Passive simulated jogging device

Abstract

A motorized machine for passively applying a tapping force to the bottoms of a user's feet includes a motor, a pedal rocking mechanism, at least one pedal and at least one bumper configured so as to cooperate to, during operation of the motor, cause the bottom portion of the at least one pedal to tap against the at least one bumper so as to provide pulsatile acceleration to the bottom of the user's foot. The pulsatile acceleration has a force sufficient to increase pulsatile shear stress to the endothelium, of sufficient magnitude to cause the release of beneficial mediators.

Claims

1. A motorized machine for passively applying a tapping force to the bottoms of a user's feet, the machine comprising: a housing; an axis-defining mechanism coupled to the housing, the axis-defining mechanism configured to define a rocking axis; at least one pedal positioned to receive a foot of the user and mounted on the rocking axis for rocking movement of the at least one pedal; a motor arranged within the housing, the motor configured to generate rotational motion to an output shaft of the motor; a pedal rocking mechanism coupled to the output shaft and driven by the motor, the pedal rocking mechanism being configured to translate the rotational motion generated by the motor to reciprocating rocking motion of the at least one pedal about the rocking axis; and at least one bumper, height-adjustably coupled to the housing, located spaced apart from a bottom portion of the at least one pedal, the reciprocating rocking motion of the at least one pedal provided by the pedal rocking mechanism providing a positive application of force for moving the bottom portion of the pedal towards and away from the at least one bumper, wherein the motor, the pedal rocking mechanism, the at least one pedal and the at least one bumper are configured so as to cooperate to apply, by the pedal rocking mechanism, the positive application of force to the at least one pedal so as to, during operation of the motor, cause the bottom portion of the at least one pedal to tap against the at least one bumper so as to provide pulsatile acceleration to the bottom of the user's foot, said pulsatile acceleration having a force sufficient to increase pulsatile shear stress to the endothelium, of sufficient magnitude to cause the release of beneficial mediators.

2. The motorized machine of claim 1, wherein the at least one pedal comprises two pedals, one for each foot of the user and the at least one bumper comprises two bumpers, one for each of the two pedals.

3. The motorized machine of claim 2, wherein the rocking of one of the two pedals is anti-phase with the rocking of the other of the two pedals.

4. The motorized machine of claim 2, wherein the rocking of one of the two pedals is in-phase with the rocking of the other of the two pedals.

5. The motorized machine of claim 2, wherein the pedal rocking mechanism has: a camshaft coupled to the output shaft of the motor; two cams, each cam eccentrically coupled to an end of the camshaft; and two pedal coupling mechanisms, each corresponding to one of the two pedals, each pedal coupling mechanism configured to contact one of the two cams, the cam cooperating with the pedal coupling mechanism to convert rotational motion of the cam to reciprocating motion of the pedal coupling mechanism so as cause the rocking motion of the pedals.

6. The motorized machine of claim 5, wherein the camshaft is coupled to the output shaft of the motor by a pulley and belt mechanism.

7. The motorized machine of claim 5, wherein the camshaft is coupled to the output shaft of the motor by a gear mechanism.

8. The motorized machine of claim 2, wherein the height adjustment of the two bumpers provides a tapping force to the bumper of approximately 0.1 to 0.5 g.

9. A method of treatment using the motorized machine according to claim 2, comprising: repeatedly adding pulses and minimally increasing cyclic strain, using the striking of the bumper with the foot pedals, to the body's fluid filled channels over the body's own pulse such that even during periods when pulses are not imparted, bioavailability of the beneficial mediators is greater than the preoperational period.

10. A method of treatment using the motorized machine according to claim 2, comprising: adding pulses, using the striking of the bumper with the foot pedals, to the body's fluid filled channels over the body's own pulse sufficient to stimulate endothelial release of at least one of nitric oxide, prostacyclin, tissue plasminogen activator (t-PA), adrenomedullin, endothelial dependent hyperpolarizing factor (EDHF), endothelial dependent relaxing factor, endothelial growth factors, and transcription factors.

11. A method of treatment using the motorized machine according to claim 2, comprising: adding pulses, using the striking of the bumper with the foot pedals, to the body's fluid filled channels over the body's own pulse sufficient to increase the activity and content of endothelial nitric oxide synthase (eNOS) in blood vessels, heart and skeletal muscle, as well as to increase the activity of neuronal nitric oxide synthase (nNOS) in the heart and skeletal muscle.

12. The method of claim 11, wherein release of nitric oxide from eNOS stimulated by pulsatile shear stress brought about by the added pulses increases release of endothelial progenitor and CD34 cells into the circulation from bone marrow that serve a reparative role in damaged vascular endothelium as occurs in arteriosclerosis.

13. The method of claim 11, wherein activation of neuronal nitric oxide synthesis (nNOS) stimulated by pulsatile shear stress brought about by the added pulses increases vagal nerve tone as measured by heart rate.

14. The motorized machine according to claim 2, wherein the foot pedals, when driven in rocking motion by the motor, are configured to passively move the feet in a reciprocal sinusoidal up and down motion with one end of the foot pedals actively rising and falling approximately 1.25 with the other end serving as a pivot point around the rocking axis, and the two foot pedals are set approximately 12 apart on the horizontal plane.

15. The motorized machine according to claim 1, wherein the beneficial mediators include at least one from the group consisting of: nitric oxide, prostacyclin, tissue plasminogen activator, adrenomedullin, SIRT1, Brain and Glial Derived Neurotrophic Factors (BDNF & GDNF), Kruppel Like Factor 2, Superoxide Dismutase, Glutathione Peroxidase 1, Catalase, Total Antioxidant Capacity, and Anti Apoptotic Proteins: p-Akt, Bcl2, and Bcl2/Bax, HSP27.

16. The motorized machine of according to claim 1, wherein the pulsatile acceleration to the user having a force sufficient to increase pulsatile shear stress to the endothelium is of sufficient magnitude to suppress inflammatory and pro-cancergenic factors, including at least one from the group consisting of: nuclear factor kappa beta, endothelin-1, STAT3, and Pro-Apoptotic Proteins: Fas, TRAILR2, Bad, Caspase 3,8.

17. The motorized machine according to claim 1, wherein the tapping provides pulsatile acceleration to the user having a force sufficient to increase pulsatile shear stress as related to the addition of pulses into the vascular circulation, heart, lymphatic channels, interstitial spaces, skeletal muscle and bone interstices, as well as slight increases of cyclic strain to the blood vessels and lymphatic channels.

18. The motorized machine according to claim 1, wherein the tapping provides pulsatile acceleration to the user having a force sufficient to increase the activity and content of endothelial nitric oxide synthase (eNOS) in blood vessels, heart and skeletal muscle, as well as to increase the activity of neuronal nitric oxide synthase (nNOS) in the heart and skeletal muscle.

19. A method of measuring the efficacy of treatment using the motorized machine of claim 1 after a single or multiple sessions over a single duration of from about 10 to 30 minutes or more, the method comprising sensing release of nitric oxide into the circulation by one or more of the following: a) descent of the dicrotic notch of the pulse waveform that provides a raw arterial pulse waveform with a photoplethysmographic sensor placed upon the finger and/or ear, and/or b) fall in blood pressure lasting several minutes after treatment, the blood pressure being measured from baseline and during treatment upon termination of treatment.

20. The motorized machine according to claim 1, wherein the motor is a DC brushless motor.

21. The motorized machine according to claim 1, wherein the machine further comprises an input for supplying power to the motor.

22. The motorized machine according to claim 1, further comprising a mounting bracket, arranged at the bottom of the machine, to facilitate mounting of the machine on a vertical support, so as to permit use of the machine by a user lying in a bed.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

(1) The above and/or other aspects and advantages will become more apparent and more readily appreciated from the following detailed description of the disclosed embodiments taken in conjunction with the accompanying drawings in which:

(2) FIG. 1 is a diagram showing the effects of the present invention in relation to the dicrotic notch of the finger pulse wave;

(3) FIG. 2 is a plan view of an apparatus in accordance with an embodiment of the present invention;

(4) FIG. 3 is a section view taken along the lines 3-3 in FIG. 2;

(5) FIG. 4 is a section view taken along the lines 4-4 in FIG. 2;

(6) FIG. 5 is a section view taken along the lines 5-5 in FIG. 2;

(7) FIG. 6 is a section view taken along the lines 6-6 in FIG. 2;

(8) FIG. 7 is a perspective view of the apparatus of FIG. 1 with the top cover and one foot pedal removed;

(9) FIG. 8 is a perspective view of the underside of a foot pedal according to one embodiment of the present invention;

(10) FIG. 9 includes diagrams showing the descent of the dicrotic notch as a reflection of Nitric Oxide release into circulation;

(11) FIG. 10 is a diagram showing the effect of the apparatus according the present invention;

(12) FIG. 11 is a diagram showing the apparatus of FIG. 1 with a bracket provided for vertical mounting; and

(13) FIG. 12 is a diagram of a prior art exercise machine.

DETAILED DESCRIPTION

(14) Basis of Present Invention

(15) Dicrotic Notch of Finger Pulse Wave

(16) The demonstration that whole body periodic acceleration (WBPA) in humans produced increased pulsatile shear stress to the endothelium with subsequent release of nitric oxide into the circulation was based upon analysis of the digital pulse wave. Direct measurement of NO in humans is not possible since NO is metabolized within 4 seconds. Descent of the dicrotic notch or wave of the digital pulse down the diastolic limb reflects the vasodilator action of NO on the resistance vessels owing to delay in pulse wave reflection. This phenomenon has been noted with endothelial-independent preparations of organic nitrates as well as with endothelial dependent agents such as albuterol and terbutaline, adrenergic agonists that act through the NO pathway. The change of dicrotic notch or wave position is computed by measuring the amplitude of the digital pulse wave divided by the height of the dicrotic notch or wave above the end-diastolic level (a/b ratio); alternately, the height of the dicrotic notch or wave above the end-diastolic level divided by the amplitude of the digital pulse wave ratio may be reported. In the current study, the dicrotic notch rather than the dicrotic wave was utilized to compute the a/b ratio since the peak of the reflective wave particularly at baseline was usually difficult to detect in elderly subjects. The a/b ratio increases when nitric oxide is released into the circulation and this change is specific for an acute rise of nitric oxide in the circulation.

(17) Cyclic variation of the dicrotic notch in a patient with fibromyalgia is shown in FIG. 1. The left side of the figure shows pulse wave and the seven-beat, ensemble-averaged from R-wave of electrocardiogram triggered pulse wave at baseline. Each pulse wave of the ensemble-averaged pulse represents an average of the seven preceding pulses. The dicrotic notch is marked as the peak, large upward deflection in diastole of the second derivative of the ensemble-averaged waveform. The a/b ratio is computed on a pulse-by-pulse basis. The right side shows, during whole-body, periodic acceleration, added pulses and movement artifacts obscure the dicrotic notch position of the raw pulse wave. The ensemble-averaged pulse depicts cyclic variation of the dicrotic notch position and a/b ratios. The latter is a trace that automatically depicts a/b ratios on a beat-by-beat basis.

(18) In the disclosed embodiments of the present invention, repeated contact is provided to the feet of a user, such as by a tapping motion, to supply pulsatile acceleration to the user. As described below, passive movement is applied only to the feet such that the finger is isolated from motion artifacts while the added pulses are too small to be depicted on the digital pulse wave. In contrast to the digital pulse wave observed during whole body periodic acceleration, in using the present invention, there is no need to ensemble-average several beats with the R wave of an electrocardiograph as shown below.

(19) FIGS. 2-8 and 11 show an exemplary embodiment of an apparatus in accordance with the present invention. The apparatus according the first embodiment includes a pair of foot pedals, each of which are driven to up and down, rocking movement about an axis transverse to the feet, preferably alternating, i.e., anti-phase, motion of the two foot pedals.

(20) As will be seen from the description below, the apparatus is configured such that each movement of the foot pedals can be associated with a percussive contact of a portion of the underside of the foot pedal, which percussive contact passes along to the user a pulsatile impact which, as is discussed above, increases shear stress to mechanically stimulate the endothelial cells to increase the activity of genes responsible for release of beneficial mediators. In particular, the tapping simulates the beneficial effects that occur, for example, while running, in which Pulsatile shear stress (PSS) is increased by addition of pulses generated by the tapping. By virtue of this feature of the present invention, a pulse is added to the circulation that is superimposed upon the body's own pulses and is detected in the radial arterial pressure waveform.

(21) In a typical operation of the apparatus, the feet will be placed on the pedals such that the toes will be raised (and then lowered) in relation to the heels by the rocking of the pedals, and the tapping applied to the toe portion of each foot. However, the apparatus is advantageously symmetrical in design so as to permit the heels, rather than the toes, to be raised and lowered, by the user turning the apparatus around 180 and placing his or her feet in the opposite direction. Such reversed usage of the apparatus results in the pulse being delivered to the heel of the user rather than to the toe.

(22) As can be seen in FIGS. 2-8, the apparatus 1, in accordance with an embodiment of the present invention, includes a housing top 14, a housing bottom 15, and left and right foot pedals, 10 and 12, having surfaces 11a and 11b, respectively, for receiving the feet of a user. The bottom of the apparatus preferably includes bottom stabilizer posts 13, e.g., made of rubber, to contact the ground, provide a leveling function and prevent slippage of the apparatus during use.

(23) As can be seen, for example, in FIG. 2, the exercise device 1 may include a speed adjustment control 16, which can vary the speed of the up and down motion of the pedal 10 and 12. The adjustment control can be in the form of a knob, switch, lever or other user-selectable device. As an example, the control 16 is depicted in the figures as a knob. The housing top 14 and housing bottom 15 are preferably coupled to one another using screws 17.

(24) As will be described in more detail below, a force adjustment control 18 is provided, a portion of which is accessible through an opening in the housing top 14 to allow adjustment of the intensity of tapping or striking force provided by the device 1. As will be discussed further below, the ability to adjust the speed of the up and down motion of the pedals 10, 12 is optional and may be omitted. Thus, in a variation of the disclosed embodiment, the apparatus does not include the adjustment control knob 16, but rather operates at a set speed approximating the average steps per minute during jogging of 140-150 steps per minute. The set speed is based upon the observation that steps per minute during jogging at 4 mph, or a 15 minute mile, or 4.3 mph, or a 14 minute mile, is 140 steps per minute or 150 steps per minute, respectively, see, for example, http://www.ontherunevents.com/ns0060.htm, and, in the case of adjustable speed configuration, may be set to approximately 60 to 180 steps per minute, and preferably, in a single speed configuration, set to approximately 140 or 150 steps per minute, a speed similar to typical jogging, as discussed above.

(25) The interior workings of the exercise device 1 can be seen in the sectional views of FIGS. 3-6, as well as the perspective view of FIG. 7, which shows the interior without the housing top 14 and without right pedal 12. As shown in these figures, the interior of the device 1 includes mechanical and electrical elements that cooperate to cause the pedals to rockingly reciprocate, e.g., anti-phase to one another, between up and down positions, the pedals being rotatable, preferably at a rearward portion of each pedal, about a common axis.

(26) The rocking motion for the movement of the pedals is provided in the first embodiment by a driving mechanism that includes a motor 20, the drive shaft of which drives a motor pulley 22. A stop/start button 21 is preferably provided to start the operation of the motor. The motor 20 is preferably a motor of a well-known type, such as a DC brushless motor, of a power sufficient to drive pedals of the apparatus. Power to the motor 20 is supplied, e.g., using power connector 23, or by disposable or rechargeable batteries, not shown.

(27) The motor pulley 22 contacts a belt 24 which is also contacting a camshaft pulley 26. The belt transfers rotational motion of the motor pulley 22 to provide rotational motion to the camshaft pulley 26.

(28) This rotation in turn causes a camshaft 28, arranged along an axis perpendicular to the camshaft pulley 26 and transverse to the feet, to rotate. A cam 30 is eccentrically coupled to each end of the camshaft 28. The eccentricity is provided, in the present embodiment, by the camshaft 28 coupling with the cam 30 in an off-center manner, that is, coupling to the cam 30 at a point on the cam 30 axially offset from the center of the cam 30. The off-center coupling causes eccentric rotating motion of each cam 30. While the cam 30 and the camshaft 28 are shown in the first embodiment as being distinct elements, the cam 30 can also be an integrally formed portion of each end of the camshaft 28.

(29) To translate the rotational motion of the camshaft 28 to the up and down motion of the pedals, each cam 30 is arranged in a channel 31 provided in a pedal coupling member 32. The channel 31 is configured such that the eccentric motion of the cam 30 causes the coupling member 32 to reciprocate, such that a front end of the coupling member 32 moves up and down to a greater extent than the rear end of the coupling member 32.

(30) The top of each coupling member 32 is affixed, for example, by screws 34, to the underside of the respective foot pedals 10 and 12. The cams 30 are arranged in the channel 31 of the respective pedal coupling members 32 such that the motion provided to the two pedal coupling members 32 by virtue of the eccentricity of the cams 30 at each end of the camshaft 28, generates alternating, i.e., anti-phase, reciprocating up and down motion of the pedals 10 and 12, so that, preferably, when one pedal is moving up, the other is moving down. However, in a variation of this configuration, the cams can be configured to provide in-phase movement of the pedals.

(31) In the above-described manner, the motion of the camshaft 28, driven by the pulleys 22 and 26 and the motor 20, drives the pedals in an up and down motion about a common axis 34. The common axis 34 is preferably provided towards the rear of each pedal 10, 12 being rotatably mounted around a pedal axle 36, disposed along the common axis 34. While the disclosed embodiment shows the common axis disposed at an extreme end of each pedal, the invention is not limited to this configuration, and the device could be alternatively set up with the axis of rotation located away from an extreme end, while still providing the rocking motion.

(32) The motor 20 is mounted on a mounting plate 38, to which various elements of the driving mechanism described above are also coupled, either directly or indirectly. The mounting plate 38 is located between the housing top 14 and the housing bottom 15 and acts as a chassis for mounting internal components of the exercise device 1.

(33) The mounting plate 38 is preferably made of a lightweight metal, for example aluminum, steel, or the like. However any sufficiently strong and lightweight material can used, such as carbon reinforced plastic, or other similar material, that will result in a lightweight travel-friendly device. The mounting plate 38 includes two pedal mounting flanges 40 structured to secure each pedal axle 36 and the rear of each pedal 10, 12. Also coupled to the mounting plate 38 are bearing blocks 42, each of which receives and secures an end of the camshaft 28, or a tubular extension thereof, to allow rotation of the camshaft 28.

(34) While the mechanism for converting the rotational motion of the reciprocating motion of the pedals is shown above using a pulley and belt system, as would be appreciated, the invention is not limited to this embodiment. Any manner of converting the rotational output of the motor to reciprocating motion of the pedals may be employed. As a non-limiting alternative, the output shaft of the motor 20 can be arranged perpendicular to the camshaft, and a bevel gear configuration used to drive the camshaft. Another variation would use a motor having output shafts along the rotational axis of the camshaft so as to directly drive the camshaft.

(35) Optionally, the motor 20 can be adjustable to increase or decrease the speed of the movement of the pedals. In the speed-adjustable embodiment, a motor controller 56 is provided, which controls the speed of the motor 20 in accordance with the position of the speed adjustment knob 16. Such adjustment is well-known in the art and can be done in any conventional manner, for example by use of a potentiometer controlled by the knob 16, in which the motor speed is varied proportionally to a position of the knob 16, or electrical or digital equivalents thereof. In such configuration, the controller 56 is digitally or otherwise configured to receive information from the knob 16 and, based on this information, control the speed of the motor 20.

(36) To provide beneficial tapping pulses to the user, each pedal 10, 12 is configured to contact a top portion of a bumper 46, at an inside contact surface 44 of each pedal, at the bottom of the downward toe stroke of each pedal provided by the reciprocating motion of the coupling members 32. Each bumper 46, one arranged under each pedal respectively, includes a bumper cover 48, for example made of rubber, and a bumper body 50, the lower part of which is a threaded cylindrical portion having threads 51.

(37) The bumper body 50 is threadingly coupled to the mounting plate 38 such that rotation of the bumper body 50 effects an adjustment of its height with respect to the bumper body 50, as well as its proximity with respect to the contact surface 44 of the pedal 10, 12. In particular, to achieve adjustment of the height of the bumper 46, an annular screw jack 52 is configured such that inner threads 53 of each annular screw jack 52 mate with corresponding threads 51 of the cylindrical portion of the bumper body 50, so as to cause, upon a rotation of the annular screw jacks 52, a corresponding rotation of the bumper body 50, causing a change in the height of the bumper body relative to the mounting plate 38.

(38) Each screw jack 52 having threads 53 is coupled to a tension cable 54 that wraps around the screw jack 52. The tension cable 54 is adjusted by the force adjustment control 18. The force adjustment control can be in the form of a knob, switch, lever or other user-selectable device. As an example, the control 18 is depicted in the figures as a knob. The force adjustment control knob 18 is coupled to the tension cable 54 so that adjustment of the knob 18 in a first direction bumpers 46, by twisting the screw jack 52 in one direction, e.g., clockwise, and adjustment of the control knob 18 in a second direction lowers bumpers 46, by twisting the screw jack 52 in an opposite direction, e.g., counter-clockwise. The knob 18 is preferably coupled to the mounting plate 38 at a dedicated rectangular portion 58 of the mounting plate 38, as can be seen in the figures.

(39) The configuration of the bumper 46 and the control knob 18 allows for adjustment of the intensity of striking of the pedal 10, 12, in particular the contact surface 44, with the top of the bumper 46 by the turning of the control knob 18. The higher the position of the top of the bumpers 46, results in an increase of the pulsatile force applied to the bumpers 46. In a preferred embodiment the height of the bumper 46 is adjusted to allow for tapping that provides a range of pulsatile acceleration having a force sufficient to increase pulsatile shear stress to the endothelium, of sufficient magnitude to cause the release of beneficial mediators, such as nitric oxide, prostacyclin, tissue plasminogen activator, adrenomedullin, SIRT1, Brain and Glial Derived Neurotrophic Factors (BDNF & GDNF), Kruppel Like Factor 2, Superoxide Dismutase, Glutathione Peroxidase 1, Catalase, Total Antioxidant Capacity, Anti Apoptotic Proteins: p-Akt, Bcl2, and Bcl2/Bax, HSP27. Preferably, such effects can be provided with an acceleration of about 0.1 g to 0.5 g.

(40) Such tapping to the feet provided by the apparatus can increase pulsatile shear stress as related to the addition of pulses into the vascular circulation, heart, lymphatic channels, interstitial spaces, skeletal muscle and bone interstices, as well as slight increases of cyclic strain to the blood vessels and lymphatic channels.

(41) The tapping is also settable so as to increase the activity and content of endothelial nitric oxide synthase (eNOS) in blood vessels, heart and skeletal muscle, as well as to increase the activity of neuronal nitric oxide synthase (nNOS) in the heart and skeletal muscle. Moreover, using the apparatus repeatedly adds pulses and minimally increases cyclic strain, by the striking of the flat, padded, hard surface of the bumper 46 with the foot pedals, to the body's fluid filled channels over the body's own pulse such that even during periods when pulses are not imparted, bioavailability of the beneficial mediators is greater than the preoperational period.

(42) Moreover, adding the pulses, using the striking of the bumper with the foot pedals, to the body's fluid filled channels over the body's own pulse stimulates endothelial release of at least one of nitric oxide, prostacyclin, tissue plasminogen activator (t-PA), adrenomedullin, endothelial dependent hyperpolarizing factor (EDHF), endothelial dependent relaxing factor, endothelial growth factors, and transcription factors, etc.

(43) By using the apparatus in the manner described herein, the efficacy of treatment after a single or multiple sessions over a single duration of from about 10 to 30 minutes or more can be ascertained by sensing release of nitric oxide into the circulation by one or more of the following,

(44) a) descent of the dicrotic notch of the pulse waveform from any non-invasive or invasive technology that provides a raw arterial pulse waveform with the preferred embodiment a photoplethysmographic placed upon the finger and/or ear,

(45) b) fall in blood pressure measured by conventional means from baseline and during treatment upon termination of treatment that may last several minutes,

(46) c) a subjective, pleasant feeling of warmth and tingling over the skin of the lower extremities that may rise upwards toward the head.

(47) The use of the apparatus also results in the suppression of inflammatory and pro-cancergenic factors such as nuclear factor kappa beta, endothelin-1, STAT3, and Pro-Apoptotic Proteins: Fas, TRAILR2, Bad, Caspase 3,8.

(48) FIG. 9 shows the descent of dicrotic notch as a reflection of Nitric Oxice released into circulation using the apparatus in accordance with the present invention. The uppermost graph in the figure depicts the dicrotic notch from the raw photoplethsmographic sensor signal placed over the distal joint of the index finger. The dicrotic notch is high on the diastolic limb of the pulse wave in a normal position with almost no positional variability from beat to beat. The middle graph in the figure depicts the finger pulse during operation of the apparatus according to the present invention without foot tapping at 180 steps per minute. Here the dicrotic notch shows variability from beat to beat as it descends down the diastolic limb of the pulse wave (force is <0.2 g). Here, some pulses are in a similar position as the baseline pulse. The lowermost graph in the figure depicts the finger pulse during operation of the apparatus according to the present invention with foot tapping at 180 steps per minute. The dicrotic notch shows variability from beat to beat as it descends down the diastolic limb of the pulse wave (force ranges from 0.2 to 0.7 g and varies according to subject's weight and involuntary force applied by the subject). Here, the dicrotic notch of all pulses have a lower position on the diastolic limb of the pulse wave than baseline and the recordings made with no tapping. The lower the position of the dicrotic notch, the greater the nitric oxide release into the circulation thereby producing the greater effectiveness of the actions of this molecule in the body.

(49) While the known addition of pulses using whole body periodic acceleration relied upon acceleration and deceleration of the blood's inertial properties, in the present invention it still plays a part but the foot tapping features provided by the apparatus produce more consistent descent of the dicrotic notch with greater pulsatile shear stress.

(50) As shown in FIG. 10, minute ventilation was measured in three seated, normal subjects during application of pulses in accordance with the apparatus of the present invention at 140 steps per minute with maximum foot tapping during a 25 minute period. Non-invasive respiratory inductive plethysmography was utilized for the measurements. Minute ventilation increased approximately 3 liters over baseline as a result of increases in both tidal volume and respiratory rate. This increase was similar to that found in three supine, normal subjects during 20 minutes of WBPA applied in the supine posture. In this study, measurements were made with a pneumotachograph and mouthpiece assembly. The Force ranged from 0.2 to 0.7 g.

(51) The increase in ventilation associated with passive movements of the feet and tapping presumably was due to stimulation of mechanoreceptor in the legs that stimulated the respiratory center as a reflex. This also occurs during passive bicycle exercise. Oxygen consumption measured in paraplegic and quadriplegic patients during passive cycling, where there can be no active muscular efforts, increases from 30 to 40 ml above baseline. This is comparable to the amount previously observed in normal subjects during application of WBPA for 30 minutes. Therefore, since the increase in minute ventilation between WBPA and foot lifting and tapping are the same, one would expect a similar increase of oxygen consumption. Thus would fall into the category of NEAT and if carried out at least two to three hours daily with dietary intake constant over weeks or months would lead to loss of body weight,

(52) Upon stopping the device after its operation of five minutes or more in most subjects, a pleasant tingling sensation of the skin over the lower extremities extending up the trunk occurs that lasts seconds to minutes. This is often accompanied by a fall in mean blood pressure of 5 to 10 mm Hg. It may be analogous to post-exercise hypotension after exercise that is thought to be related to an increase of nitric oxide release.

(53) FIG. 11 shows application of the apparatus 1 in a vertical orientation, so that a user can use it while lying on a bed. For such purpose the apparatus can be fitted with, or have, a bracket 60 extending from the bottom thereof, in this case extending leftward in the figure with respect to the apparatus 1. The bracket 60 is configured to securely and adjustably mount to a vertically oriented support member 62, for example a headboard portion of a bed 64. The same benefits as described above are provided with the apparatus in this position.

(54) Although example embodiments have been shown and described in this specification and figures, it will be appreciated by those skilled in the art that changes may be made to the illustrated and/or described example embodiments without departing from their principles and spirit.

(55) Thus, while there have shown and described and pointed out fundamental novel features of the invention as applied to a preferred embodiment thereof, it will be understood that various omissions and substitutions and changes in the form and details of the devices illustrated, and in their operation, may be made by those skilled in the art without departing from the spirit of the invention. For example, it is expressly intended that all combinations of those elements and/or method steps which perform substantially the same function in substantially the same way to achieve the same results are within the scope of the invention. Moreover, it should be recognized that structures and/or elements and/or method steps shown and/or described in connection with any disclosed form or embodiment of the invention may be incorporated in any other disclosed or described or suggested form or embodiment as a general matter of design choice. It is the intention, therefore, to be limited only as indicated by the scope of the claims appended hereto.