The disclosed method and apparatus generally relate to physical therapy for knee joints.
The anatomy of a knee joint consists of three bones. These three specific bones are the femur (thighbone), the tibia (shinbone) and the patella (kneecap). The patella is located in front of the knee joint, and provides partial protection for the anterior portion of the knee. Typically, bones are connected to other bones through ligaments. Specifically, the knee joint has four ligaments functioning as resilient elastic cables linking the femur and tibia together for the purpose of maintaining knee joint stability.
Collateral ligaments are located vertically on opposed parallel sides of the knee joint. The medial collateral ligament is located on the outer inside of the knee joint, and links the femur and tibia. The lateral collateral ligament is located on the outer outside of the knee joint, and also links the femur and tibia. The purpose of the collateral ligaments is towards controlling knee joint sideways motion, thus fortifying the knee joint against unusual movement.
Cruciate ligaments are located inside of the knee joint, and cross each other in the general form of an “X”. The anterior cruciate ligament is located in front, behind the patella, and the posterior cruciate ligament is located in the back, linking the femur and tibia and having a purpose towards controlling anterior and posterior movement of the knee joint.
Upon completion of knee joint surgery or other type of knee joint treatment, such as knee joint replacement or replacement or repair of any torn or damaged previously described ligaments, bone fracture and bone fracture surgery, or internal fixation surgery, or for treatment of arthritic conditions, or meniscus repair, or for knee injury recovery, regaining normal knee joint flexibility, range of motion and strength typically requires a physical therapy rehabilitation program.
Following knee surgery, or arthritic treatment, or injury treatment, or other procedure or course of treatment for the knee joint, physical therapy may be beneficially applied to restoring full and painless motion of the knee joint, along with re-establishing associated ligament and muscle suppleness. Restoration may be followed by a knee joint strengthening program focused on regaining normal function of the knee joint. A physical therapy program progressively stretches muscle(s) and tendon(s) to their former flexibility. A final rehabilitation phase encourages complete return of normal knee joint functionality.
There remains a need for an apparatus and method for a knee joint flexion support allowing for incrementally-applied physical therapy.
A knee flexion rehabilitation device may comprise a knee support system and a base which connects to and supports the knee support system, wherein the knee support system may comprise a knee support bar and a plurality of pads configured to removably mount to the knee support bar, further wherein each pad has an outer diameter different from that of another of said plurality of pads.
A knee flexion rehabilitation device may comprise a plurality of knee support bars, each knee support bar having an outer diameter different from that of another of said plurality of knee support bars; and a plurality of pads, each pad being configured to mount to at least one of said plurality of knee support bars.
A base of a knee flexion rehabilitation device may comprise a bracket system to mount the knee support system to a patient support system, such as a bed or therapy table. Other embodiments of a base may exist so as the knee flexion rehabilitation device is self-supporting and mobile.
A method for using a knee flexion rehabilitation device may comprise establishing a support bar, effectively increasing the diameter or a cross-section dimension of the support bar by attaching one or more pads thereto, supporting a knee joint on the dimensionally-enlarged support bar for initial flexibility treatment, reducing the diameter or a cross-section dimension of the support bar by removing or changing one or more pads, and supporting a knee joint on the dimensionally-selected support bar for subsequent flexibility treatment. The ability to select the support bar's effective diameter may allow for optimal therapeutic outcomes for differing situations, procedures, and protocols.
The above brief description sets forth rather broadly certain features of the disclosed apparatus in order that the description thereof that follows may be better understood, and in order that the present contributions to the art may be better appreciated. There are, of course, additional features of the disclosed apparatuses that will be described hereinafter and which will, in whole or in part, form the subject matter of the claims appended hereto.
Thus, it is to be understood that the disclosed subject matter is not limited in its application to the details of the construction and to the arrangements of the components set forth in the following description or illustrated in the drawings. The disclosed subject matter is capable of other embodiments and of being practiced and carried out in various ways, including being fabricated with fixed dimensions, non-folding components, or other structural locking mechanisms. Also, it is to be understood, that the phraseology and terminology employed herein are for the purpose of description and should not be regarded as limiting.
As such, the concepts upon which this disclosure is based may readily be utilized as a basis for designing other structures, methods, and systems for carrying out several purposes of the disclosed subject matter. It is important, therefore, that the claims be regarded as including such equivalent constructions insofar as they do not depart from the spirit and scope of the subject matter described herein.
Disclosed is a knee flexion rehabilitation apparatus and method adapted for knee joint flexion rehabilitation following knee joint surgery or other type of knee joint treatment, such as knee joint replacement or replacement or repair of any torn or damaged previously described ligaments, bone fracture and bone fracture surgery, or internal fixation surgery, or for treatment of arthritic conditions, or meniscus repair, or for knee injury recovery, regaining normal knee joint flexibility, range of motion and strength. The apparatus is capable of use for reducing muscle spasm, pain and swelling; having such arrangement to provide appropriate flexion support of the posterior intersection concerning the femur and tibia of a non-operative, arthritic, injured, fractured, or post-operative recovering knee joint; promoting deliberate gravity assisted passive flexion towards gradual knee joint muscle and tendon stretching, and mechanical decompression of the knee joint to alleviate pain, pressure, swelling, and general discomfort.
The knee flexion rehabilitation device 10 in general may comprise of three main assemblages, the knee support system 11 and a base 13. In some embodiments, such as seen in
The knee posterior support bar 12 may be substantially oriented parallel to the patient support surface 15, which may be substantially horizontally oriented. The knee support system 11 may further comprise a strut 19 configured to position the support bar 12 over or near the patient support surface 15. The support bar 12 and the strut 19 may be mechanically joined, or formed as a unitary structure. In some embodiments, the support bar 12 and strut 15 may comprise hollow tubular members.
In some embodiments, such as in the embodiment of
In other embodiments, the support bar 12 may rotate about a different axis than that of the strut 19. As may be seen in
In various embodiments, the post 28 may rotate in the socket 30. The post 28 may translate in the socket 30. The post 28 may rotate and translate in the socket 30, depending on embodiment. Alternately, the post 28 may be fixed against rotation or translation in the socket 30 via apertures 38 and pin (not shown), or detents, or other suitable locking mechanism. Thus, the knee support system 11 may rotate on one or more axes, and may translate in a variety of planes so as to accommodate a wide range of patient sizes, weights and conditions, and to accommodate a wide range of treatment protocols. Additionally, the socket 30 may translate along the strut arm 32 to further aid in proper positioning in relation to a supine or sitting patient.
An embodiment, as seen in
In yet other embodiments, such as the embodiment illustrated in
In some embodiments, a socket 30 may be disposed at one end of the curved member 40 of base 13. As in the embodiment of
In other embodiments, the disclosed apparatus, referred to as knee flexion rehabilitation device, may generally be comprised of a knee support system 11 connected to and supported by a base 13. The disclosed device and system may comprise a plurality of pads for a knee flexion support bar. The support bar may be substantially straight, or may comprise one or more curves. The support bar may be provided as part of a knee flexion rehabilitation device, such as that disclosed in PCT/US15/19336, filed Mar. 7, 2015, and entitled Method and Apparatus for Knee Joint Flexibility Rehabilitation, the entire disclosure of which is incorporated herein by reference. Those having skill in the art will appreciate that the pads may be used with any other suitable support bar such as those described herein.
The preceding paragraphs have described various embodiments of the knee flexion rehabilitation device with the focus largely on the various embodiments of the knee support system. For purposes of simplicity, the drawings may have included a particularly simple and effective base. In the following paragraphs, an embodiment that describes that base with more specificity and other embodiments focusing on the base are described. It will be readily understood that any of the above described embodiments of the knee support system can be used with, or adapted to be used with, any of the below described embodiments of the base to construct a knee flexion rehabilitation device and provide incremental knee therapy.
In some embodiments, the base may comprise a strut 44 extending from a patient support surface 15, as may be seen in the embodiments of
As may be seen in the embodiments of
In some embodiments, the support bar 12 may be mounted to the strut 44 at one end of the support bar 12, as may be seen in the embodiment of
In yet further embodiments, a knee support system 11 which is connected to and supported by a base 13, may be mounted to the edge of a patient support surface 15, such as in the embodiment of
As may be seen in
In other embodiments, such as that of
The base 13 may be provided as part of a knee flexion rehabilitation device 10, such as that disclosed in PCT/US15/19336, filed Mar. 7, 2015, and entitled Method and Apparatus for Knee Joint Flexibility Rehabilitation, the entire disclosure of which is incorporated herein by reference. In the embodiment of
The preceding paragraphs have described various embodiments of the knee flexion rehabilitation device with the focus largely on the various embodiments of the knee support system or base. For purposes of simplicity, the drawings may have included a particularly simple and effective pad system. In the following paragraphs, an embodiment that describes that pad system with more specificity and other embodiments focusing on the pad system are described. It will be readily understood that any embodiments of a knee support system can be used with, or adapted to be used with, any of the embodiments of a pad system to construct a knee flexion rehabilitation device and provide incremental knee therapy.
The pads may comprise any suitable material, such as foam, plastic, fabric, gel, and the like. Similarly, the pads may be solid, inflatable, hollow, or contain internal structural components for rigidity and shape. The pads may comprise any suitable density, stiffness and elasticity desired for patient comfort and condition. For example, a system of pads may comprise pads having a density and compliance configured to meet needs of specific patient conditions (such as arthritis, TKA, meniscus repair, ligament repair, broken bone recovery, for example). Those having skill in the art will appreciate that some surgeries and uses may require softer layers depending on the sensitivity and severity of the condition of the knee joint and surrounding patient tissue, as well as the presence and location of sutures and bandages, and degree of swelling.
The pads may further comprise any suitable coating and outer surface texture. In some embodiments, the pads may be sterilizable for re-use, or may be disposable. In yet other embodiments, the pads may comprise a substantially breathable surface to allow moisture and patient fluids to wick away from the leg. In yet further embodiments, the pads may comprise impermeable surfaces that may be cleaned. In other embodiments, a disposable cover may be placed over one or more of the pads. In further embodiments, a pad or outer layer may be coated with balm or medicated salve to promote patient comfort or healing (such as for heating or cooling, or a such as a lotion, lubrication, or pain relief medication).
Furthermore, the pads may be suitably shaped to cradle the knee joint, or to provide a smaller fulcrum point. The effective diameter of the support bar may be changed by pads having substantially uniform thickness, or may be changed by pads having varying thickness. The cross-sectional shape of the pads may be round, square, rectangular, triangular or have a different polygonal shape, or may be irregularly shaped. The support bar may be tubular, or round. If the pads are irregularly shaped, or have a varying thickness, the support bar may be square or keyed to substantially prevent the pad from slipping about the support bar. Thus, the pads may effectively increase a radius or cross-sectional dimension of the support bar. The pads may be removably affixed to the support by any suitable device, such as hook-and-loop fastener, interlocking surface texture, interlocking configuration, adhesive, friction fit, the weight of the patient's leg, pins, screws, clamps, or straps.
In some embodiments, the one or more supple pads 14 may translate along the support bar 12 for any embodiment of the knee support system 11. In other embodiments, the one or more supple pads 14 may rotate about the support bar 12. In yet other embodiments, the one or more supple pads 14 may rotate about and translate along the support bar 12. These features may be the most readily apparent in
As may be seen in the embodiment of
In other embodiments, a system of pads may be provided, with each pad having a different thickness, as in the embodiment of
In some embodiments, one or more of the pads 14, 16, and 18 may be provided with one or more wings 84 and 86 against which the femur and/or tibia may rest to further control range of motion. Each wing 84 and 86 may extend from a pad 14, 16, or 18 at a tangent thereto. A single-wing embodiment may be keyed to the support bar 12 so as to substantially restrict rotation of the wing 84 or 86 about the support bar 12. In the embodiment of
In some embodiments, such as those of
In such an embodiment, the tibial wing 89 and 93 of the outer pad 88 and mid pad 90 of a “U” shaped arc of pad material such that when said pads are nested with the inner pad 92, the wings of the outer pads 88 and 90 do impede access to wing 96. Alternately, wings 89 and 93 may be disposed such that the U-shaped nature allows the overlap the outer edge of the preceding wing and thus the wings 96, 89, and 93 nest so as to form a single platform. These features as disclosed for the tibial wings 96, 89, and 93 hold for the femoral wings 91, 98, and 94.
Thus, a system of pads may provide for separate pad use, or may provide for pad layers. The pads may be color-coded, textured, labeled, or otherwise suitably marked to indicate the approximate range of angles provided by the pad, and/or to indicate the order of use. By varying the effective diameter of the support bar, the physical therapist (or patient, or doctor or other caregiver, as the case may be) may allow therapy to progress through each layer or pad size based on the patient's level of comfort, thus better allowing for a patient-specific recovery regimen. A system may provide a plurality of pads having dimensions suitable for allowing finer or coarser increments between ranges of motion. For example, a system of five layered pads may provide the same effective diameter as a system of three layered pads, but may provide smaller range-of-motion increments than the three-layer system. Similarly, a system of five pads for sequential placement on the support bar may provide the same maximum effective diameter as a system of three pads, but may provide smaller range-of-motion increments than the three-pad system.
For example, a system of four layered pads may comprise a first pad having an outer diameter of about 1.5 inches and configured to mount to a support bar, a second pad having an outer diameter of about 2.5 inches and configured to nest over the first pad, a third pad having an outer diameter of about 3.5 inches and configured to nest over the second pad, and a fourth pad having an outer diameter of about 4.5 inches and configured to nest over the third pad. The first pad may be color-coded red and labeled with a range-of-motion (ROM) marking indicating a range of motion up to about 90 degrees (as measured by a goniometer). The second pad may be color-coded blue and labeled to indicate a ROM of up to about 105 degrees. The third pad may be color-coded green and labeled to indicate a ROM of up to about 120 degrees. The fourth pad may be color-coded purple and labeled to indicate a ROM of up to about 135 degrees. Of course, any number of such pads may be used in a variety of thicknesses to provide desired ranges of motion.
In another example, a system of three pads may comprise a first pad having an outer diameter of about 1.5 inches and configured to mount to a support bar, a second pad having an outer diameter of about 3.0 inches and configured to mount to a support bar, a third pad having an outer diameter of about 4.5 inches and configured to mount to a support bar. The first pad may be color-coded red and labeled with a range-of-motion (ROM) marking indicating a range of motion up to about 90 degrees (as measured by a goniometer). The second pad may be color-coded blue and labeled to indicate a ROM of up to about 112.5 degrees. The third pad may be color-coded green and labeled to indicate a ROM of up to about 135 degrees. Of course, any number of such pads may be used in a variety of thicknesses to provide desired ranges of motion.
A system of pads may thus comprise a kit having a plurality of pads, and instructions for use. A pad carrier may be provided to allow for ready arrangement, transportation, storage and deployment of the system. The pad carrier may allow for ready visual identification of each pad. Instructions may be printed on the pads, and/or separately provided in a manual. The pads may be provided as part of a knee flexion rehabilitation device, or as a separate system. The system may be configured for use with any other suitable support bar, such as the back of a chair or the edge of a table, chair or bed.
Similarly, a knee flexion rehabilitation device system may comprise a kit having a plurality of support bars, and instructions for use. A knee flexion rehabilitation device system carrier may be provided to allow for ready arrangement, transportation, storage and deployment of the system. The knee flexion rehabilitation device system carrier may allow for ready visual identification of each support bar. Instructions may be printed on the support bars, and/or separately provided in a manual. The support bars may be provided as part of a knee flexion rehabilitation device system, or as a separate system expansion kit. The system may be configured for use with any other suitable support system.
In yet further embodiments, a system of pads and support bars may comprise a kit having a plurality of pads and support bars, and instructions for use. A pad and support bar carrier may be provided to allow for ready arrangement, transportation, storage and deployment of the system. The pad and support bar carrier may allow for ready visual identification of each pad and support bar. Instructions may be printed on the pads and support bars, and/or separately provided in a manual. The pads and support bars may be provided as part of a knee flexion rehabilitation device system, or as a separate system expansion kit.
A method of using the foregoing knee flexion rehabilitation device may comprise removably mounting a first pad to a support bar, the first pad comprising a first outer diameter; positioning the support bar, having mounted the first pad, at the posterior of a knee joint; moving the knee joint through a first range of motion; removing the support bar from the posterior of the knee joint; removing the first pad from the support bar; removably mounting a second pad to a support bar, the second pad comprising a second outer diameter less than the first outer diameter; positioning the support bar, having mounted the second pad, at the posterior of the knee joint; and moving the knee joint through a second range of motion.
Alternately, a method of using the foregoing knee flexion rehabilitation device may comprise nestably and removably mounting a plurality of pads to a support bar; positioning the support bar, having mounted the plurality of pads, at the posterior of a knee joint; moving the knee joint through a first range of motion; removing the support bar from the posterior of the knee joint; removing the outermost pad of the plurality of pads from the support bar; positioning the support bar, having the outermost pad removed, at the posterior of the knee joint; and moving the knee joint through a second range of motion.
As may be seen in the embodiments, the layers may incrementally increase the diameter of the support bar to allow a physical therapist a method of incrementally increasing a patient's knee flexion. With reference to the embodiment of
As the range of motion of the knee 100 increases, the third pad layer 18 may be removed from the support bar 12, thus reducing the effective diameter of the support bar, as may be seen in the embodiment of
As the range of motion of the knee 100 still further increases, the second pad layer 16 may be removed from the support bar 12, thus reducing the effective diameter of the support bar, as may be seen in the embodiment of
In yet further embodiments, a system of support bars may be provided, wherein each support bar may comprise a different diameter. As may be seen in the embodiment of
A system of such support bars may be used progressively as described above to provide various overall support diameters. For example, a support bar 12C with pad 116 may be used initially to support a patient's knee through a first range of motion, then a support bar 12B with pad 114 may be used to support a patient's knee through a second range of motion greater than the first range of motion, and then a support bar 12A with pad 112 may be used to support a patient's knee through a third range of motion greater than the second range of motion.
The disclosed method and apparatus focused on the application of knee rehabilitation, yet the same methods and apparatus could be applied to other joints. Elbows, shoulders, ankles, wrists, and any other joint that may benefit from controlled flexion therapies may be addressed through the disclosed material. For each joint, placement of the device in reference to the joint may require minor modification dependent on the degrees of freedom seen for each particular joint with actual placement determined by which plane and axis of motion a therapy protocol will address for the particular session. In addition to joint placement, the proper diameter pads may vary from joint to joint, so that a complete set of pads for the apparatus may include more than the minimal diameters shown and discussed. For example, an elbow may be better suited for applying the joint to the device from the underside of the support bar and pad, utilizing a set of smaller pads than for a knee, and then flexing upward around the pad rather than downward over the pad.
Although the disclosed subject matter and its advantages have been described in detail, it should be understood that various changes, substitutions and alterations can be made herein without departing from the invention as defined by the appended claims. Moreover, the scope of the claimed subject matter is not intended to be limited to the particular embodiments of the process, machine, manufacture, composition, or matter, means, methods and steps described in the specification. As one will readily appreciate from the disclosure, processes, machines, manufacture, compositions of matter, means, methods, or steps, presently existing or later to be developed that perform substantially the same function or achieve substantially the same result as the corresponding embodiments described herein may be utilized. Accordingly, the appended claims are intended to include within their scope such processes, machines, manufacture, compositions of matter, means, methods or steps.
This application claims priority to U.S. Provisional Patent Application 62/374,664 entitled “Method and Apparatus for Variable Knee Flexion Support” filed Aug. 12, 2016, which is hereby entirely incorporated herein by reference.
Number | Date | Country | |
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62374664 | Aug 2016 | US |