Patent Publication Number: US-6905508-B2

Title: Lumbar support and adjustment assembly

Description:
REFERENCE TO RELATED APPLICATION 
   This application is a continuation-in-part of application Ser. No. 09/661,078, filed Sep. 13, 2000 now U.S. Pat. No. 6,547,809, entitled Multi Function Treatment Table. 

   BACKGROUND OF THE INVENTION 
   The within invention is an improvement of the inventions of my U.S. Pat. No. 4,915,101 (1990), U.S. Pat. No. 5,922,011 (1999), and that reflected in my application Ser. No. 09/661,078, filed Sep. 13, 2000. 
   Numerous devices, including chiropractic, osteopathic, obstetrical, delivery, x-ray and operating tables, which suspend or position a patient in a unique way for some special purpose, are known in the art. 
   U.S. Pat. No. 4,568,669 (1971) to Stiles discloses a posture board wherein the patient is rotated 180 degrees from an initial upright position on his back to one of complete inversion hanging by the ankles. With the body hanging freely, normal gravitational pull is reversed thus causing a therapeutic effect on bone structure, spinal column, muscles, internal organs and body fluids. 
   U.S. Pat. No. 4,103,681 (1978) to Shanley similarly discloses a tilting traction apparatus where the patient, again lying on his back, is rotated about a pivot point to treat back injury or postural misalignment. 
   U.S. Pat. No. 4,292,926 (1981) to Krause presents an apparatus for effecting postural treatment of humans in which the patient, while resting face down on a pivoting platform, can vary the position of his arms, adjust his center of gravity while in suspension and, thereby, affect his posture upon the table. 
   It is to be appreciated that the success of any device designated to treat lower back dysfunction is in large part dependent on proper positioning of the patient prior to, during, and after treatment. For example, in standard traction therapy, the patient wears a pelvic harness and is positioned supinely (face up) in bed, with the spine slightly flexed and knees bent. Straps or roping which is attached to the harness are then inserted into a pulley mechanism and weights attached at an opposite end, causing a desired pulling/traction effect. Such pulling traction force produces an elongation of the spinal column (distraction) and a reduction in internal intervertebral disc pressure. This creates a vacuum phenomenon inside the disc, which retracts protruded gelatinous material back into its fibrous casing and off of the spinal nerve roots. With the pain gone and the anatomy restored to its natural state, the traction phase of therapy is complete. 
   An alternate theory for accomplishing the same result is based on extension, rather than flexion of the spine, to achieve reduced intradiscal pressure, while simultaneously anatomically moving nerve roots away from the herniated disc. 
   While the general principles of flexion and axial traction of the spine are known in the art and have been effected in various strap and/or harness arrangements, either alone or in combination with rotating-pivot type tables as are described above, the inventor has found that both flexion and extension, as well as lateral positioning with traction, can all be beneficial depending upon the patient&#39;s particular ailment or condition. 
   As such, there exists a need for a system which combines varying degrees of both traction or distraction with concomitant patient position flexion, extension, lateral flexion, and or axial spinal positioning. The present invention being both beneficial to the patient and convenient to the doctor, fulfills this need in a variety of ways in that the inventive treatment table not only enables rotation of a patient about a pivot point but, additionally, permits the relative, selectable positioning of the patient&#39;s arms, upper torso, legs, lower back, head and shoulders through manual adjustment or an automatic keypad control. The present invention also allows a complete choice as to prone, supine or lateral positioning of the patient prior to treatment. It further enables the doctor to vary the position of the patient prior to and during treatment, and to vary the degree of tractive force applied to the patient by selectably variably rotating the patient platform to increase or decrease the tractional gravitational pull applied through such rotation. There is further provided a “dynamic rotation” into a variable vertical traction position, i.e., the patient stands upright against the table, supported by an adjustable shoulder, arm and hand support and is lifted off the ground, thereby achieving tractional dynamics related to those described above, namely a rapid lengthening of the muscles and longitudinal ligaments of the spine increasing the separation of the intervertebral disc and articular joint spaces. This results in both mobilization of the spine and rapid development through the “disc unloading” of a negative internal disc pressure responsible for causing the vacuum phenomenon for retracting protruding disc material back within the borders of a healthy disc while keeping the patient suspended in mid-air, or while the patient remains standing on a weighted patient platform, utilizing the weight of the lower extremity, the force of gravity, and selected patient anatomical positioning. 
   My instant invention therefore defines functionally over the structure of my earlier inventions in the following material respects: 
   1. Ability to concurrently or sequentially lift and rotate the patient, thus providing various treatment options to the physician, including more effective traction of vertebral segments prior to and during table and patient rotation, thereby reducing stress on articulate vertebral surfaces of the patient and obtaining a generally more ergonomic patient interface. 
   2. Ability to change radius of lower back support assembly, to effectuate varying degrees of lumbar extension and lumbar support, as well as a general mobilization of the lumbar spine (lower back). 
   3. Ability to tilt, at a variety of angles, the top or bottom half of the lower back support assembly, allowing a greater range of positions of the patient&#39;s lumbar spine, and to increase or decrease the lumbar lordosis. 
   SUMMARY OF THE INVENTION 
   In multi-function chiropractic treatment table, a lumbar support and adjustment assembly includes a rigid support plate mounted upon a rigid body support frame of said table; an upper pneumatic cylinder having an upper piston rod associated therewith, said cylinder having a proximal end rigidly secured to said support frame and having a distal end having an aperture for fluid type reciprocal receipt of a proximal end of said piston rod therein, said piston rod also having a distal end and a lower pneumatic cylinder having a lower piston rod associated therewith, said lower cylinder having a proximal end pivotally secured to said support frame and having a distal end having an aperture for fluid tight reciprocal receipt of a proximal end of said lower piston rod therein, said piston rod having a distal end, in which said proximal ends of said respective cylinders are separated from each other by a longitudinal dimension in a range of about 20 to 30 centimeters. Further included is a lumbar cushion mounted upon an upper side of a rigid lumbar thrust surface, a lower side of said surface pivotally secured to each of said distal ends of said piston rods of said respective upper and lower cylinders; means for selectably changing the extent of extension of said upper piston rod relative to said upper cylinder; and means for selectably changing the extent of extension of said lower piston rod relative to said lower cylinder, whereby the height and angulation of said lumbar cushion relative to said body support frame may be readily changed by same assembly. 
   A principal object of the invention is to provide a multi-purpose table to effectuate flexion, extension, traction, lateral movement and distraction of the spine, as may be required in the treatment of spinal disorders and/or maintenance of proper human posture, in such a manner that the relative positions of the patient&#39;s arms, legs, lower back, head and shoulders can be varied. 
   Another object is to provide a multipurpose rotatable traction/treatment table permitting patient rotation and dynamic lifting of a patient while standing, concurrently with selective patient body positionings as may be required in the treatment of disc herniations and other disorders and/or maintenance of proper human posture. 
   Yet another object of the invention is to provide a treatment table having a range of motion from zero to at least ninety degrees and, within that range, which can pivot from zero to at least ninety degrees, thereby providing the ability to achieve spinal positioning including spinal flexion, extension, lateral flexion, and axial spinal positioning and traction in the absence of a lower leg support assembly enabled by inherent torso support and placement of the human body at or near its center of gravity at the lower back support assembly. 
   A still further object is to provide a table which having a variety of pneumatic and other adjustments to permit that patients of widely disparate age, height and weight to be accommodated, without requirement of extended physician set up time. 
   Another object of the invention is to provide a multi-purpose table that is simple to operate, weighted and designed for safety so as not to tip, and constructed of quality materials. 
   A yet further object is to provide a system in which the position of the upper torso support assembly may be varied relative to the lower back support assembly. 
   It is another object to provide a system than can concurrently or sequentially lift and/or rotate the patient, this providing various treatment options to the physician, including more effective and safer traction of vertebral segments by inducing less stress on atriculate vertebral surfaces of patient, and a generally more ergonomic patient interface. 
   A further obfect is to provide a system by which the patient may exercise and strengthen the spine and related musculature to maintain and enhance the health thereof. 
   It is another object to provide a treatment table capable of easy and variable patient means to remain on body support platform during “dynamic” liftoff including overhead or underarm patient hand gripping means and overhead thoracic harness strapping means. 
   It is a yet further object to effectuate flexion, extension, lateral flexion, and axial spinal positioning through easily accessed patient activated control switches to allow patient participation in treatment, improved patient safety, and better patient compliance. 
   Other objects and advantages of the invention will become apparent from the Detailed Description of the Invention, the Drawings, and Claims appended herewith. 

   
     BRIEF DESCRIPTION OF THE DRAWINGS 
       FIG. 1  is front diagonal perspective view of a chiropractic table which embodies the inventive lumbar support. 
       FIG. 2  is a rear diagonal perspective view of the structure of FIG.  1 . 
       FIG. 3  is an elevational view of the lumbar back assembly. 
       FIG. 4  is a side operational view of the lumbar support assembly in which a lower piston rod thereof is extended to greater extent than an upper piston rod. 
       FIGS. 5-15  are views of different relative heights and angulations of a first cylinder-and-piston pair relative to a second pair, and resulting changes in position of the lumbar support cushion caused thereby. 
       FIG. 16  is a bottom-up view of the lumbar traction assembly. 
       FIG. 17  is an upside down view thereof. 
       FIG. 18  is an exploded view of the major mechanical groups of the lumbar traction assembly. 
   

   DETAILED DESCRIPTION OF THE INVENTION 
   With reference to the views of  FIGS. 1 and 2 , the present chiropractic treatment table for effecting extension, flexion, traction and distraction of the spine of a patient, to which the invention relates, may be seen to include a base  10  adapted to rest upon a floor  12  in a typical treatment room of a chiropractor, physical therapist, or other health professionals involved in physical medicine. The chiropractic table may be seen to optionally include a pair of elevation means  14  and  16  to enable positioning of patients of various heights on the table. Elevation means  14  and  16  preferably comprise extensible hydraulic pistons, each including upper ends which support a transverse axle  22 . 
   As may be appreciated in the view of  FIG. 3 , axle  22  is journalled within channel  23  of block support  25  of rigid upper body support frame  26 . 
   The instant multi-purpose treatment table thereby includes said upper support platform  26  having an upper part  28  and a lower part  30 . Said lower part  30  of Upper rigid support frame or platform  26  is secured to said pivot block  25  (see  FIG. 3 ) which is rotatable upon said pivot axle  22  at the approximate mid-point of lower part  30  of frame  26 . As may be further noted, said upper part  28  defines a plane which is directed at an angle of about thirty degrees relative to a plane defined by said lower part  30  of the upper support platform  26 . Such an angle is necessary in that it allows the patient&#39;s upper body to be ergonomically supported by a body support assembly  32 , permitting the back to extend convexly and backward relative to base  10 . Support assembly  32  is mounted upon said upper part  28  of said rigid support platform  26 . Said body support assembly may or may not be divided into, and may or may not include, moveable sections with hydraulic or pneumatic pistons or other means for elevation and de-elevation of the body support assembly  32 . Said assembly may contain an integral air bladder for additional immobilization. 
   With reference to  FIGS. 1 and 2 , the system may also be seen to optionally include a pair of positionally adjustable arm support means  42  and  44  which are located proximally to the sides of a body support assembly  32 . As is set forth below, said arm support means include a selectably adjustable rear portion  46  which is secured to said upper part  28  of the rigid support platform  26 . Said arm support means  42  and  44  include (i) substantially horizontal arm rests  50 ; (ii) a chest and shoulder support  51  situated posteriorly and angled inwardly in a patient direction from said arm rest; and (iii) a tilted hand grip  52  depending integrally upwardly and inwardly, proximally to said chest and shoulder supports  51 . 
   The present treatment table may be seen to optionally include a lumbar and buttock support assembly  40 , which is displaced from said body support assembly  32 . Lumbar assembly  40  is connected to telescoping piston rods  53  and  55  (see  FIG. 4 ) or other means which provide for elevation and de-elevation thereof. Said assembly may include an internal air cushion in the form of an inflatable air bladder, for added support and tissue mobilization. The same is true of the upper torso support assembly. 
   More particularly, shown in  FIG. 4  is the use of airfoil pistons  138  and  139 , both of which are secured, at the proximal ends thereof, to a rigid support plate  116  that is secured to lower part  30  of rigid support platform  26 . It is, however, to be noted that lower airfoil piston  139  is pivotally secured to support plate  116  at a pivot point  140 , while upper airfoil piston  138  is rigidly secured to plate  116  at point  121 . Distal ends of piston rods  53  and  55  are both pivotally attached to rigid lumbar thrust plate  141  at points  142  and  144  respectively. As such, lumbar support cushion  146  may be readily tilted relative to platform  26  to provide independent articulation, movement, and adjustment of the effective radius of cushion  146 , that is, relative to lower portion  30  of platform  26  as is shown in  FIGS. 5  thru  16 . 
   Therein may be seen the essentially unlimited number of variations of height and angulations of the lumbar assembly that may be achieved by the present system. 
   The present chiropractic table may be seen to further include means for selectable reciprocal vertical extension, i.e., an electromechanical linear actuator or an extensible hydraulic or pneumatic piston  57  (see  FIG. 2 ) which enables rotation of said rigid support platform  26 , upon said horizontal pivot axle  22 , by rotation of pivot block  25  to which platform  26  is secured. It is, accordingly, to be appreciated that extensible piston  57  facilitates a central function of the chiropractic table, i.e., the rotation of all assemblies attached to the rigid support platform  26 , including body support assembly  32 , the lumbar support assembly  40 , and the adjustable arm support means  42 , all through the use of a single control means, namely, extensible piston  57 . 
   With reference to the bottom-up view of  FIG. 16  of the lumbar traction assembly  40 , the lumbar bottom cover is removed to reveal the components of the assembly inside of the lumbar that plate  116 . The lumbar support frame and support frame plate are also removed to facilitate the illustration of FIG.  16 . As may be noted, the lumbar side brackets  150 / 156  are slidably mounted to lumbar plate  116 . Therein, said plate  116 , a lumbar cushion plate  154 , and lumbar cushion  146  are rigidly mounted on lumbar side brackets  150 / 156  of lumbar traction assembly  40  may thereby move lumbar cushion  146  relative to lumbar support plate  116 . 
   With reference to  FIGS. 17 and 18 , shown a top view of the assembly of  FIG. 16  which, particularly, illustrates the process of power traction of the inventive lumbar support and adjustment assembly. Therein, a mechanical lock rod  160  screws onto a spring assembly  162  which is fixed onto a lumbar thrust bracket  141 . Said thrust bracket is, in turn, attached to lumbar side brackets  150 / 156  on which the lumbar cushion  146  and lumbar cushion plate  154  are mounted. A lumbar cushion group  166  thus formed is slidably mounted to the other components of the lumbar plate group  164 . Thereafter, lumbar cushion group  166  is locked onto a mechanical lock slide  168  for linear movement, sliding into lumbar plate center slide  170 . In addition to plate center slide  170 , the lumbar cushion group  166  is also slidably mounted at the sides of the lumbar cushion plate  154  by a pair of lumbar side bracket slides  172 . 
   Further shown in  FIGS. 17 and 18  are lumbar traction hydraulic rod  174 , lumbar plate side slide  176 , ball bearing sleeve assembly  178 , lumbar traction hydraulics  180 , mechanical lock solenoid  182 , mechanical lock clamp  184 , lumbar mechanical lock  186 , link bracket  188 , load cell  190 , mechanical lock release table  192 , lumbar plate side slide  194 , and up and down lumbar mounting plates  196 . 
   The above described lumbar plate group  164  and lumbar cushion group  166  the power traction function of the inventive multi-function chiropractic treatment table. That is, after the proper height and angulation of the lumbar support and adjustment assembly, shown in  FIGS. 4-15 , has been established, the doctor may, through the use of controls  74  (see  FIGS. 1 and 2 ) accomplish selective stretching or traction of the lower back of the patients while handles  42  and  44  are held. 
     FIGS. 1 and 2  further illustrates a system control  74  for use by the doctor which includes the following functions buttons: 
   
     
       
         
             
             
             
           
             
                 
             
           
          
             
               1. 
               TBL LFT = 
               Table Lift. 
             
             
               2. 
               TBL LWR = 
               Table Lower. 
             
             
               3. 
               ROT BACK = 
               Rotate Table Back. 
             
             
               4. 
               ROT FWD = 
               Rotate Table Forward. 
             
             
               5. 
               ARM UP = 
               Translational Arm Height Up. 
             
             
               6. 
               ARM DWN = 
               Translational Arm Height Down. 
             
             
               7. 
               OPEN 
             
             
               8. 
               OPEN 
             
             
               9. 
               ARM R. UP = 
               Arm Rotate Up. 
             
             
               10. 
               ARM R. DOWN = 
               Arm Rotate Down. 
             
             
               11. 
               LUM IN = 
               Lumbar In 
             
             
               12. 
               LUM OUT = 
               Lumbar Out 
             
             
               13. 
               OPEN 
             
             
               14. 
               OPEN 
             
             
               15. 
               RBK TL = 
               Rotate Table Back with Table Lift. 
             
             
               16. 
               RFW TLW = 
               Rotate Table Forward with Table 
             
             
                 
                 
               and Lower Table. 
             
             
               17. 
               SAFETY ON AND OFF = 
               A safety on and off button is 
             
             
                 
                 
               included which stops pneumatic/ 
             
             
                 
                 
               hydraulic piston and ceases all 
             
             
                 
                 
               table movement. 
             
             
                 
             
          
         
       
     
   
   As a safety measure, controls may also be incorporated into overhead gripping means  54  or into handgrips  42  (see FIGS.  1  and  2 ), with optional patient control of other functions. 
   While there has been shown and described the preferred embodiment of the instant invention it is to be appreciated that the invention may be embodied otherwise than is herein specifically shown and described and that, within said embodiment, certain changes may be made in the form and arrangement of the parts without departing from the underlying ideas or principles of this invention.