patient through the loss of the previously reached balance between the weights resting on the two feet . The apparatus also includes a number of movable arms provided with retainers or stops to be applied tn th patient's body at different (pelvic, sacral, sternal, humeral and dorsal) levels in order to prevent him from assuming postures different from those therapeutic even during the deambulation. According to a preferred embodiment such retainers consist of oleodynamic pistons assembled in suitable hydraulically driven structures and controlled for an optimum positioning. The description of the invention will be better understood with reference to the accompanying drawings which illustrate only by way of a non-limitative example a preferred embodiment thereof. In the darwings: Fig. 1 is a perspective view of the apparatus of the invention; Fig. 2 is a schematic elevation side view of the same; Fig. is a plan view of a detail of one arm provided with retainers; Figs. 4 and 5 are a frontal elevation view and a side view of a second embodiment of the invention, respectively, in which the retainers are oleodinamically driven ; Fig. 6 is a detail of a movable framework where oleodynamic cylinders are provided. With reference to Figs. 1 to 3 the apparatus includes a - _> - bridge framework of tubular metal sections formed by a front beam 8, a rear beam or a pair of rear beams 10, and two uprights 12 extending from the floor to the ceiling of the operational room and secured thereto by mutual abutment of pressure discs 14 adjustable through threaded pins 16 without drilling or permanent securing devices. A travelling band 18 for deambulation having a varying resistance is placed between the two uprights 12 on two footboards or load cells 19A and 19B sensitive to changes in pressure and each adapted to transmit to a corresponding display 20A and 20B the weight resting on each patient's oot. Attached to the rear beam 10 are a certain number (five in the illustrated example) of pulleys 22 around which traction lacings 24 are wound which are subjected to tension by devices 25 of the known type such as electric or hydraulic pistons, counterweight systems of conventional mechanical (rocker arm) or hydraulic type, or other equivalent systems shown only schematically. The traction values are displayed by suitable indicators to the operator. Such lacings pass around pulleys 23 of front beam 8 and are provided with the ordinary accessories used in the traction techniques such as traction bands and slings, length regulators, a.s.o. The apparatus is also provided with a number of rigid retainers or stops 25 to be attached to the patient's body for its blocking in the posture forced by the correction traction means. Such retainers are carried by horizontal arms 0 which can vertically slide along uprights 12 by means of sleeves 3 and be adjusted in their lengths as they are formed of several pieces 30 . - 0 30B and 30C slidable perpendicularly to one another. The described apparatus has both diagnostic and therapeutic functions. It is thereby possible to show first of all the comfort postures or postural defects of the subject and then to lead the same subject to take on correct postures which becomes stable and definitive as the therapy proceeds. It is now disclosed by way of example the treatment of a subject having five suspension points, and namely: one at the cranium, two at the thorax, and two at the ischium (inguen) . The patient is placed on travelling band lδ with his feet resting exactly on the corresponding footboards sensing the weight. The right display 20A shows the weight resting as a whole on the right foot and the left display 20B shows the weight resting as a whole on the left foot. Such weights are almost different from each other because the total weight divides equitably very seldom but rests more on the right side or the left side than the other side according to the importance of the posture defect to be corrected. The right or left ischiatic suspension acts for levelling the values of the two displays 20 through the corresponding traction lacing 24- This operation aims at balancing the pelvis to avoid resting defects on one side or on the other side. Now a symmetric thoracic traction, i.e. a balanced weight release on the right and left sides, is carried out in order to compensate about 20 % of the body weight. The preceding values of displays 20 are very likely varied at the end of such operation. Actually, if the subject had. for example, a posture of the trunk inclined to the right side due to the rotation of the backbone or to the retraction of the muscles responsible for that movement towards that side, the indifferentiated upwards traction of the trunk will raise the pelvis on that side and will deduct a weight equal to the intensity and amplitude of the postural lack of balance. The traction is then differentiated by means of a lateral thoracic tie-rod 24 so as to compensate the values of displays 20. Finally, a light cervical traction is carried out for excluding the weight of the cranium: the patient is then subjected to differential tractions at several levels, the intensity thereof expressing the existing myofascial reactions. The pelvic, sacral, sternal, humeral and dorsal retainers or stops 28 are then fastened to the patient's body in order to discourage any attempt of compensation by an attitude other than that forced by the correcting tractions. Patient is invited to walk by setting a very low resistance at the beginning. It is self-evident that under such conditions the patient cannot make use of his usual (and wrong) scheme of deambulation as: - his proprioceptive sensations of his own weight are deeply changed and then he cannot make use of his usual scheme of movement; - the attempts of compensation made by the assumption of di ferent, less tiring, comfort postures are cancelled by the differential tractions of lacings 24 and by stops 2 ~ fixing the therapeutic posture. Any pressure sensor on stops 23 can display the different ■ thrusts of the several points of the body and then the attitude against a back thrust which rotates the backbone. Under such conditions the subject is forced to invent a new way of movement and shall do this by using skeleton, muscles, a.s.o. which are now correctly postured. If at the beginning he moves with extreme difficulty, as the therapy proceeds the subject will stably reach a new global, now correct scheme of movement. The displays can translate into objective data the progress of the therapy. In fact, as the therapy proceeds and the several defective bends of the backbone and the myofascial reactions are compensated and cancelled, it is as though the trunk of the patient got longer. As a consequence the efficiency of the thoracic traction will be progressively reduced, and the displays will show it by an increase of the weight shown. The responsible personnel can then draw up a hospital file of the patient in which the detected values in the several therapy sessions will be recorded until stable values not subjected to change are reached. Thus a graph as well as digital data of the reached, global and definitive, correct posture can be obtained. The described apparatus is susceptible to be used in combination with a microprocessor capable of storing treatment beginning and end data, the evaluation of the differences detected, and data during the treatment to statistic research purposes. It is also possible to use a microprocessor for controlling the function on the base of a stored program. Alternatively, the orthostatic posture of the subject can be put under control by detecting the displacement of a reference point of the patient's body in the space. To this purpose a photoelectric cell and a scanner can be used. In Figs. 4 to 6 a second embodiment is shown, in which stops 2S are moved by oleodynamic cylinders" 30 ' carried on frames 40 vertically movable along guides 50 parallel to uprights 12' between which slidable footboard l8 is placed. As can be seen, cylinders 30' can be horizontally displaced on the relative movable frames 40 and approached to or moved away from each other by a further oleodynamic positioning cylinder 60 attached to a proper plate 62.

Claims: Claim: 1. A diagnostic and therapeutic apparatus for re-educating the posture of the human backbone, wherein it includes in combination means for monitoring the orthostatic posture of the patient, means for carrying out a differential traction on the same patient at different levels in order to cancell out all or a part of his weight, means for correcting the postural defects by leading the patient again to the respect of the symmetries in the three planes of the space and for blocking the patient within postural limits inside which he is free but from which he cannot come out, means for allowing the patient to walk in his tridimensionally corrected hanging posture in order to force him to the new automatic scheme of movements adapted to the incidental situation. 2. The diagnostic and therapeutic apparatus as claimed in claim 1 , characterized in that means for measuring the weight resting on each foot of a standing or walking subject is used for monitoring the orthostatic posture of the same . 3. The diagnostic and therapeutic apparatus as claimed in the preceding claims, characterized in that the means for measuring the weight resting on each foot of the subject feeds data to a microprocessor controlling automatica ly the operation of the traction means for leading the subject to a predetermined postural scheme. 4. The diagnostic and therapeutic apparatus as claimed in the preceding claims, characterized in that the means for measuring the weight resting on each foot of the subject are footboards sensitive to changes in pressure or load cells placed under the walking surface of a travelling or slidable band. 5. The diagnostic and therapeutic apparatus as claimed in the preceding claims, characterized in that the traction means are lacings or traction slings adjustable in length and slidable around pulleys carried by a frame which can be firmly anchored to the floor and/or to the ceiling of the operational room, and put under tension by electric, mechanical or hydraulic devices. 6. The diagnostic and therapeutic apparatus as claimed in the preceding claims, characterized in that said traction slings are designed to the treatment of the subject through five suspension points, and namely one at the cranium, two at the thorax, and two at the ischium (inguen) . 7. The diagnostic and therapeutic apparatus as claimed in the preceding claims, characterized in that the means for correcting the postural defects and for blocking the subject in the horizontal plane are a number of stops which are placed against the patient ' s body at the predetermined points by vertically shifting and adjusting rigid support arms slidable along the uprights of the apparatus. 8. The diagnostic and therapeutic apparatus as claimed in the preceding claims, characterized in that said stops are provided with pressure sensors for measuring the thrust of the subject. 9. The diagnostic and therapeutic apparatus as claimed in the preceding claims, characterized in that said stops are carried by oleodynamic pistons attached' to rigid, hydraulically driven support structures which can be properly moved and positioned. 10. The diagnostic and therapeutic apparatus as claimed in the preceding claims, characterized in that an electronic central processing unit is provided which is adapted to receive data detected by the load cells of the travelling band and the values of the tractions at the several levels of the body during the therapy so as to plot the whole treatment. 11. The diagnostic and therapeutic apparatus as claimed in the preceding claims, characterized in that a device detecting the position of a reference point attached to the patient's body in the space is used for monitoring the orthostatic posture of the patient. - 15

Inventors: GIOVANNETTI GIOVANNI BATTISTA, GIOVANNETTI, GIOVANNI, BATTISTA
Applicants: GIOVANNETTI GIOVANNI BATTISTA, GIOVANNETTI, GIOVANNI, BATTISTA
Application year: 1993
Main classification: A61B5
IPC codes: A61B5, A61F5, A61H1, A63B22