Method and apparatus for treating soft tissue injury

Abstract

An apparatus for the treatment of a soft tissue injury (eg a soft tissue injury that may be the cause, or contributes to, acute or chronic pain such. as sciatica) comprising; a thermal imaging arrangement to scan, a least a portion of a patient to provide a thermal image; a processing arrangement to review the thermal image to determine a point or region of thermal anomaly on the patient; a laser treatment device to provide a laser beam (eg for low-level laser treatment); and a guidance arrangement for the laser treatment device to guide the laser beam to the point or region of thermal anomaly on the patient as determined by the processing arrangement; to thereby treat the patient.

Claims

1. An apparatus for the treatment of a soft tissue injury including associated inflammation, comprising: a thermal imaging camera to scan at least a portion of a patient to provide a thermal image; a processor operable to receive information from the thermal imaging camera and to review the thermal image to determine a point or region of thermal anomaly on the patient; a laser treatment device to provide a laser beam, wherein the laser treatment device provides laser treatment radiation at a wavelength in the range of 800 nm to 900 nm; and a guidance arrangement comprising a servomechanism operable to move the laser treatment device and to direct the laser beam to a desired location, and wherein the guidance arrangement comprises a universal arm operably attached to the laser treatment device to guide the laser beam to the point or region of thermal anomaly on the patient as determined by the processing arrangement, to thereby treat the patient; and wherein guidance of the laser beam to the point or region of thermal anomaly comprises providing the laser treatment device into contact with the skin of the patient at a force causing skin blanching; and wherein the laser treatment device comprises a force sensor, photosensor or oximeter to generate and provide a signal to the processor when skin blanching has been detected and to cause the processor to halt the guidance arrangement from further movement of the laser treatment device towards the patient once skin blanching has been caused.

2. The apparatus of claim 1, further comprising a bed to support the patient.

3. The apparatus of claim 2, wherein the guidance arrangement moves the laser treatment device with respect to the bed or moves the bed with respect to the laser treatment device.

4. The apparatus of claim 2, wherein both the thermal imaging camera and the laser treatment device are mounted on a single arm which is moveable with respect to the bed or in which the bed is moveable with respect to the single arm or both the bed and the single arm are moveable with respect to each other.

5. The apparatus of claim 2, wherein the thermal imaging camera and the laser treatment device are mounted on separate arms each of which can move with respect to the bed.

6. The apparatus of claim 2, wherein the bed is arranged to support the patient in a vertical, prone or semi-prone position.

7. The apparatus of claim 1, wherein the servomechanism is operable to direct the laser beam at a selected angle and a selected distance with respect to the patient.

8. The apparatus of claim 1, wherein the laser treatment device provides low-level laser treatment (LLLT).

9. The apparatus of claim 8, wherein the laser treatment device comprises two 300 mW 830 nm infrared laser beams.

10. The apparatus of claim 1, wherein the laser treatment device provides laser treatment radiation at a wavelength of 808 nm, 830 nm or 850 nm.

11. The apparatus of claim 1, wherein the thermal imaging camera provides a digital thermal image, and wherein the point or region of thermal anomaly determined by the processor comprises an area in the digital thermal image that is no more than about 0.5 C. warmer than an immediately surrounding area.

12. The apparatus of claim 1, further comprising a timing clock or timer which prevents the laser beam from being directed to a single point on the patient for more than about 6 minutes.

13. An apparatus for the treatment of a soft tissue injury including associated inflammation, comprising: an infrared camera or thermal scanner to scan at least a portion of a patient to provide a thermal dataset; a processor operable to receive information from the thermal imaging camera and to review the thermal dataset to determine a point or region of thermal anomaly on the patient; a laser treatment device to provide a laser beam, wherein the laser treatment device provides laser treatment radiation at a wavelength in the range of 800 nm to 900 nm; and a guidance arrangement comprising a servomechanism operable to move the laser treatment device and to direct the laser beam to a desired location, and wherein the guidance arrangement comprises a universal arm operably attached to the laser treatment device to guide the laser beam to the point or region of thermal anomaly on the patient as determined by the processing arrangement, to thereby treat the patient; and wherein guidance of the laser beam to the point or region of thermal anomaly on the patient brings the laser treatment device into contact with the skin of the patient at a force causing skin blanching; and wherein the laser treatment device comprises a force sensor, photosensor or oximeter to generate and provide a signal to the processor when skin blanching has been detected and to cause the processor to halt the guidance arrangement from further movement of the laser treatment device towards the patient once skin blanching has been caused.

Description

BRIEF DESCRIPTION OF DRAWINGS

(1) Embodiments of the present invention will be hereinafter discussed with reference to the accompanying drawings wherein:

(2) FIG. 1 shows a side view of an apparatus according to one embodiment of the present invention;

(3) FIG. 2 shows an end view of the apparatus shown in FIG. 1;

(4) FIG. 3 shows a perspective view of an alternative embodiment of the apparatus shown in FIG. 1; and

(5) FIG. 4 shows a perspective view of an alternative embodiment of the present invention.

(6) In the following description, like reference characters designate like or corresponding parts throughout the figures.

DETAILED DESCRIPTION

(7) Referring now to FIGS. 1 and 2, there is shown an apparatus 10 for the treatment of soft tissue injuries according to a first embodiment of the present invention. In this embodiment, the apparatus 10 includes a bed 12 upon which a patient can lie including an upper surface 14 to support the patient. For the purposes of describing this embodiment, it is assumed that the patient has a soft tissue injury for which the patient lies prone on the surface 14. Pillows and other forms of support (not shown) may be provided on the bed to hold the patient in a selected position.

(8) It will be appreciated that in other embodiments, the apparatus 10 need not include a bed 12 but may be used in association with a separate bed. In such embodiments, the apparatus 10 includes the thermal imaging arrangement 16, the processing arrangement 30, the laser treatment device 18 and the guidance arrangement 28.

(9) The apparatus 10 for treatment of a soft tissue injury has a thermal imaging arrangement 16 which is used to scan a least a portion of the patient to provide a thermal image and a laser treatment device 18 to provide a laser beam to provide appropriate treatment. The thermal imaging arrangement 16 may be selected from infrared imaging cameras well known to those skilled in the art (eg Flir Max 76 (Flir Systems AB, Tby, Sweden), and Meditherm med2000 IRIS (Meditherm Inc, Fort Myers, Fla., United States of America)). The laser treatment device 18 may be selected from suitable laser probes, which may emit one or more beams, well known to those skilled in the art. Particular examples of suitable cold laser probes include Maestro Laser Therapy System (MediCom Inc, Prague, Czech Republic), and the Weberneedle Combi-Laser System (Weber Medical GmbH, Sohnreystrasse, Germany)).

(10) In this embodiment, both the thermal imaging arrangement 16 and the laser treatment device 18 are mounted on a single arm 20 which moves longitudinally on a rail arrangement 22 as shown by the arrow 32 with respect to the length of the bed. The arm 20 has an essentially vertical portion 24 and a transverse portion 26 which extends over the bed. Both the thermal imaging arrangement 16 and the laser treatment device 18 are mounted on a housing 28 which is fixed to and moves transversely on the transverse portion 26 of the arm 20 as shown by the arrow 34 in FIG. 2.

(11) The arm 20 can be moved longitudinally along the bed 22 and the housing 28 moved transversely to generally centre the thermal imaging device over the region of the soft tissue injury. Alternatively, where the general region of soft tissue injury may be less clear then the thermal imaging arrangement can be scanned across and along the patient to find regions of thermal anomaly. This scanning across and along can be done automatically by the apparatus of the present invention or by indirect control by an operator who may define a general area of interest such as the shoulders, neck or lower back.

(12) The vertical portion 24 may be able to be raised or lowered relative to surface 14.

(13) In other embodiments, the housing 28, or the individual laser treatment device 18 or thermal imaging arrangement 16, may be raised or lowered along vertical portion 24.

(14) It will be appreciated that in some embodiments, a thermal image as such is not created, but rather simply a dataset, which contains colour information associated with location. This dataset can then be processed directly to provide the guidance information for the guidance arrangement 18.

(15) In such an embodiment, the thermal imaging arrangement may be used, or can be replaced by a thermal scanner which does not necessarily generate an actual image, but rather the dataset.

(16) In such an embodiment, the apparatus 10 will include a thermal scanner for scanning at least a portion of the patient to provide a thermal dataset, a processing arrangement to review the thermal dataset to determine a point or region of thermal anomaly on the patient; a laser treatment device to provide a laser beam, and a guidance arrangement for the laser treatment device to guide the laser beam to the point or region of thermal anomaly on the patient as determined by the processing arrangement, to thereby treat the patient.

(17) A processing arrangement 30 takes information obtained by the thermal imaging arrangement 16 and reviews the thermal image to determine a point(s) or region of thermal anomaly on the patient. As previously described, the single point on the patient preferably corresponds or resides within a hot spot(s) (ie a point of greatest surface temperature on the region of the body shown in the thermographic image); in a typical thermal image, this will be indicated by white colour and will represent a surface temperature that is no more than about 0.5 C. warmer than the immediately surrounding region(s). Such hot spot(s) will typically be no more than about 5.0 cm in length or diameter, and more preferably, no more than about 2.0 mm in length or diameter (eg a hot spot on the patient's body of about 1.0, 0.5 or 0.2 mm in length or diameter) A second point for treatment may be identified by a surrounding and/or adjacent spot(s) that is slightly cooler (eg <1 C., preferably about 0.5 C., cooler than the hot spot(s)) which, in a typical thermal image, will be indicated by red colour.

(18) In the case where a thermal data set is generated in place of or as well as an actual image, corresponding guidance information for use by the guidance arrangement is generated from the dataset indicating where the different thermal regions are located.

(19) The information on the point(s) or region of thermal anomaly on the patient is then transferred to a guidance arrangement for the laser treatment device 18 to guide the laser beam(s) to the point(s) or region of thermal anomaly on the patient as determined by the processing arrangement, to thereby treat the patient. In this illustrative embodiment, the guidance arrangement operates to move the laser treatment device 18 to the region or point(s) by, in this example, having arm 30 scanning or traversing across and along the patient to the region or point(s) of thermal anomaly on the patient to direct the laser beam(s) at a selected angle and/or a selected distance with respect to the patient. In another embodiment, the laser treatment device 18 may be located generally stationary with respect to the patient and an associated directing and/or focusing mechanism operates to direct the laser beam(s) to the region or point(s) of thermal anomaly. In one particular example, the directing mechanism may be a servo or actuator arrangement operating to directly manipulate the laser treatment device 18 to the correct orientation so that the laser beam(s) is directed to the desired location. Additionally or alternatively, the guidance arrangement may comprise a servo or drive arrangement to lower the vertical portion 24 relative to the bed such that the laser treatment device 18 is moved towards, and in some embodiments to contact, the skin of the patient. In another example, the laser treatment device 18 may be statically mounted and guidance of the laser beam(s) achieved by a mirror arrangement controllable to direct the laser beam(s) to the desired location. A timing device associated with the processing arrangement 30 is used to determine a suitable treatment time and then the laser beam(s) is switched on and off in accordance with the treatment time.

(20) It can be seen that by this arrangement, the process of determining a treatment point(s) or region and then applying cold laser treatment to that point(s) or region is essentially automated.

(21) FIG. 3 shows an end view of an alternative embodiment of the apparatus shown in FIG. 1 wherein the laser treatment device 18 is provided on an orientable arm 38 mounted to housing 28. The particular orientable arm illustrated is a 4 axis robotic universal arm, however those skilled in the art will understand that alternative arms with a fewer or more axis points may also be suitable. Suitable universal robotic arms include those available from Universal Robots A/S (Odense, Denmark).

(22) FIG. 4 shows a perspective view of an alternative embodiment of the present invention being an apparatus for the treatment of soft tissue injury. In this embodiment, the apparatus 50 includes a bed 52 (however, in other embodiments, the bed may not be included in the apparatus) upon which a patient can lie including an upper surface 54 to support the patient. For the purposes of describing this embodiment it is assumed that the patient has a soft tissue injury for which the patient lies prone on the surface 54. Pillows and other forms of support (not shown) may be provided on the bed to hold the patient in a selected position.

(23) Over the bed 52 extend, from one side, two semicircular arms 56 and 58. The arm 56 is a detection arm and carries a thermal imaging device 60 such as an infrared imaging camera and the arm 58 is a treatment arm and carries a laser treatment device 62. Each of the arms 56, 58 is supported independently on a track 64 on the side of the bed 52 and each can move longitudinally along the track 64 as shown by the arrows 68, 70. Each of the thermal imaging device 60 and the laser treatment device 62 can move along the inner circumference of the semicircular arms as shown by the arrows 66 so that they can independently view and provide treatment to the patient.

(24) In use, the treatment arm 58 can be moved to one end of the track 64 so that the detection arm 56 can move along the patient to locate a point(s) or region to be treated and then the detection arm 56 can be moved to one end of the track 64 so that the treatment arm 58 can move along the patient to enable the laser beam to be directed to the desired point(s) or region.

(25) From the thermal image or thermal dataset, a location for directing the laser beam may be determined. In one embodiment, a reference grid may be provided over the image which is shared with the guidance arrangement, with the location of the determined point or region of thermal anomaly identified on the grid for use by the guidance arrangement.

(26) In alternative embodiments, the arms can be on opposite sides of the apparatus and be constructed so as not to interfere with the other arm traversing along the full length of a patient.

(27) In some cases, it may be preferable to treat a patient while the patient is standing up and the bed can then be essentially vertical to provide a fixed surface for a patient to be positioned against and both the thermal imaging arrangement and the laser treatment device can be appropriately positioned to scan and treat a selected point(s) or region on the patient. The patient should remain still (ie in the same position) after scanning by the thermal imaging arrangement to optimise the subsequent direction of the laser beam(s).

(28) Throughout the specification and the claims that follow, unless the context requires otherwise, the words comprise and include and variations such as comprising and including will be understood to imply the inclusion of a stated integer or group of integers, but not the exclusion of any other integer or group of integers.

(29) The reference to any prior art in this specification is not, and should not be taken as, an acknowledgement of any form of suggestion that such prior art forms part of the common general knowledge.

(30) It will be appreciated by those skilled in the art that the invention is not restricted in its use to the particular application described. Neither is the present invention restricted in its preferred embodiment with regard to the particular elements and/or features described or depicted herein. It will be appreciated that the invention is not limited to the embodiment or embodiments disclosed, but is capable of numerous rearrangements, modifications and substitutions without departing from the scope of the invention as set forth and defined by the following claims.