Patent Publication Number: US-6217538-B1

Title: Cervical/upper thoracic relaxer

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     Not applicable 
     STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT 
     Not applicable 
     BACKGROUND OF THE INVENTION 
     This invention relates generally to passive cervical traction devices, and in particular to gravity-assisted occipital support and cervical stretching apparatus used during the administration of physical therapy. 
     Spinal cervical and thoracic disorders can result from trauma or from long-term life-style activities, or emotional stress. These conditions can cause cervical muscle tension/spasm, facet joint locking, ligament/capsule tightness and contracture, soft-tissue hypomobilities and arthritis. Conventional therapies include traction, manipulation, mobilization, therapeutic exercise, heat/cold therapy, ultra-sound and short-wave diathermy. 
     In one physical therapy treatment protocol, the patient rests in a semi-reclined position on a treatment table while cervical and thoracic flexion is applied manually by a physical therapist. During this procedure, the therapist&#39;s hands (the heels of his hands) engage the patient&#39;s occiput bilaterally, providing slight cervical/thoracic traction and stretch. The therapist rests his elbows in a slightly spread position on the treatment surface directly behind the patient&#39;s head. This technique has proven to be effective, but requires one-on-one attendance by a therapist. Additionally, it imposes a physical strain on the therapist, who is required to maintain his/her arms and hands in a spread apart, fixed position during the treatment session, which extends over a typical treatment period of five minutes. 
     Conventional traction devices can be categorized as clinical machines and home units. Typically, clinical machines are powered by electric, pneumatic or hydraulic means, and are used in the supine position. Home devices are used in either the supine or seated position (utilizing standard chairs found in the home such as a folding chair or kitchen chair) and are usually passive, usually relying on a suspended weight in one form or another. 
     Portable cervical traction devices have been developed as an aid to the therapist to provide for home treatment. These mechanical devices employ passive (gravity-assisted) supports for inducing a traction effect at the intervertebral joints (facet and/or disc) and stretching the patient&#39;s neck muscles, ligaments and other supporting tissues. 
     Conventional therapy devices include cervical traction machines which either require or avoid transmission of forces through the left and right temporomandibular joints (TMJ). One cervical traction machine utilizes a recliner chair with a head harness for achieving a desired degree of cervical or thoracic flexion while the patient is seated. The head harness used in most home traction kits require the transmission of force through the TMJ, which can be painful. 
     Other traction devices such as the Saunders cervical traction machine (U.S. Pat. No. Re. 32,791) includes adjustable wedges which avoid force through the TMJ. The flexion angle of the neck can be adjusted from 15°-25° in the supine position. However, the Saunders home device cannot be adjusted to include thoracic flexion and is relatively expensive. 
     Presently, there is no conventional device or appliance that is as effective as the manual treatment provided by a trained professional. One reason for this is the ability of the trained professional to continuously modify and adjust the manually applied stretch and traction force in response to feedback information received from the patient as the therapy progresses. Nevertheless, a need exists for a passive device which can be used by the therapist as an adjunct to manual treatment protocols. Moreover, a need also exists for a portable apparatus that can be used safely and effectively by a patient at home on an unsupervised outpatient basis during self-administered therapy for the relief of pain and muscle spasm reduction. 
     BRIEF SUMMARY OF THE INVENTION 
     The present invention provides a portable, free-standing support frame for passively inducing cervical and thoracic flexion while maintaining traction. The patient assumes a static, semi-reclined position with the patient&#39;s upper torso and head being elevated and inclined with respect to the floor or other support surface. The support apparatus includes a free-standing frame with a base platform for placement on a floor or other stable surface, a head support frame that projects transversely with respect to the base platform and a head cradle with a V-shaped engagement block including edge portions extending transversely on opposite sides of the occipital center line for engaging the occiput. The head cradle is adjustably coupled to the head frame for holding the engagement block at a selected elevation above the base platform, which is determined by the length of the patient&#39;s torso. 
     According to this technique, most of the patient&#39;s body weight is supported by the floor or other support surface, with the weight of the patient&#39;s upper torso providing a gentle stretch/traction force maintained in cervical and thoracic flexion. The edge portions of the V-shaped engagement block of the head cradle are symmetrically arranged and slope away from the occipital center line to accommodate a wide range of head sizes. 
     The occipital engagement cradle can be quickly set-up, adjusted and supported at a desired elevation for maintaining a gentle, gravity-assisted cervical and thoracic flexion stretch/traction. After the initial set-up, the traction forces and flexion angle are adjusted by positioning the patient&#39;s pelvis and lower extremities away from or closer to the cradle. A therapeutic effect is produced by combining gravity with the angle of flexion along the cervical and thoracic spine, which results in the mild traction of intervertebral joints, muscle relaxation, and stretch of hypomobile tissues throughout the treatment region when performed statically. 
     The foregoing gravity-assisted, passive features are provided by the portable, free-standing support frame of the present invention which can be quickly erected to a stable, operative position for therapy. Its principal component parts are pivotally coupled so that it is expandable into the stable, upright service position and completely foldable and collapsible to a minimum profile configuration for storage, without requiring tools for set-up or conversion to the storage configuration. 
    
    
     BRIEF DESCRIPTION OF THE DRAWING 
     The accompanying drawing is incorporated into and forms a part of the specification to illustrate the preferred embodiments of the present invention. Various advantages and features of the invention will be understood from the following detailed description taken in connection with the appended claims and with reference to the attached drawing figures in which: 
     FIG. 1 is side elevational view of the device and its occipital support cradle in the operative treatment position with a patient utilizing the apparatus for passive flexion stretch and traction; 
     FIG. 2 is a front perspective view thereof; 
     FIG. 3 is a front elevational view thereof; 
     FIG. 4 is a rear perspective view thereof; 
     FIG. 5 is a front elevational view of the occipital support cradle; 
     FIG. 6 is a top plan view of the occipital support cradle mounted on a coupling plate; 
     FIG. 7 is a left side elevational view thereof, shown partly in section; 
     FIG. 8 is a side elevational view, partly in section, of the occipital support assembly mounted on a support platform; 
     FIG. 9 is a sectional view, partially broken away, of a rotatable coupling; 
     FIG. 10 is a front plan view of the coupling plate and occipital support cradle; 
     FIG. 11 is an elevational view, partially in section, showing a pivotal coupling and non-skid pad; 
     FIG. 12 is a top plan view of the traction apparatus shown in its collapsed, minimum profile storage configuration; and, 
     FIG. 13 is a side elevational view thereof. 
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
     Preferred embodiments of the invention will now be described with reference to various examples of how the invention can best be made and used. Like reference numerals are used throughout the description and several views of the drawing to indicate like or corresponding parts. 
     Referring initially to FIG.  1  and FIG. 2, a portable, free-standing support frame assembly  10  is shown in its erect, upright treatment position for maintaining a gentle stretch, traction force in cervical and thoracic flexion. A patient assumes a static, semi-reclined position (FIG. 1) with patient&#39;s upper torso and head being elevated and inclined with respect to the floor or other support surface  12 . The support frame assembly  10  includes a base platform  14  for flat engagement on the floor surface  12 . A head support frame in the preferred form of a bolster board  16  projects transversely with respect to the base platform in the erect, upright treatment position. Preferably, the bolster board  16  is inclined at an angle α in the range of 75°-90° with respect to the base platform when the support frame assembly  10  is erected in the upright treatment position. 
     A head cradle in the preferred form of a V-shaped occipital engagement block  18  is releasably mounted on the head support frame, so that its elevation above the floor surface  12  can be manually adjusted. The V-shaped occipital engagement block  18  includes edge portions  20 ,  22  that extend transversely on opposite sides of the occipital center line L (FIG.  5  and FIG. 10) for engaging the occiput. The head cradle  18  is set so that the patient&#39;s head is positioned at a selected elevation above the floor surface  12 , which is determined by length of the patient&#39;s torso. 
     The edge portions  20 ,  22  extend outwardly from a vertex point and define an included angle φ (FIG. 6) in the range of 90°-110°. The head cradle  18  also includes a flat ledge surface  24  which slopes at an angle θ with respect to a horizontal line H (which is parallel with the base platform  14 ), as shown in FIG.  8 . According to this arrangement, the edge portions  20 ,  22  are presented for bilateral engagement against the underside of the occipital lobes. The base support platform includes left and right base rails  14 A,  14 B that are joined together by a pivot coupling  26 , thereby permitting folding movement of the left base rail relative to the right base rail from a retracted minimum profile position (FIG. 12) to a spread-apart operative support position, as shown in FIG.  2 . 
     The base rails  14 A,  14 B are stabilized in the spread-apart, operative support position by a foldable cross-bar assembly  28  that extends between the left and right base rails in the spread-apart, operative position. The cross-bar assembly  28  includes first and second cross-bar segments  28 A,  28 B that are joined together by a pivot coupling  30  which permits folding movement of the cross-bar segments relative to each other. The opposite ends of the cross-bar segments are joined to the base rails  14 A,  14 B by pivot couplings  32 ,  34 , respectively. 
     The extended position of the cross-bar segments is stabilized by the clamping attachment of the bolster board  16 . The base end portion  16 B of the bolster board  16  is fitted with open ended clamps  36 ,  38  which in combination with the bolster board  16  form a bridge across the pivot coupling  30 , thereby securely locking the cross-bar segments  28 A,  28 B in the fully extended position. The clamps  36 ,  38  resiliently engage the cross-bar segments, thus permitting the bolster board  16  to rotate in pivotal movement about the cross-bar assembly during erection of the support frame assembly. Additionally, the clamps  36 ,  38  can be separated from the cross-bar assembly to permit folding movement to the minimum profile configuration as shown in FIG.  12  and FIG.  13 . 
     Referring now to FIG.  2  and FIG. 4, the bolster board  16  is stabilized in the upright operative position by left and right struts  40 ,  42 . A pair of pivotal coupling members  44 ,  46  connect the struts to the base rails  14 A,  14 B, thereby permitting folding movement of the struts relative to the base rails. Additionally, the pivot couplings  44 ,  46  are further rotatably coupled to the base rails  14 A,  14 B by a swivel cooupling  48 . In the preferred embodiment, each pivotal coupling member  44 ,  46  includes a clevis  44 A and pivot pin  44 B (FIG.  11 ). The swivel coupling preferably is formed by a ball and socket union  48 A,  48 B. 
     The opposite ends of the struts  40 ,  42  are pivotally coupled to the bolster board  16  by an upper cross-bar  50 . The cross-bar  50  is secured to the bolster board  16  by a compression clamp  52 . Referring to FIG.  4  and FIG. 9, the tightness of the compression fit between the clamp  52  and the cross-bar  50  is adjusted so that the bolster board  16  can be manually rotated as required during set-up. 
     The upper end portions  40 B,  42 B of the struts are pivotally joined to the cross-bar  50  by pivot couplings  54 ,  56 , respectively. 
     Because of the variation of physical body size from patient-to-patient, it is necessary to provide means for adjusting the elevation of the head support cradle  18  with respect to the floor surface. According to a preferred embodiment of the present invention, adjustment of the head support cradle  18  is provided by a coupling plate  58  which is releasably attached to the bolster board  16  by a pair of L-shaped brackets  60 ,  62  (FIG.  8  and FIG.  10 ). Each L-shaped bracket includes a right angle tang portion  60 A,  62 A, respectively, which is engagable with the reverse side  16 B of the bolster board as shown in FIG.  8 . In this arrangement, the bolster board is intersected by multiple pairs of index slots  64 ,  68 . The slots of each pair are in horizontal alignment with each other, and the slots are arranged in two parallel columns, with the slots within each column being in vertical alignment as shown in FIG.  3  and FIG.  4 . 
     Referring now to FIG. 5, FIG. 6, FIG. 7, FIG.  8  and FIG. 10, the occipital support cradle  18  is generally in the form of a V-shaped wedge with left and right occipital support block portions  18 A,  18 B diverging symmetrically from the occipital center line L. As shown in FIG. 5, the left and right block portions  18 A,  18 B form sidewall boundaries of a pocket which receives the patient&#39;s neck, as shown in FIG.  1 . 
     According to this arrangement, the patient&#39;s head is supported against the coupling plate, with the occipital lobes engaged against the edge portions  20 ,  22 . Preferably, the pocket  68  is deep enough so that the patient&#39;s neck and the patient&#39;s shoulders do not touch the bolster board when the patient is correctly positioned. This allows the patient to apply his torso weight for inducing a gentle flexion stretch/mild traction force, assisted only by gravity. Moreover, the patient can rotate his torso to either side while his head and neck remain engaged and immobilized. Preferably, the patient&#39;s head is secured by a strap  70  to ensure that the proper engagement is maintained. To further assure stable positioning of the support assembly  10 , non-skid pads  72 ,  74  are attached to the underside of the left and right base rails  14 A,  14 B (FIG.  11  and FIG.  13 ). Preferably, the occipital support blocks  18 A,  18 B are enclosed within a soft, disposable covering  76 , either a vinyl or foam material. 
     During set-up of the portable support frame  10 , the base rails  14 A,  14 B, the cross-bar segments  28 A,  28 B and the struts  40 ,  42  are unfolded outwardly with respect to each other to the fully extended position as shown in FIG.  2 . Referring to FIG. 12, which shows the collapsed, minimum profile condition, set-up is initiated by unfolding and extending the base rails  14 A,  14 B simultaneously with unfolding extension movement of the struts  40 ,  42 . At the same time, the lower cross-bar assembly  28  is unfolded to the straight line support position which limits further unfolding movement of the base rails. Next, the bolster board  16  is rotated downwardly, until the clamps  36 ,  38  are in a position to engage the cross-bar  28 . The cross-bar segments  28 A,  28 B are then inserted into the jaws of the resilient clamps  36 ,  38 , which form a snap-fit compression union. The struts, base rails and bolster board are dimensioned appropriately to position the bolster board within the preferred angular range. 
     The portable support frame  10  of the present invention provides the following advantages: 
     1. It combines cervical and thoracic flexion in order to produce a mild flexion stretch of the posterior soft tissues, including muscles, ligaments and facet capsules. 
     2. It combines this flexion stretch with a static traction of the weight bearing intervertebral joints. 
     3. The amount of traction force is determined and adjusted by the user changing his or her body position. 
     My invention cannot be used for conventional intermittent or static traction for several reasons. Chief amoung them is that the amount of force for the “pull” cannot be precisely controlled (important when applying traction). The therapist must know the amount of force in order to objectively treat certain conditions, as well as make knowledgeable changes based on patient response during or following the prior treatment. 
     Another key distinguishing feature is that a conventional traction device is often used to treat a bulging intervertebral disc. The angle of pull force can be critical, and the bulge is almost always in the cervical region. Clinical and home traction devices allow the angle of pull to be adjusted in accordance with the faulty disc. My support frame invention does not have this adjustability, and therefore, should not be used for that diagnosis in most instances. 
     My support frame invention can be used effectively to produce relaxation with a positive effect on pain via gentle stretch in a flexed position combined with a mild traction of the weight bearing intervertebral joints for: 
     1. More effectively managing certain conditions with little or no intervention by a health care professional. In other words, as a home therapy program initially guided by a professional by prescription, or purchased by a lay person without prescription and without professional supervision. 
     2. It can be used by health care providers as a valuable, brief treatment immediately prior to other treatments in the clinic, such as before applying traction (with some exceptions), manipulation, mobilization and the like, to be more effective (indicated conditions would be almost always in the subacute and chronic phases) and unsupervised patient use as part of a home program. 
     Secondary benefits include further improvement in the relief of pain, release of hypomobile facet joints and costovertebral joints, and reduction of soft-tissue hypomobilities. 
     My support frame is unique in that it is a stand-alone floor design and combines gravity-assisted gentle, static traction (circumventing the TMJ) with mild flexion stretch of neck and upper back posterior soft-tissue components. 
     My support frame also has value in the clinic in connection with a brief, preparatory treatment in both subacute and chronic therapy regimes for the neck and upper back, enhancing effectiveness of subsequent techniques by its relaxation effects. Once instructed, the technician or therapist can perform the set-up or the patient may perform self-setup. Either way, employee time is minimized. And the physical strain to the professional while performing a manual technique is eliminated. 
     The professional prescribing my support frame for home use is likely to see good follow-through in patient compliance as a result of its comfort and ease-of-use. 
     My support frame invention is intended for use by the following: the unsupervised at-home patient; physical therapist; D.O.; massage therapist; and D.O.C. in connection with therapy for relieving pain conditions of the neck and upper back including general aches and pains, tension or muscle spasm, tension headache, facet joint subluxation (hypomobility), soft tissue hypomobility, degenerative disc disease, other joint disorders, including some classifications of arthritis. 
     Although the invention has been described with reference to an exemplary arrangement, it is to be understood that various changes, substitutions and modifications can be realized without departing from the spirit and scope of the invention as defined by the appended claims. 
     
       
         
           
               
               
               
             
               
                   
                 TABLE I 
               
               
                   
                   
               
               
                   
                 Description 
                 Material 
               
               
                   
                   
               
             
            
               
                   
                 Bolster Board 16 
                 High impact polystyrene 
               
               
                   
                   
                 (HIPS) injection molded 
               
               
                   
                 Base Platform 14 
                 High impact polystyrene 
               
               
                   
                   
                 (HIPS) injection molded 
               
               
                   
                 Head Cradle 18 
                 ABS plastic, injection 
               
               
                   
                   
                 molded 
               
               
                   
                 Covering 76 
                 Vinyl; foam padding 
               
               
                   
                 Strap 70 
                 Nylon 
               
               
                   
                 Upper Cross-Bar 50 
                 Aluminum tubing, 1″ O.D. 
               
               
                   
                 Lower Cross-Bar Assembly 28 
                 Aluminum tubing, 1″ O.D. 
               
               
                   
                 Left and Right Base Rails 
                 Square tubing, aluminum 
               
               
                   
                 14A, 14B 
                 (1″ × 1″ × .062″ wall) 
               
               
                   
                 Left and Right Struts 
                 Square tubing, aluminum 
               
               
                   
                 40, 42 
                 (1″ × 1″ × .062″ wall) 
               
               
                   
                 Pivot Assembly 44, 46 
                 Machined steel 
               
               
                   
                 Swivel Assembly 48 
                 Machined steel 
               
               
                   
                 Non-Skid Pad 72, 74 
                 Synthetic rubber