MULTI-FUNCTIONAL THERAPEUTIC HOSPITAL BED CONVERTIBLE INTO A STANDING AID

Abstract

The invention relates to the field of medical technology, and more particularly to multi-functional hospital beds. The claimed structure comprises a vertical stand in the shape of an inverted L, which is connected to a folding bed. The bed has two sections, one of which can be folded onto the other, whereupon both sections can be folded to the vertical stand. A movable frame is disposed in the top corner of the stand, wherein said frame can be fastened in two positions: to the top part of the stand, and also at an angle of 45 degrees to the stand. A motor is provided, which pulls a cable. Said cable passes through the stand and the end of the movable frame. This provides two operating modes: Mode 1 is that of a bed. In this case, the frame is fastened to the stand, and the bed is unfolded. Traction or fixation can be applied to individual parts of a patient's body. Mode 2 is that of a standing aid. In this case, the bed is folded, and the frame is positioned at an angle of 45 degrees. The legs of the bed form a support, and the patient can be verticalized with the aid of the cable and a harness. The invention is simple and universal and is also capable of replacing several pieces of hospital equipment at once.

Claims

1. The medical exerciser includes a bed, a support strut with interconnected vertical and horizontal parts forming an inverted letter L, while the support strut is connected to the bed in the lower part, the lower part of the support strut incorporates an actuator with an attached end of flexible cable, stretched along the vertical part of the support strut, and: the bed is made of movable sections so that they could be folded, and their sides facing the floor in the folded state could form a support, which surface is parallel to the vertical part of the strut; a movable frame is installed in the junction of vertical and horizontal strut parts, so that it could be fixed in at least two extreme positions, in the first position the frame is fixed to the horizontal part of the strut, and in the second position the frame forms a 30 to 60 degrees angle with the vertical part of the strut; the free end of the flexible pull cable is extended through the moving frame.

2. The medical exerciser according to claim 1, wherein the bed is made of two movable sections so that the farthest section from the strut can be folded onto the next section so that their upper parts from the floor come into contact, after which both sections can be folded to the strut.

3. The medical exerciser according to claim 1, wherein the flexible cable is extended through rings or rollers located at the vertical part of the support strut and the movable frame.

4. The medical exerciser according to claim 1, wherein the movable frame can be fixed in position when it is the bisector of the angle between vertical and horizontal parts of the support strut.

5. The medical exerciser according to claim I, wherein there are support elements and handrails on bed parts facing the floor so that they do not touch the floor when the bed is folded and at the same time form support elements and handrails when the bed is folded.

6. The medical exerciser according to claim 1, wherein the flexible cable actuator is an electric motor.

7. The medical exerciser according to claim 6, wherein the actuator system additionally includes a load-counterweight.

8. The medical exerciser according to claim 1, wherein the flexible cable at its free end splits into at least two parts and the fasteners are placed at the end of each.

9. The medical exerciser according to claim 8, wherein a binder or elastic straps or suspensions are fixed to the flexible cable ends with fasteners to provide for individual body parts fixation.

10. The medical exerciser according to claim 1, wherein there are loops on the bed sections side facing the floor, to which patient fixation straps can be attached.

11. The medical exerciser according to claim 1, wherein the flexible cable is a rope.

Description

BRIEF DESCRIPTION OF DRAWINGS

[0023] FIG. 1the first general schematic view of the present invention.

[0024] FIG. 2the second general schematic view of the present invention.

[0025] FIG. 3schematic view in bed mode.

[0026] FIG. 4schematic view in standing aid mode.

[0027] FIG. 5schematic view of force transfer system.

INVENTION EMBODIMENTS

[0028] For the purposes of the present description, it is necessary to clarify a number of terms and definitions that are used throughout the text for clear understanding.

[0029] Terms bunk, couch, bed, hospital bed, medical bed, therapy table, kinesitherapic table and the like should be understood in the present description as medical bed, i.e., the bed used for patient placement for further treatment.

[0030] Term standing aid should be understood in the present description as an independent device or a device complementing another device to bring a patient's body to an upright position in order to prevent and treat alleviation of negative physiological and psychological consequences of prolonged sitting and lying positions (pulmonary and renal failure, pressure sores, osteoporosis, depression). The standing aid may be applied, but not limited, to impaired motor functions due to spinal cord, spinal medulla and brain injuries; joints and spine after surgery; post-stroke conditions and other diseases accompanied by limited motor abilities.

[0031] The term stretching or extension in the present description is synonymous with the term traction and shall be understood in the following sense. Traction (extension) is a set of methods for prolonged stretching of limbs or muscles in orthopedic medicine. It may be used as a treatment method, for example, but not limited to fractures, as well as in the treatment of the spinal cord (spine traction).

[0032] The term post-traumatic rehabilitation, which in some parts of the description can be used simply as rehabilitation shall be understood as an integrated and prolonged patient recovery process after injuries, including those leading to complete or partial immobilization. Such a process may include the creation of a comfortable environment for a patient (but this condition is not mandatory) with fixation or extension of individual body parts. This process may also include a set of measures aimed at maintaining physical fitness, combating muscle atrophy and maintaining a patient's mental state, as well as other measures.

[0033] The term binder or tractional binder is understood for the purposes of the present description as a large strip of fabric or ductile material (or any another material with similar properties) to achieve the desired stretching (pulling force). Such a binder can be of a certain shape, may be applied with the consideration of individual patient characteristics and it may be reusable or expendable.

[0034] The term power scheme or power frame or power rack should be understood in the present description as a rigid structure made of high-duty materials, such as steel or aluminium. Such a frame provides changes in force application direction and usually (but not necessarily) may include one or more moving units for force transmission from electric motor or power column. Such a frame is combined with the bed frame or standing aid directly.

[0035] The term flexible pull cable or pull cable in the present description is understood as a flexible element, such as, for example, but not limited to, a flexible cable, rope or tensile (e.g., stitched or reinforced) flexible band, by which and with the use of transmitting elements it is possible to transmit the force from the electric motor to the desired point.

[0036] The term force transmitting clement is understood as a flexible transmission clement, which allows changing force direction. Such an element is, for example, a movable or fixed unit, which is rotatable. Another option may be a roller with the possibility of rotation. It is possible to use simple loops through which a flexible pull cable passes. Other embodiments of such elements are known in the art, equivalent in function to the described units or rollers.

[0037] The present invention represents the following structure (FIG. 1). The basis is the bearing frame (101) which, preferably, is a vertical strut (102) with a base (104). Such a strut may be attached to a room wall where the device is planned to be operated. The lower part (103) of the bearing frame (101) is at the same time both the base (104) of support strut (102) and one of the bed (106) supports (105). The electric motor (107) is preferably located in strut (102) base area (104). Additionally, the bearing frame (101) can also be used for electrical communications branching, flexible or other transmissions, power supply and control elements.

[0038] The bed (106) has a complex structure. In addition to the first support (105) formed by part (104) of the support strut (102), it includes at least two moving partsthe first (108) and the second (109). The first part (108) is connected to support (105) by the first joint (110), for example, a hinged one, which allows part (108) to rotate relative to support (105). The second part (109) of bed (106) is connected to the first part (108) by means of the second joint (111), which is a hinge, for example, and also allows the second part (109) to turn in relation to the first part (108). Thus, there are at least two extreme positions of the bed's moving parts. The first (FIG. 3) forms the bed proper on which the patient can lie horizontally. In this case, the second part of the bed (109) forms one straight line with the first part (108), and such a straight line is perpendicular to the vertical strut (102). As a result, the device takes the form of a medical bed. The second extreme position of the bed elements forms a standing aid (FIG. 4). In this case, the second part of the bed (109) folds onto the first part (108), which, in turn, is fixed on the strut (102).

[0039] On conditionally a bottom (top and bottom are defined by FIG. 3) surface (112) of the second part (109) of the bed (106) the supports (113) are located. Preferably they are legs and, preferentially, with four support points. The supports (113) are preferably designed in such a way that in the standing aid position, they will not rest against the support strut elements (102). This can be implemented, for instance, as follows (FIG. 2). The support strut (102) consists of several vertical columns (201), preferably two. Then, supports (113) may be of four legs (202) and in standing aid position they will be between columns (201). There is a stopper (114) and handrail (115) on the conditionally lower surface of the first part (108) of the bed (106). Moreover, their location is such that in the standing aid position (FIG. 4), the stopper (114) forms the standing aid support and the handrail (115) forms the standing aid handrail, which is designed to help patients to rise independently or semi-independently. In this case, the handrail (115) is designed in such a way that it can change its inclination angle relative to the surface of the first part (108) of the bed (106).

[0040] Generalizing the description of the bed structure (106) it can be summarized that the bed (106) is made with the possibility of transformation by simple manipulations with standard fittings (including connections (110, III), as well as fixing devices, not shown conventionally in the figures of drawings) into the standing aid support clement (FIG. 4).

[0041] The vertical support strut (102) in its upper part (116) is connected to the horizontal frame (117), which, in one of the invention embodiments can be made with a possibility of inclination angle variation relative to strut (102). The frame (117) preferably has a loop (118) (or similar function element) at its far end from the attachment place to strut (102) with which the holding cable can be used (not shown conventionally). In this case, the second end of such a cable may be fixed to the room wall or ceiling. The strut (102) also has, preferably, an additional supporting element (119) located at an angle relative to the strut itself (102) in such a way that the end of the strut (116), as well as the additional supporting element (119), form a triangular angular frame (117) mount. Several fixed rollers (301, 302) or, in another embodiment, movable rollers (301, 302), but with the possibility of their subsequent fixation in certain positions, can be mounted on a plate (117). A force transmitting clement (120), such as, for example, a fixed unit is also installed in the area of additional supporting element (119) connection and the vertical support strut (102).

[0042] A rotating frame (121) is installed in the upper part of the vertical strut (102) with fastener (122). The frame is, preferably, installed in an additional supporting element (119) attachment area to the vertical support strut (102) and location of the force transmitting clement (120). Any type of attachment (122) can be used, for example, a hinged mount. The plate (121) fastening mechanism (122) provides the ability to change the plate (121) position between at least three extreme positions. The first of these positions is when the end (123) of frame (121) not fixed to the strut (102), which is fastened with the fastening element (124) on the additional supporting element (119). The second of these positions is when end (123) is fixed at the strut (102) surface with the fastening element (125). The third position is when the frame is in an intermediate position between the first and second positions described above with the use of the rotation mechanism (122) lock, In the latter case, the preferred frame (121) inclination angle relative to the vertical column (102) equals 45 degrees, if the second of the above possible frame (121) positions is taken as zero degree. There is a transmitting element (126), preferably a slide sleeve in the end area (123) of the frame (121).

[0043] Important parts of the present invention are pulling cables, binder, as well as flexible transmission rods. From (FIG. 3) the electric motor (107) using transmitting elements (for example, fixed blocks) (120, 126), and also, in the bed position, using transmitting elements (301, 302) with flexible cable (303) through which the force is transmitted. It is also preferable to use a load (304), which can be a massive block mounted on guides (310) parallel to the strut (102) to improve performance and reduce the load on the electric motor (107) with the ability to move in a vertical plane along the axis of the strut (102).

[0044] In one embodiment, the end portion of the pull cable (303) may be split into two cables. In another, preferred, embodiment, the pull cable (303) consists of two independent flexible elements (305, 306), which can move both synchronously and asynchronously and pass through the same transmitting elements (120, 126, 301, 302).

[0045] An important element of the invention is that the binder (307) be made from flexible, but durable (reinforced or stitched) fabric, for example. Two opposite sides (308, 309) of such a binder are connected to the ends of two flexible cables (305, 306). Such connections are preferably made detachable. Thus, it is possible to transfer force from the electric motor (107) to the binder (307) by a flexible cable (303), which is divided into two elements (305, 306), as well as a set of force transfer elements (120, 126, 301, 302). It is important to note the application of force to the binder (307) at two (or more) points. In this case, it is possible to transfer the forces of complex directions with non-trivial moments relative to the central binder point (107) with the use of a binder with asynchronous movement of elements (305, 306).

[0046] Let us consider the use of the invention in the preferred embodiment.

[0047] Various therapeutic methods may be applied in the exerciser. One of them is a therapeutic method to restore normal motor patterns using high level neuromuscular stimulation. This is an active curative approach that uses five key elements:

[0048] 1. The exercises are performed in a horizontal and vertical position of the patient propped against an unstable support, when a part of the body rests on the suspension with no support upon the bed. Such exercises can be performed both with hanging out with the use of electric motor, and hanging out of separate parts, using auxiliary weights and/or elastic elements;

[0049] 2. In a similar way it is possible to remove (compensate) the gravitational effect on individual muscles or groups of muscles by hanging out the whole body or body parts. It also allows to perform movements without overcoming the limb weight, as well as to create the effect of slight spine and joints stretching;

[0050] 3. It is possible to use weights (loads and/or elastic elements) of calibrated value in reduced gravitational action for a planned and controlled load increase when performing exercises.

[0051] 4. It is possible to limit or completely relieve the effects on certain body areas by fixation in both horizontal and vertical body positions and adding the load on non-fixed muscle groups.

[0052] 5. The vertical positioning is aimed at restoring the postural-tonic and dynamic activity of postural and vestibular reflexes. It stimulates and maintains orthostatic reactions, reflex mechanisms of anorectal expulsion and urinary bladder emptying, and improves respiratory function;

[0053] The use of the exerciser also involves testing procedures that evaluate the neuromuscular function of kinetic chains with an emphasis on integrating the function of local and global muscles. For example: a test for neutral position holding time to check the local muscles function; a test to identify weak kinetic chains and the disruption of their interaction.

[0054] It is possible to carry out manual correction using dynamic mobilization/manipulation techniques (tractional, rotational, flexural, extensional, lateroflexional, ventrodorsal, lateral) by fixation and unloading in different initial positions in the cervical, thoracic, lumbar, sacrococcygeal regions of vertebral column, postisometric relaxation and myofascial muscles release.

[0055] It is possible to put the patient in an isometric body weight holding position with manual pulsation or controlled vibration from external vibration devices. The workload and instability degree can gradually increase during exercises from the weakest to the most complex. Thus, the exercises can be used in groups of patients from the lowest functional status to trained athletes.

[0056] Thus, the following effects may be achieved:

[0057] 1. Restoration of the correct sequence of muscular tension, fixation of new motor patterns;

[0058] 2. Restoration/compensation of disturbed functions with activation of individual body reserves;

[0059] 3. Normalization of active movements' amplitude and accuracy;

[0060] 4. Improvement of motor actions sensory support (visual, verbal, tactile control);

[0061] 5. Restoration of vertical position static patterns;

[0062] 6. Balance exercise in a vertical position;

[0063] 7. Cardiovascular system improvement;

[0064] 8. Stimulation of intestinal and urinary bladder activity;

[0065] 9. Improvement of respiratory system functions;

[0066] 10. Prevention of contractures;

[0067] 11. Improvement of psycho-emotional condition;

[0068] 12. Increased tolerance to physical activity;

[0069] 13. Prevention of osteoporosis.

[0070] And other effects as well.

[0071] About the exerciser in the unfolded position (bed position); In this position, the supports (113) constitute four legs (202); the bed elements (108, 109) represent a monolithic structurea bed (106). The rotary frame (121) is in a position perpendicular to the support strut (102). The roller (301) provides for force transmission in an upward direction relative to the bed surface (106).

[0072] Physical exercises, unloading or stretching exercises are performed by placing the patient on the horizontal bed surface (106) in the lying or sitting position. A binder (307) can be used for manipulations, although equivalent elements may also be used, for example, simple fixation of the pull cable (303) or elastic cables fixation (not conventionally shown in the drawings) at the end section (303) or its elements (305, 306). Another option would be to replace the binder (307) with suspensions for separate body parts. In one embodiment, such suspensions may be structurally similar to the binder (307). The following is a non-limiting (not complete) list of possible manipulations.

[0073] Body parts or the whole body fixation on suspensions of an off-loading module (117) in the raised position above table surface (static cables);

[0074] Fixation of body parts on suspensions with elastic cables;

[0075] Body parts or the whole body fixation on suspensions with a cable sliding through the block;

[0076] Exercises with non-balanced weighting of block exerciser (for example, in combination with off-loading module or separately);

[0077] Fixing the limbs with special bands on the guide at table underside;

[0078] The primary nodes preferably operate in bed mode as follows.

[0079] 1. The method of performing exercises on unstable supports is based on the use of loads for maintaining body weight under the load of biomechanical chains. This is a therapeutic method that uses a high level of neuromuscular stimulation to restore normal functional movement patterns.

[0080] 2. Performing exercises on the block-roller increases the instability of the support and extends the range of possible movements. It is possible to create spiral-diagonal movements, coactivating (coactivation or contractionthe contraction occurs both in agonists and antagonists) local and global muscles in response to performing exercises under body weight and cable sliding through a block. It helps to increase the freedom of motion range in the joints, and stabilizes the spine and the joints.

[0081] 3. Exercising with the use of elastic cables fixed on the discharge module helps the patient to master flexion, extension, circular and vortical movements in the limbs and trunk under lightweight conditions. Such exercises contribute to improvement of tactile and proprioceptive input of sensory irritation in the case of movement disorders, and also to improve the mutual spatial body part sensing. The ability to move the suspension points at different angles allows creating an adjustable force aimed at weight compensation at any point of the bed area.

[0082] 4. The combination of the unloading module and the power column provides the possibility of transition from lightened movement conditions to exercises with weights. Such combination provides an integrated approach to individual rehabilitation program, increases the variability of possible exercises and continuity in physical therapy methods application at different recovery stages. The ability to control the power column cable direction, a small step weight variation (preferably from 1.0 to 30 kg) makes it easy to adapt the exercise to individual abilities of each patient.

[0083] 5. Body part fixation in a predetermined position with special straps allows securely fixing the limb in the correct position. The method is used for treatment by the correct position in case of spastic pareses, or contractures development. Additional opportunities for muscles, tendons and ligaments stretching in different initial positions.

[0084] Let us consider some possible exercises.

[0085] In the initial position (hereinafterLP.)lying on the back, one leg bent at hip and knee joints, the other one on the bed in a deflexion position. The suspension points are located above hip and ankle joints. Ankle damper tensionvertical. Femoral damper tensionthe suspension point shifts in the cranial direction along the leg axis, the tension force depends on what is to be obtainedresistance or relief.

[0086] Movement: flexion and extension in the knee and hip joints.

[0087] I.P. lying on stomach, the hip joint is extended, the knee is bent. A cuff with a metal ring at the end is fixed on the lower part of the surae. In the case of severe weakness of thigh muscles for independent leg extension, the suspension point is placed vertically above the knee joint flexion axis, the damper is slightly tensioned, and the patient tries to unbend the leg with a swinging motion (visual control through side mirror is desirable). The power module, block position and load are selected individually to resist bending/unbending.

[0088] I.P. Lying on back. The legs are unbent at hip and knee joint, one leg is raised at 45 degrees above the bed plane. Arms are along the body, palms down.

[0089] Additional equipment: surae cuff, elastic cable.

[0090] Movement: straight leg down.

[0091] Recommendations: inhale in the initial position and exhale at the highest tension phase. Ensure that no additional tension is created in other body parts. The suspension point moves in the cranial direction when the resistance is to be created. The power module may be used.

[0092] Exerciser in unfolded position (standing aid position). In this position, the rotary mechanism (122) is locked; the rotary frame (121) is in the intermediate position. The bed (106) is in the folded state, that is, the second part of the bed (109) folds onto the first part (108), which, in turn, is fixed on the strut (102). In the preferred embodiment of the support strut (102), the four legs (202) are in the described mode, in the gaps between columns (201). The stopper (114) and the handrail (115) occupy the corresponding position (FIG. 4) and become parts of the standing aid.

[0093] The exerciser in the folded position allows, among other things, to bring the patient to the vertical position with the aim to train orthostatic stability and maintain the maximum mobility level against gravity. The afferentation from articular and muscular-articular receptors is enhanced due to joints and spine closure, which stimulates the functioning of the cerebellum and the vestibular apparatus. The arising senses make it possible to consciously coordinate movements and control the body position in an upright position.

[0094] In the preferred embodiment, the module is equipped with all the necessary adjustments, handrails and latches, which allow adjusting the device to individual peculiarities of the person, performing trunk and upper limbs movements in a natural standing position.

[0095] It is possible to reduce hyperlordosis of the lumbar spine, and excessive abdominal bulging due to support height and depth adjustment for body front, which, combined with compression stockings and an abdominal binder, reduces excessive blood deposition in the abdominal cavity and lower limb vessels and also facilitates diaphragmatic flutter and its displacement into chest cavity in the expiratory phase. This is especially important for patients with tetraplegia and paraplegia above the Th6 level (6.sup.th thoracic vertebra) since orthostatic hypotension is the most common manifestation in acute and early recovery period at the upright position for this category of patients.

[0096] Adjustable feet-holders ensure reliable fixation of the feet in the correct position.

[0097] It is possible to use the power and discharge module when performing exercises in the standing position. Thus, the device allows performing the following exercises among others in the standing aid mode.

[0098] I.P. Standing in a standing aid. One hand holds the standing aid handrail and the other straight arm is lowered along the body and holds the elastic cable or power column cable.

[0099] Movement: one arm up against the elastic cable resistance or power column load. Simultaneously with arm upward movement, the trunk leans towards the supporting arm. The active arm shall remain straight. In the initial positioninhalation, in the maximum arm abduction phaseexhalation.

[0100] The multifunctionality of the exerciser allows simultaneous using of several types of effects in one exercise. For example, the distal part of the limb may be fixed in a raised position above a table surface (discharge module) and the proximal part shall be connected with an elastic damper or power column with lightening/weighting action, depending on the exercise purpose. This allows performing movements without overcoming the limb weight. And also to create conditions for performance of movements in a strictly assigned direction. The simultaneous use of horizontal surface (kinesitherapic table), unloading module, power module, and elastic cables significantly increases the variability of possible impacts.

[0101] One or several limbs are suspended with the help of loops/cuffs at the beginning of exercises with the use of a discharge module and elastic cables. As a result, it becomes possible to virtually neutralize the effect of gravity on the motion. For example, hanging the leg by foot and thigh the load on the hip and knee joints reduces. Elastic dampers can be used both for limbs unloading and for weighting during active movements. An unstable support can be created with the use of cables and suspensions to enhance active segmental stability by joint contraction of local and global muscles.

[0102] Thus, the above described implementation examples and methods of using the claimed technical solution show that the present invention is a universal device that is able to easily replace many individual complex hospital devices. Also, the claimed device is structurally simple, and, therefore reliable. The design of the claimed solution has great potential for modernization and use, and the combination of structural elements, as well as compatibility with many existing medical devices, allowing for a wide range of rehabilitation and therapeutic exercises.

[0103] All this shows that the claimed invention can be implemented on the basis of the presented description with achievement of the claimed technical result. At the same time, the examples described above are not exhaustive. Other ways of implementing and applying the present invention in the framework of the formula at a practical technological level could become obvious to a specialist.

INDUSTRIAL APPLICABILITY

[0104] The present invention can be easily implemented on an industrial scale with the context of current technological development. Thus, there are no obvious problems in the manufacture of individual power elements of the structure, their transportation and assembly, including assembly at the place of intended use. The manufacture of moving elements of the described device, as well as their connections, is also a trivial task for modern industry. Electronic equipment, including controls, as well as electrical safety, such as those used in the present invention, are repeatedly described in various sources of information included in the prior art. Thus, the task of bringing the claimed invention to industrial production will obviously fall into the class of overcoming the usual engineering difficulties typical of such procedures for a specialist. The invention and development of new, not previously known means and methods for the industrial implementation of the claimed invention will not be required.