Patent Document

CROSS REFERENCE TO RELATED APPLICATIONS 
       [0001]    This application claims priority to a corresponding provisional application U.S. Ser. No. 61/187,168, filed Jun. 15, 2009 in the name of the Applicant, which is incorporated herein by reference. This application is also related to U.S. Pat. No. 6,821,288, which was issued on Nov. 23, 2004 in the name of the Applicant and which is also incorporated herein by reference. 
     
    
     FIELD OF THE INVENTION 
       [0002]    This invention relates generally to therapy tables, and more specifically, to an automated therapy table having various support portions capable of independent automatic actuation of a person&#39;s lower extremities through passive exercise by performing leg elevation, approximation/decompression of the leg, internal/external rotation of the leg, ankle plantar flexion/dorsiflexion, and foot inversion/eversion. 
       BACKGROUND OF THE INVENTION 
       [0003]    Over 2.5 million people worldwide suffer from Multiple Sclerosis (MS) and over a quarter of a million children and adults suffer from some form of joint contracture. Joint contracture is a stiffening of the muscles near the joints that can make it difficult for individuals to move. In some cases, this leads to joints locking in a painful position. 
         [0004]    Physical therapy, especially regular stretching, is important in helping to enhance the range of motion for affected muscles and to prevent or delay contractures. Physical therapy can also help maintain muscle tone and reduce the severity of joint contractures. With regular exercise, muscles are kept strong and joints more flexible. It is believed that strengthening supporting muscle groups to compensate for weakened muscle groups might be beneficial to patients with early stages of Muscular Dystrophy (MD). 
         [0005]    People with various forms of debilitating illnesses, such as Multiple Sclerosis (MS), Charcot-Marie-Tooth (CMT), and Muscular Dystrophy (MD) suffer from progressive weakness, pain, and degeneration of skeletal muscles that are required for voluntary movement. For treatment, these people often seek the assistance of a physical therapist, chiropractor, or other medical practitioner in order to alleviate their discomfort. A physical therapist will often resort to stretching techniques to ease a patient&#39;s discomfort—positioning the patient on a therapy table and manually stretching and manipulating the patient&#39;s body. This can be physically demanding for the therapist. The lower extremities are especially difficult to manipulate because of their length, size, and weight. 
         [0006]    A need therefore existed for an automated therapy table which may be controlled by a physical therapist or other medical practitioner to actuate various component portions of the table in order to move parts of a person&#39;s body, specifically the lower extremities, in a desired direction for a desired period of time without causing physical stress to the physical therapist or medical practitioner. All of the functions of the automated therapy table, accompanied by the thought process of the patient assisting in the direction of every movement, help to rehabilitate and strengthen muscles. 
       SUMMARY OF THE INVENTION 
       [0007]    In accordance with one embodiment of the present invention, a therapy table is disclosed. The therapy table comprises at least one torso platform for supporting a torso of a person, and an exercise platform coupled to the torso platform, the exercise platform for exercising at least one of a leg and a foot of the person in a desired range of motion. 
         [0008]    In accordance with another embodiment of the present invention, a therapy table is disclosed. The therapy table comprises a base, a torso platform coupled to the base for supporting a torso of a person, and at least one exercise platform coupled to the torso platform, the exercise platform for exercising at least one of a leg and a foot of the person in at least one of leg elevation, leg approximation, leg decompression, medial leg rotation, lateral leg rotation, ankle plantar flexion, ankle dorsiflexion, foot inversion, and foot eversion. 
         [0009]    In accordance with another embodiment of the present invention a method for treating the lower extremities of a person is disclosed. The method comprises the steps of providing a therapy table comprising a torso platform for supporting a torso of a person; at least one exercise platform coupled to the torso platform, the exercise platform for exercising at least one of a leg and a foot of the person in at least one of leg elevation, leg approximation, leg decompression, medial leg rotation, lateral leg rotation, ankle plantar flexion, ankle dorsiflexion, foot inversion, and foot eversion; and thinking by the person of a particular movement while performing one of leg elevation, leg approximation, leg decompression, medial leg rotation, lateral leg rotation, ankle plantar flexion, ankle dorsiflexion, foot inversion, and foot eversion. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0010]    The present invention will become more fully understood from the detailed description and the accompanying drawings, wherein: 
           [0011]      FIG. 1  is a perspective view of one embodiment of an automated therapy table for treating lower extremities in accordance with the present invention. 
           [0012]      FIG. 2  is a side view of the automated therapy table of  FIG. 1 , shown performing the movement of leg elevation. 
           [0013]      FIG. 3  is a side view of the automated therapy table of  FIG. 1 , shown performing the movement of leg approximation. 
           [0014]      FIG. 4  is a side view of the automated therapy table of  FIG. 1 , shown performing the movement of leg decompression. 
           [0015]      FIG. 5  is a perspective view of the automated therapy table of  FIG. 1 , shown performing the movement of internal leg rotation. 
           [0016]      FIG. 6  is a perspective view of the automated therapy table of  FIG. 1 , shown performing the movement of external leg rotation. 
           [0017]      FIG. 7  is a side view of the automated therapy table of  FIG. 1 , shown performing the movement of ankle plantar flexion. 
           [0018]      FIG. 8  is a side view of the automated therapy table of  FIG. 1 , shown performing the movement of ankle dorsiflexion. 
           [0019]      FIG. 9  is a top view of the automated therapy table of  FIG. 1 , shown performing the movement of foot inversion. 
           [0020]      FIG. 10  is a top view of the automated therapy table of  FIG. 1 , shown performing the movement of foot eversion. 
           [0021]      FIG. 11  is a side view of the automated therapy table of  FIG. 1 . 
           [0022]      FIG. 12  is a side view of a gear mechanism and femur support portion of a clamp of the automated therapy table of  FIG. 1 . 
           [0023]      FIG. 13  is a perspective view of the femur support of the automated therapy table of  FIG. 1 . 
           [0024]      FIG. 14  is an exploded view of a roller assembly and foot housing which may be used with the present invention. 
       
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS 
       [0025]    The novel features believed characteristic of the invention are set forth in the appended claims. The invention will best be understood by reference to the following detailed description of illustrated embodiments when read in conjunction with the accompanying drawings, wherein like reference numerals and symbols represent like elements. 
         [0026]    Referring to  FIGS. 1-14 , an automated therapy table for treating lower extremities, hereinafter automated therapy table  10 , is shown. The automated therapy table  10  is dimensioned to support a person  46  in a supine position and to assist the person  46  in performing passive controlled movements such as: leg elevation, approximation/decompression of the leg  48 , internal/external rotation of the leg  48 , ankle plantar flexion/dorsiflexion, and foot inversion/eversion. In its simplest form, the therapy table  10  comprises a torso platform  20  for supporting the torso of the person  46  and an exercise platform  21  to assist the person  46  in any one or any combination of the aforementioned exercises. 
         [0027]    Referring to  FIG. 1 , the automated therapy table  10  may have a base  11 , a lumbar platform  12 , a thoracic platform  14 , two arm platforms  16 , and a head support  18 . It should also be clearly understood that substantial benefit may be derived from the automated therapy table  10  having one whole upper body platform to support the person&#39;s torso, head  58 , and arms  56  or from the automated therapy table  10  having certain platforms combined to form one piece (e.g. the thoracic platform  14  and the lumbar platform  12  may be combined together to form a torso platform  20 ). 
         [0028]    The automated therapy table  10  is shown as having two leg platforms  22  and two foot plates  44  movably coupled to an inferior end of the torso platform  20 . While each leg platform  22  could comprise a single section capable of medial/lateral or posterior/anterior movement, it is preferred that each leg platform  22  be multi-sectioned in a manner corresponding to the leg  48  and ankle  52  joints. 
         [0029]      FIG. 2  shows the automated therapy table  10  performing the passive movement of leg elevation. Leg elevation helps relieve lower leg swelling, which is commonly known as leg edema. Leg edema is typically caused by abnormal accumulation of fluid in the tissues of the lower extremity. Usually, individuals who sit for long periods of time, experience leg tightness or leg edema. To prevent this, individuals who are bed-ridden or lack mobility should elevate their legs as often as they can to loosen tight muscles. Leg elevation is also beneficial in returning blood to the body, which can improve leg circulation. 
         [0030]    In order for the therapy table  10  to be able to assist a person  46  in the performance of this movement, the exercise platform  21  may have a leg platform  22  hingedly coupled to the torso platform  20  with a hinge assembly  32 . In one embodiment, the therapy table  10  will have a support member  60  coupled to a bottom surface of the leg platform  22 . A pivot arm  62  may have one end pivotably coupled to a distal end of the support member  60  of the leg platform  22  and may have another end pivotably coupled to a bottom surface of the torso platform  20 . There may also be an actuator  34  having one end that is pivotably coupled to a proximal end of the support member  60  of the leg platform  22  and another end that is pivotably coupled to the base  11  of the therapy table  10 . When the actuator  34  extends, the leg platform  22  is raised and when the actuator  34  retracts, the leg platform  22  is lowered back to a resting position. While it is shown in the figure that the hinge assembly  32  has two pivot arms  62 , it should be clearly understood that substantial benefit may be achieved from a single pivot arm  62  or more than two pivot arms  62 . 
         [0031]      FIGS. 3 and 4  show the automated therapy table  10  performing the passive movements of approximation (see  FIG. 3 ) and decompression (see  FIG. 4 ) of the leg  48 . Leg approximation/decompression help relieve joint pain caused by compression and flexion. Joint pain can be alleviated by decreasing pressure on the joint and by increasing blood flow by eliminating metabolic waste, which can reduce inflammation and numbness in the leg. Decompression is a safe and natural alternative to surgery, injections or prescription medication. One of the primary benefits of approximation is to simulate weight bearing to maintain/increase bone density in individuals who lack mobility. 
         [0032]    In order for the therapy table  10  to be able to assist a person  46  in this type of movement, the exercise platform  11  may have a leg platform  22  for supporting the leg  48  of the person  46 , a foot housing  42  coupled to the leg platform  22  for supporting the foot  50  of the person  46 , and at least one actuator  34 . The actuator  34  may have one end coupled to the foot housing  42  and may have another end coupled to the leg platform  22 . When the actuator  34  extends, the foot housing  42  moves in an inferior direction, and thus allows the leg  48  to move inferiorly along a frontal plane (leg approximation). When the actuator  34  retracts, the foot housing  42  moves in a superior direction, and thus allows the leg  48  to move superiorly along a frontal plane (leg decompression). 
         [0033]    To further assist in this movement, the exercise platform  11  may also have a roller assembly  35 . The roller assembly  35  may comprise a roller block housing  38  (see  FIG. 14 ) coupled to the distal end of the leg platform  22  and at least one roller  37  within the roller block housing  38 . A roller block  40  may be coupled to the roller  37  within the roller block housing  38  and a bi-directional roller  36  may be coupled to the roller block  40 . At least two rows of wheels  39  may be coupled to a distal end of the bi-directional roller  36  and at least two corresponding tracks  41  may be present in the bottom surface of the foot housing  42 ; each track  41  would be dimensioned to receive a row of wheels  39 . The roller assembly  35  would assist the movement of the foot housing  42  in an inferior and superior direction as the rollers  37  move within the roller block housing  38 . 
         [0034]      FIGS. 5 and 6  show the automated therapy table  10  performing the passive movements of internal or medial (see  FIG. 5 ) and external or lateral (see  FIG. 6 ) leg rotation. These movements help strengthen and stabilize the respective rotators of the hip. Over time, the piriformis muscle tightens from the lack of immobility and use. It is believed that internal and external leg rotations improve a person&#39;s motional disability by preventing external torsion of the tibia. The exercise platform  21  of the therapy table  10  may assist these movements if it has a leg platform  22  for supporting the leg  48  of the person  46  and a rotation assembly  29 . The rotation assembly  29  may have a leg restraint  24  (such as a clamp  25  or strap) coupled to the leg platform  22  for securing the leg  48  in place. There may be a plurality of teeth  64  coupled to a bottom portion of the leg restraint  24  and a gear mechanism  28  coupled to the leg platform  22  that also has teeth that mesh with the teeth  64  of the leg restraint  24 . When the gear mechanism  28  is rotated, it causes the leg restraint  24  to rotate the leg  48  either medially or laterally. The roller assembly  35  may also assist the movement of the foot housing  42  in lateral rotation and medial rotation when the wheels  39  move along the tracks  41  of the foot housing  42 . Furthermore, the exercise platform  21  may also have at least one rail  26  coupled to the bottom portion of the leg restraint  24  and at least one channel  27  formed within a top surface of the leg platform  22  that receives the rail  26 . Together, the rails  26  moving within the channels  27  help to guide the rotation of the leg restraint  24  within the leg platform  22 . 
         [0035]      FIGS. 7 and 8  show the automated therapy table  10  performing the passive movements of ankle plantar flexion (see  FIG. 7 ) and ankle dorsiflexion (see  FIG. 8 ). These movements treat and help prevent lower extremity disorders associated with injury, illness or immobility, including ankle contractures. Since the ankle  52  controls the movement of the leg  48  relative to the foot  50  and is, therefore, subjected to the weight of the entire body and the forces generated by the dissipation of kinetic energy when the foot  50  makes contact with the ground, it has been determined that articulation of the ankle  52  through plantar flexion and dorsiflexion is paramount to relieving joint stiffness, inflammation, and providing increased range of motion. 
         [0036]    In order to assist with these movements the exercise platform  21  may have a leg platform  22  for supporting the leg  48  of the person  46 , a foot housing  42  coupled to the leg platform  22  for supporting the foot  50 , a foot plate  44  pivotably coupled to the foot housing  42 , and at least two actuators  34 . One actuator  34  may be a superior actuator  34  having one end coupled to the leg platform  22  and having another end coupled to an anterior portion of the foot housing  38 . The other actuator  34  may be an inferior actuator  34  having one end coupled to the leg platform  22  and having another end coupled to a posterior portion of the foot housing  38 . When the superior actuator  34  extends, it causes the anterior portion of the foot housing  38  to move, thereby allowing foot plantar flexion. When the inferior actuator  34  extends, it causes the posterior portion of the foot housing  38  to move, thereby allowing foot dorsiflexion. 
         [0037]      FIGS. 9 and 10  show the automated therapy table  10  performing the passive movements of foot inversion (see  FIG. 9 ) and eversion (see  FIG. 10 ). These are movements in which the sole of the foot  50  is made to face inward and outward, respectively. Foot inversion and eversion help eliminate metabolic waste and strengthens the calves and shins. 
         [0038]    In order to assist these movements, the exercise platform  21  may have a leg platform  22 , a foot housing  42  coupled to the leg platform  22 , a foot plate  44  pivotably coupled to the foot housing  42 , and four actuators  34 . A lateral superior actuator  34   a  may have one end coupled to a lateral portion of the leg platform  22  and may have another end coupled to a lateral anterior portion of the foot housing  42  and a medial superior actuator  34   b  may have one end coupled to a medial portion of the leg platform  22  and may have another end coupled to a medial anterior portion of the foot housing  42 . A lateral inferior actuator  34   c  may have one end coupled to the lateral portion of the leg platform and may have another end coupled to a lateral posterior portion of the foot housing  42  and a medial inferior actuator  34   d  may have one end coupled to the medial portion of the leg platform  22  and may have another end coupled to a medial posterior portion of the foot housing  42 . When the lateral superior actuator  34   a  and the lateral inferior actuator  34   c  extend, this allows for the movement of foot inversion. When the medial superior actuator  34   b  and the medial inferior actuator  34   d , this allows for the movement of foot eversion. 
         [0039]      FIG. 11  shows the automated therapy table  10  in an at rest position. In one embodiment, the therapy table  10  may be used to perform all of the following movements: leg elevation, leg approximation, leg decompression, medial leg rotation, lateral leg rotation, ankle plantar flexion, ankle dorsiflexion, foot inversion, and foot eversion. In order to do so, the therapy table  10  may have a base  11 , a torso platform  20  coupled to the base  11 , a leg platform  22 , a support member  60  coupled to and extending downwardly from a bottom surface of the leg platform  22 , a roller assembly  35  coupled to a distal end of the leg platform  22 , a foot housing  42  coupled to the roller assembly  35  for supporting the foot  50  of the person  46 , a foot plate  44  pivotably coupled to the foot housing  42 , a hinge assembly  32  that pivotably couples the leg platform  22  to the torso platform  20 , an actuator  34  having one end pivotably coupled to a proximal end of the support member  60  and having another end pivotably coupled to the base  11  of the therapy table  10 . The table  10  may also have a plurality of actuators  34 , each actuator  34  having one end coupled to the leg platform  22  and having another end coupled to the foot housing  42  as well as a leg rotation assembly  29  coupled to the leg platform  22 . 
         [0040]    The leg platform  22  may be movably coupled to an inferior end of the torso platform  20  by the hinge assembly  32 . An actuator  34  or drive mechanism raises and lowers the leg platform  22  along a sagittal plane during leg elevation movements (see  FIG. 2 ). The actuator  34  is coupled at one end to the leg platform  22  and the other end is either coupled to the base  11  or rests on the floor. 
         [0041]    As shown in  FIGS. 12 and 13 , each leg platform  22  may have a leg restraint  24 , e.g. a hinged clamp  25  and/or straps to hold the patient&#39;s leg  48  in place. A system of rails  26  and gears  28  also may be used to allow internal and external leg rotation (see  FIGS. 5 and 6 ), moving the leg  48  along a transverse plane. The leg platform  22  may have channels  27  to receive the rails  26 . These channels  27  and rails  26  may help to guide the leg restraint  24  as it rotates within the leg platform  22 . The clamp  25 , rails  26 , and gears  28  are shown positioned proximate the patient&#39;s  46  knee  54  joint. 
         [0042]    As shown in  FIG. 14 , the leg platform  22  may also have a foot housing  42  where a patient&#39;s  46  foot  50  will rest and a foot plate  44  that is movably coupled to the foot housing  42 . In one embodiment, the foot housing  42  may be coupled to a bidirectional roller  36 , the bidirectional roller  36  may then be coupled to a roller block  40 , and the roller block  40  may be slidably coupled to a roller block housing  38 . The roller block  40  moves along a sagittal plane as the rollers  37  move within the roller block housing  38 , allowing for the ankle plantar flexion/dorsiflexion movements and for foot inversion/eversion movements. This design would also accommodate for the difference in the lengths of patients&#39;  46  legs  48 . The bidirectional roller  36  also allows the foot  50  to move along a transverse plane, allowing for the foot inversion/eversion movements. The foot housing  42  may also have a hinged clamp and/or strap to hold the patient&#39;s  46  foot  50  in place. 
         [0043]    There may be a pair of actuators  34  or drive mechanisms on each of the lateral side and the medial side of each leg platform  22 . There may be one lateral superior actuator  34   a , one medial superior actuator  34   b , one lateral inferior actuator  34   c , and one medial inferior actuator  34   d  may be used to move the foot housing  42  in relation to the leg platform  22 . The superior actuators  34   a / 34   b  may be located directly lateral and medial to the patient&#39;s  46  legs  48 . An alignment enclosure  30  may be used to keep the superior actuators  34   a / 34   b  straight. If all four actuators  34   a / 34   b / 34   c / 34   d  extend at the same time, then the automated therapy table  10  will assist the movement of leg approximation (see  FIG. 3 ), wherein the leg movement occurs along a frontal plane. If all four actuators  34   a / 34   b / 34   c / 34   d  retract at the same time, then the automated therapy table  10  will assist the movement of leg decompression (see  FIG. 4 ), which also occurs along the frontal plane. 
         [0044]    If the superior actuators  34   a / 34   b  extend and the inferior actuators  34   c / 34   d  contract or remain stationary, then the automated therapy table  10  will assist the movement of ankle plantar flexion (see  FIG. 7 ), wherein the foot  50  moves along the sagittal plane. And if the superior actuators  34   a / 34   b  contract or remain stationary and the inferior actuators  34   c / 34   d  extend, then the automated therapy table  10  will assist the movement of ankle dorsiflexion (see  FIG. 8 ), the foot  50  also moving along the sagittal plane. Furthermore, if the medial actuators  34   b / 34   d  contract or remain stationary and the lateral actuators  34   a / 34   c  extend, then the automated therapy table  10  will assist the movement of foot inversion (see  FIG. 9 ), wherein the foot  50  moves along the transverse plane. And finally, if the medial actuators  34   b / 34   d  extend and the lateral actuators  34   a / 34   c  contract or remain stationary, then the automated therapy table  10  will assist the movement of foot eversion (see  FIG. 10 ), the foot  50  also moving along the transverse plane. 
         [0045]    It is preferred that the patient  46  internalize or think about each movement while performing the movement. As an example, when the patient  46  performs the movement of decompression, the patient  46  may think “long” or “lengthening” as he/she performs the movement. This type of communicative balancing amplifies the benefit of the movement and is a valuable aspect of the method because it will help to maintain long-term effects from use of the automated therapy table  10 . 
         [0046]    In a preferred embodiment, the automated therapy table  10  is pneumatically driven. However, it should be clearly understood that substantial benefit could be derived from an alternative configuration of the automated therapy table  10  in which other automated means for adjusting the component portions and supports is used, such as hydraulic, electric or perhaps even lever-type means. 
         [0047]    This apparatus and process makes the job of the therapist significantly less difficult and less physically demanding. Thus, instead of the therapist being required to bend over the automated therapy table  10 , grasp a portion of the patient&#39;s  46  leg  48 , and physically move the patient&#39;s  46  leg  48  in the desired direction for the required period of time—the therapist can select the desired portion of the patient&#39;s  46  leg  48 , the desired direction of movement, and activate the appropriate actuators  34 . The actuators  34  will then move the appropriate part of the patient&#39;s  46  leg  48  in the proper direction, and the part of the patient&#39;s  46  leg  48  will be held there until the therapist determines that sufficient time has passed to make it appropriate to release the part of the patient&#39;s  46  leg  48 . While it is generally contemplated that the therapist will activate the actuators  34 , it would be possible for the patient to do so as well. 
       STATEMENT OF USE 
       [0048]    It is preferred that a world trained technician, physical therapist, or other health professional operate the automated therapy table  10  of the present invention. It should also be clearly understood that substantial benefit may be derived from the patient being able to operate the automated therapy table  10  himself/herself. 
         [0049]    Prior to receiving any treatment, the patient  46  will ideally undergo a physical assessment to determine the existence of any contraindications. If there are any, then certain modifications may be made to the usual movements. 
         [0050]    For the movements of leg elevation, internal/external leg rotation, ankle plantar flexion/dorsiflexion, and foot inversion/eversion, the movement will be held for several seconds. Preferably, these movements will be held for less than ten seconds each. For the weight bearing movement of approximation (or compression), the movement may be held for longer than ten seconds. During each movement, the patient  46  will preferably be instructed to think in the direction of the movement. It has been found that doing so helps increase the healing effects. For example, during the movement of foot inversion, the patient  46  will think that his/her foot is moving inwardly toward the midsagittal plane of the body while his/her foot is actually moving inwardly toward the midsagittal plane of the body. As another example, during the movement of leg decompression, the patient  46  will think that about the lengthening of his/her hip muscle(s). Thinking in the direction of the movement is recommended for every movement of the automated therapy table  10 , except the weight bearing movement of leg approximation. 
         [0051]    The patient  46  may alternate movement of each of the lower extremities or the movements may be performed synergistically. Arm movement may also be performed in combination with the leg movements. For example, the patient&#39;s  46  arms  56  may be raised above the patient&#39;s head  58  and decompressed along the same plane (sagittal plane) as the patient&#39;s  46  legs  48 . And preferably, the patient  46  will be thinking about stretching his/her arms  56  and legs  48 . 
         [0052]    All of the movements described herein help to treat myofascial abnormalities. Myofascia is a thin film that wraps around muscle tissue. It wraps around the muscle fibers individually as well as the muscles themselves and also forms the tendons and ligaments which connect the muscles to other parts of the body. A great deal of pain can result when the myofascia of a person becomes tight or thick. Fibromyalgia syndrome (FMS) is an example of a condition wherein the lack of myofascial flexibility is present. When the myofascia loses its elasticity, the efficiency of neurotransmitters, which communicate messages between the brain and the rest of the body, are impaired. Among other symptoms, physical pain usually results from myofascial abnormalities. All of the movements disclosed herein will help to create myofascial release. 
         [0053]    This disclosure provides exemplary embodiments of the present invention. The scope of the present invention is not limited by these exemplary embodiments. Numerous variations, whether explicitly provided for by the specification or implied by the specification, such as variations in structure, dimension, type of material and manufacturing process may be implemented by one of skill in the art in view of this disclosure.

Technology Category: a