Patent Grant
11179284
The concepts herein relate to a mover device for persons with reduced mobility. The invention, which will be described below in details, can be implemented both in a medical-hospital environment, to assist elderly and disabled patients and/or persons with reduced mobility in general, and in a private environment, for instance in the house of a person with reduced mobility, just in order to assist and increase his/her own motor skills, by using the mover device according to this invention.
More or less complex devices and machines are known to assist persons with reduced mobility. A device of this kind is disclosed by patent document U.S. Pat. No. 6,213,435B1. The device here disclosed is substantially an auxiliary device conceived to help a patient with reduced mobility, for instance a bed ridden patient, in leaving the bed or in sitting up in bed. The auxiliary device comprises a holder which can be coupled with a bed frame by way of a fitting suitable for securing the holder itself to a side of the bed and a post coupled with the holder and adjustable in height. The upper end of the post is provided with two handles which are adjustable in height by raising or lowering the post and conceived for helping a patient to leave the bed or to sit up in bed. However, to be able to use such auxiliary device, a patient needs a residual mobility, at least in order to grip the handles as necessary to get up. Therefore, the device described in U.S. Pat. No. 6,213,435B1 is not a general-purpose one, i.e. it is not applicable to patients featuring strongly reduced mobility or totally devoid of mobility. Also, the presence of a nurse, assistant, or doctor is in any case necessary to prevent a patient from losing his/her balance and even falling down when gripping the handles. Therefore, the just described auxiliary device features many drawbacks.
Also in other known methodologies used to assist patients with reduced mobility, the presence of an assistant is always necessary to help a patient in his/her movements, for instance in laying down on bed, in sitting up in bed, in entering a bathtub or a shower, and in performing other movements that are potentially dangerous for a patient with reduced mobility.
In the light of the foregoing, it is therefore apparent that the known art as described above does not disclose any method or device that enables a patient to simultaneously move precisely, firmly, and effectively.
In the light of the foregoing, the concepts herein, which will be described in detail below, aim at providing a mover device easy to be assembled and a system reliable in its operation.
In certain instances, the concepts herein render users or patients with partially or totally reduced mobility independent from a constant presence and supervision of an assistant, nurse, or doctor.
In certain instances, the concepts herein provide a mover device and a procedure for moving patients that enables a patient to be moved safely, effectively, and precisely.
In certain instances, the concepts herein provide a mover device and a procedure for patients' movements capable of independently controlling the movements of a patient, or of individual parts of a patient's body, along the three axes.
These objects and others will become apparent in the present description and will be achieved by a mover device and a system in accordance with any of the attached claims and/or any of the following aspects.
In a 1st aspect, there is provided a mover device for the body of patients and/or persons with reduced mobility, suitable and configured for being operationally positioned above, or close to a health and/or medical and/or domestic and/or orthopaedic installation, be it movable or fixed, for instance a support, a bed, a seat, a shower and/or a bathtub, the mover device comprising:
In a 2nd aspect in accordance with the 1st aspect, each support element is configured for:
In a 3rd aspect in accordance with the 1st or 2nd aspect, every support element is configured for moving parts of said patient's body to at least partially modify the position of a patient in the space and/or to make parts of the patient's body get closer to the health and/or medical and/or domestic and/or orthopaedic installation and/or to make them move away from the health and/or medical and/or domestic and/or orthopaedic installation.
In a 4th aspect in accordance with the 1st, 2nd, or 3rd aspect, the mover device comprises a plurality of fourth movers, preferably arranged, in particular, in correspondence with the motor-driven operating portion, each fourth mover being configured for moving a respective support element at least for vertical translation, and in particular in such a way as to get closer to the health and/or medical and/or domestic and/or orthopaedic installation and to move away from the health and/or medical and/or domestic and/or orthopaedic installation.
In a 5th aspect in accordance with the 4th aspect, each fourth mover comprises an electric motor, for instance a DC, stepping, or synchronous motor, and a pulley which is engaged with a respective support element, more particularly the support element is at least partially wound on the pulley.
In a 6th aspect in accordance with any of the aspects from the 1 st through 5th, the mover device also comprises a control unit configured for controlling and/or programming the movements of said support elements in order to make it possible to move, and in particular to at least lift and/or change the position of or to at least partially reposition parts of the patient's body or the patient himself with respect to said health and/or medical and/or domestic and/or orthopaedic installation, or with respect to a further health and/or medical and/or domestic and/or orthopaedic installation (for instance a wheelchair) arranged in proximity of said health and/or medical and/or domestic and/or orthopaedic installation.
In a 7th aspect in accordance with any of the aspects from 1st through 6th, every support element is movable in both directions (getting closer to and/or moving away from), preferably by way of a vertical translational movement, by getting closer to or moving away from said surface or upper portion of the frame towards the health and/or medical and/or domestic and/or orthopaedic installation in order to make it possible an appropriate positioning, for instance by way of a translation, rotation, and/or roto-translation of said at least one respective part of the patient's body.
In an 8th aspect in accordance with any of the aspects from 1st through 7th, the mover device also comprises an operating element, preferably shaped like a circumference or an ellipse, supported by the frame and configured at least to rotate about the frame in the same plane as said upper surface or portion of the frame or in a plane parallel to said upper surface or portion of the frame.
In a 9th aspect in accordance with the 8th aspect, the support elements are rotationally integral with each other and directly or indirectly engage said operating element to rotate integrally with the operating element.
In a 10th aspect in accordance with the 8th or 9th aspect, said operating element has one degree of freedom, said one degree of freedom being a rotation with respect to the frame, said rotation preferably taking place about an axis substantially vertical with respect to an upper surface or portion of said health and/or medical and/or domestic and/or orthopaedic installation.
In an 11th aspect in accordance with the 8th, 9th, or 10th aspect, the mover device comprises a first mover configured for driving said operating element into rotation.
In a 12th aspect in accordance with any of the aspects from 8th through 11th, the frame comprises a guide configured for allowing for the rotation of the operating element with respect to the frame itself.
In a 13th aspect in accordance with any of the aspects from the 8th through the 12th, the mover device comprises a first mover configured for driving the operating element into rotation.
In a 14th aspect in accordance with the 13th aspect, the first mover 8 is an electric motor, for instance a DC or stepping motor.
In a 15th aspect in accordance with the 13th or 14th aspect, the first mover is housed on board the operating element itself.
In a 16th aspect in accordance with the 13th, 14th, or 15th aspect, the first mover rotates integrally with the operating element.
In a 17th aspect in accordance with any of the 1st through 16th aspects, the mover device also comprises one or several cross-members, preferably supported by said operating element, each support cross-member featuring a main development direction and bearing at least one support element.
In an 18th aspect in accordance with the 17th aspect, at least one support element movably engages a respective support cross-member so that it can translate at least along the main development direction of said support cross-member.
In a 19th aspect in accordance with the 17th or 18th aspect, said one or several support cross-members engage said operating element by way of at least one guide rail or at least a pair of guide rails and are configured for moving translationally along said at least one guide rail or said at least one pair of guide rails.
In a 20th aspect in accordance with the 17th, 18th, or 19th aspect, said one or more upper cross-members are integral with the operating element upon rotation of the operating element.
In a 21st aspect in accordance with any of the 17th through 20th aspects, the mover device comprises an auxiliary mover, preferably arranged below with respect to the support cross-member(s), and an element suitable for being driven into rotation by the auxiliary mover, the auxiliary mover being configured for allowing for a translational movement of the support cross-member(s) transversally to its/their respective main development direction(s) of the support cross-member(s) itself(themselves).
In a 22nd aspect in accordance with the 21st aspect, the element features an elongated shape along a main development direction, which also operates as an axis of rotation of the element itself.
In a 23rd aspect in accordance with the aspects 21st or 22nd, the element comprises an endless screw directly operated by the auxiliary mover, or alternatively comprises an alternator belt system.
In a 24th aspect in accordance with any of the aspects from 17th through 23rd, the mover device comprises at least one intermediate connection element configured for operating as a connection between each individual support element and its respective support cross-member.
In a 25th aspect in accordance with any of the aspects from 17th through 24th, the mover device also comprises at least one swing arm, and in particular a pair of swing arms, mounted on a support cross-member, either directly or indirectly by way of an intermediate connection element slidable along said support cross-member, every swing arm bearing at least one respective support element and being configured for rotating and/or translationally moving with respect to said support cross-member.
In a 26th aspect in accordance with the 24th or 25th aspect, one or several support cross-members bear an intermediate connection element, said intermediate connection element bearing at least one support element and/or at least one swing arm.
In a 27th aspect in accordance with the 24th, 25th, or 26th aspect, said intermediate connection element is also configured for sliding along its respective support cross-member parallel to the main development direction of said support cross-member.
In a 28th aspect in accordance with the 16th or 27th aspect, the mover device comprises at least a third mover configured for allowing for said intermediate connection element to slide along its respective rotation bar, said at least one third mover being mounted on board a respective support cross-member being integral therewith in the translational movements of said support cross-member.
In a 29th aspect in accordance with the 28th aspect, the third mover is an electric motor, for instance a DC, stepping, or synchronous motor.
In a 30th aspect in accordance with any of the aspects from 25th through 29th, said at least one swing arm comprises at least one swivel arm, and in particular at least a pair of swivel arms, said at least one swivel arm comprising a first portion and a second portion, both featuring an elongate shape and connected to each other, at least one from the first and second portions being configured for rotating with respect to the other portion and with respect to the frame.
In a 31st aspect in accordance with the 30th aspect, both the first portion and the second portion of said at least one swivel arm bear a respective support element.
In a 32nd aspect in accordance with the 30th or 31st aspect, the mover device comprises a fourth auxiliary mover configured for moving translationally said at least one support element borne by the swivel arm in a substantially vertical direction.
In a 33rd aspect in accordance with any of the aspects from 17th through 32nd, said support elements and said one or more support cross-members are supported by the frame and arranged in the space in such a way as to form an operating area within which the possible movements of said support elements, of said one or more support cross-members, and/or of said operating element define a plurality of stability positions for a patient or for parts of the patient's body.
In a 34th aspect in accordance with the 33rd aspect, said stability positions can be selectively selected and/or interpolated by way of said control unit.
In a 35th aspect in accordance with any of the aspects from 1st through 34th, said control unit is configured for communicating by way of a wired connection or wirelessly with, and/or be managed and controlled wirelessly by:
In a 36th aspect in accordance with any of the 1st through 35th aspects, said control unit is configured for being controlled by way of a voice command so that a patient, or an appointed person, is capable of controlling and managing the movements of the motor-driven operating portion by way of a voice command.
In a 37th aspect in accordance with any of the aspects from 1st through 35th, the mover device also comprises at least one housing and gripping element to house and grip parts and/or joints of said patient's body, said at least one housing and gripping element being engaged or engageable by a respective element, the housing and gripping element being configured for housing a part of a patient's body.
In a 38th aspect in accordance with the 37th aspect, said housing and gripping element is configured for being moved and/or translated in both directions, by getting closer to and/or moving away from the health and/or medical and/or domestic and/or orthopaedic installation and consequently for at least partially modifying the position in the space of a patient using said health and/or medical and/or domestic and/or orthopaedic installation.
In a 39th aspect in accordance with the 37th or 38th aspect, said housing and gripping element is configured for controlling the movements, and in particular for at least partially changing the position of and/or lifting a patient or parts of the patient's body, with respect to said health and/or medical and/or domestic and/or orthopaedic installation.
In a 40th aspect in accordance with the 37th, 38th, or 39th aspect, said housing and gripping element is configured for moving a patient or parts of a patient's body, from a health and/or medical and/or domestic and/or orthopaedic installation (for instance a bed) to a further health and/or medical and/or domestic and/or orthopaedic installation (for instance a wheelchair) arranged in proximity of said health and/or medical and/or domestic and/or orthopaedic installation.
In a 41st aspect in accordance with any of the aspects from 1st through 40th, the mover device is of a type installable on a floor and/or to a wall and/or to a health and/or medical and/or domestic and/or orthopaedic installation, such as a bed, a shower, and/or a bathtub.
In a 42nd aspect in accordance with any of the aspects from 1st through 41st, the mover device is a transportable and/or removable one, where by removable we mean that the mover device is configured for being removed from said floor or wall or health and/or medical and/or domestic and/or orthopaedic installation.
In a 43rd aspect there is provided a system comprising:
In a 44th aspect in accordance with the 43rd aspect, said accessory is a processor, a computer, or a mobile device, such as a smartphone, tablet, or laptop, and the system also comprises a software and/or a mobile application installed and/or configured for operating on said processor, computer, or mobile device, the software and/or mobile application being configured for allowing for a wirelessly communication with, and for wirelessly controlling said control unit, so as to allow for moving, and in particular at least lifting a patient with respect to said health and/or medical and/or domestic and/or orthopaedic installation.
In a 45th aspect in accordance with the 44th aspect, the software and/or mobile application are configurable and/or customizable, for instance by a physiotherapist, a doctor, or an appointed person skilled for this purpose, according to the specific requirements of any specific patients.
In a 46th aspect in accordance with the 44th or 45th aspect, the software and/or mobile application are configured for allowing creation, modification, and storage of appropriate physioterapic movement programs and/or supporting programs in a memory.
In a 47th aspect in accordance with any of the aspects from 43rd through 46th, said accessory is a wearable accessory, for instance a cuff or a sleeve, the accessory being wearable for instance by a patient, a doctor, an assistant, or an authorized person.
In a 48th aspect in accordance with any of the aspects from 43rd through 47th, said accessory is of the movement recognition type, and the check and control unit is configured for translating specific movements of the wearable accessory into specific movements of said support elements and/or into specific patient's moving programs.
In a 49th aspect in accordance with any of the aspects from 1st through 48th, said health and/or medical and/or domestic and/or orthopaedic installation is of a movable type (for instance, a wheelchair) or of a fixed type (for instance, a bed or a bathtub) and can include any health installation (for instance, a bathtub or a shower) and/or a medical installation (for instance, a hospital bed) and/or a domestic installation (for instance, an armchair, a sofa, or a chair) and/or an orthopaedic installation (for instance, a wheelchair or a transportation device, for transferring elderly and/or disabled persons).
In a 50th aspect, the mover device in accordance with any of the aspects from 1st through 42nd and the system in accordance with any of the aspects from 43rd through 48th are particularly intended for a domestic use by a private (for instance, at a patient's home) or for use in a public facility (such as a hospital or rehabilitation centre) or in a private facility (such as a clinic).
In a 51st aspect, in the mover device in accordance with any of the aspects from 1st through 42nd, and/or in the system in accordance with any of the aspects from 43rd through 48th, every support element is movable according to at least two degrees of freedom.
In a 52nd aspect, in the mover device in accordance with any of the aspects from 1st through 42nd, and/or in the system in accordance with any of the aspects from 43rd through 48th, every support element is movable according to at least three degrees of freedom.
In a 53rd aspect, which can be taken independently or dependently on any of the aspects from 1st through 52nd, there is provided a mover device for the body of patients and/or persons with reduced mobility, suitable and configured for being operationally positioned above or close to a health and/or medical and/or domestic and/or orthopaedic installation, be it movable or fixed, for instance a support, a bed, a seat, a shower, and/or a bathtub, the mover device comprising:
In a 54th aspect in accordance with the 53rd aspect, in the grip condition said at least one housing and gripping element is in a stimulated or energized condition wherein said inner chamber features a shape, pressure, or volume different from a shape, pressure, or volume, said inner chamber is in the rest condition.
In a 55th aspect in accordance with the 53rd or 54th aspect, the mover device also comprises a control unit configured for controlling and/or programming the movements of said support elements so as to allow for moving, and in particular at least lifting and/or at least partially changing the position of or re-positioning said parts of the patient's body or of a patient himself/herself with respect to said health and/or medical and/or domestic and/or orthopaedic installation, or with respect to a further health and/or medical and/or domestic and/or orthopaedic installation arranged in proximity of said health and/or medical and/or domestic and/or orthopaedic installation.
In a 56th aspect in accordance with the 53rd, 54th or 55th aspects, said at least one housing and gripping element is configured and/or shaped for engaging a respective support element in order for making it possible for it to be moved by said support element, in an engagement condition with said support element, said at least one housing and gripping element being also configured for:
In a 57th aspect in accordance with any of the aspects from 53rd through 56th, said at least one housing and gripping element includes an inner chamber configured for getting deformed and/or changing its own shape, for instance by increasing or decreasing a volume of its own and/or an internal pressure of its own, as a consequence of an external energization or stimulation.
In a 58th aspect in accordance with any of the aspects from 53rd through 57th, said at least one housing and gripping element includes an inner chamber containing, or is configured for containing, a fluid or a composition suitable for varying its own pressure and/or getting deformed and/or changing its own shape and/or volume as a result of an external energization or stimulation.
In a 59th aspect in accordance with the 57th or 58th aspect:
In a 60th aspect in accordance with any of the aspects from 53rd through 59th, said at least one housing and gripping element includes a quick fastener, the mover device also comprising an operating device configured for being connected to said quick fastener to provide said external energization or stimulation to said at least one housing and gripping element.
In a 61st aspect in accordance with the 60th aspect, said operating device is integral with and/or can be part of said at least one housing and gripping element.
In a 62nd aspect in accordance with any of the aspects from 57th through 61st, said inner chamber is an elastic and/or deformable chamber configured for featuring a greater volume in a grip condition of said at least one housing and gripping element with respect to a volume that said chamber has in a rest condition of said at least one housing and gripping element.
In a 63rd aspect in accordance with any of the aspects from 58th through 62nd, said chamber is of a pneumatic type and contains, or is configured for containing, air or other gases.
In a 64th aspect in accordance with any of the aspects from 58th through 62nd, said chamber is of a hydraulic type and contains, or is configured for containing, an incompressible fluid.
In a 65th aspect in accordance with the aspect from 63rd or 64th, the chamber features an internal pressure greater in a grip condition than the internal pressure said chamber has in a rest condition.
In a 66th aspect in accordance with any of the aspects from 53rd through 61st, said inner chamber is deformable, the operating device being configured for decreasing the pressure internally to the chamber down to a pressure lower than the ambient pressure, in particular in order to create a substantially vacuum condition internally to the chamber, so that the chamber features a lower volume in a grip condition of said at least one housing and gripping element with respect to the volume said chamber has in the a condition of said at least one housing and gripping element.
In a 67th aspect in accordance with the 66th aspect, said inner chamber includes a plurality of deformable elements arranged internally thereto, said deformable elements being configured for getting deformed in order to grip said parts and/or joints of said patient's body in a grip condition of said at least one housing and gripping element.
In a 68th aspect in accordance with any of the aspects from 53rd through 61st, said chamber includes electro-active materials (for instance polymers) or “smart” materials configured, for instance, for:
In a 69th aspect in accordance with the 68th aspect, the electrical energization of the electro-active materials causes a transition of said at least one housing and gripping element from a rest condition to a grip condition, the change of shape of the electro-active materials making it possible for said at least one housing and gripping element to grip parts and/or joints of said patient's body.
In a 70th aspect, which can be taken independently on or dependently on any of the aspects from 53rd through 69th, there is provided a garment, for instance a pyjama, a pair of trousers, a nightshirt/nightdress, or a T-shirt, configured for being worn by a patient and/or by a person with reduced mobility, said garment comprising at least one housing and gripping element to house and grip parts and/or joints of the body of said patient and/or said person with reduced mobility in correspondence with at least a portion of the garment intended for being put, in conditions of use of said garment wherein the garment is worn by said patient and/or by said person with reduced mobility, in correspondence with or in proximity of parts and/or joints of said patient's body, said at least one housing and gripping element being engageable or engaged with a respective support element of a mover device in accordance with any of the 1st through 69th aspects, the housing and gripping element being configured for operating at least between:
In a 71st aspect in accordance with the 70th aspect and with any of the aspects from 53rd through 69th, the mover device comprises said garment.
In a 72nd aspect in accordance with the 70th or 71st aspect, said garment is a pyjama, a pair of trouser, a nightshirt/nightdress, or a T-shirt.
In a 73rd aspect in accordance with any of the 1st through 72nd aspects, the mover device comprises a patient position recognition device configured for recognizing the real-time position of the patient, said patient position recognition device being connected to said control unit.
In a 74th aspect in accordance with the 73rd aspect, said patient position recognition device are configured for recognizing the real-time position of a patient even below or across elements and/or obstacles interposed between a patient and said patient position recognition device, said elements and/or obstacles being for instance blankets, pillows, or garments.
In a 75th aspect in accordance with the 73rd or 74th aspect, said control unit is configured for:
In a 76th aspect in accordance with the 73rd, 74th, or 75th aspect, said patient position recognition device comprises at least a thermal imaging chamber.
In a 77th aspect in accordance with any of the aspects 1st through 76th, the mover device comprises a device configured for making the connection and disconnection between a patient and the mover device easier and/or for making the connection between the mover device and the patient take place autonomously and/or automatically without a help by a further person or health operator.
In a 78th aspect in accordance with the 77th aspect and with any of the aspects from 73rd through 76th, said device configured for making the connection and disconnection between a patient and the mover device easier comprise or correspond to or constitute said patient position recognition device.
In a 79th aspect there is provided a procedure for moving patients and/or persons with reduced mobility, comprising the following steps:
In an 80th aspect in accordance with the 79th aspect, the procedure also comprises a step of stimulating or energizing said inner chamber so as to increase or decrease a volume and/or an internal pressure of said chamber and/or to make said inner chamber get deformed and/or change its own shape.
In an 81st aspect in accordance with the 80th aspect, the step of connecting at least one of said support elements to said at least one housing and gripping element follows the step of stimulating or energizing said inner chamber.
In an 82nd aspect in accordance with the 81st aspect, the step of connecting the support element to the housing and gripping element is performed, the operating device being connected to the quick fastener of the housing and gripping element.
In an 83rd aspect in accordance with the 81st aspect, the step of connecting the support element to the housing and gripping element is performed after disconnecting the operating device from the quick fastener of the housing and gripping element.
In an 84th aspect in accordance with the 80th aspect, the step of connecting at least one of said support elements to said at least one housing and gripping element precedes the step of stimulating or energizing said inner chamber.
In an 85th aspect in accordance with any of the 79th through 84th aspects, the procedure also comprises a step of energizing said at least one housing and gripping element so as to increase or decrease an outer circumference thereof in order to exert a given pressure on said part and/or joint of said patient's body.
In an 86th aspect in accordance with any of the aspects from 1st through 78th, the mover device comprises a slide configured for rotationally moving along an axis.
In an 87th aspect in accordance with the 86th aspect, the slide engages the operating element and is configured for rotating integrally with said operating element.
In an 88th aspect in accordance with the 86th or 87th aspect, the mover device comprises rails engaging the operating element, said rails being parallel and respectively opposed with reference to their arrangement on the operating element.
In an 89th aspect in accordance with the 88th aspect, the slide is configured for rotationally translating along said rails.
In a 90th aspect in accordance with any of the aspects from 86th through 89th, the slide comprises auxiliary rails.
In a 91st aspect in accordance with any of the aspects from 86th through 90th, the mover device also comprises at least one support cross-member engaging said slide in correspondence with opposite end portions.
In a 92nd aspect in accordance with the 91st aspect, said support cross-member is configured for rotationally translating in an independent manner along an axis that is orthogonal, and in particular coplanar with the axis of translation of said slide.
In a 93rd aspect in accordance with the 92nd or 91st aspect when also dependent on the 90th aspect, said support cross-member is configured for rotationally translating along said auxiliary rails of the slide.
In a 94th aspect in accordance with the 93rd or 92nd aspect, the translation of the slide along said axis implies an integral translational movement of the support cross-members along said axis of rotation of the slide.
In a 95th aspect in accordance with any of the aspects from 91st through 94th, the mover device comprises at least one swing arm, said swing arm engaging said support cross-member and being configured for rotating with respect to said support cross-member.
In a 96th aspect in accordance with the 95th aspect, said swing arm bears a respective support element.
In a 97th aspect in accordance with the 96th aspect, the mover device comprises a fourth mover configured for moving said support element at least along a vertical translational movement.
In a 98th aspect in accordance with the 97th aspect, the fourth mover is configured for moving said support element in both directions, by getting closer to and moving away from the installation.
In a 99th aspect in accordance with the 97th or 98th aspect, said fourth mover is borne by a respective arm.
In a 100th aspect, said fourth mover is borne by a respective arm in correspondence with an end of said arm.
In the figures, the reference numeral 1 identifies a mover device in accordance with the present concepts herein as a whole. In the context of the present description, by mover device 1 we mean a device conceived, pre-set, and configured for moving, either partially or completely, the body of a patient or person having reduced motor skills. In the context of the present description, the term “patient” can be construed in general as “user”, i.e. in the meaning of a person who potentially can take advantage of the use of a mover device in accordance with the invention. For explanatory not limitative purposes only, examples of users or patients are given below for whom a mover device in accordance with the concepts herein can be used in a particularly advantageous manner. A user or patient who needs a support and aid in moving his/her own parts of the body, or his/her own body in its entirety, might have temporarily limited motor skills, for instance because of a crash or an accident (i.e. a person who suffers a road accident or an athlete recovering from a sport injury), or it might be a matter of a user or patient, more or less elderly, having permanent limited motor skill. Also, a mover device 1 in accordance with the concepts herein can be used both in the medical-hospital environment, for assisting elderly or disabled patients and/or persons having reduced mobility in general, both in a private environment, for instance in the house of a person having reduced mobility, just in order to assist and increase his/her own motor skills. The following is a complete description of a preferred embodiment of the invention, with a number of particularly advantageous variants thereof. The mover device 1 is conceived and configured for being positioned above (or in proximity of) with respect to a health and/or medical and/or domestic and/or orthopaedic installation 100, 100′, which will be identified, for ease of reference, as “installation” or “said installation” in the rest of this description. The installation 100, 100′ can be of a movable or fixed type, and in particular can be at least one of the following installations 100, 100′: a support, a bed, a couch (for instance a couch used for physiotherapy, rehabilitation, and/or orthopaedic sessions), a seat (such as a chair, an armchair, a sofa, and the like), a shower, a bathtub and similar installations wherein a patient has reduced mobility, because of his/her own limited mobility and/or because of the nature of the installation 100, 100′ itself which sometimes does not allow for an easy and comfortable positioning of the patient (for instance, a bathtub). Ultimately, the installation 100, 100′ can be any health installation (for instance, a bathtub or a shower) and/or a medical installation (for instance, a hospital bed) and/or a domestic installation (for instance, an armchair, a sofa, or a chair) and/or an orthopaedic installation (for instance, a wheelchair or a transportation device, for transferring elderly and/or disabled persons). The mover device 1 comprises a frame 2 suitable for firmly supporting the mover device 1 itself. The frame 2 is pre-set and configured for being secured to the ground or floor, in order to provide a firm constraint. In a variant, the frame 2 can be secured to the installation 100, 100′ itself above which it is arranged. In a further variant, the frame 2 can be secured to a wall or a ceiling, on a side or above and in proximity of the installation 100, 100′ above which it is configured for assisting a user in his/her movements. The frame 2 comprises a binding portion 3 just configured for positioning the mover device 1 in a stable equilibrium in proximity of, or at least partially above, the installation 100, 100′. The frame 2 can be partially or completely made of metal material, in order to provide a firm support to the mover device 1. The frame 2 comprises an upper portion 4 which, in an operating configuration of the mover device 1, can be at least partially arranged above the installation 100, 100′. The mover device 1 also comprises a motor-driven operating portion 5, supported by the frame 2 on an upper surface or portion of the frame itself. By motor-driven operating portion 5, we mean a portion of the mover device 1 comprising a plurality of movers (for instance electric motor, preferably DC, stepping, or synchronous motors), whose operation and main technical characteristics will be described below. As shown in the attached figures, the mover device 1 also comprises an operating element 6 supported by the frame 2 in correspondence with the upper portion of the frame and being part of the motor-driven operating portion 5. The operating element 6 engages rotationally the upper portion of the frame 2 and is supported, in the embodiment here shown, by an upper surface of the frame 2 itself. The operating element 6 preferably has one degree of freedom, consisting of its rotation with respect to the frame 2. The rotation of the operating element preferably takes place about an axis that is substantially vertical and orthogonal with respect to the upper surface or portion of the frame 2. The operating element 6 is thus configured for rotating with respect to the frame 2 in the same plane as the upper surface of the frame 2 or in a plane parallel to a plane defined by the upper surface of the frame 2. In a variant, the operating element 6 can rotate in a plane transversal with respect to the plane defined by the upper surface of the frame 2. In order to make its rotation easier, the operating element 6 features an at least partially curvilinear outline or profile, and in particular a completely curvilinear outline or profile. Preferably is the operating element 6 shaped like a circumference (the embodiment illustrated in the attached figures) or, alternatively like an ellipse or like a rectangular structure or auxiliary frame, also rotatable with respect to the frame 2 (these variants are not shown in the attached figures). The operating element 6 also comprises at least one guide rail 7, or a pair of guide rails 7, whose technical function will be better explained below. The embodiment here illustrated shows an operating element 6 provided with a pair of guide rails 7, and consequently reference will be made to a pair of guide rails 7 below in order to make the explanation simpler, with no prejudice for other technical solutions. To make it possible for the operating element 6 to rotate, the motor-driven operating portion 5 comprises a first mover 8. The first mover 8 is just configured for driving the operating element 6 into rotation. The first mover 8 can be an electric motor, for instance a DC or stepping motor. In accordance with one embodiment, the first mover 8 is housed on board the operating element 6 itself and rotates integrally therewith. In order to make the rotation of the operating element 6 easier, the frame 2 comprises a guide 9 conceived and configured for allowing for the operating element 6 to rotate with respect to the frame 2 itself. For instance, the coupling between the operating element 6 and the frame 2 can be of a type that uses gearwheels, wherein the guide 9 is substantially a rack and the first mover 8, integral with the operating element 6 itself, drives a first gearwheel into rotation, which allows for the rotation of the operating element 6, just movable with respect to the frame 2, with respect to the guide 9, which is firmly secured to the frame 2. In a further embodiment of said mover 8, not shown in the attached figures, it is possible to think about a motor provided with a rubber pinion in contact with the first mover 8 to make it rotate with respect to the frame 2. The motor-driven operating portion 5 of the mover device also comprises a plurality of support cross-members 10 supported by the operating element 6. The support cross-members 10 feature respective main directions of development and are arranged parallel to each other (see for instance
The mover device 1 also includes intermediate connection elements 12, slidable parallel to the main direction of development of the support cross-members 10. The intermediate connection elements 12 are mounted on respective rotation bars 13 and can slide along them and can consequently be considered as being part of the motor-driven operating portion 5. The mover device 1 possibly includes at least one intermediate connection element 12 for every support cross-member 10 and consequently for every rotation bar 13; for instance, the embodiment illustrated in the attached figures includes only one intermediate connection element 12 for every support cross-member. However, variants can be envisaged wherein there are several intermediate connection elements 12 for every support cross-member 10. In order to make it possible for the intermediate connection elements 12 to slide along their respective rotation bar 13, the motor-driven operating portion 5 includes a third mover 11a, which might be an electric motor, for instance a DC or stepping motor.
The mover device 1 might also include at least one swing arm 15, 15′ mounted on a support cross-member 10, either directly or indirectly by way of at least one intermediate connection element 12. Advantageously are at least two swing arms 15, 15′ provided for one and the same support cross-member 10, as shown in detail in
The operating portion 6 also comprises a plurality of support elements 16 that are at least translationally movable, to get closer to or move away from the installation 100, 100′, hence to/from the patient located above the installation 100, 100′, or in proximity of the installation 100, 100′ itself. The support elements 16 engage the operating element 6 indirectly, i.e. by way of intermediate connection elements 12 and support cross-members 10, and consequently are configured for rotating integrally with the operating element 6. Operationally wise, the support elements 16 can feature at least one degree of freedom and can move, or be moved, along at least one axis in the space; said axis is preferably the z axis, the axis along which the vertical translation of the support elements 16 takes place. The support elements 16 are configured and structured for being traction-operated and can include for instance belts, wires, ropes, or elongate traction elements in general. Each support element 16 is configured for at least partially or entirely supporting a patient's weight and is pre-set for engaging and moving at least one respective part of the patient's body in the space and with respect to the installation 100, 100′, in accordance with the degrees of freedom it benefits from. The movement of parts of the patient's body transmitted by the support elements 16 aims at least partially modifying the position of the parts of a patient's body in the space, for instance by way of a translation, rotation, or roto-translation of said at least one respective part of the patient's body, by preferably getting closer to and/or moving away from the installation 100, 100′. The movement of each support element 16 is possible because the motor-driven operating portion 5 includes a plurality of fourth movers 17, each of which is configured for moving a respective support element 16 at least in a vertical translation movement, and in particular by getting closer to the installation 100, 100′ and moving away from the installation 100, 100′. Each fourth mover 17 possibly includes an electric motor, for instance a DC or stepping motor, and a pulley which is engaged by a respective support element 16. Operationally wise, the electric motor drives into rotation the pulley, which the support element 16 is wound on or unwound from in order to make a part of the patient's body get closer to or move away from the installation 100, 100′ in the operating conditions of the mover device 1. As shown in
In accordance with an additional embodiment illustrated in
The mover device 1 can also comprise a plurality of housing and gripping elements 18 to house and grip parts and/or joints of a patient's body (see
In one variant, the mover device 1 comprises at least one housing and gripping element 18′ configured for operating at least between a rest condition and a grip condition. Optionally, the mover device 1 comprises a plurality of housing and gripping elements 18′ only. One housing and gripping element 18′ will be described below for ease of reference. A housing and gripping element 18′ can substantially assume the shape of a band configured for being put around a part and/or a joint of a patient's body and/or a whole patient's body to make it possible to move it (see
Another possible embodiment of the housing and gripping element 18′ is, for instance, a noose which exploits the tension of the support elements 16 to exert a pressure onto a patient (as with happens in a common slip-knot). In such embodiment, the housing and gripping element 18′ comprises internally thereto flexible elements which operate in such a way that the pressure on the parts of a patient's body is released whenever the support elements 16 are not tensioned (and consequently do not effect movements) on the parts of a patient's body.
In another embodiment, the housing and gripping element 18′ can assume the shape of a “simple” noose to be tightened by using Velcro, geometrically studied and structured in such a way as not to slip down along a patient's body, yet not applying a too high pressure and/or problems which are physically (dangerous) for a patient's body.
In a further embodiment, the housing and gripping element 18′ can assume the shape of a “global” sling configured for being almost entirely wound around a patient's body, operating on the basis of the same technical principle as described above (application of a pressure to parts of a patient's body) or on the principles and technical characteristics that will be described below.
In a rest condition, the housing and gripping element 18′ can engage a part and/or joint of a patient's body, whereas in a grip condition the housing and gripping element 18′ engages a part and/or joint of a patient's body. The housing and gripping element 18′ is also configured for assuming an energized or stimulated condition in a grip condition. The housing and gripping element 18′ assuming an energized or stimulated condition determines its transition from a rest condition to a grip condition. The housing and gripping element 18′ is configured for assuming the energized condition upon an energization or stimulation coming from an operating device 22 or from a tension, construed as a traction force exerted onto the housing and gripping elements 18′ by their respective support elements 16.
In order to make it possible a connection between the housing and gripping element 18′ and the operating device 22, the housing and gripping element 18′ is provided with a quick fastener 23. The operating device 22 is configured for being connected to the quick fastener 23 of the housing and gripping element 18′ to provide an external energization or stimulation to the housing and gripping element 18′. In one embodiment not shown in the attached figures, the operating device 22 is integral with the housing and gripping element 18′ or is a component part of the housing and gripping element 18′.
The housing and gripping element 18′ is also configured and/or shaped for engaging a respective support element 16 so that it can be moved by it. In particular, in an engagement condition with the support element 16, the housing and gripping element 18′ is also configured and/or shaped for being moved and/or moving translationally, namely for getting closer to or moving away from the health and/or medical and/or domestic and/or orthopaedic installation 100. Substantially, while engaging the support element 16, the housing and gripping element 18′ is configured and/or shaped for at least partially modifying the position in the space of a patient (or of portions of his/her body) who is using the health and/or medical and/or domestic and/or orthopaedic installation 100. In particular, the housing and gripping element 18′ is thus configured and/or shaped for moving, and in particular for at least partially changing the position of and/or lifting a patient with respect to the health and/or medical and/or domestic and/or orthopaedic installation 100 and is also configured and/or shaped for moving a patient, or parts of a patient's body, from a health and/or medical and/or domestic and/or orthopaedic installation 100 to a further health and/or medical and/or domestic and/or orthopaedic installation 100′ arranged in proximity of the health and/or medical and/or domestic and/or orthopaedic installation 100.
As shown for instance in
The inner chamber 25 is at least partially elastic and/or deformable. As seen in more details below, the inner chamber 25 being elastic and/or deformable makes it possible for the housing and gripping element 18′ to switch from a rest condition to a grip condition and/or vice versa. The inner chamber 25 includes internally thereto a fluid, composition, or more generically any materials suitable for varying its own pressure and/or getting deformed and/or changing its own shape and/or volume upon an external energization or stimulation (coming from the operating device 22), as a function of the type of chamber 25. Four embodiments of the housing and gripping elements 18′ are described below, each having a different type of chamber 25.
In a first embodiment of the housing and gripping element 18′, shown in
In a second embodiment of the housing and gripping element 18′, shown in
The hydraulic chamber 25 has a greater internal pressure in a grip condition than the internal pressure the chamber 25 has in a rest condition.
In a third embodiment of the housing and gripping element 18′, shown in
In the third embodiment, the chamber 25 has a lower volume and internal pressure in a grip condition of the housing and gripping element 18′ respectively as compared to a volume and to an internal pressure the chamber 25 has in a rest condition of the housing and gripping element 18′.
In a fourth embodiment of the housing and gripping element 18′, shown in
As far as electro-active materials are concerned, they can be defined as materials having the characteristic of getting deformed whenever an electrical current is applied thereto.
The “smart” materials becoming electrically, chemically, or thermally energized by way of an appropriate operating device 22, determines a transition of the housing and gripping element 18′ from a rest condition to a grip condition. The “smart” materials changing their shape substantially allows for the housing and gripping element 18′ to grip parts and/or joints of a patient's body.
Examples of operating devices 22 for “smart” materials or for electro-active materials can include: electrical cables, temperature-difference operated devices, vibration-operated devices, ion-diffusion-in-electrolytic-substances-operated devices.
Preferably are the “smart” materials of an electro-active polymer (EAP) type (for instance ion-exchange membranes, gel polymers, etc.).
In the fourth embodiment, the quick fastener is of an electric type and/or is configured for interfacing to an operating device 22 of an electric type or configured for generating an electric field.
The mover device 1 possibly also include a garment 28 comprising one or more housing and gripping elements 18′. Preferably are the housing and gripping elements 18′ integral with the garment 28. The garment 28 might be, for instance, a pyjama, a pair of trousers, a nightshirt/nightdress, a T-shirt, or an overall substantially incorporating the whole patient's body. A garment integrating a plurality of housing and gripping elements 18′ is shown in
In the operating conditions of the mover device 1, said structure of the mover device 1 creates a “virtual” operating area above the patient, internally to which the possible movements of the operating element 6, of the support cross-members 10, of the intermediate connection elements 12, and of the support elements 16 define a plurality of stability positions for a patient (or for parts of his/her body), which are selectively obtainable, preferably by way of interpolations. By stability points obtainable by way of interpolation (or interpolable stability points) we mean stability points reachable via a coordinated movement of the operating element 6, of the support cross-members 10, of the intermediate connection elements 12, of the swing arms 15, and/or of the support elements 16. The possible movements of the operating element 6, of the support cross-members 10, of the intermediate connection elements 12, of the arms 15, and/or of the support elements 16 take place inside said operating area, which can be better defined by making reference to three cartesian axes orthogonal to each other. Such cartesian axes is shown in figure N, and consists of the x, y, and z axes. The x and y axes are orthogonal to each other and define an operating plane, substantially corresponding to the plane on which the operating element 6 lays. The rotation of the operating element 6 with respect to the frame 2 takes place in said operating plane, or parallel to said operating plane. The translation of the support cross-members 10 and of the intermediate connection element 12 also takes place in the operating plane or parallel thereto. Conversely, as far as the z axis is concerned, it is to be said that it develops in a substantially vertical direction, orthogonal to the operating plane, and defines, together with a sheaf of vertical directions parallel thereto, a sheaf of directions along which corresponding support elements 6 are moved, by way of respective fourth movers 17. Coming back to the previously mentioned stability positions for a while, it is worth emphasizing that the motor-driven operating portion 5 and the control unit 19, and consequently the mover device 1 as a whole, are configured for controlling an almost unlimited number of stability positions internally to said operating area. Such stability positions can just be obtained by interpolation of the possible movements of the movable components 6, 10, 12, 15, 15′, 16 which, as previously described, are possibly translational movements along the x, y, and z axes, rotation movements with respect to the x, y, and z axes, and roto-translation movements with respect to the x, y, and z axes. Substantially, the control unit 19 is configured for imposing a specific law of motion to each movable component 6, 10, 12, 15, 15′, 16 of the motor-driven operating portion 5.
Here below it is explained how stability positions are obtained by interpolation. The control unit 19 knows at least some values (for instance at least the extreme values and one intermediate value, or in any case at least two values) of the law of motion of each movable component 6, 10, 12, 15, 15′, 16 and is capable of deriving, through a computation, the values of the law of motion (which is substantially a function and/or an algorithm) internally to a range in which just few values only are known. A specific position of the movable component whose law of motion is “being analyzed” corresponds to every value of the law of motion. Since the control unit 19 is capable of computing any stability points, any point internal to the operating area makes-up a stability point of the system, and consequently it represents a possible stable position of parts of a patient's body or of the patient himself/herself. It is also to be said that every stability point is reachable by way of a plurality of different operating configurations, which include different spatial arrangements or positionings of the movable components 6, 10, 12, 15, 15′, 16.
In order to control the coordination of said movable components of the motor-driven operating portion 5, the mover device 1 comprises a control unit 19 (see
The control unit 19 can also be provided with a detection device for detecting the positions of parts of a patient's body, such as for instance 3D or infrared cameras and/or sensors, in order to optimize and achieve a better safety for the patient himself/herself, to collect and/or store in a storage data intended for being used by a specialized staff, either in real time and/or recorded and/or remotely, and to have a real time monitoring, control, and feedback (be it a properly said feedback or not) by the control unit 19.
Concerning software and/or mobile application, it is to be said that they are programmable, configurable, and customizable, for instance by a physiotherapist, a doctor, or an appointed person having the necessary skill for this purpose, on the basis of the specific movement requirements (or movement compensation) of each individual patient. Also, the software and/or mobile application can be configured to make it possible to create, modify, and save appropriate physiotherapic movement and/or support programs, specific to every patient, in a storage.
The concepts herein also refer to a system 21 comprising a mover device 1 of the previously described type and an accessory 20 of the type briefly described above, such as a remote control, a wearable accessory, or a device whatsoever which enables humans to communicate and/or to interface to the control unit 19 of the mover device 1, or a processor, computer, or mobile device. The accessory 20 is configurable and, in the operating conditions of the mover device 1, configured for controlling the control unit 19 in a wired mode or wirelessly, so as to allow for moving, and in particular at least lifting or re-positioning a patient with respect to the installation 100, 100′. Advantageously is said accessory a device (for instance a glove, wrist, or sleeve) wearable by the patient himself/herself or any other devices that enable humans to communicate and/or to interface to the control unit 19 of the mover device 1, or alternatively by a doctor, assistant, or authorized person.
The mover device 1 can optionally comprise a device 29 for recognizing a patient's position. Such device 29 is configured for recognizing a position of a patient in real time and are connected to the control unit 19. In particular, the device 29 for recognizing a patient's position is configured for recognizing the position of a patient in real time, even under or across elements and/or obstacles interposed between the patient and the device 29 used to recognize a patient's position. Such elements and/or obstacles interposed between a patient and the device 29 used to recognize a patient's position can include, for instance, blankets, pillows, or garments.
In the embodiment wherein the mover device 1 includes a device 29 for recognizing a patient's position, the control unit 19 can be configured for receiving information relevant to the patient's position from the device 29 used to recognize a patient's position and for processing the information coming from the device 29 used to recognize a patient's position. Also, the control unit 19 can be configured for operating at least one support element 16 and/or at least one housing and gripping element 18, 18′ in such a way as to moving a patient or to pre-set a patient and/or the mover device 1 to move a patient as a function of the information coming from the device 29 used to recognize a patient position. Preferably the device 29 used to recognize a patient position comprises at least one thermal imaging camera or a plurality of thermal imaging cameras.
The mover device 1 can optionally comprise a device configured for facilitating the connection and disconnection between a patient and the mover device 1 and/or for making the connection between the mover device 1 and a patient take place autonomously and/or automatically without a further person or health operator giving help. In one embodiment, the device configured for facilitating the connection and disconnection between a patient and the mover device comprises, correspond to, or constitute the device 29 used to recognize a patient's position.
The concepts herein also include a procedure for moving patients and/or persons with reduced mobility, comprising a first step of pre-setting a mover device 1 like that previously described. This procedure also includes the step of engaging at least one housing and gripping element 18, 18′ with a part and/or joint of a patient's body.
In the embodiment of the procedure that includes housing and gripping elements 18′, the procedure includes a step of determining a transition of the housing and gripping element 18′ from a rest condition to a grip condition, optionally by way of the operating device 22. The step of effecting a transition of the housing and gripping element 18′ from a rest condition to a grip condition possibly includes, for instance, the step of operating the operating device 22 as shown in
Also, the procedure possibly comprises the step of connecting at least one support element 16 to the housing and gripping element 18, 18′ in such a way as to firmly engage and make the housing and gripping element 18, 18′ integral with the support element 16. This procedure might also include a step of operating, by way of the control unit 19, the support element 16 in such a way as to allow for moving, and in particular at least lifting and/or at least partially changing the position of or re-positioning, that part and/or joint of the patient's body which is engaged by the housing and gripping element 18, 18′ with respect to the health and/or medical and/or domestic and/or orthopaedic installation 100, or with respect to a further health and/or medical and/or domestic and/or orthopaedic installation 100′ arranged in proximity of the health and/or medical and/or domestic and/or orthopaedic installation 100.
In the embodiment of the procedure that include housing and gripping elements 18′, the procedure possibly also includes a step of stimulating or energizing the inner chamber 25 or the outer shell 24 in such a way as to increase or decrease a volume and/or an internal pressure of the chamber 25 and/or to make said inner chamber 25 get deformed and/or change its own shape, or to modify the external circumference or outer diameter of the housing and gripping elements 18′, in accordance with the modes previously described with respect to the embodiments according to
In one embodiment, the step of connecting the support element 16 to the housing and gripping element 18′ follows the step of stimulating or energizing the inner chamber 25, as (with reference to the first embodiment of the housing and gripping element 18′) in the sequence of steps of the procedure shown in
In a variant, the step of connecting the support element 16 to the housing and gripping element 18′ precedes the step of stimulating or energizing the inner chamber 25.
The concepts herein provide a mover device 1 and a system 21 that feature the following advantages as compared to the technical solutions of the known art.
The mover device 1 and the system 21 here proposed are first of all controlled and operated by a patient himself/herself and/or by a person appointed to monitor the patient's conditions; also, they can be, either additionally or alternatively, automated, for a local or remote control by persons appointed to monitor the patient's conditions.
Also, the mover device 1 and the system 21 here proposed are reliable and effective in their operation.
The mover device 1 in accordance with the concepts herein provides functional and active movement of parts of a patient's body or of a patient himself/herself in their entirety. Such movements, especially for elderly and/or disabled patient, are very advantageous in that they are capable of preventing sores and hematomas from forming, due to an extended permanence in a given rest position. Also, the control unit 19 makes it possible to achieve a high accuracy in spatially positioning the movable components 6, 10, 12, 15, 15′, 16 of the motor-driven operating portion 5, and consequently it provides for a multiplicity of stability positions to the parts of the patient's body that are moved by way of the elements 17, 18. Advantageously are such positions computed by the control unit 19 itself, by way of an interpolation of the motion functions of the movable components 6, 10, 12, 15, 15′, 16, while guaranteeing high reliability and simultaneously allowing for a real time monitoring of the patient's physical and/or comfort conditions.
In addition, the mover device 1 and the system 21 in accordance with the invention, being it possible for them to be controlled by a user himself/herself in accordance with the previously described modes, are capable of rendering patients with reduced mobility at least partially independent, at least for that which concerns displacement from an installation 100, 100′ such as a bed, a wheelchair, or a seat in general, and vice versa.
Also, the mover device provides for a firm grip on a patient and a safe, effective, and accurate movement of the patient. Also, thanks to the housing and gripping element 18′ described above, patient's movements are effected by patients painlessly.
| Number | Date | Country | Kind |
|---|---|---|---|
| 01560/16 | Nov 2016 | CH | national |
| 102016000119875 | Nov 2016 | IT | national |
| 00705/17 | May 2017 | CH | national |
| 102017000059606 | May 2017 | IT | national |
| Filing Document | Filing Date | Country | Kind |
|---|---|---|---|
| PCT/IB2017/057354 | 11/23/2017 | WO | 00 |
| Publishing Document | Publishing Date | Country | Kind |
|---|---|---|---|
| WO2018/096479 | 5/31/2018 | WO | A |
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| International Search Report and Written Opinion for application PCT/IB2017/057354 dated Dec. 22, 2017, European Patent Office, Rijswijk, Netherlands. |
| Number | Date | Country | |
|---|---|---|---|
| 20200179202 A1 | Jun 2020 | US |
