Forward head positioning is an increasingly observed malady in our society. As is well known to orthopedists, chiropractors and other medical practitioners the human head in its normal position should sit in a direct fashion on the neck and shoulders. Partly because of certain increasing habits in our society the head can become displaced to a posture where instead of sitting directly on the neck and shoulders, is displaced forward of that normal position to what is called a “forward head posture” (or “FHP”). FHP is identifiable when the position of the ear is forward when compared to the shoulder, as opposed to being posited directly over it. FHP has become so widespread that it may already constitute a health hazard having the ramifications of a pandemic, since when left untreated FHP can develop degenerative and disabling joint diseases affecting countless numbers of people.
There are numerous reasons why FHP is becoming such a more common problem. For example, vastly increased use of computer screens accustoms the operator to move and maintain the head (and ears) in the undesirable forward head posture. The problem is exacerbated in children and young adults by long hours devoted to video games, not to mention conventional television watching. Yet another source believed to be responsible for the malady particularly in children, is the present custom of children carrying extremely heavy backpacks to and from school. The weight of such backpacks is so high as to require head placement in a forward position to balance the load, which results in the increasing observation of forward head posture in both children and young adults. As another example, FHP occurs in athletes playing contact sports, such as football or soccer, in which a given player's head will move involuntarily in an unplanned direction. In football, it is known that a player's head will moved in several directions when the player is tackled or blocked. In that instance, the head will move in a direction that causes stress on the spine and the head translates forward of the shoulders. The same type of movement may be experienced when a given play is using his or her head during soccer to hit the soccer ball.
Basic damage resulting from forward head posture (FHP) arises because the upper cervical portion of the spine can become chronically misaligned. The head will translate forward of the shoulders. Every inch the head moves forward of the shoulders dramatically adds mechanical weight loads to the neck. For example, an individual with poor posture may have his or her head translate a number of degrees from the anatomically correct position, which is considered zero degrees. In a normal anatomical position, the head aligned forward of the shoulders in the zero degree position, such that the ears are lined up with the center of the shoulder. In that position, there is about 10-12 lbs. of weight loaded to the neck and cervical spine. When the head moves forward, such that the ears are displaced away from the centerline, there is an increase in the number of pounds imposed on the neck. A 15 degree displacement can create up to 27 lbs. and a 16 degree displacement can impose an additional 60 lbs on the neck. The forward positioning of the head can pull the spine out of its anatomical alignment, and can add up to thirty pounds of abnormal leverage on the cervical spine and, as a result, can pull the spine out of alignment. Movements in head posture forces muscles in the upper back and neck areas to work harder to keep the head (including chin) properly aligned, as opposed to dropping forwards towards the chest area. It is known by those of ordinary skill in the art that FHP may result in the loss of 30% of vital lung capacity due to the loss of the cervical lordosis. Cervical lordosis is a curvature of the cervical spine or the vertebrae in the neck region. The slight curve present in the cervical vertebrae enables comfortable movement of the neck and supports the weight of the head. The cervical curve allows flexibility between the vertebrae to allow normal head movement. The range of the cervical lordosis is 34 to 44 degrees. When the natural curvature of the spine changes, such that an acceptable cervical lordosis curve is lost or misaligned, problems can arise which present in a number of symptoms, such as neck and back pain, neck stiffness, vertigo and nausea, headaches and tinnitus, high blood pressure, insomnia and fatigue, numbness or tingling sensation in the neck, and other symptoms known in the art.
While the difficulties arising from FHP are certainly well recognized in the healing arts, efforts to correct same by treatment with orthopedic devices and the like have not been successful. Basically such efforts have taken the form of using cervical collars to in some manner immobilize the neck. The objective of these collars, or for that matter of other prior art treatment, has simply been to utilize traction to displace the head from its improper position.
Neither these prior art collars, nor to the best of applicant's knowledge any other presently available devices and/or apparatus, are however effective in reversing the damaging effects of FHP.
As used herein, the term “Z-axis” refers to the horizontal axis extending in an anterior-posterior direction with respect to a set of axis positioned at a hypothetical human, where the corresponding vertical axis is referred to as the Y-axis and the horizontal left to right side axis with respect to such human is referred to as the X-axis. Many of the prior art devices that have been used or proposed, while achieving adjustments along the Z-axis are not otherwise concerned with simultaneously improving cervical lordosis. Most cervical collars are designed to immobilize the neck and/or cause axial translation to decompress the cervical spine while causing the cervical spine straightening. This may produce mixed benefits, as ligament impairment cannot improve around a straightened cervical curve, as this is an abnormal alignment, which will ultimately result in permanent arthritic changes to the cervical joints. Ligament rehabilitation requires improvement of joint alignment over time. Most current extension traction therapy designed to improve cervical lordosis is practiced for 20 minutes or less.
Dellanno, U.S. Pat. No. 8,038,635, the disclosure of which is herein incorporated by reference in its entirely, teaches a forward head position correction collar featuring in combination a shoulder collar assembly, a chin-mastoid piece for engaging and positioning the head of a wearer of the collar and a means interconnecting the chin-mastoid piece to the shoulder collar assembly for manually and incrementally adjusting the chin-mastoid piece with respect to the shoulder collar assembly in an anterior/posterior (Z-axis) direction along the Z-axis. It would be desirable to provide an adjustable collar for use in correcting FHP. It would be desirable to provide a forward head position correction collar featuring in combination a shoulder collar assembly, a chin-mastoid piece and a cheek or jaw piece for engaging and positioning the head of a wearer of the collar. It would be preferable to engage and position using force applied to the cheek jaw rather than the chin. One objective of Dellanno is to improve cervical lordosis with a full correction collar over many hours. The present invention is thus relatively comfortable and can be used at work or at home or even during sleeping hours to avoid unhealthy postures that impair the health of an injured neck.
The present invention features an adjustable forward head posture assembly for use in positioning the head of the wearer to a desired position. The assembly comprises a first member for removably mounting the assembly to the wearer, a second member adjustably secured to the first member, and a third member for engaging the chin of the wearer, which is adjustably secured to the second member. The second member engages a portion of the head of the wearer and is adapted to move relative to the first member for purposes of positioning the third member. The third member engages another portion of the head of the wearer and is adjustably secured to the second member. The adjustable movement of the second member and third member, either individually or in combination, is advantageously used to capture the head of the wearer in a first condition and move the head to a second condition, the second condition being the preferable position of the head relative to the body as desired by the operator of the posture assembly.
In an alternate embodiment, the present invention features a forward head position correction collar assembly comprising: shoulder collar assembly; chin-mastoid piece for engaging the head of a wearer of the collar; a cheek or jaw piece for engaging and positioning the head of a wearer of the collar; and a means for interconnecting the chin-mastoid piece and/or the cheek or jaw piece to the shoulder collar assembly.
The cheek or jaw piece for engaging and positioning the head of a wearer of the collar may be attached to, connected to, or substantially a part or portion of the means for interconnecting the chin-mastoid piece to the shoulder collar assembly. The cheek or jaw piece for engaging and positioning the head of a wearer may be equipped with or contain one or more pads for cushioning the engagement with the cheek or jaw. There may be provided means for manually and incrementally adjusting the chin-mastoid piece and/or the cheek or jaw piece with respect to the shoulder collar assembly in an anterior/posterior (Z-axis) direction along the Z-axis The means for interconnecting the chin-mastoid piece and/or the cheek or jaw piece to the shoulder collar assembly for manually and incrementally adjusting the chin-mastoid piece and/or the cheek or jaw piece with respect to the shoulder collar assembly in an anterior/posterior (Z-axis) direction along the Z-axis may further interconnect the chin-mastoid piece or the cheek or jaw piece to the shoulder collar assembly to displace the chin mastoid piece and/or the cheek or jaw piece in a vertical direction with respect to the shoulder collar assembly simultaneously with and proportional to the incremental adjustment along the Z-axis. The vertical displacement of the chin-mastoid piece and/or the cheek or jaw 'piece with respect to the shoulder assembly proportional to the Z-axis displacement for the chin support piece and/or the cheek or jaw piece may be yielded by a point moving at a 5-25° slope with respect to the Z-axis. The means interconnecting the chin-mastoid piece and/or the cheek or jaw piece to the shoulder collar assembly may feature a track affixed to the chin mastoid piece which is disposed at a slope having a vertical to horizontal rate of change corresponding to the vertical and horizontal displacement of the chin mastoid piece and/or the cheek or jaw piece with respect to the shoulder assembly and a pinion gear engaged with teeth in the track, and means for displacing the chin mastoid piece and/or the cheek or jaw piece with respect to the shoulder assembly in accordance with the rotational position of the pinion gear. The means may adjust the supported head of the wearer from the forward head position to an increasingly corrected position.
The forward head position correction collar features a lordosis correction assembly secured to the rear of the collar and engageable with the rear of the wearer for applying corrective forces by enabling increased pressure to be brought against specified vertebrae. The lordosis correction assembly includes separate adjoining units, each having an advanceable surface which can be individually advanced against a selected of said vertebrae from the posterior of the vertebrae.
The forward head position correction collar may allow vertical displacement of the chin-mastoid piece and/or the cheek or jaw piece with respect to the shoulder assembly and which is proportional to the Z-axis displacement for the chin support piece is that yielded by a point moving at a 10-25° slope with respect to the Z-axis, preferably about a 10° slope. The forward head position correction collar may provide advanceable surfaces of the units of the corrective assembly defined by a plurality of separate side by side pads. The distal ends of the pads may be selectively displaceable toward the wearer's vertebrae to enable selective increase of pressure against selected vertebrae. The pads may be individually inflatable to enable said displacement.
The forward head position correction include means for locking the position between the chin mastoid piece and/or the cheek or jaw piece and the shoulder assembly when the desired adjustment has been attained. The locking means may be releasable for enabling further adjustment. The track and pinion gear may be provided at each lateral side of the correction collar, to enable balanced displacement at each lateral side of the collar.
The forward head position correction collar includes a corrective assembly comprising an inflatable chamber and a surface facing the user which corresponds in shape to the desired corrections. The lordosis correction assembly secured to the rear of the collar may be engageable with the rear of the wearer for applying corrective forces to the upper, middle and/or lower cervical spine. The lordosis correction assembly secured to the rear of the collar may be engageable with the rear of the wearer for applying corrective forces to at least the cervical vertebrae of the wearer.
The invention is diagrammatically illustrated by way of example in the drawings appended hereto, in which:
The present invention is a new type of forward head position (FHP) correction collar, which utilizes a mild axial translation with significant corrective Z translation forces for the sagittal planes. The invention provides an orthopedic correction device which can be readily used by a patient suffering from FHP, which can reverse the damaging effects of compressive loading, shear, and neck moments which FHP generates at all seven cervical vertebra of the patient.
In accordance with the present invention a forward head position correction collar is provided which in combination includes a shoulder collar assembly, a chin-mastoid piece, a cheek or jaw piece for engaging and positioning the head of a wearer of the collar, interconnecting means for interconnecting the chin-mastoid piece and/or the cheek or jaw piece to the collar assembly as to enable the chin-mastoid piece and/or the cheek or jaw piece to be manually and preferably incrementally adjustable with respect to the shoulder collar assembly in a Z-direction, to thereby adjust the supported head of the wearer from the forward head position to an increasingly corrected position; and the interconnecting means further being adapted to displace the chin-mastoid piece and/or the cheek or jaw piece in a vertical direction with respect to the shoulder collar assembly simultaneously with and proportional to the incremental adjustment of the chin-mastoid piece and/or the cheek or jaw piece along the Z-axis. The proportional vertical displacement with respect to the z axis displacement for the chin-mastoid support piece and/or the cheek or jaw pieces is that yielded by a point moving at about a 5 to 25° slope, and preferably at a 10 to 25° slope with respect to the horizontal Z-axis.
The FHP correction collar may further include a lordosis correction assembly secured to the rear of the collar. This assembly is engageable with the rear of the wearer for applying corrective force to the upper, middle and/or lower cervical spine. The lordosis correction assembly can also be used to selectively support only one or only several of the seven cervical vertebrae, and thus need not support the entire neck curve. Further, the assembly may by virtue of its fit with a given patient, be able in such instances to support one or more of the upper thoracic vertebrae.
It is to be appreciated that the terms “forward” and “back” are often misused when applied to flexion and extension motion of the head. As described herein the reference coordinate system is one wherein the x-axis extends right to left in the frontal plane, the y-axis is the vertical axis, and the z-axis resides in the front to rear sagittal plane. The present invention is concerned with translational movement along the sagittal plane, i.e. in the direction of the z-axis (front to rear). This contrasts to much prior art as exemplified e.g. in such representative prior art as Bonutti U.S. Pat. No. 6,770,047, which is concerned with rotational movement around the x axis (flexion and extension or looking up or down movement). See, e.g. FIGS. 4 and 5 of Bonutti. The exemplary prior art Bonutti invention is designed to stretch the neck in flexion (negative x direction, see FIG. 4), or in extension (positive x axis direction, looking up, see FIG. 5) The patient can control this motion by an adjustable control knob located at their naval area, whereas in the present invention the control knob is in the neck area and causes a completely different motion. The present invention thus has a neck brace that moves forward (positive z axis) and rearward (negative z axis). There is no flexion or extension motion. The object of the present invention is to correct cervical lordosis breakdown at specific areas and to correct forward head posture. The design of the invention is dictated by the intended motion objectives.
In the views of
The Z-displaced and vertically displaced positions of the chin-mastoid piece 14 and/or the cheek or jaw piece 19 with respect to shoulder collar assembly 12 is adjusted by knobs 35 at each lateral side of collar I 0, each of which turn a pinion gear 36 which is meshed with teeth in track 20 (
Operation of the device is better understood by reference to
Thus when the knob 35 is rotated, displacement upwardly of the chin-mastoid piece 14 and/or the cheek or jaw piece 19 is enabled with respect to assembly 12 because of an incline of the support track 20, and of the alignment maintained in the support bracket 18. The support bracket 18 is schematically shown at 0° for purposes of clarity.
The interaction between the support bracket 18 and the chin-mastoid piece 14 and/or the cheek or jaw piece 19. When the adjustment is made the rods 26 are first released by rotating release means 23 (
The cheek or jaw piece 19 engages and positions the head of a wearer of the collar. The cheek or jaw piece 19 may be provided with pads 39, and is suited for engaging the individual's cheek or jaw at a position lateral to the nose.
Side and top perspective views of the chin-mastoid piece 14 and/or the cheek or jaw piece 19 and associated support bracket 18 appear in
The present apparatus as further seen in
The correction surface 29 can comprise a plurality of separate adjoining pads 39. These can be of a foam or a similar material, or as shown in
As also mentioned, pads 39 can be non-inflatable units formed of rigid or soft foams or other materials. In such instances the pads can be selectively advanced against desired vertebrae by simple mechanical arrangements. The distal ends of the pads 39 (remote from the patient) can be covered by hard plates, which are biased toward the patient by an adjustable threaded member 50 extending through housing 45 to a point at the rear of the assembly. As shown in
The pads 39 can also be inflatable, but instead of directly bearing against the user's spine, can drive separate but contacting pads against the spine, where such separate pads are comprised of foams or other materials.
A key aspect of the present invention is that means are provided which interconnect the chin-mastoid piece and/or the cheek or jaw piece to the shoulder collar assembly; such that these means are manually and incrementally adjustable so that the chin-mastoid piece and/or the cheek or jaw piece may simultaneously be moved in two explicit directions, one of these being in an anterior/posterior direction, i.e. along the Z axis, and also in a vertical direction with respect to the shoulder collar assembly. Furthermore these two types of simultaneous movement are such that the displacement along the vertical direction is proportional to the incremental simultaneous displacement along the Z axis. The functioning of these principles of the invention are best appreciated by viewing
The present invention thus seeks to treat the medical condition now known as Cervical Kyphosis/Forward Head Posture Syndrome. In order to correct this crippling condition, the patient's neck curve must be supported at the precise vertebrae that are causing the reversal of the neck curve while simultaneously repositioning the head rearward to align over the shoulders. This latter movement is a rearward translational movement and not the rotational movement as can be seen in the cited prior art.
The first assembly member 62 comprises a shoulder pad 66 that is shaped or fit on the shoulders of and around the neck portion of the user. The first assembly member 62 is preferably made of a relatively hard, but relatively flexible and durable polymer such as polypropylene, polyethylene or nylon. Preferably some form of plastic is used for most of the components of the collar assembly 60 to reduce weight and provide a device that is durable when used over a period of time.
The pad 66 has two arms 68 and 70, that are joined together at the back 72 from which a neck support 74 extends away from the two arms 68 and 70. Preferably, the two arms 68 and 70 are made of nylon using an injection molding process that incorporates the back 72, which is made of the same material. To cushion the mounting and use of the pad 66, the collar assembly 60 has durable, but soft cushion material that is attached to the surfaces of the first assembly member that will engage the user. The material is preferably a foam laminate, which may include suede, or other shock absorbing and cushioning material that is comfortable for the user to wear. Faux suede material is preferred that is secured to the bad using an epoxy or industrial grade glue or other securing means known in the art. Similar individual engaging, but comfortable material is also applied to the cheeks and chin portion.
On opposite sides of the arms are an adjustment assembly 76 and 78, which are mirror images of each other relative to an imaginary longitudinal axis extending medial of the collar assembly 60. The adjustment assemblies 76 and 78. Because adjustment assemblies 76 and 78 are mirror images of one another, assembly 76 will be described as illustrative of assembly 78,
Assembly 76 includes a movement means mounted thereto for adjusting the position and condition of the second assembly member. The movement means includes a track 82 that is mechanically engaged with an adjustment member 84. The track 82 has teeth for controlling the movement of the adjustment member 84 relative to the long axis of the track 82. A rotatable knob 86 is used to adjust the position of the adjustment member 84 along the track 82. The knob 86 can be turned clockwise or counterclockwise to control the movement of the adjustment member 84 along the track 82. The adjustment member 84 extends away from the track 82 when it is mounted. The adjustment member 84 provides the support for a tower assembly 88 that is adapted to move in a periscope manner from a lower condition to an upper condition, relative to the long axis of the adjustment member 84. On the opposite side of the collar assembly 60 there is another tower assembly 90, that is the mirror image of the tower assembly 88. Tower assembly 90 is movably joined in periscope fashion to an adjustment member 94, which is movably attached to a track 98. Track 98 and adjustment member 9, operate in the identical manner to the controlled and stepped movement of track 82 relative to adjustment member 84. The position of the adjustment members 84 and 94 move along their respective tracks, preferably in coordination with one another along a longitudinal axis 64 and 64′ of their respective tracks 82 and 98, such that the tower assemblies 88 and 90 will move toward the rear or away from the neck support 74 of the shoulder portion of the collar assembly 60.
Because the tower assemblies 88 and 90 are mirror images of one another, the description of tower assembly 88 will be exemplary of the description of tower assembly 90. As illustrated in
The third member 100 comprises a subassembly having a pair of opposed arms 106 and 108 that are attached separately to the tower assemblies 88 and 90. The assembly of arm 106 to tower member 88 is illustrative and exemplary to the assembly of arm 108 to tower assembly 90. Arm 06 is rotatably mounted to the distal end of the tower assembly 88. Arm includes a base 110 to which an adjustable extended arm 112 is mounted to a chin subassembly 114. The extended arm 112 includes a slot and a releasably locking pin that is shaped to move within a series of openings 116 formed within the interior of the arm 112. The openings 116 facilitate stepped and controlled movement of the chin subassembly 114, so that the piece can be adjusted by sliding the locking pin and securing it in place.
The chin subassembly 114 includes a chin-mastoid piece 118, opposed cheek or jaw pieces 120 and 122, respectively, and a chin receiving member 124 for engaging and positioning the head of a wearer of the collar 60 is also provided. The cheek or jaw piece 120 and 122 being movable with respect to the shoulder collar assembly so as to adjust the position of the collar assembly 60. The check or jaw pieces are connected at each of its sides to one of a pair of the tower assemblies 88 and 90. The mounting of the chin assembly 114 enables the collar assembly to move to adjust the position of the wearer's neck and cervical spine, when a fulcrum assembly is operated 124.
As shown in
On both sides, slide the open ends of the shoulder portion on to the shoulders and apply gentle pressure to help engage the collar assembly 60 on the head of the individual. Then, the knobs on both sides of the tracks assembly are operated so that the tower assembly moves along the track. Leave fulcrum in default lower position or adjust to upper position. To adjust, depress thumbwheel while compressing springs and slide fulcrum up or down.
Turn thumb screw until fulcrum pad moves to desired position. Note: Thumb screw can be adjusted as described in this step while patient is wearing collar if desired. Both posts should be in a full forward position and engaged with track. Flip chin rest up so that it will engage the bottom portion of the chin of the individual. Pull collar over head from back and top, avoiding ears; Loosen small knobs on posts and adjust cheek pads evenly so that they rest on cheek bones. Re-tighten small knobs. Flip chin rest down and adjust as needed by pulling spring buttons out and sliding chin rest up or down, making sure the chin rest is positioned comfortably below chin.
For example, since the FHP is a position that produces damaging structural stress on the entire spine it is reasonable to apply the collar in post-operative spine surgery patients. This applies to cervical, thoracic, or lumbo-pelvic post-surgical procedures. This allows healing of the spinal joints without the damaging shear and moment mechanical stresses produced by the forward head posture position. For the above reasons the collar may also be used in post-traumatic situations from car accidents or sports injuries, etc. Therefore hospitals and EMT personnel will desirably employ its use. The lordosis correction assembly can also be used with conventional cervical collars where forward head posture correction may be difficult, i.e., with older patients where fusion of spinal joints has advanced to a point where minimal movement is possible. These conditions will still benefit from some mild lordosis support. This will reduce some of the mechanical strain and pain in these patients.
The progressive improvement of the cervical lordosis requires precise support to the offending misaligned vertebrae. In the examples cited, the vertebra is CS. As illustrated in
While the present invention has been set forth in terms of specific embodiments thereof, the instant disclosure is such that numerous variations upon the invention are now enabled to those skilled in the art, which variations yet reside within the scope of the present teachings. Accordingly, the invention is to be broadly construed and limited only by the scope and spirit of the claims now appended hereto. The description of the material used applies to all embodiments described herein, it be understood that the invention covers equivalent material known in the medial and manufacturing arts, which are acceptable to governmental agencies, such as the United States Food and Drug Administration. The embodiments shown are exemplary and it is contemplated that other equivalent forms can be used within the scope of the objects of the invention.
This application claims priority based on provisional application Ser. No. 62/646,523, filed Mar. 22, 2018, the contents of which are incorporated by reference in their entirety. This invention relates generally to orthopedic correction devices and apparatus, and more specifically relates to a forward head position correction collar.
Number | Date | Country | |
---|---|---|---|
62646523 | Mar 2018 | US |